Just no. No.

You know, there are some things in life I just really struggle with.  For example, if someone tells me they are going to do something, I expect them to follow through.  If they don't follow through, it's a waste of everyone's time.  So naturally, after a few times of poor follow through, I make sure I let those people know I'm not going to engage in wasting time with them.  I'm a fairly patient person, so it takes a while before I get to that point.  While this issue of follow through bothers me immensely, I'm actually more fired up about something else at the moment.  I've been trying to determine how my annoyance with lack of follow through is connected to my current frustration with this piece about bipolar disorder.  I think the rub is a) simple disrespect, b) maybe it is about follow through after all.

In the case of the....ahem...article, I am so angry and annoyed that I'm physically upset.  My chest feels tight, my hands are freezing cold (something that only happens as a result of excitement/anticipation, or considerable anger), and blood is pounding through my veins.  In addition to this, I am almost at a lack of words for how I feel, a rare occurrence indeed.  So why all of this vitriol and emotional taxation?  

I believe it starts with the general tone of the piece; it is sensationalist, disrespectful, and generally negative.  I think I'm also incredibly pissed off that it is clearly an opinion piece masquerading as substantiated fact regarding mental health disorders (that it was originally published in Real Simple is further evidence of this).  I find it unconscionable that it is classified under Health and not opinion, that's low even for CNN.  I will say, I empathize with the author, having grown up in a home with a father who had(has) a diagnosis of Bipolar I, and who has gone off and on medication, as well as in and out of psychiatric institutes.  Also, I support the fact that she was empowered enough to leave the situation which she found threatening, unlike my own mother.  I can appreciate her efforts to find appropriate support and care for her (ex)husband.  However, her careless, dramatized narrative is sickening, and heartbreaking.  I believe the intention of this article was to be about the author's experience, however, it fails to make that point. 

Not only does the author (technically authors) portray individuals with a mental health diagnosis as dangerous, she uses pathologizing language, and quotes others using similar disrespectful language.  For example, her husband's "mind was the problem", because as you know, people with a diagnosis of a mental illness are broken and need to be fixed so they can be, as she put it "normal".  The author makes these comments and uses such language while making paltry attempts to say, "there isn't anything wrong with being mentally ill".  She cites her desire to make her daughter feel more comfortable by expressing, " I never want her to feel mental illness is something that should be hidden" but due to her husband's "erratic behavior", a poor euphemism for mental illness, they only see him once a year, and they "don't keep in touch."  This makes sense, as long as you bring it out once a year and play with it, you aren't hiding anything!  And of course, "there is no known cause, but a family history of the disease makes a person more likely to get it."  Makes a person more likely to "get" it?  I can't even go into the data side of that statement and the genetic heritability of something like Bipolar disorder, let alone stand by the irresponsible, if unintended, presentation of the diagnosis as a contagious disease. 

One of the other large issues I have with this piece is the quotes used by the author from a psychiatrist who heads a mental health center, which is supposed to provide specialized treatment to individuals with a diagnosis of Bipolar disorder.  The seeming utter lack of respect for individuals with a diagnosis of Bipolar disorder from this psychiatrist's quotes are appalling.  His use of the phrase "bipolar people" in describing an individual with the diagnosis is obscene.  Given that the entire article is written in such a way that mental illness is classified as solely a medical issue, this type of language becomes even more ridiculous.  For example, when was the last time we spoke of people who are managing a terminal illness such as cancer, "cancer people"?  Or people with broken appendages, "broken people" or "fractured people"?  Perhaps they just all fall under the umbrella of "sick people"?  It seems unlikely that anyone would allow their doctor or medical staff to refer to them by their illness; "As a cancer person, you might experience symptoms of nausea, headache, and death."  Or, "Yeah, the cancer in bed 5 is scheduled for surgery at 9am."  Take it to the logical conclusion.  If you ever have the need to seek mental health services, it is never, ever, ever, ever, ever, appropriate for whomever you may be working with to treat you as though your diagnosis defines you as a person.  You are not "Cancer", you have cancer.  Likewise, you are not "Bipolar", you have a diagnosis of Bipolar disorder.  Also, the fact that an "accurate" diagnosis can take between 10-20 years (*Proudfoot et al. (2009)) means it (any kind of diagnosis) should be treated with a special kind of tentativeness.

