Category Archives: Psychology

Autism in Love

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d0a08b_dea72ec2e51f45c3b2a5a9e1a948da8a.png_srz_p_346_192_75_22_0.50_1.20_0.00_png_srzI am on a Boeing 757, sitting in the economy section, one of the few times I am grateful for having short legs.   I am returning home from New York where a film I conceived and executive produced just premiered at the Tribeca Film Festival.   It is truly an honor, given the numbers: 6700 films were submitted and only 120 were selected for the competition.   The film, “Autism in Love,” is in the “world documentary feature” category, competing against 11 others in its category for a coveted award.

One of the films in competition with “Autism in Love” is called “In Transit,” a beautiful and moving documentary interweaving stories told by real passengers (i.e., not actors) on the Empire Builder, an AMTRAK train whose route goes from Seattle to Chicago.   The stories themselves are captivating, but I was equally captivated by the fact that the stories were told as the American landscape unwound behind it, creating a kind of metaphor within a metaphor.   Each person seems to be in some sort of transition in their lives, moving internally as they physically move through the landscape.  But on a train, the sensation is that it is the landscape that is moving, so that one’s internal movement is mirrored by the movement of the landscape.  And of course, all that occurs on a screen projecting a “moving picture,” a medium that is, by definition, about movement.

I am doing the same thing now, traveling at 514 miles per hour, four-fifths the speed of sound, 40,000 feet above the ground.  We humans, through the ingenuity provided by our cerebral cortexes, create and build machines that allow us to use nature in order to defy it.   We build machines that move us from one place to another for many reasons, but ultimately we build machines that move us physically in order to move us emotionally.

The film I produced, expertly directed by Matt Fuller, follows the lives of several people diagnosed with autism as they navigate the waters of romance and love.  Their lives are very different from one another’s, but they each live in the landscape others have called autism.   I have lost any objectivity I might have had about the film, but judging by the reviews I have been reading, it succeeds in a message I was hoping for; that love is love and nearly anyone, despite having a label that others insist prevent them from loving, can teach us about it.

In college days I was taught that humans, by nature and physiology, are novelty seeking animals.   That is undoubtedly what makes solitary confinement so punishing.  But without the contrast of stability there could be no novelty, just as a figure disappears when the ground around it disappears.

So whether we find ourselves riding the rails of AMTRAK, sitting on a bus, or flying on a Boeing 757, we ultimately remain figures embedded in the world around us.  We are moving, or being moved.

For more information on “Autism in Love,” see www.autisminlove.com, or better yet, see “Autism in Love” on Facebook.

Mass Murder in the Alps

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The Germanwings disaster intrigues me more than most, perhaps because as a psychologist who flies for fun my interests bridge psychology and aviation, and all roads seem to be pointing to the mental health of the copilot who apparently flew the Airbus into the ground, killing himself and 150 others.

Crash investigators are charged with determining the cause of airplane accidents.   Cause is a complex, multi-layered concept.  One can say, for example, that the immediate cause of the Germanwings disaster was the co-pilot’s directing the airplane into a fast descent into the terrain below, causing the airplane and its inhabitants to break into pieces.   But what “caused” the copilot to direct the autopilot to fly the aircraft into the ground?

The word that I hear most often is “suicide,” one of those verbs that disguises itself as a noun.   Because we know that the copilot went onto the internet and looked up ways to kill himself as opposed to ways to commit mass murder we assume his intention was the former, and the others who died were “merely” collateral damage. But does calling the pilot’s action suicide get any deeper at the cause?

Psychologists have come a long way in understanding the ingredients of suicidal behavior.   But it is more difficult to imagine the depth of cognitive distortion, the outrageous amount of blindness that must occur when severely depressed to not feel for the families of others on board.

I have survived the suicide of four of my patients in my career, and scores more who either tried and failed or had strong enough impulses to require hospitalization.   In the vast majority of those situations, the perpetrator and the victim were the same.

I did have one suicidal patient who dealt with his anger toward his father (who had shot him at point blank range when my patient was a teenager) by “putting people in the hospital,” as he used to say.  Occasionally, he targeted police officers for his aggressive attacks, which were certainly suicidal gestures, but each time it occurred the police responded professionally and subdued him.   (On one occasion, two Burbank police officers brought him to my office instead of jail after he attacked a co-worker because they were either insightful or well-trained enough to realize that his aggression was a sign of his suicidality.)

