Archives for posts with tag: May Mental Health Month

Many years ago, I was working on a research study evaluating the efficacy of bullying prevention program for elementary schools. To do this kind of research, schools must be recruited for participation. I was placed in charge of the task of contacting schools and districts as well as making presentations onsite. If memory serves, I made over 50 presentations. (In perhaps another post, I will write more about this. I enjoy public speaking but this was a very high pressure situation. Basically, I threw up about 2o minutes before nearly every presentation though I think I did a good to excellent job with everyone. Looks can be deceiving. A person can be funny, informative, and relaxed, and still have thrown up 20 minutes earlier. You just never know about another person’s life, just by looking.)

One of the presentations was to all elementary principals in a particular school district. After I was completed, there was a bit of time for one on one conversations. There was one principal who made a bee-line for me. She gave me the kind of handshake that starts as a firm “how do you do” and turns quickly in a seemingly never ending grip. Meanwhile she was earnestly telling me about her school. My co-worker, Truc, was also there. Truc observed this action intently; Truc is an excellent observer as well as being very funny. Later Truc said, ‘Elizabeth, she was saying, “Please, Elizabeth you must help our school. You ARE THE ONLY ONE WHO CAN HELP US!”‘

School principals have very demanding jobs with a lot of rushing around. That principal had a story to tell me and she was going to hold onto me until she had a chance to finish and could see that I understood.

Back in days as a researcher, that kind of poignant social interaction was rare. In my clinical life in private practice, especially as a psychologist with a specialty in diagnostic assessment, it is a frequent occurrence.

Everyone has a story, a life story. Families in need, need to tell their story. Some of them do not know where to start. Some of them don’t know how to stop. Both of those extremes keep me on my toes. In particular, parents and their teen children who engage in self-harmful and life threatening behaviors carry an incredible urgency in their stories. This is not my treatment specialty but within my diagnostic specialty, suicidality is much more prevalent than in the general population, especially for girls. So I encounter this situation with some frequency and help families secure appropriate services, which unfortunately, are in short supply.

Parents of suicidal teens are some of the most isolated people you will ever meet. They have a story that they are afraid to tell for fear of being judged harshly, among other reasons. Given the way that many people judge teens and their parents, it is a realistic fear, unfortunately. Sometimes we see another person’s tragic situation and blame them for it. To believe that they have control over it makes us feel safe.

I have heard many stories from parents, so many in fact, that I can tell you one that story is based on many.

I am incredibly alone. My house is full of people and each of us are shell shocked and alone. The loneliest moments are when we are yelling at each other.

I have met many many healthcare providers. I have gotten anywhere between 10 and 50 minutes to tell my story. There is so much to say, much more than I ever thought there would be to say in my life, ever.

You are a stranger to me but I need to tell my story. I will trust you with my helplessness. I will trust you with my failures as a person and as a parent. I will trust you with my shame at times for the unspoken regrets I have about ever choosing to be a parent. Bringing this child into the world has been painful and ungratifying but I will try to move try to move Heaven and Earth to save him.

I will trust you the best that I can. Sometimes I may not do a very good job. Three seconds later, I may do a good job again. My emotional life is like that; it is lived three seconds at a time, either dealing with, waiting for, or trying to ward off the next crisis.

I will do this because it is my job, to put myself second when my child is sick, so very sick that she may take herself from this world before she really even knows who she is, where she is, or the things that can heal with maturity.

Please help us.

We want a different story to tell.

We all move forward through time because that is the nature of time; it progresses. Due to our brain structure, we are also able to travel back in time through memory. And based on our memories, whether they are biased, fading, or correct, we think about them as well as our current experience to make predictions about the future. These predictions often inform our current behavior.

Thus, we live in the past, the present, and the future. This makes life rich, but it also makes it complicated. We get all kinds of messages about which time is the best. “Live in the moment!” “Keep your eye on the prize!”

