Category: Emotions

Posted on

Heart Poops.

“Loving just one is too little; loving all is being superficial; knowing yourself and loving as many as possible, letting your soul hide all the powers of love in itself, so that each gets its particular nourishment while consciousness nevertheless embraces it all – that is enjoyment, that is living.”
― Søren Kierkegaard, Either/Or: A Fragment of Life

     An interesting trend has begun to appear in several of my conversations with other people: What to do with emotions. One idea is that emotions are supposed to be destroyed, rather than experienced, in some form of stoicism. Another is that emotions should be expressed whenever and however someone would like. There is some truth in these concepts, but they miss the mark.

     I’m unsure where this line of thinking came from, but it’s disturbing. Emotions are a natural part of the experience of life. They aren’t good or bad, they aren’t wrong or right, they just…are. I can’t stress this enough: EMOTIONS ARE NOT GOOD OR BAD! They are morally and ethically neutral. You are entitled to your emotions and should never be ashamed of them.

     There is an analogy that may help. You remember those analogies on the SAT? Like, “Pockets are to pants, as pouches are to marsupials”. I love those things. I have a new one for you:
“Emotions are to the heart, as poop is to the digestive tract”

Sounds ridiculous, doesn’t it? But it’s true! In the same way feces are an important product of our body, emotions are a crucial product of our heart. If you eat, you poo. At least you should. If you’re alive, you feel. Again, at least you should.

There are people that struggle with constipation and they just can’t get anything out. Chronic constipation can lead to impacted bowels. This is a block in the intestines which becomes so hard only liquid can go around it. Ironically, one of the symptoms of constipation can be diarrhea. This is because the liquids ingested can make their way around the impacted bowel. Left untreated, it will become more impacted until surgery is necessary. Without surgery or early interventions, it can even lead to death. DEATH! Your own feces can kill you if you hold on to it for too long.

On the opposite end of the spectrum are people that struggle with chronic diarrhea. This can be a symptom of Crohn’s disease, irritable bowel syndrome (IBS), parasites, or a dozen other things. Diarrhea is problematic because food doesn’t sit in the digestive system long enough to absorb nutrients. Plus, it gets pretty messy. Ironically, diarrhea can be a symptom of both constipation and diarrhea. Another potential complication from diarrhea is also death from dehydration.

So what?

How, in the world, is talking about feces supposed to help us understand appropriate expression of emotions? Many years ago a psychoanalyst, Freud, talked about people being anal retentive or anal expulsive.  He believed:

“The Anal retentive personality is stingy, with a compulsive seeking of order and tidiness. The person is generally stubborn and perfectionist. The Anal expulsive personality is an opposite of the Anal retentive personality, and has a lack of self control, being generally messy and careless.” (Source)

There’s a lot more to this concept, but this should be enough to help understand the analogy. Some people make the mistake of holding their emotions in (anal retentive) while others make the mistake of overly expressing their emotions (anal expulsive).

Neither of these options are healthy. Expression of our emotions, as much as possible, should be on our own terms and with intent. Without this level of self-control it’s easy for our emotions to begin controlling us. In the same way that people shouldn’t feel ashamed for going to the bathroom, they shouldn’t feel ashamed for having emotions. Where we are held accountable is what we do with our emotions; how we express them.

Don’t hold it in forever because that may kill you! It will certainly poison whatever relationship you’re in that’s eliciting these emotions. But don’t fling your emotions all over the place either! You won’t even have time to process an experience and absorb the existential nutrients. Besides, who would want to be around that smell? It’s gross, unsanitary, and will probably leave a stain.

The best alternative is to acknowledge the feelings with enough time to make a choice about how they’re going to be expressed. This early identification is key! Holding emotions in too long may push us to the point where we don’t have an opportunity to choose when, where, or how we’re going to express them.

Happy Heart Poops, everyone!

