Peak Global Worry

A butterfly flaps its wings in Brazil and I worry about tornados in Texas.

One of the consequences of our globalized world and our expanding sense of our interdependence is the globalization of worry. Think globally, act locally is good advice, but is often misconstrued as worry globally and huddle in a corner locally.

What can you do about the rise of the alt-right? Climate change? Plastics in the worlds oceans? Do those questions make you feel empowered to go out and make a change or do they make you want to take a nap? Many of us have a sense of our very personal implication in combating these ills combined with a profound sense of powerlessness. We are told that we must “never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has” and then we are confronted with problems that seem to baffle the will of tens of millions of thoughtful, committed citizens. Perhaps we just need to be more thoughtful.

I have an analysis of why we get this mixed message, how it serves the very wealthy and the very powerful but this is blog about the mind. Suffice it to say that there are things we can impact and things we can’t impact and lots of the everyday, run-of-the-mill grief that I see comes from people mistaking which is which, coupled with common-though-odd, unexamined ideas about how we actually make an impact. (Hint: Clenching your jaw and shoulders while you scroll through social media posts about the approaching enviro-pocalypse does NOT reduce carbon emissions).

I am not a quietist. I believe in change, in action. But worry isn’t action. Awareness doesn’t have an impact. They may be prompts to action but in and of themselves they do nothing. And for many people, at certain doses awareness and worry become a serious hurdle to effective action. So. Think Globally, Act Locally, and Reduce Your Reliance on Worry.

Quebec's Broken Family Support System

Premier Legault announced that the government is going to review Quebec’s Youth Protection systems. I have never worked for Youth Protection but I have had plenty of chances to see it’s workings as an involved outsider. I hear patients/clients talk about how grateful they are that Youth Protection fulfilled its mandate and made sure they were safe from an abusive or neglectful parent. I see people who are furious that Youth Protection never became involved in their lives or stepped out too quickly and left them in a dangerous, destructive home situation. And I see people who are terribly hurt because Youth Protection intervened in ways that harmed them, exposing them to worse violence and abuse than they experienced at home.

I also see many parents who feel overwhelmed by the demands of parenting. Some of them, many of them, wish they had more support to be the parents they would like to be. The demands of parenting often become more overwhelming when people are faced with poverty and all the grinding daily indignities and difficulties that entails, which is also often tied up with classism and racism. A traumatic childhood of one’s own can make parenting even more challenging and it is my experience that many people who come seeking help to deal with difficult home situations were themselves in painful, destructive homes as kids. Others have mental health issues that they cannot get adequate care for.

Youth Protection is a very blunt instrument for dealing with the problem of families that are struggling to be nourishing and caring enough environments for kids. Any regime risks, on the one hand, pathologizing and further penalizing poverty, lack of skills or abilities and racial or cultural difference, and, on the other hand, leaving kids in terrible danger. We hear about it when kids die in their homes. We hear about it when racialized communities are targeted by the state and kids are taken out of their culture. People who have had helpful experiences of Youth Protection may - for very good reasons - not want to tell their stories, and we may not be as excited or mobilized by them as by the disasters. Most people also don’t hear about the people who grew up in homes where violence or neglect were a daily reality but who didn’t die. But lots of good enough experiences do exist.

We are asking Youth Protection directorates and workers to address a whole host of ills - individual psychopathology, family dysfunction, gaping holes in our care of mental illness, gender inequity, trauma history, addiction, poverty, racial discrimination, particularly the systematic targeting of native people - that are working at a bunch of different levels; individual, family, neighbourhood, community, city, province etc. Like the boy who sees every problem as a nail, we ask Youth Protection to deal with all of these super complex problems by handing them a hammer and then we are horrified when they misidentify a nail.

So Premier Legault, if you happen to read this article, let’s move away from how better to identify a nail and use a hammer. Expand the mandate of the commission to ask “What can we do at every level to help families with children do fabulously well?” Let’s be imaginative, hopeful, honest, kind and generous. You know, like a family.

Normative Masculine Marital Despair

Normative Masculine Marital Despair is the fancy name I have given a thing that I could probably do a research project on with 12 participants and then call it a thing-conclusively-proven-by-science, then trademark it and write a book and go on a speaking tour, but for now I will content myself with a humble blog post.

Never pick up a cat by the scruff of the neck

Many men, myself included, have moments where we feel that we are incapable of pleasing our female partner. Usually this happens when our female partner is telling us we have screwed up in some way. Sometimes we think, “Okay, fair enough, I blew it.” Sometimes we think “Hm. I don’t think that’s accurate. I think I did pretty well.” Neither of those is NMMD. NMMD is when we say “I will never be able to satisfy her. I will always get it wrong.” Women may have a similar feeling, but in my experience with couples most women may fear being a not being happy or that their partner will not be happy but it seems to me that is slightly different than fearing that you do not have the capacity to ever satisfy your wife or female partner. I have rarely seen a woman react in the ways that many men I have seen.

