Tag Archives: Therapy

Escaping the Groundhog Trap

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J.C. Schildbach, LMHC

I’m not a big fan of Groundhog Day—the holiday or the movie.

As a kid, the holiday just confused me. Why a groundhog? Can’t you just see if you cast a shadow yourself? Or if a bush, a stone, a dog…anything casts a shadow? I wondered at the particular properties of groundhogs, and why their shadows might be somehow different than those of any other thing on the planet. I suppose I never quite felt like anybody adequately explained the magical properties of particular varieties of burrowing rodents for me to really get behind the holiday or its alleged meaning.

The lack of a real explanation is one of the things that keeps me from enjoying the movie, Groundhog Day as well. What caused this to happen? And why is the resolution what it is? What would make any magical powers of time control so interested in getting Bill Murray’s character, Phil, together with Andie MacDowell’s character, Rita? Perhaps a resident of Punxsutawney is one of the aliens from Edge of Tomorrow who accidentally infected Phil with the time control powers. But that can’t be it, because then Phil would’ve had to die every day, and he only died on some of those days.

Beyond that, the movie just follows the theme of so many movies from the 1980s about how great small-town America is, and how some cynical guy from the big city needs to learn to appreciate that. As for Murray’s arc in the movie, it’s rather similar to Scrooged.

The audience is also expected to root for Phil to ‘get the girl,’ even after he uses his powers of time repetition to manipulate one of the local women into sleeping with him, and then trying to manipulate Rita into falling for him by pretending to like everything she likes—information he gathers from her in conversations she will never remember.

Ultimately, Phil has to get through one day being kind and helpful, rather than acting like his usual, egocentric self (but, again, why is this the resolution—and would it really matter whether Rita decided she liked him or not?). But that last, single day of generous Phil doesn’t feel much different from the videogame-style resets that go on through the rest of the movie, or in Edge of Tomorrow, and hardly seems like a long-term change to his character as much as it feels like him resigning himself to being a decent human being for one day if he ever wants to get out of Punxsutawney. How is his decency not just more manipulation—another possible route out of the repetition he is trapped in?

Many people have labeled Phil’s situation in Groundhog Day an “existential dilemma” or otherwise termed the movie as existentialist. Properly speaking, though, if Phil’s was an existential problem, he wouldn’t have a long period of being able to make whatever decisions he wanted with no thought, responsibility, or consequences at all, only to be pushed into making the “right” decisions–as judged by whatever power kept him perpetually trapped in Punxsutawney on a particular day–until he did what was deemed correct by that power and the “spell” was broken. He would be responsible for whatever he did, and nothing would compel him to do anything.

groundhog drive

The most important lesson of all–Don’t drive angry.

Still, it’s something of a tribute to Groundhog Day, the movie, that it has become synonymous in our culture with repetitive behavior or situations. And it is perhaps the fantasy that we could relive a particular day until we did it right, managing to impress everyone around us, and connect with our one true love in the process (as well as the opportunity to indulge in a great deal of irresponsible behavior along the way), that has led it to this level of popular recognition. Or perhaps it’s the underlying idea that we are trapped by our own behaviors in repetitive cycles, and that we can change ourselves in order to achieve a better life—along with the wishful notion that we need to be good people if we really want to get what we want.

After all, the idea of breaking out of repetitive cycles and habits, or perhaps of creating better habits and repetitive cycles, along with being better people…good people…our best selves, is what underlies much religion, philosophy, and, yes, therapy.

We all struggle through our own behavioral patterns, habits, and the potential sameness of our days, the rut of weeks, months, seasons, and years. But no bizarre fluke of time is going to trap us in a loop and push us to do things differently and become better people, or pursue what we want. That’s on us.

Whatever I might think of him, Phil found out that it wasn’t a groundhog, or the celebration that surrounded a groundhog’s shadow, that was at the core of his problem. Rather it was his own shadows, the darkness he threw out into the world.

So maybe Groundhog Day is the perfect time to look around at our own shadows and what they say about our forecasts—how much more winter we may have in store—and then think about what, if anything, we want to do to change that.

Happy Groundhog Day.

 

I Want to Quit Writing About the Duggars, But I JUST CAN’T

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JC Schildbach, LMHC

Praise Jesus! Joshua Duggar has been cured of his addiction to pornography in just a few short days!

Okay, maybe not so much cured, as that he just removed a reference to pornography addiction in the ‘official statement’ he issued on his family’s website/Michelle’s Blog.

Who, other than Josh, his family, and probably their lawyers, know why he removed a reference to pornography addiction, as well as to “my actions that happened when I was 14-15 years old,” in the official statement he made regarding his use of the Ashley Madison website to engage in extramarital affairs?

Let’s engage in some wild speculation, shall we?

With an ongoing trickle of information about a lawsuit by the one, non-sister victim of Josh’s “actions that happened,” Child Protective Services incidents at the Duggar home, questions of impending bankruptcy, and other Duggar-related strangeness over the months since the public first became aware of Josh’s troubled teen years, it’s likely that the Duggar family isn’t entirely ‘out of the woods’, legally speaking. Porn addiction you say? Extramarital affairs you say? Sexual assault of minor females you say? Hold up! Strike that! It’s only extramarital affairs. Nothing to see here, folks.

Okay, legally speaking, I don’t think there is really any way that anybody could determine that authorities need to, say, seize Josh’s computers and phone, and whatever other devices he used to feed his “pornography addiction” in order to make sure that his viewing habits didn’t include any material involving minors. There needs to be much stronger probable cause than one’s sexually assaultive teenage behavior. Although, if Josh hadn’t actually escaped legal punishment for his behaviors, he might still be banned from accessing pornography at all.  But…

There are still hackers and others out there who, with the information they already have, could potentially make the connection between Josh and whatever pornography he viewed—especially if he accessed it using any of the same email accounts or payment methods as he did for his Ashley Madison account.

Such digging won’t necessarily turn up anything illegal, but Josh (just like anybody else) probably wouldn’t really want any personal details about his pornography viewing habits to be made public. Just imagine the scandal if, say, there was any gay pornography in there; or even some “shemale” (sorry, that’s the porn industry term) pornography.

I’m guessing, though, that the real reason has to do with the Duggars doing as much damage control as possible—if that were even possible. After all, Josh’s parents and the two of his sisters who came forward as victims, are working with The Learning Channel (TLC), along with other groups, on an hour-long special about child sexual abuse. The parents, Jim Bob and Michelle, were reportedly hoping to parlay that collaboration into another reality show where—and I’m not making this up—Jim Bob and Michelle would counsel victims of childhood sexual abuse.

On the eve of such an important TV event, the Duggars probably don’t want to remind the public that their connection to childhood sexual abuse is not just that they are the parents of victims, but also that they are the parents of a perpetrator. The Duggars also probably don’t want greater public awareness of the expanding list of Josh’s unresolved sexual compulsions while they are pretending to know anything about how to counsel anybody with a history of sexual abuse—especially given their insistence that they had handled Josh’s sexually assaultive behaviors “in house.”

Still, a show where Jim Bob and Michelle counsel sexual abuse victims would be fascinating television—I mean, if you could get past the completely unethical situation of subjecting sexual abuse victims to the ongoing harm that would come from having a couple of unqualified, uneducated, sexual abuse enablers conducting therapy sessions.

Who were the mystery women Josh Duggar hooked up with through Ashley Madison? Wild speculators want to know. (And watch the fingers there, Grabby!)

Who were the mystery women Josh Duggar hooked up with through Ashley Madison? Wild speculators want to know. (And watch the fingers there, Grabby!)

Of course, it’s possible that Josh’s ‘official statement’ was revised so that we can all focus on what’s important in this whole situation: the cheating. Why cloud that up with a bunch of side issues like pornography? I mean, we already know about the Ashley Madison account, and that Josh paid for the ‘affair guarantee’ package, and that he also had an OKCupid account, where he used some DJ’s selfie for his profile pic. But, really, why address situations that nobody else has bothered to expose, yet—right?

Then again, maybe Josh just realized that he was using the term “pornography addiction” wrong. Pornography use doesn’t really rise to the level of an addiction until it’s causing some serious problems in one’s life—and not just the kind of problems that arise when one is publicly exposed as having cheated on one’s wife via a web site designed for cheating spouses, despite having served as a “family values” spokesperson. See, that’s not even really related to using pornography at all—except for all the Ashley Madison pop-up ads that are connected to pretty much every porn site on the entire Internet.