With all of the talk regarding "mental illness", there is no mention of "mental health".  I firmly believe they are not dichotomous concepts.  Instead of describing what a state of mental health would be for a person experiencing symptoms of Bipolar disorder, only their "bizarre ideas" and "erratic behavior" come up.  There is no compassion in this framework, and there is very little genuine hope highlighted either.  They author's damnation with faint praise for the "treatment" of such mental health concerns is quite apparent.  But, hey, it might allow people to live an almost "normal" life.  If you told the average individual who uses a wheelchair to supplement mobility they could have an almost "normal" life because of the wheelchair, it would be considered horribly offensive.  Why not just address them as gimp, or cripple?     

The last concern to be mentioned is the statement, "If you suspect that you or a loved one may have bipolar disorder, talk to your primary-care doctor about how to proceed."  Only if there is no other alternative should you consult a primary-care doctor first regarding any kind of mental health concern.  You would not go to the Dentist to get more information about or be treated for the measles.  There are specialties in the field of psychiatry and counseling for a reason.  A primary-care doctor may be able to provide a prescription or a referral, but medications should be monitored by a psychiatrist, and the combination of medication (when needed) and counseling is considered the most effective treatment available for mental health concerns.   

People with a mental health diagnosis, or those who are working to manage a mental illness, are not dying. Therefore, they should not be treated as though they are.  I am aware that the author likely experienced her husband's mental illness as a loss, the title is pretty much a giveaway.  However, we don't need to use the hushed tones and solemn phrasing found in funeral homes.  I would imagine this situation was terrifying for the author, and I certainly can't take issue with her experience.  I personally find it difficult to blame individuals with a mental health diagnosis for their mental health concerns, which I think this article actually does.  That, perhaps, is the most upsetting part for me.  Having paranoid delusions and being placed in and out of mental health facilities is not a life I would like to live.  I find it hard to accept that someone else who does live that way is enjoying it and intentionally engaging in such destructive living.  I would not add to that psychological and emotional pain, as a matter of fact, I've dedicated a large portion of my life to to reducing the pain, or making it bearable.  I would not expect the author to stay in the situation she faced, and it is unfortunate that she felt guilty for leaving her husband as he struggled with his mental health.  That is not my issue.  Aside from what has already been mentioned, my issue is the propagation of negative and harmful stereotypes about individuals with a mental health diagnosis, and the begrudging "hope" presented regarding such individuals "leading relatively normal lives."  I find it troubling that nowhere in the article is there a call to change the system we currently operate in that does not provide adequate care for mental health concerns.  For the sake of her daughter who is worried she might "get it [bipolar disorder] I would hope this author would be a strong advocate against stigma, against the continued discrimination and disrespect of individuals with mental health concerns, and for adequate, supportive care and understanding.  This applies to not only individuals experiencing mental health concerns, but the people in their lives.  Someone living with a person who has a mental health issue could potentially use support and understanding of their own, possibly even counseling.  This narrow, limited view of what "mental illness" is, without so much as a reference to mental health or wellness is problematic.

*Proudfoot, J.,  et al. (2009).  What happens after diagnosis? Understanding the experiences of patients with newly-diagnosed bipolar disorder.  Health Expectations, 12, 120-129.

[R]ABBA

 I'm working on writing something that highlights one of my most unusual quirks-- spontaneous and sometimes elaborate stories produced by my imagination regarding events in my daily life.  Serious daydreams.  Most recently it was an urban gladiator style match between two panhandlers standing on opposite sides of an exit ramp.  Who really wants this $20?  More on that later.

This morning, I've been working on data in R.  I've been listening to ABBA as I go along.  There may be some daydreaming as this happens too, often times in the form of me ripping my laptop in half with my bare hands.  Sometimes it's me having a stroke of genius, instead of feeling like I'm just having a stroke.  I think my choice of ABBA is a subconscious way of reminding myself I have options.  During the first year of my doctoral program, a Pink Squirrel Associate and I decided that we could always leave the doc program and start a successful disco group called Ex Post Facto.  It could still happen.  We would team up with other groups like Phi Hat and the Degrees of Freedom.

When it comes to using ABBA as a tool for motivation, I can't decide if watching them supports my drive to complete my program or makes me want to start collecting jumpsuits.  

