Ego and other possibilities

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The term “ego” is an ancient one, with Latin roots. It simply means “I” or “Self.” Its first known use in English was in the late 1700s. Psychologists love to argue about whether there actually is an “I” in the sense of predictable personality traits, or whether at any given time, our behaviors and moods are the result of ingesting food, drugs, and alcohol, exercise, responding to the expectations of others, the amount of sunlight in a given day, how much love we’ve soaked in, the amount of sleep we’ve managed to get, and maybe the cosmic forces at work on us.

Of course, a related meaning of ego has to do with our personal valuation of this “I” that may or may not define us. Sometimes, we are more certain of ourselves, our internal integrity, our worth, and our motivations than other times. And of course, for reasons still being debated, some of us vastly, vastly, vastly over-estimate our worth to the world and believe we are entitled to unlimited resources and praise. Why are some people far too humble and others sickeningly prideful?

Though Dr. Bossypants is not Buddhist, she believes Buddhists possess significant wisdom. As she understands it, the Buddhists believe that this “ego” or sense of separate individuality gets in our way of recognizing how artificial the boundaries between apparent “individuals” are. If we had less attachment to ego, we could more clearly see the unity, the connection, the oneness of all the pieces and parts of ourselves and our fellow beings, our earth, our galaxy, and even the time-space continuum.

It is indeed jarring to consider ourselves as one with all living beings, because this would include our current leadership, those aspiring to leadership, our alcoholic uncle, and even terrorists who blow themselves and others to smithereens. Most of us consider it creepy or stupid to seek even a tiny corner of common ground with these fellow human beings who act so abhorrently.

At this juncture, Dr. Bossypants must confess she is about to make claims that can’t be fully substantiated. But as far as it can be studied, it does not appear that the infliction of pain, hatred, deprivation, or even death is effective in changing human behavior for the better. Oh yes, we can change human behavior with such actions, but the change is, at best, temporary compliance, with enhanced motivation for later revenge.

It requires intelligence, tenacity, self-control, creativity, and great strength of character to find common ground with people we refer to as evil. These same attributes, plus wisely-used resources, are necessary to contain, reroute, and/or defeat the spread of destructive behavior. Research suggests that violence begets violence. Dr. Bossypants readily admits that this totally sucks because revenge feels good whereas the application of containment and compassion are tedious, slow, and even dangerous (in the short run).

But the real, long-term dangers are far worse: Ever-deadlier weapons, shriveled empathy, us/them dehumanizing rationalizations, bigger prisons, less education, hungry, abused, or unwanted children, and the increasingly shrill declarations of US FIRST. It just doesn’t work that way, dear readers. The ways we treat each other—including every single “other”—are the building blocks of the future. Just as violence will engender more violence, ultimately, kindness will bring forth more kindness. Humans appear to be uniquely able to make corrective choices. Dr. Bossypants is rooting for us all. With courage, we can choose some better paths.

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More thoughts on trauma

045 (2)In our continued considerations of trauma and the costs of trauma to human development and functioning, Dr. Bossypants came across a horrifyingly illustrative example, recently published in the New Yorker. http://www.newyorker.com/magazine/2017/04/03/the-trauma-of-facing-deportation. It has to do with childhood trauma and the extreme physical and psychological costs of such trauma. It also demonstrates the role culture plays how pain and terror are expressed.

The mind is a most amazing expression of life. Dr. Bossypants uses the term “mind” rather than “brain” because some consider the brain a seething mass of neurons, electrical impulses, neurotransmitters, and gray matter—a complex but eventually unravel-able mystery—whereas in Dr. Bossypants’s lexicon, the mind encompasses consciousness and something beyond the sum of the parts of the brain. The mind goes beyond nurture or nature, biology, rewards, or punishments. Victor Frankl said, “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” Dr. Bossypants might add, “In our response lies our survival.” Regardless of your own leanings, dear reader, at present what we know is that this mind/brain organ adapts, acts, and reacts. It learns and then makes changes accordingly. For the most part, it seeks to survive, but as in the article noted above, sometimes, it assess the hopelessness of a situation and begins to shut down.