Rather than Josh talking about pornography addiction, I’d like to just start calling it compulsive masturbation involving pornography, but there are clinical differences between pornography addiction and compulsive masturbation. And who knows?  Maybe Josh was just doing a lot of looking.  But really, just looking at pornographic pictures and/or videos for, say, thirty minutes a day until you can rub one out hardly reaches the level of compulsion. In today’s wired world, with plenty of access to free porn, that’s practically normal behavior.  (And by ‘normal,’ I mean it’s pretty damn common–not that it’s necessarily healthy–but that’s a discussion for another time).

Porn addiction, in contrast, involves an ongoing compulsion to consume ever more pornography, to the point where it’s occupying vast quantities of one’s time, and leading one into trouble. For example, imagine that every time you popped onto Facebook, you were, instead, hopping onto the Internet to find more pornography. That’s getting closer to the “addiction” range.

Josh probably just wanted to keep that clear. After all, it wouldn’t look good if he really did have an addiction to pornography. That might suggest that he continues to struggle with sexually compulsive behaviors, and that maybe the ‘treatment’ he got all those years ago didn’t quite root out the whole problem.

Of course, if Josh has graduated to affairs with adults, and is only looking at pornography with adults, at least that means he’s gotten away from the children. You have gotten away from the children, haven’t you, Josh?

Will Megyn Kelly's Trump-imposed exile end in time for her to interview the Josh Duggar mistress(es)? And when is Trump going to announce his plan for constructing a wall around the Duggars (and making them pay for it)?

Will Megyn Kelly’s Trump-imposed exile end in time for her to interview the Josh Duggar mistress(es)? And when is Trump going to announce his plan for constructing a wall around the Duggars (and making them pay for it)?

At any rate, now that we’ve made it to this stage, who wants to bet on just where Josh’s affair partner(s) will turn up first? I’ve got my money on a Megyn Kelly exclusive interview, unless her spat with the Donald has caused her to lose favor with the Duggar demographic (I’m guessing they’re more a Huckabee crowd than a Trump crowd—but it’s hard to know). Something tells me, though, that I probably shouldn’t rule out the affair partner(s) turning up in a full spread in Playboy, or Penthouse, or Hustler—if those all still exist—if not a full-blown porno movie with a Josh lookalike—or maybe Josh himself if he falls on hard enough times.

Well, that’s probably enough wild speculation for now.

—

Whew! Now that I’ve gotten all that out, I think I feel okay. I just hope I can get through another day, another week, before I feel compelled to write more about Josh or any of the rest of them.

Pray for me.

What? Me Network?

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JC Schildbach, LMHC

A few weeks back, as a favor to a friend, I was invited (compelled?) to speak with a small group of victim advocates—county employees who serve as a kind of official support system for those people directly impacted by a crime. The topic: sex offenders and sex offender treatment.

I agreed to the meeting several months prior, when I was still working directly in the field of sex offender treatment. Having moved away from that field, I hadn’t exactly been immersed in relevant information. As ‘luck’ would have it, though, the Josh Duggar situation provided plenty of focus on issues of law and treatment regarding sex offenses, and an easy access point to discuss much of the involved information.

I had not prepared an actual presentation–the kind with Powerpoint slides, and handouts. Rather, the victim advocates sent me a number of questions via email, and I spent the allotted hour attempting to provide straightforward answers. As with any specialized field, though, nuanced and complex answers are far more the norm.

A quick sampling of some of the (paraphrased) questions and the (overly simplified/incomplete) answers:

Q: What are recidivism rates for adult offenders versus juvenile offenders?

A: Much lower than most people think, in both cases.

Q: Is treatment for offenders a “one size fits all” program, or is it tailored to the specifics of the offender and the offense?

A: There are standardized “assignments” and program requirements, but, as with any form of therapy, it works best when the particulars of the people involved are taken into consideration.

Q: Do you see a lot of commonalities among offenders?

A: As with any ‘diagnosis’ or behavioral category, there are going to be a great many similarities—or those points where behaviors, and justifications for those behaviors, share many similarities—for example…

The lunch hour actually went by pretty quickly. And, despite feeling a bit nervous about providing accurate information without delving into boring details, nobody fell asleep. (Which reminds me, I promised to email some information about various psych tests, which I never did—and I also meant to ask about doing a quick once-over of my friend’s notes to make sure I hadn’t misspoke or inadvertently conveyed any muddled or inaccurate information).

At any rate, the lunchtime meeting was a good refresher about how necessary, and how difficult, it can be to properly ‘network’ within one’s chosen field. It’s quite easy to sit back and complain that people know so little about the specialization you’ve devoted a great deal of your working life to, without doing anything to address that lack of knowledge.

Happy face mad

Of course, it can be extremely difficult breaking through all the noise and confusion to relay one’s own specialized understanding of specific issues, or to have the patience to let the specialized knowledge of others in.

After all, we can all get bogged down in our day-to-day life. And going to trainings or other networking opportunities can feel like just another professional obligation—more about checking a box on a form, than about gaining knowledge and understanding that can truly help in one’s ability to help others—not to mention, the opportunity to meet and connect with other people who are potentially valuable allies and resources.

Still, I suppose we all have our fair share of networking disaster stories.

Take, for example, the time that I went to a breakfast fundraising event for the King County Sexual Assault Resource Center as a special guest of the Seattle Archdiocese (damn, that sounds important, doesn’t it? But, truth be told, I was actually the ‘plus one’ to my boss’ invitation as a special guest of the Seattle Archdiocese). Anyway, after the program of speakers, ranging from local media luminaries, to elected officials, to experts in the field of sexual assault treatment, to the families of sexual assault victims, as the time arrived for everyone to mingle and/or make a quick getaway to avoid mingling, I managed to upend a glass of water, which drained directly into the chair where I was sitting. Mingling in wet pants—not really a comfortable experience, or a good way to convey anything you want other professionals to remember about you.

Beyond various faux pas, I think many professionals go to trainings and seminars with those colleagues we already know—potentially insulating and isolating ourselves from other attendees. Whatever your impressions of people in the mental health field, plenty of us are actually introverts who find crowds and forced socialization to be extremely draining. For some, the same skills that make us effective in a one-on-one or group session, or even a phone-based intervention—such as being able to focus not only on a person’s words, but the whole of what people are communicating non-verbally—can make it very difficult to just mingle in a large crowd.

There is also the potential for fumbling when you’re on the ‘turf’ of some other specialization. I mean, imagine how potentially uncomfortable it can be when you work in the field of sex offender treatment, and are attending a conference for providers who treat the victims of such offenders. Ultimately, the goals are the same—to reduce the impact of such trauma, and combat the underlying causes of such offenses—but you’re definitely working different sides of the same street.

There are also several forms of specialization that can reach into most other areas of treatment—substance abuse, personality disorders, suicidality, and on and on. No practitioner has the ability to become truly well-versed in every possible situation they encounter. Ideally, though, they will learn enough to recognize when they need to refer out, and how to recognize the signs of those areas with which they aren’t particularly familiar.

I suppose this is all weighing on me a bit heavily, as I have my licensure renewal coming up, and need to make sure I have all of my trainings in order. I’ve done plenty of trainings, and perhaps a whole lot more personal study, over the past few years, but not all of that counts for official training credits.

On top of just staying abreast of one’s own field, and finding trainings of interest that fit one’s schedule and budget, the state instituted a requirement that all counselors have to have training in how to deal with suicidal clients at regular intervals. I’m trying to approach this positively. I get the reason for its necessity (although the real reason for the change in requirements had to do with previous problems in the state’s credentialing process that allowed people with little-to-no education in mental health to call themselves “counselors”—which led to multiple tragedies and other less-than-ideal outcomes).

Still, having worked in suicide prevention for years makes the requirement a bit redundant for me. I know and respect many of the people conducting the trainings, and certainly learn from them each time I have occasion to encounter them. But as a general topic area, I could be brushing up on or exploring other areas where I haven’t already spent years of professional focus, particularly given that the trainings are aimed at practitioners who aren’t particularly sturdy in their suicide prevention/intervention skills.

Mental Health practitioners are also required to take regular ethics trainings—I suppose for those therapists who can’t remember not to force their own views on people, not to run around blabbing about their clients, and not to sleep with their clients.

That said, I will look to make the most of my remaining trainings, try to be pleasant and sociable, and pay attention so that I might actually gain some new insight. And I vow not to be one of those terrible bores who offers up one’s own experiences during question-and-answer periods, just to show how knowledgeable one is, rather than actually seeking information from the experts providing it.

And perhaps I should just schedule one of those suicide prevention trainings ASAP—or maybe after I cast about a bit to see if any of my friends in the field have been blowing off that training too, and want to go along.

A Reframe for Dick Whitman OR Don Draper Gets Just Enough ‘Therapy’ to Go On Being Don Draper

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JC Schildbach, LMHC

(Spoiler Alert!)

