Resilience

Today was an infantile attempt at staring him straight in the eye, and opening my mouth to speak blurt out my mind. I was trying to narrow it down with J over pasta at Tiamo’s today – just what is it that I’m so afraid of, and it got down to a few (maybe two) dot-points.

• That raw, vulnerable emotion would be met with stone cold rationality. This is almost, always the case with you. It’s like a roadblock almost, that freezes me in my tracks and disheartens me from taking another step further.
• That my words would not give justice to the point that I was trying to bring across. This is a global impairment. I come head to head with it every time I feel a gurgle that starts deep in my stomach and bubbles up into my throat, threatening to be spat out in a cascade of – there’s no better word – verbal diarrhoea.

Turns out my fears in both senses were recognized. There was stuttering and awkward silence, sentences that tripped over each other, words that tumbled out in rumble-jumble, questions that were posed and met with quizzical stares. And yet, despite and in spite of it all, they were right, it wasn’t half bad.

Late in the afternoon, the psychosocial perspective guys gave a talk on resilience. They opened with a simple definition of it. With a little help from Wiki – it’s simply, the “positive capacity of people to cope with stress and catastrophe,” or the ability to spring back/recover quickly from difficult sitatuions. Derived from Latin, it simply means ‘leaping back’.

But what I gathered is that resilience is a frame of mind. Call it optimism, hope, it’s a perspective you take. All the evidence against can rack up, but quantity and quality don’t even seem to matter, because it is a choice. It is why not every son of an alcoholic father becomes an alcoholic himself. It is why it doesn’t mean that all sexually abused daughters will never get the chance to experience what it means to be able to experience real love in their lifetimes, or learn how to conduct a healthy, functioning relationship.

And that’s the beauty of it. That little seed of strength that lies in every person may even be what the whole field of psychology is banking on.

So all this talk of resilience has made me realize that I’m quite the tough cookie. No, not the glass always half full, blind optimist, or fanatic hopeful. I don’t even want to use the realist – it seems like a wastebasket category for people who are afraid to be associated with the naivety of optimists or the hopelessness of pessimists. The fence-sitters.

But I have choices. Someone quite wise said that it’s about choosing what brings life over what brings death. And today, I can choose to see the good in the conversation we had.

I choose to see it as a small step towards communication. I want to learn how to be comfortable sharing my thoughts and emotions with you. I pray that one day you will learn that emotions and feelings are just as important as, if not more than logic and pragmatics – and that love, in one grand sweep, can render all these irrelevant and show itself to be the greatest of all.

We’ll get there.

I’m an ENFJ

The last few days, a couple of us have been on a sort of little self-discovery rampage. And what better, more efficient way to find the answers but through a brief personality test, supposedly based on Jung’s and Myer-Brigg’s typology. After 72 yes or no questions, it churns out a chunky, detailed, descriptive narrative that claims to depict said individual’s make-up from childhood, to adolescence, to mid-life, well into the golden years. This interestingly enough, culminated in us spending yesterday evening trawling through the literature.

Last way I’d thought we’d spend a Friday night.

So personality tests to me are a curious thing. There seems to be an innate fascination with them, and I’m no one can debate the latest spate of test results that come up left, right and centre on Facebook feeds. Everything from the semi-respectable, “What is your most dominant trait”, to the cute “Which Disney guy is for you?”, to the lewd, “What would your stripper name be?”, to the seemingly innocuous, “What is your personality ice-cream profile” and to the downright ridiculous, “What Barbie Doll/Mighty Morphine Power Ranger are you?”. Some even provide directive answers to many of life’s major decisions, “What is your ideal career/partner?”. Heck, even “What kind of tattoo should you get?”

It’s like we’re all trying to find ourselves in relation to objects and contexts, fictional characters and media personalities. It seems ironic, contradictory even, that we look to a score, or a label to tell us what we should already know.

But really, I was surprised by how seriously I was taking it – this deluge of information on my profile – and perhaps more struck by, was that feeling reassurance (?) that it pretty much hit it right on the nail. On the other hand, D & G (haha, get it?) were scanning through their respective acronyms, picking out the parts that fit and for those that didn’t, trying to fit a triangle into a square.

