How to take a confusing topic (racial identity) and write about it in a way that validates Black and Brown readers, but that also engages white readerHow to take a confusing topic (racial identity) and write about it in a way that validates Black and Brown readers, but that also engages white readers? I'm not sure that this is the only way, but Beverly Daniel Tatum does so with healthy helpings of research and theory; frequent quotations from research participants, memoirs, and articles; and heaping doses of compassion and empathy. Clearly there are problems, but Tatum does not spend her time pointing her finger; she also does not refuse to hold (frequently white) people's toes to the fire. This is a balancing act, yet she does this balancing well (and whites reading this as a first foray into learning about race will likely respond with defensiveness). As she quotes James Baldwin, “Not everything that is faced can be changed. But nothing can be changed until it is faced.”
And, it's these quotes and others that I'm drawn to as I write this review:
"(N)o matter what we do, how successful we are, what friends we make, we don’t belong. We’re foreign. We’re not American." – Michael Luo
“I was taught to recognize racism only in individual acts of meanness by members of my group, never in invisible systems conferring unsought racial dominance on my group from birth.” – Peggy McIntosh
“To deny race and ignore the existence of racism actually causes harm to people of color because it a) falsely perpetuates the myth of equal access and opportunity, b) blames people of color for their lot in life, and c) allows Whites to live their lives in ignorance, naiveté, and innocence.” – Neville, Gallardo, & Sue, 2016
“Are you saying all Whites are racist?” When asked this question, … I am conscious that perhaps the question I am really being asked is, “Are you saying all Whites are bad people?” The answer to that question is of course not. However, all White people, intentionally or unintentionally, do benefit from racism. A more relevant question is, “What are White people as individuals doing to interrupt racism?” (Tatum, 2017, p. 115).
I particularly like Tatum's chapter on preschoolers' growing racial identity and how to support it in positive ways. In talking to her four-year-old son about slavery, a conversation she hadn't expected to have at that point, she reported simultaneously trying to achieve three goals:
(1) I didn’t want to frighten this four-year-old, who might worry that these things would happen to him (another characteristic of four-year-old thinking); (2) I wanted him to know that his African ancestors were not just passive victims but had found ways to resist their victimization; and (3) I did not want him to think that all White people were bad. It is possible to have White allies. (p. 147).
I heard Tatum talk about these ideas shortly after the first edition of her book was published. I don't know why it has taken me so long to read her book. I'm glad I did. ...more
I read nonfiction regularly, but I am more likely to "gulp" mysteries and fantasies than nonfiction. I gobbled Cris Beam's To the End of June: The IntI read nonfiction regularly, but I am more likely to "gulp" mysteries and fantasies than nonfiction. I gobbled Cris Beam's To the End of June: The Intimate Life of American Foster Care. She compellingly and insightfully combined case studies, statistics, and theory about foster care, especially about teenagers in foster care.
Beam concluded that we both are failing at foster care (e.g., no state meets more than two of seven federal criteria for successful care), and that our failures have long-term consequences for these children and teens in terms of increased homelessness, low rates of college attendance, poor relationships, increased crime, and problems getting and holding jobs.
To be clear, our failures don't just affect these children and teens, they affect the US society and economy.
The cause? As Beam concludes, "Is the root problem there one of poverty, inequitable opportunities, institutionalized racism, or one giant pileup of minor discriminations? Again, the answer is yes, yes, yes, and yes" (p. 63).
Nonetheless, there is no easy solution.
If poverty and its attendant burdens— depression, anxiety, drug use, heightened community violence, paucity of support systems, and so on— can sow the seeds for child abuse, then child welfare needs to go back to prevention. But this is a tall order for one sprawling and splintered administration, which has always been reactionary: it treats symptoms, not disease. The solution, as it has always been, is bigger than foster care, bigger than abuse; the real solution will be rooted in society as a whole. (pp. 63-64)
While the ultimate cause is unclear and it remains uncertain why so many children, especially why so many African American children, are being removed from their homes, one problem is clear and can be addressed: "each move means another ruptured attachment, another break in trust, another experience of being unwanted or unloved" (pp. 89-90). As Beam concludes, too many children are traumatized by being in foster care, which focuses more on housing than attachment. Further, because the system focuses more on housing and often has foster parents who are unprepared to deal with traumatized children, foster children hit 18 (or 21) unprepared for the adult world. (My own daughter's foster parents were wonderful, but should have been allowed to adopt her rather than having her given to us.)
I wish the quality of the research available on foster children and their birth, foster, and adoptive parents was better. Beam outlines interesting observations and some useful hypotheses, but it is not clear that there is good, controlled research available.
