Integrating the Reality of the Newtown Murders

We’ve got three days and nights between us and it now. Three days of conscious sadness, three nights (for those who slept) of subconscious processing of the incomprehensible, and we’re living our way through the fourth. This is how our psyches work; this is how we integrate truths into our reality. We don’t “get over” tragedies; we digest them because we have to, because we don’t have the option of rejecting them, of vomiting them out of our minds.

Sure, people try and sometimes succeed at kicking truths out of their conscious minds, exercising full denial, but the subconscious holds it all, and if we don’t let the conscious mind give the sub an assist, integration is delayed or distorted. We need to give this some, but not too much, conscious attention.

On Friday, when the news broke, I cautioned you to be selective in the amount and type of media coverage you would allow in. Not to callously ignore what happened, but to avoid immersing yourself in the breaking newsfeeds, or visualizing the scene, or putting yourself in their shoes. I recommend this still.

It’s not a failure of your human empathy to have a limit to how much you can receive, ingest, digest, and eventually integrate. If you want positive changes to come of this, you have to stop before you’re overwhelmed or you’ll deplete yourself of everything you have to contribute before you’ve had the chance.

So here on Day 4, I’m mindful of what happened. I’m reading headlines but not very many stories. And I’m finding support in music, a language loved and trusted by all parts of my mind. This song has been playing as I wrote this, and it’ll be on repeat for a while longer. It’s not about this or any specific event; it touches on a number of chronically tragic realities in our world, and it reiterates that we CAN do something to make it better, one relationship at a time. It’s one of my most reliable go-to tunes when I need to be uplifted.

Wishing you peace.

 

A Failure of Empathy

My first video blog post!

For professional organizers and other nonclinical in-home/onsite professionals: Recognizing inadequate empathy in a mental health professional’s description of a client.

Video link: A Failure of Empathy

 

Doing Harm for the Holidays with Hoarding Trash-Talk

(Originally published December 2010; republishing by popular demand)

‘Tis the season for festive social gatherings and small talk with acquaintances or strangers. What will you chat about? Hoarding is a hot topic these days—if the subject comes up, what will you say? Typical comments overheard include: “I just can’t believe how those people live! It’s disgusting!” “I know! Don’t they have any pride? And where are the families? I would never let my mother rot in a house like that!” “Well, I’m glad I don’t know anyone like that. Yuck!”

Guess who these comments were overheard by?

People who hoard and their loved ones! Nice going, Mr. and Ms. Insensitive—now YOU’RE the one making a mess. My clients tell me about you: How they thought you were a nice person until you went off about hoarding with them standing right there, fearing their cover might be blown. The six months we’ve spent building up their courage to have a guest over? Shot. Thanks a lot, helper.

People who hoard live and work among you, and they’ll be at the holiday parties. The lady in the lovely beaded suit, that guy you think might work in the accounting department, the couple who always sit two rows ahead of you at your place of worship … they might have hoarded homes. And your remarks cut them deeply. You think their homes are cluttered? Well, their minds are cluttered too—with YOUR garbage.

You wouldn’t stand around a party making loud fat jokes—even if you’re thinking it, chances are you know better than to say it. Add hoarding to your list of off-limits topics. If you can’t say something nice, stuff your mouth with hors d’oeuvres until the urge to judge passes. If someone else brings up the subject of hoarding, before you respond, realize that someone who hoards might hear what you’re about to say. How about “I agree it’s difficult to understand, but they deserve compassion like everyone else.” Your choice in this moment could make someone’s spirit sink … or sing.

 

Tomorrow We’re Taking Your Leg: Hoarding and Suicide

My heart is breaking for Spencer Harris as I imagine what this was like for him.

I have often said that forced hoarding cleanouts are the psychological equivalent of involuntary surgery. Many people who hoard view their belongings as an extension of themselves, as Mr. Harris did. He killed himself on May 17, about a week after a 24-hour eviction notice was enforced on him. He was given a day–one day–to get out.

The eviction notice was issued by an official described as “experienced in handling hoarding situations.”

News reports say Mr. Harris was given a temporary storage container in which to sort through his things and decide what to keep. In other words, an operatory in which to cut off his own leg, or arm, whichever he preferred.

They gave him a POD and a deadline. What he needed was a mental health professional and a psychologically realistic timeline. The introduction of a therapist truly “experienced in handling hoarding situations” and using the harm reduction approach would have greatly improved Mr. Harris’s chances of developing better insight and integrating needed changes into his life, which by friends’ accounts was vibrant and active.

