Masks of Melancholy

“Masks of Melancholy” is the name of a book on depression written by a friend, Dr. John White, who was a psychiatrist and a church leader (he died several years ago). This phrase has always struck me as a great description of depression. John was bipolar and he knew a lot about “The Masks People Wear” (see an article on my web site about such masks).

Depression puts on a mask. The mask can look needy or agitated or “pissed off” or apathetic and all kinds of other miserable things. The mask depends pretty much on our genetic wiring and what was emotionally practiced in our family of origin.

I have been depressed lately. I visit this state periodically like I am checking in with how bad life can really be. My mask is “agitated anger.” People I love bug me. I long to be left alone but I am lonely when no one is around. I ask for help in a way that keeps anyone from really caring. I isolate when I want to connect. Even coffee and chocolate (both vital food groups) fail to inspire me. “Pissed off” pretty much summarizes how I feel it. “Stay away” is what my mask reads to others.

So now that I have told you more than you want to hear, let me refer you to some resources that might be helpful to you.

Visit Wing of Madness to learn what depression and anxiety are all about — it is a great resource. As well, take a look at the Mayo Clinic screening test for depression. This assessment will give you a pretty accurate reading of where your emotions are right now. Print off the results and take it to your doctor or counsellor if you wish. (If you are visiting with Carole or me, do bring the results with you.)

As for me and my treatment, I think I am going to take off my mask (it doesn’t fit very well, anyway), visit Crema Café a few blocks from my office in West Vancouver, eat a piece of their wheat-free chocolate cake, and drink a grande latte. It won’t cure my depression but it does put a smile on my face.

Counselling with Paddy — a Client Rave

Sometimes I receive raves. Here is one that I received not too long ago. [If passing this on to you seems too self-promoting, see the previous blogs on depression. You will be happy then!]

I walked into my first appointment with Paddy reluctantly to say the least, but I quickly learned that I was there for a purpose. I wanted him to know how “right” I was and how I had been so “wronged.” Paddy called me on it quite quickly.

What I received from him was far greater than I could have asked for. In those sessions where I was at my weakest, it was there that I felt safe to be “known.” Paddy would not judge me. Instead, I felt accepted and valued.

Paddy has an amazing calming ability. His compassion, counselling skills and use of humour were invaluable to me. He has the ability to reframe things causing me to look at life from a different perspective – frequently changing the intensity of my emotions. No two sessions were alike but Paddy remained constant, which was an anchor for me.

Anyone looking for a counsellor would be hard–pressed to find a more compassionate listener. But don’t go see Paddy if you aren’t willing to be challenged. And be sure to bring your sense of humour! Thanks Paddy.

What Do You Say to Your Depressed Friend?

Mostly we say stuff that doesn’t help our depressed friend but relieves our urgency to impact helpfully and avoids our anxiety in sitting numbly. Then who are we helping? Probably ourselves.

Sitting patiently, looking caringly, wondering quietly — this helps, but eventually it is probably necessary to say something. So here are a few statements that, if said truthfully, have a better chance of helping than harming. Notice that the statements are non persuasive or argumentative, that they are not trying to be artificially “up,” and that they do not pose to identify (“I felt sad for a couple of days last week.”).

• You’re not alone in this.
• You are important to me.
• You are not going crazy.
• When all of this is over, I’ll still be here and so will you.
• I can’t really understand what you are feeling, but I can listen.
• I’m with you. I’m not going to give up on you.

Today a friend came into my office and asked in the most friendly way, “How are you doing?” And I told him of my dysphoric mood and he listened. And when I thought I was finished telling and talking, he still listened, looking affectionately, so I said some more. I found some good stuff to tell him that was hiding in my subconscious just below the melancholia. And then he asked to pray for me, offered me his hand to stand up and held me quietly for 15 seconds or so and then simply announced “Amen.”

[Next blog on “What Not to Say to Your Depressed Friend.”]

This blog is adapted from an article on Depression Alliance.

