Category Archives: Mental Health

Oct 18

“Sex Education” Wrap-Up: Wounded Healers in Youth

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If you’ve finished watching (this means spoilers ahead!) all four seasons of the Netflix series Sex Education (see previous post), you’ve seen a number of flawed but well-meaning helpers reach fairly satisfying turning points in their lives. This includes not only student “sex therapists” Otis and O, who ultimately vie to become their college’s sole sex therapist, but also Otis’s mom Jean (Gillian Anderson), a practicing sex therapist in actuality, who’s eventually seen in flashbacks to her teens.

In my estimation, one of the major themes of Sex Education is that of the wounded healer, a concept known to non-shrinks as “therapists are as screwed up as the rest of us.” Although many other TV series and movies have depicted dysfunctional therapists (some examples here and here), typically it’s played for laughs and/or derision and not so much for understanding or acceptance. Not really the case in Sex Education.

Roger M. Cahak, Psychology Today, on the origins of “wounded healer” in the work of Carl Jung. “His theory is that therapists who have been wounded can provide their clients with a deeper level of empathy, patience, and acceptance. Since we’ve already traveled the journey, we’ve encountered the hazards and dead ends, navigated the detours and discovered the most breathtaking vistas.”

All the significant helpers in Sex Education struggle with their own issues. Although Otis, for instance, is highly anxious about having sex himself, he is able to offer sound advice to his more sexually active peers. O’s unresolved issues include a budding awareness of her own asexuality, yet she’s extremely well informed about the issues plaguing her more sexualized clientele. Jean, a mostly successful therapist who has experienced multiple episodes of depression, has a history of childhood and family trauma.

Over 25 years ago Robert Epstein and Tim Bower wrote (Psychology Today), “Here’s a theory that’s not so crazy: Maybe people enter the mental health field because they have a history of psychological difficulties. Perhaps they’re trying to understand or overcome their own problems…”.

Recent research confirms that many mental health professionals do have their own significant issues. In a study of psychologists “(o)ver 80% of all respondents reported having mental health difficulties at some point, and 48% reported having a diagnosed mental illness. These rates are similar to rates of mental illness in the general population,” reports The Conversation.

Similarly, a 2018 Social Work article notes that a large 2015 survey of licensed social workers found “that 40.2 percent of respondents reported mental health problems before becoming social workers, increasing to 51.8 percent during their social work career, with 28 percent currently experiencing such problems.”

Naturally, it’s important that practicing therapists seek and maintain whatever forms of help they need in order to function effectively. When this is not the case, impaired therapists need to be identified.

There are other kinds of wounded healers besides therapists, by the way. In her recent post “Are You a Wounded Healer?” Diana Raab, Psychology Today, states, “They can be mothers, fathers, or found in many other vocations. They often have a tendency to make their family and friends feel better, especially when their loved ones experience challenging times. Because they’ve dealt with their own challenges in the past, they more easily understand hardship. They also know, like therapists, that to help others heal, it’s important to instill hope so the person is able to see the light in their darkness.”

Are you a wounded healer? Raab provides this list of possible traits:

  • You are a lifelong seeker.
  • You have a strong sense of purpose.
  • People call on you when in need.
  • You’ve helped people since you were a child.
  • You look at all experiences as an opportunity for growth.
  • You’re able to find the calm in the chaos.
Oct 11

Friendship Breakups: Another Kind of Heartbreak

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When friendships work, it’s a great thing. When they don’t, friendship breakups can occur. Consider Amy Poehler‘s viewpoint: “Only hang around people that are positive and make you feel good. Anybody who doesn’t make you feel good kick them to the curb and the earlier you start in your life the better. The minute anybody makes you feel weird and non included or not supported, you know, either beat it or tell them to beat it.”

Of course, being on the dumped side of friendship breakups can be quite painful. Unfortunately, it happens a lot.

In her review of Irene S. Levine‘s 2009 Best Friends Forever: Surviving a Breakup with Your Best Friend, psychologist Diana Zuckerman noted: “We don’t expect to marry our elementary school sweethearts, and it is equally rare for our best friends from childhood to be there for us forever.”

Similarly, later-formed friendships don’t always last either. As the subtitle to Jennifer Senior‘s fantastic article “It’s Your Friends Who Break Your Heart” states, The older we get, the more we need our friends—and the harder it is to keep them.

