Monthly Archives: June 2014

Crystal Surreal

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As my next novel, The Situation, becomes available today, I step back two years to reflect upon its predecessor, my much maligned Crystal From The Hills. You don’t have to read CFTH to get The Situation. It’s easy enough to follow the action, infer the major events of the previous novel, if not its subtext, and get involved in its story. What you might miss is the contrast between friends pictured above–the paths defined by different needs for both characters and readers: for mere consciousness on the one hand, for heroism on the other–for empathy above all. Who are you? Where are you in your life, and what do you want from drama? Here’s a few thoughts from November 12′:

I’m not sure what an example of surreal fiction is. When I think of surrealism, I think of painters like Salvador Dali, or filmmakers like Jean Cocteau, or Luis Bunuel. I’m told Jacques Lacan is the man for those following the unconscious. Not sure that’s true. The author Polizzoti writes that Freud and the surrealists were nonplussed by one another, especially Andre Breton, who reportedly met the Viennese physician and was underwhelmed. These writers were poets, stylists of the 20s and 30s, contemporaries of the absurdist Dada movement, and men who reported interest in the unconscious, and went about the task of creating images that simulated dreams. For what it’s worth, I’ve tried a modest and similar tact with Crystal From The Hills, having read some of Lacan and Breton, and then staring at that remarkable painting by Magritte: the one that frame a woman’s naked body within the contours of a feminine hairline. ‘Le Viol’ it’s called: the rape. Simplicity and genius. And horror.

Mine is a story that begins dreamily on the streets of Oakland, with an ambiguously aged man holding a sign that reads, “Hungry White Trash” as he panhandles by the side of a freeway. You might get the idea that it’s a joke, but not entirely. In fact, there’s a history to the joke, and horror: a serious underpinning. Chris Leavitt has suffered an accident. That’s the pitch, the beginning of the story and the forerunner to a back-story. There will be a few accidents depicted if you read on, as well as deliberate action, malevolent and kind. There is no hero per se (heroism comes later), just a hapless everyman riding a string of bad luck, making several wrong decisions, struggling to act like an adult. He’s playing with life. He has a girlfriend, sort of. It’s Jill Evans, ten years before her stints playing support character in Living Without Blood, and almost twelve years before she takes the lead in The Big No, my second novel. Jill gets around, and here she goes back in time, getting younger, lucky girl. I have a villain of sorts, a guy who’s not around, but who gets talked about a lot. He’s Weed, a drug dealer, video game star, con artist—a bad, absent, abandoning guy. His influence is balanced by Sweet, Chris’ other friend, who is even more childlike than Chris, yet affable and easy to have around. He sticks around. There’s an aged yet autocratic aunt—Chris’ only surviving relative, an endearingly caustic woman. Others in the story are lawyers, doctors, police, employers, street thugs, ghostly figures (dubbed “Shadows”) that hang around with hallucinatory menace: not all bad people; just people with seeming power and a willingness to use it.

            CFTH is a story that concerns itself with many ideas. It relies on continuity and the experience of ideas, fragments that have been indicated previously in the text. If you read a few pages then put it down for three weeks, then I’m sorry if I bored you. If that’s not the case and you’re just dilatory in your reading habits, then I’m afraid you may miss out. A good read is like good therapy. You don’t go once a month, like it’s a check up. You’re supposed to remember bits and pieces, like it’s embedded in your experience, and just know where you left off—no bookmarks are necessary if it works. There are associations to be made along the way. Don’t look for patterns, just experience the sense of revisiting as you note terms, phrases that appear to get repeated in the novel; themes that seem to link to one another. This is a story about accidents; personal, physical, even sexual, and habitual. It’s a story about rejection: also personal, and also institutional. There is trauma involved, and the problems related to poor memory and dissociation. You might feel what my characters don’t: that’s the point. Chris doesn’t remember much in the beginning, but builds his story along the way, and tells others, and you, what’s happening in his own time, on his own terms. His friend Sweet has an even worse memory than he does, but low and behold, it is he that becomes the chronicler of events in the end; the witness. Trauma victims need witnesses. That’s written somewhere. Above all there is a problem with reality, regressions in time, age. Characters aren’t sure what’s happening. They lack real perspectives, real goals. They don’t even use their real names. Despite all this, CFTH is actually not a confusing novel, in my opinion—not if you’re present, that is. It’s not all in Chris’ mind: things actually happen.

            Bad things happen. Evil lurks, as in any good action movie or pulp mystery novel. Darth Vader types hover, and towering infernos exist. Read the novel some of these cheeky references will make sense. Meanwhile, like the “Shadows” of Chris’ imagination or psychosis, the author and reader are witnesses to all that goes down. CFTH is a novel that may move you, or it may leave you cold, or I suppose—just to cover all bases—it may leave you feeling something (?) in between.

