When you hurt another, you may ask forgiveness from them. The Pope has asked forgiveness of those molested by priests and for the treatment of indigenous people in the New World. People convicted in court may ask forgiveness just before sentencing. Preachers and politicians ask forgiveness when caught in sin and then enter rehab to prove just how sincere they are. All of us do wrong at some time. Forgiveness is an issue that comes up often in life and in counseling. What does that word mean?

It does not mean saying that the wrong is now okay. “Sure you hurt me, but I forgive you, now it is okay.” That definition makes forgiveness extremely difficult if not impossible. It is giving a gift of dispensation to the one who harmed you. There is another view. Forgiveness can mean, “I don’t like what you did, and it is not okay but I will let it go. It doesn’t mean I want to have anything to do with you again, but I am not going to let anger and resentment devour me.” A quote attributed to the Buddha is that holding onto anger is like grasping a hot coal. The one who gets burned is you.

Many years ago I was having a conversation with a person who was working on recovery in AA and was doing step work. The eighth step is making a list of people you have harmed and you become willing to make amends to them. The ninth step is to make direct amends to those you have harmed except when to do so would injure them or others. It became quickly obvious that the person’s goal was to seek forgiveness even though in that case it would cause pain to the person wounded and to others. There was no talk about making amends. One universal principle throughout cultures and spiritual traditions (including secular ones) is to give without thought of return. When the Bodhidharma met with the Emperor Wu, one of the questions Wu asked was how much merit he had earned for all the monasteries he had built and all the other good deeds he had done in the name of the Buddha. “None,” said Bodhidharma. According to the story, the conversation was a short one. There are times when asking forgiveness is a manipulative act. We are asking forgiveness of the one we have already harmed with the sole purpose of making ourselves feel better. What is the merit of that? None. You are just doing more harm.

This is a place where the steps give good guidance. Look into your heart. It may be better to seek how you can make amends to those you hurt rather than ask forgiveness. Forgiveness belongs to the one harmed, and it is for them and within them that forgiveness occurs. If you are going to ask anything, ask how you can make amends and even then, only ask when doing so causes no further harm. Making amends with no expectations (including the expectation of forgiveness) may be a better way and work better at allowing yourself forgiveness with time.

For further thoughts on working on reconciliation and the process of forgiveness I strongly recommend “Negotiating the Nonnegotiable: How to Resolve Your Most Emotionally Charged Conflicts,” by Daniel Shapiro. Shapiro is the founder and director of the Harvard International Negotiation Program. As a psychologist and negotiation specialist, he has worked with families as well as corporate and governmental groups including conflicting parties in the Middle East. He provides a very thoughtful and guided method for the process of forgiveness and reconciliation.

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On Friday, we had snow, then sleet, then some rain and then into Saturday it became sleet and then back to snow that lasted almost into Sunday morning. The weather forecasters had been tracking this storm for a while. It looked touch and go as to what we would get and how much and when it would start here in eastern Virginia. A manager at one of the places I work sent out one of the best cancelation emails I have ever received: “Due to the impending doom, classes are canceled tomorrow.” She is from upstate New York and has a sense of humor about snow south of the Mason-Dixon. And my work schedule put me at the particular work place just as it started to snow. She ended up canceling classes for the afternoon as well. The snow stuck to the roads pretty quickly.

Today, Sunday, is chilly and beautiful. The wind has calmed and the sky is achingly blue. When I looked up early this morning, I thought “I haven’t seen a sky that color since I was last in New Mexico.” I went out after breakfast to start shoveling the driveway. We have a fairly long and curved driveway. It is uphill all the way to the street and trees line both sides. I have to shovel the whole thing side to side so that we can get traction up the hill to get out, and so that we don’t accidentally slide into a tree or slip into the side of the house trying to traverse its aggregate length on the way back down. I decided last year that I would know when it was time to move when I get too old to shovel it.

I have a system for shoveling. I start at the top and work in angles and use gravity to help. It is the simple kind of geometry I liked back in late elementary and early high school. I still wear the galoshes I got around 6th grade complete with loafers from that time inside. My coat is a nylon jacket I got in 9th grade all those decades ago. They feel like old friends that are there for me every winter. And I wore thermal and wicking shirts I used in winter while I trained for marathons some years ago. Marathons take over your life. I just run for fun these days. It is a nice meditation time. I think I wrote most of my dissertation while running.

