Friday, March 18, 2011
The Mental Benefits of Rote Memorization
Rote memorization has become the pinata for the entire field of education. Always a highly politicized area of our civilization, educational values, pedagogy and the role of modern teachers have all borne the blame for countless societal ills. Teachers today too often receive a figurative scarlet letter "F" from the public for failure to teach basic language skills, and for their seeming inability to convey appreciation for our cultural heritage. And for emphasizing "rote memorization" over "real learning." Today, we give "real learning," the moniker, "critical thinking."
In his book Doing Our Own Thing: The Degradation Of Language And Music And Why We Should, Like, Care (2003), linguist John McWhorter makes the argument that the changes in the educational system are a symptom of a larger cultural movement toward increasing informality in learning and communication. A symptom, not the cause. You can pursue Dr. McWhorter's ideas further at the link above. Here, I'd like to extend this portion of his thesis into the realm of mental health.
The fact of the matter is that the trend in the West over the past 45 years or so has been to emphasize self-expression over self-discipline. Rather than push people to learn detailed rules and traditional strictures for writing, talking, even painting, the goal has been to rid the mind of such arbitrary, stuffy, tedious, and (let's face it), plain hard rules of craft. Instead of considering such rules means for expressing erudition and discipline, we see them as bygone ways of conveying snobbery and classism. Worse, so the prevailing paradigm asserts, the rules snuff out creativity by binding up energy in their mastery, and leave little left over for true meaningful expression. It's like a mind subjected to rules must necessarily be dimmed by them; only a mind that can vent itself in every direction at once, without limit, can be authentic.
I suspect this paradigm represents too much of a good thing. To use a metaphor, it would be like saying a bare light bulb is more "real" and beautiful in its unshaded authenticity, then light filtered through a crafted chandelier or stained glass window. Which would strike you as more beautiful?
Worse, as a counselor, I fear that doing away with rote rules and making everyone focus on "self-expression" might have set many people up for failure.
Yes, there are the divergent thinkers out there, those inherently creative and rebellious types who withered under hidebound, authoritarian learning methods like rote memorization. These types likely did revel in the newfound cultural freedom to express themselves in their own, idiosyncratic ways. They could cut ties with the past and their "establishment" elders.
But what about other hardworking people? Those folks who, when you take away the rules and tell them to express, find themselves with nothing to say? Or no good way to say what they do harbor in their hearts? What if they find "critical thinking" exercises frustrating, intimidating or frankly, beyond their ability? Or worse case scenario, they express themselves proudly, believing they are profound, only to find the world beyond the classroom--friends, bosses, coworkers--responding with a resounding yawn? I can't imagine the devastation this kind of person experiences is worth throwing out the proverbial baby with the bathwater. I think rote memorization might have left them a more viable legacy.
My grandfather was poorly educated. He technically attended school through the eighth grade. But because the one-room rural schoolhouses in the Appalachia of the 1920s lacked enough teachers for every grade, he was only able to cobble together about five or six years worth of true schooling. Despite that, he had a 39-year work history that ended in management, he supported a wife and family of six children, read the bible...well, religiously, and became an accomplished folk woodcarver.
Still, he recalled his schooling with some fondness. He remembered having to memorize parts of Edgar Allan Poe's The Raven. By the time I knew him, his school years were over fifty years in his past. His recollection of the poem was fragmentary and inaccurate. But he really did love it. His one regret from his education was not that he didn't get to do enough critical thinking or self-expression. No, he always wished he could have gotten more training in spelling. That rote memorization exercise so many of us hated in school was what he desired the most.
My Baby Boomer father could still recite Shakespear's "Tomorrow and Tomorrow and Tomorrow," soliloquy from MacBeth and "The Jabberwocky," by Lewis Carroll, some thirty years after he graduated high school. These are the legacies of his education, poetry that even today I would wager he is proud to recite.
Rote memorization ended up having far-reaching consequences for both my grandfather and my father. There is a pride in holding something in your skull that is *yours,* that no one can take away from you. What seems arduous and merciless to master in youth pays dividends years later. It is even better, of course, when the effort is freely chosen. I spent the summer of 1990 memorizing "The Raven" for myself...all 102 lines of it. If asked, I could recite it in about eight minutes, at about 90% accuracy. By contrast, from my teenage years, I can recall few "critical thinking" exercises in which I did well. I felt much better about myself when I added a bit of Poe to my own being.
