Friday, January 21, 2011

Thursday, January 20, 2011

Can Two Marshmallows Make You Smarter, Happier, and Healthier? :)

If you mix a couple of spoonfuls of hot cocoa mix with a couple of spoonfuls of chai tea latte mix into your cup of hot milk you have an almost perfect ending to a day full of snow shoveling, baby tending, neighbor visiting, and house keeping.  Almost perfect but not quite.  To get to perfection I have found there are two other essential ingredients to your little bit of heaven you will soon be sipping on the milk-stained and graham cracker-crumbed couch.  One of these ingredients is the fluffy whipped topping that is often seen sitting atop yummy hot drinks.  The other of these ingredients is a bit less familiar.  In fact, until my mom plunked this ingredient into a little bowl she handed me with our traditional party mix and a few Christmas cookies ready for me to sample I had no clue that such a thing existed.  Laying scattered throughout my party mix and one with a leg lodged under a Santa cookie I first met the gingerbread marshmallows!  Shaped like little gingerbread boys, Jet Puff apparently came out with a new holiday marshmallow for this year.  As I peered down at them in my bowl, and my mom explained what they were, I admit I was a little skeptical that a gingerbread marshmallow would make the grade.  Too many things claim they are something-or-another 'flavored', and too many times if the taste is not just outright unpleasant then I find myself pondering if I can detect a hint of the 'flavor' purported.  Pinching one of the little guys in between my fingers I do the sniff test and admit that he does smell distinctly gingerbread-ish.  Assuming the chalking white dust, that I can only guess is to keep the little guys from sticking together in their bag, does not bode well as a taste indicator I plopped the squishy man into my mouth.  Mmmm. . .   . . .   . . . YUM!  He did, in fact, fit the gingerbread-flavored bill!  And as a contrast to our salty and spicy party mix I fell instantly in love with these scrumptious treats.  Not long after beginning my love affair with these sweet brown men I found myself wondering how he would perform in hot chocolate.  After confirming his excellence in hot chocolate I then began my experimentation stage.  And this is how we came to our cup of perfection.  So I described the mix of powders and the stirring into the milk, but the next steps must be followed very carefully in order to obtain 'just the right' taste of perfection.  First you place a layer of gingerbread men marshmallows on top of your hot cocoa/chai tea latte drink.  This allows them to melt into a lovely gingerbread-ey blob of goo.  Then you cover them in a thick cloud of whipped topping.  Finally, you strategically place one, or two if it has been a particularly long day, sweet little gingerbread man marshmallow on top of his fluffy white pillow.  Ahhhhhhh. 

Now if I could just wait a few minutes before I enjoy this lovely treat I will be a smarter, happier, healthier me. . .

In 1968, while on the faculty at Stanford University, Walter Mischel began what would become a decades' long study started with more than 500 four year old participants and trays full of marshmallows, cookies, and pretzel sticks.  This study became know as 'The Marshmallow Tests'.  The initial goal of the experiment was to identify the mental processes that allow some people to delay gratification while others simply give in to their impulses. A researcher would take a four year old into a small room in the Bing Nursery School on the Stanford University campus.  The room contained a desk, a chair, and the tray of treats.  The child was then asked to sit down in the chair and pick a treat.  The researcher told the child that he or she could either eat one treat  right away or, if he or she was willing to wait while the researcher stepped out for a few minutes, the child could have two treats when the researcher returned. The researcher then explained that if the child rang a bell on the desk while the researcher was away the researcher would come back right away, and the child could eat one treat but would give up the chance to have a second. Then the researcher left the room.

About 30 percent of the children studied successfully delayed gratification until the researcher returned 15 minutes later, but the remainder of the children couldn't control their impulses long enough to get the second treat.  Some of the children immediately ate the treat while others resisted it briefly, did not ring the bell, and then surrendered to their desire.  Most of the children appeared to struggle in resisting the treat and held out for an average of less than three minutes.

Initially, psychologists assumed the children’s ability to resist the urge to eat the treat depended on how much they desired the treat, but during the observations it was obvious that every child craved the extra treat. Mischel concluded that what determined the children's self-control was what he called "the crucial skill [of] 'strategic allocation of attention'.”  After hundreds of hours of observation researchers found that the children who were best able to resist the urge to eat the treat distracted themselves by covering their eyes, pretending to play hide-and-seek underneath the desk, or singing songs from “Sesame Street” rather than focusing on the treat.  Their ability to to refocus did not extinguish their desire, but it helped them avoid falling victim to their impulses.  Conversely, the children who tried to 'stare down' the treat ended up generally ringing the bell within 30 seconds or just eating the treat without ringing the bell at all. 

