In a year where I feel like I’m huddled in the quiet place at the center of a tornado, I’ve been spending a lot of time watching the swirling whirlwind around me and marveling at its cruelty. Whenever I venture a little out of my comfortable quarantine space, bad things seem to happen. A few days ago I commented on an article online, and every day since, I’ve been barraged by people accusing me of intellectual, educational and moral degeneracy. These people don’t know anything about me except for one line of text, and based on that they feel entitled, and even morally obligated, to treat me like an enemy.
What’s more, I understand the urge. Sometimes people express opinions that fill me with righteous anger, and I wonder how anyone could possibly think the way that person does. Unless I consciously push back against the hardwired workings of my brain, it will automatically put that person I disagree with into the category of “other,” a person who is not part of my tribe, and not to be trusted.
Our brains evolved to classify people in this manner in order to keep us safe. When confronted with someone new, our brains will almost instantaneously assess that person’s appearance, demeanor, and attitude, and decide if that person is “us” or “other.” This was a matter of life or death in antiquity. Someone from a neighboring tribe would quite likely be an unsafe rival who competed with us for food and other resources, and they could be dangerous to our physical safety.
Unfortunately, as the centuries progressed, this hardwiring to the ancient structures of our brains didn’t change, and people still unconsciously continue to assess those that are unlike them to be threats. We can easily see this behavior in teenagers who form cliques that are fiercely loyal to each other, and who roam school hallways together looking for “others” to crush.
While people gain identity, safety, and companionship from being part of the group, they may also be stifled by it. Those that don’t conform to the group norms can end up ousted from the group, and find themselves in the cold and frightening role of “other.” As a result, people stop being creative, stop growing and changing, and stop trying to understand those who are different from them in order to avoid losing their safe place as part of the tribe. Sometimes, people will even do things that go against their own moral codes in order to remain in good standing with the group.
While we may not form cliques as often as we get older, we still join and conform to tribes. It may be a political party, a career path, an ethnicity, a religion, or even a family group. Our identities become bound up in these groups and we’re hardwired to see people in other groups as “the other” and somehow threatening to us, even if they actually have no intention of harm.
As people become more and more identified with their tribes, they lose objectivity, and they can be easily manipulated into hating the other group. Unethical people who are looking for power will often use this all-too-human tendency to unite against an “other” to rally people behind them. This process is extremely dangerous. Throughout history we’ve seen what happens when groups of people are demonized, labeled and feared: genocides, civil wars, concentration camps, witch burnings . . . the very worst of human atrocities. They all happen because of this hardwired tribalism.
So what’s the fix? How can we intervene? Well, the first step is to start paying attention. First, pay attention to the messages within your particular groups. Who is it that is being placed in the role of “other,” and who is benefiting from placing people in that role?
Next, pay attention to the feelings in your own body. If you feel comfortable with the messages of one particular group, but the other group’s messages make you feel physically uncomfortable, that’s not a sign that the other group is bad. It’s a sign that you have become so aligned with the beliefs of your own group that the way people from other groups see the world feels alien to your nervous system. Instead of further rejecting the worldview of other people and seeing them as wrong, grow curious. Start investigating other ways of thinking and believing. The more that we understand other people, the more we can embrace their differences.
Read books about topics that you’re uncomfortable with, and by people who you don’t agree with. Talk to people from the other group with an open and compassionate heart and mind, and try to understand why they see the world the way that they do. Nobody arrives at their beliefs in a vacuum. They’ve had life experiences that led them to where they are now. Understanding and knowing those stories breeds compassion, and we are in desperate need of compassion right now.
In my work as a therapist I talk with people from every imaginable group, and I can tell you that suffering, and a need for understanding are universal. Showing understanding for someone in a group different from yours is healing for everyone involved.
So, next time you’re online and see someone posting an opinion that you don’t agree with, instead of pelting them with insults, I encourage you to ask them why they believe what they do, and ask it with a truly open mind. If they answer, it might not change your mind, but it might help you to have understanding and compassion for a different way of seeing the world. It might help you to bring that person out of the “other” category and into the “us” category.
The truth is that we are all human, and while seeking out the differences between us in order to categorize, label and oppress people might be part of our hardwired nature, I believe that we have the capacity to rise above our hardwiring and make choices. People do it every day. They choose not to punch that person that made them angry, or ram that car that cut them off. We have the capacity to choose our behavior because of our amazing frontal lobes, which give us reason and self-awareness. I encourage you to start viewing people as a tribe of humankind in all of its wondrous and beautiful variety. Maybe then we can start treating each other with true humanity.