We can't turn back the clock and return education to its hidebound traditions. That would be as unrealistic as asking men in their thirties to put on monocles and bowler hats, and pushing women in their twenties not to shave their legs. Instead, I wonder if modern educational pedagogy is adaptive and willing enough to incorporate the best of what worked in the past with that freedom of expression they sell today? Is there a place for hidebound rules of learning and expression? Should we, perhaps let people choose their light bulbs, but still cover them with cut crystal chandeliers and stained glass?
Sunday, November 14, 2010
Leave Diagnosis to the Professionals
A hundred years ago, professions were impenetrable. The professional-client relationship was unequal, and the former held all the cards. Physicians wrote prescriptions in Latin and described medical conditions in dense nomenclature well above the heads of their poorly educated patients. Lawyers too relied on Latin for their documentation, so the client never knew if what was written was exactly what was discussed. Providers of various services held a virtual monopoly on them. Those they served had only the word of the professional that their best interests were being overseen. There was no way to double-check someone suspected of dishonesty, except to find a professional with the same expertise, and then there was no guarantee that he (yes, most were men) wouldn't be just as dishonest.
Those of us in the modern world might sometimes reflect upon the status of old with nostalgia, and regret that we were born in more literate times, among a more skeptical public. But the fact is that there was corruption among professionals in that Golden Age. There were incidences of sexual exploitation, overcharging or just plain nasty treatment based on snobbery and prejudice. Or sometimes, the professionals didn't know what they were doing and did more harm than good by cloaking their actions in dense language with long-tailed words. They were also known to blame the victim. After all, who could check up on them?
Today, we live in an age of the Undermined Professional. The public challenges professional judgement and refuses to be anything but an equal in the exchange of professional services. After all, knowledge, once prized, hoarded, cloaked in obscuring and secretive words, is now cheap and as easy to find as punching the buttons on the remote control or clicking the computer mouse. In this modern age, patients tell doctors what to prescribe, and clients tell mental health professionals how they want to be diagnosed.
Since I fit the latter situation, there's today's lesson.
The rash of what I call "cyberdiagnosis," or "point-and-click" diagnosis. I find myself more and more having to field requests from patients who want me to verify what they have already decided about themselves, because they found a symptom list on the Internet. In the old days, we called the symptom checklist "cookbook diagnosis." In my earliest graduate school training, we received strong warnings from the clinical faculty about the dangers of this approach. It tends to create too many "false positives," seeing something where there might not actually BE something. Second-year medical students are known for this tendency, diagnosing every cough or headache they develop as lung cancer or a brain tumor. My professors of yesteryear couldn't have foreseen the Internet, which pipes professional knowledge into any home with a computer, or pharmaceutical companies with their punchy bulleted lists of symptoms on television commercials. Not surprisingly, these developments have produced an epidemic of the very phenomenon we were being trained to avoid. Untold numbers of people now think they're sick or mentally ill. Knowledge without training and experience can be a dangerous circumstance.
Simply put, symptoms are not enough to diagnose illness. Mental illness in particular is defined as normal behavior carried to extremes. But there are more circumstances in which someone might show extreme behavior, besides having a mental illness. It is the role of a mental health professional to tease apart what is transitory from what is systemic, what is external from what is internal. Other factors have to be considered, among them, social circumstances, relationships, medical condition and childhood history. Just because someone is rundown and tearful doesn't mean they're depressed; thyroid problems can cause this. Hearing voices doesn't necessary mean someone has schizophrenia; sleep problems or medication side effects can mimic it. And just because someone has trouble focusing attention or remembering details doesn't mean they have adult attention deficit disorder (ADD); lifestyle stress can simulate it.
With regard to the ADD diagnosis, I've actually upset several patients because I disagreed with their cyberdiagnosis on this condition. My most glaring example was a young man recently, whose wife had point-and-clicked her way to diagnosing him with ADD because he was distracted and irritable toward her. Although he had no history of this condition before, she wanted me to corroborate her Internet research.
