Saturday, March 27, 2010

“Problems With Attention”

“Problems With Attention”

I am sure almost everyone knows someone that has a problem with “attention” and is taking medication for it. They might be a child or an adult. They are often given the labels ADD or ADHD.

Fact: there is no conclusion as to whether this is a “disease” that one is born with or we get from living in an environment. Or maybe it is a combination.

Fact: taking certain mediations does help some people.

Fact: taking certain mediations also can have side effects especially aggressiveness and anger.

It is also a fact that some teachers and parents mostly want quick answers.

I believe that until we appreciate much more about “attention” and a child’s “interest” we will not get very far.

What happens to you when you are doing something and you get interrupted? Well, you don’t like it! Now much depends on how we have been brought up, how skilled we are at handling that moment of interruption.

It was pointed out a long time ago to me that a very active ten-year old in a crowded two bedroom apartment in Chicago might be labeled ADD but on a farm in Kansas just a rambunctious ten year old.

Of course it is not that simple, it depends too on what is going on in the farm house.

I believe “interest” is a “feeling” that is always being transmitted outward and I also believe we have to be dealing, daily, with a large set of punishing feelings that inform us of our environment. They are: anger, fear, distress, contempt, shame, and surprise. Now tell me what if a youngster or for that matter an oldster is feeling high levels of all of these? Would these not interrupt their “interest?” Would it not make it hard for them to “pay attention?”

It is said that children are able to pay attention to intense tasks like video games and T.V. or homework at times. I think this makes much sense because it is at these times they can “escape or avoid” all the negative in their life, all those negative feelings. It is when they are in the “general” environment, the social “feeling” environment, that they “go crazy.”

It is because they do not have the skills to relate or unfortunately the support system around them to relate. To relate it has to be a two, three, four way street.

I have more then once refused to simply place a child on medication because the teachers have wanted it, demanded it. Parents should refuse such demands. Doctors have to be only the child’s advocate! Teaches are not doctors. Medication is not there to make the teacher’s job easier. Medication sends the message that the child is sick when in fact we the community might just be the one that is sick.

Now why might medication make things worse and why does it work? Just because it “works” does not prove in any way that there is a “biological” problem it just means that the chemical is working on the “attention” or “interest” mechanism. Heroin “works” also. I have had people tell me that “honestly” doc I didn’t take my “Adderal” (a medication for ADD) all the time, just when I was “bored”, when I needed to really get the job done. So it “works” as a stimulant. Of course this is well known.

Why do the dugs cause anger? Well we believe, simply, that when our “interest” is interrupted we feel, well, bad. What often happens when we feel “bad?” Well, we often get angry. Don’t you? If you intensify the interest, say with medication, the result of the interruption will be just that much worse and so will the anger.

Schools need more money and we all need to pay more attention to our children and to each other and others and see how things improve.

Brian Lynch, M.D.

“Testing, Testing, 1,2,3… Testing..”

“Testing, Testing, 1,2,3… Testing..”

I told someone the other day that helping someone is often like having your hands and feet tied and being gagged at the same time but still having to do something.

This has to do with one of the most important ideas I work with and that is that any type of criticism or negative feedback only makes things worse. Am I very good at this? Oh, I don’t know. I think I fail miserably at taking my advice all the time but nevertheless I think it is true.

I think we are all trying to do our best. I wrote this in my book and discussed it once with someone and that was the last time they ever talked to me as they really could not accept that idea. It has been my experience that the great majority of people, at some level, “need” to think that people at some level “want” to be or are “bad.” So if they are or “we” are all bad at some level then we must “choose” to be or do bad things and thus cannot always be trying to do our best.

The idea is simple, and that is that we are made to connect with each other. The only way we connect is through truly being interested in another. The only way to do that is to do our best, to “love” in the healthiest sense of the word. I believe this is a most natural and basic biological urge, this urge to connect. Therefore to do other, not to do our best makes little sense. If we are doing things that hurt ourselves and others then it seems to me a mater of simply not knowing how to achieve our goal. True enough there are monsters all over the world past and present. Pol Pot, Ghenhus Khan, Hitler, Sadham Hussein in our own home but they knew and know less than anyone about feelings yet have and had the need for connection no matter how perverted it was or is. Yes they where doing the best they could and can given the “learning” in “loving” they had which was almost none. If you don’t learn it how can you do it? Now many people will be irate about these ideas? Nowhere do I say that you do not remove yourself form harm or defend yourself from it when need be.

