Wednesday, December 8, 2010

Visits to My Psychologist, or The Joys of Tele-Therapy


I wrote an entry not that long ago on my experience of seeing a psychologist after years of not having therapy. I’m still seeing her.

The way Australia’s universal health care system, Medicare, works, it will cost me only about $15 a session until the end of the year. This is because the out-of-pocket expenses I’ve incurred are now over the maximum amount needed for the Medicare ‘safety net’ to kick in. Until the end of the year, whenever I visit my psychologist or any kind of doctor, Medicare pays 80 per cent of my out-of-pocket expenses.

The safety net starts all over again at the beginning of the calendar year, but the 18 Medicare-subsidised psychology visits allowed per year are allocated from the time in the year they began, which in my case was mid-June. This means that, while it would be natural for me to want to ‘blow’ my last six visits before the end of the year because I would pay next to nothing for them, in reality I have to stretch them out till June next year. I’ve decided to have two more visits this year (I’ll need these to cope with pre-Christmas socialising, if I manage any) and then one visit a month till the end of April, leaving a six-week gap until my 18 subsidised visits start again in June, if I decide I need them.

The system is quite limited, with Medicare still favouring psychiatry over psychology – if there are limits to psychiatric visits per year, they’re much higher, and the psychiatrists charge heaps more than the psychologists. But I’m grateful the system is there at all – psychologists have only been subsidised by Medicare at all for the last four years or so.

The very limitations of Medicare’s support for psychological services also indicate the practical orientation of psychology, suggesting that the powers-that-be don’t see these services in traditional psychotherapy terms. As someone who has enthusiastically embraced the therapeutic relationship, I’m still having trouble with the relatively informal nature of my visits to my psychologist, including the fact that they are at differing times of the day, with differing time intervals in between.

I’m finding it difficult to really let go and complain about my parents to my psyche, especially when it comes to discussing my mum. I have been able to talk about my mother with my psyche in ways that are productive, but all the while I’ve somehow feared that she would think I was complaining about her. This is paranoid, I know, but it’s also indicative of the types of therapists I’ve seen in the past, who, if they had inferred this kind of parallel, would have identified it as part of the therapeutic process. Despite my psyche’s easy confidence, I don’t quite trust her to be robust enough to handle the enormity of my angst towards parental figures!

Because the fact remains, as with my relationship with my mum, I’m more analytical than my psychologist (not more intelligent). And when I whinge about my mum being in her own little world, perhaps in some way I’m also complaining about my psyche’s chats at the beginning and end of the session – she often talks about her family during these chats. I know why she does this – she told me once her small talk is meant to put the client at ease – but part of me wants her to myself for the entire session, even during those minutes when you’re getting seated, or getting ready to go.

Anyway, I wrote this post because I wanted to mention two things my psyche has said that have really penetrated my consciousness and made me understand, almost for the first time, that I have much more power over my mind, and the way it operates, than I’d thought.

Since about the age of seven, my mind has sometimes felt like a frightening, uncontrollable place that gave me pain and suffering in unpredictable ways. Even before the more adult kind of social phobia I’ve detailed in this blog, I was subject to a sense of dark dread that would hit me for the most trivial reasons – accidentally taking some small item home with me from my grandparents’, knowing my parents were going out that night and a babysitter was coming over, and, when I was really young, dreading I would go to hell when I died, or that the communists would take over Australia (no need to allocate blame for where the last two fears came from!).

Everything I thought about, including normal adolescent fears, was mediated by that lonely dark dread of the worst happening, the worst being somehow beyond imagining and not able to be faced and dealt with in any way. This overweening, lonely angst was the precursor to the more specific fear I would later develop – the fear of my phobic symptoms manifesting in uncontrollable ways.

Anyway, my psyche said something interesting to me a couple of months ago. She’d mentioned an episode of a comedy-drama series we’d both been watching, Offspring. The heroine of Offspring is Nina, a young, accomplished obstetrician who is nervy, self-obsessed and awkward. She has a crush on Chris, the sexy paediatrician she works with, and her feelings for him only exacerbate her painful self-consciousness.

The main technique used to depict Nina’s angst is to show her walking along the hospital corridor as we hear her innermost thoughts in voiceover while, in sync with these thoughts, various expressions of fear and embarrassment cross her face. This is both funny and painful to watch, and possibly inexplicable to those who don’t suffer from anxiety (a cousin of mine said she couldn’t warm to the character; one female reviewer complained of the Ally-McBeal-style ditziness of the heroine). In fact, watching these scenes has been at times quite a profound, even therapeutic, experience, with the comic angle helping to demystify the anxiety, and diffuse the sense of the viewer being trapped in Nina’s claustrophobic inner world.

Nina is obsessed with what others think about her, dreads specific events in the future, and, when locked in her own thoughts, is disengaged from the world around her. Yet, most of the time at least, she’s not that transparent. When she encounters a frightening or unexpected situation in the real world, she appears to be distracted and sometimes flustered, but her actual thoughts remain unknowable to others. She’s as opaque as the next person. Seeing this has also been therapeutic for me.

(We interrupt this blog entry for a brief TV review: unfortunately the series subsequently disappointed, as Nina didn't really develop at all; rather than gaining a greater sense of herself, she was just as people-pleasing, insecure and trapped in her thoughts in the last episode as she was at the beginning, and the plotting, so strong initially, gradually deteriorated as the series progressed.)

Anyway, at one session soon after a particularly apt episode, my psyche brought up the topic of Nina, and I gleefully told her I’d been watching the show.

‘Nina is very attached to her thoughts’, my psyche said. ‘Most people have different kinds of thoughts but they don’t pay much attention to them. There are some people, though, who get very attached to frightening thoughts. This is what you do’.

The combination of my psyche saying this, and me having recently watched the process being played out on screen, was quite powerful. Through my understanding of mindfulness I’d already been aware that thoughts were separate from the self, that they were random mental events rather than the basis of my very identity. But this dramatisation of an attachment to fearful thoughts, and my psyche so clearly pointing out that attachment, somehow made me understand in a much more practical way not only that my thoughts are not me, but that my attachment to fearful thoughts is something that I have some control over. If I’m attached to my thoughts, then there is a possibility that I can detach from them, at least partially.

I’m not saying for a minute that this will stop me getting fearful, especially when I’m dreading, for example, an upcoming summer barbecue full of groovy people who I know just well enough for them to invoke terror. What it means is that I have an extra tool in my arsenal when faced with scary thoughts. I had already been able to respond to these thoughts by telling myself: ‘these are just thoughts, they are not the truth’. But now I can add to that, and say: ‘these are just thoughts, and I can see how I cling to them as if they were the truth’. I can see for the first time that there is some security in these thoughts for me, that they represent a kind of ‘home’, and that it doesn’t have to be that way.

Talk about good timing.

As I’m writing this, I’m also wondering if the attachment to thoughts has got something to do with my feelings towards my mum. Do thoughts become a security blanket when there is no one to cling to? Are insecurity and fear a form of security seeking? In being so attached to my thoughts am I somehow refusing to separate from my mother? Am I metaphorically burying my face in her absent shoulder?

That’s not the only example of my psyche saying something relatively straightforward that has really resonated with me. As the copywriting aspect of my business has expanded while the editing aspect has diminished, I am starting to deal with clients over the phone more frequently. This is downright terrifying, and I’m currently facing imaginary scenarios of being in constant, crippling fear of clients calling if the business should seriously take off.

I’m even more fearful of people in the context of work than I am in the rest of life – I have a terror of success, a compulsion to display my fear combined with a deep need to please superiors (in this case, clients) and demonstrate my talents. These contradictory aims make dealing with clients in a functional way challenging to say the least, and I’ve avoided writing about this because it’s such a difficult and seemingly insurmountable area. The anticipatory fear that I sometimes experience in these situations is akin to the feelings of dread that originated in my childhood.

Recently, my psyche said of my ‘scary’ clients: ‘you give them so much power’. In the context she meant I was giving them the power to produce my symptoms, as well as power over how good or bad I felt about myself. I was using them as judges of whether or not I was an okay person.

This isn’t the first time a therapist has pointed out something to this effect. One very insightful psychiatrist once stated that in my fear of making a fool of myself socially, I turned other people into objects whose existence was only relevant in relation to me – that I corralled others for the purposes of giving me negative attention. At the time this certainly chimed, but it was an abstract idea, one I couldn’t really do much with. A problem was identified, but no concrete solution was suggested or implied.

With what I understand now about thinking, I was able to read my present psyche’s remark more usefully than I could have in the past. She was actually saying to me: ‘You give your clients so much power in your thoughts’. In other words, it was the way I was rehearsing encounters with these people in my head, or simply the feeling that I adopted automatically when I thought about them, that was the issue. I was giving them power in and through my cognition, through the exercise of my mental faculties, at specific moments in time. These specific moments occurred every time I conceptualised them, not simply during my actual dealings with them.

In the past I’ve simply assumed they had the power I was attributing to them. After all, they are my clients, the people who hold the purse strings. But are they really the arbiters of my self-worth? In reality, they are simply people who want a service from me. If I sound awkward or frightened on the phone, they have the choice of whether or not to deal with me in the future. Their personal judgments of me, whether positive, negative or somewhere in between, are not really all that relevant. They are not sitting on some pedestal miles above me, dictating how I should feel about myself.