Oh, R..."I have met my destiny in quite a similar way, the history book on the shelf is always repeating itself.  Watterloo- [R] I was defeated, you won the war.  Waterloo- [R] Promise to love you for ever more.  Waterloo- [R] Couldn't escape if I wanted to.  Waterloo- [R] Knowing my fate is to be with you.  Waterloo- Finally facing my Waterloo"

Only the Good...

Happy 

       birthday,

               Mom. 

                    

Eatapuss Tex: Political Comments

I spent nearly 8 hours yesterday utterly engrossed by the filibuster taking place in the Texas senate, lead by Senator Wendy Davis.  I was impressed on many levels.  I was also thoroughly disgusted at times as well.  If you happen to have 3 hours to spare, I highly recommend watching the last three hours of the special session once it is posted online.  If my experience of watching the Senate was anything like the experience of people who enjoy sports watching a game, I think I get their...intensity.

Any situation that involves moving to ask the previous question on a motion to ask the previous question regarding raising a motion on a motion on an appeal of a ruling on parliamentary procedure is, most simply, insane.  Did you follow all that?  Yeah, it took almost an hour for them to sort it out too.  Bureaucracy at its best.  It would put a Vogon to shame.  The Senate majority decided to change the rules to accommodate themselves in order to put it to rest. They still failed to pass the bill.

In addition to the genuine enjoyment I got from watching the interaction of the Senate members, the comments posted on the live feed were absolutely hilarious at times.  I managed to collect a few of the more entertaining or interesting ones.  I did not change the screen  names, and I should point out it was a continuous feed of comments, updated approximately 75 at a time so there was no way to really follow any one person.

Chuck Bee:
sometimes i wonder what my children will learn about history, and then i remember our books come from texas

• Everything is bigger in Texas, including the omissions, revisions, and lies.

Tess Devlin: 
I love that everyone who isn't doing something is running around trying to look like they're more important than they probably are.

• Isn't that the definition of politics?  Not doing anything while trying to look important while not doing anything...?

Jorge Cruz: 
If abortion = killing babies, if I kill a baby can I say i had an abortion?

• Stunning logic, I'm impressed.  My "this works in theory" hat is off to you, Jorge Cruz.  

JeffGannon:
I like the part of the bible where Jesus forced everyone to bend to his will.

• Or, like, when "God" commanded that his followers slay all men and then take the women and children and cattle of the dead for their own and wage war against those who sin.  That's real respect for life.  Kill the people you disagree with, and then take all their stuff.  It's not only the American way, it's the Christian way.

ou42football: 
If you could actually control your own vagina... YOU WOULDN'T NEED TO MURDER BABIES!!!

• I feel like this premise deserves air time as a CW show involving a superheroine who fights crime with a...tight*...control of her vagina.  Or maybe a porno (note: don't google 'superhero vagina porno' at work unless you are using someone else's computer).   
• Totally right!  When men don't control our vaginas and instead women in the US have appropriate levels of control (i.e. rights) over their reproductive organs with stuff like abortion, we aren't "murdering babies" because abortion isn't illegal and it doesn't involve babies at all!  Of course, we could just start having sex with more women instead of men, that would fix the issue too.
•   * For more mind-blowingly awesome Cheap Trick songs about sex, prostitution, suicide, murder, or drugs please listen to any and all of the four studio albums from 1977-1979.

David Vargas:
This reminds me of this Star Trek Manga where they met a Klingon that enjoyed what he called, 'the combat of words'.

• This one gets a mention simply because anyone who can work Star Trek, Manga, and Klingon into a topic relating to a) women's reproductive rights, and b) politics in general deserves to be recognized.  If he had managed to make reference to the Ferengi Rules of Acquisition (aka, the Conservative's Handbook of Life), I would have made him my subject line.

Indubitably, however, the BEST two comments were the following:

TheLatinoWhisperer:
HE SHOULD KNOW BETTER THEN TO TANGLE WITH AN OLD KNARLY VAGINA! :)

• I'm pretty sure Don't Tangle with an Old Knarly Vagina is the 14th chapter of The Art of War.

Eatapuss Tex:
Ever wonder in the morning why your toilet bowl's gone dry? Republicans sneak in at night and slurp out all the water.

