There but for Fortune

I have often been accused of being too literal, and so please understand that when I use the phrase “dumb luck” I have no intention of insulting anyone, but instead I use the phrase because, quite literally, luck itself cannot speak.  It has no message, no meaning.   It doesn’t know where it comes from and it doesn’t know where it’s going.   It’s a meandering ghost lurking behind every tree and under every stone and in every breath we take and even those we don’t.

Pilots like to believe that they are in control of their destiny.   It’s important that they believe that, because if they didn’t, they likely wouldn’t step foot in a cockpit and advance the throttle.   Flying is certainly more dangerous than staying at home and watching TV, and that is because there are more opportunities for something unlucky to happen.   “Fate is the Hunter” could not be a more apt title for aviation writer Earnest Gann’s autobiography, along with a 1964 film starring Glenn Ford and Suzanne Pleshette.   Shakespeare said it best when, no doubt while sitting on a pubstool, he said, “Shit happens.”   Good thing there was a bumper sticker writer around to write it down at the time.

I have found it fascinating over the years to listen to pilots discuss a recent deadly accident—any recent accident.   One might think they would be kinder to fellow pilots, but most often they are angry and critical of the pilot who died.   Even before knowing a detailed explanation, they blame the pilot for doing something stupid to cause their own demise.   “Pilot error” is in fact the cause of over 75% of fatal accidents according to the NTSB, but there’s a big percentage left over.   And that’s where the hunter comes in.

Dumb luck wields its unwitting existential sword in all directions.   It kills and it rescues.  Take, for example, my bout with stage IV cancer.  I don’t exactly feel lucky to have survived this far, now seven years after my cancer diagnosis.   Instead, I attribute my survival primarily to modern science and the physicians who have mastered their art at City of Hope.    I never had much hope, really, nor did I have much faith.    What I did have in copious amounts was resignation and compliance.   And in the end, I think it was entirely them, the physicians, who were to blame for you reading these words.   I am deeply grateful, even if you’re not.

But that too involved not a small measure of luck.   I had a protein, labeled simply P16, residing in my squamous cell carcinoma that was particularly responsive to the chemotherapy and radiation that killed, or at least postponed, the tumor’s metastasis.   That was lucky.    And I was lucky to have found that team of physicians who practiced their art form flawlessly, as well as a profoundly supportive family to monitor and shield me from contextual harm.

And yet, there are those whose bodies end up downstairs, in the basement morgue, refrigerated until claimed by their loving and supportive families.   Many of those had copious measures of hope and many of those even had sublime faith, but the mortality police came and snatched them anyway.  

The thing about dumb luck is that, by definition, it is out of our control.   We can hope and faith our way through the vicissitudes of this churlish life all we want, and the freaking plane might still crash, and the wayward car might run the light and smash us to smithereens.   These are hard realities, and not incidentally, it’s the anticipation of the slings and arrows of outrageous fortune that is the definition of anxiety and the chief reason why pharmaceutical companies remain a good investment.

What remains out of our control can plague and preoccupy us, or we can choose the path of optimism, with the caveat that optimism when blind becomes ignorance, and ignorance causes a lack of the kind of healthy vigilance that keeps us relatively safe.   Going with the flow I sometimes think can be fun in a kayak, but it can also smash the kayak into a boulder and ruin our day.

Optimism, I suppose, is simply the idea that luck strikes disproportionately on the positive side of things, giving more than it takes.   The balance of probability, as Conan Doyle’s Holmes would say, certainly leans in that direction.   Plane crashes happen every day, but proportionately to miles flown, that’s still very little.   When they do, it’s usually the pilot’s fault, but usually isn’t always, and there’s still more than a smidgeon of fate involved.  So, to paraphrase the brilliant folk musician Phil Ochs paraphrasing everyone else, there but for dumb luck go you or I.

The Wrong Gauge

It should all be rather simple.   The heading indicator tells you which direction you are going, the altimeter tells you how high you’re flying, the airspeed indicator tells you how fast you are going.   But it isn’t so simple, because aviating isn’t just about reading our gauges; it’s about how we read them.

Many, many moons ago, I attended an “Evolution of Psychotherapy” conference, which those of us who have been in the head-shrinking field for a while will remember as the mecca for psychotherapists.   Roughly every decade, Jeff Zeig, a renowned Arizona psychologist, would bring together the living legends in the world of psychotherapy, until they died out one by one and it just got too depressing.  At one of those conferences, the brilliant psychoanalyst James Masterson was asked by a member of the audience why it was that no matter how confrontive she was with a particular patient, the patient remained unphased.   Masterson replied quite masterfully that the therapist was likely using “the wrong gauge” by judging her level of confrontation by how she would feel if someone said those things to her.   What mattered, of course, wasn’t her confrontation gauge, but the client’s.

