Should Quebec pay for your therapy

"After slaying the giants, perhaps we should have a go at barriers to accessible psychotherapy, Sancho?" 

"After slaying the giants, perhaps we should have a go at barriers to accessible psychotherapy, Sancho?" 

Spring 2014 was a different time.  Back before we had a Liberal government that looked like it was going to rule Quebec for the next 10 years, a push was on to publicly fund psychotherapy.  The Quebec order of Psychologists was pushing for it.  An organization called the Coalition for Access to Psychotherapy was pushing for it.  Then two doctors got elected and decided to dismantle the health care system.  The idea of the government paying for anything in the health or social service sector that can't be contracted to the rapacious SNC-Lavalin or some equally befouled Quebec engineering firm seems Quixotic. 

As readers of the blog know, I used to work in settings where I got to provide psychotherapy for people who really needed it and often could not afford it.  Dr. Barrette laid me off (there were some intermediaries involved, too).  Now, I provide psychotherapy privately to people who benefit from it and who can afford to pay for it out of pocket or through private insurance.  I work on a sliding scale but my overhead, much of which is government mandated licensing fees, means I can't see the clients I used to and still make some money at the end of the day.  I feel useful, but I doubt I have kept anyone out of the hospital doing this.  Even for a person with serious mental illness who everyone agrees would benefit from psychotherapy, it is nearly impossible to get it in the public system anymore. 

By contrast, for the cost of one night's stay in a psychiatric hospital bed, I could offer one year's psychotherapy once a week at the low end of my sliding scale to someone recovering from a severe depression.  I could give a year's family therapy to a family supporting someone with schizoaffective disorder.  I could offer a twice a week dialectical behavioral therapy group for people with borderline personality disorder.  

Nevertheless, I have serious reservations about government funding psychotherapy.  Government will insist on putting psychotherapy through a meat-grinder; make it highly routinized, outcome driven (as opposed to outcome-minded) metric-oriented etc.  In other words they will use all the bureaucratic tools that have protected us from corruption in the construction industry.  And like with the construction industry, where government money goes, corruption will surely follow.  If psychotherapy becomes publicly funded, I predict within two years you will have psycho-therapeutic equivalents of SNC-Lavalin springing up, offering to fix major depression in four sessions using a manualized, patented therapy that has been extensively tested (on seven people who were feeling a little blue) and can be administered via the internet by qualified practitioners in the developing world.  Doctors will be the gatekeepers for publicly-funded therapy meaning a huge uptick in psychiatric diagnoses.  Think psychiatry and big pharma in the US

Speaking of the US, maybe it would be worthwhile looking at Obamacare.  If we want Quebecers to be able to get psychotherapy regardless of their income, maybe we should be looking at some of the deepest pockets in Canada. 

Sun Life Mutual, Manulife and Desjardins make billions of dollars in profits each year and sell plenty of insurance in Quebec. They could be doing more to ensure that access to psychotherapy is equitable (and I am sure they will embrace the chance to show civic-mindedness and gratitude for the billions). 

First, they should be required to offer packages that are in line with Quebec law.  Manulife among others has plans that only reimburse you for psychotherapy delivered by a psychologist (check with you insurer about the details of your plan).  That despite the fact that by Quebec law, psychotherapy can be delivered by a variety of professionals.  Quebec insists social workers, creative arts therapists, OTs, nurses etc. meet specific criteria and pay for a psychotherapy permit overseen by the order of psychologists.  But the government doesn't require insurance companies to use the title.  If all psychotherapists meet the same standards, and are delivering the same service, that service should be reimbursed equally by insurance companies.  Require insurance companies doing business in Quebec to respect Quebec's own regulatory regime, offer equal coverage for any psychotherapist, regardless of training.  That would increase access for insured people and reduce the costs of private psychotherapy. 