I walked up to the road. The only tracks in the snow were birds and squirrels and rabbits. I wondered how the little fox who used to hang out some last summer is doing. Hope he or she is okay. The first thing I noticed as I started shoveling was that the alternation of the types of precipitation resulted in snow on top of a layer of ice. Ice does not shovel very well. Hidden in the snow were lots of branches and small limbs that had come down in the wind yesterday – little barriers that could stop a blade quickly. The combination of snow and ice took me back to the snows of ’66 back home. We missed a lot of school for snow days that year, and a snow fort I built in our front yard stayed there for weeks with its ice armor over the snow walls.

I like shoveling snow. It is a kind of meditation. There is the cold, the stark clarity of the landscape, the clean scent of frozen air. There is the serenity of the quiet. Just birds and squirrels were out except for three times when people and their dogs walked by. Today was interesting. How to push snow while standing on ice. I do a lot of balance work with taijiquan and qigong. I used those principles to stay upright. Relax, sink your energy (qi) down to your center and below. Root your feet to the earth. Let energy come up through your feet and legs, direct it with your waist – silk reel – express the energy with your arms and hands. Keep the posture up, breathe to the diaphragm, move from the lower dantien. Embrace tiger, return to mountain. Flow with Dao in harmony with nature. Hard to stay mindful all the time, though, and that is okay. Memories of past snows, thoughts of internal ongoing conversations and writing projects, the occasional blasts of songs by Adele in time to movement of the shovel. Sometimes the brain was as busy as the arms and legs. If I did start to slide, I would just flow with it and stay upright and in control. Just pretended I was in a pickup hockey game with Denis Leary.

The fitbit says I walked a little over three miles. I could probably go out and do the whole thing again now. The sun has softened up the ice. But it is getting late in the day. The temperature is falling. The sun and its yang power will be back tomorrow to take the yin cold of the ice and turn it to water. Let softness, yielding, and flexibility overcome the hard and rigid – practice wu wei in the aftermath of the storm.

Since 2008, Massive Online Open Courses have been providing free or low cost high quality college courses.  There are several sites that offer outstanding courses from universities around the world.

EdX.org is based in Cambridge, MA and governed by Harvard and MIT. You can read more about their principles and goals at https://www.edx.org/about-us.  As with most MOOCS, you can take courses live, or you can audit an archived course that has ended but stored online and still available. More about EdX later.

Coursera’s mission is to “provide universal access to the world’s best education,” and has partnered with major universities all over the world. Like EdX, it has apps for your Android and iPhone as well, to make it even easier to take courses.

iVersity is a European based MOOC with a variety of courses. EdX, Coursera, and iVersity all offer courses in languages other than English if you also want to practice your other-than-English language skills.

You can also use these as resources for students, and there are some geared just to students with resources for teachers and parents.  Khan Academy is a good resource and also has test prep for the SAT and other tests. If you, or someone you know, are interested in tech and coding, there is the Code Academy and Udacity. The World Wide Web Consortium also has classes with certificates you can earn for learning various computer languages and coding.

For a long list of free courses, MOOCS, and other free learning sources, take a look at Open Culture.

I hope you check these out and find something to stretch your mind. The course you take may be work or career related or just something you are interested in and take for fun. The most recent course I took on EdX was called “Chinese Thought: Ancient Wisdom Meets Modern Science” taught by Edward Slingerland of the University of British Columbia. Slingerland did an excellent job of looking at Chinese philosophers such as Confucius, Mencius, Mozi, Laozi, Zhuangzi, and others and using modern neuroscience, psychology, anthropology and sociology research to examine the ethical models of human behavior that each philosopher espoused.  Do expect to spend time on courses. There are lectures (the EdX ones I have taken are not classroom lectures but more like very well made documentaries), reading assignments, message boards for class participation, tests, and papers. There are certificates for passing. Be sure to read the details on the site where you sign up.  Give your brain a work out, and keep learning and growing your entire life.

There is a Zen story of a master who stands with his eyes closed and yet catches a falling object while those wide eyed around him have not yet perceived the object’s fall. He is in the moment and completely attentive.

Ruth M. Buczynski, PhD, president of the National Institute for the Clinical
Application of Behavioral Medicine
, recently talked about how to rewire your brain to improve willpower. A March 23, 2015 article in Medscape discussed a study in Sydney, Australia that looked at nine modifiable triggers for low back pain. The leading trigger is distraction while performing a task or activity.

