Sermon: Pentecost 5, 2013: The Land of The Lost

What do Blue Jay's Short Stop Munenori Kawasaki and Jesus have in common? In this sermon we learn what it means to travel to the land of the lost. The texts included 1 Kings 19.1-15a (Elijah fleeing from Queen Jezebel), Galatians 3.23-29 (in Christ there is no male and female), and Luke 8.26-39 (Jesus healing the Gerasene demoniac). Besides Munenori Kawasaki, I also discussed this article in the New Yorker about Ittetsu Nemoto by Larissa MacFarquhar. The connections between Elijah's wilderness despair, that of the man possessed by "Legion" demons in Luke's Gospel, and the epidemic of suicide in Japan is worth exploring at some depth.

It's worth noting for you preachers out there that my strangely humorous turn to Kawasaki might have been slightly jarring, but I thought it was important to lighten the mood a bit and introduce the theme of joy, which in an inherent feature of Agape Love. Hard to find that joy in any of the scripture lessons appointed for the day, but it does often appear in other healing stories. I think that it's okay to take the congregation into some dark places sometimes, but you have to take them back home again--you can't leave them there. And all this talk of suicide could be a bit harsh. Sermons should generally be emotionally dynamic, and so going from the bitterness of those desert-depression images to the glory of Kawasaki's home run seemed like a good way to accomplish that, homiletically. It's not a perfect sermon, but it's pretty good for me.

Also influencing this sermon was the hymn "Just as the Deer Longs for the Water Brooks" set to Finlandia (which we sang as the Psalm). That's one of my favourite tunes of all time, and the melancholy mode fit the sermon topic perfectly. On a similar vein, Amy Grant's "Everywhere" was playing as I worked on this sermon last night. I find that listening to music while I'm doing sermon prep is really helpful to get into the desired emotional state, which, in turn, helps me to get the congregation to that same feeling place.

A Few Breakthroughs

I mentioned previously that I spent three days at the SSJD Convent Receiving the Appreciative Inquiry Training offered by the Clergy Leadership Institute. The instructor was Rev. Dr. Rob Voyle. Rob is psychologist with a great deal of clinical experience, as well an executive coach and even a former Cathedral Dean. He is an interesting guy whose life purpose is to be "Helpful, healing, and humorous."

Registration was limited to be about 25 people, and mostly that was composed of Senior Diocesan Leadership plus a dozen or so parish priests like myself. That made for an interesting dynamic, as when I was paired with Bishop Yu to do an interview designed to discover the deepest, most compelling personal motivations of the subject!

The "Appreciative Inquiry" framework has a lot to offer, and I've already had two opportunities to apply it. Last night I hosted a Stewardship Committee meeting in my home. We are prepared our fall Stewardship Campaign and are facing a substantial deficit as we do so. Raising the giving in the parish by about 30% would fix it and get us back to a balanced budget, but raising giving by that kind of level is going to take some real excellent leadership from everyone involved in the campaign.

So I started the meeting by asking people to go around the room and tell us about something they really, really enjoy doing. When they finished sharing, I explained that this was an easy way to get toward an understanding of people's core values and passions. Knowing that makes moving forward on a group project far easier because it means you can put the builders in charge of building and the deal makers in charge of deal making, etc. The meeting went on and accomplished many things, though not without a few moments that really challenged my skillfulness as a small-group leader. As they left, people said they felt encouraged and enthusiastic about the work ahead, which is great sign.

The second application of Appreciative Inquiry techniques happened in a one-on-one pastoral care situation. Obviously, I can't share much about that, but I will say I was able to resolve a long-standing stuck-ness that had defied several other interventions. One of the things I noticed right away was a large degree of consonance between the method I was employing and the parishioner's therapeutic instincts. In other words, it felt like the right approach to both of us. The energy of the whole dynamic shifted noticeably and I'm really happy about that.

So, there you have it, my endorsement of Appreciative Inquiry. It works, simple as that.

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Baby Morality

Scientists at the Infant Cognition Center at Yale have been researching whether infants are born with a sense of right and wrong. Increasingly, the evidence seems to be that they do! Check out this demonstration of the testing method....

Man, that Square makes me so mad! Lol. I'd love to try this with Henry when he gets slightly older!

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Sermon - Pentecost 4 2009

As promised, here's the sermon that Marili preached on Sunday while I was upstairs with the kids. It's a really solid sermon that launches from an analysis of the problem of child prodigies (think Michael Jackson) who are raised to believe that love is a reward for performance.



Here's the audio...


Here's a direct link to the MP3 file...

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Zen and the Art of Motorcycle Mainenance

Zen and The Art of Motorcycle Maintenance: An Inquiry Into Values is a well known book by Robert Pirsig which is part travel journal, part philosophy book, part novel. It's really a meditation on lessons learned both in academia and on the back of a motorcycle. Well worth the read.