But what about the people we deal with from time to time and try and help, indeed ourselves!? Are we always trying our best? I think we are. I think, however, we will, over and over, sabotage our best laid plans to “test” ourselves and others. We want to see if we still “love” ourselves enough to accept ourselves and, of course, we need to see if others will accept us so we test them. This is a well recognize residual effect of abuse and we all have suffered some abuse if from nothing more than living.

We test everyone. We test our parents, our spouses our lovers or friends our children, the police and our bosses.

The grandmother calls off the picnic at the last minute. The boyfriend is 45 minutes late. We say something controversial in earshot of the boss. Not only do we engage in corrupt activity but we seem to go out of our way to get caught.

These are all secret “tests” for many people testing whether we will still be loved despite our “despicable” behavior.

Friday, March 26, 2010

“Trust”

“Trust”

Trust is the foundation for relationships. What I have found is that often there is absolutely no doubt that the desire is there but the ability to follow through is lacking. It is lacking because the person never had a chance to learn the complete arch of trust.

The problem is they where raised in a very domineering and negative environment. They where always told “no.” “I want to go to the show.” “No?” “”Can I do this or that?” “No?” “You can’t go out with Javier.” “You can’t go to that school.” “Be home by eight. “

In this environment the child learns to be devious. They learn to get what they want and they learn, mistakenly, that this is the only way the world works. I must lie, cheat and steal to get what I want. It becomes like a computer program. I want something and I expect a “no” and my reflex is a devious response. I grow up and ask my girlfriend or boyfriend or my husband and wife and I expect to enter into a dishonest contest.

It is not uncommon for a scenario to pass that even though the other party says “yes” that the abused partner is in such a state of shock or disbelief it seems that they will have to “test” the other party. “Hey honey can I use the credit card to go out Friday night.” “Sure but we are kinda short. Try and limit it to 50 dollars.” But I go out again Saturday and use the card again and spend another 35 dollars. I see this as an obvious “test.” Will he or she get angry like my father? Or I convince my boyfriend I really need something and then take it back for a cash refund instead of just asking for the money. I just cannot help myself. When confronted I then accuse the other of being “abusive” of being “distrustful”, “mean”, “cheap” or monitoring everything I do. The other finds themselves in a “no win situation.” No one likes to be in the situation of being distrustful, how is trust reestablished once broken?

A famous T.V. Dr., who I have some problems with, does say one truth and that is “patients lie all the time.” Now “all generalizations are false” but we all lie some of the time and he is very correct, most patients will “lie” about something and often something rather significant. If they would just ask me it would be much better. But this often because they see me as a parental figure that will automatically deny them. It is also certainly more often due to various forms of shame. I do not deny that many have been shamed and humiliated by many a physician. But that is another issue.

Finally, a solution to this problem is not easy. It is not a simple problem of “lying.” Please understand that the person sees their actions as “the only why of surviving”. They see their actions as “the way to do things.” They do see other people doing things “the right way” but this confuses them as in their experience it has never worked. In their experience as a child they where always rejected. To now learn that a loving trusting relationship can exist in its own right is a major relearning process on a subconscious level full of land mines. And part of that process means also tolerating a respect for the other and for the legitimate “no.” Sometimes “no” means “no.” Often the other is so traumatized that any “no” becomes a simple challenge to overcome. This is extremely dangerous. This is what I call being “there” and not “here.” The person is back in the abusive relationship and not in the present and cannot respect the viewpoint in the present and needs of their “now” partner.

Copyright 2010

References:
www.brianlynchmd.com

Tomkins, Silvan S.: Affect Imagery Consciousness NY: SPringer Publishing Company, 1963.

Shame and Pride : Affect, Sex, and the Birth of the Self by Donald L. Nathanson Paperback (March 1994)
W.W. Norton & Company; ISBN: 0393311090


“The Origen of Conflict”

The Origen of Conflict”

I often talk about a movie entitled “The House of Fog and Sand.” I use it as an example of what the director states in the DVD “extras” and that is “The film exposes the unsettling truth that sometimes it is our hopes, rather than our hatreds, that divide us.”