It used to be thought, and likely still is, that people on the autism spectrum have difficulty understanding others’ perspectives, a lack of what the prolific psychologist David Premack originally called a “theory of mind”.  That observation has led to the view that people on the spectrum lack empathy, but it may well be that the problem instead could be caused by reading the wrong gauge.    It turns out, some new research indicates, that while it may be true that people diagnosed with autism often have difficulty understanding the perspectives of so-called “neurotypicals,” they don’t seem to have difficulty understanding each other.   In that sense, they only “lack empathy” when dealing with people who lack empathy for them.   We may, mistakenly, be looking only at the person with autism, and not the people with whom they are interacting.   That has led to a revision of the “empathy problem” such that some prefer to call it a “double empathy” problem.   The problem only occurs when two people lack empathy for each other.   Otherwise, the world turns just fine.

Reading the wrong gauge can have tragic consequences.  The crash that killed Buddy Holly, Ritchie Valens and the Big Bopper (the day the music died) took place in snowy conditions in Northern Iowa.    21-year-old pilot Roger Peterson, in spite of his young age, was not inexperienced, but although he passed the written portion of the instrument exam, he failed the instrument checkride and wasn’t technically legal to fly on that snowy day.  No one could determine exactly why, just 5 miles from the airport, the airplane that Peterson was flying turned and crashed nose-down at high speed, but one theory that emerged is that the airplane he flew on that day had a new attitude indicator (or “artificial horizon”) installed, one that was different from the gauge in the airplane Peterson had been used to flying but that happened to be out of service that day.   In one gauge, the depiction of the airplane in the center moved in relation to the static horizon line, and in the other, the airplane symbol remained stationary while the background horizon moved.   The result is a “figure-ground” difference such that up is one direction on one gauge and down on the other.   Flying blindly in a snowstorm, Peterson could have thought he was climbing when in fact he was descending.   He may well have been flying the “wrong gauge.”  Had he not done this, Buddy Holly would likely have lived to know his son and Don McLean may never have been able to retire.

In primary flight training, we are taught not only how to read our gauges, but how they relate to one another and even the best ways to scan from one gauge to another.   In psychotherapy, we try to teach our clients how to read their own gauges, especially the one that tells us what to do with the other gauges.   When clients first appear, it’s not uncommon for them to perceive themselves living in a world in which they can’t tell up from down.

It should be simple– the airplane is climbing or descending, I’m getting too angry or too tired.   It’s making sure we are reading the right gauge at the right time in the right circumstance, and then knowing how to level out and stabilize ourselves; therein lies the challenge.

 

 

 

 

The Putt and the Pendulum

Poe_pit_pendulum_byam_shawIt’s a good thing you can’t copyright titles, because I had to steal this one.   It’s just too good.   The play on Poe refers to a clever study by Harvard social psychologist Daniel Wegner designed to emulate a phenomenon well-known to golfers—the tendency to miss easy putts when the pressure is on.   In the study, subjects were told to hold a plumber’s pendulum—a string with a pointed weight on the bottom of it—and try NOT to move it in any direction. Wegner found that the greater the pressure to get it right, the more the string moved. The more you try not to do something, or tell yourself not to do something, the researchers hypothesized, the more likely you are to do it.

Eventually, after a series of similar experiments this notion became known as the “ironic effect,” because giving clever names to common phenomena makes you famous, helps you get published and increases your chances for tenure and income, especially after you do a TED talk. Perhaps because it wasn’t catchy enough, Wegner renamed the phenomenon the “white bear (or polar bear) problem” after reading Dostoevsky during his summer break.  Fyodor wrote: “Try to pose for yourself this task: not to think of a polar bear, and you will see that the cursed thing will come to mind every minute.

Ironic processes have been proposed to arise as a result of the unconscious (automatic) component of thinking being heightened during periods of stress, creating an overload which then interferes (through “hyper-accessibility”) with conscious thought, resulting in less focus and poorer performance. The unconscious monitor is thinking “If I miss this putt I’ll lose the tournament, be ashamed, and my mother will have to tell her friends in the nursing home.”   The stress created by TV cameras, high stakes, and Tiger Woods teeing off behind you can be intense, thrusting the unconscious monitor into consciousness, thus interfering with the conscious thought—“softly about six inches to the left,” thus distracting the golfer enough to impair concentration and performance.

Increase the pressure to do something right and we are more likely to do it wrong.   But that principle doesn’t work all the time.   Performance under pressure works like an inverted U-shaped curve, in which too little pressure has no effect on performance, and too much pressure really screws us up.   The trick is to find that middle way, in which there is just enough pressure to push us toward our best performance.

When I was a young teenager, there was an Orthodox synagogue located down the street from where I lived called the “Sea Breeze Synagogue.”   The old wooden building was built close to the turn of the last century, and badly in need of repair, but rather than tear it down they decided to build a new building in the empty lot next door.   There was a steel girder, about a foot wide, spanning the length of the empty hole where the foundation and basement was to be, maybe 25 feet long.   The width of the girder was certainly large enough to walk across without fear.   But the fact that it was suspended over a large hole, large enough to do serious damage should one fall into it, made the walk from one end to another too daunting. I knew some kids who did it, or said they did, but I wasn’t going to be one of them.

It was an easy task, but the context “spoke to me” and made it out of the question.   If I simply were able to put it out of my mind it would have been a sea-breeze.   But instead, had I tried it, the knowledge that if I fell I would likely not survive or be paralyzed for life would overtake my focus and I would, as it were, be more likely to miss the putt.

