Sunday, December 30, 2012

Are emotions worth it?

I recently picked up a book I’d never heard of before by an author I wasn’t familiar with just to have something to read.  The book was “Forbidden” by Ted Dekker and Tosca Lee.  I definitely didn’t go into it expecting any profound insights; I just wanted to be entertained. 

The book takes place in a distant future in which all human emotions except for fear have been selectively eradicated from the human genome.  Fear was left intact because it was considered the “only emotion necessary for survival.”  I’ll agree with this in premise; fear is definitely necessary for survival.  I remember reading about a woman who sustained a head injury in an accident that rendered her unable to experience fear.  As a result, she frequently found herself in dangerous situations.  She’d been attacked and robbed several times.  Her doctors were concerned for her safety.  Without a mechanism to warn her she was in danger, she was unable to differentiate between what was safe and what wasn’t.

On the other hand, too much fear can be debilitating.  I see a lot of patients who are plagued with anxiety.  They see danger or the potential for danger everywhere, even in places that are perfectly safe.  Often, they are completely unable to relax.  They live in a constant state of alertness; they are always on guard.  Many of them avoid going to places where large groups of people gather; they stay away from malls, popular restaurants, concerts, PTA meetings, parties, and they plan their trips to Wal-Mart in the middle of the night when everyone else is asleep.  (This seems a bit backwards to me; aren’t you more likely to encounter a criminal at one or two in the morning than in the middle of the day?  I don’t know). 

In addition to thinking about fear, the book got me thinking about human emotion and what it would be like to live without them.  There are a few characters in the book whose abilities to experience emotions are restored after drinking a serum.  The main character wavers between embracing and cursing his newfound emotional palette.  He is initially exhilarated by his first taste of love.  He realizes that the love he and his mother felt for one another was merely was hollow and motivated by fear.  His mother is killed by people searching for the serum.  He grieves – really grieves – for the first time in his life.  He grieves for the loss of his mother, but also for the fact that he only gained the ability to really love her after she died. 

He sets out with his childhood (female) friend to discover how and why all humanity is bereft of all emotion except fear.  When he sees her for the first time after drinking the emotion-restoring serum, he realizes that he is in love with her.  He wonders why he never realized this before.  (Probably because he was incapable of love before).  He is intoxicated and invigorated by his love.  He sees that it gives his life meaning but also that he is willing to die for it, if need be.

And then the love of his life is killed by their enemies before his very eyes.  He is devastated.  He curses love.  He wants to die.  Life has lost all meaning for him.  He begins to think that maybe humanity is better off without emotions. 
Here he captures a fundamental truth about human emotion: with great joy comes great sorrow.  With great pleasure comes great pain.  There is no happiness without sadness, no love without loss, no hope without disappointment. 

This book lays out a very poignant argument for embracing all emotional experience, even those that are painful.  In many ways, this is the very thing I attempt to convey to my patients.  Sure, you can cut yourself off from your emotions to avoid feeling sad, insecure, or anxious, but at what cost?  Is it worth the loss of joy, happiness, pleasure, and love?  You can’t just cut out “bad” emotions; when you cut yourself off from your feelings, you sever ties with all of them, both good and bad. 

Is it worth it?

Sunday, December 23, 2012

Challenging Perfectionism

For most perfectionists, there is some sort of rule or assumption underlying their need to be perfect.  Each rule or assumption has its own particular variation.  Most, however, take one of the following forms:  "I have to be perfect or ...."  "If I'm not perfect then..." "If I make a mistake it means..." "If I allow myself to accept anything less than perfection then..."  Notice that each of the previous statements suggests the presence of some sort of fear.  "If I am not perfect then..." I must be a failure.  Or people won't like me.  Or whatever.  "If I allow myself to accept anything less than perfection then..." my life will turn into a complete mess.  Everything I do will be mediocre.  I'll never be successful.  Or whatever. 

In this way, perfectionism serves to protect a person from his deepest fear.  Usually the fear is rooted in the belief that one is not good enough as he is.  If he is perfect, however, people will not see how inadequate he really is.  When he is perfect, he can forget about his own perceived inadequacies, at least for a time. 