What do willpower and distraction have in common? Both are associated with losing focus. How can we practice focus and get better at it? Buczynski suggests a simple breathing exercise for five minutes a day. Simple does not mean easy, however. Many people give up mindfulness or meditation because of a racing mind. Buczynski recommends just focusing on your breath, and when thoughts come into your mind (as they inevitably will) just acknowledge them and return to breathing. You can focus on the sound of the air as it flows in and out or the temperature of the air or whatever works for you. The important thing is, return to focusing on the breath. It gives you practice for staying on task, and returning to the task when you wander.

Any time I work with someone who has issues with anxiety and stress, we start with the breath. Slowing your breathing and breathing abdominally does many good things for you – lowers blood pressure and heart rate, lowers stress hormones and in doing so lowers blood sugar and redirects blood flow to the organs. You are balancing your sympathetic and parasympathetic nervous systems.

So if you want to feel better and more balanced mentally, emotionally, and physically, start just focusing on breathing to your abdomen slowly and mindfully. You will improve your willpower and your focus. Paying attention to where you are now can also save your back.

Sunday – I went running this morning in the clear cold air. I came upon a flock of migrating black birds – hundreds, maybe more than a thousand of them. They seemed to be on every branch of every tree. Some were on the road, and a guy had to blow his horn to clear a way to his driveway. The sound of all those birds took me back over thirty years to the first time I came upon such a group. I was walking in the woods to Lake Matoaka to take pictures. I was checking my camera as I walked and suddenly realized I was surrounded by an incredibly loud noise. “What IS that?” I thought. I looked up and was surrounded by birds everywhere. So of course I immediately thought of Hitchcock’s “The Birds.” It was like being swallowed up by a great big living, vibrating-with-sound-and-movement organism. I walked along more slowly and mindfully and just watched in amazement. I remember that day there were at least two or three species each in their vast group. This morning I just smiled at all the racket and hoped nobody rained on me as they flew over and I ran in their shadows. I wondered what it was like in the days when passenger pigeons were still alive and their flocks would block out the sun for days because their numbers were so large as they crossed the sky. And now there are none, thanks to people. A few moments later a shot rang out somewhere down across one of the ravines. The woods immediately became silent. Within a few moments, the bells of a church over in Toano started to ring through the woods in the direction from where the birds originally came. I kept going with the only sounds that of a few local birds that live here year around, and the sound of the bells. A few seconds the only sounds were just a couple of crows and sparrows and my footsteps. I got back to the house and listened intently and maybe about a half mile or so across the ravine, I could hear the cacophony of birds again, recovered, back in the groove, calling out to each other and the world, carrying on their journey. My run became a meditation of yin and yang.

Tuesday – Another running morning this time in the cold damp gray overcast of a day between winter storms. I passed by a man unloading his pickup of his hunting gear. About a mile later I passed a woman in her front yard smiling with joy and wonder at a small deer in her front yard. She was holding her hand out to the deer trying to get him to come to her. I thought of a time years ago at Bryce Canyon as I walked along with a young summer ranger intern. He was studying ecology in graduate school. Every time we came upon one of the little ground squirrels that frequent the trails, he would stomp his foot and scare them away. “You don’t want to habituate them to people,” he said. The deer today was already pretty habituated, and getting more so. Every action we take is linked to everything, and our intentions don’t always play out in a way we hope for or even think about. A gesture of felt kindness and wonder may have consequences we are not mindful of – like making a deer more vulnerable as prey.  You really can look into any action, or even a bowl of rice, and see that we are connected to everything in the infinity of time and space. Every why has a why. I kept running. A mile or so later I was in the part of the neighborhood bordering on deep woods. A single shot rang out. I just kept running.

You may be at a point in your life where you want to go out on your own in a private practice and maybe even do some consulting.  Or you may have a passion for something and feel inspired to start a nonprofit supporting the cause. Or you may already have taken one of these steps and want to maintain or grow what you have started. You may find that for you, deciding to make these changes follows the same stages as the transtheoretical model of change – pre-contemplation, contemplation, preparation, action, and maintenance.  The preparation stage is critical.

There are many web resources for persons deciding on whether to go into business or whether to embark on starting a nonprofit. There are also many web resources for those on low budgets as sole proprietors of a counseling practice, and there are also some resources for nonprofit organizations to save money and to help develop the organization. Let’s explore some of these.