Getting stuck in any one time can cause a lot of problems, though. For example, depressed thoughts and feelings, for example, come in part from viewing today’s misery as being a constant. The past was always bad and the future will be bad. Past joys and the possibility of joy in the future are buried under the weight of today’s despair. Impulsive behavior comes from living too much in the moment. I want this now. I feel this now. The past doesn’t matter and the future only matters in like of getting the goal I want right now, accomplished.Later, after the negative consequences come crashing down, impulsive behaviors result in regret and guilt about the past. And anxiety often comes from living in the future of “what-if’s” and “what might be”.

One of the things I have noticed in my mindfulness practice, is that I am better able to integrate my past, present, and future. I observe the present and recollect the past. I use information from both of these times to inform the plans for my future. Being able to travel through the time of my own life is a fascination to me. I don’t always travel at the right time or to the right place. But I think I am getting better at it, more frequently feeling in more of some kind of balance.

Memory makes life complicated. But without it, we would always live in the present moment. And that, my friends, would be although a simple way to live, a very dependent, sometimes incredibly distressing way to live. There’s no sophisticated learning without memory. There are no moments of beautiful nostalgia. No dreams for the future and no appreciation for the way that people and their relationships unfold over time. I could go on and on.

A life with just one time is like a story without a beginning or an end, just the middle. And the middle is the crisis, as I recall, the problem that needs to be solved. I want to continue understanding the grand narrative of my life. It has many beginnings, middles, and ends. My life has many stories, some unfolding as we speak, and they are all part of who I am and how I connect with the rest of life.

Maya Angelou died today at the age of 86. She taught me so much.

I learned the power and beauty of the spoken word. Poetry accentuates the music in language. Maya Angelou’s poetry did this to such a great degree that for me, reading her written poetry instead of listening to her read it, was like watching a brilliant jazz combo with no sound. It just wasn’t the same. Her voice was powerful, beautiful, and the words were hers.

Many of us know that Maya Angelou feared the power of her voice so much that she stopped speaking to anyone other than her brother, Bailey, for years. She had been raped as a child, told her brother, who told adults, and the man who had raped her was briefly imprisoned and then murdered after a few days after his release. The then 9 year-old Marguerite Johnson held her voice responsible for the man’s death. Over time, she recovered from her trauma enough to speak again.

Not only did Maya Angelou overcome the fear of the power of her voice but she used the power of her voice as a singer, a poet, a teacher, and as an activist. And when she read her poem, On the Pulse of Morning, for President Clinton’s inauguration in 1993, I got goosebumps that seemed to last for days.

Another lesson I learned from Maya Angelou was the power of telling one’s life story, and further, telling it in installments. I started reading her autobiographies in high school. Although her first book, I Know Why the Caged Bird Sings, remains my favorite and the most memorable, I loved her life story. I burned through the three subsequent books that had already been published and then eagerly waited for the rest to be written. Her life is fascinating and she was pretty open about her imperfections. I see now that I missed her final installment published last year. How did that happen? Oh yeah, I was experiencing cancer treatment and the resulting chaos.

My blog is, in part, a memoir that unfolds in frequent, short installments. As you know, I get a great deal out of writing this blog. It’s not just the writing, it’s the sharing of my writing, the conversations that ensue, and the miraculous times when the words I write are exactly what a reader needs to think about at that time. Every once in awhile, I have a little nagging thought that my writing is self-absorbed. Maybe I am enjoying the attention I get from writing this blog, a little TOO much. I am no Maya Angelou but I have an interesting story to tell and I write well enough. Someday my daughter will read this blog and I hope it will be something that enriches her life and our relationship.

Maya Angelou also taught me the power of resilience. She was abused, repeatedly traumatized, mistreated, and oppressed. Maya Angelou’s life was a triumph of the human spirit and a testimony to the highest power of resilience. And then she used her life experience to help others. That may seem like a natural thing to do but it is not the case. Think of how many people justify their lack of compassion for others by giving examples of how they managed to be successful despite adversity so everyone else should be. These are justifications by parents for rejecting their own children and for everyday citizens for justifying policies that let children in our country and all over the world go hungry, to be poorly educated, and to live in unsafe conditions. Maya Angelou could have hurt others with her stories, beaten up others with her success, but she didn’t.