The question Dr. Bossypants wants to raise is this: Why do humans hurt each other? Some argue that males hurt each other to show dominance and thus attract mating partners. Dr. Bossypants hastens to note that there is ample evidence this is not necessarily the case.

Is it fear that causes us to hurt each other? Deep down inside, are we so afraid of being hurt that we hurt others so they can’t hurt us? Or is it fear of deprivation, leading us to hurt others for the sake of accumulation, which then becomes greed?

Or expediency? The threat of pain, or pain itself, changes behavior temporarily, but it has a lot of psychological collateral damage. When big people hurt little people, or crowds of people hurt one person, we usually call that bullying. And we generally don’t approve. We’ve come to realize that such bullying causes a lot of damage to the one bullied.

Is it pleasure that causes us to hurt each other? Sadism exists; those who are sadistic enjoy causing pain. How did that twist come to be in that psyche? It doesn’t seem very adaptive, or loving, or helpful…could it have manifested due to early childhood trauma? Could it lie quietly in our cultural narrative, increasingly brought to the surface by media and war? Does it somehow come back to fear?

The sad truth is that Dr. Bossypants does not know the answer to this basic question, and believes that perhaps, no one else does either. In fact, there may be a multiplicity of answers. What is known is that inflicting pain on others, either bodily or psychologically, ultimately does not pay off very well. In the short run, bullies might get the lunch money, but in the long run, Dr. Bossypants suspects that the lunch money will not make the bully happy, and such actions cost the community and the victims a great deal more than the lunch money.

What Dr. Bossypants does know is that humans have choices. We can evolve beyond hurting each other, whether on the playground, the street corner, or the battlefield. Nonviolence takes great courage and extraordinary intelligence. It takes self-restraint and self-sacrifice. It is noble and rare. It begins at home, in the refusal to hurt each other. Potentially, it can extend to a global way of being. Yes, Dr. Bossypants may be guilty of extreme optimism, but no, she hasn’t been smoking anything. And frankly, dear readers, nonviolence will turn out to be a far better choice than the annihilation of our species.

Trauma–Not good.

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Another fascinating mini-series by Dr. Bossypants is about to begin. Que: Dancing in the streets.

In upcoming blogs, we’ll examine an important and ubiquitous part of being human—stress and trauma. Dr. Bossypants believes that we are in a most precarious position in human history. Sure, we’ve always had wars, violence, sexual abuse, psychopaths, and natural disasters to deal with. Some of our fellow humans have these things for breakfast every day. This does not mean we should normalize suffering, nor any of these precipitators of suffering. In fact, it is time we get serious about eliminating sources of suffering and trauma.

True, we’ve always had war, and killing. But we haven’t always had nuclear weapons, nor have we had the glorious but potentially deadly Internet, nor the other technologies and forms of travel now readily available. Methinks we had better grow up fast here people. Fast indeed. The devastating degradation or complete annihilation of the planet and humans dwelling upon it is in play.

So we begin by examining responses to trauma:

Psychologists have a checkered history when it comes to assessing and addressing the effects of stress and trauma on human functioning. Dr. Bossypants has had significant professional exposure to these issues and, to no one’s surprise, strong beliefs as well.

Defining trauma is difficult and fraught with political and financial motivations that, when examined, are sickening. We, people and governments alike, want to pretend that trauma doesn’t exist, or that inflicting it has no cost.

The word itself comes from a Greek word that means “wound.” To be human is to wound and be wounded. But to be human is to also have choices, and assess consequences. We want what we want, and, tragically, we don’t want to be told that what we want might hurt others, or even cause long-term devastation.

