Showing posts with label disorders. Show all posts
Showing posts with label disorders. Show all posts

Tuesday, September 8, 2009

What is Mindfulness?

Unless you're deaf or live in a cave, you've heard the word mindfulness. The term has started creeping its way into psychotherapeutic vernacular. Originally an Eastern mystical exercise, it has now forms the cornerstone of some major Western psychotherapy techniques including Dialectical Behavioral Therapy and Mindfulness Psychotherapy. What is it? How do you practice it? Why won't the Dalai Lama shut up about it? What will it do for you?

Mindfulness is a technique that concerns the way you respond to the content of your mind. When you are mindful, you watch the contents of your mind with a curious, innocent nature, rather than an analytical and judgmental nature. To really understand what mindfulness is, you have to understand what it isn't. To do that, lets examine our day-to-day mental life.

We go through most of the day somewhat oblivious to what's going on inside of us. We analyze, worry, prioritize, and plan one thing to the next. When we get bored, anxious, or sad, we respond by thinking of ways to relieve that feeling. If I'm bored, I think about what I can do for stimulation. If I'm anxious, I start telling myself not to be anxious and plan out ways to gain an upper hand in the situation. If I'm sad, I might start analyzing the crap out of my life, looking for something I can correct to alleviate the sad outlook. There is a snap, automatic judgment that occurs in between the unwanted thoughts and feelings and our reaction where we say: I don't like this; I want something better.

This automatic resistance to experience is normal. It's what keeps our species going. For example, if I'm lonely, I look to solve that loneliness by meeting someone. If I'm concerned about my status and appearance, I do something to help boost that status. When I'm horny, I call up your ex girfriend/mother. This is how our ancestors pushed forward, found ways to survive, and deposit their genes in you.

The trouble occurs when you realize that contentment and satisfaction aren't the aim of evolution. Following your "genetic destiny" by resisting and reacting doesn't guarantee happiness. Why? Well, why should it? The "aim" of evolution is survival. It's tricky, because our biology and psychology coaxes us into believing that if we follow the plan our genes have designed for us, we'll be happy and content. "Keep fighting for money, love, status (generally, "security") and you'll be happy! I promise!*"

Mindfulness is a different way of responding to mental content. Instead of being stuck in our heads, planning, thinking, dwelling, worrying, resisting, and reacting, mindfulness tells us to STFU and wait. In mindfulness, we look at our experience with curiosity as it unfolds and morphs from one thing to the next. When you're bored, you look at the way boredom feels. When you're anxious, you see how your back is all tense and twisted and your mind cluttered with thoughts about what might happen. It's interesting. Strange. When you're depressed, you see how your moods and interpretations are gloomy. Hm. Okay. Not the greatest feeling in the world, but interesting.

All of this is accomplished with relaxed attention. You aren't trying to force yourself to do something special with your thoughts or perception. You aren't trying to see the world as all rosy and full of rainbows and love. You're just looking at what's already here without being a dick to yourself.

Mindfulness slowly collects you and puts you back in your body. You don't automatically stop thinking, and when you first start, your mind starts to wonder and analyze content, but over time, you start to analyze less. You stop thinking about your thinking, which has the overall effect of minimizing the clutter in your head. You can kind of think of it like frogs mating. When your mind is reacting to content, you generate new thoughts, and then new thoughts about the new thoughts. Each generation doubles in size. Before you know it, your mind is full of frogs**. (Wait, what?)

When you practice mindfulness, you stop generating new thoughts about your thoughts. Over time, the original thoughts pass and your mind starts to clear up. When your mind clears up, strength and joy start to creep in. You find that you're able to work through difficult feelings, situations, and stages without resorting to automatic resistance and reaction. You find alternative, wiser ways of responding to things that help create long-term rest and harmony.

