"The Chicago Scam"

I had just admitted two addicts in their sixties in the same hospital room. They were buddies and this was not their first visit to the rehab and as I walked by the room one of them called to me, “Hey Doc, come here I want to tell you something.” What followed was a fascinating half-hour on how not to get scammed. He said, “Now doc I am telling you this so you won’t get hurt.”

 He proceeds to explain the intricacies of a version of a “Pigeon Drop” scam. This is where you convince someone to put up collateral for a bigger payoff in the near future, of course, the bigger payoff never comes. I was seated in a chair at the foot of his bed against the wall as he regally held court. He explained in detail how he entered the bank with a woman and she withdrew 10,000 dollars and gave it to him. He sincerely cautioned me not to fall for any such a scam. I thanked him and I got back to business.

 Later he once again summoned me and this time with an anguished gaze he asked, in a pleading voice, “Doc you don’t think I am a bad person do you?” I don’t remember exactly what transpired but I do believe I did say “no” he persisted and went on and on for a while explaining how he had done nothing wrong, nothing at all wrong that, “That the lady had gone into that bank of her own free will and taken out the money.” He had not laid a hand on her.

Switch to “The House of Cards” a movie that captures what I experienced above. I don’t know if a city can have its signature on a scam but this one is set in Chicago. It has its weakness such as the plot being centered on a psychiatrist getting caught up in investigating the lives of grifters to the point of participating in the life. Yet, in doing so it touches on the emotion of interest-excitement. She is bored with her life and the patient leads her to investigate this other world. She is ultimately hurt as she is “played” by the leader of the group, made love to in the making of a scam, and then abandoned. 

My purpose in bringing the movie up is to parallel it with my experience in the hospital in this way: A deal goes bad and there is violence. There is an older partner who is upset about this and, if I remember correctly “resigns.” He throws a major fit and goes on and on about how honorable they were because nothing they ever did involved violence or hurting anybody. He had a “code.” After all, he had his “ethics” to uphold.

Of course, all this is to say that human beings can justify anything. It is not in any way to “condemn” these people or to say they are “evil.” It is to start to appreciate what psychologist Silvan Tomkins calls “script theory.” It is to get away from simplistic terms such as to “excuse” actions and behaviors. It is to deeply understand it.

 Many will want to say about my patient, “Oh, he knew that he was doing wrong.” “Oh, Dr. Lynch your so naïve. He was playing you!” Well, if he was what was his goal? What was he getting out of it? Laughs? One never knows. 

It seems to me that we don’t want to hurt people but we are hurt and taking care of that hurt is important. That puts us in a tough bind, a shame bind. Damned if I do and if I don’t so I make all kinds of compromises and secondary rules and before I know it I live in my castle, my world. And yes I am saying that while I am in that castle I cannot make any other “choice.” 

My patient does not believe he is doing anything wrong at any given moment. But then you ask why does he have to ask if I think him a bad person? Good question. That is the problem with making it “right” and “wrong” black and white, “good” and “evil.” The situation is as they say “what it is.” And what is it? As someone said we are indeed “many selves” at once. Shame and “shame binds" help us understand all of our conflicting interests and how we can live with all kinds of what we call “cognitive dissonant” behaviors at once. So does he or doesn’t he know he is doing “wrong” and will punishing him or arguing with him do any good? It seems to me that all of the above are pretty much non-starters. He is pushed and pulled by fears and demons that only he understands and the only antidote is a sense of safety and security however impossible that may seem.

Brian Lynch

'Withdraw'

Brian Lynch

This term turns out to be a powerful way to summarize several ways in which we deal with emotional pain. It is probably, on average, the first step we take when hurt. It can be recognized in recognition of “fight or flight.” We do not like pain and move away from it.

A great cause of pain is the world causing us a sense of humiliation or any sense of shame. The idea is to get a sense of how this concept of “withdrawal” along with a few others in later essays, is capable of engulfing huge swaths of our behavior. I start by thinking in biological terms. Pleasure- pain. Did you ever nudge an amoeba with a pipette under a microscope? The organism moves away. It withdraws. A sea anemone closes its tentacles.

So on the most practical level, it is a move toward safety, although depending on the circumstances some would call it cowardice others prudence. Would that such labels be of any use? The purpose here is to show that such responses as “withdraw” start at such an early age we are well within their clutches before we can do much about them. It can take years to free ourselves and unfortunately, we can become more entangled in our web.