As an aside, there were several places where Beam misused psychological terms (e.g., referring to Erik Erikson as a social psychologist). A small complaint about an otherwise beautiful book.
Merged review:
I read nonfiction regularly, but I am more likely to "gulp" mysteries and fantasies than nonfiction. I gobbled Cris Beam's To the End of June: The Intimate Life of American Foster Care. She compellingly and insightfully combined case studies, statistics, and theory about foster care, especially about teenagers in foster care.
Beam concluded that we both are failing at foster care (e.g., no state meets more than two of seven federal criteria for successful care), and that our failures have long-term consequences for these children and teens in terms of increased homelessness, low rates of college attendance, poor relationships, increased crime, and problems getting and holding jobs.
To be clear, our failures don't just affect these children and teens, they affect the US society and economy.
The cause? As Beam concludes, "Is the root problem there one of poverty, inequitable opportunities, institutionalized racism, or one giant pileup of minor discriminations? Again, the answer is yes, yes, yes, and yes" (p. 63).
Nonetheless, there is no easy solution.
If poverty and its attendant burdens— depression, anxiety, drug use, heightened community violence, paucity of support systems, and so on— can sow the seeds for child abuse, then child welfare needs to go back to prevention. But this is a tall order for one sprawling and splintered administration, which has always been reactionary: it treats symptoms, not disease. The solution, as it has always been, is bigger than foster care, bigger than abuse; the real solution will be rooted in society as a whole. (pp. 63-64)
While the ultimate cause is unclear and it remains uncertain why so many children, especially why so many African American children, are being removed from their homes, one problem is clear and can be addressed: "each move means another ruptured attachment, another break in trust, another experience of being unwanted or unloved" (pp. 89-90). As Beam concludes, too many children are traumatized by being in foster care, which focuses more on housing than attachment. Further, because the system focuses more on housing and often has foster parents who are unprepared to deal with traumatized children, foster children hit 18 (or 21) unprepared for the adult world. (My own daughter's foster parents were wonderful, but should have been allowed to adopt her rather than having her given to us.)
I wish the quality of the research available on foster children and their birth, foster, and adoptive parents was better. Beam outlines interesting observations and some useful hypotheses, but it is not clear that there is good, controlled research available.
As an aside, there were several places where Beam misused psychological terms (e.g., referring to Erik Erikson as a social psychologist). A small complaint about an otherwise beautiful book....more
My name is Patric Gagne and I am a sociopath. I am a passionate mother and wife. I am an engaging therapist. I am extremely charming and well-liked. IMy name is Patric Gagne and I am a sociopath. I am a passionate mother and wife. I am an engaging therapist. I am extremely charming and well-liked. I have lots of friends. I am a member of a country club. I throw parties for every occasion you can imagine. I live in a nice house. I am a writer. I like to cook. I vote. I make people laugh. I have a dog and a cat, and I wait in carpool lines next to other women with dogs and cats.
This surface image conflicts with Gagne's self-perception and overt behaviors:
I’m a liar. I’m a thief. I’m emotionally shallow. I’m mostly immune to remorse and guilt. I’m highly manipulative. I don’t care what other people think. I’m not interested in morals. I’m not interested, period. Rules do not factor into my decision-making. I’m capable of almost anything. (p. XIII)
This conflict between self-perception and perceptions by others is one factor that can make any diagnosis difficult, mental or physical, even if the person is willing to disclose what is going on.
Gagne talks about her behavior in behavioral terms, both as her behavior eradicates pressures to behave violently (negative reinforcement) but is also as reinforced by a deep sense of peace (positive reinforcement).
For weeks I’d been engaging in all manner of subversive behavior to make the pressure disappear and none of it had worked. But now—with that one violent act—all traces of pressure were eradicated. Not just gone but replaced by a deep sense of peace. It was like I’d discovered a fast track to tranquility, one that was equal parts efficacy and madness. (pp. 21-22)
Gagne initially saw her sociopathic tendencies as something to struggle against (to get other things she wants, including acceptance), but another way of understanding her is that she and her mother pathologized normal behaviors (small children lie and steal), but if her parents' lives and marriage had been better under control, they would have been able to accept her and redirect or socialize her behavior more effectively, as her mother did when Gagne was very young. Because her mother was struggling, she was unable to focus on her daughter's needs as well as she might otherwise have done; she allowed Gagne to unquestioningly accept the sociopathic label and provided little guidance to counter its effects. Acceptance from others and self-acceptance were central to her ability to change.