Never-Ending Problems: Like Dandelions in the Grass

I like solving problems – always have. I like to think triangularly, question appreciatively, figure out what has not worked before and suggest something that I think is brilliant, create a plan for real change, and measure the anticipated success. I was taught all this in grad school, some of my female friends tell me that this is such a “man thing,” but I have lived this as far back as I can remember – when I was 8 years old I tried marriage counselling with my folks! I think I did pretty good.

Now John Gottman comes along as a marital researcher and says that about two-thirds of relational problems are perpetual, like dandelions in the grass. Some troubles are unsolvable he says, and lots of arguments never accomplish a thing other than rehearsing for the next squabble. Never-ending — sounds discouraging.

Carole and I have a bunch of unsolvable problems, mostly the same ones we had when we were first married. No matter what I do to “persuade” (coerce) her to do what I want (or she me), the problems keep flowering. The solvable ones delude us into thinking that we are pretty good at conflict solving, and it’s true that we’ve had some dramatic successes. It is the unsolvable ones that really bug me.

Here are some perpetual problems that you are probably familiar with:

Personality or “your way in the world”: Who is the most introverted in the dyad and who is the most extroverted? (See previous blog.) This probably doesn’t change much. Neither does the tension between the one that is most emotionally intuitive with the one that is perseveringly logical. And some people are emotional stuffers (always have been) while their devoted other is pretty much a feeling gusher (always has been).

History: You can’t change a person’s history. The times in which you were born, and the ways in which you were raised, or dynamics in your family of origin – this is set in history. The goodness of your connection has a lot to do with how winsomely you accept each other’s life before you met.

Sensitivities: How do you react to failure, or criticism, or loneliness, or unpredictability, or being excluded from a group? This is well-wired by the time a child becomes an early teen.

Some things change really slowly. Things like your view of what success or failure means in life, or what a worldview might be. Our relationship to money, emotions, work, conflict are hard to change, but change they do.

Habits change slowly as well. If you are an early-to-bed kind of person and you are married to a late night email addict, this too can change. Savers always seem to marry spenders – at least in my practice. Maybe that is why they come to therapy. Habits change – slowly.

I have discovered that unsolvable problems require different strategies than solvable ones. First off, you need to be willing to distinguish solvable from unsolvable problems. Make two lists of your problems. What can be negotiated (solvable) and what cannot (unsolvable)? What is most important to you (grade this 1-3)? What can you let go?

Secondly, focus 80% of your resources towards the good things that you already do well. Show a little “benevolent disinterest” (differentiation) towards the problem areas. It is not a moral failure to take a break from working on faults while you celebrate the good stuff you do now. Over-focusing on problems (many of which you can’t solve anyway) is a serious waste of good humour and friendly faith.

Can I Trust You? (Trust Rebuilding Questions)

One of the privileges of listening is that you get to learn. And I get to learn lots.

The other day a client told me about 4 levels of trust rebuilding when trauma has undermined a love relationship. Here are 4 questions that she uses to figure out if trust in her relationship can be rebuilt.

Do I trust that you are growing for you? Some people change just to appease the other and not because they have any interest in growing. You can only trust the change that is motivated by inner desire.

Do I trust that you are capable of the change that you want? Lots of people have good intent but this might not be enough to restore confidence in the relationship.

Do I trust that you are honest in what you say? Of course, there are levels of deceit and we all lie to ourselves. But do I see an honest attempt to be truthful in words and ways?

Do I trust that you will do what you say? Follow through is the big thing. Unless the person’s behaviour changes, it is hard to trust again.

I find these helpful questions when a friendship is violated by gossip, or when a partner promises to be clean and sober, or when a teenager needs to be bailed out from jail. Can I trust you?

My 3 Lives

I think of myself as having 3 lives.

There is my “family life;” marriage to Carole, organizing and participating in the household, that kind of thing. Plus, I am a new grandfather, which totally delights me. I anticipate weekly stroller-walks with Jasper Patrick McLaren on the West Van seawall, coffee cup in hand (my hand).