• This is hands down the absolute winner of the night.  Not only for the actual comment, but for the screen name (I swear I didn't alter it, and I wish I could claim I thought of it).   

Click, Click...: A Preview

The cops were milling about the house, most of them doing their best to look useful.  One of them was inspecting the mantel, covered in various bits of kitsch and personal mementos.  The blood spatter on the faces of a small collection of antique alarm clocks was a stark contrast to the smiling faces in photos of family and friends that surrounded them.  The unmoving, dead hands of each clock behind the unnaturally stained glass were an ironic reflection of their owner.  

There was a faint buzz in the air; the stereo was on, a record endlessly spinning on the platter.  The tonearm was patiently waiting in the last groove, hissing and popping.  A glance at the label would have told me April hadn't lost her sense of humor, side 2 of The Sounds of Silence.  Someone bumped the record player, managing to capture the attention of the whole house.  The needle skipped across the vinyl in a screech.  When it finally landed, Paul Simon lamented, "...s read: 'Richard Cory went home last night and put a bullet through his head..."   

I suppose it was a somewhat common scene for most of them.  A body, a gun, blood pooling as it flowed from what remained of a human head.  They were asking questions.  I wasn't in a place to give them direct answers.  I can't say if I was more shocked by the violent death or the fact that she actually succeeded.  Well, maybe it wasn't that shocking; April often found a way to make things work the way she wanted them to.  Her ingenuity and enterprising nature were two of her more dubious core strengths.  April's recent actions, however, lacked her general tactful, subtlety.  Then again, death may not have been her ultimate goal.  I can only imagine that her intended outcome was something beyond putting a 9mm round through her frontal lobe...     

        

I have a folder on my computer labeled "Premise Beach".  I have four stories outlined.  The last one reads:

Story Premise:

Grad student in Counseling Psychology fancies herself an actual writer in order to avoid writing her pre-dissertation.

It's a wacky premise.

Collector or Collected?

Counseling: Sunlight on Water

Myths about what happens in counseling abound, and are sadly inaccurate.  Like many processes, counseling loses its essence when reduced to individual steps in an attempt to convey its mechanics.  I don't read minds, although I am good at asking people in many different ways to read their own.  I don't tell clients what to do.  I don't "fix" people.  I don't give advice.  I don't provide absolution.  I don't give false hope.  I don't analyze people like they are a science project.  I don't play games.  I don't give you a label and send you on your way.  I don't tell clients what they want to hear, and sometimes I tell them things they very much do not want to hear, but I try to do it when they are ready to at least try.  More often and even better, clients end up telling themselves, I just provide the space.

My professional identity is founded on the notion that I am something akin to a purveyor of opportunity. When clients come for counseling, I see that as an opportunity (and a privilege for all involved). Some people do not have access to the opportunity that therapy provides, for example it is beyond their financial range perhaps or maybe they are simply not interested in it. However, when a person seizes the opportunity, I provide them with more. The client may not know where to go, or rather, they do not believe they know. I do not show him or her the path, I reflect many paths and illuminate different things. I do this by using the information he or she provides and the knowledge we develop together; the client chooses the avenue we explore. I envision therapy as being sunlight on water. Not the sun itself or the water but the interaction of the two. The sunlight warms the water, illuminates it, reflects upon it but remains stable while the water moves and flows. I also believe that therapy is more about growth or promoting growth than anything else. This frame helps respect the process of therapy and the work a client does.

The second layer of my professional foundation is the concept that therapy is most effective when there is a convergence of person, place, and time. I call this the "Confluence Theory of Counseling". This incorporates a person’s willingness to change, which stage of change he or she may be in, the therapeutic match between client and counselor, and a client’s life events and external factors among other things. I believe that growth can happen when these factors are misaligned but it is most effective when they meet. Given my clinical experience working with involuntary clients, I would say that sometimes the convergence takes place after a therapeutic relationship is established.