Senior admits to undergoing a phenomenon she calls “a Great Pandemic Friendship Reckoning,” which she believes most people have experienced as well. (She’d been interested in this topic pre-COVID too.) “You lose friends to marriage, to parenthood, to politics—even when you share the same politics. (Political obsessions are a big, underdiscussed friendship-ender in my view, and they seem to only deepen with age.) You lose friends to success, to failure, to flukish strokes of good or ill luck. (Envy, dear God—it’s the mother of all unspeakables in a friendship, the lulu of all shames.)”

Not to mention, she adds, the three other huge events that can alienate friends: moving, divorce, and death.

But these were your friends! Shouldn’t you be able to survive the rough stuff and move on? “These life changes and upheavals don’t just consume your friends’ time and attention. They often reveal unseemly characterological truths about the people you love most, behaviors and traits you previously hadn’t imagined possible…”

The bottom line, of course, is that whether friendships drift apart or come crashing down, hurt and heartbreak are involved. So how can this be prevented?

The problem is that when it comes to friendship, we are ritual-deficient, nearly devoid of rites that force us together. Emily Langan, a Wheaton College professor of communication, argues that we need them. Friendship anniversaries. Regular road trips. Sunday-night phone calls, annual gatherings at the same rental house, whatever it takes. ‘We’re not in the habit of elevating the practices of friendship,’ she says. ‘But they should be similar to what we do for other relationships.’

Oct 04

“Heartbreak”: Relationship Endings

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In Heartbreak: A Personal and Scientific Journey by Florence Williams the main perspective involves “the physicality of loss”—in the author’s case, caused by divorce after a 25-year marriage. “I was shedding weight I didn’t want to lose, barely sleeping, and my pancreas suddenly stopped producing enough insulin,” states Williams. “I was tipping into diabetes. My body felt like it was plugged into a faulty electrical socket” (Los Angeles Times).

What else motivated Williams to delve deeply into the research about this level of heartbreak? What did she find out? From The Atlantic: “I wanted to know why we feel so operatically sad when a romantic attachment dissolves. What I discovered is that love changes us so deeply—at a physiological level—that when it’s lost, we hurt more than if we had never loved at all.”

More info from a Publishers Weekly review excerpt: “She cites studies showing divorce to be a greater health risk than smoking; hears about experiments on monogamous prairie voles, in which those separated from their partners produce more stress hormones; and learns about ‘broken-heart syndrome,’ the symptoms of which are similar to a heart attack.”

Read her NPR interview recap at this link.

Selected Quotes from Heartbreak

Feeling rejected in this way increases blood pressure and raises cortisol levels while “reducing feelings of belonging, self-esteem, control, and meaningful existence.”

If you place someone who has recently suffered heartbreak in a scanner, parts of the brain light up that are very closely related to the parts that fire after receiving a burn or an electrical shock.

As with some people who suffer decades of complicated grief over the death of a loved one, some people really can’t pick themselves back up after heartbreak.

…(M)oving around can help prevent depression, as well as a host of arterial and metabolic woes. As blood pumps and new neuronal growth factors flow, we become more creative, more self-aware, more ourselves.

In one study, people who more quickly associated negative words with their exes were less depressed and felt better faster.

To claw my way through heartbreak, I would try to awe my way through it. I knew one place to find it: outside.

Our task-focused frontal cortex appears to quiet down when we are outside while other parts of the brain, perhaps those associated with empathy and creativity, power up.

Sep 27

Closure On Grief: Is it Possible?

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When it comes to the process of grief, dealing with uncertainty is hard; many long for closure instead.

In 2009 social psychologist Daniel Gilbert, author of Stumbling on Happiness, posted an article about how we deal with uncertainty (“What You Don’t Know Makes You Nervous“). He explained that not knowing is anxiety-provoking because it tends to make you project your feelings into the future—feelings that may never happen.

What about closure, the often-sought alternative? First, what actually is closure? Sociologist Nancy Berns, author of Closure: The Rush to End Grief and What It Costs Us (2011), finds that the definition of this widely used term varies depending on who’s using it—and, in short, that closure is a made-up concept.

From her website:

Closure has been described—in contradictory ways—as justice, peace, healing, acceptance, forgetting, remembering, forgiveness, moving on, answered questions, or revenge….

But closure is not some naturally occurring emotion that we can simply find with the right advice. Healing? Yes, healing is possible, but that is different from closure.