Psychologists recommend distraction as a chief strategy for dealing with such distractions.   In other words, think about something else while doing the thing you already know how to do well, and your newly conscious thought will serve as the antidote to the venomous voices in your head. While it seems counter-intuitive that thinking about how to best prune roses while walking across a tightrope will increase the likelihood of making it across without splattering one’s viscera on the floor of the arena below, to then be devoured by the abused lion while the lion-tamer is distracted by the malfunctioning of his assistant’s wardrobe, who in turn might be distracted by the thud of your own body having fallen three feet from her, I am told by psychologists more knowledgeable than I that indeed this is a good way of coping with the white bear problem.

My white bears often overwhelm me, and distraction never quite does it for me.   I try, for sure, but sometimes I just have to give in to the white bears.   Maybe that’s why I could never play golf.

 

 

The Route Not Taken

I submitted an article for a column I write in Plane & Pilot magazine called “The Route Not Taken.”   I’m fond of the piece, probably because I just submitted it and haven’t had the requisite amount of time and distance to re-read it and hate it, and to question what I was thinking and what makes me think I have the chops to be writing articles in magazines anyway.

The idea of the piece is essentially that pilots are often reluctant to divert from their original destinations because certain elements of their personality that may be strengths also work against them.   Their dogged goal-directedness, for example, may contribute to a diminished psychological flexibility—perhaps the main ingredient required to make the important decision whether or not to divert from their original destinations or route.   Diversions, by the way, are an essential part of keeping pilots and their passengers safe from potentially hazardous weather, bumping into other airplanes, or being escorted by an F-16 or two and forced to land at a military base to be greeted by uniformed machine-gun toting patriotic Americans taught not to smile even when pointing a gun at an unarmed, gray-bearded and balding man exiting a wimpy airplane, perhaps alone or perhaps with a miniature poodle left in the cockpit because he couldn’t carry him out of the airplane at the same time that his hands were reaching for the sky.

In writing the article, I couldn’t help but think about a few diversions in my own life, although I decided not to mention them because of space limitations and because they weren’t specific to aviation.

It was the summer between the second and third year of college, and I saw an ad for a researcher position at Learning Magazine in Palo Alto.   The researcher was the one who read articles and wrote summaries for the staff writers, and it was a step above the mailroom on the path to becoming a writer.   I interviewed well, but didn’t get the job. When I told my housemate, who knew how badly I wanted the job and also happened to be a fearless, only child, he asked my permission to call the editor himself and find out why I didn’t get hired.   I reluctantly gave in, and sure enough Jason was able to coax the editor to reveal “off the record” that although I was the most qualified and possibly most talented of the three finalists, I was the wrong gender.   The magazine staff was almost entirely male, and they were being pressured from management to even things out.   Jason was angry, but being rather feminist even in those days, I wasn’t, and even felt somewhat satisfied that I had lost the job for a good cause.

But I have often thought that, had I been able to score a paycheck for writing, which was my first love, I would never have gone on to become a psychologist.   It is not that I entirely regret having spent most of my life in a career that has allowed me the privilege of contributing to the relief of suffering one human at a time; my career has been a blessing on multiple levels. Yet I do sometimes regret that my practical fear of not earning enough money to support myself and a potential family —a fear to some extent that was nurtured by my parents’ dogged determination to shrug off their own poverty—prevented me from following my deeper passion.

I also know had I gotten that job at Learning Magazine I have no idea how my life would have turned out.   The entire game would have been altered. Every subsequent moment would have been different, never to intersect with the life I actually ended up having. The expenditure of any significant amount of energy on regrets over paths not taken is one of the least productive ways of engaging the past, unless of course we use it as motivation to act in a more courageous way in the moment.

There are, of course, many reasons pilots end up making decisions to forge ahead when doing so may not be the safest thing to do, and each pilot in each circumstance will be motivated differently.   While the article in Plane & Pilot began as an article about diversions, it turned into an article about psychological flexibility– a key factor that correlates highly with overall measures of mental health.   There is considerable evidence that enhancing one’s own ability to be less rigid is a skill that can be learned. It requires the motivation and determination to do so, but people who already find themselves too rigid to adjust their plans and thinking to the demands of the moment often don’t lack the determination to see things through. It just requires the decision to channel that determination into being more flexible, or, as Yogi Berra was alleged to have said: When you come to a fork in the road, take it!

 

 

 

 

Not Flying

Although it’s only flown once in the last year, my airplane is still required to undergo its (expensive) annual checkup, because in this country of fractured health care and inconsistent legislative imperatives, we are required to take better care of our airplanes than we are of ourselves.

While it is receiving its annual checkup, it is taken apart and I cannot fly it.   But I miss her, so after writing this, and going shopping for dinner tonight, I will be heading to my hangar to pay her a short visit. I know it can get cold and lonely in that hangar, especially with the cowling off.

It is said that absence makes the heart grow fonder, which is a platitude that has always rung true for me, at least until enough time passes that the walls of the heart thicken and whatever fondness may have resided there calcifies just enough to cause the heart to stop beating and kill us.   That is why falling in love with anything or anyone is one of the worst ideas God has implanted in the human psyche, yet many of us weaklings do it anyway, over and over again, until we drop dead from grief and longing.

