I initially intended to write about the experience of boredom, its potential causes, possible remedies, and the relationship between boredom and suffering. In fact, I still plan to talk about boredom (and chronic boredom in particular), probably as soon as next week. While researching the topic, however, I came across a study about boring people. The study helped to shed some light on why I react certain ways to certain people (including some of my patients). Since the information was helpful to me, I thought it might also be helpful to others.
We probably all know or have known at least one "boring" person. Naturally, we attempt to avoid interacting with this person whenever possible. On those unfortunate occasions when we do have to interact with him or her, we find ourselves struggling to pay attention and yearning to get away. It's human nature: we simply do not like people who bore us.
It is true that what one person finds boring another may find fascinating. Theoretically then, boring is not a trait that is inherent to a particular individual. The individual in question might be boring to one person but rather interesting to another.
And yet, there are certain things that make a person boring to almost everyone, regardless of the circumstances. Leary, Rogers, Canfield, and Coe identified some of these factors in their study, "Boredom in Interpersonal Encounters: Antecedents and Social Implications." The two interpersonal behaviors most associated with being boring were negative egocentrism and banality. The researchers defined negative egocentrism as a behavioral dimension (or category) that includes behaviors such as making frequent negative comments, excessively complaining about personal problems, being self-centered, and showing a lack of interest in others. The authors defined banality as a behavioral dimension encompassing behaviors such as talking only about trivial or superficial subjects, being interested in only one topic, and telling the same stories or jokes over and over again.
Other factors associated with being boring (but to a lesser extent) include "low affectivity" (characterized by low enthusiasm, limited eye contact, low emotional expression, a speaking in monotone) and "tediousness" (characterized by talking slowly, taking a long time to respond, taking a long time to make one's points, adding unneccesarry details, and dragging the conversation on).
The researchers also found that people respond very negatively to boring individuals. Not only do they view them as boring, they also see them as unfriendly and disinterested in others.
This whole thing sort of validates something I've noticed about myself as a therapist. Throughout my career, I've noticed that there are certain patients who just seem to rub me the wrong way. I groan when I see their names on my schedule. In session, I find myself surreptitiously glancing at the clock more often than usual. Every peek at the clock brings despair, as I realize that only a few minutes have passed since I last checked. I breathe a sigh of relief when the session finally ends and they are safely out the door.
Over time, I was able to determine what these patients have in common: they complain about the same problem or set of problems during every session and consistently reject any effort on my part to help them. I now realize that in addition to constantly complaining without trying to change, these patients almost across the board engage in the very behaviors most strongly associated with being boring. They complain excessively about their problems, they are completely focused on themselves and how unhappy they are, and they are disinterested in hearing feedback from me (and probably from anyone else). They show interest in a very limited range of topics, primarily their problems, their symptoms, and their suffering. And they tell the same stories (about their problems) over and over and over again, as if they haven't told them in every other session we've had.
Fortunately, I do not encounter this kind of patient very frequently. I do, however, feel better knowing that my emotional reaction to them is probably quite normal.
Sunday, October 28, 2012
Sunday, October 21, 2012
Becoming disillusioned
As young adults, I think most of us start out with a certain number of illusions. We have ideas about the world and our place in it. Those with the most ambition seem to have the most illusions. Many intelligent, talented emerging adults have been praised and lauded throughout their lives for their talents and abilities. They are told they can do or be anything if they apply themselves diligently.
And so they graduate high school and set off to take on the world with a head full of dreams. Most are optimistic about their futures. If asked, they would probably say that they have an important contribution to make to the world, that they are destined for greatness, or that they are going to do big things.
After spending some time in the "real world," many of these once hopeful young adults enter a period of disillusionment. They may encounter a world that is not receptive to the kind of big changes they'd envisioned themselves making. Their power (and thus their ability to enact change) may be limited by virtue of their youth and inexperience. They may lack the resources, the venue, or the support to achieve the great things they were once certain they would accomplish. Or they may find the demands of adulthood consume all their time and energy, leaving precious little to devote to pursuing their dreams.
For me, disillusionment came soon after I started my first job after college. Looking back, I can't even recall what I hoped to do with my life. I just know I envisioned myself making a big impact on the lives of a lot of people. I had a lot of ideas that I initially pursued with vigor. Soon after college, I begn completing the requirements for certification in biofeedback. I proposed a research project at my place of employment and got the go-ahead from my boss to start doing the background literature review. I started working towards formal licensure as a clinical social worker in the state of Virginia. I did a project on the side for a woman who ran a small non-profit focused on suicide prevention.