Now, when the usual dread descends, I tell myself that I am giving these people unnecessary power. I’m using them to make myself feel scared. In reality, they are marginal to my life. This thought process doesn’t banish the dread of course, but there is a real reduction – its hold on me weakens. The ‘judges’ start to descend to earth, devolving to their actual status as fallible human beings with their own agendas.

One thing I’ve been doing ever since I started to see my psyche is write down the most salient points she makes, sometimes during the session. I then type them up on my ‘therapy’ file (obsessive? me? never!) This has been a good thing to do, and occasionally I’ll read through the file. Because my thinking constantly seeks to go back to its old habits, and drag me back into the dread – that confusingly comfortable, familiar place of pain, humiliation and discomfort.

Sunday, November 14, 2010

The Emotional Trajectory of the Common Cold


I’ve recently recovered from a slight cold and am fascinated by the emotional trajectory I’ve been on.

The cold hit me on Monday night, with a sudden fit of hayfever-like sneezing when I turned the dusty gas heater on in the loungeroom. I started to feel that hazy exhaustion that creeps up on you slowly until your brain finally registers the fact of malady. I didn’t want a cold because I can never sleep while my nose is running, but that first flooding of the taps was it. After that it was just the kind of cotton woolly, remote feeling that only makes sense when you’re lying in bed propped up by pillows reading a deliciously spooky book with Classic FM playing the top classical 100.

In other words, the first day of the cold was utter bliss. It happened to be a public holiday, adding to the sense of unearthly lull. I had a deadline the next day and did the few hours of work required to keep up. Then I escaped to the haven of Bed, and read for a while, and when my brain was too tired to read, slept, and then read again. Lovely.

The next day I had to do more work. I met the deadline at around 3, and then it was back to bed, again feeling suitably deserving. Naughtily I hadn’t had a shower since Monday – not like me at all, but it was scary how easily not having a shower became normal!

By Thursday I was starting to feel stir-crazy and desperate to get out of the house. I got up early and, determined to stay up, showered, dressed and escaped to the local shopping mall, ostensibly searching for early Christmas presents but really just playing hooky. Unfortunately I was squandering my limited stores of energy and that afternoon after lunch I collapsed in front of the heater, alternating between a futile struggle to keep reading and an exhausted doze. I was starting to be plagued by the usual spectre of Things Not Done, and to get angry about my lack of energy.

A visit to my mother that morning hadn’t helped. I’d dropped over to borrow a handsaw on the way back from the shopping mall. October has been the wettest spring in Victoria for 18 years (thankfully the dams are now more than half-full) and my front yard was a wilderness of feral foliage threatening to engulf me like the forest in Sleeping Beauty. I would take control! I would rise like the Phoenix with renewed strength and hack through the gnarled branches of my wintry hibernation, greeting the emerging summer sun and embracing a fuller life.

Detailing my relationship with my mother would take a book rather than a blog entry, but she has always reflected my own mental and physical health issues (many of which, sadly, she unwittingly passed on to me). I’ve recently realised that, apart from chronic low blood sugar, she has probably been suffering from low-level depression, or dysthymia, for my entire life. (Quite possibly her mother also suffered it.) On this day she was on the couch reading the paper, and now that she has osteoporosis (it is being treated but it’s a long haul) she’s increasingly surrounded by the semi-controlled mess of my hoarder father.

She looked up at me with that undisguised, slightly bitter exhaustion she hides so well from her friends and extended family, but is ‘where she lives’, so to speak. Everything seemed to crystallise in my all too damning assessment: she wanted to move from the house years ago, and downsize as her friends were doing; my father wouldn’t move because of his hoarding, and the strong emotional attachment he retains to his birth family, from whom he’d bought the house when my sisters and I were still young.

My mother got her first fracture a few years ago, running around the too-big house and enormous garden as she desperately cleaned up before a birthday celebration – her birthday. It seemed to me on the day I visited that she was trapped in that house, and was now further entrapped by her condition. And I too was similarly trapped in my large rundown flat, which allowed me to spread myself out but was bringing me down with its overactive garden, and the burden of fatigue caused by rising damp, dust and mould.

In a sense, I was both my mother and my father – staying in the house because the part of me that loved to spread out was now free, but burdened by its size and age. And the rent was going up by $50 a week in January.

It all seemed so hopeless, no doubt through the prism of my lingering cold, and I left with an exaggerated determination to hold victory over my own lack of energy, expressed in the chaos of my front garden. So naturally the afternoon hiatus in front of the heater was upsetting, forced as it might have been.

Things got a bit better on Friday – I did an hour and a half of ruthless sawing, sadly paying little heed to the laws of pruning, choosing branches for disposal I could reach on a footstool. I left the mess where it fell, and the next morning sawed and piled the branches neatly.

I’m only now just getting back to normal. Chaos is at bay in both the back and front yards, although the front already needs one more good bout of the clipper and the handsaw, and one of the branches of the plum tree out the back seems to have shot out by two feet in about ten days – I kid you not. But it pains me that all I have the energy to do is keep things at some level of order rather than imposing my own order, and developing or reshaping the garden. On the other hand, I live on a main road, and the untamed bushes give me valuable privacy, not to mention the shade they offer to the armies of joggers, nannies, young families, dedicated dog walkers and iPod-strewn power walkers that pass by every hour of the day.

All is not lost. I spoke to my psyche recently about the feeling of not being able to separate from my mother, or forgive her for her lack of nurturing. ‘It’s your turn now,’ she said. In the context of the discussion, she meant it was my turn to be in life’s spotlight, to be an adult and enjoy myself. But I also read this remark another way – that it was my turn to take over the role of mothering myself.

Sometime in the future I may also have to look after my mother a bit. I say ‘a bit’ because, given the fragility of our relationship and my low energy levels, an intense level of the caring role on my part would be impossible, and because two of my sisters also live in the area and, if necessary, will be able to share the burden. But now at least I can countenance offering some level of care in the next five or ten years, even if it’s just a regular tidy up of the house or a weekly trip to the shops. Now I can stop expecting that one day in the very near future my mother will finally decide to do ‘her job’ and look after me. She won’t – it’s my turn now.

Thursday, November 4, 2010

A Nest in Spring - My Pigeon Encounter


Recently I wrote about a non-human ‘friend’ I’d made, a blackbird that for about a month was knocking against my bathroom window several times a day. Having anthropomorphised what is apparently a common occurrence (a Google search reveals that during the mating season blackbirds sometimes mistake their reflections in the window for predators, and attack) I felt suitably chastened, and a little miffed when the blackbird abruptly ceased her futile quest, having probably gone off to mate.

The explanation didn’t satisfy me completely though. The blackbird seemed to be trying to get a foothold on the wisteria in order to peer inside – she seemed genuinely curious and would only fly away when she saw me coming. Once or twice I noticed her calmly perched on a high branch of the plum tree outside the window, watching me as I showered. She was fascinated, not merely disturbed, by the world beyond that strange invisible wall she kept knocking into. I wasn’t bird watching – she was human watching.

But I would not be alone for long. Soon after she left, a loving couple moved in next door. Again, they were clearly visible through the bathroom window. They seemed very close, and would sit side by side for hours without a word, torsos touching, enjoying an effortless togetherness. Unlike the blackbird, they were sublimely uninterested in me, although perhaps made uncomfortable by the persistent curiosity.

Then the determined building started. In record time the house was finished and not long after that a new development occurred – the arrival of twins!

Okay, so this new family weren’t human either. They were pigeons and in perfect cooperation and record time they had built a rudimentary nest in the plum tree, only about a foot from the window, that they took turns to sit on, patiently minding two small eggs. The nest is surprisingly small and frail looking. It’s been through a lot in the past few weeks, and, truth be told, is now studded with layers of pigeon pooh, yet it continues to withstand the powerful winds and blinding rain we’ve experienced during what has been a wet and chilly spring. I’ve witnessed one of the adult pigeons perched calmly on it during a windy storm, rocked by the force of the wind but seemingly confident it would withstand the battering.

Seeing the branch swinging and the bird calmly moored there for hours, feathers plumped up against the cruel wind, inevitably made me think about human endeavour (I know, anthropmorphising again!). We all assume that the aim of life is happiness. But perhaps it isn’t. Perhaps at particular stages of our lives it is just to hang in there.

Every time I’d go to the bathroom, except for very early in the morning, one of the pigeons would be sitting on the nest, keeping the eggs warm. You’d think the boredom must have been excruciating, but I’ve come to believe that pigeons either don’t experience boredom, or process it differently (perhaps they also receive some hormonal help).

For a while I had no idea that the male was still involved. I thought the female was heroically going it alone, and that perhaps the male was feeding her. But early one morning I witnessed an exciting event. In an uncanny silence, one pigeon hopped off the nest as the other one waited on a nearby branch. The waiting one climbed onto the nest immediately afterwards and settled in for a long stint.

I’ve seen this a few times now and the sense of cooperation and non-verbal communication is palpable. And at the time it made sense: two distinct personalities had seemed to be in play. One of the pigeons would eye me a bit nervously when I approached the window and shamelessly gawked at it, while the other avoided looking at me altogether, as if hoping I’d disappear.

