The Day That Never Comes

          I have been meaning to write this post for quite some time.  The revelation came to me one night while I was thinking about aspirations of "finally catching a break"  and the kind of mindset that accompanies such thoughts.  For starters I'll reference the Metallica song "The Day That Never Comes".

          I'll not dwell on the song and it's meaning too much as I cannot speak for the band.  Nevertheless, the title of the song and a few lyrics serve as a nice punch-line and prompt for this post.

Waiting for the one

The day that never comes

When you stand up and feel the warmth

But the sunshine never comes, no...

          I am quite certain that a great many people have had the experience, at some time or another, of thinking "If I can just... then I'll be good."  Of course entering some verbiage and / or a time frame to the statement.  What I've found is that these experiences just correlate a chain reaction from one If-Then to another.  For example, for me, two years ago it was "If I can just get accepted to graduate school...", then "If I can make it through this semester to the break...", then "Once classes start again...", etc, etc.

          What I'm starting to realize is that we've somehow allowed Hollywood, Television, and Novels to so impact our lives that we've begun to re-imagine our lives like a series of capstone endings.  That is, a picture perfect, sentimental, (more or less) happy ending.  And that's it, the story ends with closure and comfort.  The unfortunate part is that that is not the way life works.  There will always be another day, to rejoice, and another struggle to (potentially) conquer.  In this sense then we are all waiting for the day when we can say to ourselves, "At last, the worst is behind me."  But life is complicated, we all know that.  And there is a reason fiction is dubbed such and fantasy is not reality.  The very subsistence of "life" is that it is indicative of a verb... living.  Phrased in the present tense and demanding active participation, however passive or pro-active those actions are is largely up to the individual.  Don't pester me with opposition about time being linear or cyclic because the matter of fact is that "time lapsed" is always linear.  It moves in one direction, consumption.

          But that fabled, romanticized, and beloved day of relief will (in effect) never come.  It may manifest itself before our very eyes, but its presence will be of short note before the next tragedy or next struggle takes center stage.  I'm not very politically oriented, but just look, for example at how fast our world moves from one tragedy to another.  Katrina -> Tsunami in Japan -> Hurricane Sandy -> Sandy Hook Elementary.  In all of these cases there are people still suffering with the traumatic fallout of those events as our media and our attention shifts away from "Yesterday's News."

          We are longing for the "warmth of the sunshine" for our hearts to be filled and our lives to be consummated.  We are dredging thorough time and space on a quest to overcome fate and searching for closure to our struggle.  But as life goes on, so do its pains.  The sunshine may never come, or it may be the silver lining behind clouds we're failing to recognize.  Either way, that doesn't stop us from continuing onward.  The new struggles, the challenge of a new pursuit, the tragedy of Trauma-X or Incident-Y provide resistance to strive against.

          Before anyone gets too uptight let me just say that I'm not trying to diminish the severity of anyone's suffering or belittle their hardships.  What I am saying is that with time and attention to open wounds (personal, cultural, and global) we begin to realize how tedious a process it is to keep our good-faith from slipping to charms of malevolence.  We will never get to see how our story ends, we don't get to write a back cover or appendix.  All we are guaranteed is the proverbial "page" we're on.  Chapters end and pages turn (thanks, Bob Seger).  The story continues and new struggles begin as quickly as old ones are (at least perceptually) closed.  Perhaps it is more apt then not say "the day that never comes" but "the day we'll never see."  The point of inquiry and interest then becomes; "What will I do in the meantime?"