What I found instead was that they had only been married for two weeks. The couple did not move in together until after they got married, so this was their first experience dealing with each other in conjugal circumstances. More, the young man was trying to work his first professional 8-4:30 job, while his wife was still in college. So while he had to be in bed by 11:00 p.m, she had an erratic schedule and was staying up until odd hours, disrupting his sleep patterns. Further, his wife wanted to talk when they got up in the morning, while he preferred quiet time to "wake up;" another feature they couldn't know about each other until they'd lived together. She was also texting him at work, distracting him and frequently pressuring him to get their new home assembled and ready for guests.
Do you see the pattern here?
She wanted him diagnosed with a mental health condition, something with a stigma that is very difficult to escape. The reality was that she was responsible for much of his behavior. No doubt, as they adapt to each other, some of his distraction and irritability will go away on its own. Some simple coping skills training might have also helped them both. But alas, the happy couple never returned for further services.
It is understandable why people try to cyberdiagnose. Life is hard, confusing and when others behave strangely, we all want to feel some control over the situation. The Internet is easy, available and chock full of information. But information without understanding, without professional experience, just creates too many false positives. So if I might invoke an old-fashioned, rather paternal perspective, leave diagnosis to the professionals.
Thursday, September 30, 2010
Words Speak Better than Actions
There is something quaint, even cute, about watching a long-term couple. Since they know each other so well, they don't always require words to know if the other needs or wants something. They can guess, often quite accurately, what's on the other's mind. I only have to hear my wife clear her throat, for example, to know she'll be wanting a drink of water soon. So I'll go ahead and get it for her before she expresses the need for it. For the little things in life, I think there's no concern with this benign form of "mindreading," and it can be endearing.
However, when it comes to strife and conflict in relationships, I observe more people getting into trouble by trying to "mindread" than almost any other situation. In fact, I've written on the topic before.
Recently, I got into a discussion about this topic with an esteemed online colleague of mine, because her perspective was quite different. I'm a self-described man of words, a believer that we can never know another's thoughts, only what they tell us about their thoughts. My colleague espoused a broader position, citing the old bit of wisdom that actions speak louder than words, and that the truth of someone's motive and character are more implicit in what they do than in what they say.
Mmm...okay, maybe. Sometimes.
But I think this is too unreliable to use as a basis to resolve conflict. Like my giving my wife a drink of water, a guess about someone else's thoughts is a guess, regardless of whether or not it is accurate. For the "serious things" in our relationships, I consider words and discussion a safer medium. More, I've long believed it a small conceit to start any discussion with some variant of "I know what you're thinking," or the confrontational "You think that just because I..." More, I think it rude to intrude on another's thoughts and act like we know more about them than they've disclosed.
We like to bash the use of words in the West. Which is paradoxical, because then we laude such people as Shakespeare or Emily Dickson for their "blank verse" and "slant rhymes;" elegant uses of language.
The reality is that sometimes, actions are based on irregular reinforcement, old habits, or even because of past psychological damage. As such, the person doing them might have no idea why they're doing them, or they could find themselves acting in a way completely at odds with their wishes or intentions. In that case, actions obscure motive and character, they don't elucidate them. Actions may speak louder, but they don't always speak clearer. That's where *talking* comes into play, encouraging the use of words and communication to bring motives for problematic actions to light.
As a caveat, I certainly think it's acceptable in a relationship situation to disclose what you think the other person is thinking. Exemplum: "When you don't talk to me for hours, it makes me wonder if you're feeling angry with me." This is phrased as a hypothesis, which the other person is free to confirm or refute. In my professional opinion, beginning discussion with that type of respect is the key to reducing conflict and finding solutions.
Thursday, July 15, 2010
You Have All the Time in the World
As I went through a lunch line yesterday afternoon, I encountered a very pleasant young woman behind the counter. As she was preparing my order, she noticed I had a rather large tome I am currently reading for entertainment. In the work week, I often read during my lunchtime. It is a meditation and a stress reliever; but mainly, I do it because I enjoy it. When I replied that my wife and I like this particular author and exchange her books, the employee innocently stated, "Yeah, it's nice to have time to read like that."