I will briefly say that the film is a tragedy that deals with a struggle over several people trying to acquire a house. People die.

The statement of the director is haunting. It is one of the greatest truths I have ever heard. To truly understand it we need to begin to understand one of the emotions that I have now mentioned many times and that is “interest.”

Our desires, wants, ambitions and needs, to wit, our interests have initially nothing at all to do with hatred, recrimination, revenge, jealously and anger. Why? Because all of these have to first start somewhere. They have to start with a desire.

Recently I experienced this with a loved one. I had not discussed the next day’s events with them. I had in my head the whole day planed out which involved a lot to do with my practice as it was a working day. I equate this phenomenon to blowing up a balloon. We blow and blow and blow and the more we blow the more we exclude others needs. We are “into our needs.” Well, returning form a trip at ll: 00 pm. I then hear the other person’s version of the day. It is nothing like my version. They too had blown up their balloon.

Had either party “wanted” to get in the other’s way? As far as I can tell in no way had they. But each balloon was emotionally burst as trust and emotional needs where not met. I withdrew for a while thinking “I had to do what I had to do.” I was tired and felt I had not been considered and now had to rearrange everything.

In the end my friend’s project was very important to both of us and it was possible to get everything done. But it was one of the best practical lessons I have had in this very message I am conveying.

No one was “right.” No one was “wrong.” It is however extremely difficult and well neigh impossible to “put on the breaks” at the very moment needed as the balloon or balloons can be broken instantaneously and I believe we then have little or no control over the initial feeling of shame, anger, disgust and distress or combinations of emotions we will initially feel . We have to have a lot of practice at recovering quickly.

Now think of the same process in any relation, in a business deal or an international conflict. So I think it vital we begin to think of the “positive” origins of conflicts and search them out, that is each other’s “interests.”


Copyright 2010

References:
www.brianlynchmd.com
Tomkins, Silvan S.: Affect Imagery Consciousness NY: SPringer Publishing Company, 1963.
Shame and Pride : Affect, Sex, and the Birth of the Self by Donald L. Nathanson Paperback (March 1994)
W.W. Norton & Company; ISBN: 0393311090

Thursday, March 25, 2010

Just one more.....




“Just One More Minute”


I was just in the dental chair. I was reminded of an unfortunate habit of medical professionals and that is to say “Just one more minute,” or one more stick with the needle or one more stitch. It seems that it almost never works out that way.


Good medical instruction teaches not to do this and I was taught more than once not to say such things. So why do we do it and why is it so irritating and so counterproductive? Of course these principles are true in any area of life. I was also just on an airline and it always seems that when the pilot gives a time of departure it never happens. This time he said we where to pull back in “one minute.” Something happened with the “tug” and it was twenty minutes later that we left. Better to say nothing.

I work with some ideas that offer a specific explanation for why this habit can be so irritating.


It is a simple idea and that is that we suffer a great deal of pain throughout our life at the moment that our “wants” are not fulfilled. This is a pretty simple idea. “We suffer a great deal of pain throughout our life at the moment that our “wants” are not fulfilled.”



So, we want the procedure to end. Someone tells us that it is going to be over in “a minute.” “Don’t worry one more stitch.” We are going to make up twenty minutes of lost time. We “project” into the future. Don Nathanson put it this way, saying “When desire out runs reality shame ensures.” A “translation” would be that, again, when we “want” something and do not get it we simply feel bad. Make sense? Makes sense to me. Why shame? Well, I hope you think about it and I think maybe you will agree that it is shame that we feel at that moment.



Now why do doctors, nurses, dentists and many others inflict these tortures on their charges? They do it out of the best intentions. They want to give us hope that “it will all be over soon.” But they themselves are engaging in a version of desire outrunning reality. They want it over with! They want to get done. They also want you to feel good. But by wanting you to feel good they end up doing something to make you feel bad.



There is a first principle in medicine and that is “First do no harm.” The longer you are in medicine the more you understand how easy it is to do harm and how often not doing harm means doing nothing before you do something.



Finally, it would not be accurate to say that it is always as I have portrayed it and that is that everyone always has the best intensions. There are many disturbed people in all walks of life and it is not precluded that such torture as described here is not very much intended by the controlling party at least subconsciously. Why this would be is left for another time.