Second, insure the uninsured.  25% of Canadians do not have supplemental health insurance (that statistic is from 2004 and I am guessing the number is considerably higher today).  The mentally ill are less likely to have private insurance than most people because they are less likely to work.  The onset of many mental illnesses is in early adulthood.  Young adults are less likely to have private insurance than older adults.  Quebec could require insurers to offer low-cost individual health plans that include mental health services (and no prior-condition clauses) that the unemployed, underemployed or independent workers would be required to buy. 

Now that would be a public-private partnership that might actually serve the public interest. 


Making Humans

When I worked in inpatient psych the stories people would tell me were always a mix of sadness and joy, brokenness and resilience, the ways family can heal and hurt, sometimes simultaneously, back and forth across generations.  Drugs, what we call -- for lack of a better term -- mental illness and plain old human hurt wound together so tight the divisions between them become indistinguishable, the things that bring people into hospital are always part of a story of a family, trying, failing and succeeding in various ways to hold a human soul.  The CBC radio documentary "Tragedy Builds a New Family" from the Sunday Edition took me back to that. 

Burkhard Bilger's piece about kids riding bulls, "The Ride of their Lives" in Oklahoma and Texas in this week's New Yorker provides a fantastic illustration of how kids can grow and thrive in all sorts of lives and how our ideas about what childhood 'should' be are circumscribed by our tribe.

I thought about a playground near my house in Brooklyn, in Park Slope. A couple of years ago, it was beautifully renovated by the city, with a rock-lined stream meandering through it and an old-fashioned pump that children could crank to set the water flowing. The stream was the delight of the neighborhood for a while, thronged with kids splashing through the shallows and floating sticks down the current. Yet some parents were appalled. The rocks were a menace, they declared. The edges were too sharp, the surfaces too slippery. A child could fall and crack her skull. “I actually kept tapping them to check if they were really rocks,” one commenter wrote on the Park Slope Parents Web site. “It seemed odd to me to have big rocks in a playground.” Within two weeks, a stonemason had been brought in to grind the edges down. The protests continued. One mother called a personal-injury lawyer about forcing the city to remove the rocks. Another suggested that something be done to “soften” them. “I am actually dreading the summer because of those rocks,” still another complained.

The parents at the camp flipped this attitude on its head. They valued courage over caution, grit over sensitivity. They revelled in the raw physicality of boys. The mothers sat in the bleachers taking videos and hollering advice—“Wyatt, just ride the way Daddy taught you!” The fathers straddled the chute, leaning over their sons to cinch the rope and shove the calf into position: “Are you ready?” “Yes, sir!” “You’ve got to take the fight to him.” “Yes, sir!” “You’ve got to want it.” When the gate blew open, they leaped up on the rail and watched their sons with clenched fists and narrowed eyes. They weren’t stage parents, for the most part. They just took following your bliss to its logical extreme. “I’d let my kid do whatever he has a passion for,” one mother told me, “even if he wanted to be a piano player.”
— New Yorker

"Even if he wanted to become a piano player" instantly become a piece of shorthand at my house. 

Finally, I have been thinking about that stupid bromide "It takes a village to raise a child," because of the reaction that has been prompted by two similar law-suits filed by people who have left hasidic communities, one just outside of Montreal (Mike Finnerty conducted a really thoughtful interview with Yohanan Lowen, the man formerly of the Tosh community; you can get there if you follow the link to audio).    I don't write about it much, but I have spent a lot of time working with ultra-Orthodox Jews in various settings.  One thing that the reaction to these two stories illustrates to me is how confused we (by that I mean everyone who isn't an ultra-orthodox Jew or part of some other tight-knit, small traditional community) are about 'community.'  We value 'community' in the abstract, we love to say "it takes a village to raise a child" but we have little experience of the travails of living in a village.  Someone I know who grew up in Grenada told me that if he did something wrong at school he would get spanked by the teacher and then when he walked home, the neighbour-ladies on his street would see him come by, crying, and each in turn would call him by name up to their front porch and each one would give him yet another spanking because they knew why he was crying "You didn't listen to the teacher?"  To me this is a perfect illustration of the mixed-blessings of growing up in a village.  Tight-knit communities are tight-knit because people feel responsible for one another and entitled to enforce compliance to community standards, in particular when it comes to kids.  They coerce people to act right.  They are conservative; they do not value change and are wary of outside ideas and different people.  Some communities are more like this, some less but you can't have maximum individualism and still eat the cake of a shared set of values and communal responsibility.  There is a reason people are leaving villages all over the world; we live in an age where personal expression and individualism are more important than adhering to norms set by the past and our neighbours. 