After publishing a few papers on the studies in the early seventies, Mischel, the Stanford professor of psychology in charge of the experiment, shifted his focus to other areas of personality research.  He explained, "There are only so many things you can do with kids trying not to eat marshmallows."

Mischel's three daughters all attended the Bing Nursery School, and he would occasionally ask them about their nursery school friends during "idle dinnertime conversation."  In talking about how their friends were doing, Mischel began observing a correlation between the children's ability to wait for the second treat in the nursery school study and their academic performance as adolescents. After talking with his daughters and asking them to assess their friends academically on a scale of 0 to 5 Mischel compared their informal ratings with the original data findings.  Beginning to see patterns emerging, in 1981 Mischel sent questionnaires to all the parents, teachers, and academic advisers that he could find of the six hundred and fifty-three subjects who had participated in 'The Marshmallow Tests.'  The subjects were in high school by that time, and he asked about traits such as their their capacity to plan and think ahead, their ability to "cope well with problems", and their ability to get along with peers. He also requested their S.A.T. scores.

Upon analyzing the results Mischel found the children who were able to wait fifteen minutes had higher educational achievements, were more likely to pursue goals, were less likely to abuse drugs, and had S.A.T. scores that averaged 210 points higher than the scores of the the children who were only able to wait 30 seconds.  The children who rang the bell quickly exhibited more behavioral problems, struggled in stressful situations, had trouble paying attention,  and found it difficult to maintain friendships.  Interestingly, 'The Marshmallow Tests' were better predictors of S.A.T. scores than IQ tests.  Findings showed them to be at least twice as predictive.  In following these subjects later into adulthood, Mischel found that at the age of 38 the subjects who had exhibited greater deferred gratification skills had lower rates of marital separation and divorces, fewer legal problems, and lower body-mass index numbers.  They were also less easily frustrated and side-tracked in their lives. 

Now that the subjects are in their mid-40s, Mischel and his research team are continuing to gather information about both the original subjects' lives and about the lives of their children, including studying MRIs of the subjects' brains.  Mischel has said, “We are beginning to clarify how changes in the cognitive representation of the object of desire changes the ability to control one’s own behavior.  It’s what allows people to resist the dessert that they swore to themselves they wouldn’t eat before they entered the restaurant … It connects to addictive behavior, obesity, the tobacco catastrophe.”

Mischel has done work showing children did much better on the marshmallow task after being taught simple “mental transformations," such as imagining putting a picture frame around the treats or pretending a marshmallow was a cloud.  The children were able to increase their ability to delay gratification by up to 15 minutes.  Mischel reported, “When we asked them how they were able to wait so well now, they said, ‘Well, you can’t eat a picture’."  What is unknown is whether or not these new skills will generalize across all domains of their lives.  Will the tasks the children learn work only during the experiments or are they able to apply them at home or school when faced with decision-making such as completing homework vs. texting friends or playing video games online or skipping classes with friends vs.joining clubs and extra-curricular activities? 

Mischel asserts, “This is where your parents are important."  Children can be taught techniques to improve their self-control and ability to defer gratification, but the techniques require practice to perfect them.  Mischel describes normal family routine, structure, and rules such as not snacking before dinner, saving allowance or gifts of money rather than spending them immediately, and waiting to open gifts on birthdays or Christmas morning rather than earlier as exercises in cognitive training that parents can use to help their children be successful in their future lives.

Mischel’s findings are currently being applied in many fields.  From early education, economics, finance, and risk-taking, to mental health which is working to understand and address behavior problems and personality disorders, marshmallow management may be the answer. 

And since I have been working on this blog for more than 15 minutes without too much frustration and without ringing a bell I think I have earned my second gingerbread marshmallow man.  Now what was that about marshmallows and body-mass index?. . .