Oh, but when he makes a mistake...When he makes a mistake, he becomes overwhelmed with the knowledge of his own deficiency.  He berates himself for erring and expects others to do the same. 

Maybe perfectionism has served him well in life.  Perhaps it has garnered him praise and recognition.  Perhaps he has achieved great things.  Would this have been possible if he hadn't demanded of himself perfection?

Perfectionists know well the consequences of their unattainable standards and relentless need for perfection in all things.  Yet because perfectionism can be advantageious at times, there is quite often ambivalence about efforts to change.  Thus, the first step in "challenging" perfectionism is to make a list of its advantages and disadvantages.  Complete a thorough cost-benefit analysis; what does perfectionism cost you and how do you benefit from it?  This enables you to fully explore your ambivalence.  In most cases, it also helps to increase motivation for change. 

So what about the benefits of perfectionism?  How do you let go of something that serves you so well in so many of your endeavors?  Ask yourself this: Is perfectionism the only way to attain these benefits?  Can you still be successful if you set more realistic standards and become less self-critical?  Will people still like and respect you if you're less than perfect?  Will you still do good work?  Will things still get done?  Or will you become just another mediocre member of society who never accomplishes anything notable?

There's only one way to find out; do it and see what happens.  Develop and carry out a few "behavioral experiments."  Start small.  Pick some small job you are tasked with completing each day.  Most likely, you expect yourself to complete even this small task with 100% accuracy.  Determine what this (100%) looks like.  Then decide what 90% looks like, 80% looks like, 70%, and so on.  Designate a specific period of time -- say, three days -- and resolve to perfrom the selected task with 80% effort and accuracy.  Pay attention to what happens as a result.  Do people berate you?  Does anyone even notice?  And how do you feel?  Do you feel more or less stressed?

Alternatively, you can try intentionally making small mistakes and observing the outcome.

What you're really doing is testing your assumptions.  Remember, perfectionism serves as a defense against underlying fears of inadequacy, rejection, etc.  The goal of your 'behavioral experiments" is to see if what you fear actually comes to pass when you intentionally perform in a less than perfect manner.  (Spoiler alert: What you fear almost never comes to pass.  Although you might want to enlist the help of a good therapist to ensure that you've selected appropriate behaviors to adjust). 

Hopefully, these strategies will get you started on the path to change.  Keep in mind that old habits die hard.  Change is never easy but it's always possible.

Sunday, December 16, 2012

Is perfectionism always a bad thing?

Perfection is an ideal faultlessness, a state of being complete and correct, such that nothing is wanting.  It is the highest attainable state or degree of excellence.  Perfection is a standard to which many strive, although most fall short.  I believe this is, in part, because perfection means different things to different people.  What constitutes perfection is quite subjective and therefore depends on who you ask. 

There tends to be general agreement that while a person may achieve perfection (however it is defined) on a given occasion, no one attains perfection in all venues at all times.  Human beings are falliable creatures; we all make mistakes.  Thus, we are challenged to accept a fundamental truth about human nature: nobody's perfect.

Some people have more difficulty accepting this than others.  These are people who believe perfection can and should be always within reach; we call them perfectionists.  The negative implications of perfectionism have been studied at length and are well documented.  It has been associated with chronic feelings of failure, unwarranted guilt, lack of self-worth, pervasive self-doubt, indecisiveness, excessive self-criticism, procrastination, and low self-esteem.  Perfectionism has also been linked to the development and maintenance of several mental health disorders, to include major depression, generalized anxiety, obsessive-compulsiveness, anoerexia, and alcoholism. 

While no one disputes the negative consequences associated with perfectionism, there are some who insist it has positive implications as well.  Adherents to this school of thought distinguish between "normal," "adaptive," or "healthy" perfectionism and "pathological," "maladaptive" or "unhealthy" perfectionism.  They argue that "healthy" perfectionism is often beneficial and its development should be nurtured and encouraged. 

So is there a "healthy" perfectionism?  Or is perfectionism always pathological? The answer depends on how you define perfectionism.  Those who promote the potential benefits of "healthy" perfectionism define the concept differently than those who insist it is always pathological. 