Your perception begins to crystallize a bit too and you can see things just as they are. Buddha and his posse taught that with that clear mind, you can look at your own identity and realize that it's not made of anything independent. There is no "I," no actual thing called Edahn. Edahn is just an idea I represent in my mind as having certain attributes, stories, and aspirations, not an independent thing that needs to be defended. It isn't something in the universe; it is the universe. Not the whole thing, but connected with it in a very intimate way. This is the point where all resistance to experience (karma) stops.

If you want to try it out, just see what's going on with your right now. What does your body feel like when it breathes? Do you feel any tension in your shoulders? What kinds of thoughts are youo having? Take a look and see if you can answer those questions. Pretend like I gave you a quiz with those questions and your job was to present the answers not in the form of words, but in the form of an experience. Show me the experience of breathing, feeling, thinking, hearing, touching, pain -- whatever is going on.

*I wouldn't deny that there's some truth behind those promises, but it occurs because of a confusion of terms, mainly, the term "love" which comes in the form of romantic and platonic love. I'll explain this another time.
**I've been informed by one of my loyal readers that frogs produce more than 4 offspring together so each generation multiplies by a factor great than 2. You're right. I assumed, naively, that each pair would have 4 kids, so each generation would double from 2 to 4 to 16. I was wrong for assuming this and I apologize, sincerely.
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Monday, August 31, 2009

Venting makes you MORE angry?

Have you ever had a friend/girlfriend/homeless person ask you if they could just "vent" for a minute about something that bothered them? Have you ever heard someone say they're going to the gym to hit a punching bag for a while to get out some frustration?

We commonly call these behaviors "venting." The idea behind venting is that by expressing anger at some other target, we discharge whatever anger is there and are free to go about our day, collecting butterflies and petting toy poodles at Starbuck or whatever it is we do when we're not on the verge of killing someone. This idea comes courtesy of Freud and his ideas about catharsis. Catharsis is the theoretical release you feel as dispelling a feeling that returns your body to homeostatis.

That's a cute theory, but does it seem realistic? When it comes to anger, we can confidently say NO. It turns out that expressing your anger actually makes you more prone to be aggressive after your supposed "catharsis." It makes sense, too: when you practice being angry and aggressive, you're more prone to use aggression later on, just as having a lot of sex will make you more lusty, or partying a lot will make you more likely to party more (lest you get a disease or a hangover, or both).

The next time someone says I'm going to [have sex/get drunk/party hard/beat up an old person] to get it out of their system, you can look at them skeptically and say something incredibly clever like...

...

oh really?
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Monday, August 24, 2009

Narcissism: Think "Alpha-Envy"

On the surface, Narcissism can be thought of a condition of excess vanity. The term is based on the Greek myth of Narcissus. Narcissus was a sexy but cruel guy. As punishment, the gods make him fall in love with his reflection in a pool, where he ends up dying. Shoulda brought a Snickers.

The DSM-IV defines Narcissistic Personality Disorder a “pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy” with 5 or more of these abridged qualities:

  1. Exaggerated self-importance (exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  2. Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. Believes they're so cool that they can only associate with the coolest people or professionals
  4. Needs lots of admiration
  5. Expects priority and favorable treatment
  6. Exploits others for their own end
  7. Lacks empathy
  8. Envies others or thinks others envy him
  9. Arrogance

But honestly, who’s going to remember all that? More importantly, do you really need to remember it all? Not really. Whether someone has 5/5 criteria met or 4/5 doesn’t really matter. Narcissism is a personality pattern that you can become familiar with and start to identify in others. At its core, the narcissist needs to maintain a certain view of themselves as important and high-status, and needs others to agree with that view.

To borrow an idea from Ethology, the study of natural animal behavior, we might look at the narcissist as a pseudo Alpha-male or female. The alpha male attains a level of status by virtue of their earned status, size, aggression, and minimal self-doubt. The narcissist, on the other hand, fakes these qualities.