Enjoy with your hot chocolate and marshmallows!: 

Monday, January 17, 2011

"Standing on Line to Get a Plain Slice to Stay": A Guide to Communicating with the New York Husband

The first time my husband and I went out to get pizza together I realized we had trouble.  We stood at the counter considering the menu and discussing crusts and toppings and sizes.  With the teenage cashier raising his eyebrows in that are-you-ready-to-order-NOW? manner we decided on two pizzas.  I would order one with my favorite toppings, and he would choose his.  I ordered the first pizza without incident.  Probably some combination like sausage and mushrooms and tomatoes and olives.  Then it happened.  The first of many future communication circuses.  Taking his turn to order the pizza he wanted, my husband looked directly at the cashier and said the second pizza should be, and I quote, "Plain."  Plain?  The cashier and I both stared at my husband in confusion and silence.  A few more moments and still silence.  I am not sure who asked first, but our mutual question was, "Huh?"  Or perhaps one of us asked, "What?"  And now it was my husband's turn to look confused, "What what?"  Back at him, "What do you mean 'what'?"  A few more rounds of this 'Who's on first?' schtick, and we finally began working together to investigate this mystery.  I was standing there wondering why in the world my husband would want crust with just tomato sauce on it.  My husband was standing there wondering why no one understood him.  And I am pretty sure the cashier was standing there wondering when someone was going to tell him what-the-heck kind of pizza we wanted so he could get back to checking his text messages.  After some further discussion that evening I came to understand that crust and sauce was not a "plain" pizza, and my husband came to understand that crust and sauce and cheese was considered a "cheese" pizza outside of New York City.

Before this incident I thought I had pretty good communication skills and some general grasp of the vernacular in different parts of the United States.  And then I married a New Yorker.  For anyone who is aware this unique language exists in the first place, a quick run through a search engine produces a number of results for 'New Yorkisms', but how do you know what you don't know?  I had no idea that sitting in my living room, standing in the kitchen, or walking through a park would become complicated events because a girl from the Midwest met a boy from NYC, and they attempted to carry on a conversation. . .

I have started a list of befuddling New York language for those of you whose relationships might be saved in the future or just in case you are traveling and find yourself trying to negotiate some sort of sanity in interacting with a New Yorker:

  • "go inside" means going to another room (Note:  Please be aware, you are already inside and not outside when this phrase will be used, and any other room you are not currently occupying is the possible destination.)
  • "run the dishes off" means to start the dishwasher (Note:  Not to be confused with scaring the dishes away.)
  • "stand on line" means to stand in line
  • "to stay or to go" means taking your food from a restaurant or eating it there rather than "for here or to go".
  • "a slice" means a piece of pizza
  • "plain" pizza means cheese pizza
  • "pie" means pizza (Note:  I have not figured out how to describe pumpkin or apple or lemon meringue, but 'pie' is definitely pizza.)
  • "bodega" means a small corner convenience store
  • "sliding pond" means a playground slide (Note:  No ponds are near these.)
  • the floor” means the ground (e.g. When walking down the street with someone, and they drop a piece of food then pick it up your response should be “You can’t eat that! It fell on the floor!)
  • "I live 'on' the Upper West Side" (Note:  No one lives "on Downtown", "on the Northeast", "on the Southwest", or "on [insert name of a neighborhood]".)
  • "Jersey" is New Jersey, and while it wouldn't make sense to drop the "New" from New York only visitors or tourists say "New Jersey".
  • "the train" is actually the subway, and anytime it's another train the actual name is used (e.g. Amtrak, MetroNorth, etc.)
  • In NYC residents of upper Manhattan refer to 207 Street at "two seventh". This has resulted in visitors being told to go to the last stop on the A train getting out at 28th street.

If anyone has some more and can help a Midwestern girl out by sharing them my husband's patience thanks you in advance.  I'll get them added to the list just as soon as I go inside. . .

Friday, January 14, 2011

The Death of Happiness: Killing Our Children's Futures Device by Device

"Friendship? Yes Please." 
                                        ~ Charles Dickens

Now more than seven decades old, one of the longest continuous studies in the history of American Research is the Harvard Study of Adult Development, and one significant finding from this study is that a key to raising happy children and being happy adults is friendship.  

Collecting more objective evidence on the subject than researchers of any other study, The Harvard Study of Adult Development began in 1937, examining more than 268 physically healthy and "well-adjusted" Harvard sophomores.  Following its subjects for more than 70 years, this study has become the preeminent example of a longitudinal study.  Including the original study beginning in 1937, the study’s longtime director, George E. Vaillant, M.D. Professor of Psychiatry at Harvard Medical School, has studied adult development, including the lives of more than 800 men and women for over 60 years.  The consistent findings of all of this study show successful relationships are the closest thing researchers have been able to identify as the most significant key to happiness. Positive relationships beginning as early as childhood have shown to be the most important predictors of happiness and success as people age.