Proponents of "healthy" perfectionism divide the phenomenon into several dimensions:

1. The consistent setting of very high standards for performance and achievement.

2. Extreme and excessive concern about making mistakes.  Mistakes are equated with failure. 

3. Chronic self-doubt, causing one to second guess oneself and one's decisions.  There are frequent doubts
    regarding the adequacy of one's work and/or performance.

4. Strong emphasis on and desire for organization in all aspects of life.

We can clearly see that not all of these dimensions have negative implications and that some of them have the potential to be quite beneficial.  In particular, having high standards for oneself and being exceptionally well organized are qualities commonly labeled as assets.  Together these characteristics (collectively referred to as "perfectionistic strivings") are associated with high levels of conscientiousness, extraversion, endurance, positive affects, life satisfaction, active coping styles, and achievement. 

In contrast, the dimensions of self doubt and conern about mistakes (collectively referred to as "perfectionistic concerns") are associated with increased incidences of obsessive compulsive disorders, depression, anxiety, eating disorders, procrastination, and an increased risk of suicide. 

When conceived of this way, it is clear that certain aspects or dimensions of perfectionism are adaptive and that others are maladaptive; it would be difficult to argue otherwise. 

Still, there are those who maintain that perfectionism in any form is never a good thing.  Adherents to this school of thought define perfectionism thus: a personality style characterized by the setting and compulsive pursuit of unrealistically high standards and/or unattainable goals coupled with the tendency to be over-critical in evaluations of one's own behaviors and efforts.  The psychopathology is inherent in the definition.  They assert that any "healthy" dimensions of perectionism cannot truly be called perfectionism, as perfectionism only refers to that which is unhealthy or maladaptive. 

Personally, I am concerned about beliefs and behaviors that interfere with personal functioning.  In my next post, I'll talk about strategies for overcoming (or at least coping more effectively with) this kind of perfectionism.

Sunday, December 9, 2012

Are there reasons not to forgive?

I've been thinking a lot about forgiveness lately.  I initially had no strong opinions on the subject; rather, I had a vague sense that while forgiveness is a worthy endeavor, there are certain situations where forgiveness would not necessarily be a suitable goal.  After doing some research on the subject, I've adopted a firmer, more coherent position on when I believe forgiveness is an appropriate goal (and when it isn't).  I've come to the conclusion that forgiveness is only necessary when both the victim and the offender want to reconcile and rebuild their relationship.  If there is no desire or intention to repair a broken relationship, forgiveness is unncessary at best and detrimental at worst. 

The currently prevailing models of forgiveness describe it as a process that begins with acknowledging the pain casued by the betrayal and ends with developing empathy for the offender and acknowledging our own falliability and capacity to offend.  We know we have forgiven someone when our negative feelings about that person and his actions have been replaced with positive emotions.

I think back to my own experiences with betrayal.  I no longer feel any anger towards people who hurt or betrayed me in the past, nor do I feel any pain associated with these incidents.  Still, I cannot honestly say that the anger and hurt I once felt have been replaced with positive emotions.  When I think back to a particular time when someone mistreated me or betrayed my trust I don't feel anger or hatred, but neither do I experience a flood of compassion for the one who offended me. 

Historically, when a person has hurt or betrayed me, I have coped with the situation by  acknowledging and working through the negative emotions associated with these incidents; in most cases, I was eventually able to understand the various factors that contributed to the offenders' actions.  Truthfully, I no longer harbor any resentment or ill will towards anyone who has ever hurt or betrayed me.  The caveat: most of these people are no longer a part of my life. 

I'm not the kind of person who is quick to cut someone out of my life at the slightest offense.  Yet there have been people in my life who proved to be toxic; when, over time, I came to realize this, I chose to protect myself by ceasing to associate with these people.  This was never a decision I made lightly.

The problem with replacing negative feelings about a person and his actions with positive ones is that having positive feelings about a person increases the likelihood that you will allow that person to be a part of your life (in some way or another).  In other words, "true" forgiveness increases the likelihood of reconciliation.  If you reconcile with a toxic person who has not changed and thus remains toxic, you enable that person to continue to affect your life in a way that will most likely be negative. 

