Friday, December 28, 2012

Compassionate Personality Disorder

This is about compassionate personality disorder. I invented this diagnosis years ago as I kept finding myself in the DSM IV but in many places but I wasn't happy with any of the diagnoses. For more about my beliefs about the DSM classification system, see what William Glasser has to say (  As Michael White used to say "every day's a field day for a psychopathologist".

I seriously believe that the centralised, patriarchal and disempowering model of so-called "mental illness" health care delivery is ineffective at best and at worst, the current model canbe very damaging to people's self esteem and even abusive by 

a) removing people's self faith inadvertently by application of a diagnosis and hidden strong biases towards pharmaceutical treatment processes, and 

b)inadvertently shifting their faith in recovery  from their own community to expensive, scarce and less readily available specialists, and by shifting their focus of help-seeking in the same direction- away from available friends, family and community towards professionals. 

Here I agree with Vikram Patel and his model of "SUNDAR" with us all empowered to help.

I am not saying this disempowerment is deliberate- the hidden memes (eg "you can't do this without chemicals, or a professional", "you are deficient in something that only they can provide, be it strategies, or serotonin") can be the cause of the harm, not the intentions of the carers.  But the system is here to stay....

.. if you can't beat-'em, join-'em.....


People with compassionate personality disorder have a heightened sense of responsibility for what they do. They have a heightened awareness of the effects they have on others.

The criteria for this disorder are as follows...

The valuing of compassion. People with cpd value compassion highly. They are committed to improving experience for people with whom they come into contact. They are commmitted to trying to relieve other people's suffering. They are more interested in connectedness than in individuation, more interested in experience than in facts, more interested in finding common ground with people than differences and more interested in finding the good in people than the bad. They don't believe in blaming others, labelling them, and are more likely to do this to themselves.

(Warning...If you aren't finding this helpful I suggest you stop here.. This is MY definition of cpd, as the entity has not really been described. A few people who see me have found it really helpful, as previously they have not been able to relate to the labels that people have given them... depression, inadequate etc. This, for some people provides a label that gives acknowledgement to their experience while valuing them as people rather than devaluing them. If you are happier with a more conventional "diagnosis" there are plenty of other places to go on the internet.. this blog might not be for you!)

The feelings of compassion....

People with cpd feel other peoples pain and anguish. They are readily able to identify with people. Because the world has so much abuse, hardship and suffering, people with cpd feel lots of pain. When joy occurs, people with cpd feel elated and high. They SHARE experience with others, rather than isolate their emotions, thoughts and feelings from others.

Guilt is a common experience for people with cpd. (see the thoughts of compassion).

Anger is extremely common. People with cpd feel anger and outrage about the injustices in the world. They cannot believe how badly some people treat others. Because they are in tune with other peoples’ pain, they often experience outrage and anger.  

Because they are so in touch with their experience, they often express their feelings to others. This attracts others to give them advice to “toughen up”, or “don’t feel so angry”. They get told “that’s just how the world is.. get used to it”. They find this difficult because they are ethically opposed to “just getting used to it” because to do so would allow others to continue to abuse people.

People with cpd are often misdiagnosed with “depression” or “anxiety”. They often get told they need medication. They see doctors. Doctors have been trained to judge people, but, although they are familiar with the feelings of compassion, have been trained by their superiors to think of these feelings (when they have them themselves) as signs of becoming “over-involved”. To be in tune with them would have them overwhelmed by the numbers game that society has imposed on them. So they encourage people with cpd to do what they themselves HAVE to do.. “Switch off”, “toughen up”, “learn to be cruel to be kind”, “be rational, not so emotional”. They diagnose depression or anxiety, and often prescribe tablets. (Don’t get me wrong... the tablets are good for some people, and for some people they are extremely good. They do help, but they aren’t the only answer.. see more below in “some advice”). 

People with cpd feel like they don't fit in with our society. They think that the world could be a better place and can't understand how harsh and cruel cold and remote others can be.

The thoughts of compassion. People with cpd are more likely to think.."I could have done better" or "I can do better". This is what makes them put in 100% for others. They think this rather than "I've done my best, there is nothing more than I can do" .. that thought which allows people to back off from a situation and then blame others for any problems occurring.

Because they feel guilty, they are likely to think "Because I feel guilty I must be bad" (or "there must be something wrong with me" or some other negative variation on a theme.) Other people are likely to reinforce this belief by labelling people with cpd as having something wrong with them, or treating them as if they are weak or deficient. 

CPD sufferers devalue this guilt as something wrong with themselves. Without guilt would not one act more irresponsibly, and create more suffering for others? For CPD sufferers, "guilt" is their conscience which for the moment has happened to stumble upon a megaphone. The problem here is not the guilt, it is the megaphone. We all need a strong conscience.

CPD sufferers are more likely to think "I must not have a negative impact". This is at odds with the belief which is becoming more prevalent in our society which is “I have the right to influence others (and the environment)”. CPD sufferers, when they are suffering, have repeated thoughts which echo "Lack of entitlement", guilt, self-blame, anxiety and shame. Society reinforces these strongly; in fact I argue that society can only force people to do things in the workforce they wouldn't normally do if they have a healthy dose of these entities- call me a conspiracist if you like!.

The actions of compassion
People with compassionate personality disorder often find themselves doing things for others or because of a sense of duty or obligation. They are ethically opposed to letting people down {as compared with people with individualistic personality disorder, or economic-rationalist personality disorder who believe that people fall into two categories.. those who don’t deserve to be let down (their friends) and those who aren’t entitled (the weak, pathetic, those “below” themselves, or the "unwell". Unfortunately the industrialised model of health care makes such discrimination necessary to prevent burn out. Practitioners must divide people into those "deserving" of help and those where the effort might be less rewarding, relying on ideas of professionalism, sustainability, objectivity and pragmatism}

When people with compassionate personality disorder are doing things for others, they often feel bad, put out, or cross with themselves for putting themselves out, BUT THEY KEEP DOING IT. That is because they are very committed to the service of others. When they are regaining energy to go back into service (resting), they feel guilty and selfish. They keep on DOING COMPASSION, RATHER THAN JUST TALKING ABOUT IT. It is this doing that makes them often feel tired. They often strive for “balance” in their lives, and they think that this will provide comfort. It is when they start thinking “life should be comfortable” that they start to feel depressed, because they find that by seeking comfort, they often have to take themselves “out of service” to others.