It comes up in my mind today because Stanley Fish referenced it in his latest blog entry. In it, Fish summarizes Pirsig's phenomenological approach:

Pirsig’s example is describing the parts of a motorcycle, an exercise that has no natural stopping point. But, he insists, no matter how much data the exercise heaped up, true comprehension would still not have been achieved, for the motorcycle “so described is almost impossible to understand unless you know how it works.” Rather than building up from particulars to generals (the empiricist method), you must begin with generals — with an in-place, intuitive awareness of what motorcycles are for, of what can go wrong with them, of what can go right with them — and within that tacit knowledge you will know where to direct your analytic attention. You can’t just begin with analytic attention, with “mere” or “pure” observation, and expect to get anywhere; you must already, in a sense, be there.

The problem is that once the parts or facts are made to appear, they seem to possess an independence, and it is (literally) tempting to rest in them and to believe that they are the foundation of things. (In theology this mistake is called idolatry.) “The division of the world into parts,” says Pirsig, “is something everyone does,” but in doing it, “something is always killed” — and what is killed is an awareness of and contact with the world before analytic thought has done its (necessarily) reductive work. (source)

The paradox is that a phenomenological approach, where we begin with what can be grasped will necessarily limit us to what we are able to pay attention to. Inevitably, we will focus on the wrong things. In maintenance terms, when you have a problem you tend to want to make it into a problem you have experience with in the past, even though it may be an entirely new malfunction. Trying to solve this paradox drove Prisig nearly insane.

In Matthew Crawford's recent book Shop Class as Soulcraft: An Inquiry into the Value of Work also uses mechanical labour as a way to explore grand themes of both philosophy and father-son dynamics.

In time, this realization leads him to a position like Pirsig’s, but he holds it polemically and without anxiety: “To regard universal knowledge as the whole of knowledge is to take no account of embodiment and purposiveness.” We should not, he says, “separate knowing from doing,” and it makes sense that his model of the true “knowledge worker” is not his father the theoretician, but the mechanic or craftsman whose knowledge resides in his hands and in his hands-on experience.

It follows then that the modern tendency to move further and further from the site of physical labor (by, for example, designing automobiles on a computer or teaching people to fly in a simulated cockpit) is disastrously wrong. As computer diagnosis takes the place of fiddling around with the machinery, “we have too few occasions to do anything because of a certain predetermination of things from afar.” (source)

Again, a worthwhile read--especially as regards the nature of work and craftsmanship. Though he can be a bit polemical at times.

But we shouldn't loose sight of one of the other main points of these books: relationships between father and son mediated through metal. It's a trope so common as to almost slip into cliché. (Here is a picture of Prisig with his son, Chris, on the trip that became the basis for the book.) Yet I know a lot of men who bonded with their fathers in precisely this way. Indeed, the time spent with my father working on his old TR-3 are a very special memory to me. Other examples abound: a writer helps his son assemble a Shelby Cobra kit as a reward for good grades. A university professor learns to find joy in work again when he reconnects with his motorcycle mechanic father.

It's a form of benign triangulation--introducing a third party into a relationship between two tends to stabilize the emotional system and lower the anxiety in the system. (Cf. Friedman) Other father-son relationships might use sports in the same way. Really, any hobby can function to facilitate the father-son bond.

I don't know how this plays out in mother-daughter relationships. I suspect it is similar, but I've obviously never observed it from the inside. Maybe someone will comment about that.

This is on my mind for obvious reasons. Father's day approaches. And I've been thinking of what kind of father I will be by the time it comes again next year. Obviously, I hope to be a good one, but how does one go about becoming "good" at a thing like parenting without trial-and-error experience? Perhaps for this reason we should just start saving up for therapy now (advice someone gave me on Sunday), and focus instead on the second or third child. By then we may have learned something about the craft of parenting!

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For Teenagers--Hugging is the New Hello

The New York Times notes that hugging has become very popular among teenagers in the last couple of years. Whether its girls hugging girls, boys hugging girls, or even boys hugging boys, it has become so popular that many schools have banned it! No one is quite sure why this has become popular, one theory is that children are raised to be more cooperative and social now--less given to cynicism and detachment. Another theory is that counterbalances the facelessness of facebook, twittering, and texting.

I'm a big fan of hugs, but I have a hard time initiating them. Fear of rejection, I guess. I always appreciated that hugs, not handshakes, are the customary greeting at the exchange of the peace at the Masses at Holy Cross. It's sometimes a bit awkward, but I think that's part of the usefulness of the practice: it's training for heavenly places.

Speaking of Holy Cross--I'm redoing their website this summer. That will mean reorganizing the current content as well as adding a bunch of new stuff. I'm particularly looking forward to producing a few short videos. I've been boning up on things like video lighting, editing techniques, sound, and optimizing video encoding. Jack of all trades, me. Funny how I'm happiest when I'm learning new skills.