Brain science tells us that one way to make and keep friends is to be good at interpreting non-verbal communication.  Doing this accurately takes years of experience in face-to-face interaction with human beings, and studies in neurobiology have shown studying and playing a musical instrument increases this ability.  

Pausing to highlight two significant things I just said. . .

Doing this accurately takes years of experience in face-to-face interactions with human beings
studies in neurobiology have shown studying and playing a musical instrument increases this ability

Pausing to review what I just retyped. . .

Okay.  Nope.  Just making sure.  Still not there.  Text-messaging, internet chatting, status-updating, mp3 player-listening, television-watching, and video game-playing are not there.  Interestingly enough, these things don't fall into the 'face-to-face interactions' or 'studying and playing a musical instrument' categories.  So now I will pause for you to consider the implications that having increasingly plugged-in lifestyles has on our children's skills in making and keeping friends and, subsequently, on their current and future happiness.  

. . .Still considering?

And now I will pause for you to consider the implications that having families and parents and caregivers who fail to recognize, acknowledge, and/or take responsibility for managing technology in their homes has on our children's skills in making and keeping friends and, subsequently, on their current and future happiness.

. . .Still considering?

Children's ability to recognize and respond to non-verbal cues, forge and maintain significant relationships, and build future long-term happiness is being inhibited by texting, online chatting, and the assortment of other technological activities that are being done in front of screens rather than participating in activities or one-on-one face-to-face interactions with live human beings.  Sorry, 'Guitar Hero' does not count as playing a musical instrument.

What is it going to take for adults to begin showing concern and accountability for their laziness, apathy, and immaturity in parenting their children and become motivated enough to take action to make necessary changes?  Investment in your children's lives is not about dollars and cents.  Parenting is an verb, not a noun.  Parenting is hard work, emotionally-laden, and a challenge to be the grown-up.  Is it easier to give in to badgering about cell phones and game systems and wireless gadgets and gizmos?  Is the guilt gone about your long hours at work, or your depressed mood, or having your children grow up watching bickering parents?  Is your life "all better" because you didn't risk having your children not 'like' you or see you as 'cool'?  More importantly, are your children's lives better?  In an increasingly instant-gratification driven society do you sacrifice long-term happiness for 'happy now for now'?  Grow up.

Educational success ('Wake Up, It's Time for School') and now lifetime happiness.  What will be the next casualty of your teched-out home?

. . .plug in, turn on, and stay tuned.

Monday, January 10, 2011

Life on the Line: Negotiating Relationships with Persons With Borderline Personality Disorder

Borderline. . .
Feels like I’m going to lose my mind.   
You just keep on pushing my love over the borderline. . .
                                                          ~ Madonna - Borderline

A few days ago I discussed the difficulties with establishing boundaries and setting limits with persons in our lives who have personality disorders or personality disorder traits.  Fear, exhaustion, confusion, panic, apathy, and Guilt with a capital 'G' are intimate companions in the lives of  many people who resign themselves to existing in a sort of half-life as they enable and perpetuate the very behaviors that are sucking the life from them and the ones they love.

Complicating relationships and interactions involving a person who has personality disorder traits is the fact that personality disorders seem to like to congregate in herds. . .or in professional jargon, the APA states in the DSM-IV-TR, "Individuals frequently present with co-occurring Personality Disorders from different clusters."  That means there are typically more than one or two unpleasant behaviors grazing nearby, and our happy tranquil picnic is oftentimes interrupted by charging, stomping and snorting.  And what do we do?  Do we jump up madly waving our arms and charge, stomp, and snort our way into the melee?  Do we snatch up our watermelon, juggle our lemonade, and try not to trip over the blanket as we run lickety-split in the other direction?  Or do we sit still and quietly while hoping our warmth and compassion will be enough to slow the charge before we are errantly gored by a horn or crushed by a hoof?

Randi Kreger, owner of and author of the well-known books "Stop Walking on Eggshells:  Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder" and "The Essential Family Guide to Borderline Personality Disorder: New Tips and Tools to Stop Walking on Eggshells" has a blog on  After reading a recent blog on by clinical psychologist Kristalyn Salters-Pedneault, PhD, in which Kristalyn voiced her thoughts and feelings after receiving what she described as "incredibly hateful" reader comments and email toward people with Borderline Personality Disorder.  Kristalyn  stated that she was "shocked by the level of vitriol," that "People with BPD deserve your compassion." and "Be grateful that you don't have to live with BPD.  And do something to help, rather than spewing out hate.  It's not helping you or anyone else."