There is my “professional life” or how I earn money. I work as a psychologist in private practice – that is how many of the subscribers to my blog know me. This is where I listen more than I talk. Plus, I am a professor at Carey Theological College in marriage and family studies where I talk more than I listen. I don’t think my students know that I listen (see previous blog entitled “Intent Listening is Indistinguishable from Love”) but they do know that I like to be listened to.

And there is my “life life.” This is where I usually find myself — in my head and in my heart. I think of this introversion as my “rumblings,” my unsaid ideas, angsts and hopes. Not many know my “life life” and perhaps not many know yours. (I think of my university extroversion as “ramblings.”)

My “life life” is where my faith sits. It used to be that faith was propositional to me – do this and God will do that. My faith is more organic now. It morphs. Today’s faith is different than tomorrow’s faith.

It also sits. My faith doesn’t run as much anymore. Sometimes it walks but often it sits.

My faith wobbles at times. This seems to me the risk of anything organic. Sometimes something is dying and something else is coming along. I don’t try to convince myself of faith anymore, and I have no need of convincing you of it either. I do less ritualistic reassurances: less study, more wondering; less being a cleric, more being a citizen; less exclusion, more welcome; less leadership, more looking.

I still maintain my coffee and chocolate sacraments. And I do church (CapChurch) where you can find me most Sundays morphing, wondering, sitting and drinking coffee.

Love, Sex and the Male Brain

Why do men “look”?

Wives almost universally hate the glance. Feeling insulted, diminished, measured according to the “vital statistics” of another seemingly more attractive woman, she worries that her spouse is unsatisfied and unfaithful. “Can’t he just want me?” she complains.

The blameworthy husband responds, “What’d I do? This is how I’m wired and I didn’t wire me. Blame God if you want — just don’t blame me.” And then he turns on the Canucks pay-per-view, not wanting to suffer more because of it, but feeling judged and aware that he has done something wrong that he didn’t intend.

And she fumes.

Sound familiar? If so, you might wish to read a recent CNN article written by Dr. Louann Brizendine entitled “Love, Sex and the Male Brain.” She is a clinical professor of psychiatry at the University of California, San Francisco. She is also the founder and director of the Women’s Mood and Hormone Clinic and a longtime feminist. She wrote “The Female Brain” and just released “The Male Brain.”

Her bottom line: “The best advice I have for women is make peace with the male brain. Let men be men.”

Welcome to David Ducklow

Carole and I have two children who have been adults for years but we think of them as our “kids.” Christine is a mom of 3 of the best small people ever and a forgiving wife of a compulsive mountain biker — they both do other stuff too. And one day Christine might join us in our shared work in journeying with people.

David who has been a spiritual director and intentional tutor for many years has recently graduated with an MA in Spiritual Formation from Carey Theological College. He is also Special Education Coach and tutor with kids with “dif-abilites” (his word). He also has a degree as a Special Education Assistant from CapU plus a BA degree in psychology and theology.

We welcome David to our shared practice. You can reach him at http://www.davidducklow.com. He works out of his home office and local libraries in North and West Vancouver.

I encourage you to read his blogs to get a sense of his deep life (http://davidducklow.blogspot.ca). And, by the way, he has “dif-abilites” too.

davidcircle

Counselling Can Be Expensive

Now that is a truism. Sometimes I tell my clients that I can’t even afford me! (I am never sure how they take that.)

But how you feel about the expense of counselling depends a lot on what you get out of it.

My fee is $170 per hour. Carole’s fee is $145 per hour and David’s fee is about $50-75 per hour. I usually see someone for about 10, 1-hour sessions, so the total is about $1700 over several months. That is a lot of money, perhaps what you pay on car insurance. And then you take that car in for a tune-up (actually they don’t tune up anymore – they download computer upgrades) or sign up for a course at Capilano U.

