This Being Human


– by Lee Smith, Ph.D.

Spoiler alert: Psychiatric diagnosis is deeply problematic, in part because the cause of symptoms is difficult to find and to test for. But there’s more…

In a scene from the television series, Mad Men, which is about the people of a 1960’s Madison Avenue advertising company, a well-to-do woman shares with a shrug the upshot of her consultation with a psychiatrist, “I got my diagnosis: He says I’m bored”. There are more serious afflictions but the key here is the shrug.

Our affluent and safe society has the benefit of the best health care in the world. And yet we are more depressed and anxious than just about any other society. In Canada, after cardiovascular drugs, psychotherapeutic drugs are the most frequently dispensed, and depression and anxiety are the fourth and fifth most common reasons for physician visits.

Quite rightly, we consult a physician or a psychologist when we’re suffering psychological symptoms. We want to know what’s going on and to get help. And many people already have ideas about what to call their symptoms thanks to education from the media, including commercials.

For alot of people a diagnosis of depression or anxiety or ADHD becomes a completed step. But what has really been achieved?

Our brains love to name stuff and a name can feel like the same thing as an understanding. Even more, once we feel like we have an understanding, we tend to stop inquiring. And so, a psychiatric diagnosis can really become an illusion that we know and understand, just as so much of our thinking builds versions of our life that can be mistaken.

Consider this: In this sense of a diagnosis being a label and a concept, we might see that we ‘diagnose’ ourselves and others all the time. When we say “I’m bored”, “He’s an idiot”, “No one cares about me”, “I’m unhappy in my marriage”, we’re diagnosing. The problem again is just letting this concept or this label stand as if it’s adequate and complete.

The idea here is that when we obtain a diagnostic label, it activates this tendency of mind to embrace or get stuck on the label and to not look further.

Our reliance on medication and on diagnosis may lead to passivity and a degree of retreat from looking at our lives. We go to the doctor for something to make it better. The drug companies love it and it’s easier work for our doctors, but the evidence is that long-term resolution is infrequently achieved. We’re not a very happy culture. We’re the richest in the world but we’re suffering richly.

There is no adequate or equivalent substitute for paying honest and open attention to our lives. On receiving a diagnosis we may stop paying attention to the immediate and remote experiences that our mind and body have ingested or are ingesting still which could be a crucial part of our problem. We may stop paying attention, we may stop looking and knowing about our lives more deeply and how we are in relation to the things we’ve experienced. Our natural abilities to sort out our lives shut down if we don’t let our experiences ‘come on line’. Maybe sometimes that’s why we want some diagnosis, so that we can have the illusion of knowing and to then stop looking, and just shrug.

Being given a medication may have the same effect. It becomes about the drug working and how the drug is doing, and we go on vacation from ourselves.

So let’s say it again – we have to pay attention to our lives. And if we have children, we have to pay careful and honest attention to their lives, too.

When We Suffer Abusive Treatment

– by Lee Smith, Ph.D.

Dr. David Lykken of the University of Minnesota says that the evidence tells us “that most of the 1.4 million American men currently languishing in prison would have grown up to be tax-paying citizens and acceptable neighbours if they had been switched in the nursery and sent home with a mature, law-abiding married couple rather than with their biological parent or parents”. By “mature” he’s referring to parents who love and care for and protect their children.

The complex harm to psychological development caused by child abuse and neglect sets a course for a big range of big problems – relationship instability, violence, addictions, physical and mental health problems, you name it.

The neglect and abuse of children is a product of generations of conditioning. If you want to shine a light on why a parent may be rarely or persistently abusive or neglectful, you’ll often glimpse the next layer of insight by looking at the parent’s parents, and then at their parents.

When we, as children, suffer abusive treatment and a life that feels dangerous we all reflexively use what we have to protect ourselves and to just survive. Leaving home or calling a responsive grown up is not always an option that a distressed child can muster. Kids are often left to their own meagre adaptations to manage their life.