Contemplation and Preparation Resources

For Counselors Graduate school teaches you all about how to be a counselor. They don’t teach you about the business aspect. A good resource for counselors is ACA and VCA. Network and talk to therapists you already know in private practice and see what has worked and not worked for them. Again, do your research and preparation.  You can get connected to liability insurance through VCA and ACA. If you are going into private practice, allow time for getting added to insurance panels – it can take months for the process to be completed.  You may have to complete forms and submit information to individual companies. There is CAQH – http://www.caqh.org/ for streamlining the process. You also need a national provider number. Information on this is at https://nppes.cms.hhs.gov/NPPES/Welcome.do

Business Resources for Entrepreneurs – If you have thoughts about going into business for yourself, or if you or your group needs help with business plans and marketing and other issues, check out these resources.  You may also find help at your local government website, including the process for obtaining a business license, or the local chamber of commerce web site. For example, you can find the Williamsburg Chamber resources at http://www.williamsburgcc.com/business-start/ and Hampton Roads at http://www.hamptonroadschamber.com/ .  To find your Virginia local government website, the state has a list of these at http://www.statelocalgov.net/state-va.cfm.  – just scroll down the page for the lists. If you are in a state other than Virginia, you can find listings at http://www.statelocalgov.net/. And you want to check on liability insurance for malpractice and also for property, injury, etc.

  • SCORE – http://www.score.org/ – SCORE is a nonprofit association dedicated to helping small businesses get off the ground, grow and achieve their goals through education and mentorship. They have been doing this for nearly fifty years. SCORE is supported by the U.S. Small Business Administration (SBA), and thanks to a network of 11,000+ volunteers, they are able to deliver their services at no charge or at very low cost. They also provide a mentoring program as well as workshops and local volunteers.
  • Small Business Administration – http://www.sba.gov/ – This site has a wealth of information for starting and growing a business.
  • Business One Stop – http://www.bos.virginia.gov/index.shtml – Guide to starting a business in Virginia
  • Enloop for writing a business plan – https://www.enloop.com/

Business Resources for Nonprofits – If you are a 501(c )(3) nonprofit organization, you can get a lot of help from Grass Roots. For starters you can get free website space at Blue Host. You will be able to put up a straight HTML site or use one of the content management systems listed below, plus a whole lot more software. It also includes email, store software, and plug-ins for your content management system, as well as learning management systems.  But there is so much more to Grass Roots. Their website describes the organization as helping “nonprofit organizations succeed, by leveraging technology to accelerate their charitable efforts. When you join Grassroots.org, you join with thousands of nonprofits, volunteers, businesses and donors working together to change the world.”

Action Resources

These are some general tools you can use regardless of the business you are in.

Office Software – The standard office suite is Microsoft Office. It can be costly, and various packages have different software included. For example, Publisher and Access are not included in the Home and Student Office edition. There is a subscription plan for Office 365. What are the low cost or no cost options? Open Source office suites have been around for years.  Open Source means that the software code is open to modification by anyone and is the software is free to download, install and use. That also means, though, that you are pretty much on your own for support. There are communities you can join and ask questions, and the software site typically keeps support, frequently asked questions and support sections. Click on the links for more information about each application. Both Google and Microsoft have online versions of office products.

Online Storage, File Sharing and Collaboration – With these you can write and create projects together and share files with others. You can keep a file private – just for you – or you can share it with individuals you specify, or you can make it open so that anyone can see it. Google and OneDrive have the office software built in. The others are online or “cloud” storage.

Encryption – There are times when for privacy and confidentiality you may want to encrypt files or your entire hard drive. For instance, you may want to keep records in a document or spreadsheet template you create rather than pay for electronic health records software. To keep your documents private, you can store them as encrypted files or you can encrypt your entire drive.

Getting the Word Out – There are lots of options here. You can use MailChimp to set up your own direct electronic mail list or newsletter for your business or your organization. There is a free version, and you can create your own templates if you want. You can set up listservs with Yahoo Groups and Google Groups. SlideShare allows you to embed your PowerPoint presentations on your website or sites like LinkedIn. Twitter has an option that allows you to embed your account feed into your web page so you can easily update information to your site with just a Tweet. Blogger is owned by Google, and you can add newsfeeds and your Facebook feed to it for constant fresh content. You can also monetize it with Google Ads. You can also embed video from your YouTube Channel and slide shows of photos from Picasaweb. The list below includes social media, pod casting, blogging, and other sites for sharing information.  Lastly, don’t forget about press releases. You can find a how-to with examples at http://www.cbsnews.com/news/how-to-write-a-press-release-with-examples/.