She said it without any obvious rancor and I'm sure she did not think about it again afterward. But I did. I had to consider that she made a couple of obvious mistakes. First, she was implying that I don't work as hard as she does, something she could not possibly know or understand. Second, she assumed that reading is only something that can be done if one is idle.
Reading, and any other recreational activity for that matter, isn't dependent on time so much as it is priority. To quote a friend of mine (hey, Leda!), "A reader is a reader is a reader." If someone enjoys reading, they'll find a way to make it a priority, to use part of the same 24 hours we all have, regardless of their other commitments. I was a reader as a child, as a teenager and as an adult. When I went away to college, my family promised me I'd be so inundated with reading assignments and papers to write for my professors, that I would almost certainly lose my love of reading.
Didn't happen.
Oh, they were right, I did get inundated with those kinds of assignments. But for a reader, mandatory reading is apples to oranges when compared to the rewards of recreational reading. One is draining, the other energizing. Even in graduate school, where I got hammered with that distinctively polite, egghead form of hazing, I still found the time to read my favorite authors. Sometimes, it was during lunchtime, or between classes or a few minutes at night before bedtime. A reader will find a way. In my experience, those who claim they don't have time to read or who profess to be burned out on it by their career...well, they were probably never readers in the first place. I feel bad for them, though I'm sure the feeling is mutual.
It's all about what you value and what you prioritize.
Friday, June 18, 2010
The Living Past
Most of us have had the unpleasant experience of traditional history classes, in which fossilized teachers read dessicated material from dusty tomes in monotone voices to us, the indifferent students. My best pencil doodles came out of such venues, and I bet that had I kept them, they'd be on par with Picasso today. The problem with teaching history in this way is that it leaves out something very important: history is alive. It endures, persists and can still actively touch our lives in a positive way. History is the tale of people--real people--whose deeds endure the test of time. History is not a list of facts about them, like their names and birth dates. When spoken about in that dry tone that so many burned out teachers maintain, the people of the past do appear dead and disconnected from us.
The fact of history's living presence can be quite a benefit for our mental health as well. Viktor Frankl, in his work Man's Search for Meaning, introduced a unique and powerful idea that anything we do--all our achievements, relationships, creations--are "saved into the past." By this, he explained that once lived, our lives become an indelible mark on the passage of time. The truth of our being, the fact of our existence, can be forgotten or denied, even hidden. But none of these consequences can change the fact that we were. For Frankl, the tide might erase the footprints in the sand, but it can never unmake the fact that someone walked there, on that beach, in that time and for their own reasons. Whatever their story might be, the thread of it, that sequence of events, has joined the larger tapestry of the living, enduring past. I liked one of Frankl's comparisons. He pointed out that as youth-oriented as Western culture tends to be, he himself would never want to be young again (he eventually died at age 92). He observed that the story of the young person is unwritten, rife with uncertainties. For the older person, the majority of their life is a certainty, undeniable, and comfortaing in that certainty. Metaphorically, Frankl noted that our sad tendency as we age is to lament the empty field in front of us, while forgetting the full granary behind us.
I've found Frankl's notion of a life "saved into the past" to be not only personally comforting, but quite useful in working with patients who come to me with grief. Losing a loved one--human or animal--is a universal experience, and perhaps one of the most painful circumstances a human being can ever face. Usually, this is associated with death, which is the ultimate loss, though breakups can be their own form of torture. Never mind such ambiguous losses as missing children, stolen pets or MIA soldiers. And of course, relationships are not the only parts of our lives that we can lose and for which we can grieve. Job loss is another type of bereavement issue. So is the loss of a condition of life, such as the amputation of a limb or a permanent damaging of our health.
