Category: Rules

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Mobile ExCommunication: Keeping Tech in Check

“Freedom is thus not the opposite to determinism. Freedom is the individual’s capacity to know that he is the determined one, to pause between stimulus and response and thus to throw his weight, however slight it may be, on the side of one particular response among several possible ones.”
~Rollo May, Psychology and the Human Dilemma (p. 175)
     Mobile technology is nearly ubiquitous and has advanced our ability to access information, people, and ideas in amazing ways. Television, gaming consoles, phones, tablets, e-readers, and even digital paper have transformed the way we connect with one another. Friends are no longer constrained by distance or mobility. Scientific ideas, education, medical advancements, politics, and the majority of the human race is advancing at an unprecedented rate. Tech is no longer an optional luxury, but an integral part of daily life.
     Yet, most family therapists could attest to the increasing frequency of complaints parents and spouses have regarding the feeling of having to compete for attention with electronics. Even though tech has proffered new and easily accessible ways to connect, it seems the art of genuine connection is being threatened.
     Here are a few ways families and individuals can help put technology in its place and foster better offline relationships. We’re going to channel the great chef, Emeril Lagasse, and remember these helpful guidelines with the acronym BAM! Now, let’s take it up a notch!

Boundaries: Does My Tech Have a Place?
     The first step for integrating technology in a healthy way with your family and by establishing healthy boundaries. It is not uncommon to establish boundaries on time/length on television or game-play, but this can be more difficult with phones. They are so easy to access! The phrase “real quick” is the most frequent lie we tell ourselves and others about “just checking” electronics. That is why it is so crucial to establish and agree on boundaries as a family. If the family is not in agreement prior to establishing these expectations, it will become a source of contention rather than an increase in cohesion. There are three areas I encourage people to focus on:

  1. Amount: 
    • Money: The amount of money someone can spend on a device, how they get that money, and how it works into a budget can be a fantastic opportunity to build trust and teach budgeting skills. Dave Ramsey has some great tools to help children learn how to manage money! There are several tools online for this, but this is what I have used.
    • Devices: Confession time! I have three tablets at home that I haven’t meaningfully used in a year. THREE. I even have an extra smart-watch! Older devices can be re-purposed in all kinds of creative ways (children’s tablets, picture frames, security system, etc), sold online, given to friends, used for shooting practice, whatever! The issue is, do we need this stuff to stick around or is it just junking up our life? Prior to getting something new, what are the rules about managing the old? With my wife’s purses, there is a rule: No new purses until you get rid of one old purse. This may sound cruel, but it was born of necessity (love you honey!).
  2. Access: 
    • Length of time: How much time, per day, can we spend on a devices? Does this include time spent for work or school? Does listening to music while exercising count? Be specific!
    • Times of day: Rather than specific times of day, I have found it can be very helpful to identify general times when electronics should not interfere with family. An hour before bedtime, during meals, and after 9:00 at night. This helps people be more intentional about when they’re on their phone and more aware of what is going on at home. 
    • Physical restrictions: Is there a centralized place in the home for electronics? Do they have a house that’s not your pocket? In addition, do electronics go into bedrooms? I would discourage this for EVERYONE. You can use an alarm clock that’s not your phone. Want your children to sleep better? Want to connect with your spouse more? Leave the phones, TV’s, gaming consoles, tablets, iPod’s, laptops, smartwatches, VR units, and whatever else out of the bedroom. 
    • Electronic Restrictions: Security is important and there can be sensitive information on cellphones. However, if there have been breaches of trust in relationship, security may not be an option for you. Discuss this with your spouse or children if it’s necessary for work. Be willing to show what you can, when asked, with a positive attitude. In addition, is there a time of day when the Wi-Fi can be turned off? Do we really need to be connected 24/7?
  3. Age:
    • GPS tracking: This is a really cool feature of new phones! Pull up the right app and you can see exactly where you child/spouse is! If you’re going to use this feature, be honest with your children/spouse. Otherwise, it will serve to break more trust than it creates. Also, remember this: These apps only tell you where the phone is, not the person. A dead battery can result in all kinds of panic when this is the primary way of “knowing” where a loved one is. It’s cool to have and it’s not a substitute for regular communication prior to going somewhere. 
    • Strangers: We teach our children not to talk to strangers, and then we give them a camera and access to the entire planet that’s full of strangers. Educate yourself on dangers and protect your children from catfishing, schemes, and human trafficking. Just like you would in real life!
    • When to buy: Children mature at different rates. Some 7 year old children can handle a full featured phone. Others I wouldn’t trust with a stick. I can tell you the rule in our house is that our children can have a phone when they can afford to pay for a phone and the accompanying plan. That is the level of responsibility we are looking for prior to offering someone unfettered access to anyone with a wifi signal. 

Alternatives: Is There Something Better Than My Tech?
     In an attempt to encourage better engagement in personal relationships, parents and spouses can accidentally engage in a power dynamic that further injures the very attachment they seek to strengthen. Here’s a fictional example:

Jennie: “Tom, why don’t you put the phone down and hang out with me?”

Tom, staring intently at his phone: “I just have to finish this email real quick!”

Jennie: “If you cared about me as much as you did that stupid email, our relationship might be better!”

Tom, looking angry and dejected: “This is for work! The thing I do to bring home money so we can eat and do all the stuff you enjoy doing!” 