This is a problem with flying. If you love it, and can’t do it, it becomes oddly reminiscent of that feeling you had when you fell in love with the girl in fourth grade who didn’t know– and probably would never know until 45 years later when you’re married and connect for the first time on Facebook, that you even existed.

Not flying, as is true with unrequited love, presents the practical problem of what to do and how to handle oneself until the desperation ends and the steed once again becomes mountable.   Many of us pass much of our time in this purgatory, and face the continual task of combatting the angst that sometimes accompanies languor.   The challenge, it seems, is to somehow get comfortable with the emptiness, how to find value not only in what we do, but what we don’t do.

This, I have discovered, can be learned.   I am a person who, when seeing an empty shelf in a bookcase feels compelled to find enough books to fill it up, or, when seeing a bare wall in my house, feels compelled to find a piece of art to make it interesting.   These things and others like them is a kind of sickness, I think, a form of avoidance of the essential, the abstract, the quiet and pedestrian.

One of my earliest failed attempts at fiction was a story about a man staring at a bare plaster wall, noticing all the cracks in the wall, and wandering through the cracks as though it were a map leading him somewhere.   The story, which sounds better as I describe it than what it was, was an unintended metaphor, I suppose, for how one can get lost in the mist of finding something in nothing, which, I suppose as well, is another metaphor for this life itself.

Ultimately, everything we either choose or are forced not to do presents us with an opportunity to do, learn, or be something else, and that reduces down to an attitude shift.   Albert Ellis, one of the two major originators of cognitive-behavioral therapy, dubbed a certain kind of thinking musturbating, in which we get fixed on what we believe we must be doing, thinking, or feeling.   Sometimes we think inside little boxes of our own creation, just like some of us manage to dress in the same drab style every day, not because it is what we particularly want to do, but simply because we feel skittish about stepping outside of our own boxes.

The voyeur in me loves to watch what people do when they are waiting to do something else.   Pilots in pilot lounges are often diligently sitting at a computer screen checking the weather and planning their next flight, catching some z’s, watching a big-screen TV, or reading a newspaper.   For some reason, I don’t see too many of them reading books, but that’s fodder for another post. At airports, as is true throughout the world, these days people are increasingly spending their precious time staring at their smart phone screens, probably, I assume, watching documentaries or studying the latest thoracic surgery research. I won’t tell you how I feel about “screen time,” although you can probably guess pretty well by now, but isn’t it sweetly hypocritical of me in that most likely you are reading this right now on some screen somewhere, and not in some tangible book, the pages of which you can feel and smell and put on a shelf and never have to worry about its batteries dying on you mid-sentence.

So I won’t be flying today, which, unto itself, is one of the several sad facts I am likely to encounter before the day is over. I do hate supermarkets, and I will be in and out in as short a time as possible. My challenge is how to make those empty spaces precious, how to find the maps to far-off places in the cracks in the otherwise bare walls, and I am confident that although I can musturbate at times with best of them, I am going to succeed.

 

 

 

The Flight of the Enchilada

enchiladaI don’t eat Mexican food too often, but when I do, I usually go for the chile relleno. There’s something wonderful about the balance between the spiciness of the chile and the softening effect of the cheese.   And even though most Mexican restaurants serve generous portions of everything, if the relleno came with only half a chile, I would likely be annoyed.   Like an enchilada, there is something unsettling about half a chile, half a dictionary, half a blog post, half an airplane, or half a flight to anywhere.

One can leave most things half-completed, but flying is something that essentially requires the whole enchilada. You can’t really stop flying mid-air between San Francisco and Houston, although you could always land and call it quits, and spend the night in a roach-infested motel in Gallup, New Mexico.   But in order to be a whole enchilada, or a whole anything, you are going to need more than the sum of its parts.

In order to get off the ground, you need just the right ingredients mixed in just the right proportions. Lift alone won’t get you anywhere, thrust won’t necessarily get you in the air, and drag—needed to keep you from going out of control, is actually designed to get you nowhere, which is why drag is a drag.   You need the whole enchilada, ingredients mixed just right, to achieve the alchemy of controlled flight.

I had a professor in college, whose name for reasons I would prefer not to mention, I don’t recall. (I give in– he slept with my ex-girlfriend, and even though she was an ex, it still bothered me.) He was fond of saying, half-jokingly I hope, that when he died he wanted the definition of “gestalt” written on his tombstone.   It was a silly thing to say, but as a mnemonic device it worked well because I remember the phrase now, more than 40 years later.   A gestalt, Dr. Whatshisname said, was the “ongoing, contingent, sociobiological organization of attention and action.”

We experience life in chunks—in organizations of attention and action, and each chunk is not only ongoing, but it is also contingent on what comes before and after it. The “before” part is obvious, but the “after” part was something illuminated by behaviorists such as B.F. Skinner, who insisted that what we do is often determined by what immediately follows it.

Contingency is important, because it is how things are connected, how we are all interdependent, and why if a tree falls in the forest we may not hear it but it will still scatter the ants beneath it.