It’s a question of insight, and self-awareness I suppose. No wonder these are such highly valued tools – for the layman, the harmless amusing test that comes up on your Home feed on Facebook; and for the psychologist, the battery of assessments we arm ourselves with, poised to administer on any client who walks through the door. All of us spend our lives trying to organize our experiences, to put a name to who we are, to fit form to our being, some way or another.

On a geeky note, I was called back to MS’s lecture on validity. For the benefit of non-psychies, validity is simply – “whether a test measures what it purports to measure.”

And with this knowledge, I begin to wonder about the utility of such tests, and become increasingly suspicious of the possible detriment of defining oneself by its result.

So I’m thinking, that at best these paper and pen tests can serve no greater purpose than just being a guide. In research, self-report questionnaires, no matter how much they have been cross-validated, and checked, there is a need to understand how a phenomenon occurs in reality. I wrote a paper on this just recently, based on Boorsboom et al.’s (2003, 2004) ideas on validity. Needless to say, it was pretty challenging, but quite illuminating; especially in light of what we all do every time we click on a link to answer a quiz.

In sum, I think it’s important to understand most personality attributes are too complex or heterogeneous to be reflected empirically, and a valid test should be concerned with understanding the nature and meaning of what it says it’s measuring. This would mean of course, understanding how attributes vary in different groups of people, and how these translate into differences in test scores.  So let’s take the context of a borderline patient for example, one would have to consider what specifically constitutes ‘anger outbursts’ and ‘impulsivity’ and how these influence test scores. For the stats people, we’re looking at causal relationships rather than correlational ones. And this could be done by causally explaining responses on a test with recourse to deeper mechanisms, by a ‘theory of response behaviour’, that is, where there are clear expectations of how attribute variations leads to varied item responses.

Of course, this would be too much brains to expect from your average Facebook app and their miniscule or next-to-nothing budgets.

In real-life, maybe describing such tests as a guide is too strong, even. A skeletal frame or outline of the people that we are and are yet to be, serving nothing more than to aid in our processes of self-discovery. It is our job to build meat upon the bone, to garner the richness of all life offers, to explore every possible facet of an identity that is continually being shaped and sharpened, to relish in the wondrous mystery of the human mind – that there will always be a part of me that I will not fully understand, and it’s okay. To not be confined to the OCEAN that is dictated to us by Costa & McCrae,  or the label of ENFJ conferred upon me by Myer-Briggs.

Because I want to believe that people can change, and that we all hold the power within us, within God that resides in us, to have a say over the direction our life takes, or the person we want to be.

Aaand… we’ll leave the ancient debate of whether personality is fixed or malleable // whether a leopard never changes its spots to another day.

Why I do what I do

The good, the bad, and the ugly.

Achievement motivation

Psychologists put forth significant effort to earn a graduate degree, and we tend to value competency, mastery, respectability, upward mobility, and financial achievement.

Connection with others

Therapists may experience a form of depth and authencity in the therapeutic process we do not necessarily experience in other familial or social relationships.

Empathy or identification with vulnerability

Our own personal life experiences may have provided us with a strong sense of empathy, or even identification, with others who feel vulnerable, hurt, wounded, pained, and undervalued.

Voyeurism or vicarious living

“My life is kind of boring, if you want to know the truth. I don’t really do that much other than hang out with friends and watch television. But I love listening to the crazy, wacky stories my clients tell. I love being able to ask them personal questions without them getting offended, things I could never ask people in any other setting. “So what’s your sex life like? “What possessed you to ever do anything like that?” “What is your deepest, darkest secret that you’ve never told anyone before?” I just really enjoy being able to peer inside the windows of people’s minds and hearts. Everything else in my life pales in comparison.”

Prestige and respect

” I don’t make nearly as much money as my sisters do. I don’t have the fancy office or the sports car. But people do look up to me. When they find out I’m a therapist, they treat me like I’m important, like what I do matters to people. I get respect and I like that a lot. It’s worth all the money in the world. And you know what? I respect myself. My sisters and my friends might be successful in business, raking in the bucks, but I know what I do really matters. And at night, I sleep like a baby because I know I’m doing my part to make the world a better place.”

And perhaps most relevant of all, and something I feel I must set aside in a category of its own:

Rescue dynamics

“I grew up not feeling very important or very good about myself. I didn’t feel useful to anyone, least of all myself. But now I get to save people. I know I’m not supposed to believe that or say that, but that’s the way I feel. Every time someone comes in miserable and leaves better off, it’s because I did something that helped – or that’s what I’d prefer to think. I thrive on being able to save people like this, and it makes me feel important.“

Motives acknowledged by clinicans according to Baker, 1992; Disclosures by clinicans by Kottler, 2003.

