Face Power

A few times in my life, at moments of great emotional intensity, I have felt that I could not look at a particular person in the face. It was as if looking at them caused my eyes and mind to burn with a weird emotional fire so that I felt compelled, actually forced as though from outside my own self, to look away.  It seemed to me in those moments that I was experiencing both my own and the other person’s emotions and hearing their ideas, not as voices, but as an unshakable certainty about how they saw me. In a milder form, sometimes looking people in the face, particularly making eye contact, can cause me an itchy uncomfortable sensation, or a feeling of intimacy, or both. This isn’t psychosis. In fact, it isn’t even unusual; I see other people react in much the same way all the time. Reading and responding to a face for signals about another’s mental states is a powerful impulse in infants that is probably biological prompted and that we retain into adulthood.

The psychologist Simon Baron-Cohen writes about how most humans, from a very early age and as part of a biologically driven process, develop a complex series of perceptual and psychological tools for “mindreading;” understanding first that we and other people have all sorts of inner states and second, for making good guesses at what those inner states are and finally for understanding that different people will have different inner states. We have a powerful natural drive towards psychology. This is also sometimes called “mentalization.” Baron-Cohen makes the case that much of this is done through paying close attention to another’s facial expressions, particularly, the direction of the other person’s gaze.

He posits that the sub-skills of mindreading are developmental. If you have a watched a 15 month old go up and down stairs over and over and over again, you know the power of development. Human (and other animal) babies at a young age spend a lot of time looking at other’s eyes to assess where they are looking. Later children will point at an object that interests them to encourage another person to share attention, then look back to see that they are looking both of which are ways for children to develop an understanding of what is going on in another person’s mind. They seem to do this without being taught to do so. Early on, we have an innate urge to build mental tools for accessing another’s mind via their face.

In many ways Baron-Cohen’s model of mindreading is similar to John Bowlby and Mary Ainsworth’s model of attachment; the biological drive of infants to form a mutual connection with a caregiver. Both are biological drives of early childhood towards a social and psychological model of the world. It is interesting that Baron-Cohen doesn’t connect ‘mindreading’ with attachment since it seems that one of the early important functions of mindreading is being attuned with one’s caregiver. It would also help explain the intensity of emotional responses people have to facial cues from their partners in conflict; these are attachment responses.

When couples fight, I have observed a curious thing often happens. They often become very preoccupied with their partner’s state of mind. “Look, he’s so angry right now. Do you see how she’s thinking that I don’t do my share around the house?” Sometimes when people are talking about very hurtful experiences from their past, they will assume the voice of the person who hurt them and take on the voice of that person, mimicking it and amplifying its negative tone, its hurtful cadences, pausing to add in what the person was thinking when they said this. They also tend to exaggerate the facial expressions of the person. They particularly echo or exaggerate facial expressions that connote contempt.

Consider the eye roll. Holy smokes, can an eye roll ever escalate a conflict in couple or a family. The couple’s therapist and research psychologist John Gottman talks about the corrosive power of contempt deployed in arguments, usually expressed non-verbally such as an eye-roll, to poison a relationship. I suspect that there is something about the primal nature of face/mindreading and attachment processes that makes negative facial micro-expressions, particularly the eye-roll so dysregulating.

Partners are very good at reading one another’s non-verbal cues, particularly fast, involuntary facial expressions, or “micro-expressions” and most particularly their eyes. We have the idea that when we see these negative micro-expressions we are seeing the truest expression of our partner’s feelings about us. People believe that because these expressions are largely involuntary they have more weight than all the voluntary, willed behaviours of the other person, such as offering support or kindness. In this weird emotion-logic of arguments - ‘what is not willed is more true than what is done deliberately’ - the eye-roll has a special place because it is partially but only partially, involuntary, a silicon semiconductor of micro-expressions. A hurt partner can understand an eye-roll as both a willful act of cruelty and a revelation of a partner’s hidden contempt for them.