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Success, Happiness, and the Mysterious Whims of Fortune

David Brooks of the NYTimes writes today about the Grant Study, a 70-year longitudinal study into success and happiness. The study tracked 268 of America's most promising young men. It recruited them from the top ranks of Harvard's sophomore class. These were the most well-adjusted, most gifted, most ambitious young men the researches could find. Our expectations would be that they would live up to the promise as their lives unfolded.

Their lives played out in ways that would defy any imagination save Dostoyevsky’s. A third of the men would suffer at least one bout of mental illness. Alcoholism would be a running plague. The most mundane personalities often produced the most solid success. One man couldn’t admit to himself that he was gay until he was in his late 70s. (source)

One of the most gifted of the bunch fell apart in his 30s. One became a major advocate for gay rights after coming out of the closet late in life, only to die at age 64.

Yet some connections to begin to emerge:

The men were able to cope with problems better as they aged. The ones who suffered from depression by 50 were much more likely to die by 63. The men with close relationships with their siblings were much healthier in old age than those without them. (source)

Another thing that emerges is that happiness much less to do with success than it does with relationship. "Happiness is love. Full Stop," he says in this remarkable video:

There is a lot of wisdom is this.

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Temple Grandin Part 2

Here is the first 10 minutes of a BBC documentary about Temple Grandin...



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Temple Grandin

Temple Grandin is one of the most interesting people walking the planet today. She is a scientist who has made understanding the way animals experience the world her focus. Considerable focus it is, too, when you consider that she is autistic. In fact, she believes strongly that her autism has given her unusual insight into the psychology of animals. But whereas many who care about animals and about how they are treated have an adversarial relationship with the livestock industry, she has worked with them to reform their methods of handling animals to be more humane. Perhaps most famously, she consulted with McDonalds to change the way their supplier's slaughter houses are designed. As a result, nearly half the cattle slaughtered in the U.S. and Canada are done so according to the stress-reducing protocols she has established.

She has a new book out called Animals Make Us Human: Creating the Best Life for Animals in which she draws on her own work as well as that by neurobiologists to explore the emotions of animals. Having pets, I know that she is absolutely right to consider our obligation to provide the happiest, most playful life we can to our creatures.

The most interesting thing, though, about Temple Grandin is how comes at things from a totally different way of understanding the world. Because of her autism, her style of thinking is peculiar and yet arrives at stunning insights. By all means, check her out!

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Lidocaine

An odd day that started normally enough with the Contemplative Eucharist here at COTM. I had time afterwards to clean up and answer some e-mails and blog a bit before rushing off to a Dentist appointment.

This was a follow up from a week or so ago. They wanted me back to fill some small cavities and clean up some old bonding work. I really like Dr. Brown and his office. No waiting, even though they were busy. Friendly staff. Good banter. Modern, pristine office. Efficient and high-quality work. And, perhaps most importantly for dentists, superb pain management.

After rubbing a topical anaesthetic of some sort on my gums they began injecting something (perhaps Lidocaine) into the gums to deaden the nerves before drilling. Here is where things got interesting. The (attractive female) Dental Assistant began massaging my left earlobe. "I'm just going to distract you from what what Dr. Brown is doing," she explained. I immediately understood, I've seen similar techniques used with children in the hospital. So I decided to relax by entering into a mode of being attentive to my body. Having meditating a few hours helped.

I noticed several things going on at once. First, the earlobe trick works on several levels. On a purely neurological level, it's true that giving my system more than one novel sensory input at a time caused my attentions to be divided and lessened my perception of the injections. On a psychological level, the earlobe massage was also both novel and soothing, so it worked that way as well. There was a moment when I was thinking, "Really? You're going to do that while he sticks needles in my gums? Hmm. Okay..." Anyway, I didn't feel a thing.

Dr. Brown drilled out the cavities and then one of his people went to work filling in the holes and also cleaning up the bonding work. When they were done I was pleasantly surprised by the difference they made. The bonding is imperceivable. In fact, my teeth look whiter than before. Well worth putting up with a little earlobe massage.

After the dentist it was off to lunch with a parishioner. Thai food at a place on Yonge: Mint. I enjoyed a Thai Ice Tea thankful that the Lidocaine had worn off.

After that I hit the gym for a sold hour of weights and cardio. Interesting how even just a few gym sessions makes a perceptible difference in how I feel.

Now I'm just finishing up my day at church. And a good day it was!

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Love Potion?

There is a hilarious article in the NYTimes about research into the biochemistry of love. Larry Young, a researcher in Social Neurobiology at Emory, recently published an article in the journal Nature that purports to explain much of the biological foundations of love. There is a sequence of drugs and hormones triggered by circumstances that produce the feelings and motivate the behaviours we call "love."