 

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Feel Before You Think Or Do

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Think before you act. That’s culturespeak—dominant culturespeak, some say—for a certain brand of lay-counseling that infiltrates business and industry, schools, anger management classes, parent-child conversations, social cliques, young and old. Feelings? That’s a therapist word. Therapists are often counseling individuals to express feelings, use “I” statements that gird the framework for feelings, the growth of intimacy. Feelings.

 

Why are feelings important, actually? Many people, especially left-brain bullies who extol the virtues of logic, or compulsive survivalists who ever assert the need for action, often ridicule those who draw attention to an affective (emotional) underpinning to any given issue or conflict. Others still consider that giving weight or time to feelings, especially negative feelings like fear, guilt and shame, is an indulgence—an exercise in what some term “navel-gazing”. Given certain contexts (do I really need to enumerate them?), the weight given to thinking or action is appropriate, but all too often the ethos is extended, given inappropriate width, while underlying feelings are either dismissed or given pat, superficial meanings, such that individuals, couples and families—the world—can move on. The person who exhibits rage, behaves with violence, is likely someone who, when later asked about their feelings, speaks pridefully of feeling “disrespected”, but makes little (if any) space for the likely truer feelings: fear, hope; desires for closeness, the experience of danger or abandonment.

 

I’d like to give readers a practical example of why acknowledgement of negative feelings is important, and why the sustaining of feeling is also important. It’s a story of a couple that struggles to slow down and really communicate: In this anecdote, a struggling pair has made room in their busy schedules for a “date night”, which will include, among other things, a night of sex. Problem: their evening is intruded upon by one of the countless distractions in their lives. The woman receives a text—someone from work needs a call back. The husband, anticipating (based upon actual past events) that the interruption will be prolonged, sarcastically gripes, “Well, so much for our so-called night of intimacy.” The woman, feeling “disrespected”, assures him she will not be long, but resents his attitude, which she casts as “entitled”. Later she returns to him, and finds that he is pouting. The “date night” proceeds, sex included, but without the earlier goodwill and spontaneity.

 

In speaking to this couple, I challenge both to recall, possibly experience, consider and then lead with feelings, rather than focusing singularly upon “what do we do.” I challenge the husband to say what he felt when he first learned of his wife’s seeming distraction. “I was disappointed,” he says. Upon some expansion, I ask “What kept you from saying that?”

“I did,” he remonstrates fully believing he’d done all he could to connect with his wife on the night in question. “No you didn’t,” I argue—respectfully: “You made a sarcastic complaint to her, and later ‘pouted’ when she returned, saying little if anything about your true feelings.” He shrugs, transforms his voice into an affected whine, and says, “What am I supposed to say, ‘gee, I’m really disappointed that we’re not having sex’. I can’t say that.”

            “Why not?” I counter. This is where the therapy really begins.

            “Because that’s not the way I am; not how I was raised, to talk about my feelings.” Note the distancing of opinion, plus the excuse, the implied helplessness: I can’t. For the moment, I ignore the historical dimension (and the affected expressions) and stay in the present.

            “Why can’t you say that you’re disappointed, if that’s your true feeling?” After one or two more fumbling replies (this man is at a loss), he says, “I don’t know.”

            “What do you mean? You don’t know why you can’t express your true feelings, your full experience?” The man shrugs. I choose to help…this time.

            “You were disappointed that a planned evening of intimacy was disrupted. That’s understandable. There was an opportunity to say you were disappointed; to point out that your wife had agreed to devote the evening to a date and not work, and that you were anxious that work seemed more important to her than working on the relationship.”

            The man nods, understanding, but looks defeated. “I can’t say all of that. Or, I couldn’t remember all of that. I’m not that articulate. Could you say it again so I can write it down?”

            “It’s not about being articulate, or memorizing lines,” I reply quickly. “It is, however, about being in the habit of recognizing your true feelings, staying with them long enough so that thoughts and eventually words, may follow. (BTW: I level a similar confrontation at the wife) You experience a feeling—disappointment, and beneath that, the pain of rejection—and because that feeling seems so difficult to experience, you move to get rid of it as soon as possible. Thus, you use humor, aggressive humor, to distance yourself from both your wife and, more importantly, your own experience.”

 

** this example is a fiction in one sense, but in another, a coalescing of exchanges noted over time.

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An Argument for Depth Therapy in Drug Rehab