24 hours to get gone. What must those 24 hours have been like for him? 24 hours of knowing that tomorrow, they’ll be at the door to separate you from a part of yourself. Facing that sentence, perhaps you would flee and get a few states away before they could do it. But if you hoard, you can’t carry all of yourself, all at one time. Paraphrasing Erma Bombeck, when you hoard you let your heart live outside your body, but people don’t get that. Erma was talking about children. How can anyone care that much about stuff? It’s just stuff.

And as long as the people in charge think it’s just stuff, there will be more tragic endings.

 

Can’t Get Ahead? This Might Be Why

People have basic needs–you know that. What you might not realize is that those needs must be fulfilled in a certain order. Abraham Maslow articulated this with his Hierarchy of Needs, which in its most basic form goes like this:

1. A person’s physiological needs for food, water, shelter, sleep, and freedom from extreme pain must be satisfied before s/he can give attention to:
2. Interpersonal safety, financial security, and bringing pain down to a livable level, all of which must be in place before s/he can have the energy to address:
3. The need for love and belonging, including the ability to do his or her part in a relationship. The ability to participate in relationships is essential for:
4. The need for esteem from others and self-esteem, which include being able to become competent at something (work, school, a talent) AND feel good about it.

All of the above are the basic human needs. Not privileges, not luxuries: needs. These are the needs articulated as the rights to “life, liberty, and the pursuit of happiness” in the U.S. Declaration of Independence. Only when these are satisfied can a person address the final, highest level need: Actualization, which in regular language means striving to be all you can be.

Right now Congress is dickering about money, as they so often do, and it’s come to the attention of my clients who receive Social Security that their payments might be affected by this debate. Now, on top of the issues they’re working on in counseling, they’re worried that their income might stop. Instead of spending our session time moving forward on problems in level 2, or 3, or even 4, they’ve plummeted back to Level 1: They’re afraid they’ll be homeless and hungry.

With a fear like that, all higher-level progress stops until it’s resolved. Clients who could have been two to four weeks further along in their growth spent that time plateaued at best, and some regressed.

Social Security income allows people to, at the very least, work on their level 2 challenges and hope to progress to level 3, 4, and ideally 5. For people on Social Security due to disability, that stable income allows them to concentrate on regaining their wellness. Cutting Social Security payments should not have been an option at all, and even if the debate is just posturing and they know in the end they will resolve it, that very debate process has done harm to the people whose incomes hang in the balance.

These folks have been forced to not only watch but participate in yet another installment of the soap opera we know so well: As the Legislature Turns. The actors–congresspeople who obviously have their level 1 and 2 needs met–put on expensive suits each day and perform their most ostentatious linguistic convolutions, disrupting their constituents’ pursuit of happiness while satisfying their own level 3 and 4 needs for love, belonging, and esteem. Meanwhile, their viewers–my clients and millions of others–languish in their level 1 hell until the ending is finally revealed.

So if you ever go through a period when you can’t seem to get ahead in life, get ahead of your troubles, make progress in counseling, make progress on a project, etc., have a look at Maslow’s hierarchy. It might be that you’re trying to, or being forced to, do things out of order.

 

Naked ADD

AD/HD, or just ADD as it’s often called by those who have it or treat it, is one of those conditions that causes people embarrassment or shame until they learn to accept it, work around it when necessary, and even find its hidden advantages. People with ADD learn, through often painful experience, to mask it when they’re among non-ADDers–to try not to fidget, interrupt, talk too much, talk too little, or forget things.

Tall order, and exhausting.

Which makes ADD-focused events such a treat. CHADD chapter meetings, annual events like the Michael Golds Memorial AD/HD Conference–these are places where it’s safe to let your ADD show, kind of like taking off your clothes at a nude beach. Nobody will point and laugh, or judge, or act superior, because everyone is equally, and voluntarily, exposed. When people who have it, treat it, or otherwise accept ADD get together in a group, the fun aspects can come out: spontaneity, flights of creative thought, exuberance, fresh ideas, witticisms … conversations that sound more like improvisational jazz than the orchestrated exchanges typical in the wider world. People don’t have to apologize or take offense for talking over each other; it’s not rudeness, it’s just ADD.

The normalizing, confidence-building parts come out too: Stories of things forgotten, things said and regretted, opportunities missed, feelings hurt … confessions that are most often met with “That’s happened to you TOO???” No one is “the only one” at these events. Then the stage is set for sharing ideas for managing the condition (tricks for being on time, getting your to-dos done, under-promising and over-delivering, deciding whether to use meds) and advocating for your needs and rights.