One thing to remember about these is that they take time and work. Don’t overdo them or over commit. You can end up spending all your time on your web projects and not have much time for your business or your organization. Have a clear vision of how you want to use them. For social networking sites, be mindful of the boundary between personal and business and what you want kept private. We won’t discuss each of these since many of them change formats and options periodically. Just click the links and explore.

Graphics Software – Photoshop is great tool, but it is also costly, and is now on a subscription basis.

Surveys – You may need surveys for feedback from customers or stakeholders, or you may need it for a research project. Both these products have free versions.

Collaborating Live – These products allow you to collaborate online in various ways – conference calling, videoconferencing, sharing files, instant messaging, etc.  Google Voice allows you to set up an account in which you can embed a gadget on your web page so that people can call you from your site. When someone leaves a voicemail, you can call for it, check it on your Google Voice page, and receive both a text and an email with the message. The text and email use voice recognition to change the vocal into text, and the quality varies depending on the phone connection and the enunciation of the caller.

Audio Recording and Editing and Video Converting and Recording – Software to help you put together audio and video projects for you site, your podcast, or your video channel. Screen recorders enable you to record your computer screen so that you can produce tutorials from your computer.

Space for Fee Websites – There are lots of places you can start your own website besides Facebook. Here are a few. You can still buy your own domain name, like counselingservices.com, and then have a site at one of these servers and point your domain to your free site. If you are using Google Sites, your free URL is sites.google.com/site/counselingservices. Just go to the control panel of the company you bought your domain from (like Blue Host, Fat Cow, Yahoo, GoDaddy and many others) and point your domain name to the URL. The company you bought your domain name from can explain how that is done. It is actually a very simple process.

Content Management Systems and Learning Management Systems – These allow you to have more than one person be responsible for various sections of the site, each with their own log in. They are open source so you would have the responsibility of doing the upgrades and security updates.

Other

If you know of other resources, please feel free to share them. We all get better when we work together.

Setting goals is important, and how you frame them is critical to succeding. A goal can be as broad as “I want to live a life of integrity” to as specific as “I want to run a four minute mile.” With the former you need to define just what integrity is – how will you know when you are living that life and when are you veering off course. How do you get back on course? For the latter, you need training, a workout schedule and a sense of just how realistic that goal is. Whether your motivation is internal or external also has an effect on succeeding. You are less likely to burn out if you are focused on getting better for you.

One thing both those goals have in common is that they are positive goals. Positive goals are “I am going to do something.” They are action oriented in that something will happen and you will know it. It gives you a place to move towards. All too often we define our goals in a negative fashion – “I am not going to do something.” There are many problems with that. First off, you are activating your brain to think about what you don’t want to do. Do not picture a blue jay in your mind at this moment. What picture just appeared in your mind? I spoke with someone recently whose goal was, “I don’t want to be lonely.” “Well, what do you want to be?” I asked. How will you know you are not lonely? Focusing on loneliness tends to leave one lonely. So we began to look at how she wants to connect with people, what kinds of relationships does she want, and first off, what kind of relationship does she want with herself. It is much easier to be in the company of someone who is comfortable and secure with themselves. Negative goals too often become self fulfilling prophecies. I can’t tell you how many times I have heard someone say, “I didn’t want to be like my parent.” And then they realized that in focusing on what they didn’t want to become, they took on those qualities and became what they vowed they would not be.

A negative goal is inactive. Tough to prove a negative. So when you are setting goals, make them positive, something you will know is present. Put in as much detail as you can. It is like writing a good story of what you want to do or become. You can even use a 10 scale to track your progress. A ten is you have achieved the goal.  A zero is you haven’t even begun. Where are you now? Track your progress up the scale. That gives you some flexibility, too. Stuck at five? Reevaluate and redefine and see what you need to do to move up even to a 5.1. Edit your story.  One of my favorite exercises is “start-stop-continue” from Jerry Lynch and Chungliang Al Huang. What do I need to start doing, stop doing and continue doing to function at a higher level? And remember the concept of wu wei or effortless effort. Sometimes when you push too hard, you push yourself into the ground and get stuck. Have a plan but relax into it and have fun. It is hard to stick with a goal when the process is something you hate or find punishing. That is why so many resolutions for diets and exercise programs fail. Flow and adapt, and make your goals positive.