And then I hit a brick wall. I had to put the biofeedback certification process on hold because I couldn't afford to pay for the supervision. I finished my literature review and reported my findings. I was told there was no way to implement the study because it would require (at minimum) one additional staff member and the organization wasn't going to pay for that. (That didn't stop them from going out to other organizations and telling them we were offering the program, even though we weren't). The person providing supervision for Virginia licensure told me she was too busy and couldn't do it anymore. The non-profit lady used my work for her presentation; I never heard from her again after that.
There were other things too, but you get the point. I was depressed. I grew cynical. I hated my job. I decided I'd chosen the wrong career field. I was completely disillusioned.
In the end I found my peace. In the process, I discovered a lot about myself. I also grew up. I learned how to function in the world as it is, not how I want it to be. It was difficult, but I think it was also necessary. Before you can cope with reality you have to accept it as it is, even if you don't necessarily like it.
And so they graduate high school and set off to take on the world with a head full of dreams. Most are optimistic about their futures. If asked, they would probably say that they have an important contribution to make to the world, that they are destined for greatness, or that they are going to do big things.
After spending some time in the "real world," many of these once hopeful young adults enter a period of disillusionment. They may encounter a world that is not receptive to the kind of big changes they'd envisioned themselves making. Their power (and thus their ability to enact change) may be limited by virtue of their youth and inexperience. They may lack the resources, the venue, or the support to achieve the great things they were once certain they would accomplish. Or they may find the demands of adulthood consume all their time and energy, leaving precious little to devote to pursuing their dreams.
For me, disillusionment came soon after I started my first job after college. Looking back, I can't even recall what I hoped to do with my life. I just know I envisioned myself making a big impact on the lives of a lot of people. I had a lot of ideas that I initially pursued with vigor. Soon after college, I begn completing the requirements for certification in biofeedback. I proposed a research project at my place of employment and got the go-ahead from my boss to start doing the background literature review. I started working towards formal licensure as a clinical social worker in the state of Virginia. I did a project on the side for a woman who ran a small non-profit focused on suicide prevention.
And then I hit a brick wall. I had to put the biofeedback certification process on hold because I couldn't afford to pay for the supervision. I finished my literature review and reported my findings. I was told there was no way to implement the study because it would require (at minimum) one additional staff member and the organization wasn't going to pay for that. (That didn't stop them from going out to other organizations and telling them we were offering the program, even though we weren't). The person providing supervision for Virginia licensure told me she was too busy and couldn't do it anymore. The non-profit lady used my work for her presentation; I never heard from her again after that.
There were other things too, but you get the point. I was depressed. I grew cynical. I hated my job. I decided I'd chosen the wrong career field. I was completely disillusioned.
In the end I found my peace. In the process, I discovered a lot about myself. I also grew up. I learned how to function in the world as it is, not how I want it to be. It was difficult, but I think it was also necessary. Before you can cope with reality you have to accept it as it is, even if you don't necessarily like it.
Sunday, October 14, 2012
Living without pleasure
People tend to think of depression as a syndrome characterized primarily by pervasive feelings of sadness. To be depressed is to be in such despair that it becomes difficult to function. Many of us have either known someone struggling with depression or have seen it somehow depicted by cultural media. As a result, few of us are completely unfamiliar with what it means to be depressed.
Many of my patients struggle with depression. For every new patient seen in our clinic, we obtain a full biopsychosocial history and perform a complete diagnostic assessment. Ideally, the goal of this assessment is to generate an overview of the patient's "problem," preferably in the form of a clinical diagnosis. In reality, however, I find that few patients really need me to tell them what's wrong; most of them already have an idea of what's wrong, which is the reason they've sought help in the first place. In other words, a person struggling with depression already knows he feels depressed; he gains very little from having me slap a label on it.
From time to time, however, I encounter patients who seem clearly depressed to me but who are quite surprised to hear me say it. "I don't feel depressed," they say. You see, depression doesn't always look the way we think it does. In fact, it's quite possible for someone who doesn't necessarily feel depressed to meet the diagnostic criteria for Major Depressive Disorder. Rather than feeling depressed, the problem for such a person might be that he doesn't feel much of anything at all.
