When Healers Become Jailers.

I found out today that a former client of mine recently passed away.

Ai Wei Wei's sculptural piece "Refraction", meant to be viewed through the broken glass of the gun gallery (as a guard might have gazed) at Alcatraz penitentiary.

I remember the last time I saw her, and embracing her. I tried to be mindfully present with her, tried to be there with her as she spoke with me: her body was weak and her voice full of hopelessness, I would sometimes interrupt her in attempts to reconstruct what worth or resistance there might be lying beneath the surface of that sea of helplessness and alienation that felt, I would imagine, like it was taking its last stranglehold on her as she was beset with yet another score of challenges: housing, medication. The very basic of needs were not accessible to her.

And in my mind as I remembered her today, I couldn't repudiate the idea that the system had catastrophically failed her, that her needs were too complex and intricate for any one institution to provide her with the assistance that she needed. And now she is gone.

In graduate school one of the first assignments I received was to answer the question "how can healers become jailers?" My supervisor at the time was a very gifted woman, and the question let loose so many ideas. Ideas about power, institutionalization, the meaning of "mental health" and "empowerment", and how the very language that we use as a "healer" can construct or deconstruct possibilities, even when we service providers don't give it a second thought.

This was before I had faced my own series of catastrophic events in the NICU and would have to weed myself out of what felt like endless fields of sorrow over the course of months: struggling against what felt like all the energy in the world that kept pushing me back down. It wasn't until I knew what it was like when you have to surrender yourself to a system of power, to trust that it will know what to do with your surrender, that sometimes it won't do the right thing, it won't SEE you or the people you love; it wasn't until then that I learned the language of defeat and of survival, and how insurmountably difficult it is to remember the things that once made you happy when the stakes are so high.

Sometimes life circumstances take one to the very dark underbelly of consciousness, a place where it's easy to feel lost, forgotten, useless and without hope. It happens. And if you've not experienced it, consider yourself "lucky" or "blessed" or whatever word you use to describe that unfathomable lightness. For those who have found themselves there, they will know you're often forced to contend with institutions that for our lifetimes we've been taught are there to take care of our society, to take care of us when we need help, to provide aid when we can no longer put up the energy to take care of ourselves or, sometimes, our loved ones. These institutions are treated like the catcher in the rye and are assumed to have the "magic wand" of healing.

Unfortunately, these systems often fail.

"Blossom Illumination" by Ai Wei Wei, Alcatraz

Too often, I read articles about people like my clients, like me, like ANYONE who has faced pain in the face, and we are treated as "other" or alien from the dominant culture, and it isn't right. The language of healing becomes codified by the popular cultural beliefs that characterize the mainstream. "Addiction" is considered a choice. "Mental health" is considered taboo. Even physical health is treated as if it's always the responsibility of the individual, even when the circumstances are dire and unpredictable.

Sometimes, more important than keeping our own worlds unscathed by pain or fear or unpredictability, it's giving people what they need when they need it, as a community. And as someone who claims to be a healer, I cannot say there's a single person I've encountered that used their need for help as a means of "manipulating" the system.

My heart is with K. and her family.

Why Comparing Our Pain Isn't Useful.

I've noticed a lot of pain-shaming on social media lately. The whole "what you went through wasn't as bad as what I went through", or "you shouldn't complain, I know someone who had it FAR worse than you do", or even "as an expert on this issue, and because what I went through was tougher than what you're facing, I think you should do this or that", or "you can't speak to your pain, I find it offensive because so many people have it worse, including me"  or even, "this group of people 'deserves' to go through pain because this OTHER group of people have also suffered and it was worse." 

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It had me questioning the usefulness of making these assertions; what the motives behind making these statements might be. 

I realized that the intentions behind the comparisons of pain likely had to do with the fact that people don't feel recognized for their own suffering, and thusly have a hard time listening to/hearing about others who are attempting to speak to their pain. For anyone who has gone through some form of trauma, you can likely attest to the fact that often, your ability to speak to it has likely been silenced in some way by the community. Pain-shaming also seems like an attempt to "control" suffering... Like as if we had a "factual" spectrum of suffering, we could have a better understanding of it; by that logic someone who has been through a level 10 of pain can talk about it/gain empathy from others for X amount of weeks (and remember, there are limits!), and level 1's shouldn't even mention whatever they're whining about. 

Well. Quite frankly, that doesn't work. 

When we compare pain, either our own with others' or even when we compare cultural suffering, we are missing a very valuable opportunity: the chance to practice empathy, to practice community.  