Why is this a “disorder”?
CPD is a disorder because it is not consistent with the dominant beliefs of modern society. People with CPD are sometimes not valued as employees because they put in extra effort trying to get to know people, which is not "efficient". Because they don't believe in "having an impact" they can be seen as indecisive. People with "realistic personality disorder" are more likely to blame them for not being strong, decisive and "in action". People with cpd will only be in action if they are confident that they have done their utmost to minimise the negative consequences of their action on others. This is in contrast to people with "realistic personality disorder", "decisive personality disorder", "remote personality disorder" and "economic-rationalist personality disorder". The latter groups use this difference to judge people with cpd, so they are continuously being judged by others. They ethically refuse to do the same back, so others see this as a sign of weakness. These others are into strength, which they see in terms of "standing by your decisions", "defending yourself", "not taking any shit", and "knowing your boundaries" etc. These people are into having an impact or influence, moving on, etc. People with cpd are more into conserving, peace, stillness, rest, appreciation rather than modification of the world.

People with cpd don't climb hierarchies because the practices that are necessary to do so are not consistent with their values.

Treatment. It is not a good idea to try to treat people with cpd, because the world is worse off if their disorder is treated. People who need compassion and support will be denied refuge from the harshness of the world. It is helpful to explain to people with cpd that they have a disorder that was once a desirable condition, but is no longer consistent with modern Western ideas of progress, efficiency and the pursuit and worship of information rather than appreciation of life. It is very important to give people with cpd permission to shout, yell, scream, and do crazy things because the burden of being compassionate all the time is extreme. It is only when they become aware that compassion is their choice that they start to feel more comfortable with the thoughts and feelings and experience of compassion, much of which is negative. When they start thinking... "I'm glad I'm feeling bad... it shows I am in tune with my compassion and love for others" that paradoxically they start feeling better. That is WHEN THEY BECOME COMFORTABLE WITH THEIR DISCOMFORT, RATHER THAN FIGHTING IT. When they become comfortable resting, and see it as a necessary break to replenish themselves before returning to service, rather than selfishness, then they become less distressed.

One risk for people with cpd is to see themselves as compassionate people. For me Compassion is a practice, as is love. I believe that one way of knowing that I am practising love or compassion for others is when I am feeling guilty, or doing something for someone which I really do not feel like doing. But this is my choice. Sometimes I choose to have a different idea of compassion. If I have exhausted all other avenues, it might be compassionate to distance myself from others. But this I see as a last resort.. a temporary way of nourishing myself so that I can continue to serve others...when I feel better. I am not prepared to go down the physical gurgler because of my beliefs about compassion. While I am feeling fit and well, I believe in selflessness. When I am feeling overwhelmed and cornered and sick, I believe in selfishness. When I get back my energy, I believe in selflessness. Like a battery, sometimes I need to be run right down before I will recharge, other times I keep on going, with little top-ups in between.

Some advice (which I am not really entitled to give, as to do so is to participate in inviting people to feel bad about what they have done already.. so please see it only as a sharing of what SOME  other people have found helpful SOME of the time, in SOME circumstances.

About doctors and counsellors.
Find the doctor who will not only prescribe, but who will also help you think about your thinking in a way that feels collaborative to you. If your doctor gives you the impression that they are pretty much only interested in diagnosing you and prescribing for you, see someone else as well. Any counsellor who checks on how their style is working for you, and seems happy to adjust it if it is not working is fine.

Don’t be fooled into thinking that your thinking is wrong or deficient. It isn’t. It is simply compassionate thinking. That anger is “ a passion for justice”. That guilt is your conscience.. your moral values system. If you lose them you would be more inclined to let the world self destruct, and you would start contributing more to that destruction. You don’t want to lose them.. just stop feeling bad about anger and guilt. And if you do feel bad about them... Don’t feel bad about feeling bad. Feel good that you can feel bad about feeling bad. Being able to feel bad is the only thing that makes you a good person. Without that ability you would start to do more bad things to people. And you wouldn’t give a stuff. You know the people who do that.. do you want to be like them?

That doesn’t mean that you shouldn’t want to change your thinking or your experience of your thinking. “Treatment” can help to create a different “space” to step into and out of when you choose. In this space you can ask yourself “Am I ready to re-enter the compassionate (uncomfortable) way of being, or do I need a rest?” You already know that resting space.. it’s the space where you feel selfish. One thing that may help is to change the “aren’t I selfish?” into “isn’t it great to be selfish like this, so that I can regain the energy to continue to be selfless?”

Thursday, July 19, 2012

Avoiding responsibility, and comparing people- not good?

So I will keep going in my elaboration of power words, and my crude attempt to categorise them-

Words which attribute responsibility rather than share it. 

An example of linguistically inviting another to take full responsibility for a problem is
"You misunderstood me", rather than the preferable sharing of responsibility..."We have had a misunderstanding"

Another is "You didn't listen to a single thing I said" or.. "I asked you to do this and you went and did the complete opposite" Once again a naeieve question can go a long way here.. "After our discussion I was expecting A, but what you did was B. I had hoped to communicate X, so I was surprised. I want to know how this misunderstanding happened (maybe I wasn't clear enough). I would be interested in what you heard and understood about what I said..."

I believe that by the speaker admitting the possibility that they might have contributed to the misunderstanding the agenda shifts slightly from blaming to problem solving.

Words which measure others comparatively.

"Too". A comparative term which can be used to imply that the listener's quality does not measure up to the "norm", either defined by the speaker, or by the culture, of which the speaker sees themselves as a representative.

 "You're too sensitive" "You talked about that for too long". If comparison is necessary, an alternative could be "She's busier than I would like to be" rather than "She's too busy". An alternative to "He's too loud" could be "I sometimes/often find it hard to have my say when he's around" as I find it hard to interrupt him. (Does this seem too (!) cumbersome or unnatural? ....Good- many problems in our communication I believe stem from the hurry to be expedient- that's how a 'doing' culture works compared with a 'being' culture)

 If comment must be made I believe consideration of how the other person would comfortably describe themselves is most respectful. For example, rather than "She's too sensitive", consider " She can tune in easily to other's feelings" "She finds negative judgements hurtful" "over-....." or "under-.. .." Prefixes used to rate a quality or action and compare it unfavourably to a standard.