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You might think that drug treatment with adolescents and psychoanalysis are terms that don’t go together, and you’d be right…sort of. Actually, a psychoanalytically-derived therapy is precisely what James Masterson, considered by many the father of adolescent psychiatry in the United States, intended for a residential treatment of troubled youth. His 1967 book, The Psychiatric Dilemma of Adolescence, offered the view that troubled kids do not “grow out of” problems of anxiety, depression, and acting out behaviors, as many of Masterson’s contemporaries appeared to assert. In this review, Masterson found that upon five years upon initial evaluation, over 50% of the adolescents previously treated in hospital settings for psychiatric conditions remained severely impaired. Although symptoms of anxiety, depression, and delinquent behaviors achieved modest reduction, some psychiatric disorders, such as pathological character traits, had not been touched upon in treatment at all.
Subsequently, Masterson was invited to take charge of adolescent inpatients at the Paine Whitney Clinic connected with Cornell University, which later resulted in his seminal text, Treatment of the Borderline Adolescent, in 1972. This book introduced the stage progression system of movement through a long-term residential program, intended to mirror the child development stages of separation-individuation as observed by Object Relations theorist Margaret Mahler. In this book, Masterson describes an initial “testing” phase of treatment in which patients relentlessly break rules or challenge staff, testing the limit-setting capabilities of staff, substituting them as parents (alloparenting, some call this), unconsciously determining who cares enough about them to maintain said limits and thus provide safety. The job of the therapists in such a setting is to convert patients from “actors and non-feelers” to “feelers and talkers”. Twenty years after this text was published, I began my career working in the field of adolescent drug treatment, though it was a further ten years before Masterson’s ideas really sunk in.
During my early years at Thunder Road in Oakland, a Therapeutic Community whose structure once bore a distinct resemblance to that described at Payne Whitney, I adapted to a cohesive treatment structure that more or less supported the Masterson approach (though few referenced him specifically), while adhering to the psychodynamic underpinning. Staff commonly used terms that were of psychoanalytic pedigree, such as “containment”, “splitting”, and “failure to thrive”; interns such as myself were repeatedly encouraged to observe transference (feelings in present relationships that are unknowing reflective of past relationships) meanings in the behaviors of patients, and more importantly, to attend to countertransference feelings in ourselves that may impinge upon therapeutic goals. Even staff not trained or educated in psychoanalytic concepts appeared to observe unconscious process in patients; in confrontation groups, counselors would routinely call out the negative behaviors, tease out the secrets of “acting out”. Then, upon the dropping of defenses, staff would zero in, often compassionately, sometimes not, upon the deeper meanings, the unacknowledged feelings.
For many in treatment this seemed not only fruitful, but also necessary, even exciting. They appreciated feeling understood. Furthermore, it seemed like common sense, this in-depth approach. Firstly, the adolescents lived in the facility and were kept clear of substances (at least, much more so than they otherwise would have been). There was clearly an opportunity for multiple therapy sessions per week, in various formats: individual, family therapy, and group. Even daily meetings were possible, and so the table was set for an in-depth therapy to occur. But the truth is that psychoanalytically-derived therapies, which call for an exploration of attachment patterns, links between family of origin memories and latter day behaviors, is frowned upon in many community mental health settings, even rehab settings wherein the intensive structure would seem tailor made for an in depth approach. There are several reasons for this, in my opinion: most concern either expediency or cost, but other reasons constitute a pronounced, if subtle devaluation of not only adolescent capacities, but also the dedicated staff that typically comprise drug treatment teams.
One assumption is that shorter term therapeutic orientations, solution-focused or cognitive behavioral therapies, for example, are easier to train to newer professionals. Their elements are easier to bullet point, sound-bite, and thus install into memory, left-brain functioning, versus the more unwieldy task of integrating a fuller experience. This is why many patients leave rehab centers armed with jargon, making glib pronouncements as to how they’ve changed; promises that all too often they cannot sustain. Often, these patients haven’t changed—not really. They’ve learned some “tools”, can parrot some phrases, maybe a few 12-step slogans. But their complex feelings haven’t about themselves and others haven’t changed, much less their understandings about those feelings. A second reason for the proscription of in depth therapy is that it is presumed to be cost-ineffective. But short term methods mean short-term outcomes, in my opinion, while short-sighted research conceals long-term effects, the attrition of growth that leads people back to rehab without understanding why earlier lessons didn’t stick. Reading this, a proponent of brief models would likely break out the sales pitch language and declare short term models “evidence-based”, and imply that psychodynamic models are not. This is untrue. Don’t believe me? Check out University of Colorado professor Jonathan Shedler’s comprehensive, 10-year meta-analysis research of over 70 studies upon the efficacy of psychodynamic models. It was published in the March 2010 issue of American Psychologist. It’ll open your eyes.
Regardless, especially in my latter years at Thunder Road, I experienced the unfortunate devaluation of psychodynamic models of care, and heard that similar things were happening at other programs. Managers began making philistine comments in staff meetings, deriding psychodynamic models as “that Freud stuff” while unknowingly using psychodynamic terms to reference current and longstanding practices. Few around me seemed to know or remember who James Masterson was, much less perceive his legacy within adolescent psychiatry. Borrowing models concurrently used in schools, clinical managers began using language connected with the Strength-based movement, which presumes a normative population of youth as the focus of care, emphasizes encouragement of adolescents’ strengths versus what is disparagingly termed a deficit-based approach. Thankfully at least, short-term models with worthy methods are coming to the forefront, muscling into the competitive arena of ideas. Most notable are the mindfulness-based therapeutic approaches, which are teaching affect (affect roughly corresponds to feeling) regulation skills (Important note: addiction is increasingly understood as a problem of affect dysregulation, not faulty cognition!), which draw their principles from advances in the area of neurobiology.

 

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