[Prairie voles] are among the small minority of mammals — less than 5 percent — who share humans’ propensity for monogamy. When a female prairie vole’s brain is artificially infused with oxytocin, a hormone that produces some of the same neural rewards as nicotine and cocaine, she’ll quickly become attached to the nearest male. A related hormone, vasopressin, creates urges for bonding and nesting when it is injected in male voles (or naturally activated by sex). After Dr. Young found that male voles with a genetically limited vasopressin response were less likely to find mates, Swedish researchers reported that men with a similar genetic tendency were less likely to get married. In his Nature essay, Dr. Young speculates that human love is set off by a “biochemical chain of events” that originally evolved in ancient brain circuits involving mother-child bonding, which is stimulated in mammals by the release of oxytocin during labor, delivery and nursing. (source)

So it is possible to create a love potion? "Absolutely," claims Young and his team:

“It would be completely unethical to give the drug to someone else,” he said, “but if you’re in a marriage and want to maintain that relationship, you might take a little booster shot yourself every now and then. Even now it’s not such a far-out possibility that you could use drugs in conjunction with marital therapy.” (source)

The funny part of the article comes from the author's speculation about the creation of an anti-love drug--a vaccine against the effects of love.

Could any discovery be more welcome? This is what humans have sought ever since Odysseus ordered his crew to tie him to the mast while sailing past the Sirens. Long before scientists identified neuroreceptors, long before Britney Spears’ quickie Vegas wedding or any of Larry King’s seven marriages, it was clear that love was a dangerous disease. (source)

Yet more avenues of treatment in the emerging field of cosmetic neurology. "Cosmetic Neurology," if you unfamiliar with the term, is the use of drugs to enhance otherwise healthy brains. They can give you drugs to make you feel good, work harder, react faster, focus better, or remember more. Imagine being able to take a drug that would temporarily improve your memory or focus just before a test? In fact, this is why Ritalin abuse has become so popular on University campuses. Interestingly, abuse of Ritalin is most common in the very competitive Universities of the northeast U.S. Despite the risks, kids are willing to take these (FDA Approved) drugs to gain an academic edge. I suppose the fact that these drugs have been approved for medically-supervised use is a comfort to abusers, but, of course, even Cocaine is FDA approved for certain conditions! In other words, just because it comes in a pill doesn't mean it won't kill you.

So once again science is opening up huge new ethical questions and opportunities!

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Authority and Hurting Others

The "Teacher's" Station in the Original Milgram Experiment
One of the most famous psychological experiments of all time was the "Milgram" experiment performed at Yale in 1965. It was the aftermath of the war and many people were wondering how so many people could be complicit in the Holocaust. The point of Stanley Milgram's experiment was to test the relationship between authority and a person's willingness to inflict pain on a stranger.

The set-up was simple. Volunteers from New Haven were told they were participating in a study testing the effect of punishment on learning. When they arrived they were paid in advance and told the money was theirs to keep no matter what happeened. They were then paired with a shill. The shill and the participant supposedly drew lots to determine who was the "learner" and who was the "teacher." The draw was rigged so the shill always became the learner. The real participant was then placed in front on an impressive panel of switches labeled with successively highly voltages. The upper ranges of these voltages were marked with labels like "Extreme Intensity Shock," "Danger," and the last three switches, going up to 450 volts, simply had X's above them.

Switch Labels from Milgram's "Shock Generator"
The participant then watched as the "learner" was led away to an adjacent room and strapped to a chair and fitted with electrodes. The "teacher" was given a chance to feel what an electric shock feels like, then given a list of questions to ask. Each time the learner got one wrong, the participant was supposed to administer a shock. The first shock was the mildest and then the second would be one degree greater, etc.

As the test progressed, the shill-learner would deliberately get things wrong and cry out in pain when shocked. As the shocks got worse, they pretended to react even stronger. In the upper ranges they would complain of heart pain, ask to leave the test, and beg. Above 150 volts they would stop responding entirely--suggesting that they were either dead or passed out. If the "teacher" objected to the person in authority, the experimenter, he would respond with a scripted progression.

So the real test was how far would the participants go before conscience kicked in and they refused to shock further. The results: a whopping 80% of people continued delivering shocks even after the 150-volt threshold, additionally, 65% went all the way to 450 volts!

The reason this comes up now is that a researcher at Santa Clara, Jerry Burger, decided to replicate the experiment in 2008. Because of ethical rules now in place, he could only take participants to the 150-volt threshold so as not to scar them with the realization that they are capable of killing someone. Still, he found that 70% of modern participants were willing to shock to the 150-volt level.

Despite all the changes since the 1960's, the cold reality is that most people in America (and presumably in Canada, too) are willing to follow instructions even when that results in extreme pain or distress to others. Little wonder that we end up in situations like Abu Graib (Cf. the Stanford Prison Experiment) and AT&T customer service. Given the right circumstances, good people will do bad things. (As an aside, if you are unfamiliar with the Stanford Prison Experiment you will find it a fascinating example of how systemic evil operates, no one, not even people running the experiment, could escape doing terrible things.)