"You're over-reacting" "She's over-sexed" Such statements leave little room for appreciation of difference. These prefixes are best avoided. "Enough" eg- "She doesn't do enough around the house". This defines the desirable or "appropriate" amount of something and discourages expression of alternative views. "Enough said". "Much" can have a similar effect eg: "She doesn't do much around the house". A preferable alternative is to describe what is done without making valued judgements. eg. "She does the ironing and cleaning. She employs a cook for the meals".

 "His response was inappropriate".
Preferable alternatives are descriptions of the event contextualised by reference to the reality to which they are being compared. For example, instead of "inappropriate", consider "She looked hurt and seemed silenced by his response. If it were me, I would not have said that because based on what I know about her previous reactions I would have guessed that such a statement would affect her that way". This leaves at least a little space to compare expectations and assumptions.

Some other negative examples of comparative words are- "extreme", "inadequate". "That was an extreme reaction" "That was inadequate". I reckon these are best avoided as labels, but could probably be introduced as theories followed by a "what do you think?"

Wednesday, July 18, 2012

Defining reality- a verbal way of asserting power

Here's my first instalment in my attempt to categorise power words. I want to consider some common words or memes which are often overlooked when considering power play in modern society.

"Actually", "really", "in fact", "in reality".  I believe these words are used to privilege the speaker's reality over the listener. The implication here is that there is only one reality, and that the speaker is being "objective". These may have the effect of raising questions about the validity of the listener's experience, perceptions or understandings.The word "realise" can be used here.

"She doesn't realise how unreasonable she is being".
" What actually happened was...."

Similar (in my humble view) are the words which define another's reality.
These are words which define another's thoughts, motives, intentions, and discourage self representation. I think that because of their offensiveness, they may create a environment which almost inevitably invites defensiveness. For example-

"You deliberately put away the milk when you knew I wanted to use it!" (notice the intentribution here)

"You think"  A blocking statement which has the effect of discouraging the listener from sharing their thoughts, because the speaker has already defined them without inviting comment.
"You think you're so smart"

It can also be used interrogatively to question one's motives or logic -

"What on earth could you have been thinking when you did that?"

"You're confused" is a common statement. Apart from defining someone else's reality, this statement ties a problem (confusion) to the subject's being, by using the "you're" or "you are"  attribution.

How often do you hear "You're confusing A with B" when you listen to an argument? Maybe a simple enquiry might reveal more of the speaker's reasoning. How about "When you say A how do you see it relating to my ideas which are.. B?" ? More respectful do you think?

Sunday, July 15, 2012

Defining Abuse- we've got it wrong. No wonder we have a problem

I believe the fact that abuse is not often identified, acknowledged or dealt with is because we define it poorly, and rely on definitions based on objectivity or upon intentions (which allows someone to self-define as "non abuser"). This system of definition encourages perpetuation of abuse.

I propose a definition of abuse based on a person's experience rather than a definition based on intention. I propose the broadest possible definition of abuse.

For me, abuse is anything which causes a negative experience in another person, physically, emotionally, or spiritually. I include passing judgement (eg-"paranoid", "sensitive", "over-reacting" etc.) I believe that we all indulge in abusive practices a lot of the time. Why do I use this broad definition? Because the creation of "milder" categories such as rudeness, persuasion, giving some home truths etc. allows too much scope  for people to continue hurting people and not call it abuse. This correspondence may be seen as abusive by some or all of you. If so, please feel free to let me know, and tell me how I could have addressed this issue in a more caring way.

I  have deliberately removed the concept of INTENTION from my understanding of abuse. I now believe that most abuse is perpetrated with "good" intentions, or is based on "good" assumptions. So abuse is not about intent (in my understanding). I know that when people have a negative experience of me I am often unaware about what it is I have said or done that has caused harm. I still call that abuse....Why?

Who defines abuse?

One way of thinking about abuse is by thinking about who is entitled to define it. My preferred way of approaching this question allows for only 4 possibilities- that it is defined  either-

1. By the recipient*   or
2. By the producer*    or
3. By shared understanding of the recipient and the producer   or
4. By an independent person or group.

*here I do not believe that producer and receiver are mutually exclusive. In many interactions (?most) we are both simultaneously producers and receivers as the abuse flows both ways.

If you allow the "producer" to be the one who determines whether what they have done or said to another is abusive or not, then there is no room for the concept of unintentional or inadvertent abuse. We all have experiences that are negative, even from friends who pass judgement or give advice with good intentions. If these experiences cannot be defined as abuse, then for me there is too much room for confusion because there are too many shades of grey. In the confusion, there is too much scope for the generation of pain to be repeated or worsened. There is ignorance, and therefore LACK OF RESPONSIBILITY. I want a definition of abuse that leaves room for movement away from abusive practices and towards relationships that are caring and compassionate.  I have witnessed many cases of abuse where the "abuser" has no idea that what they have done is harmful, when most other witnesses would call it abuse.

If you allow an independent person to define abuse, such as the College of Psychiatry or take a dictionary definition, then this also invites lack of responsibility for others feelings. Why? Because each of us has a different history, different life experience and this generates our understandings. So if I say to someone "you are special to me", that may be a term of affection and they may have a positive experience, but If I say it to someone who has been sexually abused as a child, I may be unwittingly using the abusers words and the person may feel physically sick. That, in my book, is abuse. I believe that in each of my relationships with people I have a responsibility to check on the effects of my interactions, and continually adjust how I communicate and respond, and act, to improve that person's experience. This is part of my definition of compassion. An impartial definition of abuse allows people to say or think..."Oh..What a pity that affected you in that way. You're so sensitive. I meant no harm, so I don't need to change. I have a right to tell you the truth. You need to toughen up.  Get real." This is the "like it or lump it response". No change occurs, and that particular relationship is on a downhill run. Our society trafficks in sayings that support this reponse such as "No pain, no gain". Shared meaning becomes less and less accessible, as does working together. If the "abuser" continues to repeat the interaction despite protest, or information from the receiver that they are being harmed, the only option for the receiver is to cut off contact. This is their right. Any method of cutting off from abuse is legitimate to me.

If you try for a shared meaning of abuse, there is little room for the appreciation of difference of peoples experience and each person attempts to recruit the other to their viewpoint. Defensiveness, denial and self righteousness are invited into the relationship, and these, in my book, are the enemies of compassion, collaboration and goodwill. The worst situation is one of compromise, when both parties have to try to extinguish their understanding of some of their experiences- the ones that they now have agreed to no longer call abuse. They are called upon to do so, despite continuation or worsening of their experiences when that particular experiential context is repeated.