Three angles on how those around us grow us up into who we are. 

Whining in Toddlers

Whining can truly make you want to pull your hair out.  Here is another in the Fridge Magnet Therapy series of printables all about how to deal with toddler whining, a suggestion from reader and friend of the site Ms. T.  I hope it proves helpful.  Your feedback is always appreciated.

Click on the image to download the pdf

Click on the image to download the pdf

Illustrations are from project Gutenberg's "A History of Champagne, with notes on the other sparkling wines of France" 1882 by Henry Vizetelly (chevalier of the order of Franz-Josef, no less.  No note about whether chevalier Vizetelly illustrated the work himself or not.)  I included an additional one (right) that didn't make it into the printable.  Is he wondering if a drink might help him be patient with the whining at home? 

Closeness Paradox

It's one of those things that is easy to say and hard to do but when your partner is hurt by or angry at you and every fiber in your body is screaming for you to retreat or lash out and protect yourself, that is the moment where you need to reach towards your partner's emotions.  To be clear: you should never put yourself in danger of being the target of aggression.  There is no excuse for physical or verbal aggression.  But the unstated request by one or both partners in arguments is almost always "Soothe me by showing me that you understand my feelings of hurt that you caused."  It is a paradox: "You are the problem.  You are the solution."  If that seems unreasonable and unfair, it absolutely is.  Nevertheless, I think everyone who has been in a relationship has done it.  We do it in different ways, criticizing, storming out, being sarcastic, shutting down, hauling in past wrongs, all the things we know we shouldn't do, we do them because we have trouble saying, "You hurt my feelings.  You scared me.  I feel vulnerable in front of you.  And I need you to help me feel safe and secure." 

"Just do that"

Why don't we just offer what our partner needs?  Why don't we just say, "I get it.  I see how scared and sad and frustrated and angry and hurt you are by what I did?"  Most people are able to do this reasonably well with a small child, to say in effect, "I see how see how frustrated and angry what I did makes you."  It gets harder with other adults.  For one thing, we think we are right about what we are arguing about and we confuse connecting with and acknowledging feelings with giving up what we want.  There are people who feed this confusion by manipulating; demanding that we change what we do as proof that we understand how they feel.  That makes it tougher to connect emotionally and still feel like you can stand your ground about what you need and want. 

Second, connecting with another person's feelings is threatening to our sense of self.  The more intense and sustained those feelings are, the more threatened we feel.  Some of us have had bad experiences of being intruded on by others which makes it even harder to tolerate another's emotions without feeling our sense of self being swept away, annihilated in the storm of our partner's emotions.  

I am finding that more often than not, couples therapy is about trying to help people connect emotionally to their partners well enough, often enough.  I think for my clients at first it can feel like being told, "Just do a triple gainer followed by a reverse jackknife.  Oh, and the pool is only four feet wide, so don't miss."  But I do think it is a skill and a habit people can develop.  The other thing is, of there is an alternative way of having a happy relationship over a long time, we don't know what it is yet. 

Lying to your kids

Want to raise honest kids? Don't lie to them or in front of them, more tips here. 

Want to raise honest kids? Don't lie to them or in front of them, more tips here. 