What to do? The article in the NY Times about Professor Burger's experiment suggests that knowledge of this effect may help promote vigilance against its affect. In fact, an instructor at West Point contacted Professor Burger to talk about how the results are being taught to military Officers.

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Researchers Say Religion Grants Self Control... Duh

According to the NY Times a psychologist in Miami just published a paper concluding that people who are religious have better self control. Of course they do. I find it amusing that this was in doubt.

Researchers around the world have repeatedly found that devoutly religious people tend to do better in school, live longer, have more satisfying marriages and be generally happier.

These results have been ascribed to the rules imposed on believers and to the social support they receive from fellow worshipers, but these external factors didn’t account for all the benefits. In the new paper, the Miami psychologists surveyed the literature to test the proposition that religion gives people internal strength.

“We simply asked if there was good evidence that people who are more religious have more self-control,” Dr. McCullough. “For a long time it wasn’t cool for social scientists to study religion, but some researchers were quietly chugging along for decades. When you add it all up, it turns out there are remarkably consistent findings that religiosity correlates with higher self-control.” (source)

The more interesting question is why this would be the case:

“Brain-scan studies have shown that when people pray or meditate, there’s a lot of activity in two parts of brain that are important for self-regulation and control of attention and emotion,” he said. “The rituals that religions have been encouraging for thousands of years seem to be a kind of anaerobic workout for self-control.” (source)

Nor it is sufficient to be merely "spiritual" in the way many claim to be:

In one personality study, strongly religious people were compared with people who subscribed to more general spiritual notions, like the idea that their lives were “directed by a spiritual force greater than any human being” or that they felt “a spiritual connection to other people.” The religious people scored relatively high in conscientiousness and self-control, whereas the spiritual people tended to score relatively low.

“Thinking about the oneness of humanity and the unity of nature doesn’t seem to be related to self-control,” Dr. McCullough said. “The self-control effect seems to come from being engaged in religious institutions and behaviors.” (source)

But there may be hope for people that are allergic to religion:

Religious people, he said, are self-controlled not simply because they fear God’s wrath, but because they’ve absorbed the ideals of their religion into their own system of values, and have thereby given their personal goals an aura of sacredness. He suggested that nonbelievers try a secular version of that strategy.

“People can have sacred values that aren’t religious values,” he said. “Self-reliance might be a sacred value to you that’s relevant to saving money. Concern for others might be a sacred value that’s relevant to taking time to do volunteer work. You can spend time thinking about what values are sacred to you and making New Year’s resolutions that are consistent with them.” (source)

The funny thing is that I don't feel like I have a great deal of self-control at all--but perhaps it's just that have self-control in certain areas of life and not others!

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The DSM, Revisited

My post a few days ago that was critical of the DSM generated an interesting off-blog discussion with a psychiatrist in the states who reads my blog. I quote it below with her permission.

I read your blog with pleasure, but don't comment because, well, I have too many passwords to remember already. But I would like to comment on your view about DSM and mental illness.

I don't think DSM is perfect, it's not always even very good. It does help us think clearly and non-etiologically about what we see in our patients. If we don't know etiology (and Lord knows, we don't), then phenomenology is not a bad way to go. Some assurance that when I say my patient has major depression that my colleagues in California, Pennsylvania, Chicago, Wyoming, and even Toronto will agree, means that we can talk about what works and what doesn't. That we can say, "this group of patients are enough alike in how they think, say they feel, behave, and the course of what's going on if we don't treat it", that we can look for commonalities in the biology and physiology and all and keep looking for etiology. Well, we can look for the biological what, we are never any good at why. Neither is any other field of medicine. We like to think we leave that to the church and the philosophers, but they are different mostly in being willing to tackle it.

As to illness being defined by interference with function: that's an idea very basic to medicine. A broken bone interferes with the normal function of bone, so it's "pathology", fancy word for illness. Measles or even a bad viral upper respiratory illness (=head cold) interferes with the function of a school child in learning and playing well with others at school--and so they are illnesses. Major depression means you can't concentrate, can't think, can't decide which shoe to put on first, and see no chance of change. It's not the sin of despair, at least, not if you go seek help. And those are things that an observer can see: you can't function in your usual roles. That's a striking one, but even the more subtle ones we don't depend solely on the say-so of the sufferer. We observe, we ask questions, we see whether the whole pattern fits one of the paradigms of "this is a cluster of signs [what's objectively observed] and symptoms [what the patient complains of] which occur together often enough that we recognize the pattern, have called it X, and here's our best stab at alleviating it".

Which is not always with medication.
On the other hand, no quarrel that we've gotten far too dependent on Pharma (the medical equivalent of the military-industrial complex) for too long. We can't do our job without (some of) their products, but we need to take control back.

So please reconsider the question of the use of diagnostic manuals, of the definition of illness.