Randi dedicated a blog of her own to thoughtfully discussing the nuances involved in validating not only persons with Borderline Personality Disorder but also the persons who are partners and family members  She asserts that these people are compassionate persons who hang in and hang on "Despite their BPD FM's (Borderline Personality Disorder Family Member') unexpected and unexplained anger; their impulsive, possibly reckless behavior; despite their inconsistent abandonment engulfment pattern; despite the fact the FM's (Family Members) often don't get their own needs met." Randi discussed healthy and unhealthy anger and grief.  All in all, a relevant and well  thought out discussion.

After reading Randi's blog I decided to take a look at Kristalyn's blog and comments as well as a NY Times article with comments that Randi had referenced.  As much as I appreciated Randi's and Kristalyn's thought-provoking blogs, I appreciated even more the discussion and comments by the people I consider to be the true 'experts' on this topic, persons having Borderline Personality Disorder traits and family members and friends of persons having Borderline Personality Disorder traits.  As a counselor who has worked with clients with Borderline Personality Disorder traits and diagnoses, but, most importantly, as a family member of persons with these challenges I find myself in the constant struggle of trying to balance compassion with limit-setting and maintaining a safe emotional and physical place for me and three 16 month old toddlers.  As the June 16, 2009 NY Times article by Jane Brody describes:
People with the disorder are said to have a thin emotional skin and often behave like 2-year-olds, throwing tantrums when some innocent word, gesture, facial expression or action by others sets off an emotional storm they cannot control. The attacks can be brutal, pushing away those they care most about. Then, when the storm subsides, they typically revert to being “sweet and wonderful,” as one family member put it.
"Brutal" attacks are indeed brutal, but that brutality may take a much more insidious form than overt aggression.  It is patronizing toward family members of persons with personality disorder traits to define "brutal attacks" as yelling and cursing and name-calling and slamming and throwing without understanding the more dangerous brutality in quiet, seething, passive-aggressiveness.  Ask anyone who is a survivor in a relationship with a family member who mixes up their traits-of-the-day potpourri with flavors from other personality disorders and metes out his or her brutality through ambiguity, “forgetfulness”, blaming, obstructionism (resentment and opposition), victimization (complaining about feeling underappreciated or cheated), stubbornness, , inefficiency, procrastination, sullenness, irritability, AND/or cynicism.

As I related in my discussion about personality disorders a few days ago, it is problematic to openly express genuine feelings about our personal experience of the chaos that oftentimes occurs in relationships with persons with Borderline Personality Disorder traits.  I described one of the reasons for this being because it is not 'politically correct' to say something negative about a person who has an illness, and in a timely manner I happen upon Randi's and Kristalyn's blogs and readers' comments discussing this very issue.  Sure enough, some people maintain that your sainthood will be revoked, and you may be burned at the stake for uttering a disparaging remark about someone with an illness. . .  Another obstacle to expressing  how we feel or describing our experiences may be because discussions with persons with these traits can oftentimes be quite frustrating and dangerous on many levels.   

Adding another layer of complication is being a professional counselor or in some other helping field because your family member may nastily complain that you are NOT his or her counselor, nurse, doctor, teacher, etc. AND THEN LATER nastily complain that you should be more "understanding" (i.e. allow whatever negative behaviors he or she wishes to exhibit at the moment) because you ARE a counselor, nurse, doctor, teacher, etc.  So to say that it is easy to vacillate between anger and guilt and empathy and compassion and exhaustion and apathy is an understatement.  Not only is it easy, but I maintain it is normal. 

Anger is one of the many emotions we experience when we are dealing with the up and down and back and forth and black and white of the Borderline Personality Disorder experience.  How we express that anger is the key issue.  You can feel angry and express anger without reacting aggressively - and aggression being not just a physical behavior but also an emotional tone and verbal script.  Although persons with Borderline Personality Disorder traits tend to balk against, be unable to tolerate, and launch an attack against anyone expressing anger or any sort of negative emotion toward them, if we do not remain genuine to ourselves we can lose our hearts and our spirits.  And, ultimately, we can lose the person we love with Borderline Personality Disorder traits.  I firmly believe that some people end up stuffing their feelings because they feel they cannot express them with full-on empathy and compassion, and this can become toxic and poison the interactions as resentment builds and builds.  It is certainly a precarious line to walk because you may very much want to be gentle and supportive while also taking care to neither enable nor perpetuate the unpleasant behaviors.