Anhedonia has been described, quite poetically, as the "paralysis of emotion." It comes from a combination of the Greek a + hedone, literally meaning "not pleasure." In mental health, it refers to an inability to experience pleasure in activities that one would typically find enjoyable.
Patients relate how they experience it. "I just feel 'blah," is a quite common description. Others talk about lacking motivation. "I don't feel like doing anything," they say. "I can't get motivated." Still others become distressed by what they perceive as a personal failing. "I don't even enjoy spending time with my kids. The whole time I'm with them I'm looking at my watch, wanting it to be over;" or perhaps, "I know I love my kids, but I just can't feel it."
I wish I could conclude my little presentation with some wisdom about how we can all learn to experience pleasure in life. The truth is, I let out an inward groan everytime a patient tells me he is unable to find pleasure in anything. That's because as a symptom, anhedonia is notoriously difficult to treat. As a therapist, I can encourage you to engage in activities that should theoretically be enjoyable, but I can't make you enjoy them. I'm not even sure I can teach you to enjoy them. How do you teach something like that? Treatment with antidepressant medications have very limited success as well. It's a situation that often makes me feel helpless.
But if I feel helpless, imagine how the patient must feel. Imagine a life without pleasure. What kind of life would that be?
Many of my patients struggle with depression. For every new patient seen in our clinic, we obtain a full biopsychosocial history and perform a complete diagnostic assessment. Ideally, the goal of this assessment is to generate an overview of the patient's "problem," preferably in the form of a clinical diagnosis. In reality, however, I find that few patients really need me to tell them what's wrong; most of them already have an idea of what's wrong, which is the reason they've sought help in the first place. In other words, a person struggling with depression already knows he feels depressed; he gains very little from having me slap a label on it.
From time to time, however, I encounter patients who seem clearly depressed to me but who are quite surprised to hear me say it. "I don't feel depressed," they say. You see, depression doesn't always look the way we think it does. In fact, it's quite possible for someone who doesn't necessarily feel depressed to meet the diagnostic criteria for Major Depressive Disorder. Rather than feeling depressed, the problem for such a person might be that he doesn't feel much of anything at all.
Anhedonia has been described, quite poetically, as the "paralysis of emotion." It comes from a combination of the Greek a + hedone, literally meaning "not pleasure." In mental health, it refers to an inability to experience pleasure in activities that one would typically find enjoyable.
Patients relate how they experience it. "I just feel 'blah," is a quite common description. Others talk about lacking motivation. "I don't feel like doing anything," they say. "I can't get motivated." Still others become distressed by what they perceive as a personal failing. "I don't even enjoy spending time with my kids. The whole time I'm with them I'm looking at my watch, wanting it to be over;" or perhaps, "I know I love my kids, but I just can't feel it."
I wish I could conclude my little presentation with some wisdom about how we can all learn to experience pleasure in life. The truth is, I let out an inward groan everytime a patient tells me he is unable to find pleasure in anything. That's because as a symptom, anhedonia is notoriously difficult to treat. As a therapist, I can encourage you to engage in activities that should theoretically be enjoyable, but I can't make you enjoy them. I'm not even sure I can teach you to enjoy them. How do you teach something like that? Treatment with antidepressant medications have very limited success as well. It's a situation that often makes me feel helpless.
But if I feel helpless, imagine how the patient must feel. Imagine a life without pleasure. What kind of life would that be?
Sunday, October 7, 2012
Things that don't come naturally
My sister-in-law has a very gentle quality about her and a very sweet demeanor. She's also very physically affectionate, at least with her family. Whenever she's around my stepdaughter (and even when she's around my two nieces), it's like no one else exists. When my sister-in-law enters the room, the kids fight over who gets to sit next to her. I watch them together - especially her and my stepdaughter - and I can't help but feel a little envious. My sister-in-law heaps on hugs, kisses, and tickles and the kids eat it up. "Why can't I be more like her?" I often wonder.
During a family vacation this summer, I noticed that my sister and her husband are always holding hands, putting their arms around one another, or sharing a quick kiss. More often than not, the two of them occupied only one chair, even if that meant one of them sitting on the other's lap. I mentioned to my husband that I was a bit jealous of how affectionate the they are with each other. "Why aren't we more like that?" I asked him.