There is a specific term for this problem when it becomes severe and it is “agoraphobia” but one point of these essays is to blur the line between those “official” words and the terms I am using such as “withdrawal.” That is “Agoraphobia” is withdrawal but all withdrawal is not agoraphobia the vast majority of withdrawal is not agoraphobia yet damages everyone. 

Yet, we like to think of it as a “them” not an “us” problem. They have the problem we do not. We do not see all the ways we “withdraw” from people hurting ourselves and others. A few examples:

In the distant past, I remember my first year away at college early in the semester I left the safety of my elite campus and went with a “townie” out to a restaurant a few miles out towards the strip malls with a friend of his. We sat down and we were talking and at some point, I noticed that his friend had disappeared. I panicked I said, "Where did he go?" How was I going to get back to school? He said he left. I was flabbergasted. My friend was a bit older and a very nice guy and looked at me knowingly like I was a lost puppy. Knowing what? Knowing that I had just “not been” around. Knowing that I had not learned about people that abandoned other people. Not knowing about people who “withdrew.”

So an important point “withdraw” is a double edge sword. We “withdraw” because we were “attacked” but this sets up a “habit” that we later cannot control, which may later lead us to not attack others but to “abandon” them when they need us.

An important insight to appreciate is that to “withdraw” can be an attack. What feels worse to be yelled at by a loved one or to simply have them disappear sometimes never to return? I have mentioned before there is research to show that children that have been verbally abused do better than those that have been abandoned.

Then just the other day deep feelings were triggered in me when a patient got a ride to see me and we were having a very difficult time negotiating something. He said, “I would have walked two hours to get here.” I saw his ride In the waiting room and then I saw him get up and leave and the patient excused himself for a minute. Then after he came back a while later I asked him what happened to his ride he said, “Oh he left.” 

A discussion ensued and I asked him what more important thing did his friend have to do? I asked, “he knew he was bringing you to the doctor right?” (he did not have to wait to see me at all). So the point is the man (fifty-some years old) “withdrew,” bolted for some reason known only to him. True enough I always say when you know the answer it makes perfect sense. He probably “hates” doctors’ offices. But it is one more testament to our level of empathy for one another or at least our capacity to carry it out.

Finally, one place where there is a crystal clear problem with “withdrawal” is in Japan where they have a specific name for it. It is called Hikikomori (pulling away, being confined). It is a phenomenon whereby young men will leave school and come home and live in their rooms. This possibly affects up to 20 percent of all adolescent males or 1 percent of the overall population. I understand that it is pretty much that it is not that they live in the house but in their room ( by definition at least 6 months). This can and does go on for years. It is often precipitated by an incident of bullying at school.

I mention that humiliation and shame are primary causes of withdrawal such as above in the case of Hikikomori. I am sure it occurs to anyone that fear would be a great motivation to withdraw and so it is, And so too are any number of sequences of feelings.

"Anger-Rage"

Brian Lynch

It was not too long ago that many thought that we all “learned” to be angry. That is it was supposed that it was theoretically possible for someone to develop without the capacity to get angry. Some people still believe this.

Intriguingly, it was Darwin that began to solidify the innate nature of anger and then was promptly ignored for some seventy years and, as I say, only recently has the notion taken hold. But then what can be said about anger?

I think many will agree that anger is problematic and maybe the most problematic of the specific emotions. Many think we should never express it while others think it should always be expressed. Many want us to “learn“ to control it.

Like so many things we seem to know so much less than we presume. Or at least if the knowledge is there it has not been widely disseminated.

It goes something like this: Anger can be triggered in essentially one of three ways. First, it is a survival mechanism that is triggered directly when the organism is threatened in such a way that it is in imminent danger. I would say “overwhelmed” but that is not necessarily accurate. That may be the case but it need not be the necessary condition in imminent danger to the point that a certain type of action need be taken.

It is thought that this is not based primarily on our cognition, that is our thinking but is “hardwired” and will take place on an individual basis based on our life experiences. The point is it is “automatic.” It is our body taking care of us.

A most important insight is that probably the great majority of anger comes secondary to the hurt after shame and humiliation or the hurt suffered after failing to reach a desired goal, not from being in imminent danger, a most important distinction.