I have experienced the range of severe behaviors one might experience when having a family member with Borderline Personality Disorder traits, and I experienced many of the worst while pregnant with triplets.  Trying to stay alive in a world that doesn't make sense during the times when someone with Borderline Personality Disorder is having difficulties managing his or her behaviors can be a challenge, and there may be times that simply breathing seems to take more effort than you are able to expend.  So ensuring that you filter all of what you say can be a crazy unreasonable expectation for even the most compassionate of peaceful love-muffins.  I desire to be a person who thoughtfully responds rather than impulsively reacts, but the humanity in me allows me to have moments of ugly thoughts and accidental verbal vomiting. 

Do I sometimes feel so angry that I can't imagine ever feeling compassion for the evil monster my family members with personality disorder traits can become?  Yes.  Do I still love my them even after the unmentionable things I have experienced in the throes of personality disorder rages?  Yes.  And one of the reasons I can still find love in my heart and go on after a particular grueling episode is because I have looked within myself and decided that I am not an infallible victim of Borderline Personality Disorder.  What I am is a regular human-being with a full range of emotions who sometimes sits quietly hoping.  . . .and sometimes charges wildly with an occasional snort.

You cause me so much pain.   
I think I’m going insane.   
What does it take to make you see?   
You just keep on pushing my love over the borderline. 
                                                          ~ (still) Madonna - Borderline

Sunday, January 9, 2011

Dialing up Delusions: Cell Phones/Smart Phones and Your Brain

Sporting bright red noses, big floppy shoes, wild hair, crazy hats, painted faces, and colorful clothes, performing silly antics with horns and puppies and cars and buckets, visited by one or three or 20 friends who bumble and fumble and tumble about, there is something about a clown that lightens my heart and brightens my day.  From Stephen Sondheim's "Send in the Clowns", Gary Lewis & the Playboy's "Everybody loves a Clown", and Smokey Robinson's "The Tears of a Clown" to Freddie the Freeloader, Clarabell, Bozo, Ronald McDonald, or Krusty the Clown most people have some distinctive visceral reaction to clowns.  For some people like me clowns may bring up joy that bubbles over the edges of otherwise ordinary days while there are some people who may have a marked and persistent fear of clowns.  Coulrophobia, or the fear of clowns, is one of the top ten specific phobias so it is difficult to imagine that with strong reactions clowns evoke such as joy or fear that anyone could miss a clown unicycling past them. . .

But miss them they did.  Less than 25% of college students using cell phones/smart phones at Western Washington University noticed a clown unicycling past them on campus.  Scientists interested in testing multi-tasking abilities sent researchers to observe students on campus and then interview them about what they remembered seeing on their walk to and from classes.  When asking students, "Did you notice anything unusual?" more than 70% of students listening to music saw the clown, but more than 75% of cell phone/smart phone users had no recall of the clown.  Really?  A person dressed in brightly colored clothes with a big red nose pedaling a unicycle was not an attention-getter?  The researchers found that not only were these phone users oblivious to their surroundings, but they maintained the delusion they were aware of everything around them.

This delusional thinking is no news to me.  I have all the evidence I need that some people are insane every time I load the babies into the van, back out of our driveway, and cautiously begin a trip to the market, post office, or our favorite pet store.  Who else but crazy people would be driving beside or toward me in a car with their very own children strapped snugly into carseats while blabbing away on their phone or 'just glancing at it' to see why it is ringing, who is texting, or what the map says will be their next turn?  It is crazy enough to engage in some selfish behavior that could potentially kill other people, but how could someone be anything but delusional when insisting his or her own family wear seat belts, sit in the back seat, not eat before swimming (although, by now I hope we all know that is a myth), not run with knives, not smoke. . .or sell crack, and not dart in front of large speeding trucks while maintaining a belief that he or she can safely drive, supervise children, operate heavy farm equipment, write the next great American novel and live while attached to a cell phone or a smart phone.  On September 12, 2008 MetroLink 111 collided head-on with a Union Pacific Freight Train.  25 people were killed, and 135 were injured when a veteran engineer missed a signal to pull onto the siding to allow the Union Pacific Train to pass.  He was text-messaging.  The engineer of MetroLink 111 showed the same "inattentional blindness" as the college students at Western Washington University.