When parents lie to their kids it is often for good reasons; a topic is scary for the parent and/or for the kid or a parent foresees that a little bit of information will raise a lot of difficult questions (see this blog post for a hilarious example of the latter).  But lying to kids is a losing proposition.  First of all, it is a pretty good way to ensure that they will lie to you and to others.  Being honest with and around your kids is the single most effective tool you have to teach them honesty.  But there are other, related reasons not to lie to kids even when it is hard.  By about five years of age kids will begin to keep track of how reliable you are in giving them truthful information about the world.  They will weigh your past record of truthfulness when deciding whether to believe what you say or not.  That includes when you tell them; "Smoking is bad for you," or "There aren't any monsters in your closet" or "I love you and I will always be there for you." 

Parents are the most important instrument kids have for making sense of their world.  Having a parent you can't trust is like trying to find your way in the woods with a compass that only works half the time.  Kids need to feel safe with their parents and part of safety is consistently helping to make sense of the world.  The English psychiatrist and family therapist John Byng-Hall wrote a wonderful article about secure attachment in families in which he talks about the correlation between parents' ability to tell the story of their lives and the feeling of safe attachment in the family.

What is most interesting is that the coherence of the narrative can predict whether or not the parent has a securely attached child. A coherent account ...[gives]... a clear and convincing picture of what it [the parent’s childhood] was like. It is truthful, succinct, yet complete, relevant, and presented in a clear and orderly way.
— John Byng Hall

There are two caveats to the rule of honesty with kids.  One is, honesty should serve the child and not the adult.  Adults shouldn't use kids as confidants simply to unburden themselves.  This requires adults to have some capacity for self-reflection and some parent-child boundaries.  And two, the information we give kids needs to be age appropriate.  "Age appropriate" is a funny term.  It's easy at the ends of the spectrum: a five year old can know that animals die, no five year old should see videos of beheadings.  But it gets tougher to find two "experts" who will agree on what is age appropriate when you get to more complicated questions.  This takes me back to what I said at the beginning; parents often lie to their kids for good reasons, because they don't want to impose their hurt and fear on their kids or because they don't have any idea about what how to deal with something hard in an age appropriate way.  But secrets have a way of coming out.  Here are some tough calls about honesty with kids. 

  • A ten year-old asks her/his parent about a family member who died before he was born, not knowing that person was murdered by another family member.
  • What should a parent say to an anxious 8 year-old who hears about an abducted child on the news? 
  • What should a parent say when his/her ex reveals to their 12 year old that the marriage ended because of an affair? 

If the child has younger siblings these questions become even more complicated because a parent should not impose secrecy on the elder sibling and cannot expect a kid to finesse "age appropriate" when it is near-impossible for an adult to swing. 

So what do I do with clients in similar circumstances?  First, I try to remember that I don't have to live with the consequences of the decision to be honest and that my clients do, so the client has to feel reasonably okay with his/her call.  Second, I advise erring on the side of honesty because it's better for your child to have a reliable guide through an uncertain world than a paper-thin veneer tacked over life's hardest questions and a guide who they aren't sure they can trust.  "Deborah was killed by Andre.  He was very sick at the time."  "It is very rare but sometimes adults do want to hurt kids, that's why your dad and I take good care of you."  "Yes.  I had an affair.  I made a really stupid mistake." (This final one is the trickiest.  A child in this circumstance will inevitably want to insert him/herself between the parents.  The parents need to give the child the message that adults take care of adult problems, but I think that a short clear statement taking responsibility for infidelity in that circumstance is better than leaving it to a kid's imagination and doesn't invite the kid to step into the role of co-parent). 

After these truthful, succinct, yet complete, relevant, and clearly presented explanations, the parent needs to say, "And if you want to talk about it more now or later we can.  There may be some things I may not be able to tell you but you can ask anything you want to."  Then shut up and listen like you have never listened before. 

Review: Saving Normal by Allen Frances

I recently heard the wonderful Ginger Campbell interview Allen Frances on the Brain Science podcast.  Almost before my headphones were off I had run out to buy Frances' book "Saving Normal, an insider's revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life."  Frances clearly and humanely outlines his case that "The cruelest paradox of psychiatric treatment is that those who need it often don't get it, while those who do get it often don't need it." 