Let’s imagine that Don Draper’s momentary breakdown—a realization of abandonment, followed by a phone call wherein he recounts his sins to Peggy, leading to an anxiety attack or some other form of emotional paralysis, which is essentially broken by a cathartic, sobbing hug with a stranger in a group “seminar”—is an honest therapeutic breakthrough.

don's anxiety

While many people have interpreted the final moments of the series as cynical—the smirk that rises on Don’s face as he sits in a meditation group, followed by the ring of a meditation bell fading into the opening of the Coke “Hilltop” commercial jingle—a better “reframe” for what happens with Don is that he recognizes how his own behavior has been impacting others, that he is able to identify his own feelings of emotional disconnection, and that he is able to gain some real acceptance of his situation and how to thrive in it.

Don's idea

In the terms of a therapeutic cliché, Don realized that when one cannot change one’s circumstances, one can change one’s response/attitude toward those circumstances.

Essentially, such a “reframe” relies on the acceptance of the idea that the “Hilltop” Coke commercial is Don’s concept (all apologies to Bill Backer)—an idea that hardly seems up for debate. Among other elements, in the final scenes of the final episode, Peggy’s plea to Don to “come home” involves the pointed appeal, “Don’t you want to work on Coke?” And the final words spoken, by one of the retreat leaders, before the Coke commercial closes out the series, are an invitation to greet the morning sunshine and bask in the possibilities of a “new day, new ideas, a new you.”

Don’s answer to Peggy’s question about working on the Coke account is, “I can’t. I can’t get out of here.” At that particular moment, it’s a statement of desperation. Don is panicked. He is stuck at a coastal retreat “somewhere in California” with no transportation.

But Don’s sense that he needs to be able to control where he is, and when he can leave, is about to melt away. After his moment of connection with fellow seminar-attendee, Leonard, Don realizes he can “work on Coke,” or any other account, so long as he abandons his need for control of the situation where he is working.

Don’s initial flight from McCann-Erickson is brought on by feeling he has lost control. He is called to a meeting for Miller Lite, only to realize he is one of many creative directors there—and not the creative director there. He quickly decides this is not for him, grabs up his catered box lunch, and hits the road.

Don’s need for control plays into his sobbing hug with Leonard—who details how he feels that his family doesn’t even look at him; that he doesn’t know how to give, receive, or even recognize love; and that “nobody cares I’m gone.”

don's hugg

In a moment of recognition and connection, Don realizes his family does not “care” that he’s gone, and that his idea of love is ill-defined at best. Of those family members he has tried to reach, daughter Sally and ex-wife Betty have told him to stay away, and that the lives of his sons are more stable in his absence. Stephanie, the niece of the (real deceased) Don Draper, both invites (the imposter) Don to the coastal retreat, and then leaves him stranded there, after telling him he is not part of her family (and after having her own desire for a therapeutic experience thwarted by what she feels are the judgmental and stereotypical attitudes about what she should value in life).

In the lead-up to Don’s hug with Leonard, it is only Peggy who urges Don to come home. And by “home” Peggy means back to work at McCann. It is Peggy alone who knows how to reach Don, and does so, rather than just accepting that Don does what Don does and leaving him to it. She appeals to the only thing that Don clearly loves—the pure joy of coming up with a winning ad campaign.

It’s possible to interpret Don’s brief breakdown as entirely self-serving—that he is distraught only because he has been abandoned instead of being the one to abandon, and because he lost the ability to just pick up and leave. He was even left without his usual means of numbing himself with alcohol and casual sex.

So when Leonard revealed his dream of being left alone in the dark on the refrigerator shelf, of course it struck a chord with Don. After all, Don’s whole career has been spent trying to get people to pick that particular item out of the refrigerator—the one that would make them whole. To do that, he needs to know how to connect with people like Leonard—people who have a sense of emptiness and who don’t know how to correct their emotional deficits. And now Don is trapped here with Leonard, in the dark and cold of that nightmare refrigerator where others are in charge of who gets in and out. That bit of recognition allows Don to plunge into his own feelings of sadness, if only for a moment, before he recognizes the value in what Peggy has told him, and the value of tuning into people like Leonard, at least until the end of the week.

It’s a fairly common misconception about therapy that such moments of insight and catharsis will lead to meaningful change, or that a therapist’s job is to provide a client with just the right piece of advice or insight to “fix” that client, and put the client on the right course for life. Part of that misconception can be attributed to “retreats” like the one where Don is stranded—certainly sold to the participants as a week of healing and life-affirming change. And, certainly, recognizing something lacking in yourself, and having a good cry can be helpful at times, but it doesn’t make you a different person. Real change takes will and work.

But if therapy is about meeting a person where s/he is, and helping that person to be the best version of who s/he can be at that time, and of using a ‘strengths-based’ approach that helps the person tune into their own abilities to address problems, then Don’s time away at the retreat is successful. Don not only has a moment of clarity and honest emotion; he gains acceptance about his own circumstances and how to change his response to them.

It is telling that in the final shot of Don’s family, we see them in a dimly-lit kitchen, Betty resignedly drawing on a cigarette, Sally, having assumed parental duties, washing dishes with her back turned to her mother and the camera. All this just before we see Don on a sunny cliff-top overlooking the Pacific Ocean and hear the opening words of the Coca-Cola jingle: “I’d like to buy the world a home, and furnish it with love.”

sally dishes, betty smokes

Don has spent a good portion of his adult life trying to fix problems with money and buying things, and exists in an industry where money and buying things is put forth as the answer to everything—even a broken home and the absence of love.

And Don has a significant history of childhood trauma and abandonment, and poor modeling from the adults in his life. A week of group seminars and meditation isn’t going to fix that.

But that week on the coast did give Don enough of a reframe to get him back to the work he loves, and to do that work successfully.

coke real thing

And that’s the real thing…or the realest thing we can expect from Don.

Suicide at the Oscars, part one: ‘Crisis Hotline: Veterans Press 1’

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J.C. Schildbach, LMHC

The topic of suicide came up in at least three acceptance speeches at the latest edition of the Academy Awards on February 22, 2015. (Okay, yeah, I’m late to the party again). And perhaps even more astonishingly, two of those acceptance speeches were actually related to films about suicide prevention hotlines. First up is the documentary, Crisis Hotline: Veterans Press 1. (A post about the short film, The Phone Call will follow soon).

Having spent more than five years working full time for a crisis line, and continuing to work in a position sideways from, and occasionally overlapping with, such work, I can’t help but come to these films with something of a bias.

As a matter of fact, I first saw a portion of Crisis Hotline: Veterans Press 1 on a Sunday morning after coming home from an overnight shift at a call center where the crisis line calls represent only one of many mental health functions with which the staff is tasked. Having spent the bulk of my work week on understaffed shifts, I was perhaps a bit resentful at flipping on the TV to see a scene what Bob Hosk, one of the Veterans Crisis Line supervisors who features prominently in the documentary, described as “five hours here at the hotline” utilizing “about four personnel to help one guy.”

Now, don’t get me wrong. I think it’s great that the resources were available and the effort was made, with (spoiler alert) a positive outcome for an active duty service member in Hawaii.

In the time since I first saw that segment of the documentary, I’ve become more familiar with the workings of the military in addressing the epidemic of suicide among veterans and service members, and will say it is truly impressive to see the complete change that has taken place over roughly the last two decades—from an approach to suicide and mental health issues that could be described as ‘don’t ask don’t tell’ to one of increasing and highly-promoted access to counseling services, to working with suicide prevention specialists and investing in the crisis line depicted in the documentary, among many other avenues.

But, back on that summer morning, knowing that in similar situations (an unknown caller making a vaguely suicidal statement, then hanging up) rather than having a specific staff member on shift to call a special “law enforcement” phone number at cell phone company to get information on the caller’s location by pinging cell phone towers, and then being able to devote ‘five hours and four personnel’ to find the caller, whichever one of us took the call would typically end up trying to call back, and, failing any respone from that, doing a quick Internet search on the phone number (like they show in the documentary) and then making a call to 911 dispatch in whatever location the phone number (probably) originated, to report that somebody had called and threatened suicide—‘no, we don’t have a name; we don’t have an address; we don’t know how they might do it or if they tried anything yet; we don’t know if there are weapons involved; no, we don’t know much of anything about anything—we’re following our protocol, sorry to bother you.’ Then on to the next call—which could range from a hospital social worker inquiring about a client’s mental health history, to a client with chronic mental illness telling us about his dinner, to someone struggling to get help for a family member with a mental illness, to…

In the case of Crisis Hotline: Veterans Press 1, my sense is that the caller from Hawaii was truly coming from a place of desperation, and, perhaps, wasn’t aware of other options available to him, or just what sort of response might kick in as the result of the call he made. He may have thought that by hanging up, he could just drop the whole matter. He may have scared himself simply by voicing the thoughts he was having about ending his life, and so tried to walk away from that.