Another interesting side of the pain-shaming coin is that people sometimes feel guilt for speaking to (or sometimes, even experiencing at all) the pain they might have felt during an event when speaking with someone who they know went through something "worse". I've experienced this personally many times because my son passed away due to his premature birth, and many think that it's then inappropriate to talk about how traumatized they feel about their baby's two week NICU stay that didn't result in any long-term medical consequences. It isn't inappropriate; in fact, there's beauty in sharing your experience, there's connection. 

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We are all allowed to feel what we feel, and what's more, we WILL feel what we feel whether we talk about it or not. In my opinion the height of dysfunction exists when the expectations of a community, the "shoulds", override the personal experience of its members.  It pushes people to cope silently; it pushes people to feel alone; it pushes people to feel like they're being "histrionic" (another word I can't stand!) for feeling anything at all. 

I want to clarify here that I am not claiming that all pain is the same,  I'm not saying that the pain of a breakup is equal to that of the loss of a child, or that the pain of losing your home to foreclosure in the U.S. is equal to that of being forced to migrate out of your country to avoid your family being tortured, leaving everything you love behind. It's not equal. Particularly when other people's pain has been communicated by someone who hasn't experienced it themselves. I also want to clarify that I'm not trying to say that it's ok when certain types of pain are silenced, particularly cultural pain (i.e. one country's/individual's struggle is honored and respected but another's isn't acknowledged at all due to privilege). 

I do, however, question the usefulness of comparison, and suggest that instead of trying to mitigate some sort of a structure by which we decide who we allow to speak to their experience, we look at the value of honoring people's pain, allowing people to speak to it, and using it as an entry point for understanding what other people's experiences might be, and as a global community, to change the things that promote suffering.

The other piece of this is that by acknowledging and respecting others' suffering, we free ourselves to feel our own-- without shame, without guilt, without accusing others of being primadonnas because we never had the chance to have compassion for ourselves when we went through something terrible. With the growth of self-compassion comes a sense of community, of having a more untainted perception of the experience of others, of feeling loved and seen, of not being shuffled aside as unimportant. 

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No one benefits from shame and silence.  Giving voice to your experience may be just the thing that helps someone else feel less shame in reaching out for help, and help them to fathom a way of creating something with their suffering that connects them to others, as well as gives them a sense of agency over it themselves. 

As Pema Chodron wrote in her beautiful book, The Places that Scare You: A Guide to Fearlessness in Difficult Times, "Compassion is not a relationship between the healer and the wounded. It's a relationship between equals. Only when we know our own darkness well can we be present with the darkness of others. Compassion becomes real when we recognize our shared humanity."

In conclusion, try not to pain-shame. It doesn't solve anything at hand, it only drives a deeper stake into our ability to understand each other. 

For further (and a beautifully written) explanation of the value of having empathy for others' suffering, and acknowledging your own as well, the speech This Is Water by David Foster Wallace is incredibly moving, and worth the 20 minutes of listening. 

Deconstructing the tightrope walk of momming in America; or "Whoa Mamas!"

After awhile, constant judgment/chatter takes its toll on the psychological well-being of the person on the receiving end of it. Although I feel I've come out on the other side of my son's first two years for the most part psychologically "intact", it wasn't easy.

The notion of motherhood in western culture seems to have been subject to a significant amount of degradation over the past century (or more), resulting in the construction of a discourse (or commonly understood cultural definition) that can be quite challenging to contend with for mothers and children both. It concerns me to think of mothers who may be feeling the effects of post-partum depression issues, mourning a traumatic birth experience, struggling with a challenging or medically complex baby and meeting their needs, or simply living as a single parent and trying to get things done, who at the same time are forced to fend off judgments based on their public persona as a mom.  

Why is it that our culture has developed so many ways of judging individuals who play a crucial role in the development of our young? Do these ideas serve to alienate mothers from each other and prevent us from forming supportive communities?

In researching primary attachment and trauma, and realizing the incredibly important role that mothers (or other primary caregivers) play in their children's developmental health, I reflected on the many impossible demands put upon American mothers, as well as the ridiculous amount of judgment that mothers have to contend with in the mass media, amongst their peers, and in mixed company on a daily basis.