This layer of foundation is also mixed with my belief that everyone can grow. While everyone can grow, not everyone takes/can take advantage of the opportunity to grow. The reason a person might not grow at a certain time is because he or she has not experienced an overlap of factors yet. In addition to the belief that everyone can grow, I firmly believe that everyone deserves an opportunity to work toward mental health and growth. Inviting clients to grow by offering them an opportunity to share in a safe space is my short definition of counseling.  One of the other core beliefs I have regarding counseling is that mental health and mental illness are not dichotomous with each other.  It is entirely possible not to have a diagnosable  "mental illness" and still have poor mental health.  Conversely, it is completely possible to have a diagnosed "mental illness" and have impeccable mental health.  Just as physical health is comprised of a more global, general wellness, so is mental health.  The failure to recognize this distinction is one of the most limiting and harmful misconceptions about counseling and mental health.  

The two pieces of my foundation were distilled from reflection and experience. It was my work with sex offenders that prompted me to think about the necessity of a convergence of person, place, and time. Some of them take to therapy well, utilize it as much as they can and make an effort to grow. Conversely, some are cognizant of the fact that they need to change their lives and one way of doing that is through treatment but they resist it. It might be that they are in the right place geographically/physically (a treatment facility) and the right time developmentally but there is a personal reason that is keeping them from fully engaging. For individuals still imprisoned, they might be in the right place personally but the space and time are not conducive to growth. There are multiple possible combinations, and I have seen many of them.

I have found that almost everything that people come to counseling for, and one of the largest controllable factors that stops people from seeking counseling, is fear. Fear of failure, fear of exposure, fear of betrayal, fear of relationships, fear of confirmation (aka fear of rejection). The fear of confirmation is a more accurate descriptor of why rejection is painful, I think. When we are rejected, it confirms all of the insecurities and negative perceptions we hold about ourselves. A rejection confirms that we are stupid, unattractive, not good enough, damaged, unequal, inferior, a terrible person...crazy, weak etc.  One of the really nice things about counseling is that a person gets to explore these concepts and decide which ones are actually worth paying attention to.

It is important to note that while I strongly believe everyone can benefit from counseling, sometimes that benefit comes at an initially painful and challenging price that some people cannot move past.  In short, sometimes people feel worse in counseling before they start to feel better.  As a client typically has full decision making power over continuing in counseling, sometimes they stop before coming to the other side of distress.  We have psychological defenses for reasons.  If they are not examined carefully, with respect to the protection they provide, harm is possible.  To undergird the removal or restructuring of the defenses is an integral part of what a counselor does in session.  These concerns are also a large part of why Counseling Psychology has a code of ethics, and a central ethical duty of Psychologists is gatekeeping.

It can be intimidating and uncomfortable for many people to recognize the responsibility and power they have over their functioning. Many people fail to make this distinction regarding counseling. Counseling is not for the benefit of the therapist. Sometimes in an effort to "best" the therapist, some people manage to outwit themselves in counseling, not realizing that by being guarded and indirect they are only impeding their own progress. Someone with a cracked tooth would be ill-advised to visit the dentist and provide inaccurate information about their situation. A lack of openness with their dentist would likely result in a lower quality of care, and a lower quality of life as a result. It is no different with counseling. The most effective way of sabotaging the positive effects of counseling is by not engaging openly, or by being a less genuine form of oneself. Therapists don't "fix" people, a) because someone seeking counseling is not "broken", ever, and b) it's the client who makes or breaks the growth process.  Counselors attend to the client's empowerment, and their willingness to make changes.  Ethically, if someone seeks counseling but remains resistant to the process, a frank, and often powerful, discussion about reconsidering counseling at a different time in life should happen.

One of the most integral realizations from my professional life that has impacted my conceptualization of counseling is what function a therapist serves. Each practitioner has their own style, and theoretical orientation.  However, it has been my experience that people working in mental health are frequently labeled “helping professionals.” This is problematic for me in many ways, although I appreciate that the label is not meant to be, and is instead supposed to be representative of something positive. In my professional perspective, I am not a helper. Helper implies that someone is unable to do something and that he or she must have assistance. It also means that there is something fundamentally wrong that must be rectified; a helper helps the person fix him or herself. I also feel that “helper” debases the therapeutic relationship, i.e. it does not respect the profound nature of people connecting in such a way. For me it is a partnership and there is tremendous work, most of which is done by the client. To say that it is “helping” discounts that perspective. I am also not a guide necessarily, it is not my journey although I am a part of it. How could I guide someone on their path? It is not about me guiding them, it is about opportunity.