"The struggle itself towards the height is enough to fill a man's heart.  One must imagine Sisyphus happy."
- Albert Camus

Freud, Adler, Charlie Sheen, and Masturbation

          Yes, you read that title right.  After little break from the academy and writing world this is what I have to offer.  I have one class this summer, Counseling Theories, and thus far we've covered some ethic considerations, introductory stuff, and as far as actual theories we've discussed Psychoanalytic and Adlerian.  For the time being, I'll spare you a rant on each.  Maybe I'll save that for a later date.
          The first point of discussion was Psychoanalysis.  Welcome to the early 1900s and Sigmund Freud.  In the most basic sense, I'd say that what I like about psychoanalysis is that there are so many "gems" of information to be uncovered.  Certainly, I do not support Psychoanalysis or Psychodynamic theory in full (just my personal preference), but that does not mean that there isn't anything valuable in the theories.  Psychoanalysis offers a great deal of insight into the realm of the unconscious, or what is working behind the scenes that we are not pro-actively aware of.  Of course, Freud was not 100% correct, no one ever is, but he certainly gave us a lot of possibilities to consider for the past 100 years and counting.  On a comical note, my colleague who gave a presentation on the topic, described the Id (part of the psyche) as a tiger.  I could barely control my laughter because I have always thought of the impulsive ans reckless Id as being epitomized by Charlie Sheen.  If you the blanks filled in, let youtube take you back a couple years:

Perhaps my most adamant critique against this model is (please, correct me if I'm wrong) the denial of responsibility.  Allow me to elaborate.  Nevermind the nonesense that our psyche is entirely developed during childhood; but even if it were, suppose that all of our present adult issue can be traced back to something that happened during our childhood... a deficit or surplus somewhere or another.  I take no alliance with this inherent "blame game."  Blame my parents, or blame this series of random events to which I've attributed the meaning of causation of my current phobia... pick your poison, I'm not buying any.  This seems lazy in my opinion.  It is lacking responsibility and ownership.  Not that we can control every aspect of our lives, but this theory inherently denies responsible ownership of our present state and thereby demands that we succumb to the whim of our past.  Perhaps an early childhood trauma did contribute to your irrational fear of X, indeed that is insightful, but I doubt its helpfulness.  What do you plan on doing about it now?  I don't know that I'd go as far as to say that insight without action is useless, but it doesn't seem to help having a flashlight in the dark if you don't know how to turn it on.  Nevertheless, I stumbled upon a Freud quote the other day that was very much to my liking:  "No one who... conjures up... those half-tamed demons that inhabit the human beast, and seeks to wrestle with them, can expect to come through the struggle unscathed"  Think about that for a good long while...  Here are some links for more information on psychoanalysis, psychodynamic theory, Freud, and Jung.  

          On to the Adlerian theory.  Again, this will be just a brief commentary, for more information about Adler, have a look here.  I have never thought of myself as an Adlerian, but what I was quite surprised and impressed with during this class lecture was how much more "contemporary" styles of therapy owe to Adler.  For example, the notion of the therapist not being an expert, therapy being a collaborative arrangement based on mutual respect, emphasis on choice and responsibility, emphasis on meaning making, and interests in family constellations.  If you've read any of my writing before, some of that should sound pretty familiar.  The one bone I have to pick with Adler is his optimism that people will be willing to change.  His theories seem to assume that people will desire a stance of activism.  For my personal interests and opinions, this is true.  However, it is certainly not a blanket effect.  It is pretty safe to say that a large number of people are perfectly content with... well... being content.  Which, then, kind of puts a buger in the whole "superiority striving" notion.  (And yes, I am aware that that phrase does not necessarily mean being better than everyone else, but closer to being your 'best self' - Maslow and Self-Actualization?).

          That brings me to the last tag in the title.  When contemplating parts of the psyche, various terms are used by Freud and Jung, but I've also heard comparisons with terms such as "should-self", "ought-self", and "actual-self".  Similarities exist, for example, the "should-self" closely resembles Freud's Superego in the sense that social-moral-cultural standards suggest you "should" do/be this.  The "ought-self" (if my memory is correct) is somewhat of an expectation of the Ego, I "ought to" do this or be this way.  We can see, then, some correlation starting to develop from Adler's notion of superiority-striving.  Once this was mentioned in class and the connections made in my memory, I couldn't help but continuously think of one thing.... "Is that what a man looks like?"