These have been the most useful insights in helping people in understanding their relationships and their struggles with “anger” problems. It is my approach to “anger management.” I have said often elsewhere that “anger management” is wrongheaded in that it focuses on anger per se. The problem with this is that most anger is of this second type of being secondary to “hurt” and that it is like asking someone to hold a hot potato and “deal with it.” “Deal with your anger.” “Control your anger.” What is missed is any understanding of the origin of the anger that is that the person was “hurt” because they wanted something and did not get it. 

In labor and management problems, anger comes from desires being blocked. So too in marriage, and in friendship. The primary thing is a desire that is not achieved then ends in hurt and this ends in a type of confusion. Anger ensues. Simply telling the person or group to deal with the anger sets up a vicious cycle and deflects the issues and gets everyone off track. Those in power can easily use it to their advantage and hammer away at “anger control” issues and make it the “the” issue. “We will not discuss anything until you get your anger under control.” 

For example, in a relationship, the person getting angry quickly can get caught in a dependent position. The more controlled person can browbeat the other to no end and obscure and legitimate desire the partner started with that produced the anger. The more the desire is ignored the greater the anger because the more the anger is focused on the more it becomes the issue and the more the conversation is co-opted and the angry party becomes more confused and more shamed and humiliated and maybe now guilt-ridden because they now start to become convinced that they are wrong about everything and maybe start to doubt the worth of what they wanted in the first place. In the end, it will only lead to more anger because, of course, they are not wrong. Ok, the wish for desire might be unreasonable but it has to be respected and negotiated.

And yet none of this has to be “on purpose” by any party involved it is that we simply do not understand anger and we do not listen to each other. We are not listening to what the other person wants and are not trying to accommodate.

Much of this explains why in interpersonal relationships when anger flares we so rarely remember what the whole thing was about. Why is that, again, it is because there is going on a great confusion. Nothing is “pure.” We have “wanted” something and have not gotten it so we are in a state of at least momentary “shock”, cogitative shock, and confusion if you will. Due to earlier learning, we have “learned” that anger is an appropriate response in these situations. “I don’t get what I want so I throw a tantrum.” Or at least show my displeasure but in that state, I do not do my thinking neurons much good. I prolong the state of confusion and shock. The ability to store short-term memory is hindered and fragmented. The feeling/affect of “surprise” is involved which further hinders my later recall.                                  

Then there is a type of anger or any emotion that is in effect fairly purely “cognitive.” That anger that follows being “hurt”, is important to understand, but is not important for survival. It is “cognitive”, it is a “learned” response, a defense against a perceived “danger”. Remember where we started when we said that at one point most experts felt we all “learned” or did not learn to be angry? We can all “act” “as if” we are angry, a “third” type of anger.

None of this is to say that anger does not get out of control and is not often difficult to control. 

“"Surprise, surprise!”

Brian Lynch

                     

 

Surprise, is an ignored emotion or feeling or more accurately an obscured emotion due to its nature, and what is that? It is that surprise is not so discrete as some emotions as it is followed immediately by some other emotion such as joy or terror. For many of us, we are particularly conditioned for one or the other, and most unfortunate for those people who have been conditioned to always or near always associate it with fear or terror. I will often hear people say “Oh I hate surprises.” This is probably due to having a history of what amounts to childhood abuse: a sibling or parent who would scare the hell out of them, as opposed to your father surprising you with a gift when he came home from work for no particular reason.

 
 
 
 One sense of painful surprise that has stuck with me since I have begun my study of basic emotion is the all too oft occurrence of the mother or today, the stay a home parent who will say, “Just wait until X comes home then you will see.” Well X does not come home until late when the kids are asleep and X prances into the bedroom and gets the kids out of bed for their punishment. The kids suffer “surprise” and terror. And at this point have no idea what is going on.
 
 For one thing, one attribute of surprise is that it “clears the circuits.” It wipes out everything that goes before it. Here the kids are in a deep sleep and are awakened, their memory banks are cleared and their Adrenalin starts pumping and they now can try and escape the intruder that came into the camp. There is no reason at all for them to be remembering that they were jumping on the sofa 10 hours previously and did not heed the pleas to stop.
 