The key difference could be said to be the self-image that both maintain: the alpha holds a strong, unshakable self-image while the narcissist holds a fragile, “defective” self-image* that is buried in pretension. The narcissist is deeply afraid of the way they see themselves and they overcompensate for that by projecting a image of status, power, and dominance. They collect what psychologists call narcissistic supplies: flashy cars, expensive clothes, membership in exclusive groups, high-status friends and associates, and anything else you might expect from someone who’s desperately trying to get you to see them as important. The narcissist’s behavior is also aimed at creating a façade of importance, doing things that only privileged people would do and refusing to do things that are “below them.” I’ll collectively call these the alpha persona. (Personas were the masks worn by Greek actors through which they would sing and act.)

He is ultimately needy, not self-sufficient and secure like his dominant counter-part; he is desperate to see himself as superior and is desperate to have others validate him. His desperation turns into a form of addiction.

Therapy for narcissism aims at exposing the defective false self and encouraging the client to accept it so the narcissist can drop the alpha persona and form authentic relationships based in intimacy and trust.

* No one’s self-image is inherently defective, of course. Self-images are neutral on their own. But the narcissist sees himself as inherently defective and unacceptable.

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Thursday, August 20, 2009

Homework #1

I tried this when I was bored waiting for court to start one day. It got really interesting and I felt like I had some immediate insight into people.

Imagine everyone around you was stoned. Some people talk a lot about themselves, others relax, others start chasing women, others might become sexually aggressive, some chat, some cry, some just want to play video games. Can you imagine what the people around you might act like?

If you can see what they look like if they were more loose and relaxed, you can identify exactly what they're problem. Forget trying to find the right label/disorder because it'll just confuse you. Instead, just put youor observations into plain English words.

I've found that some people are very serious about their appearance, others serious about their jobs and roles. Some are shallow, others friendly and timid. Some people are waiting for you to play with them, others are islands who want are addicted to scheming and exploitation. It's really fascinating what you can find when you try this.
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Monday, August 10, 2009

Freudian Slipping

"Yesterday I had a Freudian slip at my in-laws' place over dinner. I meant to say 'please pass the carrots' but I accidentally said 'your mother's a stupid hooker.'"

Ah yes, the Freudian Slip. Freud called it fehlleistung which I think is German for completely bullshit theory. While I dig a lot of Freud's work, I'm not a big fan of this particular idea. Nonetheless, it behooves the amateur psychologist to understand what the fuck Freud was talking about and why he cared so much about your mother. But first, I would just like to get to know you we need a little background.

Freud was a smart mofo. He helped pioneer the idea (in the West) that people were not fully aware of what was going on in their mind. He divided the mind along two dimensions, what I'll call content and awareness. The id comprises your primal desires, you know, basic stuff like killing, stealing, and mother-fucking. It operates unconsciously. The superego comprises the social rules that restrict the id: don't fuck that, don't kill this, don't take those. The ego mediates between the two when anxiety is running high by using defense mechanisms. I can't have that? REPRESS! I can't do that? RATIONALIZE! I can't achieve this? INTELLECTUALIZE! The superego and ego operate at the conscious, unconscious and preconscious (almost conscious) levels.

Freud thought that people get tripped up when they don't process things correctly. He thought, based on what he observed, that people were avoiding expressing their disappointments and traumas through their defense mechanisms and this led to complications in their life. When people finally got in touch with their hidden traumas and disappointments, they experienced catharsis, a big emotional release. They could then attain insight into the relationship between their past trauama and present reactions and no longer be controlled by those traumas.

The whole process was taking the unconscious, hidden material and bringing it back into conscious awareness so that it could be squared away. Once you appreciate that, it's easy to understand what Freud was trying to do: summon the unconscious. Freud had a nifty bag of tricks to accomplish that task. He investigated dreams because he saw them as unconcious goldmines, free of conscious editing and censorship. He tried to eliminate the personality of the therapist to create a blank screen for the patient to project their unconscious conflicts (which explains why old-skool Freudian therapists are so unresponsive and irritating). He encouraged free association to coax patients into stop monitoring themselves and tap into their unconscious reserves, like making them dream while awake. And of course, he paid attention to Freudian slips. A Freudian slip happens when a person means to say one thing but slips up and says something else. Freud thought of that as unconcious content bubbling up to the surface and exploited it for deeper meaning and insight.