As long as you keep cutting the enchilada in half, and realize that you still have an enchilada, then each half becomes a whole unto itself, especially if you keep eating it. You’ve just created smaller enchiladas. That is why in order for something to really be whole, it needs to be something greater than the sum of its parts. If, on the other hand, you were able to break down the enchilada the way I remember breaking down water in chemistry class into hydrogen and oxygen, interesting things begin to happen.

Enchiladas require tortillas, which require flour or masa, and water. To make the cheese you will probably need some milk, rennet, and maybe a starter culture. You might even add some salt to be adventurous.   Then there’s the chile pepper, and maybe a little guacamole.   None of those things on their own look or taste anything like an enchilada. But, mixed together in the right proportions and under the right Mexican sun, something greater than the mere sum of its parts begins to emerge.

It is, of course, alchemy when we mix ingredients to create something transformative.   It is alchemy when we mix lime with sand and water to create concrete, which by some magic of physics or chemistry becomes the building I am writing this in, and alchemy when you add rice to salmon roe and quail eggs to create the transcendent mixture of earth, sea and sky we call sushi.   It is alchemy when we fall in love, and even greater alchemy when we remain in love. It is alchemy when we fly an airplane. It is alchemy that is the foundation and the very substance of the feeling of awe, which so many have equated with a sense of holiness, numen, or spirituality.

Flying, as is true with everything we do, is a gestalt—a contingent organization of attention and action.   To be up high, beyond the realm even of happy little bluebirds, is an alchemical miracle.   As is true for love, good food, and those things that we value most, it is the transformation of disparate elements under the right conditions—a series of intentional acts that taken together exceed the mere sum of its parts.   It is, dare I say, the whole enchilada.

 

 

 

 

 

Arriving

I am editing this post now on a short flight from Warsaw to Cracow, where a small disability film festival will be showing the film I produced and I will be doing a Q&A. The captain will soon announce our arrival in Cracow, and despite my trepidation about being in Poland for the first time (the land my ancestors escaped from), I am looking forward to the adventure.   But before I arrive, here are a few thoughts I wrote about the idea of arrival:

I arrived late at my friend Ollie’s house a couple of weeks ago, in the midst of a conversation among some of his “LA friends” about the three legs of the stool that comprised “success.” I don’t recall exactly what those three legs were—I vaguely remember something about opportunity and luck, but I do remember bristling at the idea that—while everyone was arguing about the legs, no one was questioning what “success” meant.   So I tried to guide the discussion there, and it came to me that they were discussing something akin to what I might have preferred to call having “arrived” somewhere, not unlike landing at your intended destination.   Each of us may start our journeys with a different destination in mind, and at some point we realize we have landed, taxied to the safety of a hangar, and tucked our airplane in for a good night’s rest.

Of course, not all journeys are specifically intended, as has been the case of my last few years living in the thick cloud of fear of my cancer returning.   Because it seems that over time that particular fear recedes somewhat, I believe I will find success, or know that I have arrived, when my few and far between moments of serenity become closer together.   I don’t suspect the ultimate serenity will likely come until the ultimate end of the journey, and of course it is possible it won’t come even then.

For some of the others at Ollie’s house, it seemed unclear to me that they had any idea of what having arrived at their destination might look like.   How many movies must you produce before you feel as though you can rest on your laurels?   Must it be just one more than your successful producer father?   How many screenplays must you write and how many Oscars must you win? Will one of those gleaming statues on your mantel do just fine, or will you ache for its identical twin?   Triplets? How much money will reside in insured bank accounts?

There is an old aviation saying that the key to a good landing is a good approach.   In order to do something well, we need to prepare the road in front of it.  Perhaps that is where the three-legged stool comes in to play.   If the first leg were opportunity, that certainly does seem important.   I did not have the opportunity to fly until my kids were grown and I was close to 50 years old.   Opportunity might imply a certain privilege, and a certain amount of discretionary wealth.   It also might imply a friend in high places who will take you there.   Luck also does seem important, although I know there are some who might argue that there is no such thing.   I believe though, along with most people and the bumper sticker, that shit happens, which also implies that from time to time shit doesn’t happen.   That’s luck, and I do think there are some who manage to inadvertently walk into a lynch mob or catch their big toe in a bear trap or find a malignant lump growing somewhere in their body.   Shit happens.

I don’t remember the third leg (and I’m not sure I have the others right either), but I imagine it must have something to do with skill or mastery.   There’s just no way to safely get to the end of any runway without having mastered the skill required to fly the airplane.   There may be shortcuts to opportunity and luck, but I suspect there are no shortcuts to skill, mastery, and the elbow grease required to get there.   At this point I don’t find it particularly difficult to land my airplane, and it is easy to forget the effort it took me to get to that place.  I remember occasionally when I think back, or the time that I made the mistake of giving the reins of my airplane to a fellow pilot who flew his own plane beautifully, and we barely survived his valiant effort to bring my steed anywhere near the center of the runway.   Perhaps a great violinist can play any violin, but I’m not sure what she would do with a cello.   In that sense, perhaps the third leg of the stool is the same thing that is needed to get to Carnegie Hall.