          

First Year of Graduate School Summary

          My second semester and first year (out of three) at the University of West Georgia ended two weeks ago.  As following form with the first semester, I wanted to write a little something to sum up my experiences this semester.
          Firstly, I must say that this semester has been exhausting.  Particularly the last three weeks or so.  I thoroughly enjoyed my classes this semester.  I thought that they had helped me to dive excruciatingly deep into this wonder we call "the human experience."  Of course, it is impossible for me to express all that I have learned over the past semester in this simple post, but that is what all the entries along the way have been for.  I also felt like there was great synergy between most of my classes.  Particularly the connection between "Psychology of Suffering and Disorders" and "Brief and Narrative Therapy."  The same instructor taught my "Suffering" course as my "Theory and Practice of Clinical Assessment" course, so naturally there was some methedological and philosophical crossover.  The topics covered in these courses most certainly influenced the topics I discussed and researched for my "Research Methods" course.
          In terms of exhausting, I have never felt so "out of gas." as the closing weeks of this semester.  For starters, my Spring "Break" consisted of me working over 60 hours at my Mental Health Tech job.  The following week, there was a stint where I was awake (not just vegged out infront of a TV or computer screen) for about 41 hours.  That consisted of a 12 hour shift at work, presenting our Psychology Department's annual conference, providing supportive attendance to my colleagues' presentations, and returning to work for another 6 hour stint... then it was time to begin working on my final papers.  From what I can recall, I think I wrote somewhere between 80 and 100 pages in a matter of 4 days.  Truth be told, I was sad to see the semester end.  My feelings of running out of fuel were not due to "uninvested sacrifice", rather, quite the opposite.  I feel as if I had contributed all that I possibly could to the courses ... to the point where the grades I "earned" were irrelevant.  My spirit may have been running out of fuel but I can hardly think of I time when my heart had felt so full.  That, has made the journey worth it all the while.
          I finally watched "The Dark Knight Rises" (yes, I'm a bit late in getting to this) but I think that the timing was just right considering the philosophical implications of the film.  There were two parts of the movie that I felt really spoke to my personal life.  First, Bain says to Batman; "You fight like a younger man, with nothing held back... admirable, but mistaken."  When I look back at my career as an athlete, I think this is very symbolic   When I first started practicing martial arts and combat sports, you could say, I was full of piss and vinegar, seething with anger at the world, and searching for an outlet.  I found that outlet in fighting.  One of the reasons I have not returned to fight in "the octagon" is because I am afraid that I could not recreate the experience of my first fight.  I was driven by a raw grotesque rotting in my guts, as if they were filled with gravel, my eyes sharp and hardened stones.  For better or worse, I don't know that I feel that way anymore.  Similarly, in the film, the parallel is that "Victory has defeated you."  Bain says this as he's pummeling Batman and the idea behind it is that Bain is still fueled by an animalistic rage whereas Batman has become soft or weakened, that he has "mereley adopted the darkness" rather than being "born in it, raised by it."
          The second connection I made to the film lies in an exchange between Bruce Wayne and Alfred.  Bruce tells Alfred, "You're afraid that I'll fail."  Alfred replies, "No, I'm afraid that you want to."  In my class discussions on Suffering, we talked about Vicarious Trauma, or Counselor's Guilt (similar in my mind to Survivor's Guilt), Burnout, and Compassion Fatigue.  The more interesting part of the discussion was about the unavailability of resources for counselors to help themselves manage their existential pains.  Indeed, a colleague said to me at the conference (mentioned above), "Wow... I hope you're taking time to take care of yourself."  I wrote in one of my journal entries that that was my "sickness unto death"; that I didn't want to or have forgotten how to "take care of myself."  In a similar sense to the film, and the more interesting part of my inquiry into these topics, is why I don't want the help in dealing with these vicarious and guilty sufferings.  I don't think it is a matter of individual egoism  by more a fundamental principle of mine.  "Suffering builds character" (from the film).  In absolute honesty, I am mortified by the thought that attempts at soothing my own personal sufferings and traumas would only antagonize the "existential" guilt.  Indeed, there is something pure, simple, and beautiful about the "9-5 grind" and carrying on your personal life in segregation.  But that concept misses something powerful, "admirable but mistaken", there is wonder and awe to be found in the depths of our suffering when we peer up (if only for an instant) from the quagmire and (perhaps only imagine) see(ing) a faint peep of sunlight.
          I have become increasingly convinced of the truth in Camus' statement that "The struggle towards the heights is enough to fill a man's heart" and of course, then, "One must imagine Sisyphus happy."  But I suppose that depends on the punchline of another favorite film of mine (Vanilla Sky), "What is happiness to you..."  For me, I have to think it is the feeling of being burried but brilliant, depth charging a rabbit hole, owing nothing to the filth of this planet and its contents, but giving everything anyway.

