Archives for the month of: June, 2014

[Originally in Health Beat, Richmond Register, June 2014]

    American psychologist, Herman Witkin, proposed in 1962 an interesting model for how people think.  It’s been subjected to all kinds of research and criticism over the past half century, or course.  So I find it gives a useful continuum for people that dovetails well with my own professional experience.

    Witkin suggested that some of us think in a context-INDEPENDENT way, and others in a DEPENDENT way.  What does this mean?

    Context-independent thinkers (CITs) can figure out problems that only have a limited number of solutions.  They’re able to tune out Real World “noise,” that isn’t relevant to the problem at hand, and focus only on the solutions possible within the situation.  These are the folks who are good at math, Sudoku, number puzzles and computer programming.  Each of those domains is basically self-contained; all the information you need to figure them out is given to you out front, you just need the ability to shuffle it around or arrange it in your head.  No outside experience is necessary.  For that reason, context-independent thinkers tend to shine early in life.  They’re the “math brains,” the “computer whizzes,” the precocious kids who outperform even many of the adults in their lives as early as grade school.

    By contrast, context-dependent thinkers (CDTs) tend to come into their abilities a little later in life.  This is because unlike their precocious peers, they must draw on their own life experiences, study how others approach the problem and make conclusions for what has worked in the past.  You have to have a past to be able to draw on it.  Rather than excel at “air tight” problems, with preexisting strategies and limited solutions, they do better with figuring out “open ended” problems, where solutions have to be assembled by building relationships with others, exploring resources and often stitching together combinations of strategies based on best judgement.  CDTs are more comfortable with ambiguity, since the “messy” situations in which they excel simply don’t have clean, ready-made solutions waiting to be uncovered by a discerning intellect.  If CITs excel at space, time and numbers, CDTs are better with literature, history or social science; areas whose problems can’t be separated from the contexts of culture, human nature and past experience.   

    Each type has benefits and drawbacks.

    CITs, for example, are more likely to jump from one problem to the next.  They are passionate and invested in solving problems, often working long hours and neglecting food or sleep to find an answer.  However, since their abilities mature quickly, they tend to use up challenges fast and want to move on to the next challenge immediately.  Since they peak quickly, they have less chance to learn frustration tolerance.  One of the biggest challenges they may face is that of boredom; they struggle with sustaining effort and focus on activities that aren’t always fascinating or that have necessary “slog” elements to them that have to be endured.  This inability so sustain interest means they may accomplish less on longer-term projects than their relevant talents would suggest.

    CDTs, on the other hand, must contend with the frustrations and setbacks that come of late-maturing capabilities.  Have you had the experience, for example, of struggling with school work, and despite your best efforts, you squeak by with a barely sufficient grade, while a classmate or sibling who “never cracked a book” seemed to always get high marks?  Enduring and persevering against this constant uphill struggle can be quite discouraging at younger ages.  One of the biggest challenges CDTs may face is that of morale or self-esteem.  On the other hand, they will ultimately learn the value of patience better than their CIT counterparts, and can take on long-term projects whose drudge elements must be endured before the rewards become apparent.        

    Of course, I always extend a word of caution with these types of useful typologies, as no one fits into them perfectly.  People are complex.  But as a model, Witkins idea may help explain some of the frustrations you’ve experienced based on which type you most favor.


[Originally in Health Beat, Richmond Register, May 2014]

   In February, I had the honor of giving a presentation to the Madison County Homemakers.  But I think I learned more from them.  What struck me was how willing members of this body of distinguished ladies were to share resources.  And not just their money and delicious foodstuffs, but psychological resources. 

    We use the term “psychological resources” frequently in mental health.  We diagnose people as being “low” on them.  We describe capacity for them while consulting with each other in staff meetings.  However, it’s in examples like the Homemakers’ where I realized we counselors don’t really define the term well.  I think it might be important to do that, since your resources are the mortar and bricks for psychological work. 

    Let’s try this:  A psychological resource is a pool of aid that you can tap to help you respond well to life’s vicissitudes.  Now let’s discuss three examples:

1.  RELATIONSHIPS.  Whatever the social networking world says about “friends,” all social connections in your life are not created equally.  Some have more distant orbits from you and your concerns.  Regardless of how you laughed and shared together at the water cooler in that workplace from five years ago, some contacts have comparably less to offer.  Know who understands you, how much they can provide support, and the limits their own personal problems place on their responses. 

    Blood being thicker than water, as the saying goes, family are often the first people we consider when we need support.  Be aware, though, that while family may have stronger ties of obligation, along with such ties can also come old resentments and jealousies which can develop from sharing closer emotional circumstances.  Older family members–parents, grandparents, aunts or uncles–often have warm feelings toward you, but they can also carry a frozen image of you in their minds, a “you” far younger than you are now.  So before you tap the smart phone and call them, be sure they’ll take your adult concerns into consideration and not see you instead as a distraught teenager. 