Heart Poops (C) 2018 Nathan D. Croy
Posted on

Moana & Frankl

Gramma Tala: But without her heart, Te Fiti began to crumble, giving birth to a terrible darkness.
~Disney’s Moana
“Love is the only way to grasp another human being in the innermost core of his personality. No one can become fully aware of the very essence of another human being unless he loves him.”
~Viktor Frankl in Man’s Search for Meaning
*SPOILERS*
            It should go without saying, but if you haven’t seen Moana, there will be spoilers ahead! With that out of the way, let’s jump right in!
The Story
            Moana is a Disney movie about a Hawaiian princess who saves her people from a destructive force unleashed by a demigod called Maui. There are several existential themes throughout the movie, but I want to focus on the stolen heart of Te Fiti as it relates to Frankl’s Logotherapy.
            Te Fiti is the god of creation and life. When Maui steals her heart, a new beast called Te Ka shows up. Te Ka, composed of magma and spewing black, acrid, smoke from its form, quickly begins destroying all the life Te Fiti had created. The poison from Te Ka, a black nothingness which destroys the essence of everything it touches, begins to spread across the land. This threatens the livelihood of Moana’s people and becomes the impetus for her journey away from safety and towards freedom.
            In the process of restoring Te Fiti’s heart, Moana and Maui discover Te Ka and Te Fiti are one in the same. Without her heart, the creative powers of Te Fiti became the consuming force of Te Ka. A force of empty nothingness which devoured life.
Existential Theme
            The tensions between creation and consumption, life and death, safety and freedom, are reflected in various ways in the movie. Maui’s internal struggle to trust others, Moana’s bind between being true to self and meeting the expectations of others, and the tribe’s willingness to reclaim their identity as explorers are all variations on this theme. This theme was also poignantly, and powerfully, encapsulated in Viktor Frankl’s Logotherapy. (More information on Logotherapy is available HERE)
            Frankl believed that, without meaning, without the opportunity to express our true self in a way that matters, we will feel like nothing. An emptiness will begin to consume us and those around us. To fill this void, we will substitute consumption for creation. Any entertaining action momentarily relieves us from the awareness of our inability to express our true self. This leads to addiction, destruction, self-harm, and anything else. In Amusing Ourselves to Death, Neil Postman identifies how modern access to entertainment has dulled our connection to self for this very reason. Yet, like Te Fiti, without our heart (self), all our actions are ultimately destructive.
Family Film Friday
Here are some questions you may want to discuss with your family after watching Moana:
            *Why did Maui have to restore the heart? Why couldn’t Te Fiti get it herself?
            *Has it ever felt like someone took your heart? What did you do? 
            *Have we ever taken your heart on accident? (Great for feedback on parenting) 
            *Have you ever been angry, like Te Ka, and not known why? What did you do?
            *What was more difficult for Maui: Putting back the heart, or learning to trust Moana? Why?
            *When you get angry, hopefully less angry than Te Ka, what do you think we could do to help give your heart back?
           
Hook
(C) Nathan D. Croy, 2017

*This is the first in a series of posts for Family Film Friday. The goal of these posts is to provide families an opportunity to discuss meaningful existential themes in movies which are accessible to people of all ages. 
Posted on

Subtypes of Borderline Personality Disorder, Part I

“People with [Borderline Personality Disorder] are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.” 
― Marsha M. Linehan
     Let me begin by saying I am not an expert on Borderline Personality Disorder (BPD). The information discussed throughout this post, like all my posts, should not be used to diagnose or treat patients. Instead, I would like to share how I’ve come to view BPD throughout my career and how my treatment changes based on that understanding. This, the first post of three, will describe a metaphor I use to help explain BPD to clients and families. The last two posts will describe the specific subtypes (I, II, and gestational) and explore existential treatment options.
     The DSM 5 outlines specific symptoms and diagnostic criteria for BPD. Information can be found here. A few theories on subtypes of BPD already exist. Millon has theorized 4 subtypes, and Lawson identified 4 types of borderline subtypes for mothers. All of these suggestions are useful in long-term treatment. However, I would like to suggest a new alternative to identifying subtypes of BPD from an existential and systemic standpoint.
     Lastly, I may not consistently use person first language throughout this post. This is not to say people with BPD are defined by their diagnoses. Rather; it is important to see this post as my clinical view on BPD rather than the people who suffer with it. 
Borderline Personality Disorder
     Often times, clients with BPD are unaware of their diagnosis or they aren’t sure what their diagnosis means. The DSM 5 describes symptoms in clinical terms which, to the one receiving the diagnosis, may mean very little. When providing treatment for clients with BPD, a primary goal is to help them understand the diagnosis. Therapists would do the same with depression, addiction, or any other diagnosis. As a way of clarifying some of the clinical jargon, a metaphor has often helped to illustrate the critical aspects of the disorder in an approachable way.
The Window Painter