That should give you a basic idea of Freud's penis. Next time we'll delve deeper into the defense mechanisms.
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Sunday, August 9, 2009

Why do men go for needy girls? (user submitted)

Dear Edahn,

Why do men sometimes like women who I would characterize as crazy or disturbed or excessively needy? I have my own theory, but yours is probably more informed/better articulated.

Curious in Cali

~ ~ ~

Dear Curious,

To make sure I understood your question, I interpreted "crazy, disturbed, and needy" as the kind of girl who is always making problems, needs lots of assurances, has a pervasive feeling of abandonment-anxiety, and can't sit still and go with the flow. Does that match your image? If so, off the top of my head, I can think of 4 reasons men get involved with girls who are needy. For the purposes of this post, I'm going to refer to the female as the needy partner, though obviously it can be reversed.

1. The men don't realize that their partners are needy until after they become attracted to other qualities. To borrow an idea from economics, they end up invested in part of the person and become unwilling to relinquish that investment after having sunk so much time, money, and effort.

2. Some men like needy girls because it gives them power. It makes them feel accepted and cared for. Needy girls also do not pose threats to men. They are inherently subservient/submissive, and that gives men an upper hand in the relationship. It gives them power. According to Emerson (1962) dependency is the basis of power. Supply/demand relationships (which in relationships, you can think of as merely having other quality dating options) are the basis of dependency. The theory is called Power-Dependence Theory and is full of awesome.

Power gives guys freedom from insecurity and self-consciousness. They can feel free to act however they want because they know they'll be accepted in the end. In my experience, if there is too great a disparity in power and dependence, the guy will lose interest.

3. Needy girls conjure up pity and sympathy in their counterparts and make guys feel "gooey" or feel the intensity of drama. This is the modus operandi of the needy person: they play psychological games for "strokes." Strokes are offerings of superficial praise, pity, or commitment-assurances. Strokes give the needy person a temporary feeling of acceptance and security that should really be coming from the needy person themselves. For example, the needy person might pick a fight over something she twisted to look like a rejection. The fight ends when the guy professes his love, apologizes (triggering pity), or gives the girl some sweeping praise. The common thread is the feeling that's produced, which I can only describe as gooey, fuzzy, and warm that drowns out insecurity and fear. The warm fuzz, however, fades like a cheap high and the needy individual starts to want it more and more. It becomes a form of addiction and the neediness spirals out of control as they become desensitized to the drug, needing bigger and strong doses.

What about the guy? The girl's games evoke one of two reactions in the guy. Some games will evoke pity. The girl will feign weakness or vulnerability to trigger the guy's nurturing response. The nurturing response is gooey and fuzzy and the guy enjoys it. He likes the warm fuzz and even starts to think it has something to do with love. Part of his confusion is based on media protrayals of love as a painful, dramatic, intense pushing-and-pulling. Those stereotypes help him justify what is obviously an unhealthy pattern. Sometimes he will respond with anger, where the guy will reject the girl's attempts at control and manipulation. The anger is a form of drama and is, imho, the most addictive substance.

The fuzzy-feeling he gets, the drama, and the way it conforms with his expectations of love make him pursue rather than withdraw from the relationship. You end up with 2 addicts whose addictions are mutually reinforcing. That's a very strong pattern.