His-story

So there has been a topic I’ve been breaching for weeks. Actually, about 8. But yesterday, as I was gushing to D yet again about another information-loaded day at school, an idea sparked and this is me attempting to give it form and figure. I was lamenting about the fact that as riveting as the material presented in lectures, seminars and workshops have been, it’s been a tad overwhelming. An onslaught of information so fast, so furious, and yet so terribly fascinating, that integrating it all and making sense of what I’m being taught has proven to be quite the challenge.

And then I forgot my old friends – pen and paper, and words. So here are the beginnings of my first clinical notes, I suppose. The exercise of scribbling down short snippets of observations and points-to-note, now to document what I’m learning, and later on about my patients, certainly appeals strongly to the annotator in me.

I want to just start by saying what an enormous privilege it is to be where I am, at this stage of my education. I will unabashedly exclaim that I’m one of those people who have been blessed with the opportunity to potentially make a living out of what I love, simply, to put passion into practice – and I hope that this is a gift that I will never squander, nor take for granted.

So perhaps I should start with the first lesson that I feel compelled to write about since beginning my clinical training. It was an epiphany of sorts in one of the early workshops on history-taking. It’s a really simple one, in fact. At risk of stating the obvious,

Everyone has a story to tell.

And if you dig deep enough, implore hard enough, are daring enough to let curiosity ask the difficult questions… there are no boring bits either. No matter how bland you think you are, or how dull you think the person next to you is.

So on that particular day, I had to share one of my own. One very close to home. I was strangely at ease with it. Although, I’ve often noted this (slightly worrying) comfort derived from my open book policy – but perhaps this is a conversation for another day. In any case, I put my hands up to play client, and found myself slipping on Dad’s shoes. They were black, but had lost their shine, and were worn at the edges. And clunky, oh so very heavy. And as the flurry of questions came, his many worries and troubles pervaded my mind, his thoughts of hopelessness and worthlessness took turns to batter at my esteem, his words spelling defeat and impending doom became my own.

And I daresay, almost like it was the first time, I really listened, and understood.

The afternoon saw us doing another activity. We were asked to get into pairs, draw our family tree and share with our partner about our histories in whatever propensity we were ready to.

So my partner was one of those people in the cohort whom I would simply label ‘colleague’. Those that you don’t talk to beyond ‘Hey, how’re you going?’, unless there is work to be done collaboratively. Sometimes, I catch myself staring at her traditional garb, covering her from top to toe and find myself wondering (perhaps rather condescendingly) – How could I  begin to understand her world? What could we possibly have in common? How could we ever relate to each other?

Well, my partner surprised me.

Without going into too much detail, she shared in vulnerability and honesty.  She explained her genogram, all the boxes and squares, intersecting lines and crosses painting a rich, vivid history of the drama and dysfunction that marks every family. That she was so forthcoming with her issues, took me aback. But I relaxed a little in my chair when I realized – We’re all psychologists in this room, after all.

No wait, we’re all human.

And it is our pain that knits us together, and our weaknesses on which we build strengths upon.

I think I conclude, at this very early stage of my career, that one of the most fundamental qualities of a good clinician is an inherent interest in other people’s stories.

I hope I’ll never tire of them. I hope that I will always respect the sanctity of each one. I hope that I will never cease to appreciate the beauty of the complex, multi-faceted, and highly individualized nature of every story I come across.

So much more to say, lots of lessons past that I need to recount and catch up on, lots of skills that I need to process more deeply and make second nature. Stay tuned.

GAD

I question with a nervous, sheepish laugh, that I don’t know why I do these things to myself.

I woke up this morning, transfixed in a semi-state of panic, washed by a wave of feverish anxiety almost, at the abrupt realization that I forgot that a possible bias in thinking and reasoning of Generalized Anxiety Disorder is:

The over-estimation of threat/danger of the situation at hand, and an under-estimation of the ability to cope.

Sigh, talk about over-catastrophizing.

And they say, that it is a thin, fine line between sanity and insanity, normalcy and abnormality.

I can say I believe it now.