     I don’t know an actual Tom and Jennie, but I suspect all of us have been guilty of being a Tom or Jennie at some point. Jennie, focusing on Tom’s engagement with his phone to the exclusion of her, has interpreted his behavior as a rejection of her. She wants Tom to notice her, but has gone about it in a way that makes Tom want to spend even more time in his phone!
     Both Tom and Jennie have this in common: a sense of rejection. Tom feels rejected because, in his mind, he’s working diligently to “bring home the bacon”. Jennie feels rejected because Tom is paying attention to his phone when he could be paying attention to her. Here’s the challenge: What are Tom and Jennie doing to cultivate a relationship where spending time together is a better alternative than spending time on the phone?
     One of the most seducing aspects of technology is its relentless availability. There is a persistent, nonjudgmental, and welcoming invitation to connect. Are families, friends, and couples, working to provide that same welcome? Neither Jennie or Tom are necessarily “at fault” here. We can talk about why Tom shouldn’t be on his phone or why Jennie shouldn’t be yelling at him. But that only solves one problem: boundaries around the phone. There is often an underlying issue of connection! In our relationships, we must be willing to ask what we’re offering that’s an alternative to technology.

Modeling: Do as I Do

     When people are struggling with addictions, it’s not uncommon to enlist the help of family members and the support networks to get involved in with treatment. If a family member is dependent on alcohol, it’s not very fair the rest of the family still gets to drink and keep alcohol in the home. At best, it’s unsupportive; at worst, it provides unnecessary temptation. However, many families regularly, and subconsciously, engage in this undermining behavior when it comes to electronics.
     How often do you ride in the car without listening to the radio? Is the television on just as background noise? Is the phone always within arms reach? There are many subtle ways to communicate the message of tech-dependence. If you want your children or your spouse to engage with technology in healthy ways, we must be willing to model this behavior ourselves!

Conclusion
     Using BAM can help provide a framework where families and individual can put tech in its place in order to encourage healthy relationship with others. We must be willing to implement this framework in our own lives, in an intentional way, and with support from others. Technology, when kept in its proper place, can enrich our lives, work, and relationships.
     Please share how your family has kept tech in check!

Mobile ExCommunication
Nathan D. Croy, (C) 2017
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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.

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Overt Assumptions

“What makes earth feel like hell is our expectation that it should feel like heaven.”
― Chuck Palahniuk, Damned
 
     For nearly 5 years, I grew up in Hendersonville, TN. Then, in my 4th grade year we moved to High Point, NC. Both states had many similarities. Food, family, and freedom were important to everyone. A few outsider, like ourselves, shared some insights into living in North Carolina: 1) “Yankees” are like hemorrhoids: If we come down and go back up, we’re alright. If we come down and stay down, we’re a real pain. And 2) Southern people are the nicest people you’ll never get to know. This isn’t to imply they’re inhospitable. Traditionally, and culturally, Southerners tend to have large and close-knit family systems. It can be difficult to get into the culture without a blood relative.
     Another slight difference was sports. When I lived in Tennessee, soccer was not even on the radar. If it was popular, I missed it. In North Carolina, it was unavoidable. Everyone played, watched, and lived soccer. Because the last 5 years had provided me very little exposure to soccer, I was not adequately prepared for this cultural shock. Still, I wanted to fit in, so I jumped in and tried to play whenever I could. I was awful.
     Part of my awfulness was due to the fact that I’m just not gifted in coordination. Some people are kinesthetically brilliant. I was kinesthetically blinded by that brilliance. To that, add a lack of general exposure to the sport. I never practiced the mechanics and fundamentals of the game. The physical act of kicking a soccer ball was a mystery to me! The ball may as well have been made out of cement. It didn’t seem to matter to anyone else that I was also completely unfamiliar with the rules of soccer! A game would be mid-half and suddenly, WHISTLE! Everyone, nearly in unison, would turn to look at me. Even the kids who didn’t know me looked! Took me three seasons to figure out what off-sides was.
     There had been a break down in communications. The other players began learning these things they were very young. The rules were taught alongside the mechanics. As they developed their mechanical skills through kinesthetic repetition, they strengthened their overall knowledge of the game. I missed these developmental milestones and was thrown into a game where nearly everyone knew all the rules; and they assumed I did, too.

     Blended (and blending) families often present to therapy seeking assistance in how to make two families into one. I’ve seen families adopt or foster children when they have had no children of their own. That’s one of the nice things about having kids: They (somewhat) ease you into the process of parenting. Slowly, they learn to roll, then crawl, then walk, then run like wild animals! It’s fine when we’ve been with them for literally every step of the way because our parenting skills have grown with them. Imagine having a 2 year old dropped off at your house if you’ve never had children before! What’s normal? Are their noses supposed to make so much snot? Do they really have no volume control? Do they really have no sense of privacy when I’m going to the bathroom?
     Sudden baptisms into parenting are incredibly difficult. A healthy response is to cut ourselves some slack and realize we’re going to be playing catch-up for a little while. But what happens when there are sudden shifts in family functioning? Isn’t that what therapy is supposed to provide? New insights, awareness, and skills which a family will implement and change their pattern of relating.
     Sometimes, therapists can make the mistake of assuming the family understands the rules of relationship. Instead, we need to make the new rules (and they ARE new) overt. This can be done through verbal or written contracts, reflecting current changes in the process, modeling/coaching, and even through paradoxical injunctions. Regardless of the means, we have to take time and make the assumptions clear. This way, we prepare the family for change and mistakes, accidents, and regression becomes part of the learning process instead of demoralizing failures. Communicating this can relieve a great deal of anxiety associated with change and encourage open discussion among struggling families.
     Have any suggestions on how your therapy or therapist has helped people adjust to change? Leave a comment below!

Fragile Soccer
Nathan D. Croy, (c) 2015