I had some concern, even after the very thoughtful interview on BSP, that this would be a soft-headed screed against psychiatry.  I know a lot of people who have benefited from mental health treatment including psychiatric medication, and I think it is very wrong to frighten people away from psychiatry who really can use it.  I needn't have worried. Frances is a psychiatrist with a great love for the profession and confidence in the good it can do.  He is absolutely committed to the idea that psychiatry can be beneficial to seriously mentally ill people and at pains to illustrate that.

But he is also clear-sighted about the failings of psychiatry and medicine generally (he is very much talking about the US situation.  I will reflect a little on the Quebec context below).  The big failing Frances takes on is 'diagnostic inflation.'  He means the tendency to expand the criteria that are used to diagnose mental illness, either by loosening criteria for exiting illnesses or by 'discovering' new illnesses.  What prompted this call was the American Psychiatric Association's process to issue a fifth edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM.  Frances thinks the authors are too quick to expand definitions which will inevitably lead drug companies to step in and push for meds for people who could do without them.  Frances is in a good position to comment because he was in charge of the DSM-4.  He is very up front about his own failings in having lead that installment and apologizes for his mistakes.  It is extraordinarily refreshing to hear someone with such a level of authority offer a public apology. 

One of the diagnostic overreaches that he addresses is 'psychosis risk syndrome'.  We are close to being able to identify people who are at high risk of developing psychotic disorders like schizophrenia.  We know many of the risk factors including certain genetic markers, we think that delaying onset of schizophrenia means being less sick and we know that being very sick with schizophrenia is very hard.  Why not target teens who are at elevated risk and are exhibiting "prodrome" symptoms; self-isolation, quirky or aggressive behaviour in the hopes of forestalling or even preventing the onset?  Frances gives a very good answer to that.  First of all, target them with what?  The answer will probably be anti-psychotic medication.  We have no indication that taking anti-psychotics before developing psychosis will help stave off or mitigate the effects of schizophrenia and the side effects can be very serious, including obesity and diabetes and everything that comes with that.  And, he points out, we can identify teens who are at risk, but that would probably involve identifying a lot of kids who will never develop the disease and potentially subjecting them to this very serious intervention.  It begins to look a lot like the aggressive screening and treatment of prostate cancer, too many people, too invasive for limited benefit.  Frances doesn't mention the possibility that teens who are identified might benefit from interventions that have less potential downside like counseling about delaying use of street drugs including marijuana and psycho-education about reality testing.  Given the way Quebec is headed, it seems unlikely that we will see a targeted public health campaign that relies on disease prevention using labour-intensive methods like psychoeducation.  

Frances also alludes to something I have mentioned elsewhere in this blog; namely that not all conditions of the human soul are diseases in any recognizable sense and yet increasingly the DSM includes them.  The idea that mild to moderate depression, or attention deficit disorder, or anxiety is a neurochemical imbalance fits very nicely with a drug company's bottom line.  The emphasis of the last twenty years on neuroscience has tilted us towards a chemical fix for ailments of the mind.  Yet not one significant advance in diagnosis or treatment of mental illness has come out of all the important research on neuroscience so far.  Diagnosis remains entirely symptom-based.  The mechanisms for the function of treatments is poorly understood, if at all. 

All of this may seem very much like “inside baseball” for people who don’t spend their days thinking about mental health but Frances makes a persuasive case that a lot of people are already getting a lot of powerful psychiatric medication that they don’t need...