For about two and a half weeks this pigeon pair took turns to keep their eggs safe and warm. Then one day, tiny moving beaks and long necks stretching up for food were barely discernible over the top of the nest. The chicks had hatched! They were half-formed mutants, skeletal and grotesque in their vulnerability.

The parents did an amazing job hiding the chicks from the world – and me. Not surprisingly, apart from feeding, the aim at this stage was to cover up the chicks and keep them safe and warm – the parent seemed to sit on top of them, and I wondered how it did not inadvertently smother them. The adult pigeon’s ability to spread out and change shape with feather plumping is quite amazing. The phrase ‘taking someone under your wing’ now makes sense to me!

As the chicks grew, the feeding process became more visible. The parent regurgitates food it’s eaten, producing a kind of vomit that it then conveys into the beak of the chick by using its own beak as a feeder. It really gets its beak down the chick’s gullet, and conveys the food using a pumping motion. I watched this many times, feeling fascinated but guilty as I’m sure the parent didn’t like anyone witnessing this act of nurturing. It amazes me that this vigorous process doesn’t damage the chick’s oesophagus! Both seemed constantly famished, pecking at the torso of the parent when the other was being fed but giving up immediately when it was clear the meal was over.

I watched each stage of the chicks’ development with something like delight, and had soon installed a little stool in the bathroom to get a better view of these David Attenborough moments. I continued to feel a bit guilty, worried I was unsettling the parent, but as the chicks grew more sentient I reasoned that they had never known a world without me in it, and indeed they would prove calmer in regards to me than one of the parents.

They grew amazingly quickly, and were noticeably larger every day. Gradually I no longer had to stand on the stool to get a good view of them, and instead of being in the nest they sat on top of it.

As they grew, the parents stayed away more and more frequently, seeming to desert them entirely during the day but always coming back to feed them in the evening (and probably in the morning, before I was up). For as long as possible the parent on duty even managed to fit on top of them in the nest at night. The two siblings seemed increasingly calm in the absence of the parent, as if confident it would return. But they also seemed to know instinctively that it was important to keep still and hide themselves from predators while their protector was gone.

For a few weeks, their main goal in life was to wait – wait for the parent to arrive with the food, wait to grow bigger, wait for that first chance to pound those impatient, unwieldy wings against the wind. They endured the long hours alone with each other surprisingly calmly. Now, when they stood up to be fed, they revealed their bulk - huge when compared with a few weeks earlier and looking like small ducks, with plenty of down, but narrow necks. Together in the nest from the get-go, they somehow continued to fit themselves in and share the increasingly inadequate space, turning when necessary, flapping a wing every now and again, and occasionally gnawing at their own necks, perhaps in hunger or boredom, perhaps shedding down.

New stages continued to occur. One morning when I checked in, one of them had ventured forth from the nest and was perched on a nearby branch. This one was more adventurous and perhaps more developed than its sibling, and it continued to explore further up the tree. I watched enthralled as it made a tiny experimental flight from one branch to the next. The next day, both were perching and moving around on nearby branches.

I was fully expecting to witness the day-shift parent come back to give them a flying lesson. What would happen at this next stage? Would the family stay anchored to the nest at night? Would I witness the young pigeons take a full flight into the air for the first time? Unfortunately, my hopes of seeing further developmental triumphs were disappointed.

Some time after their sally forth earlier that morning, I discovered them sitting companionably together in the nest, looking diminutive, peaceful and sweet. I gave them my usual greeting (I can’t confess it, it’s too embarrassing).

Then an hour or so later I went by again, and they were gone. Just like that. No sign of them in any part of the tree. No goodbyes, not even a ceremonial escorting of them into the big wide world by the parent. They’d just disappeared.

I was shocked, bereft. The nest looked obsolete, forlorn. I sensed its purpose was complete.

It wasn’t the total end, although close enough. That evening I saw the shapes of young birds – for they’d become birds by this stage – in the spangling evening leaves. I rushed outside. Relief! The two young were sitting next to each other on a branch in easy sight, and Mum or Dad, still large in comparison, was keeping watch from a branch further up. I gazed up at the two young and they gazed down at me serenely – that silly gawking monster again. It was the parent, funnily enough, who took fright and flew away. Since then, I’ve only had one more sighting, when I was just able to discern the parent feeding one of them in a part of the tree near the neighbour’s fence. It appeared for a while that the plum tree was still the ‘home tree’, although a few days later I’m not so sure. But the nest has been well and truly forgotten by everyone except me.

Nature makes life look so simple. Pigeons don’t seem particularly enterprising to me compared with some other bird species, perhaps partly because of their environment, but it strikes me they’re the hippies of the natural world. They do whatever is required to sustain existence, and live peacefully in the moment. They also seem to really enjoy simply hanging out with their kids and partners, and on sunny days they soak up the sun, sometimes with a close friend beside them to enjoy the moment with.

Like other birds they seem able to call on extraordinary reserves of stamina and endurance when required. Seeing the parent and even the chicks getting sodden in the bitter spring storms, yet never complain or give up, made me think of the documentary Travelling Birds – I’ve never forgotten the look of preternatural determination and concentration revealed by the amazing close-ups of migratory birds, their wings beating the air as they travelled hundreds of miles without a rest.

Ah well. The plum tree’s branches are now so extensive it’s threatening to wrap around the house and trap me in there. With its main tenants now gone, and its job of protecting one small family completed, it’s time for some judicious pruning.

Wednesday, October 6, 2010

The Dilemmas of Therapy



I’ve been seeing a psychologist for the last few months. This is a kind of miracle – I stopped seeing my last therapist in 2003 – but it’s more low-key than it sounds. Anyway, something that happened last week made me think of the differences between different kinds of mental health professionals, and the way these differences have played out in terms of my own experiences and the various life stages at which I’ve seen therapists.

My therapist is a registered, or counselling, psychologist. This means she’s a full member of the Australian Psychological Society and is entitled to practise as a psychologist, but she doesn’t have a Masters degree in psychology or, I assume, the extent of supervised clinical experience with the mentally ill that a Masters would entail. This is the first time I’ve seen any kind of psychologist for any length of time. Previously, in my early to late thirties, I saw two psychiatrists consecutively over a period of about nine years.

She’s good at what she does, and has a talent for ‘reading’ people, which I think makes up for her presumed relative lack of clinical experience. But I sometimes feel as if I know the ‘rules’ of therapy better than she does; and the arrangement as a whole, with her modus operandi as part of it, is very different from the therapeutic relationships I’ve had in the past.

For example, my psychologist is never on time, and she never apologises for being late. Sometimes the lateness is a piddling few minutes but it’s usually more. Once she was almost fifteen minutes late and appeared at the door of the dollhouse-sized waiting room with nary a ‘sorry’.

As someone chronically deprived of my mother’s attention, this presses all my buttons. What’s most fascinating about it is not that as a patient my reactions to such a situation might be overblown – that would be expected. It’s that these reactions aren’t – can’t be – a key part of the therapeutic relationship. They can’t be examined and their underlying dynamics unearthed.

Such a situation simply wouldn’t have occurred with my previous therapists – for one, if a rare example of extreme lateness had occurred they would have apologised; for another, they would probably have raised for discussion in the consulting room the feelings that such an episode would have aroused in me.

Inevitably the therapeutic relationship, as it applies to my psychologist and me, does have some degree of the type of parent–child dynamic that occurred with the two psychiatrists – I feel needy before I see her, relieved when I can sit opposite in the tiny, untidy room and pour out my fears and triumphs. But this dynamic is underlying rather than dominant, and it’s not being used as part of the therapeutic process.

This is not just because of her perceived lack of qualifications, of course. It’s also partly due to the fact that I don’t, consciously at least, want to put her in that position – how many parent figures can you have throughout your life (an infinite number, it seems, as I still treat people in authority as parent figures); partly that my therapist is either about my age or slightly younger (it’s hard to tell – she’s very good looking, and probably botoxes); partly due to my lowered expectations as a result of my excessive aloneness in the last few years; and partly because of the way the Medicare (national insurance scheme) operates – the rebate is limited for psychological help compared with psychiatry, a maximum of 12 visits a year or 18 if the GP approves, so the sessions are widely spaced (once every two or three weeks) and they’re very practically oriented.

My psychologist and I mainly talk about strategies, tactics and techniques in relation to examples I bring up of problematic episodes that have already occurred or potential scenarios I’d like to venture into. We’ve looked at the past, but mainly in terms of how it affects my perceptions of others and of relationships today.

My therapist was chosen for me by my GP and I listened to my gut feeling in deciding to see her, and then to stick with her. I had to rely on my gut feeling because I was desperate to see someone at the time, and I knew that if I checked on her credentials before my first appointment and she wasn’t sufficiently qualified my head would say all sorts of judgmental things about her.

And my gut feeling was on the money. The fact that she wasn’t a clinical psychologist initially quietly horrified me (‘But I’m sick! I have about five different mental illnesses all blended together in an indivisible whole – how can she possibly help me?’). She does, however, have a human resources background, which was perfect for the issues I was grappling with at the time. She continues to be great at putting my many work issues into perspective.

So the current situation has both advantages and disadvantages. Because of her not being a clinical psychologist, as well as all the other reasons outlined above, I still feel as if I’m essentially on my own.