Gagne brings up a range of interesting perspectives about noncriminal sociopathy, which she sees as on a spectrum rather than a binary, but her overreliance on dialogue to tell her story and her initial unwillingness to explore multiple perspectives for her behavior – she seems to have favorite ways of looking at herself and avoids others in this narrative (as we all do) – make this less satisfying for me than it could have been.
Gagne's (2020) Modern Love column in the New York Times, which led to her contract for this book.
Making of a Therapist is a short, practical, nonjudgmental book, useful for beginning and more advanced therapists. Louis Cozalino is a psychodynamicaMaking of a Therapist is a short, practical, nonjudgmental book, useful for beginning and more advanced therapists. Louis Cozalino is a psychodynamically-oriented therapist, so talked frequently about transference and countertransference (our clients' reactions to us and ours to them that are not reality-based, but that stem from prior history with significant people in our lives). He also talked about resistance, our often-unconscious unwillingness to pursue therapeutic tasks.
Making of a Therapist is a pragmatic book and an optimistic one. Cozalino believes in change, even when clients and their therapists don't (yet). His ideas were illustrated by frequent case examples, often ones where clients, supervisees, or he felt stuck and unable to use therapy effectively.
I listened to Making of a Therapist on audiobook. I liked the narrator's voice but didn't like his reading. Especially in the beginning, he did not use pauses effectively. It was hard for me to hear headings and paragraphs, which then meant that I spent time getting reoriented rather than following Cozalino's narratives....more
Nunchi is a book for the socially clueless, offering guidance for handling difficult situations based on Korean wisdom. It's also a book for the rest Nunchi is a book for the socially clueless, offering guidance for handling difficult situations based on Korean wisdom. It's also a book for the rest of us, reminding us on how to read social situations better. Her description of Nunchi rules: First, empty your mind; lose preconceptions to observe with discernment. Second, manners exist for a reason. Third, be nimble and quick, while never passing a good opportunity to shut up. Most questions will be answered without ever being asked. Obviously, these are rules that many of us (with good nunchi?) follow habitually, but that all can profit from.
I listened to Nunci, a good choice while performing other tasks (e.g., easily followed even while paying attention to the road). Unfortunately, although the narrator has a pleasant and clear reading voice, she could have been reading a catalogue, reducing my listening pleasure and leaving me wondering who has the extraordinarily poor nunchi she describes. ...more
Knapp and Fingerhut's text is their fourth edition. I've used three of these with my students, who have consistently commented that they like it (highKnapp and Fingerhut's text is their fourth edition. I've used three of these with my students, who have consistently commented that they like it (high praise from students). This is especially high praise, as I have colleagues who use it with doctoral students – and I enjoyed reading/rereading it.
Why do I like Practical Ethics so much? They talk not just about what we shouldn't do (the floor), but focus also on what we want to do, who we want to be as psychologists (the ceiling). Their text is liberally peppered with helpful case examples. As they discuss these cases, mostly drawn from psychotherapy, they often observe, "It depends" (a very important question when making ethical decisions). And, they are kind and compassionate as they discuss ethical errors. For example, as they discuss Zimbardo's and Milgram's research – often used to talk about ethical lapses – they graciously recognize both researchers' best intentions while suggesting other questions that could have been asked. I also like Knapp's ethical acculturation model, their discussions of boundaries, of competency and, new to this edition, their focus on social justice.
I've known both Sam Knapp and Randy Fingerhut for years and have worked closely with Sam at various points (as have half of the psychologists in my state). The thoughtfulness, compassion, and the clarity of their writing is no surprise....more
I've read many memoirs, especially mental illness-focused memoirs, so I probably set a moderately high bar when I read them. For the first part of AccI've read many memoirs, especially mental illness-focused memoirs, so I probably set a moderately high bar when I read them. For the first part of Acceptance I was less than enamored (I've heard this before); however, her last chapter, especially, was insightful, incisive, and raised important points that we all should hear. If you are limited on time, go straight to that chapter. (My students will read this chapter in the Fall.)
In short, Emi Nietfeld described anorexia, Adderall addiction, and self-injury; she was hospitalized, placed in a long-term treatment facility, then an overly rigid foster home, and experienced periods of homelessness, sometimes choosing dangerous living situations when she didn't have other options.
When you read my last paragraph, you might think that Emi was a piece of work, but this paragraph focused on her rather than her context. Her mother was charming, bright, and a hoarder. She dismissed Emi's concerns, often letting adults in the mental health system believe that Emi was the problem, when there were only narrow pathways through the house that smelled of mouse pee. Emi's bed was often either covered in her mother's purchases or a friend of her mother's was sleeping there. Her other parent transitioned to female when Emi was 10, then blamed Emi for abandoning her.