It seems to me that there might be a fourth leg to this stool, which would make arriving somewhere more of a chair, I suppose.   In order to know that one has arrived at one’s destination, it seems necessary to know where one is going, although I’m not so sure about this.   Some people might refer to this as a goal while others might call it an intention.   I have never been a big fan of goals, thinking that it often detracts from the journey itself, but I can’t imagine knowing that we have arrived somewhere without knowing where we intend to go.   T.S. Elliot comes to mind here, of course, in poster form from the sixties: We shall not cease from exploration. And the end of all our exploring will be to arrive where we started and know the place for the first time.

I’m not entirely sure Elliot wrote those words, because I don’t trust posters from the sixties, and I don’t know the context.   But it’s compelling to tie the notion of arrival  directly to departure, in that wonderfully prosaic platitude (and Harry Chapin song) that all of life is a circle.   If we are to consider this notion seriously, as in ashes to ashes, then we will ultimately know that we have arrived when we reach the beginning.   But for now, I’m looking forward to three days in Crakow.

The Map and the Territory

The other day, a colleague of mine called me to consult on a case.   The client was a young adult who had been diagnosed with autism.   At one point she said, “His black and white thinking is caused by his autism…” My heart rate instantly quickened and before the apoplexy could do too much brain damage I interrupted her and curtly said, “No. His black and white thinking isn’t caused by his autism, his black and white thinking causes his autism.” She seemed confused, so I did my best to explain the damage that can be done by reifying labels.   I probably did a lousy job, because her mystification lingered.   I don’t know if I can do it better now, but I have the advantage of being able to cut and paste, so here we go.

I told my colleague that the more you rely on a label (a diagnosis) the less you are likely to know your client. Although it’s helpful, indeed necessary, when starting out in any field to learn the jargon, and thus have a convenient shorthand for describing a phenomenon and reducing the morass of information into manageable wholes, it can also lead us down wrong paths.   It is no accident that the more experienced a clinician the less jargon you will hear.

Humans are simply far more different from each other than we are alike.   The self-proclaimed “autistic” psychology professor Stephen Shore is credited with the cute saying that “If you’ve met one person with autism, you’ve met one person with autism.”

Diagnostic labels obfuscate more than they clarify.   Reducing someone’s personality to a group of symptoms does serve to focus on what some have concluded are the most meaningful bits and pieces, but by doing so we too easily fail to see the richness and contradictions of those behaviors that lie outside what we expect to see, and that makes us prone to errors.   If the label we give to the jar with the white powder in it is “flour” then that is what we expect will be in the jar, not the sugar that you put in the wrong jar when you were preoccupied with getting the internet upgraded. It is not necessarily that it becomes a self-fulfilling prophecy (although it could, if a therapist subtly steers his or her client toward the expected set of symptoms through explanations or interpretations that elicit those symptoms), but rather that the therapist actually “misses” the deeper truths of who is sitting opposite.

Diagnoses are, essentially, metaphors, in the same way Susan Sontag brilliantly described cancer as a metaphor in her seminal essay “Illness as Metaphor.”   Metaphors can be compelling ways to describe things, but they are not the same as the things we are describing. You can’t meaningfully say that John is schizophrenic any more than you can put a blanket of air on your bed, shoot an idea, buy a moral compass from the nautical supply shop, or really give me a piece of your mind.   That is not to say that—like John the Baptist, I cannot be a good shepherd even though I have no sheep. What I do mean to say is that I may indeed be a good shepherd, but I am much more than that, and by the way, I have goats (well, I used to). As the semanticist Alfred Korzybski famously said, “The map is not the territory.”

Another Hungarian hero of mine– Thomas Szasz, made a career out of professing that psychiatric diagnoses were essentially a form of social manipulation.   A psychiatrist himself, Szasz insisted that he was not anti-psychiatry, but anti-coercive psychiatry.   He saw psychiatric diagnoses as socially constructed with little to no medical evidence to support them, to be used, perhaps, to remove someone’s freedom (as in the case of hospitalizing a schizophrenic), cast someone aside from society (such as calling homosexuality a disease, which although eventually abandoned was done for decades), or sell drugs that don’t work or cause more harm than good.

Too many wrong roads are driven when we begin to think that the metaphor is the real thing.   The depth of personhood, the miraculous complexity and uniqueness of each individual, is transmogrified into the label we put on the package.   Korsybski once dramatically demonstrated this when he took a break from a lecture to eat some biscuits that had been wrapped in white paper. After commenting how much he enjoyed them, he offered some to students in the front row, who enjoyed their taste until Korsybski removed the white paper to reveal that they were dog biscuits. The students became nauseated, and Korsybski said something to the effect that we not only eat food, but we also eat words.

The problem with my colleague stating that her client’s “black and white thinking was caused by his autism” is that “autism,” as are most psychiatric diagnoses, is merely the label on the dog biscuit package.   It may or may not have anything to do with what is inside the package, but instead may have everything to do with what we think is in the package.   The truth is that, to this day, as is so with many things, we scientists know a lot about what the collection of symptoms we call autism looks like, but we don’t know much at all about how it comes about, or what goes on physiologically to cause those symptoms.