Let's take a look at a few of these ideas that linger beneath the surface of our cultural consciousness, and could possibly affect the psychologies of the individuals most pivotal in the healthy development of our babies' brains. As follows, I will use the term "mother" with the pronoun "she", but without the intention of excluding individuals who fall into the role of primary caregiver and do not identify with the term "mother" or the feminine gender. I should also note that these are my own observations, and thusly reflective of a middle class white woman living in America; many other expectations exist for moms in other cultures as well as within my own that may not be as noticeable to me due to the limitations of my perspective (and I welcome other parents to speak to the expectations they've experienced in the comments section!):

Self-Portrait with Daughter Doon, Diane Arbus, 1945  

1. Stay at-home/Don't stay at-home: There are competing messages from varying sources regarding whether a mother should stay at home with her children or not. On the one hand, there is the 1950s mentality that mothers should abandon their careers to raise their children, sacrificing their all to be the best possible caregiver for their tiny charges. On the other, there is the commonly held belief that mothers who stay at home with their children lead unfulfilling lives and have sacrificed too much for the sake of family to be interesting people with valid contributions to give our communities.

There is another inconvenient aspect of modern life as well: the cost of living has gone up so significantly in the past 50 years that it's challenging to make ends meet on a single income in many areas of the United States. Nonetheless, it seems that regardless of the choice (or non-choice) a mother makes, it opens her up to criticism and judgment from others.

2. Breastfeed/Don't Breastfeed: Lots of clinical research supports the notion that human breast milk provides the most comprehensive nutrition for human babies. It also helps promote attachment between mom and baby in the very early stages after birth. On the other hand, huge developments in research have resulted in the creation of the most nutritious infant formula that has ever been on the market, enabling moms who can't or choose not to breastfeed to provide their babies with the best possible nutrition they can.

At this point in America, it's about a 50/50 division between breastfeeding/formula feeding moms in the first year of a baby's life, with a high percentage of women (in comparison with 50 years ago) attempting to breastfeed in the first months after a baby's birth. It's a win-win, right? How wonderful is it that we have two options to provide healthy nutrition to our babies. Nonetheless, to take a closer look at the cultural representations, interpretations, and common beliefs about either category, you would think that either choice is an abomination!

Victorian daguerreotype of a breastfeeding mother; Schlessinger Library, Radcliffe Institute, Harvard University 

Women who do breastfeed are treated as though they are disgusting and/or obsessed with their role as a mother. The act itself is discouraged in many arenas of our society (how many women have witnessed an actual "pump room" at their place of work that's not a bathroom?). What's more, womens' breasts have been so thoroughly sexualized in this culture that it's almost impossible for others to re-imagine breasts as a useful and important component of an infant's health and not a gross temptation aimed at tantalizing and/or disgusting men.

On the other hand, mothers who feed their babies formula are treated as though they don't care about their baby's health. Medical or physical issues that may prevent a mother from breastfeeding are treated as "obstacles" that with determination, anyone can "get over" (even when, in fact, they can't). When a woman makes the choice to formula feed, she is perceived as selfish and "uninformed" about what are the most nutritious ways to care for her child.

3. Be a parenting expert!: As parents in America, we are met with a barrage of useful information regarding the proper way to rear a child: when to wean from the bottle/breast, whether to rear-face a child seat, the developmental stages and how to know when your child is behind, when to introduce solid food, how to not "spoil" a child, etc. etc. etc. I would venture to guess that the parenting advice industry is the most lucrative it's ever been. I would also wager that there are more "expert" parents (and non-parents) giving lots of advice to all who will heed it.

The New Mothers, Sally Mann, 1989

Anyone who has visited an online "birth board" (site where mothers/parents post and discuss issues they're facing, eg. BabyCenter) and has seen any posts about whether or not to rear-face a child seat will know that these "experts" will use very strong arguments to sway people to their side of a discussion (for example implying that parents have a death wish for their child should they choose not to rear-face beyond 12 months). Pages-long arguments can be found discussing whether or not a mother should let a child "cry it out" when attempting to encourage sleeping through the night, whether to co-sleep (when parents have their baby sleep either in a crib adjacent to the parental bed or have their baby sleep in bed with them), whether to cloth-diaper, swaddle, or any number of parental choices that in America  were once within the scope of the parents' individual choices.

What's more, it's not only mothers/parents judging each other, I've found that even non-parenting individuals will pass judgment on parents who choose to do something different than they would.  

4. Silence around all ideas that are in opposition to the dominant paradigm: Possibly the most insidious expectation of mothers is that of silence on all issues in parenting that might reflect discontent. I've noticed that the most celebrated "form" of motherhood is that of the mother in a blissful state. It's as though this has created a feedback loop, in which most mothers express the parts of their daily lives that reflect  bliss (and are celebrated for it), and those that express frustration or anger with challenges that come up are perceived as unfit parents.

Mother Berthe Holding Her Baby, Mary Cassatt, 1900

Our culture, instead of providing reflection, understanding and support for parents struggling with the myriad stresses that come with the territory of parenting (for example infant colic, sleep deprivation, toddler tantrums, etc. etc.), oftentimes judges parents that express frustration with that struggle. This has created a dynamic in which it can feel unsafe to express any dissatisfaction with the parenting experience, to the extent that it can even be challenging for parents to reach out for help when they need it.