What I don’t understand is the overwhelming number of press reports that refer to the behavior of the copilot as suicide instead of homicide.  One could argue, perhaps not too cleverly, that the copilot’s actions leading to the death of 150 people and his own makes it 150 times more likely to fall under the category of homicide than suicide.

I consider it a character flaw whenever I have difficulty finding compassion for the perpetrator of heinous acts.  Compassion for victims is easy; it is the perpetrators who need it more.  Understanding is helpful in finding compassion, but I don’t know that science will be able to determine the “reasons” why this copilot pointed his airplane’s nose to the ground.   There is no brain left to scan that might reveal a lesion.   We are left only with our theories, our knowledge that depression is often a combination of helplessness, hopelessness, distorted thinking, rage and blame turned inward.

This would not be the first time in history one has used an airplane as a weapon of mass murder.   But most of the others have been in the context of war between nations.   When mass murder takes place in the context of war within one’s own mind, there is no societal sanction to welcome you home.  The punishment of having ended one’s own life in the process does not bring the innocent victims back to life, nor does it lead very far down the road to compassion.

Perhaps more than most I should be able to understand someone whose depression is so great that he is able to transform his own pain into what can and arguably should only be called a case of mass murder-suicide.  But for me that is likely going to require considerably more effort.

Walking a Banana

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Walking a Banana

Walking a Banana

More than a few years back, I called my cousin on the phone to ask him some real estate advice. He advised me against the deal I was pursuing, and added this bit of wisdom: “It’s the deals you don’t make that make you rich, not the deals you make.”

That was difficult advice for me. Ever since my early twenties, when I decided that I was done hiding from life, being alive meant engaging, taking risks and making deals. Saying no to something that looks like it might be a good deal feels like a retreat from life; there is no way to win if you keep folding your cards.

But then, knowing when to hold and when to fold is what makes a good poker player, and that is really what my cousin was saying. The poker expert Mike Skelza once said something very similar to my cousin: “It’s not how many hands you win, it’s how many hands you don’t lose.”

Of course, if you don’t ever make any deals, or take any risks, there can never be any gain. And every gain seems to require the pain of mistakes made along the way. Each of us has had it drilled into our psyches that we learn by making mistakes– so why do we fear them so much?

Sometimes it has to do with shame, and sometimes with perfectionism—an overly critical internalized voice that accepts nothing but the best from ourselves and others. Doing something wrong confirms an underlying self-hatred, a feeling of never being quite good enough.

That is why many therapists have their clients practice making mistakes. The iconic psychologist Albert Ellis developed a series of “shame-disputing” tactics that included walking a banana tied to the end of a leash as if it were a dog. Those clients whose fears of mistake-making were based more on perfectionism than shame would be encouraged to make mistakes intentionally and often, in order to ultimately get comfortable with the fact that few mistakes have disastrous effects.

But in aviation, small mistakes can have disastrous effects. Fortunately, it is rarely the single mistake that causes the mishap, but rather a series of bad decisions. That is why good aviation instruction includes intentionally making mistakes in order to learn how to recognize and recover from them. Or, as happened to me a couple of months ago, allowing students to discover their own mistakes before correcting them. After a complex instrument approach, I was told to do a “touch and go” in which I immediately took off after landing. I forgot to raise my flaps, which I didn’t notice until long after I should have. My instrument instructor, Michael Phillips, waited for me to figure out why the airplane was flying with its nose down and tail in the air like a downward dog in order to maintain the airspeed I was trying to get it to. I have done perhaps a thousand touch and goes, and never before forgot to raise my flaps, but now I know what happens when I do.

Focusing on not making bad deals, as my cousin suggested, is ultimately a way of not focusing too narrowly on winning. If we focus too narrowly on winning, we are less apt to notice our mistakes, and correct for them. I was so relieved that I successfully accomplished my instrument approach that I forgot the simple necessity of raising my flaps on my way out of the airport. You can drive full steam ahead toward your goal, but if you hit a deep pothole your axle will break and you’ll never get there. If, instead, you drive determinedly toward your goal but keep your eyes peeled on avoiding the potholes along the way, you may eventually get there.