One protective adaptation is for kids to pay careful and ongoing attention to the abusive parent. Kids can then shift their own behaviour in order to modulate the state of mind of the distressed parent. By “being good” somehow, some control and safety may be had. And the felt reason is to be safe, to be accepted, if not loved.

But vigilance is not just something someone does now and then – it becomes a way of living born of the need to be safe. So paying rigid attention to the Other becomes a deeply ingrained pattern for distressed kids, a habit that we don’t even know we’re strengthening through repetition. It’s automatic. And we grow up that way.

To not pay attention to the Other but to pay attention to yourself can be dangerous because when the guard gets let down you might be open to a new kind of attack. Scolding “What’s wrong with you?” would do the job, but sharper sticks are easily at hand. The internal reaction to one’s own emotion then becomes complicated instead of being one of acceptance. Kids may be ‘taught’ to feel ashamed of their own emotions, and so there can develop an internal sense that our own emotion is wrong, bad, awful, disgusting.

And so yet another way we commonly protect ourselves is by keeping our emotion hidden even from ourselves. Children experiencing frequent fear may use and over use their natural ability to space out, slipping away from awareness to nothingness. No feeling, no problem. An emergent problem here is that children don’t learn about their emotions and how to tolerate, regulate and know them, a problem which can extend through adulthood.

These and so many other ways of protecting ourselves and trying to get needs met become an automatic way of life that we carry on into adulthood. The emotional infrastructure from childhood results in the understandable tendency to live our adult life with other people in ways that are similar to our developmental history.

Our development doesn’t end with childhood. Hopefully those unfortunate early relationships will be supplemented by the loving aunt or teacher or friend’s mother, or by later healthy relationships that help to undo the earlier abusive conditioning. It is indeed never too late to face and to work on your life.


– by Lee Smith, Ph.D.

Lights! Camera! Action!

The bright beacon behind us delivers the images to the screen. We know that what we’re seeing is something that was recorded to film some while ago. But here it is now, right there, and we squirm or cry or cheer or boo.

Good movies are compelling because they pull us in and we react as if to reality.

OK, cue the psychologist.

Our own life, our own history, which was also recorded some time ago, is something that we project into new moments all the time. But because the projector is invisible to us and because we live in the theatre of life all the time, the actual projection of our past onto the present isn’t noticed during our usual, day-to-day activity. Let’s look at some examples.

Do you ever think you know what other people are thinking? Can we ever really know what’s on someone else’s mind? It seems to me that we have a hard enough time knowing our own thoughts and motives. ‘Knowing’ what someone else is thinking is really our own thinking being projected on to someone else, and we then laugh or cringe or judge.

Some people react to mishaps in traffic, such as a bad lane change, with anger, feeling like it’s a personal inconsideration. It takes a mindful moment to realize that people just make mistakes and that our anger is about our mind, not someone else’s evil intent. A similar, scary scene is of men glaring at each other in bars, challenging “What’s your problem?” if someone looks at them – it’s like their past abuser needs to be confronted in each moment.

We assign motives and make attributions about things all the time. These come from our mind, as we construct our reality. Parents may react to what their teen or even their toddler does as if their child is defying them in some profound way, when the child may be simply responding to his own wishes to be with friends or just exploring her world.

Is love at first sight not a full on projection, perhaps keeping us from taking a second look? Isn’t dread of future disasters, a.k.a. anxiety, a projecting out in time of our past pain?

Here’s some hard science: A functional MRI brain imaging study in the 2010 journal Emotion found that the sadness we feel watching a sad movie clip (think Terms of Endearment) is accompanied by activation in “cortical areas that are characteristic of cognitive elaboration, increased self-focus, and ruminative problem solving that would be typical of reappraisal processes”. Translation: We relate to the movie with what we know about ourselves. What’s more, another group of subjects who had completed a Mindfulness-Based Stress Reduction course showed much less of that “It’s About Me” cortical activation, although they felt just as sad and even read their body signals of sadness more vividly.