 Surprise has much to do with trauma. But first, let me say that I want you to appreciate that pure surprise, I believe, is never pleasant. That is the initial jolt is a painful shock, it is only made worse or ameliorated by interest and or joy that might flow so the odds are weighted against coming out with a lifetime average of good experiences with surprises.
 
 But back to trauma; so logically when bad things happen surprise is likely to be involved and whether we are a “good” guy or a “bad” guy the emotion is almost impossible to control. Again, when it happens, and especially when we are a “good” guy when we are blindsided our memory banks are wiped clean, at least for the moment. This means that memory can and tends to be fragmented. Not repressed but fragmented and associated with fear-terror and shame. When we are small do we have power? Not likely, we therefore feel helpless. If we are subjugated to this trauma repeatedly we might turn to anything at hand to soothe ourselves sleep, food alcohol, incest, cutting. Each of these will bring on new experiences of surprise and new experiences of secondary feelings and some relief of interest and joy but of course, interest and joy will come at a very high price later on of shame and guilt.
 
 Much of sleep problems are due to childhood traumas such as those just described. A famous case is that of Michael Jackson. Michael was not shy about talking about his father terrifying him and his brothers at least once. One night in a dormitory arrangement when his father came in an open window dressed in a frightening costume. Michael seemed to be tracing his sleep problems to that incident. His father, of course, was, “teaching them a lesson.” A lesson that ended in his son’s death some fifty years later and a murder charge for Dr. Murray.
 
 How do we fix things? As always not easily done and too much to do justice here but it is but certainly not by ignoring things. It is essentially by reconstructing and bringing into consciousness the sequence of events, i.e. learning and then deconstructing what has been reconstructed so that we can have control over those feelings, and affects that are controlling us.
 
 So surprise at its core is a painful experience and its evolutionary role is essential to our survival. It is meant to clear the circuits so that we might forget entirely what was going on just before the event that is now taking place so that we can put our full attention to it. We are out gathering mushrooms in the jungle and a Bengali tiger catches our eye. No matter how good the treasure trove of mushrooms we want to clear our minds of dinner and focus on the tiger.
 
 As culture has become more sophisticated, unfortunately, so have the various ways feelings can become complicated. Surprise is primary for survival that then leads to joy.
 
 I want to thank Jim Duffy, psychologist, and Melvin Hill, therapist for much of my understanding of the above.
 
 

"Therapy"

"Therapy"

Brian Lynch

"I just dropped in to see what condition my condition was in." 

Kenny Rogers

I am a person that talks to people with the hope that through a good conversation, we will come to some conclusions about their lives that will help them move forward. Through serendipity, it often happens, I learn something and I move forward. That is we both learn.

So what have I learned recently? It is this, that therapy itself can be used for many purposes. Or let us say not “used” or ok “used” but unconsciously used for various purposes not all of them “good.”

People supposedly come to therapy to solve problems. But it is obvious that maybe the stated purpose and the subconscious one may be very different. It may be the proverbial one step forward and two or three back as I have mentioned before. Once that first step has been taken then fear and shame take over and progress is inhibited. It is well known that patients often will have a period of worsening symptoms before real improvement is seen.

If indeed this is the case, the case that they take a step backward, then what would be the characterization of that step backward?

I think both the patient and therapist have to be very vigilant for a time. For what? For one a physical or emotional form of “withdrawal”:

Is this person coming to me to “escape” the outer world and establish a fantasy world that is in effect one of dissociation? A world in which I ( the patient) don’t learn much about life and how to carry what I learn into the world?

Or do I use the session as another kind of “withdrawal” which is a bit more subtle and that is like a drug? I simply lose myself in the process. I become “addicted” to the process of therapy. The therapist for example becomes the only person I talk to. Then I can actually “withdraw” by not coming to the sessions. Or be “withdrawn” in the sessions.

Finally, I can spend the time in the session in various ways of “attacking” myself or the therapist.

All of this is to say that therapy is a microcosm of life, as it should be but it is one where the stakes are supposed to be a bit out of the ordinary. It is everyone’s job to come back to the straight and narrow, to the problem at hand a bit quicker than we do in normal life, that is “to solve the problem.” But “quicker” in therapy even with something as useful as these explanations can and often is nothing akin to “quick.”

Brian Lynch

I want to thank Jim Duffy, psychologist, and Melvin Hill, therapist for much of my understanding of the above.