I once read a psychologist refer to “hypermentalization” meaning over-interpreting another’s mental states, particularly negative mental states. They went on to joke about “excrementalization;” meaning a shitty ability to read another’s mental states. That’s what we do when we are in a fight with our partner; we excrementalize. We tend to accurately see negative expressions that cross our partner’s face but completely miss or minimize expressions of neutral or positive mental states. If my partner thinks “I’d like to strangle him,” and that causes her to raise her eyebrow in a way which betrays her thought to me I don’t credit her for NOT SAYING a hurtful thing, for refraining from being nasty. If she then sincerely says, “I love you and I want to work things out” both in words and in facial expression, I will probably remain focussed on the eyebrow-raise as a true expression of her emotion and the rest as unimportant or even more destructive, as a lie.

If you understand from your partner’s look that they are pissed off or resentful of you, it may be useful to remember that your understanding of their expression may be very accurate, the product of a well-built and primal system for mindreading and checking on connection to the one you love. But it is almost certainly incomplete. When we are in conflict, with our attachment responses pumping and our mindreading on high alert for negative we see, correctly, that the glass is partially empty, and reject the 93% that is full. In that circumstance, force yourself to look for information that may disprove your idea about your partner.

Progressive's Pachinko and the Executive Meeting

In the last few weeks I have seen clients struggling with a lot of internal division. These are people who are pretty self-reflective and for whom examining their actions and their motivations is an important part of their identity. These are good qualities but like all good qualities, they can be carried too far. I get to see from outside how they can end up hamstringing people.

We know about the trap of black and white thinking but there is a self-reflection trap that sometimes causes people a lot of grief. I think of it as Progressive’s Pachinko. In the Japanese pinballish game the ball is continually bouncing off one nail or another, unable to pursue a clear course, like Bob Dole/Dan Savage’s phrase “A liberal is someone who can’t take their own side in an argument.” People with a progressive outlook can often get hit with this pretty hard, rehashing in their own minds the ethical implications of every decision. They are often uncomfortable with hierarchical decision making, even in their own minds.

I definitely identify. I had a dificult decision to make recently. It was a decision that had some important implications for me. Every ten minutes, I would ask myself what I should do. I felt like my clients feel; stressed and angry at myself because it felt self-inflicted.

So I used for myself a process that I had stumbled on with clients. First, I asked, “Have you already made a decision that some part of you is having difficulty catching up with?” It turned out I had. I had decided, but I felt apprehensive about my decision. People can spend a lot of time and energy trying to maintain the idea that they haven’t made a decision when they already have.

Second, I asked myself if there was any new information or perspectives on the issue that merited re-examining the decision that it turned out I had already made. The answer was no. So an emergency meeting of the executive committee of Jeremy Wexler Global Enterprises about this decision would not bring a different result but will bring more worry.

Third, I set a date to convene the executive committee to review the decision. It turned out I had made a decision even though I was having a hard time acknowledging that I had. Making a decision can bring some peace, but living in my head it was like trying to work in an office where people were constantly rehashing questions that were settled at the last meeting. “Maybe we should try it this way.” “I still think we should have gone with plan C.” These different voices have important stuff to say. One part is in charge of being scared of anything new. One part is responsible for protecting my sense of independence. One part manages the division of me that dives into any new thing because the grass is always greener. They all bring something to the table. But they tend to be unruly, and will argue their various points all day long. But my wise mind is the boss, a really good boss, a boss who cares about everyone, who takes everybody’s perspective seriously and then makes tough decisions and implements them.

My wise mind had already listened to all the factors. It had already made a choice based on what I knew and what I felt. Re-opening the decision was only adding extra emotional friction. But, it was clear that some members of the executive committee still had serious reservations.

“Okay,” said the wise mind. “We already committed to this course of action for good reasons. I know some of you don’t like it but I expect everyone to give it an earnest try. We will reconvene the executive committee in three months on, January 10, when we will have some new information and we will check in about how this is going. I assure you that I am fully open to the possibility of changing course at that time.”

And that seems to have been enough to appease the dissidents.

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."

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.