Copyright 2010





References:
www.brianlynchmd.com

Tomkins, Silvan S.: Affect Imagery Consciousness NY: SPringer Publishing Company, 1963.


Shame and Pride : Affect, Sex, and the Birth of the Self by Donald L. Nathanson Paperback (March 1994)


W.W. Norton & Company; ISBN: 0393311090

"Feelings as Tapestry"

Feelings as Tapestry

We can think of each and everyone of our personalities as a tapestry or ornate weaved rug.
The materials for the finished product would start with the emotional apparatus we are born with.
There is a lot of evidence to say that we are born with a fixed set of emotions or feelings. For our purposes today I will name them as anger, fear, interest, surprise, distress, disgust, contempt, joy and shame.

Imagine each of these as one of the threads we had to start with to weave with on our loom to make our tapestry or rug. The moment we were born the threads would all be separated and “pure” but immediately life would begin to weave them into our unique patterns of “knowing” the world."

There is myself and my twin brother and my one year old sister and there is a terrible thunderstorm. How do we feel? I might feel much fear followed by some distress and then more fear. My twin, on the other hand, might at first feel surprise and then fear but then joy at the lighting and laugh. My sister on the other hand simply might stare out the window in amazement, or intense “interest.”

Since this storm was very intense and stimulated our nervous system in all of us in intense ways we all “recorded” it in someway in our memories and it is now part of our instruction manual as to how we will respond to thunder storms. We, that is, learned in those moments how to respond to thunderstorms. How did we learn and who was are teacher? Well, it is obvious that we were nothing much but putty in the hands of nature. Nature was our teacher and why one felt interest and he other felt fear is pretty much an accident. But little by little through these intense experiences and then by grouping similar experiences we learn what the world means to us. We begin to form our personality.

We can see it can be and is a very personal world just as every custom rug and tapestry is unique in the world so is every personality. Each experience is like a series of knots that are securely tied. Can they be untied? This is an important question.

The next thought about our patterns or life is once we have these feelings what do we do? During the thunderstorm what did we do? I cried. My brother laughed and danced around. My sister was still. We all could have “done” many different” things and still felt the same. I can be fearful and run away or I could have tried and ignored the problem by suppressing the feelings. Whatever I do at these early ages will also start to become “learned” experiences and like secure knots tied deep in the tapestry of our personalities. Can they be undone? This is an important question.

Once the tapestry or rug is made can it be changed? This is the question of therapy and the work of therapy. The purpose of this piece is to get us to think about how personality is formed starting with innate feeling most of all. But we are not rugs or tapestries we are living breathing humans that can and do change but it is not easy.

Brian Lynch, M.D.


Copyright 2010
References:

www.brianlynchmd.com
Tomkins, Silvan S.: Affect Imagery Consciousness NY: SPringer Publishing Company, 1963.

Shame and Pride : Affect, Sex, and the Birth of the Self by Donald L. Nathanson Paperback (March 1994)

W.W. Norton & Company; ISBN: 0393311090



How To Get Where You Want To Go Brian Lynch, M.D. 2000 PageFree

Wednesday, March 24, 2010

“I’m going to have a nervous breakdown.”

“I’m going to have a nervous breakdown.”

I remember when I was thinking about going into medicine I wondered what a “nervous break down” was. I mention this as many people still use this phrase. In these few words I want to help us understand that we can help ourselves by being more understanding of our mental states.

First, if you have ever had that thought: “I am going to have a nervous breakdown” I would like you to think about how you felt at the time. Were you angry? Was there a lot of fear? Usually it is the case that there seems to be “too much” going on in our lives that is stimulating our unpleasant feelings that we become very overwhelmed. Anger, fear, disgust, distress and shame take over. Doom looms in the future. We think, “What is on the other side.” We don’t know. We see disaster in the world but what will become of our own mind? We know the phrase “nervous breakdown” but have we ever seen someone have a “nervous breakdown?” True enough people “shut down.” They do have radical changes in their behavior and they do become hospitalized and many of us have lived through unfortunate circumstances.  I may be being unfair, you may have a clear idea of a “nervous breakdown”, even so and for those that don’t I want to say we can be much clearer in our thought and if so, much better off.