For instance, though some of us may be loathe to bring him up, we must note that Sigmund Freud initially recognized and wrote about the tremendous wounds inflicted on women who were sexually abused. The (white, male, privileged) scorn heaped upon him for these astute observations precipitated a breakdown of sorts, and a recanting of his findings. For this, and many other wrong-headed actions and notions, Dr. Bossypants is not a big fan of Freud.

We will discuss the ubiquitous occurrences of sexual assault in later posts. We only note it here to say that humans are quite resistant to admitting the costs of trauma. Dr. Bossypants hopes to hammer this home in upcoming blogs. But for now, let’s move to the cheery subject of war and related forms of domination.

War is a common preoccupation of those who’ve ascended to power in human communities. It has, until recently, required boots on the ground. Boots with real human feet in them, and real deadly weapons strapped across their real, human hearts. The act of killing a fellow human being, or having a fellow human being try to kill you is traumatic. Period. It is not a sign of weakness or inadequacy to be traumatized by killing. In fact, if killing another human being is not traumatic for the one who kills, then something is wrong. We do not want to pathologize tender, caring, emotionally-mature human beings. Those who kill without pain and remorse are the aberrations of our species, and they need help and/or containment.

Dr. Bossypants isn’t being clear, here’s a summary. For the psychologically healthy soldier, war (of all sorts) is traumatic. This does not mean that that all soldiers will develop post-traumatic stress disorder, but many will. Rightly so. It is a terrible thing to kill other human beings and not feel a thing, even though we have many movies and television shows that would have us believe otherwise. For the general health and evolutionary development of our species, war is to be avoided. We need to go upstream.

In the USA, we are wildly privileged, wealthy, well-fed, lovely people. We need to win hearts and minds by being wise, generous, involved, honest, and fair. We need to embrace liberty and compassion for all, knowing we will get hatred in return for some time to come—there are many, many toxins that stay in the psyche for generations after war, violence, starvation, rape, theft, and brutality have been visited upon a community. But here’s the truth: Violence begets violence. Harsh judgment begets harsh judgment. Selfishness and greed beget selfishness and greed. We will harvest (or be harvested) by what we sow. Without significant healing and maturity, this is a psychological truth.

Therefore, we have to get smarter, kinder, and more generous. This is difficult, because we, too, have been traumatized. We are frightened and have become selfish—even greedy. But this is what Dr. Bossypants believes: We can acknowledge our pain, our own failings, and our woundedness. We can find the moral fiber to choose something besides endless repetitions of human mistakes. We need to open our borders intelligently, feed hungry people creatively, honor other people’s needs and beliefs, and do our best to contain the violence that is simmering near the boiling point on this beautiful planet. Otherwise, I think it will not be long before the planet will be rid of us, and get to heal itself without the pesky human beings now dwelling here.

 

 

 

 

Bossiness on Healthcare

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A roving reporter chanced upon Dr. Bossypants and did a quick interview for our edification.

Q:        For our listening audience, could you tell us by what authority does Dr. Bossypants issue her edicts?

A:       Yes. Here is an abbreviated list:

  • Some people like her.
  • She has a two masters degrees and a doctorate from an accredited institution of higher learning.
  • She was a professor for 24 years, and had the good sense to retire in a timely way.
  • She’s stayed alive and in shape for many decades, produced lovely children, marrying only twice, with the second attempt lasting over thirty years and counting.
  • She has faced a deadly disease.
  • She grows a fine garden and eats healthy food.
  • She thinks she knows what’s best, but she tries to be reasonable.
  • And, as mentioned above, some people like her.

Q:        What does Dr. Bossypants have for us to consider today?

A:        The topic for today, dear readers, is greed, government, and healthcare.

Q:        Well then, hmmm. What does Dr. Bossypants have to say about these important topics?

A:        Listen up, people. Dr. Bossypants has been a keen observer of human nature for many years. Humans are greedy. We don’t have to be, but most of us are. And corporations (posing as people, or not) are greedier. We all need some limits.