All of this may seem very much like "inside baseball" for people who don't spend their days thinking about  mental health but Frances makes a persuasive case that a lot of people are already getting a lot of powerful psychiatric medication that they don't need, medicines with serious side-effects that may not have been adequately tested on the populations for whom they are being prescribed.  He reports that the sale of anti-psychotic drugs at $18 billion (US) now delivers more cash to the pharmaceutical industry than anti-depressants.  Anyone who has any experience with them knows anti-psychotics are powerful medications with very serious potential side-effects.  They are helpful to people with psychosis.  But now they are being marketed for use with children and the elderly.  20% of people treated by primary care physicians for anxiety now receive an anti-psychotic as well, according to Frances.  The trend towards GPs prescribing psycho-active medication is troubling for Frances as well.  That GPs give out anti-depressants and anti-anxiety medications routinely should surprise no one, but I was amazed to learn that 50% of anti-psychotics are prescribed by GPs.  (I am not sure if that accounts for GPs taking over the prescription of anti-psychotics after an initial prescription by a psychiatrist.)  Frances goes through the familiar litany of the dangers and over-promises regarding SSRIs for treating the 'worried-well' market.  These are problems we see here in Quebec, though certainly not to the degree they are experienced in the US. 

Whose fault is all of this?  For Frances the answer is pretty clear.  Big Pharma and the big money it is willing to throw around to advertise direct to consumers (only in the US and -- apparently -- New Zealand as well), to co-opt the better judgement of doctors and researchers as well as to fight legal battles and pay fines when they get caught behaving badly (as with the off-label marketing of anti-psychotics for kids).  He gives policy recommendations for taming the excesses of big pharma.  Naturally, dear to my heart are all the plugs that he makes for psychotherapy as an alternative or adjunct to pharmacology. 

There is no organized psychotherapy industry to mount a concerted competitive push-back against the excessive use of drugs.
— Saving Normal

Here in Quebec, we are retrenching from any kind of public outpatient psychotherapy, at great cost to our well-being, I believe.  It is nearly impossible in Montreal to get psychotherapy at a CLSC (public health and social service clinic).  This despite the fact that we know that psychotherapy can sometimes head off   episodes of serious mental illness later for certain people and keep them from needing much more expensive hospital care.  Follow-up care after a psychiatric hospitalization is spotty and seems unlikely to get better with more cuts coming. 

The lack of a credible alternative is part of what is fueling the appetite for drugs. If we want to see the biomedical model of mental illness restored to a more modest role and with it the role of psychotropic medication, we need to take seriously the challenge of collectively creating a psychotherapy that is credible to the people it can help.

While I am a believer in psychotherapy, if I have a quibble with Frances, it is over this.  My experience is that many psychiatrists and other psychotherapists have been and continue to be high-handed, overly jargonistic, faddish, opaque and sometimes deeply anti-scientific.  Frances himself mentions the terribly misguided satanic ritual abuse accusations of the 1990s and the role played by therapists who "developed and instant expertise on day care sex."  Many people mistrust us because they view psychotherapy as elitist mumbo-jumbo that changes tack every ten years.  All those primary care doctors who are prescribing medications rather than sending their patients to therapists don't trust talk therapy.  Why should patients?  Hell, I have met quite a few psychiatrists who don't have faith in psychotherapy.  The lack of a credible alternative is part of what is fueling the appetite for drugs.  If we want to see the biomedical model of mental illness restored to a more modest role and with it the role of psychotropic medication, we need to take seriously the challenge of collectively creating a psychotherapy that is credible to the people it can help. 


Mystics in Therapy

I read a wonderful reflection on mysticism the other day and started to think about what makes it hard to put some things into words. 

Mysticism is a seemingly positive term that denotes a negative, as the word darkness, which seems a positive term, denotes only an absence — the absence of light... A nonmystic is someone who believes that when truth is explained to him in words, he should understand that truth. The mystic is some one who knows that real truth, meaningful truth, can never be fully expressed in words.
— Joseph Dan, The Heart and the Fountain, p 2-3

Sometimes I see clients in therapy who are mystics in the sense that Dan describes.  They may not identify as spiritually inclined but they mistrust language to adequately convey truth.  Dan goes on to says that for the mystic, "Only the trivial, or the false can be communicated and understood."  It is hard to administer a talking cure when a person views language as untruthful. 