In some ways this is good for someone like me, who was never parented properly and has spent their lives searching for the perfect parent. In the past I relied on my psyches to be excessively parental, and while I was seeing them, I didn’t ever really take full responsibility for seeking sustainable adult relationships.

This had serious and long-term implications for my emotional development. Neither of my previous psyches fully realised the extent to which I needed to be ordered around when it came to relationships. There was one crucial point in my life when I needed to be told very firmly to have sex with the first realistic contender that came my way, to be set sexual ‘homework’ if you like. But the extent of that need simply wasn’t evident to my therapist at the time, and I didn’t have the maturity or self-awareness to articulate it.

Realising the limitations of my psychologist’s skills (and she is skilled in many ways) puts the responsibility onto me for my own recovery. And I’m hardly a rank beginner. I have a friend with OCD who has been practising exposure for so many years now he’s virtually an expert, and we have regular debriefings about it. I’ve also done plenty of my own reading as well as attended a social phobia group that included CBT and exposure.

Yes, my social phobia is complex and difficult, as it’s combined with a compulsion to display my symptoms to particular people and an underlying terror of making meaningful connections with others. My therapist works with me on exposure, but because of the nature of my problem, I have to tailor the program in conjunction with her. It would be wonderful if my therapist could tailor a program exactly to suit me. But exposure is exposure. I know enough now to tailor my own program with her help – she is my back-up.

And I have another weapon in my armory, a weapon that only I can wield – meditation. I finally have the self-love to use it regularly, and it’s beginning to show subtle but noticeable results.

Those are the advantages of not being able to completely turn my therapist into a parent figure. There is also a major disadvantage.

Because I can’t go through the ‘transference’ (when the patient falls in love with the therapist as an all-powerful parent figure) it means that I don’t feel emotionally ‘held’ during the session. And this means that the scary feelings that come up for me whenever I am in close contact with a person for any period of time can’t be taken out and looked at honestly.

Oh, I suppose they could if I insisted, but it would all be terribly awkward. I like my psyche and she says amazing things at just the right time, but she’s not really ‘mine’ – and to talk about some of the feelings that come up for me in relation to her (as opposed to the outside world – I can talk about that, no problem) would be more than my fragile self-image could cope with.

I think I’m a bit frightened that if I reveal those feelings, she won’t be on my side any more. And that inability feeds on itself – if I can’t articulate those feelings then I may start to display them through my panic symptoms in the consulting room, and that would be extremely embarassing. And my fear is that I’d then be on my own again, just as I was before I started seeing her. This is not a positive therapeutic situation!

My current way of dealing with this problem is to see the sessions themselves as part of my exposure therapy. It’s difficult for me to sit in the same room with just one other person for an hour. The session becomes part of my (self-administered) treatment, with the psychologist as unknowing resource.

Of course, this may not work indefinitely. My symptoms are already clamouring for attention in the consulting room and there may come a time when I can no longer manage them adequately without acknowledging them. I guess that will be a time of reckoning: the time either to seek another therapist or to attempt to turn the therapeutic relationship into something more challenging for both of us.

Monday, September 13, 2010

Hitting Australians When They’re Down: Unemployment Payments and the Demonisation of the Unemployed


During the 2007 election, Kevin Rudd’s mantra of support for ‘working families’ caused many a journalistic snigger. During the recent election, the two larger parties were rightly derided for their shameless dog whistling in regard to an irrational fear of a few thousand unfortunate boat people.

But to my knowledge no journalist has admitted that the concept of working families is in itself a form of dog whistling. The unmentionable ‘other’ is of course the ‘non-working family’ – as well as, heaven help them, the single unemployed who have failed to fulfil even their reproductive duties. Julia Gillard’s announcement during the campaign that unemployed people would be stripped of their benefits if they did not turn up to employment interviews was a whistle so clear it could have been heard by every toy poodle in Paris.

In the current climate it is politically unwise to mention unemployed people in the mainstream media, the very group that is most in need of the assistance of government, unless it is in the context of turning them into part of the favoured group – the employed (a worthwhile aim, but not one that justifies starvation-level payments). Both of the larger parties are now willing to alternately demonise and disregard this group of Australians in order to appeal to the ignoramuses in the country’s most marginal seats.

Not only does this process create a convenient scapegoat, but it also makes it easier for the parties to ignore the very real suffering caused by the grossly inadequate welfare payments that unemployed people receive, confident that Australians like you and I won’t be clamouring for change. If the unemployed are inherently shifty, if they are markedly less deserving than aged pensioners and those with disabilities, and if they cannot be trusted to have a good reason for not attending an employment interview, they should be grateful for what they get.

The rhetoric of the deserving and undeserving poor is not simply a matter of semantics; it has huge ramifications for the kind and level of support that people down on their luck receive. After the 2009 bushfires in Victoria, the country watched astounded as an avalanche of community goodwill and generosity blanketed the survivors, many of whom had lost most of their belongings. Donations of goods quickly arrived by the truckload and some people even offered cars and caravans to the victims. The Victorian Bushfire Appeal eventually raised an astonishing $379 million.

Yet later that year the federal government had no difficulty selling the fact that the 2009 budget included a $32.50 increase to disability and age pensions while the Newstart (unemployment) Allowance, already significantly lower than the pension, remained unchanged (in July 2010 it was a miserly $231 a week for a single adult). Perhaps governments fear the goodheartedness of their citizens as much as they fear unpopularity; a fully informed citizenry might clamour for a tax system that funded adequate unemployment benefits, leaving less money for electoral bribes to the pampered middle class.

This situation is all the more offensive given that unemployment is an accepted part of, and even considered vital to, the running of modern growth-based economies. Zero unemployment is said to lead to wages growth, which may lead to inflation, and high inflation is a politician’s worst nightmare. Governments are therefore busy scapegoating a group whose disadvantaged status it is arguably in their interests to maintain. (Outrageous growth in executive salaries, however, is assumed to have no effect on inflation.)

Poor people weren’t always the scapegoats of politicians. Remember Bob Hawke’s impassioned declaration in 1987 that no Australian child would live in poverty by 1990? At the time he was laughed at for having such a lofty and unachievable goal. But compare the urgency of his rhetoric, and the apparent electoral importance of the issue at the time, with the silence on poor children, as opposed to average families, today.

So what’s the situation for those receiving Newstart Allowance in Australia? Here are some disturbing facts:

• About 600,000 Australians receive the Newstart Allowance. More than half of them have been receiving it for over a year.

• The Newstart payment for a single adult was only $33 a day in July 2010. This is almost $120 a week lower than the Disability Support Pension, and less than half the minimum wage.

• In July 2010, a family with two children headed by an unemployed sole parent had to make do on only $460 per week.

• While Newstart has not increased in real terms for almost two decades, in the last ten years electricity costs have nearly doubled (91 per cent), while housing and health costs combined have risen by about 60 per cent.

• The national unemployment rate for 15 to 19-year-olds was almost 17 per cent in June 2010.

• Providers of job services for long-term unemployed people receive an average of only $500 per person to assist them to return to work, less than most other wealthy nations.

In the absence of visibility, unemployed people endure a hardship that the rest of Australia, apart from the welfare sector, largely ignores. Many will be forced to accept food parcels, clothing and emergency payments from charitable organisations. Large numbers will shiver in cold houses or risk getting the electricity disconnected because they can’t afford to pay heating bills. Unemployed single parents will watch helplessly as their children are marginalised through their inability to provide for their educational needs. The threat of homelessness will loom when the rent goes up or a long-term landlord decides to sell. The costs of petrol and public transport, especially for those living in remote areas, may be prohibitive.

In its 2010 election statement, Australia’s peak welfare body, the Australian Council of Social Service (ACOSS), asserted that blaming unemployed people for their predicament was ‘both cruel and pointless’. It called for wholesale reform of the welfare payment system to reflect the cost of living, and for the single adult rate of Newstart to be immediately increased by $45 a week.

Yet from the moment of her ascension to the prime ministership, Gillard’s rhetoric has in effect been moving in the opposite direction, suggesting that first and foremost it is the business, even the duty, of government to reward those who are lucky enough to have work – those good, solid, irreproachable folk who ‘set their alarms early’. In her acceptance speech she affirmed that ‘I believe in a government that rewards those who work the hardest’.

During this speech Gillard acknowledged the role of the entire workforce in bringing Australia through the GFC relatively unscathed – ‘the working people, employers, employees, the trade unions, the small and big businesses, the employer associations who all made this possible’. Yet she failed to commiserate with those whose lives were thrown into chaos due to the rise in unemployment at the height of the GFC.

It’s true that during the GFC many employers, fearing a skills shortage, reduced their employees’ hours rather than sacking them, and good on those who did; it’s also true that the official unemployment rate, which is always far lower than the actual rate, rose to 5.8 per cent, an increase of 1.6 per cent, between May 2008 and August 2009. For Gillard, employers and employees who weathered the storm were worthy of congratulations, but not any former workers that employers had dumped to maintain the viability of their businesses.

This kind of rhetoric signals an astonishing reversal of the self-definition of a Labor government, which has traditionally associated itself with advocating for the disadvantaged. It also ignores one of the most important roles of the tax system: to redistribute the nation’s wealth in order to improve equity.