And keep up the blog, which I enjoy. I have one (down at the moment, but will reappear when my daughter fixes it: Called Judithio,
http://www.newrambler.net/judithio
Mostly but not entirely my journaling aloud about street ministry and discernment towards diaconate. I was confirmed in 1969 in Toronto--a grad student at UofT then, attending Grace Church on the Hill; we were confirmed at a small inner-city parish (I don't remember where now) where the Bishop was when we were in town (it gets complicated). Anyway, clearly being an Episcopalian has stuck. Thank you for your work in Toronto.

Cordially, faithfully, wishing you joyous Advent and Christmas,

Judith Crossett

Judith H. W. Crossett, MD
Director, Geriatric Psychiatry
Clinical Professor of Psychiatry
University of Iowa Carver College of Medicine

I'll just add that I do have a copy of the DSM-IV TR on my office book shelf alongside some other reference books that I occasionally use to look up one thing or other. So I'm not actually as anti-DSM as my previous post might have suggested, I guess I go back and forth on these issues. So a big thanks to Judith for calling me to explain myself better.

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The DSM

The process has begun to update the DSM (the Diagnostic and Statistical Manual of Mental Disorders). The DSM, currently in version IV (Aka, "The DSM-IV"), defines what constitutes mental illness for treatment and insurance purposes. The question, however, of what gets included or excluded is controversial because what is considered a mental illness has been changing so quickly in our culture.

You see, unlike in fields like Cardiology or Oncology, the fundamental disease processes of mental illness are still known. Thus, grouping illnesses by common origin (etiologically) is impossible. The approach was abandoned as the grand psycho-theories of people like Freud collapsed. Instead, the editors of the DSM take a taxonomic approach, grouping symptoms together into common clusters. A certain cluster of problems has been identified as "Major Depression" and another "Schizoaffective Disorder."

This becomes a huge problem in something called "differential diagnosis." How do you know, for instance, whether someone has a "Panic Disorder" (Code 300.01) or "Obsessive-Compulsive Disorder" (300.3) or even "Post Traumatic Stress Disorder" (309.81). The symptoms can be virtually identical, and it ultimately becomes a clinician's judgment call about where the person fits best.

Even more interesting, to me, is the multiple categories where one of the criteria is something like "...behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." In other words, if the patient thinks is a big problem, it's a big problem, otherwise, it's not. This criteria is especially common in the sections on sexual dysfunction and seem, to me, to be a cop-out. Essentially anything you might do or desire is considered okay until it impairs "function" or causes "distress." Am I the only one that thinks that's a strange way to define illness?

So they are revising the big book of badness. No doubt the number of diagnosable illness will continue to increase (as it has with every version of the book). The big winner will be the drug companies.

One of the therapist friends told me that she found the DSM-IV to be utterly useless. She she didn't get reimbursed by insurance she never even opened it anymore. There is wisdom there!

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Is Teasing Good For You?

The NY Times Magazine has worthwhile article defending teasing. Increasingly, children and adults are being prevent from engaging in this kind of play.

The reason teasing is viewed as inherently damaging is that it is too often confused with bullying. But bullying is something different; it’s aggression, pure and simple. Bullies steal, punch, kick, harass and humiliate. Sexual harassers grope, leer and make crude, often threatening passes. They’re pretty ineffectual flirts. By contrast, teasing is a mode of play, no doubt with a sharp edge, in which we provoke to negotiate life’s ambiguities and conflicts. And it is essential to making us fully human. (source)

The article is quite thorough and examines teasing behaviors among animals as well as humans. It seems that teasing serves a very important social purpose. Really it is a "playful provocative mode of commentary" that allows things to be said that would otherwise go unexpressed.

Teasing is just such an act of off-record communication: provocative commentary is shrouded in linguistic acts called “off-record markers” that suggest the commentary should not be taken literally. At the same time, teasing isn’t just goofing around. We tease to test bonds, and also to create them. To make it clear when we’re teasing, we use fleeting linguistic acts like alliteration, repetition, rhyming and, above all, exaggeration to signal that we don’t mean precisely what we’re saying. (source)

This has huge significance for understanding relationships, of course.

Studies find that married couples with a rich vocabulary of teasing nicknames and formulaic insults are happier and more satisfied. Romantic teasing provides a way of negotiating the conflicts that send many couples to the therapist’s couch. To explore how playful teasing shores up marital bonds, I asked couples to tease each other using the same nickname paradigm used in the fraternity study. The nicknames they invented drew on the metaphors of love documented by the Berkeley linguistics professor George Lakoff: they made references to each other as food objects (“apple dumpling”) or small animals (“adorable duckling”). The more satisfied the couple, the more the teasing was filled with off-record markers. And in a separate study, partners who managed to tease each other during a conflict — for example, over money or an infidelity — felt more connected after the conflict than those couples who resorted to the earnest criticism many therapists recommend. Teasing actually serves as an antidote to toxic criticism that might otherwise dissolve an intimate bond. Teasing is a battle plan for what Shakespeare called “the merry war.” (source)

Teasing not only helps communication, it actually helps establish and maintain intimacy bonds. We often tease those we wish to know better.