Whether the arena is investing in real estate, making a business decision, flying an airplane, or teaching a child with autism, mistakes are going to happen. Given their inevitably, it is always a good idea to get a certain comfort level with making them, without letting our fixation on the goal get in the way. If you can’t, there’s always the leash and the banana.

Flying as Therapy

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Unknown-1 Along with sailing, polo and race car driving, aviation can be an expensive hobby.   But I am fond of reminding detractors that by and large flying cost about as much as ongoing psychotherapy, and can be equally as effective.  Here’s how.

Piloting an airplane requires complete and thorough attention.  Sophisticated instruments eases that burden a bit, but one needs to constantly monitor them, listen attentively to the sounds of the engine, and keep vigilant eyes out for things that might go bump in the day or night.  Stuff can happen very quickly in an airplane, and a lapse of attention can be deadly.

It is the combination of complete attention and mastery of the fear that accompanies any dangerous activity that in part makes it a therapeutic experience.  But there is another element that also makes it therapeutic.

Humans are outrageously complex organisms, and the human brain functions more efficiently and effectively (at some tasks) than the most complex computers.  What makes the brain so incredible is its ability to manage so many functions in parallel.   At any moment, the human brain is processing and directing multiple complex processes, the vast majority of them outside of awareness.

Some of those processes have to do with attempts to resolve conflicts that arise in childhood and continue to play out in daily life.   These ancient conflicts, along with those that arise in the more recent course of work and family relationships, are streaming through our awareness, and can wreak havoc with our daily lives as we allow them to rear themselves when it would serve us better to direct them instead into the background.

Most people see a good psychotherapy session as one in which the client comes to believe movement has been made toward resolution of childhood conflicts.  But those conflicts are a little like a war that goes on interminably, and, recalling the famous bumper sticker from the sixties, what if they gave a war and nobody came?

That is not to say that it is a good thing to deny the existence of our conflicts, but rather to embrace them and trust in our integrity to be responsible for them and “work them through” when the time is appropriate to do so.  Stepping into a cockpit does not stop the world from turning outside; the world remains unjust, the argument with your partner still festers, but in that moment one’s job is to simply fly the airplane.

We can eliminate suffering not only through successfully resolving conflicts, but also through coming to accept those conflicts and engaging life more fully in the moment.  That is what a “healing exchange” with a therapist can do, and that is how flying, or engaging in any activity requiring complete focus and which forces one to live fully in the moment can be good therapy.

Flying with Understanding

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Bald-eagle-wallpaper2In Jonathan Livingston Seagull, a rather silly story made into a really silly movie, Richard Bach wrote these words, which I find enchanting:

Don’t believe what your eyes are telling you.   All they show is limitations.  Look with your understanding.  Find out what you already know, and you’ll see the way to fly.

As a child, my self-esteem, on a scale from one to ten, was well below zero.   My mother, catching me during a moment of extreme self-doubt, told me that I was capable of doing anything in life that I wanted.  Challenging her optimism, I told her snootily that I could never fly.   Undaunted, she lovingly crouched down, put her arms on my shoulders, looked me directly in the eyes, and said, “Ira, if you wanted to badly enough, you could fly.”

At first, in my confusion, I began to trust my mother less.   But there was a part of me that wanted to believe in her magical thinking.   So over the years her words, and the conviction with which they were spoken, echoed.  Eventually, I began to understand.

I knew that as a mere mortal I could never actually fly, but perhaps I could accomplish things that logic and reason (“eyes,” in Bach’s metaphor) couldn’t, if I could somehow learn how to look with my understanding.  Perhaps I could learn to not be deceived by the facts in front of me, by the obstacles that life creates, but instead to believe in my ability to understand that which transcends facts, just as my mother leapt over reality with her conviction and belief in me.

You may know the Hasidic story about the origins of the philtrum, that little indentation above the mouth and below the nose.  According to the story, when we are conceived we are given all the knowledge in the universe.   Then, at birth, God touches us right below our nose and we forget everything.  We then spend the rest of our lives trying to remember what we already know.

What we already know is our understanding, which is more than the sum of our knowledge.   It is the way we imbue knowledge with meaning and connection that transforms it into understanding.