Objective 3 (a) of the ALP constitution states that the party stands for ‘the abolition of poverty, and the achievement of greater equality in the distribution of income, wealth and opportunity’. Point 23 in Chapter 7 of Labor’s national platform makes a direct reference to unemployment benefits, revealing that the ALP’s aim is, in fact, that they be sufficient to live on. It states that Labor is ‘committed to ensuring that pensions and allowances support a decent standard of living and full participation in Australian society’.

In addition, through the tax system governments of all stripes are required to redistribute resources to make society more equitable. That’s not some socialist goal; it is reiterated in the Henry tax review, which unequivocally states that ‘Australia’s tax and transfer system needs to raise and redistribute revenue efficiently, equitably (my italics) and in a fiscally sustainable manner …’

Sadly, the present low level of Newstart payments is counter to both Labor objectives and the fundamental role of taxation. They fail to take into account the most basic realities of the cost of living – housing, for instance.

According to housing advocacy group National Shelter, rents are rising at a rate three times that of the Consumer Price Index (CPI). In the March quarter 2010, the median rental for a newly let one-bedroom flat in Sydney was $385 – almost $100 more than the single adult rate of Newstart and the maximum weekly Rent Assistance payment ($56.70) combined! In addition, the miserly Newstart Allowance ensures that the costs associated with searching for work – transport, decent clothing, access to computers and so on – are prohibitive.

To make matters worse, the gap between unemployment payments and pensions will continue to widen if the system isn’t overhauled. This is because increases in the former are calculated using the CPI, while pensions increase in line with wages, which are historically higher than the CPI. In addition, Newstart recipients face significantly harsher income tests than do those receiving the DSP, and lengthy waiting periods if they have substantial savings.

If Gillard’s rhetoric uses silence and innuendo to suggest an undeserving poor, the Howard government deployed a metaphorical pick-axe in its wrecking of the public image of unemployed people. Following its 1996 election victory the Coalition began demonising unemployed people with particular zeal; they were lazy dole bludgers who were lucky to get anything.

The government introduced Work for the Dole and the concept of mutual obligation, tightened access to benefits and reduced levels of payment in some instances. Tony Abbott coined the term ‘job snobs’ and reportedly claimed that the welfare state encouraged welfare dependency, while Mal Brough falsely stated that one in six unemployed people were ‘cruisers’ and ‘dole bludgers’ who were exploiting ‘the generosity of the Australian taxpayer to fund their lifestyle choice’.

At the same time, the Howard government reduced the ability of the welfare sector to challenge these negative images by effectively muzzling it. It defunded some advocacy groups, required welfare organisations to provide advance warning of any public criticisms of the government, and threatened to introduce legislation that would take tax breaks away from non-government organisations that advocated changes to legislation, if this advocacy was ‘more than ancillary or incidental to their core purpose’.

The rhetoric of the undeserving poor helped to justify Howard’s refusal to increase Newstart (and pension) payments despite the economic boom, as well as his shameless finessing of middle-class electoral bribery and tax rorts for the wealthy to stay in power (what the Welfare Rights Unit labels ‘upside-down welfare’).

Howard changed the tenor of federal budgets, turning them into Christmas-style handouts for voters who were encouraged to care only about how they would benefit financially. He increased funding for wealthy private schools, introduced a rebate for private health insurance and created a First Home Owners Grant. In 2006, Coalition treasurer Peter Costello announced profligate superannuation concessions that blatantly favoured the wealthy and created a tax rort for older high-income earners.

The Labor government has continued to produce regressive policies and encourage the ‘gimme gimme’ attitude of voters. Its proposed ‘cash for clunkers’ (Cleaner Car Rebate) scheme – which may now be on the scrapheap – is a relatively minor example. The scheme would throw $2000 at those who could already afford to buy a brand new car, and would no doubt be enthusiastically taken up by comfortably-off parents whose university-attending children were currently driving bombs.

More disturbingly, the government foregoes billions of dollars in tax revenue each year by giving generous tax breaks, such as negative gearing, to property investors. (This policy has also contributed to steep increases in the price of property, and therefore helped to fuel rent increases that have worsened hardship for the poor.) Moreover, despite the recommendations of the Henry review, the Labor government has maintained the superannuation concessions for the wealthy, concessions that are costing the country billions. Removing these property investment and superannuation tax breaks would release funds for fairer Newstart payments, so that the poorest Australians could afford the basics.

The mainstream media has been doing little to champion the rights of unemployed people. This year the voice of the social welfare lobby was conspicuously absent from post-budget ABC radio news bulletins, while Lateline did its bit to keep social justice out of the post-budget discussion.

On the program that followed the budget speech of 11 May 2010, the only non-government perspective was given by the dry-as-dust Chris Richardson from Access Economics (Richardson is, in any case, a former Treasury staffer). Predictably he called for the government to cut spending, failing to distinguish between worthwhile and wasteful spending; interviewer Leigh Sales made no attempt to challenge either the social or economic basis for this assessment.

In fact, while the ABC is obsessed with balance, in the area of social justice it makes no attempt to give equal time. Journalists are required to be fluent in the rhetoric and jargon of neoliberalism, so why aren’t they equally familiar with the concepts of social justice, equity and inequality?

On the contrary, seasoned interviewers such as Fran Kelly and Kerry O’Brien repeatedly fail to call politicians to account on the regressive aspects of their budget and election giveaways. Nor do they raise the contradiction inherent in politicians repeatedly saying they can’t afford to fund adequate income support and services for disadvantaged people while blithely handing out tax cuts to those who don’t need them. In the fourth estate, the idea of a nation that supports the ‘fair go’ seems to have been abandoned.

This lack of oversight has enabled the government to make life increasingly difficult for disadvantaged people, the unemployed among them. Initially applied to Indigenous welfare recipients in the Northern Territory, welfare quarantining for non-Indigenous welfare recipients was to be rolled out in the NT from July this year, despite evidence that it doesn’t work. It will apply to long-term unemployed people, some young people on benefits, those deemed to be at risk of financial crisis or domestic abuse and people referred by child protection authorities. At the end of 2011 the scheme will be assessed with the possibility that it could be rolled out nationally.

This scheme costs a whacking $4400 per person on average, money that would be much better spent on family intervention programs – such as those run by Uniting Care, which cost less and are proven to work – as well as treatment for addictions, financial counselling services, greater job search assistance and an increase in allowances. ACOSS has labelled the scheme ‘a top-down, one-size-fits-all, bureaucratic solution to complex social problems’ that is ‘poorly targeted and expensive’ and will ‘inflict shame and indignity on income support recipients’.

In an eloquent example of bipartisanship between the two larger parties, prior to the election Tony Abbott declared that he approved of the scheme and suggested that he would implement it if the Coalition won government.

If governments can get away with such an ineffectual and even harmful policy with little public protest, there is a strong risk that unemployed people will be unfairly targeted in other ways when the economic good times are gone.

The UK offers a sobering example of what can happen when the concept of the undeserving poor takes hold. According to journalist Johann Hari, the people most able to shoulder the burden of David Cameron’s obsession with reducing debt – the wealthy – aren’t being asked to do so.

Instead, in another example of the twisted logic of upside-down welfare, the poor are being hit; the unemployed, for example, will lose £6.50 from the £65 they receive a week. Hari quotes a chilling off-the-record remark made to The Times by a government minister: ‘the undeserving poor are undeserving’. He goes on to show that cutting government spending is not only bad for poor people, but also disastrous for the economy – that is, it will simply create more poor people.

So how to counter both the demonisation of and the silence around unemployment? How to build sufficient momentum in the community to pressure the government to raise unemployment payments to reflect the cost of living?

The human brain thrives on narrative. Australians need to hear the voices and stories of unemployed people themselves, and to begin to understand what their lives are like. Just as Howard knew that it was vital to prevent the media from humanising the Tampa boat people, both the government and the Coalition no doubt realise that if unemployed people were to tell their stories they would receive a measure of sympathy from the community.

The voices of unemployed people can be heard in a report the Brotherhood of St Laurence produced in March this year, Making Work Pay and Making Income Support Work. The report found that the social security and tax systems created significant barriers for people trying to return to work and combining part-time work with welfare payments. It called for ‘a wide-ranging overhaul of income support, housing and employment services’ to ease the transition. But in doing so it also exploded the popular myth that the unemployed are somehow different from, and less motivated than, the rest of us. Conversely, it found that:

… given their personal circumstances, income support recipients are shown to make sensible decisions regarding engagement with paid work … in stark contrast with the stereotypes of welfare recipients as ‘dependent on welfare’ or incapable of making ‘responsible’ decisions …

Indeed, the report concluded that ‘even the most disadvantaged participants held positive attitudes to paid work’. It laudably includes quotes from unemployed people themselves – people like Ian, who says: ‘I want to be cut off the [Newstart] payment as quick as possible … to get back to work, even if it’s just a bit over Newstart, I’d rather do that’.

The welfare sector needs to continue its fight to get the issue of unemployment payments into the mainstream media, and to tell the stories behind the statistics. In turn, journalists need to understand that the experiences of disadvantaged people are vital to presenting a complete picture of this country, and to bringing back the concept of the ‘fair go’; but they also need to realise that news stories that don’t demonise the poor or oversimplify their circumstances make for stronger, more accurate and more hard-hitting journalism.