Margaret Atwood said “At core, men are afraid women will laugh at them, while at core, women are afraid men will kill them." Appearing incapable before one’s female partner is a powerful fear that subjectively holds some of the same terror of helplessness as the female fear of being overpowered and killed by a man. We can view this as silly and dismiss it or as so powerful that men should never have to experience it but I prefer to take it seriously as an element that may drive a lot of conflict in opposite-sex couples, but that does not have to.

This video may be a upsetting but it is a good illustration of the mammalian freeze reflex “freeze”

Lots of men take a deep breath, know that the feeling will pass and get on with their day. Some men get aggressive when they feel this way, some men seek to get away. Some men freeze. I once heard the feeling of hopelessly failing at marriage described as similar to a cat being “scruffed.” Not being a cat owner I had to go check it out and when I saw it I thought it was actually a pretty powerful analogy. Stephen Porges and others have theorized that extreme stress or the memory of extreme stress particularly when there is an element of helplessness or immobility can result in “dorsal vagal shutdown”, that is collapse. This is described as the same reflex that makes the springbok that gets jumped by a lion go limp when it senses that it cannot escape. Many men talk about feeling trapped, stuck or unable to breathe when they talk about this feeling.

When these responses have a lot of secondary gain, for example if a female partner backs off from asserting that something isn’t working for them, NMMD and the response may become more likely to recur. The feeling may also reactivate other, earlier traumatic experiences of being powerless from earlier in a man’s life which can amp up the emotional intensity of the response.

The reactions that can come out of this feeling can fuel a lot of crappy stuff in a relationship, as I think is probably pretty evident, particularly if they happen regularly. But feelings are always legit, worth noticing and breathing through. By calling it Normative I hope people will understand that it is common, both to take the shame out of feeling it and also to help men realize that while lots of other men feel this way, other men have figured out how to manage their responses to it in ways that don’t blow up their relationships.

Great Resource for Anxiety for People of Any Age

So here’s my theory about Lawrence J Cohen’s great book “The Opposite of Worry: The Playful Parenting Approach to Childhood Anxiety and Fears.” He wrote a book for anxious parents and then decided he would have more luck getting them to read it if he said it was for helping their kids be less anxious.

I love the title and for that alone is worth it; the absence of anxiety isn’t the opposite of anxiety. Feeling playful, full of creativity, joyful as when we are goofing around with someone we love that is the opposite of anxiety. Cohen really emphasizes parents and kids feeling connected rather than simply focusing on behaviour, something I really appreciate.

The book is full of great, practical approaches to anxiety that anyone can use. Hug yourself when feeling anxious, wrap both arms over the opposite shoulder, alternate pats or squeezes on the opposite shoulder. It feels warm and embracing, it requires a little cognitive and kinaesthetic work, so it takes us out of our anxiety, it is easy to remember for a person who is feeling freaked out.

It also contains a lot of wisdom addressed to anxious parents (a.k.a. the part of ourselves that might think other people’s anxiety is a problem but our own is absolutely reasonable and the only thing keeping us together.)

If you know you are safe, but you still feel anxious, then you may welcome a chance to lower your anxiety. If you believe you are in danger, however, then it would be foolish to relax. You need to be prepared to act at a moment’s notice. That’s why some highly anxious children angrily reject suggestions to relax. Abe [a] boy who was ... afraid of thunderstorms, once said to his mother, ‘three deep breaths are not going to stop us from being hit by lightning’

Finally, Cohen takes a very humble and humane attitude towards his clients, friends, family and himself in this book; he is definitely not the all-knowing therapist who understands clients much better than they can understand themselves. He learns from kids and parents alike about how to manage anxiety.

What to consider if you want to become a therapist

Recently a lot of people have spoken to me about becoming therapists. Some of these people are just starting in the world of work and some are looking at second or even third careers. It occurred to me that it might be helpful to list some of the things I talk about with people who are considering therapy as a career path. 

1. Being a therapist can be really rewarding, stimulating and challenging. It isn't for everybody but if you are curious about people's inner workings, if you are reasonably compassionate, if you have a good mix of humility and confidence, it is a great way to spend your work days.

2. Find out early what the licensing requirements are for where you are going to practice. I live and work in Quebec and it is highly regulated and the rules for practicing have been overhauled in the last ten years. A surprising number of people still spend several years in school with the idea that, "I'll figure that stuff out when I graduate." A school may be very happy to take your money and hand you a diploma that does not allow you to enter private practice as a therapist. It is on you to be clear about how to enter the profession. It can feel daunting but call the local licensing bodies and find out what EXACTLY is involved. 