No Exit, No Resolution: Reflections on Postmodernism, Trauma, and Narratives

          Recently, I participated in the University of West Georgia's "Student Psychology Annual Research Conference" (SPARC) and presented my final research paper for my "Brief and Narrative Therapy" course.  In spite of preparation and lack of sleep, the presentation was well received and I felt it was quite outstanding and received several compliments on the presentation.  Below, you will find a link to a .PDF version of the the presentation that is publicly available on Google Drive as well as a .PDF of the essay which is also publicly available on Google Drive.  I have not posted the essay here in its entirety due to formatting errors in the past.  However, these documents (as stated) are publicly available for viewing, download, and searchable on the web.  I have provided the abstract from the essay for reference.

Abstract

The term “postmodernism” can refer to many different things ranging from art to politics. Postmodernism also has connotations with philosophical and social movements. The concentration of this essay is to examine the social sphere of the philosophical notion of postmodernism. It is, then, to say that the philosophical and social distributions of postmodernism are intimately connected. The first part of this essay will examine the precursor to postmodernism, “modernism”, as well as some of the movement’s weaknesses or shortcomings. The following will also address some of the social effects of interrogating meta- and personal influences. This essay asserts that we as a society and as individual persons are not, nor can we be, prepared for the “discursive construction” that embodies the heart of postmodernism. In fact, it may well be in our best interest not to be. A case will also be made against postmodernism and how it has been enacted within the world. Furthermore, I postulate that we exist within a unique state of trauma, perhaps post-trauma, in which our memories, narratives, and confidants are called into question from every angle. Nevertheless, The World and our worlds have not stopped or been enacted upon retroactively. Rather, we continue working, living, and being in a nameless age; a narrative with an innumerable amount of blank pages left to fill. So, it would seem, that somewhere between catharsis and oblivion, at the intersection of nowhere and everything, it is very probable that something quite therapeutic occurs.

Link to Presentation

Link to Essay

Trajectory of Psychotherapy - Psychological Suffering: Final Reflection

** The following was submitted as the last reflection paper for my Psychology of Suffering and Disorders course **

          For this reflection paper we were asked for our thoughts on the “trajectory of the field.” The first thing that comes to mind is part of a conversation I had with some of our colleagues after class on Thursday. I mentioned that a friend of mine, who is in her Podiatry Residency posted something on her Facebook titled “Dear Lawmakers: This is what it's like to be a doctor today.” As I read through the article (link here) I couldn't help but think of the parallels I was seeing with my own career projection. To summarize, the physician laments his soaring student debt and modest salary as a young doctor while purchasing a home and raising a family. He presents a question about why doctors still bother; and answers that it is not about the money any more, it is because they care. I thought this bore a striking resemblance to my thoughts on entering a career as a psychotherapist or even as a psychologist. As ***** pointed out below, if money is your game, you're in the wrong field. So, why do therapists still bother with 2-3 years of graduate school (5-7 if you're chasing a doctorate) and another 3 years of supervised training? I suspect it is not too different from the reasons stated in the article.

          More to the point, I think that there are two predominant directions that “the field” is headed in simultaneously. Firstly, I think the divisions between professions (Psychiatrists, Psychologists, and Therapists) is only going to deepen. As technology, science, and medicine relentlessly accelerate and are pushed by various influences (consumer demand, payment policies, research and education politics, etc...) the idolatry of a “human science” seems to be waning even from its current crippled state. Secondly, I suspect that further integration between these fields will develop regardless of who holds the “majority share.” While technology can do incredible things, the screaming voice of the last half-century or so is pleading that capital and industry can not solve all our problems.