But beyond my initial reaction to the portion of the film I saw back on that sunny Sunday morning, and my somewhat-tempered-by-time-and-new-information response now, I have mixed reactions to the film.

I’ll say that, overall, I think it’s an excellent depiction of some of the most challenging types of work that happen at crisis lines, and at the Veteran’s Crisis Line Center in particular, which the film notes “is the only call center in the U.S. serving veterans in crisis.” (A more accurate description would be that it is the only call center in the U.S. specifically established to serve veterans, and specifically engaging the particular protocols of that call center in order to assist veterans. Any crisis line in the U.S. will take calls from veterans, and do what they can to help. Call centers affiliated with Lifeline routinely take calls from veterans and their families, in part because the callers don’t always ‘press 1’ when prompted to get transferred specifically to the Veterans Crisis Line Center. And, while Lifeline workers typically will explain to such callers that they have not reached the veteran’s line, they always offer to help.)

Semantics aside, not all calls to a crisis line are life and death—or even crises. Each time the phone rings, it’s not a given that the caller is a someone on the verge of taking her/his life, or a family member of such a person. But you wouldn’t know that from watching this film. You only get the slightest whiff of the lighter calls, when, early on, the camera moves through the call center, the sound of constantly ringing phones and poignant snippets of dialog, reaching the microphones at just the right time: “really proud of you…Where were you stationed?..So twice you tried to hang yourself before?…Do you want me to send someone there for you?…Did you get injured while you were out on active duty?…diagnosed with PTSD?…If there’s anything we can do for you…”

Okay, so those don’t come across as all that light. That particular scene is one of many subtle manipulations used by the filmmakers—layering audio to create a particular impression of an “always on” call center. For the sake of drama, the filmmakers leave out audio involving callers who are just seeking information or non-emergency services. They leave out the repeat callers who are really just touching base and giving a brief synopsis of their day. They leave out those calls having any of a number of angles that aren’t even remotely related to suicide.

The filmmakers also choose to escalate the drama in a completely unnecessary way. For instance, the music, most often quiet, involves drawn-out, high-pitched tones that add to the tension viewers are meant to feel—as if trying to talk a stranger out of suicide isn’t drama enough.

I love this woman: Maureen--Crisis Line Responder, Extraordinaire

I love this woman: Maureen–Crisis Line Responder, Extraordinaire

On top of that, the final segment of the film takes place on Christmas Eve. The scene opens with outside shots of the call center at night, American flag flying, trees wrapped in colorful, twinkling lights, as a soft jazz version of “Have Yourself a Merry Little Christmas” plays–the song adding a sting of dark humor with it’s ‘all our troubles will be miles away’ and ‘let your heart be light’ emotions. The timing of the scene was undoubtedly selected because of the heightened emotions many viewers are likely to have around the idea of a “Christmas miracle” or notions of family togetherness at the holidays. But it also serves to reinforce the popular, but ill-informed, notion that ‘the holidays’—Christmas in particular—are a time of heightened depression and increased suicide, an impression reinforced by a shot of the notepad where the crisis responder has written a quote from a suicidal veteran: “Holidays are depressing.”

There are other things that could be taken as manipulation, but which I think were not only clinically sound decisions, but also place the focus where the documentarians wanted it: on the people working at the crisis line. Not hearing the callers, for instance–while likely done just as much for clinical reasons, as for legal and artistic reasons–provides for greater control over how the information will be presented to the audience, and also removes any impressions viewers might have of the callers based on their voices, or the tones they are using.  While I obviously don’t know the specifics of how any of the callers in the documentary spoke or sounded, anybody who has spent time working on a crisis line knows that many of the callers can come across in a way that, shall we say, challenges empathy. Responders need to be aware of the potential biases they bring to calls, and need to develop skills for de-escalating and connecting with difficult callers. At any rate, difficult or not, hearing the callers’ voices would create a completely different film.

Still, one of the most valuable aspects of the film is in giving voice to the crisis line responders, not only in their moments of calm where they appear to be completely in control, but when they are giving voice to frustrations as well. During one call, Robert, a veteran himself, complains that the response time from police is “ridiculous.” In a separate interview segment, Robert expresses the anger that crisis line responders can feel toward callers: “How dare you take your own life?” But part of the reason Robert’s rawness comes across in a potentially endearing fashion is that the filmmakers also let him speak about his struggles with questions of his own abilities, whether or not he has made the right decisions, or whether he made them in time—questions born of situations where the interventions failed.

There are other responders in the film with whom I had a harder time connecting—feeling a sense of kinship, or understanding their particular reactions, or the ways they tried to connect with callers. I don’t want to dwell too much on my snotty, hypercritical reactions, though—or even mention them in any specificity. For one thing, I know only a very limited amount about what was happening in those particular situations. And I don’t know how those people move about in daily life, or in their routine work at the crisis line.

But why I will most back away from potentially harsh or nitpicky-sounding criticism of any of the responders is because I can’t imagine having to work a crisis call with the knowledge that cameras are on me, and that whatever I do could end up on HBO.

That said, there is one responder in particular, Maureen, who comes across as the undoubted ‘star’ of the film. Little is explained about Maureen or her background, except, perhaps, that she reveals that she has sons, as she is complimenting a caller on her handling of a difficult situation.

Beyond that, Maureen demonstrates the perfectly complicated balance of compassion and detachment that is rare in crisis line workers. She is able to connect to the callers, but does not get visibly drawn into the drama, despite mentioning calls that ‘stay with you.’ Early on, we hear her say, “It’s ultimately the veteran’s decision if they are going to live or die…and as a responder, you have to have a really good grasp of that.” Truer words have never been spoken.

Maureen is able to deliver lines of perfect connection to callers–lines that may seem odd to those unfamiliar with such situations. After asking a caller about how his friend (who died in combat) would react to news of the veteran’s suicidal intent, she listens for a bit, then says, “He’d kick your ass? So he’s a good friend.” Maureen is able to drably ‘contract for safety’ with callers, getting them to promise that they at least won’t kill themselves while they are on the line with her, and then works to expand on that promise.

Maureen is the responder featured in the final scene of the movie—the one that takes place on Christmas Eve. Against this backdrop of heightened emotion, she is tasked with drawing a soldier with a gun out of the desert, and back to his parents, despite much of his life unraveling. She is further challenged by limitations on her involvement—having to direct the veteran’s mother on how to bring him home, and then sitting silently, listening, and hoping it all works out.

In the end, Crisis Line: Veterans Press 1 leaves much to contemplate—whether from a clinical or technical perspective—or any of the other myriad perspectives that could be brought to the film. It is incredibly effective in that it is able to provoke a range of emotions, and could, potentially, be used as a tool for training crisis line workers and volunteers, service members and their families, or really anyone who wants a better understanding of how crisis lines work, how the mental health system can be accessed, or how the military is responding to concerns of suicide among its ranks.

It remains to be seen if the film will help draw more workers and volunteers to crisis services, or perhaps scare more of them off. And this is where I have the most difficulty with the film. How much is too much when trying to convey the intenstity of real-life situations? What level of manipulation and film-making technique serves to create understanding, and what level serves to drive only emotional response?

Granted, the vast majority of people who see Crisis Line: Veterans Press 1 will never work in a crisis line call center. But, there’s always a chance they might need one.

So (obligatory ending)…

If you are concerned that somebody you know may be struggling with thoughts of suicide, call (or get them to call) the National Suicide Prevention Lifeline at 1-800-273-8255—Veterans Press 1.

Yes, Gina, There is a Bipolar Disorder: Tom Sullivan’s Pretend Apology

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by JC Schildbach, LMHC

I have a hard time believing anybody really cares about anything Fox News Radio Host/Fox Business News Anchor Tom Sullivan said two weeks ago, or a week ago, or ten minutes ago. But, after a segment on his radio show, wherein Mr. Sullivan expressed his belief that Bipolar Disorder is a made up malady, Mr. Sullivan got a bit more attention than he maybe wanted.  And then he apologized.

I feel compelled to share Sullivan’s apology in all of it’s glory, because it is such a perfect example of a non-apology, the kind that one writes when one is drunk, and mad at the people to whom one is being made to apologize–the kind of apology that would properly elicit a playground response of “If you were really sorry, you wouldn’t have said it in the first place.”