Understanding cannot be found simply by reference to our bodily sensations, or our “feelings.”  In instrument flying we learn that our eyes and the rest of our body can deceive us.   Our brain misinterprets the signals it receives through our senses.  We must, instead, fly with all of our understanding, and have faith that even if our bodies deceive us into thinking we are flying straight and level, we choose instead to believe what our instruments tell us.  And if our instruments give us conflicting messages, we must bring our entire understanding to the cockpit—the sum of our knowledge that transcends its parts and becomes a meaningful whole.

Our eyes do deceive us.  They show us the covers of books, but not what is inside of them.  They show us facts, and facts limit us.   They bind us to the ground; they show us what is, but never what can be.  They are the stories the news media, scientists, and our best friends tell us.  When we believe them, we deceive ourselves.     It is only through looking with our understanding that we can truly see, and it is only then that we can really fly.

Shit and Shinola

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Unknown-4Although my dad, who never made it past high school, took pride in his vocabulary, he was not beyond vulgarity– undoubtedly resulting from his Bronx roots and likely nurtured by his 3-year stint in the Navy.  One of the vulgar sayings I heard emanating from my father was that a particular person didn’t know shit from Shinola.

Shinola was a popular brand of shoe polish, presumably with enough of a cachet that it could be used to distinguish the high quality stuff that was applied to the top surface of your shoes from the low quality stuff that might be found clinging to the bottom. It also had a nice alliterative ring to it, more so than the other phrase I heard my father say in similar situations– that a particular person didn’t know his ass from his elbow.

Although Shinola was the “good stuff” and the other wasn’t, I came to associate the two words.  One became what behaviorists call the “discriminatory stimulus” for the other, which in English means that one thing signaled the presence of the other.   I was therefore surprised the other day to see an advertisement in a magazine for a new Wright Brothers commemorative watch made by, you guessed it, the Shinola Company.  That took me to the Internet, to find out how it came to be that a shoe polish company began manufacturing watches.   What I learned is that the modern Shinola Company, headquartered in a beautiful building in Detroit, began three years ago after the initial investors bought the rights to the Shinola name from the New York based company that had since gone out of business.  Besides watches, the new Shinola manufactures leather goods, journals and bicycles, all made nearly exclusively from American components, or so they claim.

Now, exactly what brought the owner of the Shinola brand to buy a name from a defunct company that is associated with shoe polish seemed intriguingly out of the shoebox to me.   Shinola has a great website (www.shinola.com), and on it they claim to be “reinvigorating a storied American brand.”

The new Shinola has been criticized because while it is true that its products are assembled in Detroit, a place badly in need of resurrection itself, most of its parts emanate from elsewhere in the U.S., and some come from abroad, including China.  “It’s not like we’re saying everything is 100% made in Detroit,” said company President Jacques Panis.    The fact that the new Shinola isn’t all about Detroit doesn’t bother me all that much; I’m not sure that the economic interdependence of nations isn’t a bad thing.

I don’t know whose decision it was to buy the rights to the Shinola brand name, but to me that is the intriguing part of the story.  Clearly, the idea that someone didn’t know shit from Shinola resulted from the fact that Shinola shoe polish was, in its day, considered the bomb, to use current parlance.  But for me, even the idea that Shinola was supposed to be a sign of quality gets lost by its contiguity with the stuff that all living critters deposit.

I imagine that if I were to buy and wear one of those watches, as Bill Clinton proudly does, I would be compelled to roll up my sleeve and declare, “See, I really do know the difference!”

 

 

Inattentional Blindness, or Hide It in Plain Sight

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imagesI have been known to search for my car keys when they are in my hand, or nervously prance around looking for my glasses when they were perched on top of my head.  Worse than that, I have even looked for my glasses while I was wearing them.  After all, it makes it much easier to find them. If you want to hide something, they say, put it in plain sight.

In the 1990’s, a group of researchers coined the term “inattentional blindness” to refer to the effect of not seeing something due to one’s attention being focused elsewhere.  The research that evolved from this approach was compelling.

It turns out that inattentional blindness is not only common, but it can easily kill you.  I have heard it said, for example, that the last thing many motorcyclists remember seeing before an accident are the eyes of the driver of the car that plowed into them. The driver of the car looks right at the motorcyclist, but because he isn’t expecting to see him, he just doesn’t.