I have no doubt that it’s healthiest for us to take a more discerning role in our life, perhaps as the director (if you’re not too tired of this metaphor by now). Paying attention helps us to keep that boundary between us and the rest of life, and to better see what’s actually going on.

When you’ve been watching a scary movie, have you noticed yourself pulling out of the movie from time to time in order to calm down your fear, reminding yourself that the film isn’t real – “It’s just a movie!” We manage our fear with mindful awareness, and then laugh at how we get pulled in. As Yogi Berra said, “You can observe a lot just by watching”, and if we watch ourselves we’ll find a lot to laugh about.

Post-Traumatic Stress Disorder

– by Lee Smith, Ph.D.

Take a deep breath…

The profoundly dirty secret came out recently that upwards of 1000 U.S. Veterans attempt suicide every month. Post-Traumatic Stress Disorder (PTSD) and inadequate help are frequently a part of their misery. This tidy label, PTSD, references the horrendous human burden and infinite complication caused by witnessing and suffering the worst depravities on the surface of our planet – not only in war but at home, school, work.

The forms of trauma are as varied as life itself, including natural disasters through to interpersonal assaults. Physical, sexual, emotional and verbal abuse, accidents and injury, sudden loss, bullying, harassment, betrayal, rape, genocide, terrorism, war – it’s quite a list. Age, severity, frequency, history and variety of traumatic exposure, and interpersonal complexities all matter. Falling down the stairs is far more traumatic if you were pushed. Some victims marinade in abuse.

And much more happens psychologically in the injury from trauma than some recording of the event itself. The fact is, trauma may lead to a whole range of adjustment problems affecting our behaviour, emotions, thinking, relationships, physical health and life-course. Because everything is always unique about trauma, in that each unique person with their own unique history experiences some unique trauma in their own unique way, the impacts are personal and highly variable. Nonetheless, there do exist general similarities across sufferers.

The tidy list of PTSD symptoms includes (a) unwanted memories of the trauma popping up anytime, (b) our bodies leaping into stress reactions and living lodged in emergency mode, and (c) avoiding anything that might cause (a) or (b) to happen, including our own memories. And life is clouded with uneasiness, all the time. Even when the mind is asleep traumatic memories commandeer our dreaming and physiology. Trauma can relocate your mind and body to a world of felt threat, emergency and despair.

Our recall of our life is most typically an uncomplicated thing. Watch as you answer this: What did you have for breakfast this morning? You’ll probably notice that you had a feeling of recalling, and that what you recalled included images and details about which you could talk for some time. These kinds of autobiographical memories are also tagged by the mind-brain with a sense of person, place and time. No one could convince you that that breakfast actually happened yesterday or at some other location.

In contrast, emotional or traumatic memories are felt and relived more than recalled.

Let’s imagine taking a veteran of, say, the Vietnam war with us for a summer hike in Algonquin Park. What might our friend experience and do? He might just freak out in response to the dense foliage, the lack of sight lines, the felt sense of mortal vulnerability from possible traps on the trail and threats in the greenery. The experienced threat doesn’t match the ‘real’ risks in the park, but instead reflect the emotional memories that flood in from another time and place, inappropriately.

Unhealed trauma means that the mental tags for place and time are unborn. The neurobiological underpinnings of healing ultimately place trauma in our past, to great relief.

Healing trauma is complicated in part because of the immediate bind between undesirable alternatives. It is our tendency to avoid unpleasant things, which include terrifying memories. I like the metaphor of dealing with slivers. Avoidance, just leaving the slivers (horrible memories) in your arm alone and wrapping them up in dressings (avoiding any reminders), perhaps with some nice local anaesthetic like xylocaine (beer, doobies), gives immediate relief. After a while of one-armed living, punctuated by explosions of pain should the slivers get bumped (reminded), life lectures us that the only wise course is to have the slivers out (to face the memories).