The policies of both the Coalition and Labor need to incorporate basic fairness for unemployed people through income support payments that enable them to retain dignity and a lifestyle not ravaged by desperate want. The Greens haven’t specified a particular level of increase for Newstart payments in their policy platform, but say they want to ‘simplify the system of targeted pensions and allowances into a universal guaranteed adequate income scheme’. Now that they have obtained the balance of power in the Senate, it’s vital that they push to bring unemployment payments into line with pensions. They should also maintain their opposition to welfare quarantining.

Unemployment can happen to anyone who is an employee, and a fairer, more cohesive society benefits every single one of us. Our new minority government needs to foster in this wealthy country a generosity of spirit and an understanding of the right of every Australian to a standard of living that preserves dignity, enables participation and provides the basis for creating a better future.

Sunday, September 5, 2010

My new non-human companions


A birdie

For about the last three weeks, almost every day, a plain brown bird, probably a female common blackbird, has been tapping on my bathroom window intermittently throughout the day, fluttering away when I rush to intercept her. I’ve christened her Mabel.

There’s a wisteria against the back wall of the house, and I thought for a while Mabel was trying to pull off wisteria stems to build a nest. But now I don’t think so. I’ve learned to creep up to the bathroom door and peer at it in the mirror on the right-hand wall, which is at right angles to the wall with the window, and when I do this I can see Mabel knocking on the glass with her beak.

The insistence of this task suggests that she’s worked out that the glass is a genuine substance, not mere air as those unfortunate birds who knock into windows think it is, and has decided that if she knocks for long enough and hard enough she can penetrate it.

No matter how quiet I am, Mabel knows when I creep up, and she stops her tapping and stares at my image in the mirror with trepidation. When I creep quietly through the door to look at her square on, she flaps away.

I glimpse before she flutters away a look of curiosity and interest on her face. She seems fascinated by the sheltered foreign world behind the glass, even eager to enter it – perhaps it seems like an incredibly safe and obvious place to build a nest? On one morning recently she’d brought what was probably her mate along, a much darker blackbird, to observe her efforts.

Why this one bird? Why is she so fascinated by the glass? Why don’t other birds of the same species act this way? Is Mabel dumber than her peers or more intelligent? If more intelligent, could she breed a series of superbirds that might become more intelligent still?

But if she seeks the strange new world she glimpses in the shadows behind the glass, why doesn’t she fear it, knowing that a huge human lurks behind it?

She’s tapping much less often now, down from her maximum of perhaps four or five tries a day, but she still hasn’t given up. On one morning she started early, while I was still in bed, and I even thought I heard her a few nights ago, but peering through the darkened window to see if she was still there was futile.

My writerly brain is always trying to find a symbolic or spiritual meaning when there is none. Does Mabel’s urgent tapping mirror my own attempts to rejoin the human race? Is that also a futile task? Or is she a spirit in human form trying to convey some vital message from the other side?

More importantly, how do I explain the scratches on the window to my landlords?

A computer

I’ve just bought a new computer and the whole thing cost me a lot more than I was expecting to pay – almost a thousand dollars more, if you count the $240 I spent for the nice computer man to come and set it up for me. This decision felt incredibly indulgent at the time – the technician who fixed my computer last time quoted only $70 to install the new software and copy the files over, but he would only do it at his shopfront.

Given the things that went wrong with the set-up (my old printer incompatible with Windows 7; the surge protection power board activating the safety switch for the circuit, causing the electricity on the circuit to turn off) I’m just relieved I chose the more expensive route. I thought I was pandering to my chronic fear of things not going right but it turned out to be a necessity; simply having these problems occurring with someone there to comment on and diagnose them was important. I bought a new cheapo surge protection board, and I’m adjusting to my dad’s old desk jet printer, while he’s been promised my seven-year-old HP laser printer as he’s on an earlier version of Windows.

It infuriated me that my old printer was still going strong but was being forced into unnecessary obsolescence – HP have created some Windows-compatible drivers for some of their older models, but not this one, and I was told that the older the model the less likely they are to do so in future if they haven’t already. I mean no offence to users of desk jets, my dad included, but it feels like going back in time after a laser printer! I’ll buy a new laser printer at some stage, but HP has lost my vote for good.

This is the first time I’ve bought a new computer in five-and-a-half years and I’m noticing a similar situation to the one that occurred last time. I’ve tried to avoid unnecessary bells and whistles (no blueray DVD player for me) but I have the same sense I did last time of a whole lot of new features on the standard programs, many of which might be helpful but that I’ll probably never get around to finding out about, as if an ideal technological life (that I’d paid for) were passing me by.

I’ve also been keeping Norton busy with some glitches while using its anti-virus program with Explorer, and was in danger of becoming a nuisance caller. Luckily I’ve cleverly worked out that I can easily test if the anti-virus program is to blame just by turning it off temporarily. And simply observing as the Norton techies temporarily take over my computer and do their swift and magic checks with their invisible hands has been both weird and instructive. Through sheer necessity they seem to know far more about the glitches that Explorer can cause than Microsoft ever will.

Tuesday, August 31, 2010

Australian media fiddles while Pakistan drowns


Australia is still awaiting the final results of our recent federal elections, which resulted in a hung parliament, the first time this has happened since the Second World War.

We were on the eve of the election campaign when news of the devastating floods in Pakistan gripped the world. The inability of the Australian media to sufficiently highlight the horror of the floods, huger than the 2004 tsunami and the Haitian earthquake combined, was appalling. I’m no news junkie but wherever I watched or listened, rarely if ever did a story about the floods headline a news bulletin, although it usually featured somewhere.

The numbers were difficult to comprehend: initially 14 million said to be displaced, with that number now at 20 million, almost the population of Australia.

This disaster is the future writ large, the massive effects of global warming evident in our lifetimes. It’s not just a matter of short-term relief: the entire infrastructure of the country will have to be rebuilt. Given the unprecedented scale of the tragedy, a national fundraising campaign should have been ubiquitous on all Australian media from day one, but this wasn’t the case.

Instead, an increasingly irrelevant media bored a population pissed off with the governing ALP for knifing a first-term PM and disgusted with the inability of the major parties to produce policies aimed at anyone but the most ignorant swinging voters. The result has been a hung parliament with independents demanding parliamentary and other reforms.

It was both heartening and sickening when, the election safely over, the ABC finally got around to holding a radiothon for Pakistani flood victims in conjunction with UNICEF's fundraising appeal – how many more lives could have been saved if they’d held it right from the start?

The response was overwhelming. UNICEF was hoping for $1 million, but in seeming record time $3 million had been raised. It appeared that Australians had been unsure of how to respond to the disaster and were just waiting for some guidance. Better late than never, but this enormous tragedy hasn’t magically disappeared – sustained and relentless media attention is still needed.

Wednesday, August 25, 2010

Tiny steps up the mountain: exposure and social phobia recovery


As once the winged energy of delight
carried you over childhood's dark abysses,
now beyond your own life build the great
arch of unimagined bridges.

Wonders happen if we can succeed
in passing through the harshest danger;
but only in a bright and purely granted
achievement can we realize the wonder.

To work with Things in the indescribable
relationship is not too hard for us;
the pattern grows more intricate and subtle,
and being swept along is not enough.

Take your practiced powers and stretch them out
until they span the chasm between two
contradictions ... For the god
wants to know himself in you.

—‘As once the winged energy of delight’ by Theodore Rilke

I stumbled upon this poem by Rilke and was struck by how apt a description of exposure therapy it was, particularly the last two lines of the first verse and the first three lines of the last verse.

As a severe social phobe with obsessional and self-defeating tendencies(!) I feel as if I am really exploring exposure for the first time in my life. But as I begin my tentative explorations, I also begin to see just how difficult the tasks – for there are many – are. There is so much work ahead.

I’m agnostic about my chances of recovery, each foot planted in an opposing camp, that of success and failure respectively. For about six years, I more or less gave up on my anxiety. It just felt too hard. Now that I’m beginning the work, now that I feel I have some of the equipment I need, I see that I was at least partly right. I see that the path is so steep, so strewn with embedded rocks and stubborn tussocks of grass, that I won’t ever reach the summit.

Yet while I’m by no means convinced that I will ultimately succeed, all progress will constitute success. Certainly I have no plans to get a job in the ‘real world’, or join a class. These achievements are for the moment impossible and may remain so. I have to see what I‘m doing as very small or I’ll get ahead of myself, try to travel too fast, and stumble. If I raise my expectations too high, I’ll achieve nothing. My work must be rooted in and held down by the realities and intricacies of the present moment.

What I am trying to do is make myself more comfortable with feelings. I want to be able to tolerate frightening emotions and thoughts in the presence of others. Paradoxically, this includes a great measure of discomfort.

A deep-seated, powerful enemy holds me back. It thunders down on me if I get too uppity, too relaxed, stray too deeply into the social world. It works through my social phobia symptoms but those benign clinical terms cannot describe its force. In a funny way it must love me; fearing my total annihilation, it is ruthless in its misguided attempts to keep me safe.