Join or Die FlagThe Gadsen Flag seems pretty popular these days – the flag with a coiled snake and the “don’t tread on me” caption. It has become the symbol of the individual, the independent “me.” There was another flag with a snake on it during the American Revolution, one with the snake divided and the caption, “join or die.” Ben Franklin even said, “We must all hang together or assuredly we shall hang separately.” The individual as a separate self is a distinctly Western concept. But how does it stand up to empirical evidence? Aristotle once postulated that men had more teeth than women, but he did not look in people’s mouths to count to see if his hypothesis actually was correct. In Zen, there is an exercise in which you look deeply into your plate of food and you are able to see all the interconnections back to before the beginning. I use a sheet of plain paper when I do that exercise with people. You could even do it with the screen you are looking at. What is there? There are letters and words, but also whatever the surface is made from, whatever is powering it, all the people who made, sold, shipped, mined material, assembled parts and more to make it, those who worked to feed them, those who grew the food, and on and on back to star dust. Nothing and no one exists independently and all and everything are connected to some degree. Any action you take ripples out like the waves from a pebble tossed into a pond for better or worse with consequences intended and unintended.

Louis Cozolino’s book, The Neuroscience of Human Relationships: Attachment and the Developing Social Brain, is an extensive and remarkable overview of how our brains work, particularly with attachments. Within the first few pages he says, “individual neurons or single human brains do not exist in nature. Without mutually stimulating interactions, people and neurons wither and die.” He goes on to discuss psychopathy in chapter 20 and includes the following:

Think about the characteristics that make for a “good citizen.” We expect each member of society to be aware of and adjust to the needs of others, recognize and conform to shared values, and live by the rules. In most instances, the needs of individuals are weighed against the needs of others and negotiations are established to create the most good for the most people. Antisocial individuals, on the other hand, are a society of one who adhere to the more primitive mandate of individual survival. It is as if they have passed over the eons of social evolution that have selected cooperation, emotional attunement, and being part of a group mind. While thinkers such as Nietsche, Machiavelli, and Rand have extolled the virtues of the Ubermensch (superman) and society even lionizes those who gain prominence and success, selfish behavior has not proved to be a successful overall strategy for group survival. For humans and other social animals, noncooperation and a sole focus on personal survival does not correlate with evolutionary success. (page 339)

I think a more positive and constructive way to function is by showing respect for ourselves and also respect for others and the relationships we all share, and respect for our responsibilities. And unlike Aristotle, we need to count the teeth. We need to look for the empirical evidence and not rely on a paid pundit whether from talk TV, radio, Internet or elsewhere. Researchers found after 9/11 that those who watched less cable news were more resilient and less depressed. Do yourself a favor and turn off those playing to emotions to increase ratings to make sales. You can read about it here and here.

Cozolino’s work is a well researched and well written book that I hope will be widely read. It speaks to all of us on our relationships in this world. [It is also an excellent resource on how attachment theory works on a neurological level, and how we develop secure and insecure attachments.] One concept I have struggled with is the Buddhist concept of “no self.” Mark Epstein’s talk about the spatial versus the temporal self makes a lot of sense to me. We experience ourselves as spatial beings even though we are moving through time and the “self  I was a moment ago is different from the self in this moment. We are constantly changing.  Cozolino takes it further. In order to function in the world, first our brains constructed the concept of “other” and then the concept of “self.” Those constructs enable cooperation, but also competition and egos that fight for supremacy when we lose sight that we all are one and that the “self” is a constructed illusion.  I remember coming across studies in graduate school about how resources last much longer when people cooperate, but when they compete, resources are much more rapidly depleted. One person competing destroys group cooperation, and all are forced to compete to survive, but ultimately, the survival of all is jeopardized and ultimately doomed by that self-centered competition for resources. There is an inherent paradox in those concepts of self and other. We cooperate with those in our tribe and those we perceive to be like us, and compete with those we deem to be different and of another tribe. We tend to forget we are all one tribe and are all in this together. Sensei Corky Quakenbush has written an interesting post on facing conflict with love using the principles of aikido. You can read it here.

Stress is a part of life. The only time you no longer feel stress is when you are no longer alive. Even then, what is physically left of you is subject to entropy and change. Recent research on mice found that reaction to perceived stressors may even be carried in our genes. Later generations of mice reacted with distress to a scent they had never smelled, but that scent had been paired with pain in their ancestors. Perhaps we pass our narratives down through our stories and even through our bodies. We go on alert in a situation we have never experienced but that distressed our great grandparents. It does make evolutionary sense.