I had this amorphous sense of being abandoned by Michelle, but now I was learning that she felt I had abandoned her. I knew it wasn’t exactly true—I had been ten years old at the time—but what did that matter? For both of my parents, emotions created their own reality. It was up to me, as their child, to assimilate their points of view, even when they contradicted what I considered facts. (pp. 178-179)
As near as I can tell, Emi ran into the most un-child-centered workers in the country. They accepted her mother's reports and charm, while denying Emi's experiences. Emi's reports are cringe-worthy, but important to listen to. Such people are still in the field.
Emi was accepted into Harvard – despite an idiosyncratic educational career – and received multiple awards, including the Horatio Alger, named after the novelist whose characters succeeded over adversity because of their virtue. Unfortunately, "while they lauded us for overcoming tremendous obstacles, there was no sense that those obstacles were unjust." That some people succeed despite such adversity – are resilient – is "evidence that no one needed a social safety net—because we had made it out" (p. 237).
Although some people do succeed, the narrative of resilience is sometimes used to suggest that people can survive and thrive even significant adversity without being affected. We may gain important gifts (e.g., empathy, appreciation for life, personal strengths), but we are not rubber bands, stretched beyond capacity and returning to normal. As she noted, "The whole song and dance of resilience chipped away at my humanity. It required a profound lack of empathy. It erased any pain, no matter how great, as long as it resulted in productivity" (p. 347).
Such as narrative is fundamentally conditional, judgmental, and destructive....more
Adam Frankel is an Obama speechwriter, an adored grandchild of Holocaust survivors, and sister-in-law to the wonderful Jen Psaki. He is also the only Adam Frankel is an Obama speechwriter, an adored grandchild of Holocaust survivors, and sister-in-law to the wonderful Jen Psaki. He is also the only son of an adoring, often neglectful, often emotionally abusive mother. Even when she was a young child, she would lock herself in her room for hours (crying), while he did not know she was there. She was unreasonably demanding and self-centered (he argues she might be diagnosed with Borderline Personality Disorder), yet she was also charming, intelligent, and socially-minded.
Frankel is interested not just in describing his family's lives but making connections between one generation and the next. He sees himself affected by his grandparents' lives, in an arguably epigenetic thread: that the stress they experienced turned genes on or off to adapt their descendants to the traumatic environment they experienced.
In reading Maus, for example, the relationship between Art Spiegelman's father's camp experiences and his irritability, relationship difficulties, and miserly behaviors was easily identified. Reading The Survivors, we can also draw a straight line between his grandparents' concentration camp experiences and their strengths (and weaknesses) as older adults. We can draw a clear line between Frankel's mother's behavior (she could arguably be diagnosed with Major Depressive Disorder and Borderline Personality Disorder, based on the stories shared here) and his own mental health struggles. The connections between his grandparents' Holocaust concentration camp experiences and his mother's depression, suicidality, and emotional instability are less clear to me, which may just be that her story was told secondhand and without the information that would help her be understood.
I always wonder about how memoirists handle writing about family and friends. In Frankel's case, some family members were supportive, some not, but he talked to them about this.
I thought about how my family saw things, their belief, spoken and unspoken, that I should just move on, that, as Linda put it, I only had one mom, and that was all that mattered. But I often felt like her behavior was forcing me to choose between her and Steph, between her and our daughter, between her happiness and my own. (p. 218)
This is the second memoir I've read this week where the author reports both a history of maternal emotional abuse and feeling betrayed because they had not known that their father was not their birthfather. (The other was I'm Glad My Mom Died.)
My students have encouraged me to read I'm Glad My Mom Died – I have a memoir assignment in several classes. I've resisted because I had no clue who JMy students have encouraged me to read I'm Glad My Mom Died – I have a memoir assignment in several classes. I've resisted because I had no clue who Jennette McCurdy is, but also because I share a Kindle account with my mom and the title seems inappropriate when I'm sharing.
I understand why my students like this book – a childhood hero, accessible, easily identified diagnoses. She (deep) dishes on her mother who had poor boundaries (showering her daughter and washing her hair in the shower until she was 17, doing breast and vaginal exams when she was showering her and Jennette's older brother together, teaching her how to restrict calories so she would continue to look younger than her true age, etc.). She (and her own mother) was the model for an inappropriate and enmeshed mother. Jennette was parentified; dismissed her own values, goals, and emotions; and profoundly pulled between her own needs and her mother's. When her mother was in a coma and dying, she attempted to bring her mother out of her coma by saying, "Mommy, I am... so skinny right now. I'm finally down to 89 pounds."