I knew what he was going to say before he said it. It's me. I know it's me. I don't have a problem with nor am I averse to physical affection - or even public displays of affection - it's just that it doesn't come "natural" to me. In fact, it's not even physical affection per se that doesn't come naturally. Almost without fail I give hugs and kisses to family and friends at every hello, goodbye, and goodnight. And any kid that hops in my lap is always perfectly welcome there. I'm just not the type of person who instinctively reaches for an embrace or a hand to hold whenever I find myself in the presence of others. That kind of affection is something that requires a conscious effort on my part. It's something I have to actually think about and remind myself to do.
I don't know why I'm not naturally drawn towards physical contact. I certainly wish I were different in this regard. I suspect that we all have our strengths and weaknesses. Some things come naturally to certain people and some things don't. I've never met a person to whom everything comes naturally. We all struggle with something.
What I do know is that just becomes something is difficult doesn't mean I can't learn to do it. I have some experience with this. I do really well with verbal and written academic work; I have always struggled with math. I have vivid memories of sobbing over Algebra homework in the eighth grade. As an adult, I needed to complete two math classes for my college degree. I took the first class one summer and the second one the next. This allowed me to focus exclusively on math without worrying about other subjects. After each class, I went to the math lab, did my homework, and had the tutor check my answers. He then went over the problems I got wrong. I sometimes spent hours on homework before I fully understood it. Whenever we had a test, I was always the last person finished; I also earned the highest final grade in both classes. I still struggle with math, but now I know I can do it; I just have to put more effort into it than other people.
I've had similar experiences with art -- I have absolutely NO natural depth perception nor any sense of proportions or spatial positioning. Yet I have, on occasion, come out with a decent drawing or painting (always after a few false starts, of course).
The point is, this whole physical affection thing is something I can learn, even if it doesn't come naturally. What I need more than anything is patience - both from myself and from others.
Is there anything you've learned to do that didn't come naturally? Was it frustrating? Do you still struggle with it? I'd love to hear your story!
During a family vacation this summer, I noticed that my sister and her husband are always holding hands, putting their arms around one another, or sharing a quick kiss. More often than not, the two of them occupied only one chair, even if that meant one of them sitting on the other's lap. I mentioned to my husband that I was a bit jealous of how affectionate the they are with each other. "Why aren't we more like that?" I asked him.
I knew what he was going to say before he said it. It's me. I know it's me. I don't have a problem with nor am I averse to physical affection - or even public displays of affection - it's just that it doesn't come "natural" to me. In fact, it's not even physical affection per se that doesn't come naturally. Almost without fail I give hugs and kisses to family and friends at every hello, goodbye, and goodnight. And any kid that hops in my lap is always perfectly welcome there. I'm just not the type of person who instinctively reaches for an embrace or a hand to hold whenever I find myself in the presence of others. That kind of affection is something that requires a conscious effort on my part. It's something I have to actually think about and remind myself to do.
I don't know why I'm not naturally drawn towards physical contact. I certainly wish I were different in this regard. I suspect that we all have our strengths and weaknesses. Some things come naturally to certain people and some things don't. I've never met a person to whom everything comes naturally. We all struggle with something.
What I do know is that just becomes something is difficult doesn't mean I can't learn to do it. I have some experience with this. I do really well with verbal and written academic work; I have always struggled with math. I have vivid memories of sobbing over Algebra homework in the eighth grade. As an adult, I needed to complete two math classes for my college degree. I took the first class one summer and the second one the next. This allowed me to focus exclusively on math without worrying about other subjects. After each class, I went to the math lab, did my homework, and had the tutor check my answers. He then went over the problems I got wrong. I sometimes spent hours on homework before I fully understood it. Whenever we had a test, I was always the last person finished; I also earned the highest final grade in both classes. I still struggle with math, but now I know I can do it; I just have to put more effort into it than other people.
I've had similar experiences with art -- I have absolutely NO natural depth perception nor any sense of proportions or spatial positioning. Yet I have, on occasion, come out with a decent drawing or painting (always after a few false starts, of course).
The point is, this whole physical affection thing is something I can learn, even if it doesn't come naturally. What I need more than anything is patience - both from myself and from others.
Is there anything you've learned to do that didn't come naturally? Was it frustrating? Do you still struggle with it? I'd love to hear your story!
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