And if you have read Maya Angelou or heard her interviewed, you know that she does not take sole credit for her resilience. She talks about the support of her brother, Bailey or her close relationship with her son, Guy. She talks about her neighbor, Mrs. Flowers, who helped her speak again by having her over for tea time and time again and talking to her in the most beautiful way.

Today, I am thinking about the power of my spoken words. I have been short-tempered, as you know. Short bursts of anger and I yelled at my daughter yesterday. She was being a pain in the butt, but yelling isn’t a solution. I am thinking about the power of my written words, not just in this blog but in my work. The reports that I write for children and teens with ADHD and learning disabilities impact their lives. The care that I take in writing them can make an important difference in the kind of support they receive from their parents and from their schools. They can also give them a new, more positive way to understand themselves and in time, lead to strategies to cope with their particular patterns of strengths and weaknesses.

Today, I am going to think about how to be an adult who helps build resilience in others, people both near and far away. What can I do to honor the people who paved the path for me, who helped me along the way, by helping build a world in which children not only survive, but thrive?

I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.
-Maya Angelo (1928-2014)

Although I see kids for psychotherapy, most of my time as a psychologist is spent as a diagnostician. I gather background information, I do tests, I scour through records, and I do lot of thinking and a lot of writing. Then I meet with parents and I go over the results.

Most of the time, parents are satisfied and grateful for the report and for my recommendations. I believe that this is a testament to their parenting and also a reflection of my experience delivering complicated information about serious problems. There are other times when I am pretty sure that the news I am going to share is going to be much different than expected and it’s going to be viewed as bad. At these times, I’m tempted to tell parents, “I don’t make the news; I just report it.”

But to do so would be flip and unprofessional. I have to keep my eye on the highest priority, which is to communicate clearly and respectfully in order to provide good patient care.

Since I specialize in conditions that impact school functioning, I do a lot of intelligence testing. As I tell parents, there is no be all and end all measure of intelligence or of every type of intelligence. But the tests I use are rigorously developed and evaluated; they are useful in helping answer questions about why children are not doing as well with school as one would expect.

Working at grade level is the expectation. But some children do not work to grade level in many areas. This can be due to a number of things such as learning disability, ADHD (although ADHD does not always impact academic learning), or lower than average intellectual ability. Lower than average intellectual ability includes intellectual disabilities but some children just have lower than average intelligence; in other words, they do not have the degree or pervasiveness of difficulty that we used to call “mental retardation”. And to make matters worse, these students usually struggle in school without special education support because they do not easily fit into one of the special education categories.

The kids who are “merely” below average often fly under the radar. If they have a cooperative nature, work very hard, and gets lots of parent support, they can actually do quite well in school until material gets less concrete and more abstract. These are the kids who start sticking out in adolescence, a time when for most teens, abstract thinking skill development accelerates rapidly. (Alas, if they could apply these higher order thinking skills to making better life decisions…)

I sometimes find myself doing private testing for an early adolescent child who has had a history of learning difficulties, which have accelerated only to learn through testing that the probable reason is low intelligence. Then I have to think about how to share this “bad news”.

There are parts of our society that confuse “goodness” with intelligence. Intelligence is a good thing but it does not make a person good nor does low intelligence make a person “bad”. Most of intelligence appears to be inherited. Another bit is subject to environmental experiences. Most people are average.

When it comes to talking to the parents about the results of these evaluations, it is very difficult to say, “Your child is a very hard worker and is actually doing better in school than we would expect.” That’s not exactly the best news to hear.

So, we do a lot of talking and I do a lot of explaining and placing things into context. I do a lot of talking about what it takes to be a happy and successful person in life, things that are not necessarily related to high intelligence.

But I try to make the challenges clear, too. A lot of kids get yelled at for not doing better at school even though they are working EXTREMELY hard. A lot of kids also need as many educational resources that a school district and family can afford to provide. They are “it takes a village” kids. I have to make my best argument for getting the child as much support as possible but I can’t do that if I gloss over the difficulties.