Most often, of course, it is the loss of a relationship that creates the most heartache in our lives. And usually, it involves death. So I begin grief counseling by challenging the very idea of "loss." Certainly, when a loved one dies, the permanency of that situation is inarguable. But only if one looks at the empty field that is the future of that relationship. What about the full granary of the past? Can one deny that the relationship with the loved one existed? No. Are all those good memories, those wonderful stories, erased by the incoming tide of grief? Nope. Have all the wonderful experiences, the laughter, the hope, the shared moments, become unmade? Uh-uh. As painful as the loss may be, the fact of the matter is that the story of the relationship has not changed. In fact, when speaking to someone who has lost a family member, like a parent, for example, I remind them that they didn't stop being a daughter or son, merely because of the loss.
Along with the permanence of the loved one's story and place in a patient's life, I work with them to realize that that person's wishes and expectations often live on, too. One of the best ways to deal with grief is to put one's energies into something productive. Bringing the loved one back is not possible. But making sure that what survives of them is not forgotten *is* within our power. One of my most memorable grieving patient encounters was with a middle-aged woman who dedicated herself to gathering all of her recently deceased mother's original food recipes from all the disparate family members. Apparently, some of these recipes were only written down once. Only one copy existed. This patient made sure to assemble every one she could get in one place; a cookbook she had published at her own expense. Then she gave copies to all her family members, so that the totality of her mother's legacy could be shared by all. Or as I later phrased it, "Mom was in every kitchen."
Often, when prodded, patients will admit that the lost loved one hoped their family and friends would accomplish this or that goal. Why not continue to work on it? Wishes don't die. In fact, the fulfillment of a lost loved one's expectations can be the most concrete way to show that they still have an influence, that a part of the relationship is still there, still capable of making us better.
Try this thought experiment. Think of someone you cared about who has died. What do you do each day to keep their story alive? How can you act now to bring their part of your own history forward, maybe even share it with the rest of us? Can you do something today to make yourself better, because they wanted it for you?
Sunday, May 2, 2010
Energy Drain From Personality Disorders
In the previous entry, I talked about personality disordered people as those who drain off our energy in our encounters with them, and give little back. Managing them takes energy from our other relationships and can cost us effectiveness on our jobs, hobbies and general happiness.
What to do?
Well, unfortunately, there is no uniformly satisfying answer. Even among mental health professionals, personality disorders are considered barriers to successful treatment. The prognosis is poor. Such clients come to us distressed, but rarely show much progress from the energy invested in them. Despite this, some dedicated and admirable counselors do still work to change the personalities of these people. Most are pessimistic about it, though. Instead, they focus on teaching difficult clients better ways to behave and cope with the vicissitudes the person her or himself so often creates. Intervention is, in short, a "damage-control" philosophy. Help them reduce the bad consequences of being what they are, but be resigned to the fact that the client will always be what they are.
Counselors have one major advantage, though. We get to go home after interacting with an energy draining person. But what about living with them? How should you handle them when they're a part of your social circle or family unit? Well, the answers there are even less satisfactory and often harder to implement. Most of us are caring, and legitimately don't want to see someone close to us suffering if we think we can do anything to help. But when do you cut off the energy drain, and say "enough?"
The secret lies in knowing when and how to set limits. A great deal of psychotherapy, in fact, goes into teaching beleaguered people to put limits on what their loved ones do to them in the name of love or loyalty. I personally spend much time on what I've referenced here several times, interpersonal strategy; the planned use of words and responses to difficult people.
The first step in setting limits involves self-monitoring. Each of us has to be attuned to our own level of energy and we have to draw the line as to how low we're willing to let it go before we clamp down on the outpouring. One of the most salient lessons to learn about people who habitually drain energy is that trying to reason with them is usually ineffective. Getting your energy is what they desire the most, even more than escaping whatever is causing them pain. They don't want your wisdom, and will likely be resistant to even your most well-reasoned and helpful advice. So don't blame yourself if you have tried your hardest, only to find you haven't been able to make their lives better, or get past their rationalizations for victimhood. If they keep calling on you, despite your frustration and sense of futility, you can begin setting limits by telling them they most likely need professional mental health assistance beyond what you can continue to give them. Make the topics they keep bringing up "off limits" if you want the person to remain a significant relationship in your life.
Other ways of setting limits might be not answering the phone every time they call, or holding them to a pre-set time in which you will listen to their woes. Insist on communicating by email or other asynchronous medium on certain conversation topics, so you have more control over the time you invest in them.