Stay-at-home moms in particular, but modern parents in general find themselves in a circumstance that is historically unique: raising their children on their own without the help of a community around them when times get tough. This situation manifests a lot of risk for both the caregiver as well as the baby, since there are no built-in resources that are easy to access when a mother is facing a deeply stressful circumstances with her child, and she is likely to feel judged by friends and the community around her should she express that stress in seeking out help.

To sum up with a personal vignette: I've never personally felt so publicly judged by complete strangers until becoming a parent. Despite the fact that I think I do just fine and feel as though I have a very strong, secure and resilient attachment with my son (and we have been through a ton together), the very public discourse of parenting "theory" allows any stranger to call that into question.

I'm curious as to how other moms cope with these "shoulds" doled out by our culture; how do you find support? How can mothers, or caregivers in general, take a stance of solidarity and support amongst each other and against these absurd judgments? 

Of Mental Illnesses and Brontosauruses...

We are in the midst of an existential crisis!

Did you know that the brontosaurus never existed? That it was a fabrication manifested because of a race to discovery (dubbed "the bone wars") that took place between two prominent paleontologists in the 19th century?

Although scientists have known since the 1970's that what was called the skeleton of a brontosaurus was, in fact, an apatosaurus skeleton topped with the head of another dinosaur, our culture has held tight to the fascinating and beautiful story of our beloved bronty, and to this day has celebrated its existence in both popular culture as well as children's educational materials. It's as though our nostalgic love for this mythical beast has taken on more cultural power than the science of paleontology. Talk about the benefits of inventing something and passing it off as science! 

In reading about this intriguing phenomenon, my mind gravitated toward another current event that hits closer to home and has the potential to affect many individuals in the coming years; the publication of the DSM-V (the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, widely considered the definitive "truth" in the diagnosis and classification of mental health issues in the United States) and its inclusion of several problematic "disorders". 

The field of psychology has long struggled with the problem of how to define the notion of mental health disorders without allowing subjective cultural belief systems to taint or characterize what is considered "disordered". An example of this struggle was the DSM-II classification of homosexuality as a mental health disorder and its subsequent deletion after considerable protest, discussion and argument between the APA and gay rights' organizations.

It seems that the ideas that we hold about mental illness in our culture are very difficult to define using the scientific method. Much like the fabled brontosaurus, mental health diagnoses have the potential to be theorized and popularized without much scientific foundation, and thusly, without warrant, to take on a cultural power of their own. The difference is that this power does not only manifest a cute-looking vegetarian creature in our children's  sandboxes or textbooks; the power of the myth of mental illness is that it can target individuals who do not "fit" into the dominant paradigm, label them with a disease, and promote the medication of these individuals.

Let me clarify that there are mental health disorders that most definitely warrant the use of diagnosis and of psychotropic medication to manage the symptoms; I also believe that if an individual feels as though diagnosis and/or medication helps them to be more functional in their life then I stand by they and their psychiatrist's use of those tools. My concern with the development of these new mental health disorders is that some of what was once considered a "normative" part of being human (ex. bereavement, toddler tantrums, hormonal shifts during menstruation) could now be treated as abnormal. Naming that abnormality has power, and can affect the individual who will now be considered "disordered". Additionally, the development and marketing of numerous new psychotropic medications has created an entity that can now benefit financially from these diagnoses. 

Assigning language (a name, a definition) to something can have the effect of making us feel as though we have more control over it; that we fully understand and can sublimate that entity. A more beautiful aspect of that experience is that we as humans can find community in naming something and in feeling less alone facing a problem that has complicated our lives by helping us find other people experiencing the same thing. However more and more, "the bones" of psychology seem to be mismatched with each other. Revisionist science is developing "disorders" to fit the medications that companies have invented; human issues that once caused us to build communities of support and prompted genuine curiosity and empathy for the sufferer are now becoming very individual experiences that can be wrapped up within simple descriptions and medicated. 

I'm curious about how people of the future will consider what we now call "psychology". Will it appear as the slap-dash brontosaurus skeleton now appears to modern paleontologists? Thrown together in such a manner as to benefit the various individuals who "discovered" or developed it? Will these disorders be manifested, defined and braided into the dominant culture to such a degree that even after their debunking they continue to affect many individuals scarred by their indelible mark? How can we as therapists and as individuals salvage the wonderful benefits of psychology without ascribing to the doctrine of a science that is struggling to define itself?