Here is what I do about fees:
• I charge $20-25 per hour less than the going rate for Psychologists ($200 as of January, 2012). I want to give back to you. And my rate has not increased for over 5 years.
• Many of you can have your fees covered under an employee assistance plan or an insurance program. Make sure that you check your coverage for “Psychologists” before you visit with me. By the way, Carole’s fees as a Registered Clinical Counsellor may be covered under your plan as well.
• By the way, if both you and your spouse are both covered under your EAP or insurance program it may mean that you have twice the number of appointments for couple counselling. Imagine how many family appointments you can have!
• Keep your receipts for your income tax – some of it may be reimbursable. Ask an accountant.
• I also create my own assistance plan with your church or community group. You pay a portion (about a third) of the fee and they pay about a third, and I will reduce my fee to correspond. And this for a maximum of 10 sessions. You would be surprised how many caring people want to provide financial assistance.

I am happy to say that most of my client-friends consider therapy to be good value and many recommend their family and friends. Counselling can be a valuable investment and worth much more than it costs.

(Updated from 2009)

Fighting: We See Things as We Are

Anais Nin commented that “we don’t see things as they are, we see things as we are.”

Acknowledging this – that our life and especially our pain, skews our seeing and our thinking – is the first step in mediation and conflict resolution.

If the psychologist observes this when two parties are deeply stuck and viciously divided, she challenges her client-friend’s way of being in the world, his world view.

The second step is to appreciate the other’s point of view – to see that it has merit.

The third step in mediation is to find an agreed upon goal that both parties can strive towards. This is popularly known as a ‘win-win’ solution and puts the combatants on the same side.

These 3 steps result in a ‘success’ that is seldom better than 70%; in other words, neither party gets the perfection they think they are due.

Acknowledging, then appreciating and finally agreeing. And that seems right to me.

Is My Marriage Worth It?

Conflict and relationships go together. A conflict-free marriage is an oxymoron.

Why? People mature at different rates; they have different values (some they don’t even know they have); and people see and experience the world differently. And all of this leads to tension that can result in conflict. And sometimes we wonder if marriage is worth it.

These are the kinds of issues my clients bring to couple therapy. Think about these questions for you and your marriage.

• If you had to create a short list of people you could spend the day with, would your spouse be on that list? Do you genuinely enjoy each other’s company? Do you laugh when you’re together?
• Do you have the same or similar values, goals and interests? Do you and your spouse enjoy doing some or lots of things together? Do the two of you want the same things out of life?
• Do you express a lot of affection and appreciation for each other? Or is there mostly indifference, negativity and hostility in your relationship?
• Do you feel understood when you are talking with your partner? Does your spouse try to see your point of view? When discussing things, does your husband or wife listen to what you have to say?
• Is your relationship usually based on fairness? Does your spouse see you as an equal? Do you feel you are treated with respect? Or do you feel used, exploited, or taken for granted?
Do you feel that your spouse will be there for you in a time of need? Can you count on your spouse for help when the going gets tough?
• Do you feel comfortable sharing your private thoughts with your spouse? How easy is it for you to talk to your spouse about sensitive issues?
• When you disagree with each other, do the two of you work together and try to resolve your differences? Or is there a lot of hostility, disregard and contempt when disagreements arise?
• Does your spouse care for you sexually? Do you make love pretty regularly? Or are you disappointed or frustrated with your affection?

The pain can be huge. This happens when conflict spikes and shared pleasures plummet. And even at these times, working on your marriage is always worth it.

Mental Illness: A Parent’s Journey (Stu Ducklow)

Stella_Ducklow

The following article was written by my brother about his daughter. Both have given permission for this to be re-posted on my blog. Stu said it was okay “as long as Stella gets all the credit” — that’s like my brother.

I have previously posted about Stella’s depression and struggle with mental illness (please see below).


Like most parents, we thought our first-born child was extraordinary, and we hovered over her as much as any helicopter parent.

She seemed to need more attention than most. When she nearly died of anaphylactic shock at age 4, we sought help from specialists ranging from a pediatric immunologist to Reiki practitioners. When eczema kept her from sleeping, we covered her with creams and dosed her with prescription meds.  When she was hospitalized for asthma, we gave away our four cats.