3. Being a good therapist means running a small business. People will sometimes say, "I trained to be a therapist not a business owner," but when you are dealing with people's mental health, you need to respond to calls in a timely way, manage your time and your calendar, bill people appropriately and have a safe and secure way of keeping records. This stuff isn't rocket science, it is part of the job, so start learning how to do it.  

4. It is important to be able to leave work at work. It takes some time and some practice and for myself I can say that it has been easier at different points in my life than others. Not sleeping at night because your clients are going through something is exactly zero help to them and it is bad for you. Wash your hands at the end of the day, take a walk, say a little prayer when you turn off the lights in your office. Do something that tells your head or your heart that work is over. 

5. Whether you went to social work school, did a PhD in psychology or got a masters in counselling, you did not learn enough in school to be in private practice on your own. People will come in with serious psychopathology including problems that they will not describe clearly such as psychosis or mania. If you can, spend some time in inpatient psychiatry; it is really worthwhile to know what psychosis, mania, hypomania ad severe depression look like.   

By  BrocialWork  on Etsy "A small reminder to take care of yourself or you won't be able to help everyone else. Remind your favorite social worker, therapist, nurse, emt, or other helping professional of the importance of self care.  Be sure to put your mask on before assisting others ."

By BrocialWork on Etsy "A small reminder to take care of yourself or you won't be able to help everyone else. Remind your favorite social worker, therapist, nurse, emt, or other helping professional of the importance of self care. Be sure to put your mask on before assisting others."

Sleep: Balm of hurt minds

I have begun to assess sleep routinely when I see new clients, particularly those with emotional or attentional problems. Sometimes sleep hygiene is the first area I work with on clients who are depressed or having difficulties with concentration or impulsivity. 

It is very nice to look at the possible roots of depression in childhood or how poor attention is impacting a couple but the fact is that if someone is sleeping poorly, it is very difficult to make headway on feeling better in just about any other area of life. Poor sleep makes life hard for individuals and families and emotional and behavioural difficulties often cause poor sleep and then become aggravated by poor sleep. 

I have two really good resources to recommend for people who are experiencing problems with sleep that are wound up with other things that might bring them in to therapy. 

The first is The Sleep Help Institute's Sleep Help for Those Diagnosed with ASD (Autism Spectrum Disorder). This is geared to parents of kids with autism spectrum disorders and though it gives lots of detailed info about autism spectrum disorders and common sleep problems associated with it including a very readable review of the research on the topic, it also gives really good basic sleep hygiene tips for parents of kids whether they are neurotypical or on the spectrum.

The institute also has a Sleep Help guide for nursing mothers and shift workers, two groups of people who I often see who struggle with mood disorders and sleep problems. They also have areas for specific sleep problems such as sleep apnea. The "About Us" section doesn't give a whole lot of info to understand the Sleep Help Institute's funding stream. They do offer mattress reviews which I haven't checked out and can't evaluate but the sections on sleep problems and good sleep habits are blissfully free of merch placements. 

The second resource is Ellen Forney's wonderful graphic-comic self-help manual "Rock Steady: Brilliant Advice from my Bipolar Life." Though Forney is writing from her experience as a person with bipolar disorder, so much of the book is useful for anybody who would like to live a more harmonious life. It is super invitingly laid out and illustrated. She talks about meditation, self-regulation, working with a doctor around medication as well as a whole section on sleep that is great, practical and easy for anyone to implement (I had one small complaint which was that she gives people who wake at night the option of having a small snack, which I always counsel people to avoid). I have this book in my office and have been showing it to many clients who are struggling with managing their emotions; the section on sleep is just one great feature of this great book. 

Close Enough, Episode 2, "Very Carefully"

Episode 2 of my podcast about Closeness and Distance. Contributors to today’s show were Orit F, Mayan S, and Chana L, Menachem F and Elana F.

Dr Drinkling’s track “Late Nights” that you heard at the top of the show is our new theme music! Thank you so much Dr. Drinkling. Please go to his Band Camp page and support his beautiful, dreamy work. drdrinkling.bandcamp.com
 

Other music on the show was, "As a Porcupine Pines for its Pork" by Billy Jones and Ernest Hare and Jimmy Dorsey and his Orchestra, playing the absolutely beautiful “Praying the Blues.”  The Grand Duo Concertant opus 48 for clarinet and piano by Carl Maria von Weber was performed by William McColl, clarinet and Joseph Levine, piano which is shared under a creative commons share alike license.

 

Thanks to the Juno-nominated Gabriel Paquin-Buki for supplying clarinet squeaks and noises, and to Sivan Slapak key grip. Someday I will have you singing yiddish show-tunes on the podcast.

 

Thanks to my friend Norm for speaking so open heartedly about his experience of being a dad.

The letters from Johanna Schopenhauer to her son, the very grumpy German philosopher were read by Tally Abecassis whose wonderful podcast “First Day Back” you should download as soon as you are finished here. The translations were adapted from David E. Cartwright’s Schopenhauer: A Biography.