If you think, for one minute, that medical insurance companies have the health of those they cover at heart, you’re a fool. Admittedly, government is a clumsy expression of the common good. It functions only insofar as those comprising the “common” take responsibility and stay involved. Yes, Medicaid and Medicare are fraught with fraud and tomfoolery. All human institutions suffer from such. But the profit-motive in healthcare needs to be removed or minimized.

And yes, as humans, we will err. It’s better to err on the side of the collective good than on the side of making the rich richer. Eventually, things get top-heavy and dynasties topple. Dr. Bossypants hastens to assure everyone that toppling is something to avoid. Middle-class is a good, good thing. Trust us on this, dear reader.

Q:        So Dr. Bossypants thinks a single-payer medical system is the way to go?

A:        Basically, yes. Dr. Bossypants is not an economist, but she suspects in the long run, Medicare for all will cost less in taxes than random and inadequate emergency care provided to the poor and uninsured.

It is to a society’s advantage to attend to the health of its citizens. Healthy people are smarter people. They work more. They take better care of their offspring. They are happier. Of course, there are limits to what should be provided, but we can figure that out.

Q:        Where would Dr. Bossypants draw that line?

A:        Cosmetic surgeries that are for appearance only. People need to pay for their own hair implants or facelifts. Also, we need to pull back from excessive medical testing, when whatever the results are, we can’t fix it anyway. These are a couple that come to mind. Dr. Bossypants has a tiny modicum of faith in the collective wisdom of ethically-minded professionals who can develop these difficult guidelines. But the basics of health care should be provided collectively, by all of us, paying taxes. Period. First things first.

Q:        What are “first things,” Dr. B?

A:        Full availability of primary care, nutritional education, preventative care, emergency services, life-saving surgeries and treatments, every possible form of birth control, sex education, (K through graduate school), abortion for those who do not wish to bear a child, fantastic prenatal and postnatal care for all who do wish to bear a child, basic dental care, basic mental health care, and support and education for those who choose to smoke or are obese, to name a few. But I would defer to the collective wisdom of an appointed team—a team absolutely and completely stripped of any chance to benefit monetarily from the decisions the team needs to make.

Q:        My, you’re judgmental and a bit nasty.

A:        Indeed. And hopelessly optimistic. We can do this, people. We can. We do it fairly well for soldiers and those imprisoned, and my yes, for those in congress. We CAN do it for the rest of us.

Cue, here, the maniacal laughter necessary for such situations.

 

Ethics. Bioethics. Health Care. Oh My.

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Being human, we’re accustomed to eating contradictions for breakfast. Even if we eat little else. We intend to behave quite a bit better than we usually do, and we squabble over what it means to be moral, or to live a good, fulfilling, worthy life.

Even if we agree on a moral rule, or make a law, we might observe the rule or obey the law for radically different reasons, or break the law for reasons we believe to be moral. Yes, indeed, dear readers. Dr. Bossypants knows it’s difficult to sort this all out, even though she has tried mightily to blog about morality and ethics in a most intriguing and approachable manner. Now, we have one more lens through which we might view moral decision-making, and then a bit of a summary, so those of you determined to put these ethical thoughts into ethical actions might do so. Right away. Please.

In the late 1970s, bioethics became a recognized specialty as hospitals and healthcare providers grappled with ethical decision-making in the increasingly contentious, conflicted, expensive world of healthcare.

Tom Beauchamp and James Childress identified four  guiding principles in the first edition of their influential book Principles of Biomedical Ethics:

  • Autonomy (Human beings should have authority over decisions affecting their health and well-being.)
  • Beneficence (Decisions should be made on the basis of doing good and being of help to others.)
  • Nonmaleficence (People should strive to do no unjustified harm.)
  • Justice (All people should be treated equally and benefits and burdens should be distributed fairly.)

Principles don’t offer concrete answers, but provide a framework to begin the hard work of ethical decision-making in the face of competing needs and limited resources.