Are these people victims of technology that is developed with an intention to reshape our very thinking, or is it simply that the people who 'need' cell phones and smart phones lean toward a personality structure that lends itself to addictive behaviors, crappy judgment, poor insight, and delusional thinking?  Whatever the answer, one thing is certain, clowns can be quite controversial. . .

Friday, January 7, 2011

Personality Disorders: To End or Not To End the Reign of Terror? That is the Question. . .

Let me hear from you.

Do you have something to say on any or all of these?  Or maybe something more to share.
  • Who out there has been effected by someone. . .or many someones in their life who have personality disorders or personality disorder traits, or do you have a personality disorder yourself?
  • What is the craziest thing that ever happened to you because of personality disorder craziness?  
  • If you have been able to maintain something resembling a sense of humor, is there something funny that you recall? 
  • What questions do you have about things?  
  • And, most importantly, what have you done to survive?

I believe that of all the mental health disorders and diagnoses out there the most insidious and the most nasty are personality disorders.  Countless numbers of people out there have never been formally diagnosed, but there are legions of us who are still effected by these people with "traits."  You know the people, the ones who keep the pot stirred and leave a nasty taste in your mouth.  The people you dread being around and who you attempt to avoid entirely whenever possible.  The people who seem to suck the very life out of a room and color the world black with their negative energy.  These are people who create conflict and chaos and then are in crisis because they have been 'victimized'.  Or at least that is their story, and they are sticking to it.  And if you know what is good for you then you had better stick to it too because anyone who has had to deal with one of these people knows that World War III is not far behind any confrontation of this person's craziness.  And so, unfortunately, many people end up enabling and perpetuating the very nasty thought patterns and behaviors that need to be extinguished.

Why?  Why, you ask, would someone do ANYTHING that would allow these people to continue on with their crazy-making?  The answers are varied, but while it may be easier to just avoid the craziness of acquaintances and distant relatives and appreciate the built-in respite from co-workers when you leave the office each day, when the crazy person or people are your spouses/significant others, parents, children, or other family members with whom you are forced to frequently and more intensively interact then the situation becomes more complicated.  And overwhelming.  Some people allow these toxic persons to continue their reign of terror because they are immobilized by fear, exhausted, confused, panicked, or lazy, or they may have developed a self-protective sort of apathy.  Some people are either unable or unwilling to establish boundaries and set limits with these persons who poison everything in their paths.  Perhaps, similarly to the cycle of abuse and violence where the abuser acts out, expresses remorse, then promises change, and since no one is always 'evil' or always 'good', during those times that small windows of relief open up we are so busy catching our breaths that we can't mobilize into action.  Whatever the reason, at some point we all feel as though we cannot go on one more minute, but on we go.

Perhaps that is when we become sad, or perhaps that is when we get angry.  Sad as we grieve the loss of healthy relationships as they could have been or 'should' have been, and angry at this villain who would have us remain prisoner of our guilt for being mad at someone with a mental health disorder.  It is not seen as politically correct to 'blame the victim', and on some level most of us can rationally wrap our heads around the idea that the person with the disorder is a victim, but as the people with these personality disorders go crashing through our lives we are the ones standing. . .or sitting. . .or laying in the devastation while they dance off to create more chaos.  Sometimes with no insight but oftentimes knowing perfectly well what they are doing  they shout their innocence and demand retribution for their own victimization.  And what is too often lost in the effort to empathize with these 'victims' is the sight of the countless other victims left in their wake.

For myself, I know that while it has always seemed uncomfortable to me I have very different feelings and interactions when it comes to people in my personal life who have personality disorders versus my clients who have personality disorders.  While I can empathize with my clients with personality disorders, and I have even liked some of them quite a lot, I have almost no tolerance for people in my personal life who infect my space with their personality disorder traits.  Cognitively, I remind myself of all the things I 'know', but emotionally, I can't stand the distorted thinking and the crappy behaviors.  I don't feel especially therapeutic, and I want to scream, "Go get a therapist!"

When I was in graduate school a guest speaker in one of my classes was a private practice psychotherapist who specialized in working with people who had personality disorder traits and/or diagnoses.  Little did I know at that time that just a few years later I would find myself in a situation where I was receiving numerous referrals and requests from colleagues and other professionals to transfer clients to me because I had gotten as reputation for doing good work with clients with these specific challenges.  At the time I was listening to this speaker I found her to have some head-shaking interesting stories, but the relevance was lost on me since my focus was a tract in children and families and school social work.  I had no idea that in less than a year I would be beginning an 18 year career as a psychotherapist.