     Imagine we are all born into a room. The architecture of the room has unique and distinct features setting itself apart from other rooms, and is mostly bare without any furniture, paint, window dressings, or decorations. As we mature, we begin to decorate our room as a reflection of who we believe we are. As others look out their perspective window into ours, and as long as the blinds are open, they will see aspects of how we’ve decorated our room. We move past other people’s windows, and sometimes other people, from within their rooms, move past our windows. Regardless of the external changes, we remain in our rooms.
     People with BPD, tend to spend an inordinate amount of time looking out their window without looking into their room. Eventually, they begin to see other rooms are decorated or designed, and they want to appear the same way. Then, instead of working on interior design, they begin to draw on the windows. The window drawing becomes so effortless that, over time, they can change the entire look of a room, nearly on demand. If, when looking into the surrounding rooms, a person with BPD sees primarily pinks, pastels, bows, and trophies, they will paint their windows to match! Then, if there are a new set of rooms appearing out their windows, the paint quickly disappears and a new set of illusions are constructed and painted to match.
     All the while, the inside of the room, the actual room, is nearly devoid of real substance. There are no chairs to relax on, no beds to provide rest, and few lights to illuminate the recesses of the room. After a time, the energy required to maintain a nearly constant vigilance, begins to consume the window painter. When this happens, they start making errors in dressing the window. Someone notices the mistake and asks a harmless question. The Window Painter panics! They turn to see their room and find it empty, save for dust and cobwebs. Consumed with dread and shame, they enable one of the few design pieces in the room: the blinds.
     With the blinds fully closed, the window painting is still very visible, but the Window Painter is hidden. These are not healthy moments of introspection and solitude. These times are when the Window Painter, looking at the back of the blinds, sees no one, no thing, with which to connect. They are utterly alone. Within that instant, thoughts of self-harm and suicide begin to spiral into perseverating patterns of self-destruction.
     This is often when those on the outside, in their own rooms, feel so disconnected and confused. Loving parents cannot understand the source of the destructive behaviors. Friends and social resources begin to be consumed with drama and crises. People begin to distance themselves from the Window Painter. Then, when they peek through the blinds, their worst fears are confirmed: everyone really was leaving!
    Enraged and unable to engage, the Window Painter scratches and claws at the illusion on the window. They throw the blinds open and show the world the cultivated emptiness of their room. This only happens for a few brief moments before the Window Painter sees into the room of another. The connection becomes a juncture, an opportunity, for the Window Painter to bare their emptiness to another. The alternative is to resume painting, pretending, pantomiming, and hoping others interpret their real needs without risking exposing the bare walls.

Diagnosis

     The primary criteria for diagnosing BPD is “frantic efforts to avoid real or imagined abandonment” (Sperry, 2003. p.93). In the metaphor of the Window Painter, there is a dim awareness of the emptiness of the room. The compulsion to look outward, to the exclusion of personal insight, is fed by the overwhelming fear and dread which awaits those who look inward. This places the Window Painter in an existential dilemma: They want nothing more than to connect with others, to see and be seen. However, their greatest fear is abandonment. If the connections they experience are superficial and communication is primarily passive-aggressive manipulation, then very little rejection is risked. After all, how can someone truly reject someone they don’t really know?
     The sacrifice for this perceived safety is true intimacy. They are not fully known by anyone and therefore unable to truly connect. Behaviors emerging from fearful attachment (Agrawal, 2004) ultimately serve to confirm the greatest fear: Everyone leaves. This cycle repeats over and over again until the person struggling with BPD is truly alone. The mechanisms by which we come to know our selves (insight), our reactions (awareness), and others (empathy), all interact to help form relationships.

About the Doodle

      The Greek letter Phi is used to symbolize many things, including the “strength (or resistance) reduction factor in structural engineering, used to account for statistical [variability] in materials and construction methods” (Bulleit, 2008). While it should not be inferred that people with BPD have reduced strength, Phi is ideal to indicate a certain statistical variability in how BPD reacts to attachment and threats to attachment. In regards to the reactivity of those with BPD, there is a level of uncertainty which is almost always certain. Reactivity, self-harm, manipulation, low insight, and various other factors should be taken into consideration when entering into a personal or professional relationship with someone diagnosed with BPD.
     This is not to imply that people with BPD are too unstable to participate meaningfully in relationships. Rather, there is a greater degree of variability in mood, affect, and reactivity, all of which can add stress to any relationship. Therefore, to have successful, healthy, supportive, and strong relationships, we must take into account this variability and anticipate the need for additional supports. These may include therapy, hospitalizations, group therapy, medications, and education.



Phi
(c) Nathan D. Croy, 2016

   

Sources

     Agrawal, H. R., Gunderson, J., Holmes, B. M., & Lyons-Ruth, K. (2004). Attachment Studies with Borderline Patients: A Review. Harvard Review of Psychiatry, 12(2), 94–104. http://doi.org/10.1080/10673220490447218

     Bulleit, W. M. (2008). Uncertainty in Structural Engineering. Pract. Period. Struct. Des. Constr. Practice Periodical on Structural Design and Construction, 13(1), 24-30. Retrieved from http://www.ce.berkeley.edu/~mahin/CE227web/UncertaintyInStructuralEngineering-Bulleit_Feb08_ASCEJofEP.pdf

     Kreger, R. (n.d.). The World of the Borderline Mother–And Her Children. Retrieved February 06, 2016, from https://www.psychologytoday.com/blog/stop-walking-eggshells/201109/the-world-the-borderline-mother-and-her-children

     Lavender, N. J. (n.d.). Do You Know the 4 Types of Borderline Personality Disorder? Retrieved February 06, 2016, from https://www.psychologytoday.com/blog/impossible-please/201310/do-you-know-the-4-types-borderline-personality-disorder

     Sperry, L. (2003). Handbook of diagnosis and treatment of DSM-IV-TR personality disorders. New York, NY: Brunner-Routledge.