So, for me, the only definition that enables both parties to feel empowered is the definition where the receiver can define abuse. This gives explanation to the paradox where a relationship fails, and both parties feel abused. Under the old intention-based beliefs- that only one of them has created abuse, they can avoid seeing themselves as part of the problem and spend most of their energy defending their position. By the experience based definition they have both been abused.. They are both producers of, and recipients of abuse. Rather than defending their position, it leaves them with the choice as to whether to acknowledge and take responsibility for their part in the production. Each person as producer can then spend their energy on trying to "step into the others shoes". What is required of them is firstly unconditional acceptance that the other has felt abused. I believe this means a suspension of understanding. If you accept without understanding, you are more open to slowly learn by trying to share the others experience. The second requirement is often an acknowledgement. Most powerful in our culture is an apology.

An example of such an apology is.. "I'm sorry. I had no idea that what I did/said had caused you this pain. I don't understand how that happened because I am not you, and I don't know what your life has been like, but I accept that you felt abused, and I therefore have been abusive. I am determined not to repeat this, and I appreciate you letting me know. I want to learn more about how what you  find hurtful because I value our relationship and want it to improve. I also appreciate how hard it might have been to let me know".

Because there are groups in our society who are more consistently abused I believe there is more of an onus for apology on those deemed more powerful. That is, more onus for men to apologise to women, Caucasians to apologise to other races, heterosexuals to gays, employed to unemployed, managers to workers, parents to children, the verbally articulate to the less articulate, and so on. There is no onus for acceptance of the apology. Some abuses are not forgivable, but the apology may help as a starting point for the rebuilding of some relationship.

If this sort of interaction occurs then there is room for shared meaning to grow, intimacy and trust, and the slow exclusion of denial, pride, self righteousness, sense of entitlement, anger and impatience from the relationship. There is a new side which emerges which is a SIDING AGAINST ABUSE. This allows people to retreat from the pain caused by having to TAKE SIDES against others.

Why do I define abuse in this way, and why am I so convinced that this is what is needed? Because the "conventional" or dominant cutural understandings of abuse, advice, judgement (and that includes all assessment of personality, including psychiatric diagnosis) have failed me. Until 1996 when I discovered a "narrative" approach to life, my own personal life was going downhill. I won't go into it here, but changing my understanding was the only way forward, and the rewards are great.

If individuals together, or groups can't model "POWER WITH", all that happens is a duplication of "POWER OVER", and POWER OVER, is, I believe, what generates a very large amount of the trouble in this world, both locally and globally. I make no judgement of the individuals who are involved in this abusive process. That is our culture. We are all trained in this way. The fish doesn't notice the water.

By defining abuse in such a broad way, I do not want to minimise the nature of anyone's own personal experience, and I would in some ways be happier if there were other powerful words for what I describe. However if I don't call harmful ways of being in this world "abusive" I would be shirking my own personal responsibilities. I must assume that at all given moments I am at risk of abusing others. If I fail to keep this thought foremost in my mind then I believe that this is the moment when I am most likely to reproduce the cultural practices of abuse.

Monday, June 11, 2012

A bit about me, and power words

I've reread my blog posts recently and realise they look pretty "negative". This doesn't sit well with the current fashion to "think positive" which (coincidentally ?) resides as a meme of the privileged or less oppressed. I believe that the less fortunate or wealthy you are, the less likely you are to naturally assume/resume the positive thinking "state". (Am I wrong here? Perhaps this is worth checking out more) Anyway, on review I am fairly happy with what I have written, and I am by no means a pessimist... I am more of an optimistic pessimist. Michael White once said to a group of us in discussion "I believe the world is pretty stuffed, so that frees me up to do what I think is helpful" ( maybe not a word for word quote, but that was his message..) I concur.

Anyhow, it is worth sharing a little more about myself before I launch into how I think we use language to exert and maintain power relationships, and how our very language of English hands us the loaded gun and we don't often realise we are firing off continuous salvos at all and sundry, especially those we love.

I am a 53 year old Caucasian male currently working as an academic in Geelong, a provincial city in Victoria, Australia. As such I believe I would be perceived as coming from a dominant gender, racial group and professional group. I am married to a female general practitioner and we have two children. As such I represent a dominant social group (the family) which has been defined as the norm, and as a self defined heterosexual I come from another dominant group which has oppressed and excluded non-heterosexuals. As an Australian of European extraction, I represent Western culture and its lifestyle, a dominant culture with a history of colonisation and displacement or extinguishment of other cultures and their practices.

A statement of my intentions. I hope that by writing i might encourage others to consider possible power practices they might unwittingly be exerting and that in some small way this will lead to a general reduction in the prevalence of abusive use of power.

Significant stimulation to write came years ago after I read "The verbally abusive relationship" by Patricia Evans and from discussions relating to the politics of power in a narrative therapy course. I also acknowledge Michael White as the source for me of numerous ideas espoused here. I have had several opportunities to discuss these ideas with women, individually or in groups, many of whom were "my" patients. I developed an interest in male experience and have had several prolonged interactions with men separating, or separated from their spouses. Thus much of the descriptions relate to gender relationships. My discussions with people who would identify as gay have profoundly educated me about many cultural prejudices we perpetuate. Some of my ideas have doubtless been influenced by working in a Western Desert aboriginal community for 6 months in 1986

Ok.. Enough about me for now.. More later when I feel a little braver about revealing my own frailties (hypocrisy is a big one)..

Back to power words... Let's start with a list. I will elaborate in forthcoming blogs.

I believe the following words are potentially oppressive, and at worst are dangerous and mental illness generating

1. Words that privilege one reality. Eg: "Actually", "really", "in fact", "in reality" and even "realise"

2. Words which define another's reality (generally following "you" Eg: "you deliberately....". "You think"

3. Words which attribute responsibility rather than share it. "You misunderstood me"

4. Words which measure others comparatively: "Too". "over-....." or "under-.. Eg: "You're over-reacting" "Enough" " inappropriate" "extreme", "inadequate".