Of all the things she must have said that day I remember only one thing.  It stayed with me into my first job when I had one of those "A ha!" moments that quickly become an "Oh no!"  The adage that the ones who are hardest to love need it the most  was embodied for me on one particular day as I paced back and forth between my office and the front desk every few minutes wondering if she was going to show up late again and quietly hoping the phone would ring in the next minute with her leaving a message canceling until next week.  She was a young woman in her early 20s with a lot of issues she wanted to address (i.e. Me to 'fix'.).  To say that her appointments were draining was an understatement.  If she arrived at all she would typically show up for her appointments 30 to 45 minutes late.  Then she would make herself comfortable on the couch in my office and look as though she was settling in for a long winter's nap.  Okay, not a nap because a nap would have meant that I could relax a bit and be a little less vigilant about what she was going to say next.  And to be more clear, with people with personality disorder traits it is oftentimes not what they say but how they say it.  The actual crisis or events occurring in their day to day lives may indeed be distressing to even the most ordinary individual, but the subjective experience of people with personality disorders takes things to a different level.

To say she irritated me or to admit out loud that I just didn't like her seemed like a betrayal to all clients I had ever seen, would ever see, and most importantly to myself.  That just wasn't who I am.  I felt that if I didn't like her I was a complete failure as a therapist because what warm, caring, "good" therapist would not like another human being???  Isn't that somewhere in our professional code of ethics?  It certainly felt as thought it should be.  I felt guilty for even having the thought that I didn't like her and hoping on a weekly basis that she would either call to cancel her appointment or just not show up at all.  I knew that 'no-shows' were a "very bad thing" for community mental health centers who depended on keeping their sessions filled, so I heaped another helping onto what was slowly becoming a small hill of guilt.  But I couldn't deny the relief that would wash over me when I realized that I was free from our appointment together for one glorious week.  I mean how many times could one moderately sane counselor explain to a client that it was really a bit difficult to do any work in a 15 minute session?  And how many more times would I find myself pushing back the rest of my appointments for the day because as she slowly put her hand upon the doorknob to leave she glanced back over her shoulder and dropped some dangerous bomb out of her mouth.

I don't remember how long it took me to come to my "Ah ha!. . .OH NO!" moment, but it couldn't have been much longer than a few weeks because of the way our diagnosing system worked in that mental health center.  A few veeeerrrrrry long weeks.  And then it came.  I realized that I had the piece to this puzzle in my memory all along!  Yes!  This was exactly how she described it!  I recalled that guest speaker from my class somehow managing to look serious but yet slightly amused and telling us that a significant diagnostic indicator (not in any books, mind you. . .) for a person with a personality disorder was when you found yourself hoping the hell he or she would not show up for your appointment, and if that didn't happen then counting the seconds until your session was over.  Something else about that client exhausting you until you felt as though you wanted to crawl into a cave and hibernate until the next spring.  Or maybe the one after.  Check, check. . .and after a quick confirmation from the trusty diagnostic manual, yep.  There we have it.

I would say that this young lady was my baptism by fire into the realm of interacting with people with personality disorders.  And during our time together I developed a fondness for her, and she was able to make some amazing positive changes.  Within the next couple of years more and more clients with personality disorders kept being directed my way labeled as "difficult to treat" or "unsuccessful" with other counselors.  These clients seemed to be able establish relationships with me that helped them make improvements, and my personality seemed to lend itself to a good skill set and good practice that helped reign in the craziness of characterological, or what most people call personality, disorders.  Some of them you may have heard before:  Paranoid Personality Disorder, Antisocial Personality Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder, and Dependent Personality Disorder.  Then there are the less familiar Schizoid Personality Disorder, Schizotypal Disorder, Avoidant Personality Disorder, Obsessive-Compulsive Personality Disorder (not to be confused with Obsessive-Compulsive Disorder), and the most nasty diagnosis of them all, Personality Disorder Not Otherwise Specified, which includes both situations where someone may have mixed traits of several different personality disorders without meeting the criteria for one specific diagnosis AND/OR situations where someone meets the criteria for a personality disorder but the diagnosis is not included in the current diagnostic classifications - such as Passive-Aggressive Personality Disorder or Depressive Personality Disorder.

I will be talking in more detail about some of the specific disorders later, but now I am looking forward to what you have to say.  Please feel free to leave your comments here, email me at