I wish every child had the same resources and same opportunities but they don’t. It’s my job to try to make sure that they can do their best with the particular package of strengths and challenges that they have. I remind myself of older kids that I see who have beaten the odds and moved mountains. Invariably, they are hard working kids, with parents who have provided early and long lasting support, with supportive teachers and healthcare providers.

Sometimes, but certainly not always, great things can result from the bad news.

About ten years ago, we planted two trees in front of our house. They were the same size and the same kind of tree, styrax japonicus (Japanese snowbell). We made planting holes of the same size and fertilized the bottom of each hole identically. They receive about the same sun exposure and I watered them in the early summers, the very same amount. Water drainage may be slightly different as one of the trees is a tiny bit uphill from the other.

If those trees were my children, one could say that I loved them equally and that they both came from “good homes”.

This is what they look like:

DSC00722

DSC00723

The first tree is the picture of health. The second tree is about half the size and oddly shaped. This difference became noticeable several years ago. Although the size difference has increased, at least the little tree is looking healthier these days. It is actually going to bloom this year. It didn’t for a few years and I actually wondered if it was going to make it. The leaves, however, are already yellowed with age on the small tree but not the big one even though they have not had leaves for more than a few weeks. When the tree was misshapen and stopped blooming, I sought out advice and gave it extra care and attention. Maybe I’ve actually given that little tree more love than the big tree.

I really don’t understand why the little tree is making such poor life choices. I really don’t understand why it isn’t trying harder. I really don’t understand why that tree doesn’t care enough and isn’t living up to my expectations. Doesn’t it appreciate everything I’ve done for it?

Yes, those are really ridiculous statements about a tree, that for whatever reason outside of its control, has a much harder time growing and thriving than the tree next to it.

However ridiculous those statements are, they are applied to children daily. Yes, I know that children have brains and trees do not. But children are vulnerable and developing beings. They need much care and support.

And you know what else? Some of them, for whatever reasons beyond their control, have a much harder time growing and thriving than others. Some of these reasons have to do with mental health.

An estimated 20% of children and adolescents in the U.S. have at least one diagnosable mental disorder. That’s a lot of people and most of them do not receive mental health services. Most of the children and adolescents in my practice have more than one mental disorder. A lot of the kids I see display behaviors that are frustrating, irritating, and annoying to their parents and teachers. And sometimes the intensity of their misery and lack of thriving is downright scary.

Unfortunately, time and time again, children even the very youngest of them, are blamed for their mental disorder with quick explanations such as, “He is choosing to act that way.” “She just needs to try harder.” “He just doesn’t care.” “She shouldn’t be behaving this way anymore.”

Sometimes those statements are just plain wrong. And sometimes there is truth to them but they are not a solution. People act as though these statements are the final word and nothing is to be done. So I ask, “Why is it so hard for this child to make healthy choices? How can we help?”

I ask, “Why is it so hard for this child to motivate himself? How can we help?”

I ask, “Why is this child not meeting developmental expectations? How can we help?”

A good bit of the time, there are adults around the child who “step up to the plate” to help. They do so despite the amount of parenting stress. They do so despite the unfair number of students in their classrooms. We also need to provide more support to parents, teachers, and the other caregivers who are the most important influences in the early part of children’s lives.

These are very difficult roles that most of us choose to take on in life. Frustration is inevitable. Sadness is inevitable. Confusion is inevitable. But the children are not responsible for the fact that it is harder for them to grow, thrive, and meet our expectations. The fact that their jobs are harder to do often translate to our jobs being harder to do.

After all of these years, my little tree is very much alive and I actually think it is interesting and pretty. I wonder how it would have grown if I’d just yelled at it?

 

George Lakoff

George Lakoff has retired as Distinguished Professor of Cognitive Science and Linguistics at the University of California at Berkeley. He is now Director of the Center for the Neural Mind & Society (cnms.berkeley.edu).

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