For the past 3 weeks I’ve been working from home because of the COVID-19 quarantine situation. For the first week, I was elated. I slept late, worked in my yoga pants, and did little projects around the house between patient phone calls. During the second week, I was less excited about it, but I was OK. Then, the third week came, and the loneliness and isolation of three weeks by myself in my one-bedroom apartment hit me hard. Like a caged tiger, I’ve been pacing around my living room, and peering through the black wrought iron of my security gate out into the quad outside my front door.
So, when my friend, Jeannine, contacted me yesterday and asked me to come over to her place for a social distancing dinner in her backyard, I was so excited I could barely contain myself. When I got to her place, I had to swallow my need to hug both Jeannine and her husband, Paul. Everything seemed hilarious. When the chicken that Paul was barbecuing caught on fire and he couldn’t figure out how to rescue it, I laughed myself silly. It didn’t matter to me that I might not have anything to eat. I’d figure that out. (The chicken ended up being perfectly cooked, by the way). When we played Mexican Train, I felt nothing but joy and camaraderie, even though I lost miserably all three times.
It got me thinking about the value of community. There’s a strange push-pull in American culture about needing others. We definitely have a hero complex. All you have to do is check out our film-making choices to see it. How many incarnations of the strong and exceptional person saves the world alone are even possible? I’ve grown to hate these hero movies. They set up unrealistic expectations of self-reliance, fearlessness, and invulnerability.
On the other hand, American culture is one of the most extroverted cultures on earth. Being highly social, overtly friendly, and always having something to say, are highly prized American personality traits. As a Highly Sensitive Person, who needs alone time to re-charge, enjoys solo creative projects, and freezes around inauthentic people, I’ve felt defective for most of my life. Telling myself that my need for solitude, my inability to come up with interesting things to say in large groups of people, and my lack of an emotional filter were weird, I’ve spent a lot of time pretending. It’s only within the past year or so that I’ve realized that being wired this way is OK, and I’ve given myself permission to be my authentic self. What a relief!
With pressure to be highly social and friendly, but also be a fearless lone savior, I think we’re all a little confused about how much community is the right amount. I’m constantly struck by how many people tell me that they feel like they should be OK with being alone, and that the deep need that they feel to belong is wrong somehow. They tell me that it’s a sign of codependence, and that they need to work on their unhealthy coping strategy of being with others to avoid feelings of loneliness. Usually this comes up while the person is grieving the loss of a loved one. Three weeks into grieving, people believe that they should be over it already.
This mindset never fails to sadden me. What a sorry state of affairs to believe, as a society, that needing people is a sign of mental illness. How terrible to think that grieving is somehow a weakness. I explain to these people that codependence doesn’t mean what they think it means. I tell them that codependence is actually a description of people that put their own needs aside in order to support others in an unhealthy and self destructive way. I’m not talking about self-sacrifice for the greater good. I’m talking about harming oneself because of an inability to set or respect boundaries. Codependence is the person in a domestically violent relationship who doesn’t leave and makes excuses for the partner’s behavior. It’s the spouse of the alcoholic who constantly cleans up horrible alcohol-induced messes, pays DUI fines, and apologizes to friends who have been subjected to drunken rages.
Needing love, community and support is completely normal and healthy. We’ve evolved over millennia as tribal creatures. Some of us need smaller tribes than others, but we all have a need to belong, to be understood, and to be loved, and that is a good thing. Society would fall apart if humans didn’t naturally organize themselves into communal groups. Where would we be if someone didn’t grow crops and share them with the rest of us? What would happen if nobody cared for the sick, or educated our children? It would be a much poorer life, indeed, if we weren’t the interdependent creatures that we are.
Interdependence is the exact opposite of codependence. When we’re interdependent, we help, support, and care for the people around us, just as they help, support, and care for us in return. Nobody is harmed in this reciprocal relationship, and everyone’s lives are enriched. Interdependent relationships are a sign of mental and emotional health. In order to have them, we have to be able to set the boundaries of what is OK and not OK in how we treat each other. We also need to be able to respect those boundaries when they are set. This type of relationship takes maturity, kindness, and compassion, and it is one of the most beautiful pieces of the great jigsaw puzzle of what makes us human.
One of my favorite things about the modern world is the web of global interdependence that allows me to buy goods from across the globe and have them in my home in a couple of days. I love that I can tap into recordings that were made in Russia or India at the touch of a button, or that I can get on a plane and be in Italy in less than a day. If I want to, I can buy a book written in another language, and then translated into my own, and absorb the ideas of another culture and another mind. The more that we share ideas with each other, the more we understand each other, and the more that we see how much we are the same as humans no matter where we were born or which language we speak.