I'm in the ICU with my dying mother, and the thing that I'm sure will get her to wake up, is the fact that in the days since mom has been hospitalized, my fear and sadness have morphed into the perfect anorexia motivation cocktail, and finally I have achieved mom's current goal weight for me: 89 pounds.
I listened to this book while traveling. I would have preferred to read this rather than listen, as her voice was very rapid and annoyed me.
As one GR friend said, "I will never again look at child actors, stage moms, or Nickelodeon the same way." Ugh....more
I love the ideas central to Adverse and Protective Childhood Experiences: that adverse childhood experiences (e.g., neglect, abuse, and being raised iI love the ideas central to Adverse and Protective Childhood Experiences: that adverse childhood experiences (e.g., neglect, abuse, and being raised in a home with domestic violence or a mentally ill or substance abusing parent) puts a child at risk of poor behavioral and physical health outcomes. Conversely, that a series of protective childhood experiences (e.g., experiencing unconditional love, having a best friend, volunteering in the community, and being part of an organized group) can buffer a child against these negative outcomes. Jennifer Hays-Grudo and Amanda Sheffield Morris clearly summarize the research on these issues, as well as the community and family interventions that can buffer children and help them become resilient.
Despite this, I was often frustrated by Adverse and Protective Childhood Experiences. Clearly, Hays-Grudo and Sheffield Morris want their book to be readable and accessible to a larger audience: they want it to be both wonky and practical. They share Robert Anda's conviction "that communities can become 'self-healing' if those of us who study adverse childhood experiences (ACEs) and those of us who have experienced ACEs talk with and listen to each other" (p. 163). They use examples and share a series of Anda's reflection questions to move the narrative in a more accessible direction.
Ultimately, though, I wonder whether they miss the mark in their storytelling. It seems to me that this reframing of children's "misbehavior" and poor health is so radical from the usual story told that one cannot be too speedy in laying out this new argument, as they were here.
At least, that's what I've been thinking, while preparing to teach a course on childhood trauma. ...more
Dear Scarlet is a sweet and honest graphic memoir of a Chinese Canadian's experience with post-partum depression, a useful read for a person experiencDear Scarlet is a sweet and honest graphic memoir of a Chinese Canadian's experience with post-partum depression, a useful read for a person experiencing it, her friends and family, or as in Teresa Wong's case, her children (when adults). She described both things that helped her (e.g., psychoeducation, medication, psychotherapy, and nonjudgmental support) and that were unhelpful (e.g., criticism, from herself or others). [image] I would have liked to have learned more about who Wong was, as in both her text and simple drawings she treats herself almost entirely as a baby-making machine and inadequate parent. But perhaps that was Wong's point: life became small after Scarlet was born, and she had a difficult time seeing herself outside of a very narrow, inadequately fitting role. [image]...more
No one likes to feel unwell, and everyone wants to be believed, especially when we are suffering.
Doctors like to work with patients who can be cured rNo one likes to feel unwell, and everyone wants to be believed, especially when we are suffering.
Doctors like to work with patients who can be cured rather than those with symptoms that can only be managed; yet, there is much that medicine does not yet know, especially about autoimmune illnesses.
Megan O'Rourke detailed her search for health, including many negative tests, some wacky treatments, and detailed analyses of some new empirically-supported treatments (e.g., fecal transplants). She described the impact of her search for health on her pocketbook, on the amount she was able to work, and her husband and their marriage.
In general, O'Rourke is hopeful about medicine but believes it has fallen far short of what it is capable of accomplishing. In particular, her experience was that it was difficult to get seen, to have doctors share medical records, and to work together. She believed her physicians tended to focus on organs rather than systems and did not emphasize whole health to the degree that they should have (e.g., diet, sleep, stress, exercise).
O'Rourke tended to dismiss the role of psychologists, as she heard this as dismissing her experience – it's all in your head. Some of the more integrative work that she wanted she might have found by going to a health psychologist, in or outside of a medical practice.
I really liked hearing O'Rourke's experience as patient. I've read several medical memoirs, each useful in this respect. I worry that The Invisible Kingdom (sometimes) seems to endorse unsupported alternative treatments and contribute to the anti-science views that are easily found in a quick internet search.
Of course, O'Rourke would argue that her descriptions of her trips down these rabbit holes illuminate how willing someone feeling unwell may be to try anything to feel better....more
There are numerous memoirs of mental illness and more biographies of true crime. What makes The Best Minds stand out is that Jonathon Rosen wrote as MThere are numerous memoirs of mental illness and more biographies of true crime. What makes The Best Minds stand out is that Jonathon Rosen wrote as Michael Laudor’s childhood best friend: a friend who admired Laudor’s vast intellect, amazing memory, charisma, and ease of solving, resolving intellectual problems. He also observed, albeit at a greater distance, Laudor’s first psychotic break, his time at Yale Law School, and his subsequent decline in less supportive circumstances.