Myth Slayers is her term for those who mostly agree with her; the Walking Wounded is for those who don’t. In short, “Myth Slayers want the freedom to grieve” (Psychology Today); the Walking Wounded “are stuck in a holding pattern internalizing the belief that without closure they cannot move on with life” (Psychology Today).

In sum, she says “…(T)here is no point of ‘final closure,’ no point at which we can say, ‘Ah, now I have finally completed my grief.’ Or, ‘Yes, now I have healed.’ There is no point at which we will never cry again, although as time goes on the tears are bittersweet and less common.”

Another expert who doesn’t believe in closure is Pauline Boss, who coined the term ambiguous loss to represent, broadly speaking, loss without closure.

Some quotes from Pauline Boss’s The Myth of Closure (2021):

My point is this: Continuing to use the term “closure” perpetuates the myth that losses and grief have a prescribed time for ending—or never starting—and that it’s emotionally healthier to close the door on suffering than to face it and learn to live with it.

Ambiguous loss makes us feel incompetent. It erodes our sense of mastery and destroys our belief in the world as a fair, orderly, and manageable place. But if we learn to cope with uncertainty, we must realize that there are differing views of the world, even when that world is less challenged by ambiguity . . . If we are to turn the corner and cope with uncertain losses, we must first temper our hunger for mastery. This is the paradox.

The secret to coping with the pain of an uncertain loss, regardless of culture or personal beliefs, is to avoid feeling helpless. This is accomplished by working to change what we can and accepting what we cannot.

Sep 19

Intimate Partner Violence: “No Visible Bruises”

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Intimate partner violence is the subject of No Visible Bruises:What We Don’t Know About Domestic Violence Can Kill Us by journalist Rachel Louise Snyder. It’s not just a domestic issue, she argues, but a public health problem. Parul Sehgal, New York Times, reviewing No Visible Bruises: “A United Nations report in 2018 put it starkly: The most dangerous place for a woman is her own home.”

Other salient statistics from the book, per Sehgal: “In America alone, more than half of all murdered women are killed by a current or former partner — 50 women every month. Domestic violence cuts across lines of class, race and religion; it is the leading cause of maternal mortality in cities including New York and Chicago, and the second leading cause of death for black women nationwide.”

An important distinction about intimate partner violence is contained in the book review by Kate Tuttle, LA Times: “‘Love is what makes domestic violence different from any other crime,’ Snyder writes. ‘That the people involved have said to each other and the world, you are the most important person to me.’ For that love to end in injury and even death, she adds, ‘requires us to mentally, intellectually, and emotionally hurdle beyond what we can imagine.'”

Julia Kastner, Shelf Awareness, describes how the author organizes her material, starting with the fact that it’s unusual, going from “The End” to “The Beginning” to “The Middle.”

Further explanation: “That is, she first studies what intimate partner violence looks like at its conclusion: homicide and regrets that various systems (judicial, law enforcement, advocacy, etc.) couldn’t do more. Next, she investigates the beginning of such violence. Abusers often come from abusive home environments and, along with their victims, grow up in a society that values stoicism, control and violence in men, submissiveness and emotional labor in women. ‘The Middle’ examines how services are provided to victims of domestic violence, and what changes should be considered.”

Regarding the profile of abusers, Snyder tells NPR the following:

Narcissism is one of the key components of an abuser… [Most] abusers, in fact, are not people with anger problems. Generally speaking, they are about power and control over one person or the people in their family. They’re often very gregarious. Only about a quarter of the abusers fit that stereotypical definition of someone who is, you know, generally angry. And so the narcissism plays out in the idea that they are owed something, in the idea that they are entitled to their authority, that their partners have to be subservient to them. There’s very often traditional gender dynamics in abusive relationships.

Some of Snyder’s proposals for safety (New York Times):

Prosecute cases without the victim’s help, as we do murder trials. Treat restraining orders like D.U.I.s and keep them on file, even after they have expired. Train clergy members and doctors to recognize and respond to domestic violence. Promote battering intervention programs. Choking nearly always precedes a homicide attempt; teach police to recognize the signs, and instruct doctors to assess women for traumatic brain injury. And, of course, there is the near-unanimous recommendation from law enforcement and domestic violence advocates: ‘You want to get rid of homicide?’ a retired forensic nurse asks. ‘Get rid of guns.’