5. Diminishing or excusing words "Only", "just" "All". As in "all you were doing was..."

6. Words which devalue non reason-related responses: "unreasonable" "emotional" "over involved" "enmeshed" "irrational" "That's nonsense", "..ridiculous", "..preposterous" "..idiotic", "..senseless" etc.

7. Words used to prevail over others. "But "

8. Threatening words. "If" "or else" .

9. Coercive words. "Should" "Ought to" "got to" or "must".

10. Words which spoil identity. They also often are preceded by "You are"

11. Words which disable. "can't"

12. Words used to assume agency. "To". The simple exclamation mark, while not a word can be abusive when used as a command without seeking consent.

13. Words which denigrate protest. For example. "nagging" "whingeing" "complaining" "squawking" "carrying on" "squealing" "whining" and so on.

14. Totalising words. "always" "absolutely"

15. Implications, insinuations. These are the words that are not said. .....More to come... Stay tuned


Saturday, June 9, 2012

Bullying, ("resilience"; and other cop-outs)

OK, I need to be honest from the start. I think the idea of "resilience" in psychology is so flawed, the quicker it is abandoned the better. Don't get me wrong.. I am all for survival skills and for anti-abuse strategies. I just think resilience training has inadvertently become a distraction from caring for and about and with people. Worse still, it has become an excuse for abandoning, blaming and even further abusing people under the banner of "helping". How many times have we heard the term "tough love"?

The meme here is "if I train them to be tough then they will be better prepared for the tough world out there". Furthermore "better for them to learn it from me.. At least I have their best interests at heart" This meme isn't far off the justification used by sexual abusers. We recognize it as inappropriate in this context... But why not elsewhere?

Is not the difference in degrees of abuse and in the nihilistic belief that we can't change the way we treat others in our society?

Why would we put our efforts into toughening people up rather than behaving in a more gentle way with each other? Why would we put a victim of bullying through resilience training (even if we did counsel the so called "bully")?

Is the answer perhaps embedded in our history? Could we have fought, killed and invaded our way to dominance over other cultures if we didn't believe that strength was good and gentleness is associated with weakness? Could we continue to send our youth to war? Could we continue to label our traumatized returned soldiers as "sick" rather than deceived and abused?

A recent study of doctors revealed that three quarters believe that bullying is common in medicine, including nearly one fifth who believe it is part of being a doctor. This doesn't surprise me. Bullying, to me, seems to love an environment of privilege, exclusive knowledge, entitlement and self attributed benevolence. Medicine therefore provides the ideal culture medium.. A petri dish that I found petrifying.

What surprises me is that a number of doctors responded that they thought bullying was rare in medicine. How could that be? Medicine is pervaded by ideas that long hours must be endured, hard decisions must be made, people are responsible for their own plight, rationality must prevail over emotionality (do I hear the word "professional"?). "Some people are beyond help". The idea that a superior must be obeyed is as strong in medicine as it is in the military. The other idea is that medical training has prepared you to "carry the can" and this justifies giving young (and not so young) doctors an impossible workload in under resourced systems then blaming them for the mistakes that inevitably occur. If that's not bullying, I don't know what is. I certainly couldn't cope well with the demands and spent a lot of my doctoring life feeling anxious.. Don\'t get me wrong though..the privilege of collaborating with wonderful "patients" and feeling like my involvement was valuable and valued far outweighed the negatives.

Nevertheless, I would rather see our efforts and funds directed towards supporting our patients and health care providers so that they felt more supported,valued and less victimized by their health care system. We don\'t need more "resilience" or "time management" training. We just need more resources directed to human care and to let it trickle down to where it is needed.. Maybe some vulnerability training would help. My experience has always been better when I have said "I am struggling" compared with when I say "I can cope".

Maybe that's why I have so much hope and faith invested in the Australian Institute of Patient and Family Centred Care. ( one of my dear friends is heavily involved) Now there's a group of people who "get it"

Thursday, June 7, 2012


Ok.. here's some more stuff I wrote years ago. I apologise for my style, and also I confess to not disguising the anger I have felt (and continue to feel) about the way the so-called helping professions (and I know I am one of them) unwittingly fail to attend to some issues that cause great mental suffering. Disclaimer. While I am not a great fan of psychiatric diagnosis, I do believe that it has some merit when it leads to mutual faith in a way forward (which at this point of time in our medical culture unfortunately I believe is heavily biased towards prescription rather than positive co-operative exploration of suffering through enquiry, discussion and most importantly checking with the client that the proposed possible stories fit with their experience,values, beliefs, goals and hopes).

OK, so here it is... it will possibly be challenging to you as it questions some societal memes.

I believe that a prevalent practice in our culture is speaking thinking and acting in a way that creates the experience for ourselves that we understand other peoples motives, and creates the experience for those others of being misunderstood. They (quite rightly I believe) say..”Hey, you’ve got it wrong. That is not what I was intending at all”.  Rather than accept their own story of what was happening, we look for evidence or justification of our own (unquestioned, or only partly questioned) belief that we have access to their intentions. Here the concepts of subconscious and personality (Thanks, Freud and others!) come in very handy. We can self-righteously say  “You think you’re motivated by this, but I know (“in reality”) that the real, subconscious reason is... blah, blah, blah”, because that was MY EXPERIENCE of you in that context (hence it is the truth of you, your thoughts, your action and your “true self” (personality). The result here is that we retreat from self questioning and learn little about different ways of thinking, speaking or behaving. I believe that we are well practised in this, and need more practise in questioning ourselves and finding new ways. So I wish to challenge the idea that we can analyse others.

I call this process “INTENTRIBUTION”- attributing and defining someone else’s intentions to them without allowing them to have the final say.  I believe this is another example of power abuse, sanctioned by a belief system which has been systematically absorbed into our culture. The high priests of this belief system are the psychiatrists, doctors, psychologists and counsellors who have been trained to believe that they have higher access to people’s subconscious, or “personality” than even the subjects have themselves. This knowledge can be gained by indulging in a 3 to 6 year course which includes a fair bit of generating stories about people without their consent, often behind closed doors without even their presence. These stories are then made accountable to current personality theory or theories, rather than accountable to the individual. Any deviation from either current theory, or current beliefs of the teacher (holder of the cultural beliefs “knowledge”). Is discouraged. Conformity or original re-interpretation of the dominant beliefs are encouraged and rewarded. Attempts by the subject to edit, oppose, correct or redefine the “knower’s” beliefs are labelled with terms like “manipulative”, “insightless”, “personality disorder”, “naieve”, “unrealistic”, “crazy” and other objectifying terms without giving air to the possibility that  the knower might be experiencing fear about having their own reality questioned.