At some points, especially at the beginning of The Best Minds, the detail and name-dropping felt excessive. Yes, they were from a privileged area, although not as wealthy as many of the other citizens of New Rochelle, NY. Laudor’s intellect, charm, and connections bought him many advantages, including this 1995 profile in the New York Times, which gave him many opportunities to advocate for the mentally ill.
One of the things you gain from Rosen’s narrative is a detailed (overly detailed?) description of the sociopolitical circumstances surrounding his life and the shortfalls of mental health care. Many of these descriptions are useful, as when he was encouraged to cashier at Macy’s following his release from his first hospitalization – a man who chose to go to Yale Law instead. Laudor complained about this, but Rosen did not consider the downside of either option or better alternatives. There are no easy solutions for very bright and capable people for whom stress puts them at risk.
Laudor and others who have serious mental illnesses are less likely to be violent than to become the victims of violence, yet one cannot help but feel for Carolyn Costello and her family. His right to choose and refuse treatment cost her life and their unborn child. It also cost him his freedom for 25+ years, as he remains hospitalized in Mid-Hudson Forensic Psychotherapy Center in New Hampton, NY....more
What might learning problems, ADHD, asthma, obesity, and cardiovascular disease have in common. Nadine Burke Harris, building on Fellitti et al. (1998What might learning problems, ADHD, asthma, obesity, and cardiovascular disease have in common. Nadine Burke Harris, building on Fellitti et al. (1998), notes that these superficially unrelated physical and psychological problems are related to a series of Adverse Childhood Experiences (e.g., child abuse and neglect; having a parent in prison, with a psychiatric disorder or abusing substances; domestic violence or divorcing parents).
[image] Problems associated with adverse childhood experiences (ACE). Source:advokids
Burke Harris argues that there should be universal screening for ACEs, as this would allow us to make effective diagnoses (that "ADHD" is, instead, a trauma response). It would also enable us to intervene effectively:
1. Reduce trauma 2. Strengthen the caregiver's ability to be a healthy buffer 3. Teach strategies that can "reset" the stress response and heal a person (sleep, exercise, mindfulness, healthy relationships, challenge irrational thinking, etc.)
"You shift the frame, you change the lens, and all at once the world is revealed, and nothing is the same" (p. 212).
Take the ACE quiz. Adversity transcends race, class, gender, and country....more
"Learning to live with—and sometimes love—one’s monsters while not letting them rule" us, is Sarah Rose Cavanagh's goal with Mind over Monsters (p. 22"Learning to live with—and sometimes love—one’s monsters while not letting them rule" us, is Sarah Rose Cavanagh's goal with Mind over Monsters (p. 226). Although she wrote for faculty working with high school and college students, her observations and suggestions are equally useful for other people working with students in this age group and for other people struggling with anxiety and depression.
Mind over Monsters presents a wider range of suggestions for preventing anxiety from ruling us than I had expected, especially as she did not explicitly discuss challenging automatic thoughts – at least in the ways that a clinical psychologist would do. She used psychological research, interviews with students and experts in the field, and her personal experiences (she has had panic attacks and periods of selective mutism) to describe a nuanced way to handle anxiety successfully and handle high school college well. Bottom line, she recommends compassionate challenge, with equal emphasis on both compassion and challenge and makes a compelling case for this approach to teaching (or working with this age group).
Among many other things, Cavanagh discussed going toward achievable tasks rather than avoiding them, matching anxiety to the task, recognizing that not all anxiety is a monster, supporting physical health and safety, learning to accept that some discomfort is normal (and health-guiding), and creating warm and safe environments (not cushioning). Adults need to create challenging but achievable environments, where students can succeed with appropriate work. She argued that "accommodating the student’s anxiety permanently also communicates that the anxiety is a core feature of the person, that it isn’t malleable or subject to change" (p. 51). Instead, we should be communicating, "I think you’re amazing. I think you are so smart, and so strong. Let’s do this together. I am here to support you” (p. 115).