In one study, a group of people were shown a short film showing three people in black T-shirts and three people in white T-shirts dribbling and tossing basketballs among them.  The subjects were asked to count how many times the players in white shirts caught a ball.  In the middle of the film, a woman in a black gorilla suit walks onto the floor, stops, turns, and waves at the camera.  She then slowly turns and walks off camera.  When the subjects were asked if they had seen anything unusual, fully half of them didn’t report seeing the gorilla at all.  Even when they tried the exercise a second time, a large percentage of the subjects didn’t see the gorilla.

This sort of thing has been replicated many ways and with many groups, including pilots.  In the late 1990s, NASA conducted an experiment to see if commercial pilots would notice distractions while making landings in a flight simulator.  In the simulation, an object rolled out onto the runway just as the plane was landing.  One-fourth of the highly experienced pilots noticed nothing out of the ordinary and landed on top of the distraction.   Interestingly, untrained pilots who had no preconception of what to expect during a landing, always spotted the distraction.

One way to look at inattentional blindness is that it is just one point along the spectrum of attention and distraction.   In order to function, humans must constantly filter extraneous information, and in essence, go on autopilot.  Sleep is a kind of inattentional blindness, which is probably why it isn’t such a good idea to fall asleep while driving a car or flying an airplane.

This may all explain how it is that hiding something in plain sight makes it difficult to find.  Perhaps the act of “looking” for something is its own form of distraction; we are engaged in the looking and not the seeing.   Seek and ye shall find may be a truism, but perhaps if ye seek too much ye shall find nothing at all.

Falling Awake

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Unknown-4Some people I know fall asleep as easily as this laptop I am working on (and just as unpredictably).  This is for the rest of us who have trouble finding the rest in us.

I have long suspected that most of my insomnia has been caused by anxiety, a slightly more syllabic way of saying fear.  Fear, in my view and counter to Frank Roosevelt’s, is nothing to be afraid of and can be our best friend, but just like our best friends, sometimes our fears can talk too much and keep us up at night.   I have used and recommended a few sleep-inducing tricks over the years (see last post), but the most effective one of all is good old-fashioned paradox.

True insomniacs will tell you that staying awake can be just as challenging as falling asleep.  That is because, as I mentioned in the last post, insomnia in its truest form is not really a state of being awake; it is a state of not being asleep.  Different thing.

It is the battle between sleep and wakefulness that itself is the problem.  When the objective of the battle is to fall asleep, the insomniac finds herself failing continually.  The failing becomes a source of tension and self-criticism, and it is all very exhausting, but not sleep-inducing.

The failure to fall asleep is often the body’s way of saying that there are too many unresolved problems, too much that is not quite right in the world that cannot be solved safely enough to allow one to sleep.

So, just as Captain Kirk solved the Kobayashi Maru test by not accepting the parameters of the simulation and then reprogramming the computer, one must change the parameters of the sleep game.   Rather than try to fall asleep and repeatedly fail, try instead to stay awake.   If you succeed at doing this, you may be able to work toward resolving whatever it is that may be keeping you awake, or simply stay awake long enough that sheer exhaustion will eventually overcome you.

The key to staying awake is to stop trying to fall asleep.  It is that shift of focus that eases the burden of the conflict and gives sleep a welcome place to reside.   Get out of bed, fold the laundry, read a book, study a foreign language, or engage in whatever activity is leftover on the grand to-do list.   The worst-case scenario is that you will be up all night and tired the next day.   At work, you might have to fight the urge to fall asleep, but that is an urge you will be happy to have when you are home safe.

Sleep may be “nature’s soft nurse,” but while she may be on call she may be attending to other patients and unavailable.  In that case, try canceling the appointment.   At least for the moment, you may not need her, and trust that she will come when she is needed the most.

Dr. Ira’s Insomnia Cure (in 2 parts!)

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Unknown-3I have suffered from insomnia off and on nearly all my adult life, as do a huge number of folks.  If you read what’s going around the internet and other fonts of wisdom on the topic of sleep it could scare you to death, or at least keep you up at night.  Insomnia has been linked to diabetes, weakened immunity, weight gain and heart disease, not to mention accidents in which people fall asleep at the helm of whatever sort of chariot they are driving.   I do like to remind myself though that aside from falling asleep at the wheel, if lack of sleep is going to kill you, it’s going to be a slow death, kind of like life itself.