When we reify something, we also give it a static quality. We take something that should be a verb and turn it into a noun that just sits around on a shelf waiting for someone to pull it off.   And in doing so, we begin to think that there is little we can do with it.   If we only referred to John as a noun, as proper as that would be, we would imagine him standing somewhere.   But if we said he was “Johnning,” we would imagine all that he does that makes him tick.   Saying someone has autism, or depression, or even a virus, leaves us little to do with it, freeze-drying it as it were, and even creates a bit more distance between us and them.   If autism, or any diagnosis, was a verb rather than a noun we would be more interested in what it does and how it works, thereby bringing it to life and moving us to engage with it.

Another problem with my well-intended colleague’s comment is the direction of causality.   We need to know the territory before we can draw a map, but drawing the map will not create the territory.   We could say with some certainty that the more it rains the more umbrellas will be sold, but no matter how many umbrellas we buy we can’t make it rain. Does giving someone the label of autism make that person lose the ability to perceive life’s grays, or does the inability to perceive gray cause us to give someone the label of autism?   And if, as I would insist, it is the latter, then what useful information does that give us?   And if we make the mistake of reversing causality, thinking that this thing we call autism causes black and white thinking, it could freeze us in our tracks. We would have succeeded only in thinking we know something that we don’t, becoming autistic-like in our thinking and missing the grays, the subtleties that might lead us down different and potentially fruitful paths.

My colleague fell into a dangerous trap, but although the landscape of our language and everyday thinking is littered with those traps, no experienced clinician or practitioner of life should fall into them.   Confusing the map with the territory is something that ultimately can hurt our clients when the label is a psychiatric diagnosis, and when the labels we serve up are liberals, conservatives, Palestinians, Moslems, Jews, Christians, or maybe even Hungarians, we may succeed only in creating obstacles to understanding each other.

 

 

Ups and Downs

I had some trouble sleeping last night, so I took the advice I usually give to others and got out of bed.   That is why I am writing these words at 5:30 in the morning, after waking at 4– a cruel hour if there ever was one.   Sleep may be one of the only occasions this life offers in which—finding oneself unable to get down, one should just get up.

It happens sometimes in aviation, when an airplane’s wings begin to collect ice, and warmer air might be found at higher altitudes.   Then, going down might be more hazardous than climbing, so sometimes you have to temporarily go up in order to eventually land safely. Usually, however, what goes up must come down, and what comes down need never go up.

One of my day jobs is to teach a class at UCLA Medical School (now sadly named after David Geffen), where each week a new “case”– as physicians are trained to refer to humans in order to see them as less human– is presented and discussed.   The other week we presented the case of someone who was ultimately diagnosed with bipolar disorder, a mood disorder in which a person swings between periods of mania and depression (hence the outmoded term “manic-depression”).

Bipolar disorder is fairly common, affecting about 6 million Americans a year, but when I was seeing 30 clients a week I found it one of the easiest diagnoses to miss.   That is because when a person shows up in front of you who might be suffering from a bipolar disorder and isn’t in the midst of either a manic or depressive episode, there is nothing in their manner that would lead one to believe there is anything to diagnose. The diagnosis resides in the history (or herstory).

The psychiatric nomenclature (as codified in its “bible,” the DSM) reflects Newton’s law in that what goes up must come down, while the opposite doesn’t apply. One can be diagnosed with either a bipolar disorder or severe depression, but if you are severely manic then you must also be bipolar.   You just can’t stay manic forever. (You can, however, according to DSM, be “hypomanic,” which means you can go on a shopping spree and charge up all your credit cards as long as you don’t go over the credit limit.)

Mania, though, has been around a long time, although I suspect it has generally been viewed as less pathological than depression. Emil Kraepelin, the prolific German psychiatrist often cited as the founder of scientific (as opposed to Freudian, which seemed to emanate more from Freud’s imagination than empirical data) psychiatry, described mania this way over a hundred years ago:

The patient feels the need to get out of himself, to be on more intimate terms with his surroundings, to play a part. As he is a stranger to fatigue, his activity goes on day and night; work becomes very easy to him; ideas flow to him. He cannot stay long in bed; early in the morning, even at four o’clock he gets up, he clears out lumber rooms, discharges business that was in arrears, undertakes morning walks, excursions. He begins to take part in social entertainments, to write many long letters, to keep a diary, to go in a great deal for music and authorship. Especially the tendency of rhyming … is usually very conspicuous. … His pressure of activity causes the patient to change about his furniture, to visit distant acquaintances, to take himself up with all possible things and circumstances, which formerly he never thought about.

One of the first things I did when I awoke at 4 was try to rhyme some words (it’s a song lyric, and it’s not bad but needs a lot of work). On the other hand, I like my furniture exactly where it is and although I love many of my acquaintances, I will be happy today to stay home and clear out my lumber room. And not only am I no stranger to fatigue, she is my constant companion.   No, this is just simple anxiety-driven insomnia, probably about a scan I have coming up.   No mania for me.