You can hear the questionable five minute clip of Mr. Sullivan’s rant–mind you, on the web site for his own show–here: Bipolar “not a problem” and “not a disability” says Tom Sullivan.

To access his apology, you need only scroll down through the Facebook-linked comments on the same page.

Sullivan’s apology starts off thusly: “Gina, Thank you for your email.” From the get-go, it’s just plain weird. Sullivan is apologizing via Facebook to an (alleged) email that nobody can see. I’m not sure if Gina’s email is presented somewhere on Sullivan’s Facebook page, or elsewhere. I have the feeling he doesn’t want anybody to see the alleged email he is pretending to respond to, because Sullivan isn’t actually addressing any concerns that any real person has about what he said. He’s interested in presenting himself as the victim in the ruckus he started, as a means to reiterate some of the same obnoxious points he made in his original rant.

He continues: “May I tell you I have received a number of similar messages but usually laced with profanity. Your message stood out for the kindness of your words.” Oh, poor Mr. Sullivan, bombarded with bad language from nasty people. But, lo—here is one kind soul, just one person moved to express words of concern and seek clarification about just what happened in this horrible controversy that was visited upon the abused Mr. Sullivan.

“First,” Mr. Sullivan goes on (in sharp contrast to his original words for which he is now apologizing), “I need to tell you I do believe in bipolar disease.” I won’t hammer on Mr. Sullivan too much for not using the proper term “Bipolar Disorder” rather than “bipolar disease.” But I do have to question what he means when he says that he ‘believes in’ Bipolar Disorder. Bipolar Disorder isn’t some mythical creature like the Yeti or the Easter Bunny to entertain or scare people or to serve as a fun part of some childhood tradition. It’s not, as Mr. Sullivan says in his audio clip, some disease made up by pharmaceutical companies and the mental health industry for the purposes of financial gain. But, I suppose when you work for a network that promotes the idea that climate change is a hoax, and white privilege is mythical, your sense of reality can get knocked out of whack.

And speaking of having problems with reality, Sullivan then writes, “There is a two minute clip going around of my comments out of a two hour discussion. It is easy to take comments out of context.” Sullivan’s complaint of a two-minute, out-of-context clip is just a few scrolls down from a five minute clip, again, on the web site for his own show, in which he says he does not believe Bipolar Disorder is a real thing, but a ‘created’ illness.

He then repeats his newly-found belief system: “Of course I believe bipolar is real and is a mental illness that needs to be treated.” Well, of course, Tom! Why would anybody think you would have any other view–I mean, aside from the five-minute (not two-minute) clip where you repeatedly say that Bipolar Disorder didn’t even exist 25 years ago, and is completely made up?

Sullivan does a 180 and becomes a champion for those with mental illness--asks why people think he said things he plainly said.

Sullivan does a 180 and becomes a champion for those with mental illness–asks why people think he said things he plainly said.

Sullivan clarifies: “The program began with the subject being the huge increase in disability claims made to the Social Security Disability Fund which is going broke in 2016.” Never mind that what Sullivan means is that the Social Security Disability Fund could be insolvent as early as 2016 if changes aren’t made to the structure or funding of benefits—saying it is going broke in 2016 is much more alarmist and easier for his audience to understand, so that they can get angry like he wants them to.

Then, explaining (well, sort of) why he chose to target people with Bipolar Disorder, Sullivan writes, “The increase in claims is startling and the number one reason for the big increase in claims is mental illness and a subset (according the way Soc Security categorizes) of mood disorder.” Sullivan doesn’t bother to explain that what now comes under multiple categories of “Mental Disorders” used to be categorized as two separate categories: “Mental Retardation” and “Neuroses and Psychoses.” It wasn’t until 2010 that Social Security broke down those two categories any further, to include numerous items, including the “mood disorders” that so irk Sullivan.

Sullivan pouts, “All I was trying to do was to point out that out of that big increase I suspect there are people who are not sick but looking for a disability check.” Yes, “all” Mr. Sullivan was doing was accusing people on disability of trying to cheat the government. No big, deal. Everybody likes to take pot shots at people on disability, right? But Mr. Sullivan didn’t just voice his ‘suspicions.’ He outright said that Bipolar Disorder is “not a disability.” In other words, Mr. Sullivan said that anybody receiving disability payments due to a diagnosis of Bipolar Disorder is cheating the government. In fact, the title of the same page of Tom’s website where he posted his pretend apology is “Bipolar Woman Says She DESERVES Disability Benefits. Tom Tells Her She’s WRONG!”

The pout goes on: “My further point was by doing so, those people were hurting those who really are sick and need help, i.e. funding, treatments, etc.” In other words, people who get disability payments for mental illness are not really sick—people who can’t walk, or who have cancer are sick!! This is perhaps the best part of Sullivan’s whole apology—the part where he truly demonstrates that he’s learned nothing from the reaction he provoked with his ignorant comments by engaging in the exact type of behavior/speech/thinking that demonstrates classic stigmatization of people with mental health issues: the ‘you don’t really have an illness, you just feel bad’ way of thinking.

And then comes the righteous indignation of a true champion for those with mental illness: “I have for years advocated on my program for more funding and insurance coverage of mental illness. Too many have ignored it and as a result our jails are now the ‘mental institutions’ where the people get zero help.” First of all, if you have advocated so long for “more funding and insurance coverage of mental illness” but are now mad that there is more funding and insurance coverage of mental illness, what is it you really want? Where is this funding and insurance supposed to come from? What form is it supposed to take. Oh…I get it. You mean that when there have been mass shootings, you’ve complained that we do not need gun control, but we need more funding for mental illness. Got it. The jails…right. So, yeah, more mental health funding to stop people who might go on a shooting rampage—but anybody else can step off. Way to advocate, Tom.

Sullivan then writes, “I apologize to those who were hurt by the clip of my comments.” I think he might be apologizing to himself right here, as he seems to think he’s the victim in all of this, and the only one who was really hurt by the unfair “clip” of his comments—which he maintains is all out of context. It’s one of those classic ‘I’m sorry you got upset about what I did’ apologies. He doesn’t actually say he’s sorry for what he said—he says he’s sorry if you had a stupid reaction to it.

Mr. Sullivan then explains that he is just misunderstood: “I am a somewhat jaded person who thinks some people are gaming our system due to their greed.” Yes, plenty of people are out there pretending to have Bipolar Disorder because of their all-powerful greed–the kind of greed that drives them to want to live off of an $1100/month disability check. I can see how life as a corporate accountant and media figure has caused you to see the true evils in life and become hardened by them, Tom.

“But,” he goes on, returning to his sensitive side, “I also believe mental illness is a very serious problem that is ignored by too many.” Well, at least you aren’t ignoring it, Tom, like those “many” others.

Quick switch back to victim: “This episode shows how easy it is to distort a persons (sic) comments, especially when the subject is very important.” Wait, where’s the distortion, Tom? You do realize that there is a five-minute audio clip of you talking smack about people with Bipolar Disorder and mental health professionals, right on your web page, just slightly above your apology—don’t you?

Then, he brings the powerful close: “It will and has reinforced my commitment to making mental illness on a (sic) equal par with physical illnesses instead of the stigma it currently receives. Again, thank you for your email and your concern, Tom Sullivan.” Well, it’s a good thing Tom’s had his commitment reinforced, because in that five-minute clip there, it sounded a whole lot like he was super-supportive of stigmatizing people with mental illness—especially phony mental illnesses like Bipolar Disorder. And, really, could that sentence about stigma be any worse? It’s like somebody read over the rough draft and said—‘Not bad, just make sure you add in some bullshit about stigma and how mental illness is just as important as physical illness in there at the end,’ but Tom wasn’t quite sure how to properly use the word “stigma” in a sentence, and didn’t feel like taking the time to look it up.

In the end, Sullivan wants to be viewed as someone who is just the victim of vicious attacks, with his words taken out of context. Unfortunately, it’s hard to have much sympathy for someone claiming his words were taken out of context when, well, they weren’t, but also when he made no effort to provide any context for anything he said in the first place, such as by touching on the way Social Security disability operates, the different categories now used, and why those changes were made. The simplest explanation (although there are a wide range of factors) is that there has been an evolution in the way “disability” is viewed and understood—in terms of both physical and mental illnesses. And, in terms of Social Security disability, there have been changes in the ways statistics have been kept and various issues have been categorized.

To give some credit, there is support for Sullivan’s complaints that the number of disability claims for “mood disorders” is increasing substantially. However, that increase is not grossly out of proportion to the increase in overall numbers of disability cases, particularly when one considers that mood disorders such as Bipolar Disorder and various forms of Depressive Disorders are more widely understood today than they were 25 years ago (when Mr. Sullivan apparently thinks the mental health community, in cahoots with pharmaceutical companies, fabricated the idea of Bipolar Disorder as a way to make money).