          I mentioned Human Science in quotations and with the pejorative of “idolatry” with specific intent. I feel that emphasis is needed there and not doing so discredits what science and medicine have done to improve our (every helping profession's) quality of care. If nothing else, options are available now that would have been beyond comprehension 100 years ago. I also think it would be dishonest of us to deny that there is any “theoretical seclusion” or “mental masturbation” going on in our field. Personally, I plead no exception to this. I suppose that I am more hopeful than making a probable projection that integration will occur. I also mentioned a waning presence of “talk therapy.” I mean this in a public/political stock-holding sense. I don't think that this necessarily means a weakening of strength within our own context and scope of practice; rather, a concentration of skills and emphasis... a refining richness in quality over quantity if you will.

          On the specific subjects of this course, I think that suffering is inevitable, perhaps even integral. Sooner or later something or someone will come along and hurt us, scar us, disease, or dis-ease us; probably more than just one or once also. As part of our growth and developmental processes, I think that a radical “foundation-shaking” occurs at some point in life (a breaking of the dam) whose reaction fosters growth in one area or another, be it “orderly” or disorderly. While this can be taken into several personal contexts, I think it is also fitting to the “trajectory of our field.” As I read ****'s post, I don't think “willingness to” or “state of” suffering has ever been the question; although, certainly we are living in an age in which our career path seems dis-ordered, the foundation of the field questioned, and no where to go but onward. In one direction or another, it will grow. Decades of medicine and technology have not abolished the need for therapists, counselors, and social workers; nor has the prevalence of CACREP-accreddited programs erased the existence of non-CACREP programs. I highly doubt either of those things will ever occur. There's no replacement for human-to-human customer service; and “it takes a hell of a drug to beat a placebo.”

Cost of Caring

           I was having a conversation with a co-worker of mine the other night, I guess you could say the topic was “The Cost of Caring.” She holds the same position as I do in Psychiatric Facility, but she is studying to be a nurse, and I a psychotherapist. Interestingly enough, this conversation had nothing to do with patient/client care but rather, care for one's self. I found this conversation to be quite fitting to a recent presentation in our class about “Secondary Trauma” to therapists ala vicarious suffering through their clients or counter-transference of suffering.

          We both shared experiences when we we “burnt out.” But there was more to it than that. The term “burn out” doesn't seem strong enough, and “compassion fatigue” doesn't fit; indeed, the curse was perhaps “caring” too much. As she described it at the end of the conversation, “It was like being a zombie on an airplane set to autopilot with the wings on fire.” In her experience she said that she was working three jobs and going to school. When people asked her how she survived she said she replied, “Coffee and B12 (vitamin).” She eventually had to slow down because after being asked by a loved one “Please stop. I never see you and I hate seeing you do this to yourself.”

          I had a similar experience in the fall of 2011. I was going back to school full time taking classes to round out medical school prerequisites (at the time I wanted to be a psychiatrist). I was also working a full time job and a part time job. To make a long story short, between school and work I was sleeping about two hours per night, seven days per week for ten weeks. To say I was a zombie on autopilot would be a severe understatement. To use Heideggarian terms, I had lost all sense of being and time; I was a machine, the anonymous “das man” … but machines break. There was no one asking me to stop, but one day I realized I was done. There was no agonizing internal debate, no emotional tossing-and-turning, one evening I just decided I wasn't going to do it anymore, it was over. I'd like to make one more comment and that was to the befuddlement of my professors when I withdrew from my classes (in spite of excellent grades) and turned in my text books. I spared them the long story and just told them I had had a change in career plans. That didn't seem to ease their confusion but as I walked away at about 8 am after working all night; somewhere in the weary black rings under my eyes they nodded as if they understood the unspoken and inevitable collapse of taking on too much.