Posted on

Child Abuse Awareness & Prevention

“The most painful state of being is remembering the future, particularly the one you’ll never have.”

~Kierkegaard 

         The following content may be uncomfortable for some. If you have young children, please read. Otherwise, go on about your business, there’s nothing to see here. This is about helping prevent and catch child abuse.

          At a place I use to work, there was a child who told a teacher her uncle wanted to play with her purse. Spotting a teachable moment, the educator encouraged the child to share and take turns. The child became sullen, said ok, and slowly walked away.
          Turns out, “purse” was a family colloquialism for vagina. Because the child didn’t have the right vocabulary, she was unable to communicate what was going on and received very conflicting messages from a very well meaning adult.
          April is child abuse awareness month. Most parents work very hard to keep their children safe. I’d like to provide three simple things you can do to help your kids advocate for themselves, maintain safety, and encourage healing if something were to happen. Most of these can be done at home, with your own children, and can help educate and empower them to protect and/or report abuse to themselves or others.
          First: be as comfortable with the words penis, vagina, and anus as you are with the words eyes, ears, and nose. Some people use bathing suit area” or “privates” to describe genitalia. While not wrong, they can lead to miscommunication and potentially teach children these areas are shameful or dirty. While this may not be an issue for young children, the message can become problematic when they’re older, curious about their bodies, and don’t feel comfortable enough to ask questions because “we don’t talk about that”. This leads to the second point.
         Second: avoid shame. It’s easy to accidentally shame children about sexuality when discussing abuse. It can be confusing to know the difference between “it’s not ok to have anyone touch you there” and “that part of your body is not an ok place”. This may sound trivial, yet it goes hand-in-hand with the first point. In addition, it begins to help children learn that what happens to us, does not define us. 
         Third: don’t abuse children. This one could go without saying, but let’s be honest! Children are most often abused by adults. All abusers aren’t malicious or evil. More often than not, they’re simply overwhelmed, under-equipped, and out done by the vast amount of energy children have. If you need help, ask. If you can help, offer. We want to help kids, so let’s start by helping their families.
         Lastly: when in doubt, call it out. Teachers, doctors, therapists, social workers, health-care providers, and child-care providers are mandated reporters. This means if we even suspect abuse in children or adults/the elderly, we have to report it to our state child care protection agency. There are state specific agencies, but there is a national hotline and website you can start with here in the United States.
          If you suspect, even without proof, a child is being abused, please call 1-800-4-ACHILD or visit ChildHelp online. Thank you.

Invisible
By Nathan D. Croy, ©2015
Posted on

A Story for Everyone

“Recall how often in human history the saint and the rebel have been the same person.”
                                                      ~ Rollo May, 1975, The Courage to Create, p. 35

     Sitting in the circle, each of us took turns looking at the other wondering who would begin. The six of us knew each other, some more deeply than others, but there was still an unease. The prompt for the group was this: Tell your story. No one knew where to start. There were several revelations as we began talking about how we should talk about our stories.
     We realized that crises are relative. That just because the trauma doesn’t bother you now doesn’t mean it isn’t still important. There had always been people along the way, but we often failed to see them in the moment. And suddenly, I was thinking of Woody Allen.
      Allen brought a “quirky” and “neurotic” perspective to his films which people had not seen before. He told uncomfortable stories in a way that was just fantastic enough to allow people a safe mental distance. As I sat, thinking about how I would tell my own story, a seemingly insurmountable problem occurred: A story requires a beginning, a middle, and an end. Identifying those aspects required an outside perspective. The characters in the story never know how close they are to their own end. The cessation of one struggle could merely be the prelude to the next act. I do not know if I can ever tell “My Story” until it is over. And by then, I would not be able to speak.
     The distance Allen brought to his movies, the perspective, does not exist for us amidst our own existence as it occurs in the here-and-now. While others, through reflection and feedback, can offer glimpses into these perspectives, they are never complete. Which means the designation of “saint” or “rebel” must be put off until our story is over. In the meantime, we can reflect on our past, the history of others, the stories already told, and the parts of our story we have already seen unfold. But let us not be so bold as to imagine we can tell our complete story. Let us also not be so timid as to believe we cannot tell the parts of our story as they happen.
     I would leave you with this thought: Perspective is a requirement for wisdom and time is a requirement for perspective. As we allow our story to fulfill itself, do not miss the foreshadowing, the past struggles, and the joys which have already occurred. We do not know how close we are to the end of our own story, let us make haste in writing and sharing what we can.

Allen
(C) Nathan D. Croy, 2014