Then there are the traumas that we actually experience in this life.  Our mind protects us by dissociating from them, but they are still there. How do we face these anxieties?  There is a great movement toward “mindfulness” these days, though the concept has been around for thousands of years.  But many think of mindfulness as only quieting the mind and falling into a blissful state away from all the worries and pain.  They get frustrated by the words and thoughts that disturb them as they meditate but may learn to just focus on the breath and let the thoughts go. They may learn to just be with wherever they are – to hear the sounds, smell the smells, see the sights, feel the surroundings and all the rest. They may be able to visualize a lake buffeted by winds that their mind stills the breeze so that the water clears and calms and reflects the full moon in their vision. But still the stressors await when they leave the meditation cushion. Sometimes the stressors and anxieties get louder when the mind starts to quiet, and visions of the trauma come up that had been forgotten.

In taiji, there is the principle of jing. In the jing state, you are calm and peaceful, but you are also aware and ready.  Mark Epstein, in The Trauma of Everyday Life, talks about “bare attention.”  In mindfulness, you are not trying for that calm quiet state alone, but also come to know and come to terms with trauma.  It is not what happens to us that matters so much, but how we react to it.  We learn to let those thoughts in and talk with them and observe them and treat them with respect.  I think it is a lot like forgiveness. To forgive doesn’t mean to say that what ever the wrong was is okay. It means I wish it had not happened, but I am not going to be consumed by it and let it run my life. I learn from it and let it be. The Buddha’s word for mindfulness, “sati” means “to remember.” We let what is bothering us come into consciousness and then learn to cope. As Epstein put it, mindfulness balances relaxation and investigation and is a combination of detachment and engagement. He tells a story about teaching a meditation class in New York City on a Saturday morning and asked the participants to turn on their cell phones.  Rather than be annoyed by the ringing and sounds of the cells, just notice the sound.  He also asked them to just breathe and take note of any sounds they heard and then just let them go.  During the discussion afterwards, a young woman revealed that her father had died a few months before. She had a special ring tone for him, but had not listened to it since his death, that the thought of hearing it had been too painful.  One of the phones that rang during the meditation had that same ringtone. She said that being in the supportive group and being mindful when it rang had given her a different experience from pain. She felt touched and love and a connection with her dad when the phone rang. His memory came flooding back in a compassionate way.

Epstein also tells the story of a monk who had a glass that was very beautiful. The glass reflected the light in such a lovely way, and the monk was very proud of the glass. What made the glass even more precious, the monk said, was that even now, he knew that the glass is already broken.  Nothing lasts, everything changes, clinging to wishes of permanence brings pain.  The time with the glass, or any thing or any one, is even more precious when you come to accept that the glass is already broken.

The American Medical Association voted not long ago to classify obesity as a disease.  The intentions were good, for obesity and the associated health problems, do need attention. There are problems with this, for example if one uses only body mass index to diagnose, then an individual with heavy musculature could conceivably be diagnosed as “obese” when clearly that is not the case. Some, such as National Review, write that this is another attempt to lessen personal responsibility and allow government to enter into our lives and our bodies.

Physicians’ attempts to change what were at one time called “conditions” or “failings” or other terms into “disease” is nothing new.   You can read an excellent summary on the evolution of the term “schizophrenia” in the November 2011 Schizophrenia Bulletin.  The article quotes Berrios, “… schizophrenia research can be described as a set of research programs running in parallel, each based on different concepts of disease, mental symptom, and human mind.” For an overall critique of schizophrenia as a disease, Models of Madness is a good start. Alcohol dependency has been defined as a disease for decades. Dr. Benjamin Rush, a founding father of the United States, is credited with declaring that alcoholism is a disease. The research of E. M. Jellinek aoubt 60 years ago is credited with giving this diagnosis credence. David J. Hanson, PhD, of SUNY-Potsdam, gives a thoughtful critique of the disease model at http://www2.potsdam.edu/hansondj/Controversies/Is-Alcoholism-a-Disease.html.