2.  MEANING.  Some life events are simply not changeable.  For example, death of a loved one, termination from a job, chronic illness.  Here, you need the resource of skilled meaning-making.  How can you use a bad event to spur you in a positive direction you may not have considered without it?  Psychiatrist Viktor Frankl stated that if we are to weather traumatic events, we must love something or make something.  Write a journal, pick a new career path, or dedicate your life to bettering others.  The ability to get beyond the negative change and use it meaningfully is a measure of this resource.  And one for which counselors are ideally suited to help you.

3.  WORDS/EDUCATION.  As a teenager, I slipped on icy porch steps, fell on my back and knocked my wind out.  Ow.  My father asked desperately if I was alright, what was wrong, why wasn’t I answering!?  Without any breath, I couldn’t say anything!  Finally, my lungs spasmed, I drew air, all was well. 

    On a psychological level, we’ve all had that experience of the “blob of badness” which others want to understand so they can help us.  But since we can’t articulate exactly what is wrong, everyone is frustrated.  The most common phrase I hear from clients?  “I wish I could explain it to you.”  Luckily, the more we study, and learn new vocabulary, the more educational resources we have to express ourselves.  We have to learn the language of suffering.  That’s why pop music about lost love or tragedy can become so famous; because many people find in it a way that they lack themselves for expressing pain. 

    Some resources, we can increase.  Others are more difficult, limited by factors in our past that we simply can’t control.  Luckily, everyone can maximize the resources they have, or learn how to best allocate them for the problem at hand.  Personal counseling can help you with goal-setting, problem-reframing and evaluating the relationships you’ll need to get through the tough times.

[Originally in Health Beat, Richmond Register, April 2014]

    Have you ever met anyone who creates the obscene graffiti on the walls of public restrooms?  Me either.  Yet clearly, SOMEONE is out there, writing scatological poetry and drawing pornographic representations of the female and male anatomy.  It’s just that no one will own up to it, right?

    I think unhelpful medical advice is rather like restroom graffiti.  Many patients make reference to it, have even taken it as their personal gospel.  But I’ve yet to meet a physician who who admits to saying such things to the patients.

    It bears pointing out that the doctor-patient relationship is rich with ritual.  A person of status (doctor), using arcane knowledge and esoteric artifacts (stethoscope), goes through predictable steps that impart role expectations to the patient.  Where this ritual goes awry, however, is when the role it teaches leads to patients feeling powerless to help themselves or improve their own health.  And unfortunately, since these ideas are driven home with physician authority and the power of ritual, they are very difficult to uproot when research calls them into question.

    In my extensive history of working with patients, my ongoing frustration has been in dealing with those people who cling to unhelpful advice.  This is because *my* purpose is to illustrate how changing your behavior, making lifestyle improvements, can help you better your health and wellness.  That is hard to do when when so many patients are already 75% convinced before they ever see me that their situation is out of their control, unhelpable.  Poorly phrased messages from medical providers, however well-intentioned, can be damaging.  I’ve written about this before, but it bears repeating, in hopes of inoculating those of you who haven’t yet been stymied by unhelpful advice.

    I cannot count the number of back pain sufferers I’ve evaluated who tell me their physician informed them that if they twist in just the wrong way or lift a ridiculously low weight, they will “end up paralyzed.”  This terrifies patients, and many will fall into deep depression, convinced that any activity in their lives will land them in a wheelchair as a paraplegic.  You’ll find them huddled in bed or on the couch, afraid to move an inch, lest they be thereafter unable to move an inch.

    Now I’ve been trained in social science, not medicine.  So I try not to let my personal anecdotal experience overpower hard data in the formulation of my professional opinions.  But when it comes to medical providers warning people of this type of consequence if they do ordinary activities, I suspect there IS no hard data to push against.

    Even still, forget my experience.  Let’s use YOURS instead!  Ask yourself:  “Have I ever, in all my X years, met a person in a wheelchair who put themselves there by doing ordinary activities around the house?”

    I’m not talking about spinal crush injuries from car wrecks.  And I’m not addressing the horrible changes from progressive neuromuscular diseases.  And we aren’t referring to the person with pain who sits in a wheelchair only because it hurts to move.  Paralysis here means no sensation, no ability to even twitch a muscle…caused by activities akin to walking to the store, changing a light bulb or mopping a floor.  So how many self-paralyzed homebodies have you met?  I’m betting I can guess your answer, huh?

    Lest I be misunderstood, I’m not suggesting you shouldn’t listen to your doctors.  In all likelihood, they truly want to be as honest and helpful to you as they can.  But you should also be sure that the advice you’re getting comes with some options to help yourself afterward.  If you leave the doctor’s office feeling otherwise, you might need a second opinion.  Or a follow-up referral to a behavioral medicine expert.  No matter how bleak the checkup, we can ALWAYS do something to improve our well-being.  You deserve to be encouraged to learn some of those ways.