When she had trouble in Grade 1, we enrolled her in a private school where students were expected to learn to read via the ‘whole language’ process which spurned phonics and spelling. When she still couldn’t read, we took her to an after-school program that drilled her in the very same phonics and spelling that we were paying the other school to avoid. Stella was reading above grade level in a few months.

But we couldn’t come up with a solution for the all-day crying jags, cutting and constant dieting that began at about the age of 16. We turned to the provincial mental health system for help. We had a lot to learn. While mental health professionals are nearly always kind and well-meaning, the system they work for seems designed to serve administrators more than the patients.

For example, Stella was confined to her unit during one short stay because staff was thinking of moving her to another unit and they wanted her available at short notice. This meant that our daily one-hour drive around Halifax, the high point of her day, was forbidden. Fortunately a good-hearted nurse bent the rules when I promised to deliver her within ten minutes of a call to my cell phone.

Over the next ten years we got used to waiting up to 16 hours in emergency wards when Stella felt suicidal or overcome with anxiety or depression. In contrast, she was seen immediately for a fractured ankle, though broken bones aren’t nearly as harmful as suicidal thoughts.

She was admitted at least ten times for short stays of about a week. Though she saw many psychiatrists, they confined themselves to adjusting her meds. Requests for some form of psychotherapy were met with blank stares. She was given a regular outpatient worker who she met with for about a year but that person was hostile to us as parents and dismissive of Stella’s chances of recovery once she was diagnosed with borderline personality disorder. 

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The Wisdom of Tenderness

In October 2007, Krista Tippett interviewed Jean Vanier, the founder of L’Arche. Tippett is the host of “Speaking of Faith” on American Public Media, one of my favourite blog sites and a source of great spiritual-theological gain for me.

Of all of Tippett’s interviews, this interview with Jean Vanier is spectacular — I would say life transforming!

The 90 minute video is a much better investment than watching another edition of “House” (also a favourite of mine!) and you can also download an abbreviated version for your iPod so you can listen to Vanier’s “wisdom of tenderness” while walking or working out at the gym.

Find the interview at http://vimeo.com/462130.

What Motivates You? (Our Triple-A “Drivers”)

We are driven by needs. Many think that we are motivated by values and many of us are some of the time. But all of us are motivated by pressing needs or “drivers.” Consider these drivers in your marriage or family, or in your business or church.

Acceptance (to be counted in). Who gets to be “in?” This is the issue here. Some attend a church for years without essentially being counted in. They feel like “strangers in a strange land.” And acceptance is pretty easy; just treat people like people you don’t know and would like to, and say “hello and welcome.”

Acknowledgement (to be known). Once you are accepted (or at least feel accepted) you will want someone to know your name and remember it when you return. The simple saying of your name and perhaps attaching some affection to it is the motivator called “acknowledgement.”

Affirmation (to succeed). We all want to feel that we have succeeded in who we are and what we do. When we are affirmed we feel that we “fit” – like a key for a lock. We know our strengths and gifts and work out of them. Success is easy then; it is who we are.

These triple-A drivers are motivators for all of us. Of the three, what motivates you the most?

Would You Like to Super-Size That?

Size matters in emotions. Some spouses bark, bully, blame and belittle with the noisier suppressing the other by volume and spite. Others may coerce their partners and kids to “submit” thinking they have some theological “right to respect” (which they clearly don’t!). Kids up-turn power into tantrums and tyranny. And then lots of families “tiptoe” their lives, waiting for the next tsunami. Yes, size matters especially the size of noise and especially again the noise of coercion. It is as if we “super-size” our emotions, pumping up insanity to defeat an enemy that used to be friends and family.

“I don’t know why you’ve got to be angry all the time,” she said to her husband of 7 years, clients of mine for several months. As I write this, I am listening to Tim McGraw singing “Angry All the Time” and that comment is the refrain: “I don’t know why you’ve got to be angry all the time.” (You can hear / watch this on You Tube. This is a tiptoe marriage, like my client friends, with super-sized emotions.