So, as I said in an earlier piece about Sullivan’s original comments (which you can read here), we can either find legitimate ways to address issues like the funding of Social Security disability, and support those suffering from mental illness, or we can demonize them and…uh…let them…er…receive stigma like always. And now, at least we all know where Mr. Sullivan stands—right, Gina?

Sylvia Frumkin’s Place

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by JC Schildbach, LMHC

I’d venture a guess that many who enter the mental health field, as with any potentially dramatic profession all the way from police to executives, do so with visions informed by Hollywood. One of the main Hollywood portrayals of the mental health worker is is that of the therapist/psychiatrist as a well-compensated genius, ensconced in a plush office, treating the worried well or other “eccentric” or “neurotic” types, while constantly being admired by clients for one’s observational skill and ability to call forth ‘breakthrough’ moments. The other end of the spectrum is the heroic social worker who, through sheer tenacity, overcomes all the problems an impoverished neighborhood can throw at her, overcoming multi-generational patterns, and very recent traumas, to really, really make a difference in the lives of an entire community.

Many in the field are drawn to books by Yalom, or Rogers, or perhaps even some acolytes of Oprah, who tell us that just by listening and accepting our clients, or by throwing the right bit of tough-love advice a client’s way, true transformation will take place, and clients will make huge leaps forward, forever changing their lives for the better.

Susan Sheehan’s “Is There No Place on Earth for Me?” is perhaps the perfect antidote to the pie-in-the-sky visions of one’s brilliance and dedication making all the clinical difference in the world. It balances out the ideas about the wondrous gift of therapy with the reality of chronic and severe mental illness, and its resistance to ‘ah-ha moments’ and dramatic progress. It pushes past that “we don’t need no medications” mantra, which can, in fairness, apply to a lot of mental health issues.

“Is There No Place on Earth for Me?” was first published as a four part series in The New Yorker in 1981, then published as a book in 1982. For it, Sheehan won the Pulitzer Prize for General Non-Fiction in 1983. A new edition of the book was released roughly a year ago, including a new afterword by Sheehan. On reading about the re-issue in the online version of the New York Times in January of 2014, and having never read it before, I put it on my ‘to read’ list, and eventually checked out an old edition from the library.

Frumkin cover

The book, written from the perspective of a journalist, and not of a therapist trying to convince the readers of the efficacy of particular approaches to treatment, is involved in ways that few case studies can be. Sheehan spent over two years with Sylvia Frumkin (not her real name), a woman diagnosed with schizophrenia. Sheehan had a great deal of access not only to the information on Frumkin’s treatment and behavior during the period when Sheehan shadowed Frumkin, but also to family members and others, getting a great deal of background on Frumkin’s life prior to her diagnosis, and the progress and setbacks that took place before Sheehan had ever met her.

Having had numerous contacts with clients diagnosed with schizophrenia, or suffering from other forms of psychosis, most often from a distance, it took me a while to get through the book. That is, the kinds of delusions, rants, and flights from treatment that plague Frumkin and those trying to help her, and which Sheehan documents in detail, were familiar to me—of course, with Frumkin’s behaviors being particular to her own case. Still, it was like trying to read about many of the most frustrating aspects of work during one’s down time.

For the uninitiated, I imagine the book is much more compelling, rather than overly familiar, and thus, somewhat draining. In discussing “Is There No Place on Earth for Me?” with colleagues, I’ve most often likened it to Kafka’s “The Trial”—a book that is deliberately tedious in its depiction of a bureaucracy more intent on sustaining itself than serving any clear purpose—although, that comparison probably has much more to do with what I bring to the reading of Sheehan’s book than to what she has documented in such depth of detail. Also, I don’t think the mental health system—either now or at the time—is deliberately set up to be frustrating…it just frequently is, particularly for those most in need of help.

In addition to capturing the daily details of the behavior of a (this) client with schizophrenia, Sheehan also does a masterful job of explaining, simply and concisely, some fairly complicated legal, medical, and treatment-related concepts. For instance, Sheehan outlines the concept of “least restrictive” forms of treatment, both the bane and the beauty of our mental health system, which has been around since well before the current lack of options made it so completely mandatory.  In doing so, she answers that most familiar of questions about why we can’t “just lock up” people suffering from chronic forms of mental illness who can become rather taxing to a variety of public and private resources.

The most fascinating elements of Frumkin’s story to me, though, were the ‘side treatments’—pointless, and sometimes dangerous, programs that Sylvia was subjected to. Without going into a great deal of detail, the treatments ranged from moving in with a relative and his family who believed that all Frumkin needed was a good dose of Jesus and discipline to overcome her laziness and wicked ways, to a doctor who felt that manipulating the insulin levels of patients to extreme degrees could cure them of schizophrenia.

Ultimately, what works for Frumkin (or worked back around 1980) is what still works for clients today: a small number of medications that prove effective in treating schizophrenia, as well as (to greatly simplify things) a structured environment and supportive professionals. Unfortunately, said medications can lose their effectiveness over time, or the side effects can become increasingly detrimental to the clients. It is also quite common for clients to simply quit taking their medications, feeling them unnecessary or viewing them as the root cause of various forms of discomfort or other troubles in their lives. In addition, the structured environments can only be maintained for as long as clients are compliant with treatment, and as long as the treatment remains effective, and as long as funding and various programs allow. On top of that, anything from the restructuring of institutions, to changes in law and other policy, to the career changes of providers, to differences of opinion between providers and family members, can lead to new doctors and other providers making changes, sometimes rather arbitrarily, to a client’s medication regimen or support systems. In Frumkin’s case, alterations to her treatment and medications were made numerous times, in the most haphazard of fashions, often by doctors and other providers who seemed ignorant of her case history, or of how the medications work.

One might also note that this book was written back before the U.S., under President Ronald Reagan, decided that people with chronic mental illness enjoy the freedom that homelessness brings. So, Frumkin’s movements within the system are relatively easy in terms of her various forays into decompensation leading to fairly quick, and relatively long-term inpatient placements, with step-downs to semi-independent housing, and other supports that are much rarer today (and for most of the last three decades).

Ideally, Sheehan’s book would be taught in graduate schools, or maybe at earlier levels, by instructors who are familiar with the clinical aspects of schizophrenia; the current and historical treatments for it; and the current and historical state of affairs with regard to mental health facilities, available inpatient beds for clients with mental health issues, and legal and systemic complications to accessing those beds or other program options.

To be clear, it is necessary, as therapists, or in other capacities in the mental health field, to come equipped with a belief that we can make a difference. Without a bit of the dreamer in us, we would never head down this path to begin with.

But it is also necessary for providers at all levels to understand just what they are up against, particularly given that almost all providers in the mental health field will end up doing at least a round or two in the public mental health system–from practicums/internships to early jobs to entire careers–where the most challenging of clients often end up by default—frequently after being abandoned by families and other support systems, including insurance companies.

Frumkin’s family, as dysfunctional as they are, and as frequently detrimental to her treatment as they can be, at least hang in there to the extent that they can—which I imagine was at least somewhat less difficult when hospital beds and supported living options weren’t at such a premium as they are today. In the end, though, this isn’t a story of a family hanging together and triumphing over a terrible disease. It’s the story of a debilitating mental illness, and the toll it takes on the client, as well as those around her, and the wildly inconsistent efforts by a variety of people and systems to help her cope.

Welcome to Sylvia’s Place.

Honey Boo Boo Needs Some Real TLC, Not Abandonment

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by JC Schildbach, LMHC, de-commissioned ASOTP

Not quite a month ago, The Learning Channel (TLC) announced plans to drop production of its ‘reality’ show, Here Comes Honey Boo Boo, as well as shelving an entire season that has been completed, but not aired. The reason? “Mama June” Shannon was photographed out and about with her former beau, convicted sex offender Mark McDaniel. Even worse, a few days after the original story broke, a photo surfaced showing June, Mark, and Alana “Honey Boo Boo” Thompson together.

McDaniel was convicted of “aggravated child molestation” for sexual contact with Anna Marie Cardwell, who is June’s daughter, and Alana’s half-sister. McDaniel served a ten-year sentence for the molestation, having been released from prison in March.

Now, I’m not a big fan of Here Comes Honey Boo Boo.   I’ve seen occasional clips on other shows, and watched most of one episode when I came across it while flipping channels. But in that episode, I saw that the family was accepting of Alana’s uncle, who is gay, without making a big deal about it. And, despite my unease at the general weirdness of the child pageant circuit, the family members seemed to enjoy each other’s company. And then the show concluded with Honey Boo Boo climbing up on a chair and sticking her butt in the air to fart loudly, which, strangely enough, served as the lead-in to a very somber, ‘feed the children’ infomercial.