Unfortunately though, virtually all of us practise this Intentribution in our day to day life, and I believe it is another poisoner of intimate, understanding, compassionate relationships, or even practical working non-intimate relationships. 

Put simply, I believe that we often think we know what is behind what another person is doing or saying, when in fact we have little or no idea. If the person disagrees with us, rather than confessing our ignorance we fool ourselves into thinking that we know more than they know about themselves, and we look for backup in the way our culture thinks about human behaviour.

Examples are...

“June thought she was doing me a favour, but I realised that she just wanted my approval. If only she could be more honest with herself and with me.”

“He was just trying to get back at me”

“Why do you always try to hurt me?”

“These type of fish prefer deep still water, especially under rock ledges, because they are safer from predators”

There are some great problems with this way of thinking. The most problematic is that if the person in question trys to explain themselves, and their explanation doesn’t fit with our understanding, we often re-indulge in the process of intentribution, relying on “deeper” and “deeper” theories (often our own, if we can’t find them in the popular or psychological literature) to explain their deficiency in self knowledge, rather than taking the opportunity to question our own assumptions.

The second is that in a patriarchal society, any attempt by others to define our own reality, by default (ie: by very early conditioning with possibly a bit of genetic programming to keep ourselves alive and feeling OK) is more often than not met with vigorous resistance, or covert undermining. This leads us away from co-operation, trust, faith and intimacy, and encourages the subject to isolate themselves from us, and encourages us to feel misunderstood and bewildered when we notice this happening. Once again, by our thoughts and beliefs we have encouraged INDIVIDUALISM. Self vs. Self. Western society reproduces itself. Lots of well meaning people, desperate for company and belonging, accidentally and systematically driving people, especially our loved ones, away.

So what do we do about this? Once again I believe that we need to reexamine our thoughts, our words and most importantly our actions when we catch ourselves doing this. In order to catch ourselves I believe there are some helpful and humble thoughts we could have.

Rather than thinking “What is actually happening here? He or she has got it wrong here. How can I make them aware of this?” I believe we have to first of all tune into our own discomfort when what we experience does not match our own version of reality. A helpful series of questions and thoughts here for me are...”

“Am I uncomfortable with what is happening here?”
“If I am uncomfortable, I must assume that this feeling is an indicator that my assumptions about what is happening are not the only possible assumptions in this context”
“Given that this is the case, what can I learn here, especially about this person’s own story of who they are and what values are important?”
“How can I question them in a way that I find out more about them, and they get a chance to put their own beliefs into words, in a way that they also might find helpful, either by having a voice, or by having the opportunity to re-evaluate their own story with my input?”
“How can I question them in a way that is compassionate and doesn’t disallow them the chance to voice their own story?”
“How can I encourage them to tell me as much as possible about their own intentions, purposes and goals here?”
“How can I do this in a way where I get to hear more than just one intention, assuming that we are multiply intentioned (See-”be an octopus”)?
“If my beliefs about this context, or about the consequences of their beliefs give rise to fear, anger, desire to control or to influence them, how can I do this in a way that clearly points out to them that I differ from them and that explains my beliefs while letting their beliefs stand there for them to re-evaluate?” 
“How can I make it as clear as possible that I am not questioning their reality here, but that I want to open up extra possibilities for us both to learn from each other?”
“How can I check that I haven’t inadvertently squashed them if I what I am saying is experienced as challenging?”
“When I look back on this conversation, what have I done well, and what have I done badly?”
“How can I let them be the judge of what I have done well or badly without inviting them to feel guilty or defensive, or the need to prop me up?”
“What have I learnt from them in this process, and how can I acknowledge this to them in a genuine way, so that they don’t feel patronised?”
“How can I make sure that they don’t feel patronised, and more importantly, can I ask them how they would let me know if they did?”
“When all is said and done, have I been clear from the outset about my own multiple intentions for this conversation or process? Have I stated these intentions in a way that doesn’t allow them too much scope to do intentribution on me?”
“How can I be accountable to the other person, but also to significant others, making sure that I give privilege to the most culturally disempowered? (being aware of my own bias and generalisations that ageism and sexism are very disempowering, so children get my first attention, women next, then men)
By privileging the heterosexual nuclear family in my bias system, am I unaware of other biases that I need to evaluate here and put up for examination? (eg, heterosexism, ablenessism, racism, religism, lookism).
“How can I learn from the other person how I could allow them to feel confident to report their experience of marginalisation (if any) because of my unwitting prejudices, so that they are not put off by my possible reaction to this process, be it anxiety, guilt, shame, anger, fear or distancing?
Most importantly. Are my actions aligned with my purposes, goals, values, intentions?

If I am practising this well (and please understand, this is rare), then this empowers me to-

1. Be clear about my own intentions and purposes.
2. Express my fears in a way that is least “infectious”
3. Be clear enough about my own beliefs to put them “out there” for examination
3. Be open to learning
4. To be constantly reminded of both my own suffering and their suffering
5. Keep myself open to my belief that each and every situation of our existence is “multiply storied”. That is that there are many different interpretations, all of them equally real and valid.
6. Allow myself to find, with the other person, a shared story, or preferrably several shared stories that result in both of us increasing our understanding of the other, but more importantly reduces that person's feelings of fear, isolation and vulnerability.
7. And this is my prime goal.... ACT in a way that sends the message to the other person that I am humbly moving in a direction that they would want me to and that they are or can be secure and safe even while suffering.

Intentribution might be a helpful process if it fits with the person's goals, but if it doesn't, I believe it has potential to superimpose our story over theirs. That is rarely helpful.

Tuesday, June 5, 2012

Some beliefs, and a bit about doing empathy

I've just been talking to my daughter.. she's in her early 20s and is quite a thinker. She's helped me to realise that I have cultivated a feeling of comfortableness with myself. It might be self deception, but it works for me most of the time. At other times I feel overwhelmed with self doubt, but I think that learning narrative therapy has helped me to talk myself around to a slightly more agreeable self view. (Thanks so much to Michael White, David Epston, Johnella Bird, Belinda, Linette, Robyn, Jacqui, Ron, Ron, Helen, Maggie Carey, Alison Morgan, Jill Freedman and Gene Coombs amongst others)

A narrative approach has also helped me define some core beliefs which keep me sane. I share them here because they may be really unpalatable. This will give you a chance to see them and perhaps never read this blog again!