Above all there is much more help available now. The first rule is that we now know that simply having someone to talk to in troubled times who will not judge you is very important. Next, I ask you to consider the truth of the statement “that it is almost as equally difficult to pursue a path of healing as it is to, as one friend said, “give up.”" I say this as I think sometimes when we say we are going to have a “nervous breakdown” it is at those times that we want to “give up.” But what does that lead to? Running way? To where? Blaming ourselves for our problems? Where does that get us? Using drugs to drown our sorrows? What does that accomplish? And then a good solution, blaming others for everything. That fixes things? All these things take a lot of energy and are what constitute giving up and are what constitute a “nervous break down” for many and in great part.

Now, I want to be very clear it is very tricky, as I do not think we “choose” to “give” up.

I said it takes as much “energy” to do one or the other, to “give up” or keep going. It is an “energy” balance and I believe it is driven by our emotional state. How overwhelmed are we by our unpleasant emotions at any given time? Is there a solution? Can we control them? We can, to a point by working today to build strong relationships with others so we do have that friend, spouse, or special other that we can always confide in and then ultimately so we can build the inner strength to calm ourselves, calm our specific feelings, when needed in the middle of the storm if we find ourselves alone. Not easy but practice, practice, practice.


Copyright 2010
References:
www.brianlynchmd.com

Tomkins, Silvan S.: Affect Imagery Consciousness NY: SPringer Publishing Company, 1963.
Shame and Pride : Affect, Sex, and the Birth of the Self by Donald L. Nathanson Paperback (March 1994)
W.W. Norton & Company; ISBN: 0393311090
How To Get Where You Want To Go Brian Lynch, M.D. 2000 PageFree

“Cast The First Stone”

“Cast The First Stone”

Whenever I write I wish not to be “pointing the finger at others”, although it is natural to first see “wrong” in others first, but very often I will write something and then be so surprised to be thinking about what I wrote and find that I remember doing a similar thing to someone just recently.

Today, I am thinking about stories I have heard and experiences I have heard concerning people that just seem to be unable to, well, share very much.

In the extreme form it might be that you could not expect them to walk across the room and get you a glass of water.

People who might live with you a week and maybe, just maybe, wash their dish from which they ate. Otherwise they feel that they need every last cent that they have as “who knows what might happen tomorrow?”

People, who know all about a given profession, are professional and yet after 20 years and claim you as their “best” friend but I bet you, you have not gotten one bit of “free” advice from them. You might be “picking” their brain! Yet you have freely given of your knowledge as you see this as part and parcel of “friendship”, of sharing. One of the best examples and “proofs” of this is email. Think of all the caring emails you have sent out without one response.

Over and over you hear, “I’d love to help you out” with this or that. “I know how to do this or that.” “You really should get this organized.”, etc. But nothing comes of it.

A relative is full of advice. You’re desperate for tuition money but you just hear criticism. Had you done this or that? They are going to give all their savings to the poor in India when they die. That is the only solution they can see. “Otherwise people just hurt you?”

So why are “we” like this so much of the time? Well, the last statement says it all. “Otherwise people just hurt you?” So it is with, for example email. It is so often that it is not the case the communication is not appreciated. Quite the contrary it is much appreciated but people cannot let on that they appreciate it.

If we are not creating the good times now, today, then we are not creating them, we are living in fear of some unknown future. Why is it that we are not creating the good times today? It must only be because we have learned to be cautious. A little logic must tell us that there should be a balance to this but then who is to tell us what that balance is? Where do we go to find out?

If we have been severely abused how do we even know we have been severely abused and that we are “over reacting?” How do we know that we should be more giving and if we where more giving we would be better off? The truth is those that don’t know don’t know and are not “evil”, “mean” or “doing it on purpose” they just do not know. Those that can give in the moment and experience the “interest” and the resulting “joy” of giving and hopefully of receiving only know it through doing. The receiving part is very important because the down side is that is almost as dangerous and “sick” is to give and give without receiving as to not give.


Copyright 2010

References:

Tomkins, Silvan S.: Affect Imagery Consciousness NY: SPringer Publishing Company, 1963.

Shame and Pride : Affect, Sex, and the Birth of the Self by Donald L. Nathanson Paperback (March 1994)

W.W. Norton & Company; ISBN: 0393311090

How To Get Where You Want To Go Brian Lynch, M.D. 2000 PageFree