There are two voices running through my head intermittently. One of them gently reminds me that I have run out of time and that my greatest battles are already lost. For years I took this voice to be the unalloyed truth, but now I’m not so sure. The other one screeches against such a passive attitude and orders me sternly to stay on track. Like a scolding parent, it drags my thoughts back into line when they veer off into fearful or childish fantasies, and when my self-talk gets too self-indulgent. This voice, in the best tradition of Monty Python, is ‘cruel but fair’.

Battling silly thoughts yet giving into panic. Letting myself breathe yet accepting the fact that I may not be able to. Acknowledging childish impulses but refusing to mistake them for reality. None of this will create miracles. There are huge darknesses, gaping ellipses of selfhood, gutterings of uncertainty and terror. There are unpredictable hormonal spikes and the plummet of low blood sugar, which feels like the carpet of common sense being swept from under my feet. It may not cause the thinking that leads to my panic, yet it is the faithful handmaiden of that panic.

The greatest contradiction: to fight my anxiety I must give up fighting. But this doesn’t mean an instant cure; in some situations I can beg myself into a rag-doll limpidity of submission and still feel breathlessness well up. A lack of physical defences can cause me to feel more unsafe than ever.

Sometimes I experience what holds on to me as simply a form of extreme shyness. This surprises me, because I have a stereotype of shy people as being very quiet. I can be loud and exuberant and at times even overbearing and dogmatic (who’d have thought?) with those I know well. But the extreme self-consciousness I feel in front of those who intimidate me (people my own age or thereabouts; those of a high status or intelligence level; those who happen to be particularly good looking and attractive) can frighten me so much I begin to disappear.

In these situations I feel like a bird picking its way uncertainly around a patch of suburban lawn, alert to the tiniest pulses of the universe. Every intimidating thought, every minute surge of blood into a vessel, a daring remark that could lead into dangerous conversational waters, whether one too many people in the room happen to be looking in my direction: anything can spark off a kind of emptying of the Red Sea of my interconnectedness. I draw the room and the separate worlds of others into myself and force them to focus their entire attention on me.

Once, at my sister’s place for afternoon tea, some family friends dropped in unexpectedly. We sat awkwardly round a circular dining table in the formal front room. I was already feeling hemmed in when my mother gave me what appeared to be a ‘significant’ look across the table. I left soon afterwards. Furious, I later asked her why she’d thrown me that sudden stare.

‘I thought how beautiful you were looking’, she said. It was some years ago now, but even as I write this, not wanting to sound boastful, I don’t entirely believe her. Instead I believe she was worried for me, and that her look was a badly timed attempt to see how I was coping.

Social phobia may be the result of having no reassuring parent figure to return to in the earliest years of life. A shy baby cradled in its mother’s arms will brave an unknown horde of new faces for a few frightening seconds and then bury its head in mother’s familiar shoulder as it smiles bashfully. An introverted child playing with friends will suddenly experience a surge of existential aloneness, and will run back to mum or dad to cling onto legs and arms until the equanimity of the world is restored.

Adulthood involves no such havens. If the parent cannot offer the needed reassurance, perhaps the child never moves through this stage but remains stuck in it. The need to hide may remain, but can no longer be acted out. As the child enters the unknown world of adolescence with all its frightening new sensations, he or she might create certain internal defences as a substitute. In my case, these became my symptoms, warding people off and creating the safety I craved. Yet it has been a lonely safety.

There was one small thing I did recently that I was proud of. Dropping into my local supermarket, I homed in on the Oral Health section and searched for my usual pack of bargain basement toothbrushes. A very scary man was hovering in the aisle in the same area. Scary because tall, statuesque, brown skinned and attractive.

Normally I would have been unable to focus on my quest in the presence of such beauty, and would have cut it short in despair. This time I continued to search as he stood one or two feet to my right, torso jutting forward as he conducted his own interrogation of the shelves. These minor exposures are exactly what I need to seek out instead of instinctively avoiding them. They are tiny steps forward that can lead me, if not to the top of the mountain, at least to a place that has a better view.

Tuesday, August 3, 2010

Time and time again


Human beings are hardwired to regret. One of the most pernicious regrets is that of lost time.

Do the following statements sound familiar? We learn from our mistakes. Even suffering brings growth. If we take a wrong direction it provides valuable feedback that can enable us to make a better decision the next time. Similarly, if we are too frightened to act in case we make a mistake, then that defeats one of the main purposes of life, which is to learn.

All of these things are true. However, it’s also true that some mistakes come at a great cost, and that some decisions have serious adverse consequences. We don’t always get a second chance. These are hard truths that I believe some new age spiritualities do not take account of.

One of my earliest heroes was the melancholy Leo Sayer, surely the forerunner of today’s emo. ‘I’ve wasted, wasted, so much time / walking on the wire’, he wailed on one of his early and greatest hit songs, ‘The show must go on’.

For me, the hardest thing to put up with in my present life is that, from my own reckoning, I ‘waste’ huge swathes of time, especially compared with my idealised image of what someone with my degree of intelligence ‘should’ be doing. Inevitably I link this wasted time with the present structure of my life, which is the result of mistakes made years ago, when I was literally a different person from the one I am now.

I’ve long forgiven the wasted time of my late teens and twenties, when I didn’t know any better. But in my early and mid-thirties, when I’d started to recover from an eating disorder and gain some sense of engagement with reality, I continued to make some decisions that I knew at the time were unnecessarily timorous. The mistakes I made then led to wasted time that to some extent continues into the present.

This doesn’t mean that I never have valuable experiences. It does mean, however, that I miss out on many important aspects of life and I don’t work nearly as much as I’d like to.

Most of the time I can live with regret about the past – it’s gone, and I know I can’t change it. It’s the continued wasting of the present, the seeming unavoidability of that waste, that’s difficult. And this also relates to the realities of ageing and living alone. I can learn from my mistakes, but the fact is – to be perfectly blunt – at 47, it feels as if I’m literally running out of time.

There are three fronts on which the time appears to be washed under the bridge by forces I can’t control: not working enough because of fear of others, and therefore not being able to shovel money away for a more secure and fun lifestyle (own house, holidays, old age, more music, theatre, expensive clothes, money for good causes); through depression and anxiety not ‘improving’ myself enough ‘culturally’, with appropriately highbrow music, film, and literature; and through having my literary creativity curtailed by the ‘failure’ to achieve an emotionally and socially fulfilled life (the blog has helped a bit with the creativity).

I envy people who write successful books out of the horrors of mental and physical illness or addiction because it seems to me that they have somehow recuperated the ‘lost’ time, made meaning of it and created something new from it. Not only do they help themselves by writing their story down and shaping it into narrative, but they help many others by sharing their story and offering hope. They may also gain financially from sharing their suffering in a way that chimes with others.

I fully understand that I am clinging onto an idealised version of myself. If I had a family I would probably be overly busy, but much of that busyness would involve mundane tasks. I’ve always had a morbid fear of being a female parent, and being given the role of self-sacrificing ‘mother’ instead of equal partner in the parenting enterprise – I look at my sisters, all of them mothers, and simply don’t know if I am better or worse off than they. But fathers also get lost in the mundane – I think of the hours my brother-in-law spends ferrying his kids to footy and basketball.

Yet even amidst the ennui and chronic exhaustion, as a parent I would be able to tell myself that I was achieving a valuable long-term goal – the continuation of the species and the nurturing of tomorrow’s taxpayers and, hopefully, stewards of planet Earth. And my brother-in-law probably uses at least some of that driving (and game watching) time to bond with his children.

As well, the wound of loneliness sometimes requires the antidote of bad television rather than the intellectually stimulating read that some busy parents, including mothers, might crave. At times, such parents might envy the likes of me, free of the never-ending drudgery and pleas for attention. But they might find me curled up in a ball bewailing my fate as I watch Ramsay’s Kitchen Nightmares rather than poring over the Collected Works of Charles Dickens as Beethoven’s Ninth thunders in the background.

Obsessed with time management

My fear of wasting time also relates to the mistaken belief that not doing something productive is somehow sinful. I certainly didn’t pick that up from my Catholic upbringing. Instead, this fear stems from the time when I was completing my Masters thesis in the late 1990s. I was on a scholarship, studying full time, and surrounded by successful people who gave papers at conferences, tutored, learned French to improve their understanding of theory, and attended reading groups.

At the time, to my way of thinking the pursuit of knowledge easily trumped consumerism, materialism and any sort of interest in popular culture, and from my lofty, poverty-stricken heights I looked down scornfully on anyone who did not value intellectual endeavour, seeing them as sadly deluded. I spent hours in the library brushing up on theory, much of which has now long since vanished from my mind.

But the sense of directedness I saw in the high achievers was pervasive. I remember one day glancing behind me at the library queue and noticing my supervisor further behind me in the line, waiting to have a book checked out. She poked her head around to scan the queue and, with a quick jerk of her body, abruptly left. I still remember what that momentary action indicated to me: the instantaneous weighing up of the time she would lose in the queue compared with the convenience of having access to the book. This suggested someone whose life had no spare seconds, who was so full of purpose and responsibilities that time management meant the difference between ongoing achievement and mere striving.

So in the couple of years following my Masters I would use every minute of spare time ‘productively’, by, say, reading small cards on which I’d drawn kanji (Chinese characters used in Japanese) while waiting forlornly at a city bus stop on a biting cold winter’s afternoon.