Here are some of my beliefs, starting with a bit about education.

In school we are taught, that we know. But what are we taught? Many people would answer that we are taught the basics: the 3 Rs, and on them we build our knowledge so that we are equipped for life’s challenges. This, I believe is to miss the main point. We are taught so much more than that, and so much less than what we need, because, put simply, school is not so much about learning knowledge as it is about learning not to question our culture.

Try some of these beliefs (these are a bit "random" and I am happy to explain my thinking about them in later blogs)

Assertion 1.  It is good to be weak.

Assertion 2. Many evils have been committed as an application of good intentions

Assertion 3. It is important to be inconsistent with children

Assertion 4. Praise can be as destructive as criticism. (this has received some recent press

Assertion 5. Depression is an essential human emotion

Assertion 6. Telling someone a secret can often be an abusive act

Assertion 7. Emotional people are more trustworthy than rational people.

Assertion 8. An impartial approach to people in conflict is destructive to human relationships.

How are you going? How many of these are you prepared to support? Could you take any of these stances in a debate, or would you feel that you were betraying yourself to do so?

These are some of my beliefs, but I didn’t learn them in school. I learnt the opposite in school, because the above beliefs don’t help greatly in the current cultural pursuit of economic rationalism in which we are all workers and consumers. If these beliefs were not systematically discouraged in school then the fabric of Western society would tear beyond repair.

How would our society be different if these assertions were accepted as "true"?

It is my strong belief that what we don’t learn in school is how to discard our cherished beliefs when we need to empathise with someone else who thinks differently to ourselves. This has never been more painfully demonstrated than in the current “deprecation of understanding” which is leading to an ever increasing rate of failed partnerships or relationships. What I mean here is that I believe we make better workers if we become systemically deskilled in intimate relationships: we spend our educative years centred on other pursuits than the things we really need (knowledge of our bodies and the skills of intimacy). The outcome of this deskilling is lack of capacity to resolve conflict. Work becomes an attractive distraction from the impossibilities of home life.

I believe we need to learn to “think different”. A professor of English has written about this and calls it the “believing game”. He describes a process whereby when faced with a challenging belief or set of beliefs, the person actively decides to suspend their own beliefs and to assume, as an exercise, that the opposing or difficult beliefs were actually true, and to “step into” this belief for the purposes of exploration. His assertion is that by doing so, a person becomes more aware of different approaches to a situation that may be helpful.

This overlaps greatly with Michael White's 3D exercise for couples (1988), an exercise in listening for the express purpose of empathising with the speaker.. not solving, rationalising, reassuring, arguing, agreeing or anything else, just trying to step into their shoes. I believe that this way of engaging is either incredibly rare, or if it happens, incredibly brief.

... if only I/we could do it in a more sustained way....

Sunday, June 3, 2012


In 1998 I wrote about something I called "doppression". I never published it, and every now and then I searched google for the word.. no hits. Yesterday I tried again and found this page entitled doppression by a comedian called Drew Michael, about oppression of people who identify with being "gay". It's time I added to the meme publically, so here's what I wrote all those years ago


There are several models for viewing the experience that is popularly known as "depression". The current dominant model consists of a collection of popular memes combined in a narrative something like this...

  1. Our natural state is not to be distressed
  2. Deviation from the natural state is a disease (pathology)
  3. Disease is predominantly caused by internal factors (genes, predisposition, biochemical disturbance)
  4. Although depression can be precipitated, the development of the disease reflects some internal deficiency or lack of coping skills.
  5. The deficiency can, to some extent, be treated with medication' and the coping skills can, to some extent be leamt
  6. The best way of learning coping skills is through intellectual processes (cognitive behavioural therapy)

Some benefits of this model are that there is a widespread faith in the view that "a suitable medication, when found, can bring relief of suffering". Many medications have been found that are helpful. The process of prescribing is viewed by doctor and patient alike as a significant step toward "recovery".

This model survives, despite recent evidence resulting from technological advances which will cause it to be reviewed (people with depression don't have lowered serotonin levels in their brains, they are actually raised) (Now in 2012 I have to review this.. but I am sure that we really don't understand the role of serotonin in depression)

Some drawbacks of this model are that the person for whom medications are prescribed, or cognitive therapy instructed, are left with the idea that the illness was consequent to them being deficient or abnormal or misinformed or crazy. Context is acknowledged, but kept at a distance.

There are many alternative models
Depression is a spiritual crisis and an opportunity for spiritual growth or awareness
Depression is the result of some karmic misdemeanour
Depression is a test of one's mettle
Depression has no meaning and is a consequence of the random occurrence of pain and
Depression is consequent to loss and represents to some extent a personal loss of self
Depression is consequent to oppression (physical, verbal) , by either people or by
people's critical ideas which have been internalised as self-truths.

Being highly interested in language and its effects, and being disillusioned by the application for 10 years of the dominant model and my belief that it disempowers the "sufferer", I have devoted much of my time in recent years to exploration of the latter model which has been articulated by several people. Most cogent for me is the modem articulation of these ideas in the context of so-called "narrative therapy".

The strengths of this narrative model are that they give rise to options for any individuals who have contact with someone with depression to look at their own possible contribution to the perpetuation of the "disease", by inadvertent oppression through the use of advice, judgement, inability to understand or accept what the "sufferer" is reporting, and give us also a chance to consider the possibility that in a dominant culture we are all trained so well to dominate that we often oppress others. Hence "doppression".

As Michael White points out, our culture has moved towards this acknowledgement by putting the "post traumatic" in "post traumatic stress disorder" which was previously known by several labels which pathologised the individual including "war neurosis".

If you accept that the narrative model may have some merit, then I would invite you to consider the possibility that the ways that we usually relate to someone who is "doppressed", actually generate and keep alive the condition. These ways include.. Pitying, advice giving, rescuing, refraining, ' criticising, confronting, neutral listening, reflecting back (without checking), indulging, ignoring, labelling (officially with "diagnosis" or unofficially with pathologising lay judgements (laybels [sic]) including "immature", "weak", "fragile", "overemotional", "angry" amongst a multitude of other labels.