4. Needy relationships fill up silences. The neediness creates a dynamic that gives both players a role, as well as a script. This helps the couple avoid feelings of silence, emptiness, and loneliness. Those feelings crop up when people don't know themselves (or trust themselves) well enough to create their own script naturally. They look for a script that'll help them structure their interaction in a way that is supposed to ensure the survival of the relationship. I see this all the time without drama too -- people playing the role of a husband and wife. Of course, not having your own script, you have no chance for real intimacy, just its synthetic counterpart; you are just an actor in your own life.

What're some of your ideas, Curious?
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Thursday, July 23, 2009

How to Diagnose Your Friends with OCD

Obsessive-Compulsive Disorder ("OCD") is a pretty fascinating disorder. One in 50 people are said to have it and if you've ever taken a class in Abnormal Psychology, you probably diagnosed yourself with it too. Here's the nuts and bolts of the disorder, including some tips for identifying it.

DSM-IV Criteria

The predominant guide to diagnosing psychological disorders is called the Diagnostic and Statistical Manual, Fourth Edition (or just "DSM-IV"). It's a the psychologist's version of the Bible, just not as depressing. If you ever find yourself bored in life and in need of something to worry about, skim the DSM-IV and I promise you'll find at least 3 disorders to keep your mind busy.

The DSM-IV offers 5 criteria for diagnosing OCD, but as an Amateur Psychologist, you can collapse them into 3 to make it easier to remember.

  1. Recurring obsessions, compulsions, or both. (Imagine that!)
  2. The obsessive behavior is severe enough that the person recognizes their unreasonableness and it bothers them.
  3. The person isn't on drugs and the obsessive thinking isn't part of another disorder. For example, if a person with an eating disorder obsessed about her weight, we wouldn't say she's OCD.
What are obsessions and compulsions?

People with OCD begin to have certain thoughts. Common thoughts include aggressive impulses, contamination concerns, and inappropriate sexual imagery. The person thinks something is wrong with having that thought and start to worry and stress out about it. For example, a person at one of my sites recently wrote in about having sexual thoughts about children, despite a long history of defending and caring for them. She thought it made her a pedophile and she freaked the fuck out.

Then comes the compulsion. The compulsion is used to drown out the obsessive thoughts. Common compulsions include whispering, praying, sorting, cleaning, thinking certain thoughts, performing strange, unconnected behaviors (like breathing in a certain way or touching a lamp 3 times). When the person engages in the compulsive behavior, the intrusive thinking goes away temporarily.

Personal Observations and a New Diagnostic Criteria

I've noticed a few features of OCD that I think might create a better understanding of the disorder. (I used to have some OCD-like behaviors when I was a kid, by the way.) First, the intrusive thought is always seen as uncontrollable and automatic. Second, the person always attaches special significance to the thought and see it as arising from their true self. For example, if they have aggressive impulses, they might think that they are serial killers. Sexual impulses? Pedophiles or fiends. Even contamination concerns are viewed as serious and legitimate.

The thing that people with OCD are not doing is recognizing that sometimes thoughts are random and just come and go, and other times, it's the things we worry about that our minds like to tease us with. Rather than being a sign that we're deviants, it's a sign of strictly held values. The more one freaks about the implications and significance of the though, the more they worry, and the more their mind teases them about having it. Therefore in my opinion, the best way to combat OCD is to have the person consider that the thoughts are only there because out minds like to tease us with stuff we find inappropriate or just send us random or even paranoid information. The thing to remember is that there is NOTHING THAT NEEDS TO BE DONE. At that point, the person can stop worrying and the obsessive thoughts won't be triggered as often.

With that in mind, here's how I would reformulate the diagnostic criteria:
  1. The persistence of a thought that is viewed as uncontrollable.
  2. Considerable distress that arises out of the interpretation and meaning attached to the thought (e.g., I must be a pedophile, that must be dirty, I must be a serial killer).
  3. A desire to erase the thought and control the mind.
And there you have it folks. I know trust that you have a pretty good understanding of OCD, how to identify it, and how to give it to people like an STD. So go! Diagnose and be merry.
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