And before I started editing, and during the times when the work dried up and I was coaxing survey responses from reluctant telephone interviewees, I’d surreptitiously go over Japanese sentences while waiting for respondents to pick up the phone. Eventually the supervisors noticed and, despite my high success rate in obtaining telephone interviews, ordered me to stop. This caused me unseen angst; I couldn’t just relax and let the time be spent simply making enough money to live on. I was obsessed with ‘improving each shining hour’.

At its height, this fear of wasting time would have extended to, say, the idea of socialising with people who I didn’t have much in common with (ie my relatives!). But one gift of my social phobia, and the exploration I’ve done in trying to understand it, is that I now see those everyday interactions as being vitally important.

There are two reasons for this: they're good for mental health generally, because as humans we need to interact with others and feel safer when we’re with others, and particularly our ‘pack’; and because they provide me with valuable exposure practice for my social phobia.

So to some extent regret about wasted time is something I live with. Slowly I’ve begun to realise that the moment, even in its occasional awfulness, even when not filled with mental exercise, has its own integrity.

I could learn kanji till I was blue in the face but it would be useless, a waste of time, unless I was attending a Japanese class or had a reason for learning it such as a planned visit to Japan. Neither of these situations applied, so the keeping up with my Japanese study became, in the end, a waste of time rather than a good use of it.

The concept of mindfulness helped me understand this. Mindfulness involves becoming an observer of the self – one’s thoughts, perceptions, feelings and current actions – in order to move into the present in a more profound way. When I divide my attention too much (writing my diary while watching tele, for instance) I’m subtly diminishing my experience of time, indeed of life. While trying to save time, I may actually be wasting it.

I love good thrillers and I need to spend some time vegging out on weekends. But I’m scraping the bottom of the barrel when it comes to decent thrillers at my local video store. So last weekend I ended up on a Saturday afternoon watching one of the worst klunkers ever made, Cold Creek Manor with Denis Quaid and Sharon Stone.

There literally wasn’t a scary moment in it; it could have been parody if it hadn’t been so dull and lacking in humour. It made me wonder about the technical aspects of thrillers – why some work and some fail spectacularly. But perhaps the most important thing for me to do was to actually pay attention to the film, observe and follow the creaky plot, and try and work out why it failed, rather than just having it on as background to my random thoughts.

Another reason why unstructured time is vital is that it refreshes the mind and enables creativity. Late one afternoon I took my seven-year-old niece to the park, supervising as she mucked around on the play equipment. For quite a long time she half-lounged on a swing, moving slowly back and forth as she gazed into space. This natural ability to enjoy mental downtime is too often mistaken for laziness. But it's the space in which new ideas and creative breakthroughs hatch themselves.

A book on worry that I read recently goes further than advocating basic mindfulness. In The Worry Cure, Robert R Leahy provides useful advice for incessant worriers who are busy dreading what the future might bring. One of his suggestions is that once you’ve brought yourself back to the present moment using mindfulness, you can add value to the moment, make it count.

I love this idea because it extends the concept of mindfulness so effectively. You bring yourself into the present, become aware of your body, breathing and perceptions; then you do something to improve the present, even if it’s just subtly. This could be something insignificant, like savouring a cup of tea, putting some music on (Beethoven’s Ninth?) or taking the kids for an ice cream.

Using intuition is also important to me in combatting my fear of wasting time. In the past I was constantly using my will to forge ahead; now I use intuition to decide whether something’s worth spending energy on. Anything that feels right can't really be a waste of time.

Being busy for the sake of it can actually cause harm. Former prime minister Kevin Rudd’s political demise provides a cautionary tale. Rudd seems to have been unable to stop work, to delegate, and he also caused great harm to his staff because he unapologetically worked them to the bone, no doubt causing havoc with their family lives.

‘A staff working year is probably like a dog year, that is it's probably worth seven years in normal life’, he was quoted as saying in The Daily Telegraph of 15 April 2010. That report also stated that he had lost 28 staff, presumably since coming to office in late 2007.

The coup that ousted Rudd in favour of Julia Gillard occurred for many and complex reasons, but the refusal to delegate seems to have been one of them. I sympathise with Rudd and wish fervently that the party had given him an ultimatum months ago rather than cruelly dealing the death blow – but I can’t help seeing in his fate a grim warning about the effects of overwork!

Monday, July 26, 2010

Social anxiety and the challenges of exposure therapy


It struck me as I jumped into the shower this morning, in the split second as I registered that the cold was not unbearable anymore, that the problem with winter is not winter but summer.

I wrote a piece about minor mishaps a while ago. One of my points was that if a crisis remains unresolved for a while it may cease to be a crisis as one adjusts to it. Winter is the same. As long as you have somewhere to live that offers reasonable levels of warmth in some rooms, eventually your body adjusts to the cold.

And just as you’ve become accustomed to it and have your bedtime routine worked out (in my case a hottie and four doonas, as well as copious layers of pyjamas), the Earth stretches as if from a long sleep and starts to exude warmth. The blossoms unfurl, the camellias drop liltingly to the ground in their prodigal abundance. Everything wakes up, and you have to adjust again.

This is not some idle complaint. It makes me think of exposure, now a central plank of short-term talking therapies for anxiety disorders and phobias. Exposure relies on the concept of increasingly difficult forays into feared experiences. These forays are graded so there is always a carefully calibrated level of discomfort, while the difficulty of the task increases. The theory is that the sufferer learns to tolerate an ever-greater degree of risk and is therefore able to deal with an increasing number of feared situations.

Exposure is an incredibly useful concept. I’ve never practised it in conjunction with a therapist, but I have a friend who is an exponent of it (he even wrote a book about it), and I practise it in very small ways.

But the challenging thing about exposure is that it is aligned to life yet also pitted against it. Creating a list of progressively more difficult tasks is a way of creating order, but the chaos of life is constantly intruding. And, depending on your disorder, it may not always be possible to retain control over the level of exposure.

Work is an area of life where I gain valuable exposure only to sometimes lose momentum. Because my work stops and starts, I don’t often get into a pattern of work. This is bad, because once the work starts again I not only have to adjust to the discipline but I also need to refamiliarise myself with processes and even skills.

As well, I have to ‘expose’ myself to a lower standard of self-care and housecleaning, which leads to an increase in anxiety levels.

I believe that I’d be able to gradually increase the level of work I was able to take on if I could control the flow of it – but that’s not the way the real world operates.

Social anxiety is another area where the exposure levels are difficult to control. According to psychologist Dr R. Reid Wilson, this is because the unpredictable nature of social life is such that it’s impossible to grade one’s exposures; and because their lifestyle may require the sufferer to carry out social tasks that go beyond their current level of comfort. 'When you have social anxiety, events that are high up on your list of threatening situations may take place before you have mastered your lower level tasks’, he says.

Dr Wilson’s excellent website is the first time I’ve come across a therapist who identified the unique difficulties of social anxiety in this way.

Another difficulty with conquering social anxiety he identifies is that the sufferer must focus on so many anxiety management skills at once, sometimes while performing a complex task like public speaking.

One way to get around the unpredictable nature of social exposure, according to Dr Wilson, is to simulate the scary situation using friends and family. For example, you could practise public speaking in front of a group of friends, conduct a role play on bumping unexpectedly into someone in the street, or ask someone to look over your shoulder while you practise writing.

Life, the universe and exposure

The chaos of life may pose a challenge to exposure therapy more generally. Unexpected stresses or adverse events in one area of life may temporarily lower our ability to challenge ourselves in the areas we need to work on. Sometimes I need to withdraw and regroup because of some unforeseen blow.

This is not to argue against exposure but to demonstrate how important it is for the individual to be in control of their therapy. This is the view of Bronwyn Fox, a recovered sufferer of panic disorder who has written books on the issue and now counsels sufferers.

The important thing is to get in touch with your gut feeling and obey it. I have learned this lesson painfully and slowly, sometimes suffering from too much exposure and sometimes not enough. In my experience both are harmful.

If I’d known about exposure earlier, there are definitely aspects of my social and working life I would have fought harder to retain, rather than simply letting them go because they were too hard. But not knowing about exposure also led me to throw myself into situations that were too difficult, which meant I got overexposed and therefore more phobic very quickly. In both cases I wasn’t managing my anxiety well because I didn’t have the knowledge or tools.

I’m not saying that everyone can expose themselves and eventually rid themselves of their anxiety. In my case I think there are some things that are just too hard and will be for a while, and perhaps forever. However, I do want to create some sort of graded exposure program.

Exposing myself

Recently I visited an arts event alone. I’ve done this heaps of times but it was in a venue that I was unfamiliar with. I’m an expert at subtle avoidance – I’ve been practising it my whole adult life – and I noted that two very effective avoidance strategies were in play: getting there late, and sitting in the back row.

The getting there late was partly my unconscious mind at work. I just missed the tram! How convenient!

Next time I will resolve to sit in a row that is somehow more ‘threatening’ (this could mean, for example, a row where the people look interesting, or towards the front, or both) and getting there before the event starts. I might have to tackle one of these tasks at a time. Even being in a room with others and experiencing my reactions can be difficult for me sometimes. The important thing for me is to stay with myself somehow, to practise mindfulness without buying into my fears.

And soon it will be time to get exposed to a completely separate dilemma – the extreme heat of a Melbourne summer.