Eventually, the person will seek a more cooperative source of energy. Unfortunately, that might only happen after the personality disordered individual becomes angry and accuses you of "never really caring." In fact, you might find yourself lumped into a pool of past people who have allegedly mistreated the energy-draining person, a "you're just like all the rest of them" category. Be prepared for such emotional outbursts, and remember that anything they say to you, even if it is the truth, is calculated toward feeding on your energy again. Guilt can be a strong motivator to buckle on your limits. Don't. Keep to them, and make it clear you aren't going to change the rules, even though you're sorry they feel so negatively about you. You might have to be prepared to lose the relationship. That's a sad outcome, but the fact of the matter is that relationships can and do end. Sometimes, they just can't survive the test of time, and you have to cut your losses and reflect on what you gained. The ultimate test, as this article originally maintained, is in how much energy it cost you and when the price becomes too high.
Monday, April 19, 2010
Energy Drain in Personal Relationships
In the previous entry, I used as a metaphor the psychodynamic idea that the mind operates via energy, and that a drain on our energy makes it harder to think, control our emotions and be happy. Sigmund Freud himself said that the main job of our mental activity is to love and to work, and I spent some time talking about the pitfalls of when the workplace siphons away energy from our personal lives.
On the other side of that equation, our personal relationships--be they familial, romantic, sexual, platonic or casual--can also tie up our energy. When this happens, the loss can make us unable to give what we need to other types of relationships and to our jobs.
My experience has been that mentally healthy people in healthy interactions will circulate energy back and forth, in the form of attention and empathy. Walking away from such an encounter makes us and the other person(s) feel like we've given something of our energy, but we've gotten something back from it as well. It is much like a fountain, which cycles the same water over and over, but creates a never-ending froth of stimulation and beauty.
By contrast, there also exist what mental health professionals call "personality disorders." Such people draw many unflattering and pejorative names in popular press: psychic vampires, dysfunctional people, bottomless pits, as well as a bevy of four-letter epithets inappropriate for a professional blog. Whatever one calls them, personality disorders are people who are damaged in some way, chronically unhappy and incapable of keeping up their end of the circulation of energy. They give nothing back, they just take and take. We walk away feeling drained, lessened by trying to engage such people. More, the draining party doesn't benefit from the encounter either. They just get reinforced by the attention, such that they keep seeking out more attention--more of our energy--but they don't use it to help themselves get any better or happier.
The Diagnostic and Statistical Manual of Psychiatric Disorders offers up descriptions of several different types of personality disorders. Although you should leave clinical diagnosis to the professionals, the following deliberately overgeneralized criterion might help you recognize when you're dealing with an energy drainer:
- Their lives always seem to be in a tumult, one crisis after another. They might have multiple accidents leading to injury, have conflict with myriad people, lose jobs frequently or have legal/financial troubles on a regular basis.
- They have more interest in getting sympathy for their suffering than changing the situation causing it.
- Such people will often talk about themselves and their own problems, but seldom ask about yours.
- They have inconsistent and contradictory attitudes and seem unaware of it. Such statements as "I'm the kinda person that," can be a red flag, especially if what follows contradicts what they told you hours, days or weeks ago.
- Often, they rationalize mistakes or poor judgement, and blame elements of the external world for their suffering.
We've all had such relationships in the past, or at least had encounters with such people in the public. The shaky data at present suggests 5-10% of the general population is diagnosable with a personality disorder. Statistically, that's one to two people out of every twenty we meet. In medical populations, it can climb considerably. Among patients needing daily medical treatment (like opioids) for benign chronic pain, for example, some studies show as much as 50% have a personality disorder. I'll admit I haven't seen data on populations of other chronic illnesses, but I suspect they might have higher-than-average incidence of such people too. We've all encountered the person who seems to gain something from the "sick role." If you've ever dealt with a doctor, nurse or hospital worker who was overly surly or churlish with you, it might be because they interact daily with so many energy drains, and function with depleted energy by the time they *get* to you. Politeness and empathy take resources they might not have.
In the next entry, I'll talk about limit-setting and how it can help curb the amount of energy other people can take from you.