I have become less interested in criticisms of the narrative model, as they often rely on dominant paradigms such as "evidence leads to truth" and "of all explanations, one must be more true than others" which is extended to "unless model A can be demonstrated to be more watertight than Model B, it is not valid". I am not disinterested in such criticism because I think the underlying assumptions are flawed, but because they are unhelpful. inasmuch as they may lead to the dismissal of possible options for change. My assumption is that any approach which broadens options for action is worth privileging.

Much about the possibility that the way we treat others, especially by the language we use, is found in the accompanying essay*. I invite you to suspend disbelief and read this paper as if it had merit and ask yourself "What if this contains some truth? How could I change my language when I talk with others?" I then invite you to try it and see. If, after you are well practised at avoiding power words, your loved ones don't notice an improvement, then I invite your criticism. Criticism in the absence of a "field trial" does not particularly interest me. If you find, as I did, that serious consideration of our language opens new doors for you and the people you relate to, please feel free to let me know.

On a personal note, I had this really negative reaction to finding someone else had publicised "doppression" as it was "my word". How crazy is that?. but it made me think about how effective is the conditioning that our self worth depends on our ownership, authorship, and entitlement to use, dispense or permit usage of memes. I'll get over it... like I did with "Obecalp"... more about that another time too. Thanks Drew for bringing it to the www.

Saturday, June 2, 2012

Not MAD..but WAD - Widespread Acknowledgement Deficiency

The heavens seem to be aligning at the moment to remind me how important it seems to be to us human beans (sic) to receive something really simple... Acknowledgement.

It's been the theme of my week. I wasn't going to blog about it because I think I now take it for granted that acknowledgement is part of our lifeblood, and if it is denied it can be so painful. I believe if withheld for long enough it can be crazy-making (a term I learnt from Patricia Evans... Or was it from an old article called "Charm Syndrome Man" by Sandra Horley?)

Anyhow, what prompted me to write about it was the last of three "acknowledgement events" in six days.

This last event was listening to a program on Radio National Australia about the Pinjarra Massacre of the Nyoongar people in Western Australia in which mounted troops slaughtered 21 indigenes in a raid. The offensive fact is that this massacre was written into history as a "battle", implying equally matched opposing parties. If anyone doubts the abusive power of words, this is a moving example. The program ends with a Nyoongar descendant talking about a forthcoming joint ceremony with the WA police  "its a real big deal that they are going to acknowledge it....first acknowledgement really"

 The other "events"?

 1. A young person I know who has been bullied in the workplace who said "I don't want the other person to suffer. I just want acknowledgement and an apology"

 2. Reluctance by a friend to acknowledge an inconvenience unwittingly imposed on others because there was no intention to inconvenience ( more about intentions and excuses in a future blog). Furthermore, the unforeseen hassles imposed didn't qualify as an 'error' therefore no apology was warranted. Further justification was that these sort of things happen all the time.. We shouldn't lead people to expect an apology because the real world out there is harsh so we do no favors to people by not preparing them for this.

 This just doesn't cut it for me and surely one could argue that this is the very reason we should model something different. Definitions of the word acknowledge predominantly describe "verbal recognition".

To acknowledge someone or something is far less demanding on the "empathy scale of difficulty" than appreciation, or even agreement.

How many times a week (or a day) are we invited (made?) to feel unacknowledged? What's up with that? What might be the effect of this?

Do you think that "low self esteem" or doppression might feed off the self questioning memes
"why wasn't that acknowledged?"   "did I just imagine that?"
How much of a leap is it from there to "am I mad?" and even "do I exist?"

 Maybe we need to start dispensing more acknowledgement and less Prozac?

Thursday, May 31, 2012

"That's just how it is"- health funding

Over the last few days I have been at a conference about the use of simulation in training health professionals. There has been a heavy emphasis on patient safety and the effectiveness of training under pressure with realistic clinical scenarios. Simulation means good training without endangering real patients, bystanders or the actual participants. The conference was wonderful, but there were hidden memes.

A dominant theme was that to run these simulations requires much preparation, co-ordination of staff and ultimately money. Many people were openly discussing how much more effective would be their training program (and ultimately how much safer would be their trainees) if they had more money. The meme was "but that's not going to happen". The explanation? "We can't do anything about this underfunding" (hidden meme)

Whenever an adverse event occurs to a patient, often what follows is a  Root Cause Assessment (RCA) which involves looking at all the factors that led to the error, including understaffing and underfunding.

A good root cause analysis of tight or declining funding for the education or health care sector (eg TAFE threats in Victoria) would challenge the assumption that "money is tight and that's just how it is"

That's what root cause analysis is supposed to do... make the assumptions explicit and examine them.

So let's do it. Let's have an open public discussion about resource allocation. How do we as a society want to spend our money? Are we apportioning our expenditure appropriately, when our healthcare system is threatened by degradation of our standard of care and training?

I am not against defence expenditure. I think countries should defend themselves (I don't believe that offensive activities eg-Afghanistan and Iraq wars are really defense. I think true defensive strategies don't require this sort of activity). But let's have the discussion, and every time there is a medical conference where everyone knows that healthcare money is not adequate, lets have the keynote speakers encourage the health profession to bring on that public debate. My guess is that our priorities would change and we could still have adequate national security. We will never know what is possible if we don't push for this debate to happen.

Meme-  "it's too complex.. we better trust those who know" (the politicians and the military strategists). This is worth challenging too.

Let's become those who know.

Monday, May 28, 2012


Hi. If you are reading this you might be interested in memes (units of meaning), words, ideas, and how we experience ourselves.

I am particularly interested in the memes we adopt as truths, and the effects of these. Some truths I believe are really worth unpacking, and urgently.

One widely held example is that "depression" is a disease, caused by an internal deficit, that results from weaknesses that are largely predetermined biologically and triggered by events.

I believe that we must consider the possibility that our (often well intentioned) efforts might unwittingly be perpetuating or exacerbating the sadness that goes with oppressed spirit.

Is this really the illness of "depression" or a process of "doppression" exacted on others by the way we interact with them?

What if doppression was more readily "curable" by identifying and having others recognize these oppressive practices as unwittingly harmful and committing to changing them, guided by those suffering from the effects of these actions? What if the collective awareness held by the "doppressed" held the secret to societal reform and a path away from bullying or abusive practices to which we have become desensitized and blinded?