The first thing a good insomniac should do is get a medical workup.   That turns out to be a productive path in only a very small percentage of cases, but in case you are one of those who suffers from treatable sleep apnea it may be a good idea.

Many books and articles tout the benefits of exercise, timed to occur well before bedtime.   Interval training may be a better way to go than pushing through a single strenuous workout.   This seems to work really well with my dogs, who will sleep through the night if they get a lot of exercise during the day, but frankly it has never helped me much.

Losing weight is almost always a good thing.  That seems to help nearly everything under the sun, and research tells us that people who are thinner also tend to sleep better.   I can tell you, though, I had just as much trouble sleeping when my BMI was 20 than I do now with a BMI of 26.

My first-resort insomnia treatment is making lists.   Transferring annoying things to do from brain to paper tends to ease my mind, allowing me to temporarily put the intrusive thoughts aside and trusting that the paper, if not my mind, will still be there in the morning.  The second thing to do is reading something particularly boring, which, when I am half awake, is practically anything.   The third thing I do is something writers, psychologists and hypnotists call “automatic writing,” which is simply letting your hand write whatever it seems to want to without giving the process any conscious thought.  Sometimes surprising things appear, although I find that most of what I write in this state is indecipherable in the morning.   But when those fail, I go to the surest thing of all, the ultimate, guaranteed insomnia cure: staying awake.

True insomniacs will tell you that staying awake can be just as challenging as falling asleep.  That is because insomnia in its truest form is not really a state of being awake; it is a state of not being asleep.    This, it turns out, warrants its own post.  More on this next week!

 

 

It’s a Drag, Man

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images-3Every budding pilot learns the four forces that act on an airplane in flight:  the upward force– lift, the downward force– weight (or gravity), the forward force– thrust, and the backward force– drag.   There are many different types of drag.   One of these is called parasite drag, which occurs partly due to friction on the airplane’s skin, and partly due to interference of other objects, such as ice.   The best way to demonstrate drag is what happens when you put your hand out the car window as you are driving.   If you face the palm forward, you expose more of the surface to the wind and your hand gets pushed back.   Unless you want to fly backwards, drag is, well, a drag.

I have been lucky in my life to not have too many stories to tell about parasite drag, either the kind that interferes with flying an airplane or the kind that interferes with navigating through life.

There was the time, however, when I allowed a woodworker to crash in my workshop for two weeks, as he was between places to stay and needed a temporary shelter.   The two weeks turned into nine months, rent-free.    My patience having run out, I did my best to politely evict him.  Even with my considerable charm I was unable to convince him to leave my workshop, so I eventually invited the police to assist me.  Unfortunately, they were no help at all, informing me that I had to go through a legal eviction process to get him out.   That would have cost me a lot of time and money, so out of sheer frustration I eventually resorted to dubious legal and somewhat primitive methods of evicting him, which ultimately did prove effective.  Although it did not exactly come to blows, one could say, I suppose, that enough thrust was used to overcome the parasite drag.

The lesson learned from this misadventure is the same one that aviation textbooks have been advising for years:  the best way to avoid parasite drag such as icing is not to get yourself into that position to begin with.   At times that is difficult to do, because sometimes you don’t see it coming.

While my life hasn’t exactly been like a box of chocolates, there were many times that my life has been a bit like being alone in the cockpit of an airplane with ice forming on the wings.   If I were to let it build up, the parasite drag could have killed me.    For all of us, in those situations the struggle is to find the “warm air,” the place where troubles melt away.    It may or may not come in the expected place, and it may not come right away, but staying where you are is usually not a good idea.

There used to be two small islands southeast of Ireland that have long since disappeared under the rising ocean.   One of them was called “Hook” and the other was called “Crook.”   Once, when Cromwell was asked how he was going to invade Ireland next time, he allegedly said, “By Hook or Crook.”   The phrase stuck, and now we say it when we are determined to get someplace without necessarily knowing how we’re going to get there.  The important thing is to know when enough is enough, when staying where we are is likely going to kill us, and start searching for warmer air.