          Anyway, the moral of the story is that caring, or rather “giving”, has a price and it is steep. Hardened nerves, iron will, and a clever wit can only take you so far. Some high-octane emotional fuel can increase this longevity but the trajectory still has an end. Perhaps that end is oblivion, perhaps not, perhaps it is a cataclysmic Armageddon, perhaps only a whisper. Some last longer than others, but it seem inevitable that when you truly give everything, sooner or later something important will fall through the cracks. Indeed, the cost of giving is expensive.

          This leads me to a more current predicament. Emptiness, a feeling of the “low fuel light” coming on … different from the previous experience in this sense. There's a secret, my foot's not coming off the throttle. Why? Because while I may feel that I'm “running out of gas” (perhaps I'm just anxious for the summer break to “refuel”) it is a satisfying emptiness rather than a hopeless void of defeat. When this semester is finished, I can look back and honestly say that there is not one thing more I could have given, not to my job, not to my coursework, not to my friends. I have given all that I can in the truest sense of “giving.” So while I may turn out “bankrupt”, the currency has been well spent. Perhaps on investments that I will never see “mature” (in the financing sense), but the return has already been “given.”

Drugs, Neuroscience, and Therapy

Preface:  The following is a response/reflection to some of the topics being discussed in my "Psychological Suffering and Disorders" course.  The topic prompt was the use of MDMA (ecstasy) in treatment of PTSD (post-traumatic stress disorder).

          Typically I'd be in favor of psychotherapy first and pharmaceutical assistance second or as a supplementary procedure; not a replacement.  I'd go as far to carry that sentiment over to many other medical and psychological conditions as well.  However, the fact of the matter is that medications can provide assistance to our profession and towards easing a person's stuggle with their suffering.

          In the specific instnace of MDMA, as ***** pointed out, many other narcotics are used within the medical realm that would be highly illegal if used on the street.  The problem I see here is not in the legallity of use but in reliance, regulation, and distribution.  There is a quite significant difference between a prescription for marajuana or a prescription for cocaine and/or the in-procedure use exclusively by medical professionals.  This would be one of my main concerns with the use of ecstasy, LSD, or (insert "illicit substance").  

          One of my larger concners would be the over-eagerness of supporters.  It seems to be a freightening trend that as soon as a new medication is relased from a pharameutical company with any "cooberating" evidence for a research study that there is a cult-like bandwagon effect.  This has been seen in recent history with SRI (serotonin reuptake inhibitor) medications.  As with anything, there are politics involved.  A shocking one is the way in which funds are transfered from pharmeceutical companies to researchers to sponsoring physicians... but that is a topic for another day.

          I'm also cocnerned about a dependence on the drug(s).  This is a two-fold approach.  My concern is for both the use by "professionals" and "patients."  I would be concerned that users may become dependent on the drug (even something as simple as ibuprophen[Advil] or acetaminophen[Tylenol]) and think of it as the primary curative facillitator rather than other therapeutic interventions.  In terms of coping with struggle, other "crutches" can develop out of "need" as well; maybe its alcohol, food, laziness, impulse spending, or any other method of dissociating from a problem.  I think that this dependence could aslo develop with the practitiioners.  I have seen many antipsychotic drugs used in both strictly medical and psychiatric hospitals ... (cough) aggressively.  While some situations warrant use of the drugs in this fashion their side effect of making a patient "docile" can frequently be abused.  In addition to this general abuse, I wonder if the "therapeutic" ability of the world's counselors will come to rely on drugs more than their ability to connect with and manifest something powerful by a soley "non-synthetic" means.

           I would have similar feelings towards EMDR or other more "cognitive" based measures.  As ***** mentioned in class, I agree that, as a (future)psychotherapist I do not feel I have the training or education in neurology to adequately apply these measures in "good conscience."  Depending on one's educational orientation as a "psychologist" I think this could aslo be true.  Personally, I would be disgusted and feel totally empty if I were to hang my ability as a therapist on neurological, cognitive, or behavioral mechanisms alone.  Speaking for myself, that "just aint my style" and the practice of medicine isn't (or won't be) my job.  Perhaps a tool in a bag of tricks, but how would you feel if you were the client who found out that that's what you meant to your therapist, a trick in a bag?