Our incredibly associative mind-brain is a medium for the subtlest of triggers for traumatic memories, jumpy-startle and threat-based anger. Every moment can be seen through a lens of dread, with the threat feeling as real as real can get. And it’s so subtle and so unconscious.

Trauma victims may be touched by literally hundreds of thoughts and things each day that prick a memory, sending the mind spinning, the body bolting and life to the crapper.

I was recently talking with a Veteran of many tours, including Bosnia, and his wife about PTSD and these qualities of emotional memory. His wife then connected how he was unduly upset by his present-day neighbour’s unkempt lawn with the once mentioned threat of hidden landmines on tour. Bingo! When our mind connects these dots, relief follows because the connections are now seen, their origins located in time and subject to management.

Unfortunately, we don’t have any anaesthetics for emotional pain. Skillful courage and skillful support and skillful help to face and open up to past trauma are the right ingredients to heal trauma’s injuries. Talk about easier said than done! But suicide and the many other forms of avoidance are not the way.

Making Decisions

– by Lee Smith, Ph.D.

Many have said that life is about making decisions. Of course, if we are each the master of our own ship, we would chose our own course in life deliberately and wisely, giving our choices the care that they deserve. After all, it is our very life that we’re tending and we all want what’s best for us.

But how do we really go about making choices in our life?

We know that we’re much more skilled in making decisions when we have good existing knowledge. Also, less complicated decisions benefit from conscious deliberation more than complex ones. Decisions made under stress more often take less or too much time and deliberation, using too little or too much of the information at hand.

Nobel winner Daniel Kahneman and others have amassed a big bag of evidence that wags a finger at us, showing that we humans make even simple decisions illogically, emotionally and from the muck of our biases and idiosyncratic conditioning.

There’s little question that the past conditions of our life, the repetition of our ways of seeing and reacting, and the present conditions in our life influence our intuitive judgment and Malcolm Gladwell’s rapid cognition.

No one would argue that we steer a premeditated course toward any of the many ruinous places that seem to outnumber the ‘happily-ever-after’ ones. Instead, we may be pulled like a space-station by the steady gravity of invisible forces into lower and lower orbits around trouble. Another way to look at how the illusion of deciding about the directions in our life develops is to consider a domino of reactions, rippling forward over the moments.

Who in their right mind would have an affair, cheat the law, hurt loved ones, court addictions, embrace hobbling debt or veer toward pain. Well, rather quite a few of us. Actions often precede awareness, and our actions can be doozies. Although we might feel confident, this confidence might be just a feeling of mastery that precedes seeing the real situation accurately.

If we stop and review what guidance we have had in learning about making decisions, for many of us the education has been meagre. For the majority of us, many major life ‘decisions’ seem to be less a matter of clear deliberation under the sun of brave honesty and thorough review of the issues at hand. While reason and logic may make cameos while we navigate choices, in the company of some amount of conscious agonizing, the reality is that much of our unconscious nature acts as our guide to choices that determine the eventual landmarks of our lives.

The forks in the road are more often navigated by processes outside of our awareness. We may be like passengers looking out the window at aware moments, exclaiming about the dangers or that we like what we see, yet submitting to the general course set by some unseen driver. Maybe that’s why blaming someone else can be so easy.

When we meet choices and crossroads, sometimes doing nothing for a while may be our best course of (non)action. You could try that with one of the decisions that’s stalking you these days. When we take some time we may become acquainted with the underlying motives, unmet needs or emotional imperatives that highjack choice. Distinguish between wants and needs. Filter out irrelevant and distracting issues. Look in the mirror to discern whether some choice reflects an aversion to some discomfort or pain that we’re better off to face and know more clearly. Boredom, anger, insecurity, ego, feelings of entitlement and fantasy can push up impulsive ‘solutions’ like mushrooms from old soil – not all of them edible, if you know what I mean.