At any rate, speaking of the weirdness of the child pageant circuit, having seen a few episodes of Toddlers in Tiaras, the TLC show that spawned Honey Boo Boo’s spinoff, I am disturbed by what can only be described as the sexualization of little girls on that show. The contestants are small children who are essentially treated identically to adult beauty pageant contestants—made to wear too much makeup, with piled-up hairdos, wearing a variety of—I guess you’d call them revealing, although that sounds weird when talking about children—dresses and bathing suits, while performing routines involving dance moves that I pray the girls don’t understand the origins/meaning of.

I’ve had offender clients specifically mention Toddlers in Tiaras as a kind of ‘gateway’ form of visual stimulation leading to seeking out even more exploitative material. And, while such ‘gateway’ comments are often spoken with the intent to limit the personal responsibility of those clients—the whole ‘society is sexualizing young girls, what am I to do?’ complaint—it is somewhat difficult to view the show without thinking, ‘Wow—pedophiles must really enjoy this.’

So, while I could start shaming Mama June for putting her daughter in the beauty pageant circuit, or for taking up with a man who molested one of her daughters; instead it seems a better course in all of this would be for TLC to invest some more effort and money in the show, and maybe take it in some completely different directions—maybe even directions that would involve some actual learning.

Broken portrait of an exploited family unit--Anna Marie, Mama June, Honey Boo Boo, and Mark McDaniel.

Broken portrait of an exploited family unit–Anna Marie, Mama June, Honey Boo Boo, and Mark McDaniel.

That is to say, it’s very odd to have a show built on the highjinks of a family that is portrayed as a bunch of unsophisticated rubes chasing a weird dream, and then to turn around and cancel the show when the matriarch of the family does something that shows she really doesn’t understand what’s at stake in a particular situation. According to Anna Marie’s own statements to the media, June minimized McDaniel’s behavior, telling Anna Marie that McDaniel wasn’t all that dangerous because Anna Marie was McDaniel’s only victim.

Such a statement is a big red flag that Mama June just might be buying a whole lot of lies from McDaniels—the kind of lies that offenders tell all too frequently. ‘It was just the one time;’ ‘I was drunk;’ ‘It was a mistake;’ ‘The victim did X first;’ ‘I paid the price/did my time;’ ‘I won’t ever do that again;’ etc, etc.

I don’t know what kind of treatment McDaniel may or may not have received in prison. But unless McDaniel has developed some understanding of his own behaviors, and unless Mama June has been educated on exactly what McDaniel did, how he did it, how he justified it to himself, what kinds of things Mama June needs to look out for in McDaniel’s behavior (preferably coming from McDaniel’s own confession); and unless she’s been given instruction in what McDaniel’s behavior means for the safety of her other children, and how to reduce risk (risk can never fully be eliminated), then it’s a little hypocritical of TLC executives to cut her off, claiming that it is in the best interest of the safety of the children involved.

And just for context, here’s the statement issued by the network at the time of the show’s cancellation: “TLC has cancelled the series HERE COMES HONEY BOO BOO and ended all activities around the series, effective immediately. Supporting the health and welfare of these remarkable children is our only priority. TLC is faithfully committed to the children’s ongoing comfort and well-being.”

Great, TLC, but where’s the support? I’ve seen many mothers of victims continue on in relationship with the men who molested those women’s children. And a supportive and appropriate relationship with an adult partner can actually reduce risk for re-offense. However, that risk isn’t (generally speaking) reduced when the offender is allowed back around likely victims, particularly without the partner being fully informed as to the nature of the offender’s behavior, and how to provide adequate support for the offender and for other family members. But maybe TLC executives are just looking at this as another example of the stereotypes they’re comfortable promoting–of poor, Southern folk accepting child molestation as a routine part of life.

It is potentially extremely damaging for victims of molestation, like Anna Marie, to see their mothers return to relationship with the offender, or to, in any way, be given the impression that they are being treated as secondary to the perpetrator of sexual violence. It definitely sends some disturbing messages about who is being given priority, and where the concern of the mother lies. It is possible to mitigate that damage, but only with some very involved, professionally-guided therapy.

I don’t want to over-simplify things here, but a major reason for women to continue on in relationship with offenders is economic. I don’t have any idea if McDaniel has any real way of providing for June’s family, but since TLC just cut off the family’s current main source of income, they are increasing Mama June’s likely reliance on someone who can provide support—and at a time when the person June is in relationship with is an offender who is very much putting Honey Boo Boo—that “remarkable child”—at risk.

So, again, why not take the show in a new direction? A learning direction? I don’t mean to advocate for making an offender a reality TV star, but TLC could at least build in scenes to Honey Boo Boo’s show, or maybe a spinoff, that follow McDaniel through treatment, and through all of the difficulties he now faces as a convicted offender trying to rebuild a life outside of prison, in conjunction with Mama June’s exposure to McDaniel’s treatment process.  The audience could see scenes of June attending sessions with McDaniel—scenes of McDaniel explaining his ‘offense cycle’ to June, of McDaniel explaining his actual offense to June, of June going through a chaperone class where she learns just what limits need to be placed on McDaniel and his contact with June’s children.

And what about making sure Anna Marie’s okay? How about, instead of channeling any income to McDaniel, any money involved in a standard TLC reality-star fee, over and above the cost of his evaluation and treatment—funded by TLC—goes to Anna Marie to make sure she can get some ongoing treatment herself?  Perhaps let Anna Marie gain some economic benefit from the exploitation she’s already suffered? She’s had various media outlets contacting her to ask how she feels about the man who molested her being released from prison. How about making sure Anna Marie’s not being re-traumatized by all of this? After all, how many victims of molestation really want the molestation being made public, and then want to have to address it, with complete strangers, for the purposes of having it blasted out all over the airwaves and the Internet?

Of course, TLC doesn’t have to do anything in this case. Perhaps TLC executives were grateful that a scandal of this sort came around when Here Comes Honey Boo Boo was pulling ratings of less than half of its peak performance, just so they had a good excuse to cut their losses. Then again, TLC could really do some good in this case. TLC could truly support the “health and welfare” of their child stars. TLC could really help advance public discourse on offenders, offender treatment, and victim advocacy.

Or TLC could just leave Mama June, Honey Boo Boo, and the rest of the clan dangling—dangling over a cliff where falling means families torn apart and potential acts of child sexual abuse—and move on to whatever other ‘reality’ show goofballs America wants to laugh at, until ‘reality’ creeps in and undoes them as well—leaving TLC to cut its losses, abandon its ‘stars,’ and run.

 

Dropping Keys, Dropping Letters

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by Jonathan C. Schildbach, LMHC, waning ASOTP, reforming soul-eater

An eighth-season episode of The X-Files was built around a “soul-eater”—a person who could draw the disease out from others into his own body, eventually vomiting it out. The concept of the soul eater is based in various forms of folklore involving a range of ideas about curses and cures, and the ability of some to take away those things that most harm or most sustain a person. Unfortunately for this particular soul eater, the demands of those who knew of his powers began to overwhelm his ability to process and expel the disease. He existed in a perpetual state of deformity and misery.

I like the soul eater as a metaphor for the work done by many people in “the healing professions.” In this field, many of us work at building a skill set that allows us to help extract the mental and spiritual toxins in others. Ideally, those receiving help will find a way to vomit out the toxins themselves. Yet, such toxins are in no short supply, and many who are most in need of help thrive on a constant diet of disease coupled with a willingness to let others take on the burdens of that disease. It becomes far too easy for helpers to end up like the suffocating soul eater, awash in the illness of others.

In the professional parlance, we call all that business of being overwhelmed by the problems of others “secondary trauma.” There’s a tendency to assume that, as trained professionals, we are able to recognize and address our own forms of distress. But, like many people in positions of suffering, particularly those who are considered high-functioning, it is entirely too easy to soldier on without addressing our own needs. We know how to address all this, and yet we often don’t, or we often address it in an unhealthy fashion, assuming it will pass in time. We take on more than we can handle, and think nothing of it. Whatever doesn’t kill me makes me more convinced I’m strong enough to take it.

Hey--eat any good diseases lately?

Hey–eat any good diseases lately?  The X-Files’ soul eater.

I bring this all up by way of saying that I’m in the midst of a career shift—not out of the helping professions, but into some different channels in the same field.