I know that my pacing loneliness is a result of a breakdown in interdependence. I also know that toilet paper shortages, and the fact that I had to buy flour and yeast on Amazon.com, because I couldn’t find it anywhere else, in order to make the bread that is currently rising in my kitchen, is a result of a breakdown in interdependence. I fear anything that threatens interdependence and understanding between humans, such as walls between nations, isolationism, or nationalism.
While I understand that sometimes we have to be alone to protect ourselves, to lick our wounds, and to heal, my hope is that these times of isolation are brief, and that we don’t end up as a world full of angsty teenagers hiding in their bedrooms playing video games with “keep out” signs on the door. When the danger of COVID-19 is passed, my hope for the world is that we will be brave enough to re-open to each other as a world full of humans who struggled together through something terrifying. I hope that we can be united in the knowledge that nobody is to blame for it because sometimes shitty things just happen because life is hard. And yet, it is the hardest times that can hone us into the best humans if we are able to give the experience meaning. May the meaning be love, kindness, compassion and community.
Below are some links for information about codependence and interdependence. Two wonderful books about overcoming codependence are Codependent No More by Melody Beattie, and Facing Codependence by Pia Mellody. Pia Mellody’s book was the first book I ever read about codependence, and it opened up a whole new way of thinking about healthy relationships for me.
I was 34 years old when I went through my serious illness, and I’ve always looked young for my age. As the illness progressed, I became extremely thin, which made me look even younger. People expected me to be healthy and happy because that’s how I looked to them. One day, while sitting in the lobby waiting to see a neurosurgeon, because an MRI scan had shown a brain abnormality that the neurologist thought was a tumor, an elderly man looked at me and said, “You don’t look sick enough to be here. You look too young and healthy.”
His words struck a painful chord in my heart. By the time that I got to that neurosurgeon’s lobby, I’d been accused of lying about my illness so many times that I’d actually begun to question my own veracity. Not because I wasn’t being honest about my illness, but because everyone around me seemed to believe that I couldn’t be as sick as I was. Multiple doctors told me that the problem was really anxiety or depression. If I’d had the energy to appreciate irony, I would have smiled at their desire to diagnose me with a mental health problem instead of a physical one because, as a psychotherapist, I was just as qualified to diagnose anxiety and depression as they were. I was afraid, yes, but it was as a result of the illness, not the cause of it.
After being disbelieved and turned away, my desire to be heard and to be helped with what I was going through became somewhat desperate. This didn’t help my situation at all. The doctors felt my desperation, and it further convinced them that I was simply an anxious person, not a sick one. A cycle developed.
As a psychotherapist, I was taught that I am not the expert on what the client is going through. Clients are the experts on their own experience, and it is my job to explore and respect that experience. It’s my belief that if medical professionals would adopt this stance, people would get the help they need to get better much more quickly and easily. Patients would feel heard and understood, and there is evidence that experiencing compassionate understanding is medicinal in itself.
Injuries, like the one that led to my illness, can happen to anyone at any age. Illness is the same. In fact, there are illnesses that primary affect the young. Just because people look OK on the outside, doesn’t mean that they are OK on the inside. I would like to ask the world to stop telling other people what they feel, what they are experiencing, or who they are. If you think about it, it makes no sense for me to tell you what you are experiencing. How on earth could I know? Ask questions. Reserve judgment. You’ll be surprised by how much you can learn about someone if you do. And you never know; the knowledge you gain might just save a life.
Every year in January, I get an MRI of my brain. This has been going on for 9 years now, so it’s not really a big deal to me, and I don’t expect that I’m going to get bad news anymore. It takes about a half an hour of being in the MRI machine, which doesn’t freak me out as long as I keep my eyes closed. I learned my lesson quick on that account when I opened my eyes during one of my early scans and saw the top of the tube right in front of my face, and nearly went into a claustrophobia panic. For the first twenty minutes of the scan, I just lay in the tube and try not to be deafened by the cacophonous clacking of the magnets, and then they pull me out of the tube and inject a contrast solution and put me back into the tube for another 10 minutes. The purpose of these scans is to make sure that a spot they found in my brain during my 2011 illness doesn’t change. As long as it doesn’t change, they tell me that they just want to let it be. I do my best to trust that they won’t ever have to do anything more invasive to my brain.
This year, I scheduled my yearly brain scan in a new location thinking that it would be more convenient for me. Getting ready for an MRI is kind of like going through security at the airport in that they are quite concerned about metals of any kind on your person. They ask if you’ve ever been exposed to shrapnel, if you have any metal implants of any sort, and then they make you strip and get into a hospital gown just in case. I hope they never start doing that last part at the airport.