I have come from a week of super-sized emotions; watching super-sized partners push and prod while their tiptoe spouses lose voice, hiding and hoping for anything else. You know of course, that it is not either men or women who coerce – in some families it is both.

I want to tell you about a conflict questionnaire that I have used over the years in my teaching and consulting. I would love it if you became an expert in understanding conflict (not necessarily doing it!). The “Thomas Kilmann Conflict Inventory” is resourceful for people who want to understand conflict and why it perpetuates.

I can provide this assessment for you. Please contact me.

Parents and Teens: A Few More Comments (Part 2)

I think a big part of parenting teenagers is self-control as in controlling oneself, not trying to control one’s near adult. If I can be more resilient as a parent then maybe I can parent more effectively. Psychologists call this “differentiation” and it is the ability to separate emotions from thoughts. When  thinking becomes clouded by emotional responses, we become undifferentiated. Families with lots of emotionally reactive reasoning used to be called “undifferentiated ego mass.” Lovely description of a family isn’t it?

Back to some comments about parenting teens with an understanding that no one does this perfectly. So first,

— Give up on being a perfect parent or having a perfect kid. Reality is more helpful than perfectionism.

— Don’t push your power, your age or your wisdom. Just because you own the mortgage on the home does not mean that you have the right to coerce or pummel your teens into compliance.

— Believe in your teen’s hyperbole. Exaggeration and overstatement is a favourite in adolescent communication. You don’t need to correct her. Anyway, she might just be the best Math student on the planet.

— You don’t have to be your kids’ friend. Accept yourself as a parent and learn to be good at it.

— Value what he or she has to say even when you disagree or have a different opinion.

— Speak quietly especially when the tension is rising. Tension goes up, voices go quieter and everybody listens more intently.

— Be careful of quick decisions. Quick conclusions are soon problems.

— Admit when you don’t know something. This is easier to do than you think. And your kid will appreciate your incompetence and see it as common ground.

So you might ask, “Did you do all these things?” Uh, no. I just did my best like you. But I wish that someone told me some of this while I was an undifferentiated ego mass.

Parents and Teens — Some Comments (Part 1)

For 5 years when I first started my work as a Psychologist, I worked for Family Services in West Vancouver where I focused on dysfunctional families referred through the public school system, police and probation.

I thought of these kids as “BC’s best” and mostly they were hopeful, resilient, and crafty and making the best out of some tough and tense circumstances at home and at school. They were also hard to handle – it was easy for me to talk with them as they got to skip school to “go see the shrink.” I remember one parent who asked if I knew of a monastery in Africa where he could send his 16-year old son. (Didn’t know of one.)

Some of the parents were excellent in loving and guiding their kids and some were clearly working out their own difficulties in marriage and life through their offspring. Some of these kids became the “Identified Problems” of the greater family tension.

Along the way, I worked up some principles for parents living with teens. These days I am having a resurgence of parents seeking help with their kids and I thought this list might make some sense to some. If nothing else, it might help parents remember what they hoped for when they were teens.

So for parents, in random order as it occurs to me…

— Be careful about criticism of anything. Even when you think you are only making a comment, it may well be experienced as another of a long list of judgments.

— Focus on your teen’s emotions. Kids “naturally” emotionally reason and this can seem illogical to you as a parent.

— Think about what depression looks like in a teen. Sometimes it is in withdrawal and sometimes it is in acting out aggressively. When your child is acting hurt and harmed, wonder about how his inner life is going.

— Say as little as possible and especially about your own experience, unless asked. When kids talk they want to talk and not listen to your thoughts.

— Don’t believe in “teachable” moments. Let your kid talk without your interruption.

— Ask questions that can be answered. Questions like, “Do you want to suggest with me 3 or 4 ideas from which you can choose?”

— Experiment in thinking in non-absolutes. If you have a 70% good relationship with your kids, then celebrate that. Don’t overly prod and provoke the 30% that is not the best.

Okay, that’s enough for today. In fact, that’s probably enough for a few days. I will post a few other ideas in a bit.

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