It could be that one of the reasons I tend to miss the diagnosis of bipolar disorder is that it is one of those labels I have never applied to myself.   Surely I have had my bouts of depression, a few of which have immured me, but the idea of having boundless energy is as foreign to my nature as waking up one day being able to speak Russian.   Not likely in this lifetime.

The idea that what goes up must come down is echoed in the notion that one can go through life getting stronger or weaker.   Freud (who happened to be born a couple of months apart from Kraepelin but outlived him by 13 years) had a rather bleak view, and having been a military man saw life as a battlefield in which each battle leaves fewer troops surviving to fight the next.   Nietsche, from whom Freud undoubtedly stole the notion of an unconscious (and who, by the way, may have known Kraepelin as they both spent time in Leipzig) is famously quoted as having said that “Whatever you don’t die from makes you stronger.”   I don’t know if he ever really said that, but a friend once tried to console me by telling me that Nietsche said that.   No good friend should waste precious breath with consolation when confrontation could suffice.   There are just too many examples of things that happen, from divorces to lawsuits to car wrecks to marriages to chronic, debilitating illnesses that wear us down and from which recovery just doesn’t happen. Surely, what comes down often just keeps coming down.

On the bright side, however, I am reminded that in order to safely return to earth, one must safely leave it.   And I am convinced that home is made more soothing after having flown far from it and fought a few dragons along the way.   It is simply a matter of fact that one’s wings can collect ice at just about any altitude, and it is never entirely clear whether warmer air can be found above or below you. And in that sense, it may matter less whether one is going up or down than whether one is going at all.

 

 

 

Angle of Attack

angle of attackAnything can “fly” if you push it through the air, or propel it, as you might have done with a balsa wood airplane as a child.   Or, if you played with dolls instead of airplanes, threw your Barbie across the room because your mother refused to let you wear your party dress to school. But if you aimed the airplane or the Barbie, or the Barbie in the airplane, straight ahead of you it quickly would have been pulled down to the ground by the relentless force of gravity.

For an object to continue on its path upwards it needs a force other than the thrust of an energetic arm to oppose the pull of gravity.   Physicists give this mysterious force the simple but poetic name “lift.”

Lift, in an airplane, is created by the difference in air pressure above and below the wing.   Due to the shape of the wing, air flows smoothly below the wing, but is disrupted above the wing by the wing’s curvature.   This disruption causes gaps in the atmosphere, lowering the pressure above the wing such that the higher pressure beneath “pushes” the wing upward toward the lower pressure.

That is why nerdy, snooty types take joy in saying that it isn’t really the airplane that is flying, but rather the wing.   For the most part, wings “carry” the fuselage and its passengers upwards. Not incidentally, when a pilot wishes to “roll” an airplane, that is, to rock its wings so that one goes up and the other goes down, he or she merely changes the shape of its wings by raising and lowering ailerons (a section of wing that is capable of moving).

Now, if you think about it for a moment, in order for the difference in air pressure to be created by the wing at all, the wing needs to have an air mass to oppose it. A wing won’t fly in a vacuum—which is why spacecraft don’t need wings at all. (Without gravity, there is no need for lift, and “up” and “down” have entirely different meanings; essentially, there is only “here” and “there”.)

Now, lest you think all this silliness is just random aviation arcana, I would suggest that it is rather important prelude to understanding the notion of “angle of attack,” which is the topic of today’s lecture. Simply stated, if you were to imagine a line drawn from the front edge of a wing to the back, and call that line the wing’s cord, then the angle between the cord and the wind is called the “angle of attack.”   It is a beautiful name, as so many things are in aviation, because, in essence, the wing attacks the wind, and the result of that altercation is not fight but flight.

If I haven’t lost you yet, you should begin to appreciate the richness of this metaphor.   First, you simply can’t get anywhere–you can’t even get off the ground, without creating a difference. Combine that difference with energy in the form of thrust and you really can take off.   It gives new depth, at least for me, to the old French saw “vive la difference!”   There really is no vive without difference.

But, too much difference may get you in trouble and lead to a stall.   You see, when a wing exceeds its critical angle of attack, the air above the wing will burble, and the pressure difference needed for the wing to fly disappears.   The wing “stalls,” is overtaken by gravity, and tumbles toward the earth.

I had a mentor who once said that the only difference between creative people and crazy people was that creative people get paid.   Sometimes, I suppose, that may be true, but sometimes crazy is just taking creative a bit too far.   Difference may be essential for flight, but too much difference may be hazardous.

As good metaphors would have it, exceeding one’s angle of attack and stalling is also a danger of metaphors themselves.   One risks the danger of creating meta-metaphors, and rapidly spiraling toward oblivion.   So, in a desperate effort to maintain your attention and remain airborne, let me lower my wings and get literal.   Perhaps it is just a simple, physical truth that in order to achieve flight we must make a difference.   That could be as simple as trying a new brand of coffee bean, adopting a neglected dog, or if you’re so inclined, creating a new vaccine.   But going too far ahead of the curve might land you out of a job or earn you a ticket to the few remaining loony bins.   Just remember to aim high, but when you begin to feel the burble, lower those creative wings of yours.

There will be a quiz next week.