This assertion is supported by research.  Studies suggest that forgiveness in toxic relationships facilitates reconciliation, even while the offender continues to engage in toxic behavior.  One study found that victims of domestic violence who reported that they forgave their partners for the abuse were more likely to return to their partner (and thus to the abusive relationship).  A recent study by J. McNulty supported his hypothesis that forgiveness can "increase the likelihood that offenders will offend again by removing unwanted outcomes for those offenders that would otherwise discourage them from reoffending."

In sum, I believe that complete forgiveness is not always adviseable.  However, it is not necessary to forgive in order to let go of anger and hatred and move forward with one's life.

Sunday, December 2, 2012

How to Forgive

Forgiveness.  Some of us offer it too readilty; others refuse to offer it at all.  It can be given freely or begrudgingly, conditionally or unconditionally.  The decision to forgive is a deeply personal one and can be quite difficult to make.  Anyone who has ever been forgiven knows forgiveness for what it is: a gift, which bestows upon its recipient a deep sense of gratitude and appreciation.

Often, when we have been hurt or betrayed by another, our initial response is to distance ourselves from the resulting emotional pain.  We become angry because anger is easier to deal with than pain.  This is a natural reaction that serves a protective function in the immediate aftermath of a betrayal.  As a long term coping mechanism, however, anger is far from adaptive.  Anger that is nurtured and fed over time becomes hatred.  Hatred eats at a person until it consumes every aspect of his life.  Thus, the person is twice victimized: first by the one who betrayed him and then by himself, in his choice to remain angry instead of trying to move forward.

We can choose forgiveness instead.  This may or may not mean restoring the relationship between victim and offender.  Sometimes the relationship can be mended.  At other times, reconciliation is ill-advised.  Fortunately, forgiveness does not require reconciliation.  Rather, forgiveness represents a change in the emotional response of one person towards another.  Forgiveness means working through the hurt and the anger and then moving past it.

Forgiveness is not something that happens immediately; it is a process that takes place over time.  There are many theories about forgiveness and each one has its own ideas about the specific path one must take on the way to forgiveness.  Still, most theories agree on a few basic tasks that must be completed in order for forgiveness to occur. 

Before a person can forgive, he must first accept the reality of the offense committed against him.  He must recall the offense in detail and allow himself to experience the emotions associated with the betrayal.  He should acknowledge and explore his anger and hatred.  He will probably find that beneath these emotions lie feelings of hurt, fear, and vulnerability.  He must allow himself to experience these emotions as well.  Hopefully, he will come to view himself with compassion and to let go of any self-blame.

I believe this is the most important step.  It is, in my opinion, where most of the healing takes place.  Personally, I think a person could work through this part of the process and go on to live a happy, psychologically healthy life.  Nevertheless, I have committed to writing about the process of forgiveness in its entirety, so I'll move on to step two.

The second phase of the forgiveness process is building empathy for the offender by learning to view him as human and therefore falliable.  An effort is made to see things from the offender's persepctive, to put yourself in his shoes and try to imagine his thoughts and feelings.  There is an attempt to identify and understand the factors that might have contributed to or motivated the offender's actions.  It is important not to confuse empathy with condoning or excusing the offender's behaviors.  Rather, the goal is to avoid the pitfall of labeling the offender a "bad person."  People are rarely all good or all bad.  Good people often do bad things.  And sometimes even "bad" people do good things. 

The third and final task of forgiving involves acknowledging that we are not unlike our offender in that we too are human and have, at some point in our lives, behaved in ways that were hurtful to others.  In this final task, we are called upon to reflect on our own lives; we are asked to recall times when we were the offender and required others to forigve us.  In some ways this is an extension of phase two, in that acknowledging our own failings makes it easier to empathize with someone else who has done something wrong.  Admitting that we too are capable of behaving selfishly prevents us from being overly judgmental or self righteous.

Keep in mind that every situation is different and that forgiveness is not always the best option.  Still, we should be aware that it is an option and should have the freedom to choose forgiveness if we so desire.

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