Arms wrapped around myself to ward off the chill of walking around in a hospital gown, I got into the machine with the help of the MRI tech and the nurse, and was prepared for it to be the same routine as every year for the last nine years, but this time, when the tech pulled me out of the tube to do the contrast injection, it was quite different. Since I have an aversion to needles, I looked away as he prepped me by wrapping a tourniquet around my upper arm and told me to make a fist. Then he told me that there would be a slight sting, and I prepared myself for the usual injection pain, but this time it was so much worse that I started to sweat and got woozy. It felt like the vein in my right arm was going to explode.
I told the tech, “Wow. That hurts a lot more than usual, and it’s making me feel faint.”
He said,”Oh, don’t worry. That’s just the pressure of the contrast against the walls of your vein.”
Trying to take deep breaths against the pain and wooziness, I said, “I’ve had this done a bunch of times and it never felt like that before.” I didn’t want to say it, but I felt like he had the needle in wrong.
His response was, “I’ll just do it as slow as possible for you.”
Um no. “Actually,” I said, “please finish as quickly as you can. I need to get this over with or I’m going to pass out. I have a history of doing that.” This is true. I’ve always been squeamish around medical stuff, but due to my protracted illness in 2011, my medical trauma has made my squeamishness exponentially worse.
He finished the injection, and said, “Never had that response before, huh?”
“No,” I said, taking deep breaths and trying to mentally be somewhere else . . . somewhere cool, like Scotland.
With that, he put me back in the MRI tube to complete the scan.
Now, it’s entirely possible that I just had a bad reaction to the injection, but the tech’s assumption that it was my problem, and not anything that he might be doing wrong was triggering for me. I’ve had blood draws before that were terribly painful and left bruises because the phlebotomist made a mistake, so I know that it’s within the realm of possibility that the extreme pain of the injection this time wasn’t just my own reaction, especially since this is the ninth time I’ve done it, and I’ve never had a problem before.
The reason that I bring this up is that one of the main premises of my book, I’m Sick, Not Crazy, is that the medical system needs a huge compassion overhaul. During my 2011 illness, I was shocked by the number of times I was told that the problems I was having were likely “just anxiety.” They definitely were not due to anxiety. It’s true that I was terribly afraid about the awful and unexplained symptoms I was having, but I knew that they were due to a neck injury I’d sustained. It took months to get any doctors to listen to that explanation.
I went from doctor to doctor without any relief, and a huge increase in stress and sickness. Eventually, I came to a frightening conclusion. I believe that there is an entrenched culture in the medical system of blaming the patient when the doctor doesn’t know what the problem is. I also believe that this bias toward blaming the patient is a major barrier between patients and the diagnoses and treatments that they need. My hope is to spread the word that a small increase in compassion and the ability to listen to what patients are saying would create a huge shift in the wellness of the community. I hope that you’ll join me in the work to spread this message.
Every three months I go to see my awesome neurologist for botox injections into some of the muscles in my neck and along my spine. After a severe injury in 2011, I was terribly ill, and had a slew of diagnoses before they finally settled on spasmodic torticollis, which means that the muscles along my neck and spine have a tendency to contract involuntarily, causing me to sometimes make odd movements with my head and my shoulders. Every now and then someone will point it out, but most of the time people can’t tell that it’s a problem from the outside. From the inside, the worst part is a sensation of movement under the skin, like bugs are crawling along the back of my neck and head. It’s not painful, but it’s frustrating and distracting, especially when I’m trying to sleep.
Today, as my doctor inserted a probe into neck and back so that she could listen to the muscles, which gives her information about how much botox to inject, we discussed the fact that we both work as providers for Kaiser, (her a neurologist, and myself a therapist) and that we are mostly lucky in our patients. I agreed that most of my patients are lovely people, and I feel honored to help them. Then she said something that resonated with me. She said, “The ones that aren’t nice to us have been through a lot. They have a lot of somatic symptoms, and they’ve been minimized to the point that they feel defensive.”
She didn’t know it, but she had stepped into one of the main themes of my book; the fact that when people are ill and seeking help, and they come up against medical professionals that minimize their symptoms and tell them that they aren’t real, it’s harmful. It causes them increased stress, which has been shown in research to exacerbate symptoms of illness, shut down healing, and erode DNA, causing aging. Research has also shown that a small amount of compassion on the part of healthcare providers/medical professionals goes a long way towards decreasing pain and healing times, as well as helping patients to understand their treatments in a way that leads to better compliance with medications and procedures that their doctors recommend.
Hearing my neurologist acknowledge the struggles that some people go through trying to get help while they are also suffering with any number of possible illnesses, and how negatively that affects them, was a beautiful thing to hear. It not only led me to trust her more as a person of empathy and professionalism, but it also motivated me to continue the work that I’m doing to get my ideas out to the world, and to you.