I enjoyed Mind over Monsters a lot. Cavanagh is a clear and entertaining storyteller who offers strong and compelling examples. She's a bit like me as a gardener: she likes a bit of chaos rather than a well-tended formal garden. This isn't entirely true, as her chapters are well-ordered and organized, just that they travel in such unexpected directions that I wasn't always able to summarize them afterwards, even though I had been familiar with the research she'd discussed beforehand....more
When the events are natural disasters or “acts of God,” those who bear witness sympathize readily with the victim. But when the traumatic events are oWhen the events are natural disasters or “acts of God,” those who bear witness sympathize readily with the victim. But when the traumatic events are of human design, those who bear witness are caught in the conflict between victim and perpetrator. It is morally impossible to remain neutral in this conflict. The bystander is forced to take sides. (pp. 14-15)
Unfortunately, people tend to want a world that makes sense and is fair (a Just World) and, further, align with power (e.g., parents, men, authority figures). As a result, bystanders often have a difficult time believing trauma victims, especially those experiencing interpersonal trauma.
Imagine being accused of causing your own abuse. Imagine people blaming and shaming you for what you do to survive. Remember, level of social support is one of the strongest predictors of a range of positive outcomes. As she wrote, "Traumatic events destroy the sustaining bonds between individual and community" (p. 307).
Herman reminds readers that trauma is not an equal opportunity destroyer. People who had early adversity (including early trauma), were less well-educated, have family members with drug and alcohol problem or in prison, and have fewer social supports post-trauma were more likely to develop chronic PTSD.
Despite being first published in 1992, Judith Herman's Trauma and Recovery does bit feel dated; she outlined the dominant narrative that continues to control conversations on trauma. She continues to be referenced regularly, with people filling in the details rather than drawing a whole new picture. Most treatment still emphasizes the roles of the therapeutic relationship and traditional talk therapy. People continue to aver that effective treatment follows three stages (Safety, Remembrance, Reconnection) – although therapists do not invariably follow this process.
My edition of Trauma and Recovery has afterwords from 2015 and 2022. Herman's updates remind us of what changes there've been in the 30 years since her first publication: changes in placement of PTSD in the DSM-5 and an addition of complex posttraumatic stress disorder to the ICD; a focus on the role of Adverse Childhood Experiences in poor physical and mental health outcomes; the role of attachments with early caregivers in preventing/reducing trauma; early intervention programs to improve outcomes; and more.
Trauma and treatment of trauma continue to be a source of productive writing and research, but as much as anything, we need to focus on advocacy. You and I have the ability to make the world a safer place for children, women, members of the military, and other trauma survivors....more
Judith Beck's father is more well-known than his daughter, but her Cognitive Behavior Therapy: Basics and Beyond is lovely. It is thoughtful, carefullJudith Beck's father is more well-known than his daughter, but her Cognitive Behavior Therapy: Basics and Beyond is lovely. It is thoughtful, carefully outlining the steps to help therapists recognize and implement the steps necessary to help therapists help their clients change. She used two cases and copious transcripts from these, illustrating the strategies she used (85-90% are from Abe rather than Maria). Video and transcripts of two sessions in their work together is also available, as is her case conceptualization and their treatment plan. Beck included 60-100 figures and tables concretely illustrating her process and work with Abe.
Judith Beck's father was humble, respectful, and wise. I saw him and brash and deaf Albert Ellis several times, the latter of whom had all the poor communication skills of someone who could not hear the person next to him. Although I've seen her in person only once, Judith Beck has her father's interpersonal style. She was graceful throughout, sharing power with her clients, readily admitting errors.
This is from the end of the book, as she talks about problems in therapy, before outlining questions that one might ask to get treatment on a better start:
"You shouldn't be able to help every client (or help every client enough. I certainly haven't helped every client over the course of my career. It's not reasonable to expect yourself to avoid problems. It is reasonable to develop your skills in uncovering problems, specifying them, conceptualizing how they arose, and developing a plan to remediate them" (p. 365, italics in original).
Directive therapies are not for everyone, but if they are for you, this may be the best book on teaching a therapy approach that I've seen....more
Fires in the Dark: Healing the Unquiet Mind is at least the third of Kay Redfield Jamison's books that I've read; her memoir, An Unquiet Mind, and NigFires in the Dark: Healing the Unquiet Mind is at least the third of Kay Redfield Jamison's books that I've read; her memoir, An Unquiet Mind, and Night Falls Fast were the other two, although neither since I've been on GR.
Jamison's previous books have largely focused on the experience and consequences, good and ill, of bipolar disorder and suicide. Fires in the Dark is largely, "a love song to psychotherapy," a phrase that she would have used to subtitle this book (Schwartz, 2023).