This causes me to reflect on the teasing that occurs between congregation and pastor. I'm always delighted when parishioners make fun of me--I think it's a very healthy way of negotiating the hierarchy that otherwise exists. I tease right back--especially during the announcements. I find that it only increases the mutual bond of affection.

-t

Pastor's Advice on Marriage: More Sex

The New York Times has a great article about the trend in evangelical circles to encourage (married) couples to have more sex.

Mr. Young, an author, a television host and the pastor of the evangelical Fellowship Church, issued his call for a week of “congregational copulation” among married couples on Nov. 16, while pacing in front of a large bed. Sometimes he reclined on the paisley coverlet while flipping through a Bible, emphasizing his point that it is time for the church to put God back in the bed. ...

Mrs. Young, dressed in knee-high black boots and jeans, said that after a week of having sex every day, or close to it, “some of us are smiling.” For others grappling with infidelities, addictions to pornography or other bitter hurts, “there’s been some pain; hopefully there’s been some forgiveness, too.” (source)

There have been a few influential books published recently encouraging couples to have more sex--notable 365 Nights and Just Do It. Both of these are reportedly very funny and free accounts of couples committing to have as much sex as possible despite demanding jobs, children, and middle-age. From what I've heard (I haven't read either one) the embedded gender ideas are basically mainstream (not scary in the way some Evangelical notions of gender can be).

The biblical, theological, and pastoral convictions underlying the role of sex in marriage is, of course, substantial. God wants us to have sex. So why don't we talk more openly about this in Christian marriage? When I do pre-marriage counseling with couples I usually spend at least one session talking about it. One of the things I always mention is that sex inside marriage is very different that the sort of love-making that happens in courtship or even when a couple is living together. Something shifts when you actually get married. A therapist friend of mine (Mary Gates) told me once that when you get married suddenly all your family comes into the bedroom with you. The sex "means" something it didn't before. It has become, in an important sense, more sacramental now that it is contextualized by Word and Spirit.

The notion of sex-as-sacrament is pretty profound. As a sacrament, this "outward and visible sign of an inward and spiritual grace" is a ritual that is what it represents: the union of two people "in mind, body, and soul." It has the power to accomplish that which we cannot do on our own--it takes us beyond ourselves and into a share of the bounty God promises us.

Like all sacraments, the best preparation for sex is forgiveness. Just like we ask God's forgiveness before touching Christ's body, we also need to have a similar spirit of openness and vulnerability when reaching toward our spouse. In fact, I have ever spent time in marriage prep teaching couples how to ask and grant forgiveness. If I teach them nothing else, this may the most important lesson in marriage prep. The sad thing is, many people do not know how to ask for forgiveness in this or any other relationship. Oddly, our culture right now has a hard time with this part of the sin-contrition-newlife cycle and that gets played out in marriages all the time.

Another problem for many couples has to do with the problems that arise from negotiating the tricky boundary between self and other. Psychologists call it "self-differentiation." Here's a scenario, Jane and Mike are married. They always have sex on Friday night, usually after spending time doing something as a couple going to the movies, dinner, or out with friends. Increasingly, however, Jane feels more distant from Mike. As a result, she feels less inclined to make love on Friday nights. Now, if she declines his advances this could be seen as a mark that she is living authentically and not just keeping up appearances. her actions will align with her desires. But, on the other hand it may not help her higher-level goal of having intimacy with her husband. If she has healthy self-differentiation she may be able to think something like, "I really don't feel like this right now, but I will do it for him." Poor self-differentiation might look like, "I really don't feel like this right now, what's wrong with me? I better do it anyway or Mike will get mad..." Note that having sex or not having sex in a particular situation could be the result of poor or good marital health. The key is whether your sacrificial offering of yourself is acceptable or not.

Note that in the Bible not all sacrifices are pleasing to the Lord. In fact, one has to be quite deliberate and careful about what is offered up and how. The wisdom here is that God doesn't want us to make sacrifice for His sake but ours! Thus, one must always examine that which is to be offered carefully.

I'm still learning how to do this this kind of discernment around self-differentiation. Something about the ability to be ones self and yet utterly connected to the other at the same time. Meditation helps, I think, as do the other typical spiritual disciplines: prayer, service to others, listening, study, etc. It's a lesson that takes a lifetime to learn.

-t

Infidelity on the Rise

According an article in the NYTimes, adultery is on the rise among older men and young couples. One possible explanation, better sexual health among older folks:

Among older people, a host of newer drugs and treatments are making it easier to be sexual, and in some cases unfaithful — Viagra and other remedies for erectile dysfunction, estrogen and testosterone supplements to maintain women’s sex drive and vaginal health, even advances like better hip replacements. (source)

More troubling for me is the shift in relatively young marriages. "About 20 percent of men and 15 percent of women under 35 say they have ever been unfaithful, up from about 15 and 12 percent respectively." One possible cause, the Internet?