Robert Bellah said “Cultures are dramatic conversations about things that matter to their participants.”

Listen, dear readers. Right now, we are engaged in a monumental conversation in our culture. We’re talking health care. Is it a basic human right? If so, how much health care should we make available in a world of apparently limited resources? Who should profit in the provision of health care, and how much profit is justified? Who should pay, and how should that duty be distributed?

Should we provide abortions to those who do not wish to be pregnant? Should we provide viagra to those who wish to have a pharmaceutically-assisted erection? Should we provide a means by which someone suffering, or near death, could choose to die with medical assistance? Oh, the inflammatory and politically-loaded questions just go on and on. They require deep thought. They require wisdom. These matters are seething with ethical quandaries.

Kant reminds us we should never treat people as a means to an end, nor deny anyone rights we would wish for ourselves.

John Stuart Mill reminds us we should choose paths, practices, and laws that insure the greatest possible good (health) for the greatest number.

Aristotle urges us to find the golden mean, the balancing point between excesses. And to be generous, courageous, and prudent.

Feminists remind us of the huge, destructive problems that arise when power is used to abuse others, to deny basic rights, and to enrich the already-rich.

Those who practice relationship-inclusive ethics remind us that we must always consider the direct impact of our actions–and our goal should be to take the most compassionate action possible.

The bioethicists offer us principles to consider, though admittedly these principles might actually conflict with each other sometimes.

We do not live in a perfect world. It is our job to make it better, not to give up in anger or despair. The ability to reason, converse, and find common ground is a human attribute we should treasure. Courage, dear ones. Be good people.

Character and Virtue

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As promised, Dr. Bossypants is now going to drag all willing readers through a whirlwind of simplified moral philosophy. Why? Because it is GOOD to think about these things. And you can impress your relatives with some of the big words. And frankly, there’s a chance we’re regressing a bit on the moral front these days…

There are many ways to approach morality and we won’t cover them all. After dipping into a few, you might even want to make up your own theory or moral code. Potential ingredients will be readily available in my next three or four blogs.

For today, we’re talking character. How would we define a good person, and what does it take to become one? A lot of very smart people have taken a run at this, but Aristotle (born 384 B.C.) gets credit for a very thorough effort.

Aristotle believed that humans are meant to grow into their full potential, which will bring about what he called eudaimonia (roughly translated as so f**ing happy and fulfilled that you and everyone around you thrives. We can trust each other. You know who you are and why you were born. Life is good.).

So how do we achieve this state of happiness?  By becoming what we are meant to be, which absolutely includes being virtuous. You know how good you feel when you make yourself do something loving even if you don’t want to? Well, Aristotle believed: 1) Each of us has unique potential to contribute positively to society as adults, and 2) To be fully human is to be virtuous.

So what’s virtue? It’s the sweet spot between extremes. Truthfulness is a virtue, situated between boasting and false modesty. Courage is a virtue, situated between cowardice and being rashly stupid. Generosity is a virtue situated between being stingy and giving so much away you impoverish yourself (or giving to show off, rather than giving from a generous heart). You get the drift. I love the following (paraphrased) Aristotle observation, and use it regularly to help John with his public speaking:

Those who try to be too funny are thought to be vulgar buffoons, trying for a laugh at all costs…even to the point of hurting others. But those who can’t tell a joke, or won’t laugh kindly at someone else’s joke are uptight and socially inept. Those who joke in a tasteful way are called ready-witted. They are flexible, and such flexibility reveals character.

How do you become virtuous? You choose it, and you practice. You emulate people who embody the virtue you are practicing. And you ride herd on your nonvirtuous impulses. You may find it difficult to be kind and nonjudgmental in the morning. Do it anyway. Over time, it gets easier. You may be tempted to tell lies. Don’t.