Mosher et al in Models of Madness review the relationship of causal beliefs to attitudes.  While at times part of the motivation to define something as a disease is to lessen the stigma, often the reverse happens.  John Read and Nick Haslam wrote the chapter, “Public Opinion.” They cite numerous studies that find that when something is defined as a biological illness, the stigmatization increases. “A belief in categories that are discrete, immutable, and invariably rooted in a biological abnormality reflect the medical model’s essentialist view of mental disorders as ‘natural kinds’. Viewing mental disorders in this essentialist fashion is associated with prejudice along multiple pathways.  Believing in immutability may promote pessimism and avoidance. Believing in discreteness promotes the view that sufferers are categorically different, rather than sharing in our common humanity. These essentialist beliefs form a toxic ensemble.” This unintended consequence should be no surprise. It is rather common among diseases for which there actually are lab tests to diagnosis. Several members of my family, including my father, had tuberculosis. People, including family members, shied away for fear of catching the disease. Virginia mandated testing and x-rays for immediate family members (despite negative tests) from my earliest memories until about college age.  Susan Sontag wrote about cancer in Illness as Metaphor, and how there was an exception in confidentiality laws at the time for one disease due to stigma, and that was cancer. She later wrote about AIDS as well. I once visited Kalaupapa, which was a leper colony on Molokai. There were still people living there, now cured of Hansen’s disease. These folks also took you on the tour of the site. You got to hear stories about how people who were even suspected of having the illness were snatched off the street and taken here, banished from their lives, and isolated from friends, family, and home forever. Kalaupapa is a very moving place to visit. You can most likely think of other diseases with stigma, perhaps even some you fear. Based on our history as humans with a fear of disease, it is remarkable that anyone thought that defining a behavior, any behavior,  as a disease would make it less stigmatizing. In some ways, it is metaphorically throwing gasoline on a fire hoping this time a miracle will happen and the liquid will extinguish the blaze.

I think there are at least two issues at the foundation of this disease problem. And this excludes the political and economic and ego issues associated with the businesses of academia and treatment programs and medicine and pharmaceutical companies. That is a whole other thing. The first issue is thinking we know what a disease is, and that we all agree on what that means. But at the foundation of these troubles is deciding just what is a disease. That is how diagnoses got started – when we research and treat or even just talk about a condition, we need to know we are talking about the same thing. Let’s define it. Unfortunately in behavioral health, from the start egos and later egos and money were involved and muddied the good intentioned waters.  Berrios mentions the different concepts of disease above in the study of schizophrenia.  A quick web search gave me many definitions for disease, among them:

  • a disorder of structure or function in a human, animal, or plant, esp. one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.
  • an impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions, is typically manifested by distinguishing signs and symptoms, and is a response to environmental factors (as malnutrition, industrial hazards, or climate), to specific infective agents (as worms, bacteria, or viruses), to inherent defects of the organism (as genetic anomalies), or to combinations of these factors
  •  A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.
  • A condition or tendency, as of society, regarded as abnormal and harmful.
  • Obsolete Lack of ease; trouble.

Pretty much anything out of the ordinary can be called a “disease.”  I remember folks going back 30 years who have justified the disease model in mental health and substance use by relying on the last – the obsolete – definition of dis-ease. These days, the term would be unease. So when people argue about what is a disease and whether something specific is a disease, they may be talking about very different concepts.

The second issue is, I think, with the problem of defining words and giving them great power. Steve deShazer was right, that words were originally magic.  But we use words to define words, and the definitions are circular. They have to be, and they are imperfect. The words defining an apple in the dictionary will never give you the experience of an apple.  Even experiencing one apple will not give you an idea of the taste and look and fragrance of all apples, or of the potential of apples or of the creation and life and death and return to the earth of an apple. Putting a label on an individual will not give you an experience of that individual. Being with that individual in one situation will not give you the experience of the whole ever changing person. Words have the power that we give them. We need to be careful.  I remember years ago in graduate school reading about a study in which individuals with no psychiatric problems gained admission to mental hospitals, and then just acted as themselves. Other patients caught on rather quickly that these folks were not mentally ill, but staff – not so much. The individuals took notes about their time in the hospitals, and nursing staff charted that they were exhibiting “writing behavior.”  David Rosenhan writes about the study here.

I will leave you with two quotes from Alan Watts, and also the remarkable story of Eleanor Longden in her own words.

“We seldom realize, for example, that our most private thoughts and emotions are not actually our own. For we think in terms of languages and images which we did not invent, but which were given to us by our society.”

“Trying to define yourself is like trying to bite your own teeth.”

Eleanor Longden: The voices in my head

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