Over the past decade or so, there has been an increase in the number of adults diagnosed with ADD. Many of them come to suspect it when their children are diagnosed and they realize that they themselves had (and often still have) the same symptoms. The diagnosis can be life-changing: You see your entire life in a new light. Sometimes there is grief–”If only I had known this back then…”–and often there is relief, like the book title says: “You mean I’m not lazy, stupid, or crazy?” And there are many more great books and websites on the subject, offering the newly diagnosed adult a wealth of comforting perspective.

I help my clients with AD/HD to integrate this reality into their self-image, understand how their brains work, and find the organizational techniques that will best serve them as they learn how to manage its challenges without losing its creative and motivational blessings. Along with all of that, I encourage them to join their peer community–their neurochemical soulmates, you could say–and soak up some much-needed acceptance and support.

And since I do all of that, I get to share in the revelry at ADD events. As Katharine Graham said, “To love what you do and feel that it matters–how could anything be more fun?”

 

National PTSD Awareness Day

Today is National PTSD Awareness Day. Seems like everyone has heard the acronym “PTSD,” but do you really know what it is?

• Post-Traumatic Stress Disorder
• Caused by a (or more than one) traumatic event that generated intense fear, helplessness, or horror.
• In the news often in relation to veterans, but many civilians have it too.
• Occurs in about 8% of the general population and 10-30% of combat vets (varies by war). Chances are you know someone struggling, possibly undiagnosed, with PTSD.
• Common causes include any form of assault, victimization, disaster, or situation that put the person in fear for his or her life or someone else’s.
• Symptoms can mimic depression, other forms of anxiety, AD/HD, sleep disorders, learning disability or conduct disorder in children, and other physical and emotional conditions.
• Not a character flaw or weakness.
• Treatable.
• More info: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
• And more info: http://www.ptsd.va.gov/index.asp

 

Death and the Longest Day

Today, the summer solstice, was indeed the longest day for two friends: one who mourned the death of her son on what would have been his 19th birthday, the other whose husband’s funeral was yesterday.

The mother spent today bathed in the love of friends and family, marking a painful milestone: the first birthday, after the first Christmas and before the first anniversary, still six weeks out, of her boy’s death. This woman is fiercely loved and supported, and her strength shows in the writings she has produced while clawing her way through the morass of her grief.

The other friend spent today in Widow. It’s a place, not just a role … a reality she dreaded and now must occupy forever. His was not a so-called natural death; her lostness, and others’ helplessness to help her, are compounded by that.

What will Widow look like at the 10-month mark? Will she be the only resident? Or will she still have the attention of the people who, just last night, shuffled through the funeral home, ate chicken and pie at the wake, and held her while she sobbed, choked, begged and bargained, and didn’t get him back?

The mother has people around her who know, or have figured out, how to support her in her grief. Are there people like that in Widow? Did they spend today wondering what to say?

Rest in peace, Max and Dave. Live in peace, Pam and Carol. 

 

What do you think about the TV shows about hoarding?

I find most of them infuriating for their shaming, watch-the-train-wreck emphasis and deplorable lack of empathy for the people they profile. There have been a few isolated instances that weren’t all bad, for example the pilot episode of TLC’s Hoarding: Buried Alive, but overall the phenomenon of hoarding on television is an exploitative disaster. 

It’s important to recognize that television programs are meant to entertain. The producers, driven by their advertisers, want you to be glued to the screen for every episode, so they pack in drama, tension, conflict, and some sort of resolution to keep you interested. Unfortunately, entertainment and competent, ethical mental health treatment are largely incompatible–hence my fury.

What you see on most such shows is an unnecessarily and sometimes harmfully accelerated process with a fake deadline imposed to give the viewer a satisfying conclusion. Those of us who abide by ethical practice take issue with these shows for a number of reasons, including:

• The key ethical tenet of voluntary consent is violated when a person is compensated with cash or products for appearing on a show and again when items are discarded against his or her will, either through coercion or deception.
• Another serious ethical violation–client abandonment–occurs when the client is not provided with ongoing therapy after the filming. Simply suggesting “you should get therapy for this” on your way out the door does not constitute an adequate transfer of treatment.
• The top ethical directive of all healthcare codes of ethics–maintaining the client’s dignity and wellbeing–is continually trampled with the insulting, judgmental, dismissive remarks and eye-rolling, retching, gagging, and other nonverbal demonstrations of disgust that run rampant through most of these shows.

Bottom line: Real-life treatment by an ethical practitioner bears little resemblance to what you see on TV.