Her description of psychotherapy is like that of a courageous journey with a fearless guide. Jamison – and the healers she quoted – describe this journey as often difficult and sometimes paradoxical: "to treat, even to cure, is not always to heal" (p. 3). Strong healers are curious, a refuge, at ease with ambiguity, comfortable with complexity, They help their clients (others prefer to talk about them as "patients") to feel safe, to make "intolerable memories tolerable" (p. 60), and hold "an unshakeable belief in … the ability to get well, compete, and make a difference" (p. 160). To heal is to recognize what was lost and to reshape that loss into something good. It often has a spiritual basis.
Jamison referred to a number of healers, most of whom were active in WWI. Almost all were white males, although she quoted some war nurses, as well as some fictional characters (e.g., T. H. White's Merlyn and P. L. Travers' Mary Poppins). She especially focused on the trauma of war.
Clearly, early 20th century is where Jamison's reading heart is, but as psychotherapy is a diverse field, focusing her reading there limits the kind of conclusions she could draw about psychotherapy, which she sees as generally long-term and insight-oriented, rather than emphasizing solution-focused treatments, Ericksonian hypnosis, or family therapy treatments.
Despite this limitation, Fires in the Dark is an engaging set of musings, although its path is not always clear. You may need to be comfortable with not always knowing where you're going....more
We are "too often simply run by losses and hardships long gone by, and by our stockpiled fears." Rather than deal directly with these, we "depart fromWe are "too often simply run by losses and hardships long gone by, and by our stockpiled fears." Rather than deal directly with these, we "depart from ourselves… or …separate one part our awareness from another" (p. 1). We all occasionally disassociate and do so without knowing it – as when we drive down the highway and miss our exit, when we are "unfeeling" after a personal tragedy, when we capably walk and chew gum.
Martha Stout capably describes both the normal dissociations and the more problematic types of dissociation. She observed that some people's dissociation, while more florid, may be easier to treat, as they are more willing to take responsibility for their behavior. Others' may not be as apparent, yet more difficult to give up.
This book was written in 2001, which is important to note. That was the end of the period where therapists were doing hypnosis with possible trauma victims and discovering Satanic cults and all sorts of other things. Psychotherapy is now more in a middle ground on this issue. We no longer deny child abuse, as had been common into the middle of the 20th century (although there is a lovely article in the New York Times about parental alienation syndrome that indicates that this denial continues). Nor do we say that abuse is everywhere. Now we recognize that horrific abuse occurs and also that we can implant false memories with hypnosis. Each time that Stout talked about her use of hypnosis, I cringed, even as she seemed to otherwise be careful and ethical in her work.
Myth of Sanity is very readable and clear, but as one GR reviewer observed, is also is a bit too "twee." Hard to find the middle ground when writing about abuse....more
Michael Pollan could sell bottled water to people during a flood, sand in the midst of a dust storm. He is an interesting salesperson, as he often shaMichael Pollan could sell bottled water to people during a flood, sand in the midst of a dust storm. He is an interesting salesperson, as he often shares his skepticism but is clearly enthralled by hallucinogens, although wants to use them in the right environment with the right guide.
I started reading How to Change Your Mind – and his more recent, This is Your Mind on Plants – as a skeptic. I'd listened to Seasons 1 and 2 of Cover Story on the role of hallucinogens in treating people with trauma and unresponsive depression. Cover Story was clear that there are a number of poorly trained and unethical practitioners out there who have done the sort of work that makes my skin crawl (e.g., numerous boundary violations have been reported).
That wasn't Pollan's experience, but he was also picky about who he worked with as guides. As he repeatedly observed, set and setting matter (i.e., how you think about the experience, where and with whom you have it). That set and setting matter to such a degree suggests that any effects are not solely due to the drug, perhaps an interaction of the drug and psychological factors.
It is difficult to do good research on the efficacy of hallucinogens – either for the searching well or for the dying, addicted, or depressed. The people serving as participants in such research are probably unusual, not a random sample from the larger population (remember, set and setting?). In addition, one cannot compare hallucinogens to a placebo, even an active placebo, as it is clear that hallucinogens have an effect on the mine, one that both subject, guide, and researcher recognize: one cannot do single, double, triple blinded research.
And, I wonder whether this can really become a wonder drug. In the 1950s and 60s, people were paying $500 a session for hallucinogen-assisted therapy. If the cost of hallucinogens came down – and do we really expect that Pfizer and Lilly will get involved, would we want them involved? – much of the cost would still be human labor. Would any insurance panel be willing to pay for a professional mental health worker to accompany a participant for a five-hour session? Would the guides, then, be poorly trained and paid guides (refer back to what I said earlier about the ethics of such work)?
And yet, the worried and wealthy well who are looking to expand consciousness may find such experiences tempting and enlightening....more
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