If Aristotle’s thoughts were reduced to bumper stickers, they might include: Hang in there; Moderation in all things; and Be all you can be. Good character doesn’t just happen. It’s a constant challenge.  He wrote, “…the virtues arise in us neither by nature nor against nature.  Rather, we are by nature able to acquire them, and reach our complete perfection through habit.”

Humans often lack willpower.  Doing the right thing is not always simple or easy. Some philosophers believe that if we deeply and completely know what is right, we will always do it, but frankly, I doubt it. Humans are famously able to rationalize their actions when they know the right thing to do, but fail to do it. This is called moral incontinence.

Although losing control and pooping your moral pants isn’t admirable, from an Aristotelian point of view, it is not as bad as deliberate wrong-doing. There is a significant difference between the person who knows what is right, intends to do it, but is overcome by fear or desire, and a person who intentionally pursues excessive gain or lies repeatedly. Someone who intentionally chooses to do the wrong thing to get quick gratification or self-gain has little hope of becoming virtuous, little hope of becoming deeply happy or fulfilled. And rather than contributing to the good of society, is likely to have the opposite effect.

There you go. Virtue ethics is about the person, not necessarily a given action. It is about choice and practice. That’s character ethics in a nutshell. Dr. Bossypants hopes you will google character or virtue ethics (or even break down and read a book) and thus expand your understanding of this particular way to think about morality. Remember. It is GOOD to think about these things.

Choices

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In my last Bossypants blog, I wrote about Narcissistic Personality Disorder (NPD). Persons with NPD and assorted other personality disorder don’t think they have a disorder. Instead, they blame everyone around them for their troubles, and for the ubiquitous misery they cause.

Remember this old joke? How many psychologists does it take to change a light bulb? Only one, but the light bulb has to really want to change.

If the light bulb has a personality disorder, this is highly unlikely.

As co-authors of a Counseling and Psychotherapy Theories text, and some other psychologically fascinating books, my far less bossy husband (https://johnsommersflanagan.com/) and I engage in endless speculation about how to alleviate suffering and facilitate human growth and development. True, people rarely change for the better if they don’t want to. But people can and do change.

Most of us like to believe in free will, the human capacity for conscious choice. But we are finite beings. Biologically, we’re limited to the attributes we were born with, and whatever we might add surgically or medically to those basics. Broadly, this is referred to as “nature.” We are also shaped by the external world—by those who love us, feed us, admire us, or abandon us. And this is referred to as “nurture.” Nurture. Nature. Together, these two 1) account for a very large percentage of who we are, and 2) heavily influence–or even limit–our choices.

Further, some argue that free will is an illusion because we’re genetically programed to reproduce. Behaviors (and choices) are thus dictated by the biological mandate to successfully reproduce with the best partners as often as possible. The more offspring carrying forth our genes, the better—so the argument goes. Of course, no one has yet successfully interviewed a gene, so a lot of these “selfish gene” explanations remain theoretical, and exceptions to the rule are as interesting as the supposed rule. But we’ll leave this discussion for another day.

Here’s what Dr. Bossypants believes. We are sentient, conscious beings, and we do make choices. These choices are influenced by many factors, including:

  • our parents, first grade teachers or that coach we had in seventh grade
  • our biological attributes or needs
  • our desire to successfully reproduce
  • the drugs we take, repeated blows to our heads, and difficulties in our lives.

But even with those forces in play, choices are still to a large degree our own.

Making good choices is more difficult for some people than others, but having the ability and the right to make choices remains a defining feature of what it means to be human. Choices can be loving or hateful, constructive or destructive, selfish or generous. We can choose to be honest or to lie. We can choose to work for our own gain, regardless of what it costs others, or we can choose balance, keeping ourselves and our neighbors equally in mind.

From the perspectives of Alfred Adler, certain feminists, the Dalai Lama, Carl Rogers, Jesus, and many other highly educated and thoughtful people, humans are happiest and healthiest when they choose to be compassionate, generous, honest, and constructive. For what it’s worth, I concur.

And yes, that’s me, second to the last on the right. Whoa.

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