In particular, last night I dropped off the keys to the office where I’ve been serving as an ASOTP for the last year-and-a-half, at least temporarily distancing myself from a particular portion of the field that I have been involved with for over seven-and-a-half years—the treatment of sex offenders.

The change was forced by way of making a shift in my full-time employment in crisis services. As I write this, I am deliberately allowing myself only some small bit of awareness of the insanity of my professional life over the past several years. Yes, I have been working full time in crisis services, while also working anywhere from zero to ten hours per week with sex offenders. Such arrangements are not unusual in the helping professions—where we are pushed to learn our craft in rigorous, unpaid positions, while also attending school and working a paid job just to stay afloat. The habits of overextension established while in graduate school can extend out into professional life, and feel totally normal, even as we are pushed toward deformity and misery.

Currently in a break from a years-long pattern of toxic soul-eating, and ready engagement with secondary trauma, I realize I’ve become numb to plenty of very bizarre things. Running plethysmography assessments, I can sit through audio scenarios of sexually violent behaviors, paying them as little attention as if they were overplayed Top 40 hits from yesteryear piped over a grocery store or dentist office sound system. I’ve become entirely too comfortable asking people about their masturbation habits, and pressing them when I think they’re lying (only in the course of assessments, of course—well, mostly). Fortunately, I haven’t become so numb that I’ve lost all awareness of the twists and turns of my mind, although I frequently find myself stumbling in otherwise polite conversations when frighteningly dark and vulgar jokes spring to mind—an entirely appropriate coping mechanism in certain circumstances and with particular people—but definitely nothing you want to spring on friends of friends who don’t even have the most limited of contexts for understanding where such thoughts could come from.

And all of that was on top of 40-plus hours per week of run-of-the-mill crisis intervention, suicide prevention, utilization management…

So, if I want to mix in some metaphors, I can say I’m now a ronin—a samurai without a master—an ASOTP without a CSOTP—which, really just makes me a guy with an expensive piece of paper that says I’m an ASOTP until next September, but which conveys no real ability to treat any offenders unless and until I take on another master/CSOTP. Weighing the massive number of hours I still have to accrue across assessment, face-to-face treatment, and supervision, in order to get the full credential myself, I think this may be it for my involvement in offender-land.

I’ve dropped off the keys; and, with no further action, the letters, too, will drop—as will the level of…expulsion required of me on a regular basis. Sure, I’ll still do what I can to draw out various forms of mental/spiritual disease when that is required of m—but hopefully now in more manageable, fun-sized portions.

 

 

Why John Grisham Wasn’t All Wrong about His Child-Porn-Viewing Friend

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by J.C. Schildbach, LMHC, ASOTP

Way back in mid-October, an eon ago in Internet time, an article and partial interview was published in The Telegraph, wherein John Grisham decried the unfair treatment an old law school buddy of his had received at the hands of the overzealous legal system. After all, Grisham argued, his friend had only looked at some child porn that was really just technically child porn, because it involved 16-year-olds who looked 30, or some such rot.

You can read that piece here: Grisham on What Makes a Real Pedophile

Jessica Goldstein put together a piece for Think Progress that explains a whole lot about what was wrong with what John Grisham said, from the perspective of why maybe, just maybe, seeking out pictures of 16-year-old girls, even if they look mature, might be problematic. It is available here: Goldstein Explains Why Grisham’s Friend Shouldn’t View Child Porn

I would add to Goldstein’s piece that, developmentally speaking, if you think 16-year-olds are capable of making rational decisions about being ‘porn stars’ then, well, you’re wrong. Look into brain development, and when people actually become capable of making decisions about the long-term consequences of their current behaviors. Add to that the problem that sixteen-year-olds, legally speaking, can’t enter into ANY contracts (even if they can legally consent to sex) and, well, it’s pretty cut and dry that 16-year-olds (and minors of all ages) in pornography are just plain being exploited, as well as frequently being abused, drugged, threatened, or otherwise coerced.

In the time since the publication of the original piece, Grisham’s friend has come out to say that his treatment in the legal system was not unfair, that he deserved what he got, and that he should have never done the things he did. It also came out that, unlike what Grisham said, his friend did not just accidentally look at some 16-year-olds who looked like adults, but that he was actively participating in the exchange of child pornography, including files involving children as young as 12 (who presumably did not look like they were 30).

Much has been made about why Grisham would have given such a distorted view of what happened with his friend. My guess is that he didn’t know exactly what happened, and that he was going off of an explanation his friend had probably given several times to family and friends when his legal troubles started. That explanation probably went very much like Grisham explained it: ‘I was drunk. I was unhappy. I clicked on a link that I didn’t realize was child pornography.’

Not surprisingly, when friends and family of an offender first hear of allegations of any kind of sexual misconduct, particularly when it falls into the realm of sexual misconduct involving children, whether that is “hands-on” contact or viewing child pornography, the default position is to not want to believe it. Likewise, the default position for the person engaging in the offending behavior is to not want to admit to it.

When offenders are “found out,” there are several stages that they often go through on the way to actually being able to own up to their actions. Very roughly speaking, those usually look like: 1) Nothing happened; 2) Something happened but it’s not nearly as bad as they say it is; 3) It was an accident/the victim did x first; 4) Something happened that is worse than I originally said, but really not as bad as they are saying; 5) Really, I have a pretty extensive history of this kind of behavior.

The offender, and those closest to the offender, simply do not want to believe that what happened actually happened, and often cling to that as long as possible, and often to the detriment of the victims of sexual abuse.

Grisham's factual failure may have led to a bit of a headache for him

Grisham’s factual failure may have led to a bit of a headache for him

So, I’ve highlighted a few of the things that Grisham said that were clearly wrong and stupid when it comes to offenders. So, what did he get right?

Grisham’s words were rather careless. Citing old white guys in prison as a big problem is not really the best way to go about making a case. Old white guys in prison is about as big a problem as young white guys not being able to get into college because of Affirmative Action. In other words, relative to other systemic problems, it’s nothing.

But something that is pretty limited is the threat that old guys (regardless of ethnicity) represent to the community at large. In the case of old guys looking at child porn, the threat can be further reduced by eliminating their Internet access and by eliminating any contact they are allowed with children.

But how do such limitations get put in place or enforced? In several states there are “sentencing alternatives” for sex offenders (and for people who have committed various other types of violations), particularly those who are not considered “violent offenders.” And, I realize the language is odd, but “violent offenders” are those kinds of offenders who, say, go after kids they don’t know or engage in physical violence beyond just the sexual acts they inflict on their victims, as opposed to “grooming” children that they are in regular contact with. Groomers, or non-violent offenders, tend to work slowly and patiently to get what they want from their victims. Violent offenders smash and grab and are a small minority of overall offenders.

At any rate, from what has come out, Grisham’s friend had no hands-on victims. And really, what’s the bigger punishment? Putting him in prison for three or more years, and then letting him out, all done, all paid for; or putting him in jail for less than a year, and then putting him out to go about rebuilding his shattered life, while under strict supervision and treatment guidelines?   Once on the outs, he has to get a job (probably not a high-paying attorney job as I’m guessing that door has probably closed), pay for whatever housing is available to him—which will likely be severely limited, be under the supervision of a Community Corrections Officer (CCO), and have to go to/pay for outpatient sex offender treatment for the next several years, potentially for the rest of his life.

At any rate, the sentencing alternatives cost taxpayers a lot less money, are just as effective from a treatment perspective. And, for the vindictive among you, such sentencing alternatives are plenty demeaning—loss of status and being under a harsh set of rules, with the threat of being bounced back to prison for violating those rules, is not something anybody wants to live with. And for those offenders who manage to maintain any kind of support network, or rebuild a new one, they get to go through the rather unpleasant process of explaining their offenses again and again, just so that they can build a group of chaperones, or at least informed contacts.

So, in a way, Grisham was right that people like his friend don’t need to be clogging up the prison system, just like Grisham is right that non-violent drug offenders don’t need to be clogging up the prison system. Sure, there need to be consequences, but there are more and less effective consequences, and more and less expensive consequences, both to offenders and to the public at large.

But since laws are generally written by politicians, and not for the purpose of doing what is most effective, but for doing what is most politically expedient/most popular, things like sentencing alternatives are created and used less and less frequently. No matter how much sense such policies make, or how cost-effective they are, lawmakers don’t want to be labeled as the ones who let sex offenders, even offenders with no hands-on victims, even offenders who are made to pay severe penalties other than prison time, out into the community.

But such short-sightedness means that more offenders actually get out of prison somewhere down the road, and with little or no supervision, and no organized checks on their behavior.  Grisham is right that there are better places for his friend to be, even if he was completely wrong about what his friend did, and what it meant.