In younger couples, the increasing availability of pornography on the Internet, which has been shown to affect sexual attitudes and perceptions of “normal” behavior, may be playing a role in rising infidelity. (source)

Interesting, but totally speculative from a scientific point of view.

The news isn't all the bad. The article ends of the following optomistic note:

The General Social Survey data also show some encouraging trends, said John P. Robinson, professor of sociology and director of the Americans’ Use of Time project at the University of Maryland. One notable shift is that couples appear to be spending slightly more time together. And married men and women also appear to have the most active sex lives, reporting sex with their spouse 58 times a year, a little more than once a week. (source)

An aside: The Talmud (Jewish commentaries on the Law) includes a fascinating discussion among Rabbis about about sex (within marriage, naturally). It is the man's obligation to provide physical affection, not his right to demand it. Indeed, sex is one of the three basic rights guaranteed to women in Jewish law (the others being food and clothing). He cannot legally withhold sex, even if the couple has already produced children. However, she cannot withhold it as a form of punishment, either.

The frequency of sex recommended by the Talmud depends on the husband's profession (and may be modified by the marriage contract). Sailors, for example, were supposed to have sex rarely. But laborers were supposed to make love more often. Scholarly types, including Rabbis, were supposed to do it about once a week. So there you go! If you're interested in Jewish views about sex, check out the book Kosher Sex.

-t

On My Mind

Troubling me is an encounter I had this week with a man wanting my assistance. He's poor and functionally illiterate. He wants me to help him get money from the government from a ten-year-old worker's comp claim. Given that he hasn't gotten any money yet, I think this is a long shot, but he's convinced that he is due the money since they sent him a letter ten years ago explaining that they may offer him a settlement. No matter how many times I explain to him that the form letter was simply describing something that they might do, he still insists that they would not have said this if they did not intend to give him money. I'm realizing that there may be some kind of learning disability or cognitive deficit complicating the situation.

Now he wants money from the City to help pay for an apartment he just rented. A City Social Worker told him that they would give him $700 if he found a suitable apartment. He found one that is too expensive to qualify and they won't give him the money, and he's mad because he thinks he is entitled to it no matter what apartment he found. I'm having flashbacks to being a Social Worker myself in Los Angeles. But those days are past. Now I'm not sure what help I can be to him.

"The answer is always in the client," is a mantra I sometimes use. Meaning, if you are at a loss with what to do, center yourself in the experience of the client. I think that this guy is incapable or unwilling to understand reality. I've tried to explain things rationally and that's not working. So I think I just need to be really clear about the boundaries and what I'm willing to do. Sure--I can make some phone calls. But I'm not going to camp out at the Worker's Comp office just to find out that his claim was denied 10 years ago.

I think a lot of priests end up in this situation--wanting to be helpful and having people ask more than we can give. It's helpful in such circumstances to look inward and experience the feelings that arise. Of course I feel guilty. Shouldn't I be totally devoted to advocating for this man and all others who come? Well, the reality is that he is not my only responsibility. I also have a church to run and other people to care for. (Not to mention my own self to keep in balance.)

So it goes. Hard not to get trapped in a cycle of guilt and anger as a minister. Easy to feel guilty for having every advantage in life and for sitting in my office answering e-mail and blogging and thinking about my sermon, etc. Easy to feel angry when someone tells you that your duty as a Christian is to help them. I know so many priests that burned out as they cycled between guilt and anger. I believe the solution has something to do with forgiveness....

-t

My Day

Today began with a meeting a copy-machine salesman. The photocopier is the most complex piece of equipment most churches own, and it is also one of the most useful. We are coming to end of our current lease in the next few months so our Sales Rep wants to see if we want to make changes, get a different machine, etc. So we talked through various options of what is available. He was surprised that I knew as much as I did about photocopiers, so I explained how I did some research on the subject back when I was at SMM. The kinds of things these machines can do now is really amazing: color, folding, book-fold stapling, scanning, faxing, etc. Of course, not all of these will be cost-efficient for us. So he's going to develop a couple of different quotes and then I can sit down with Corporation to discern which way to go!

I was on the phone today talking with a psychiatrist who is treating someone that I see on a pastoral basis. The medical team wanted to know if there was a way the church could support this person. we talked about it, and it seems that there are some small ways the church might be able to help this person more. To be honest, though, it's challenging for congregations to accommodate severely mentally ill folks. We will continue to do what we can to offer this person love, companionship, and a sense of belonging, but even doing just that requires a significant amount of resources. It's a remarkable challenge to the self-understanding of congregation to encounter a challenge such as this. It puts the whole notion of Christian community to the test!

Next I've got a staff meeting to attend and then Mass at Trinity Chapel. That's always a treat!

-t