Sometimes mysticism looks like a defense.  I will say something like: "Did that make you sad?"  The mystic replies "Not exactly sad."  I say, "So how would you describe the feeling?"  The mystic: "I can't describe it."  Talking about feelings is like dancing about architecture.  But in this scenario the mystic also can't dance about dance.  The mystic ineffability of inner experience can be a way not to experience feelings.  For many people, saying "I am sad" with intention is akin to God saying "Let there be light."  It is the baldest, most powerful truth of all, in that it creates the reality to which it refers.  (An odd variant on this theme: saying to another person, "I feel lonely" with intention can be a powerfully connecting thing).

Because being a mystic means having access to a truth which cannot be adequately conveyed, it holds a special status, for good or ill.  "I am sad," is a profoundly human statement, and it makes me like 99% of my fellow humans who have experienced sadness.  Saying "The word 'sad' is inadequate to describe what I am experiencing," means I stand alone.  Being an unremarkable human with unremarkable human feelings can feel good a.k.a. 'normalized,' or bad (as in 'unimportant').  To connect with another risks making my experience banal. 

Mysticism and depression are two degrees of separation apart.  Nihilism is the missing link.  The mystic denies the possibility of being able to bridge the gap between one's self and the universe beyond through language.  The nihilist denies the possibility of bridging the gap between self and other entirely.  Depression is the affective prison in which a person is convinced of the impossibility of connection with others, the world of sensation, God, even elements of the self. 

Some therapies have taken the mystical contention about language to heart.  Sue Johnson, the founder of Emotionally Focused Therapy views purely cognitive therapies as flawed because they don't address affective truth, a felt, experienced truth that is prior to and largely inaccessible through language or at least through cognitive language alone.  (I find it ironic that Sue Johnson has spent tremendous effort to empirically demonstrate EFT's claims that reasoning is insufficient for addressing matters of the heart.)

Rabbi Shais Taub talks about addiction as an expression of the urge to transcendence that is part of mysticism.  "Crippling self-consciousness is the root of addiction.  When they (the addict) take this poison it simulates the effect of spirituality in that there's this release from ego, rather than being self-transcendent release from ego... it is a self destructive release from ego.  ...(T)elling the addict... 'Don't you see you're destroying yourself?' is the most ridiculous thing you can say because if they could articulate what their soul they would say  'Yes, I am trying to destroy Self.'"  (You can listen to the whole episode of Tapestry here.  The interview with Rabbi Taub is at about 19 minutes).

I feel both the mystic's tendency to view some of the most important things as ineffable, the desire to connect outside of language and to transcend the crippling 'self'.  But I also feel a hard-headed commitment to the 'communicability' of many of our most complex and difficult truths. 

"It is not in heaven so that one could say, 'Who will go up to heaven for us, to get it for us and make us listen to it, to do it?' "Nor is it beyond the sea so that one could say, 'Who will cross the sea for us, to get it for us and make us listen to it, to do it?'"   For the thing is very close to you, in your mouth, and in your heart, to do it."

 

 

 

 

 

Tools for When Kids Lie

Some basics for dealing with kids and teens when they lie.  Parents often find this very difficult because they worry that a child or teen who lies will grow up to be a liar.  The fact is every kid lies at some point (as does every parent) and few people are chronic liars.  I hope these will help you if you feel like you are at the end of your rope.  One thing I didn't have space to point out in the printable: I mention various punishments or consequences in the printables.  These are examples and not recommendations per se It is important for you to set consequences you feel okay with (within the limits of not physically harming or humiliating a child or making a child afraid for his/her safety).  I may make a printable about consequences at some point so be sure to check back. 

This is the second in the Fridge Magnet Therapy printables series.  I love feedback so please let me know if/how these are helpful.  

You can click on the image which will take you to a pdf or on this link. Lying

Illustrations are by Alice Carsey (Pinocchio 1916)  and Charles Copeland (Pinocchio in Africa, 1911)