Advisors

Despite Malcolm Gladwell's assertions his book, Blink, I think it is far too common for people to get in trouble when they go with their gut feeling.  On a regular basis, I converse with therapy clients who are describing their anxieties, fears, neuroses, joys, obsessions and other issues.  At some point, we begin to discuss how they manage (or don't) their emotions.  Anger, for instance, is an emotion that kind of gets a bad rap.  Some of my clients have been court-ordered to attend "Anger Management" therapy or group sessions for the same.  The problem isn't primarily anger, in and of itself.  Anger is just an emotion like any other.  Any clinician will tell you that a great deal of the time, anger is actually a masking emotion.  The real cause of a person's anxiety lies in another uncomfortable emotion which is covered up by angry behaviors.  That is because angry behaviors are predictable.  When one chooses anger and angry behaviors (yelling, screaming, blaming, accusing, aggresssion), other parties tend to respond in kind.  Then the person doesn't have to deal with the real feeling... probably something like shame or embarrassment or hurt or guilt.  So really, what we are talking about is how we manage our emotions in general, not just anger.

So, we talk about what skills the client already possesses and uses to manage their uncomfortable emotions.  Ironically, angry behavior (which is distinct from angry feelings), IS in itself a method by which many people try to manage their other uncomfortable emotions.  Let me clarify: I often raise my client's awareness about emotions by pointing out that there are some emotions that we feel like we need to regulate and some that we do not.  Comfortable emotions are ones like: Happiness, peacefulness, calm, love, joy, pride, serenity.  We're okay with those feelings.  When we are feeling those things, we try to make those feelings last as long as possible.  Contrariwise, when we feel things like: guilt, disgust, shame, embarrassment, hurt, betrayal... we consider those to be quite uncomfortable and want to get rid of, or change those feelings.

I believe that one way to begin to change how we manage our emotions is to better understand how they should function in our lives.  Many people seem to believe the notion that if we feel something intensely, it has greater veracity.  That is to say, that the stronger we feel something, the more we think we should act on it.  While it is certainly true that strong feelings CAN indicate the right behaviors, it is not universally true.  Consider the following scenario: A guy goes out with a group of friends on a professionally guided backpacking trip.  One part of the trip takes the group to the top of a steep cliff face.  They break out the gear and get ready to rappel down the face of the cliff.  They anchor to a strong tree trunk at the top, have all the proper items: ropes, locking carabiners, harness, gloves, etc.  One of the guides rappels down to act as the belay person and everyone is ready.  So, our guy steps up and gets connected in his harness and is shown the technique.  Every precaution has been taken, and yet... he is about to step off the cliff and descend ... and he's never done it before and his heart is pounding and he's ... afraid.  His fear is almost palpable.  He decides to back down.  Better safe than sorry, right?  That is an example of allowing his emotion, fear, to dictate his behavior.  Now, what if he decides that, despite being fearful, that he wants to take the risk.  He recognizes his fear, but reminds himself that he has done every reasonable thing to ensure that he will be relatively safe in this endeavor and he hops backward off the cliff and enjoys the thrill of his (somewhat) risky behavior.  That would be an example of allowing his (justified) fear to guide his behavior (going with a group which includes trained guides, proper equipment, etc) but not control it.

In my opinion, this is what our emotions are for: to inform us.  Our emotions should guide us, but ultimately, they should not control us.  I like to think of a person's functioning as being similar to the President.  A good President surrounds himself with advisors.  Their function is not to make the ultimate decision, but to inform the President.  A military advisor may caution that a bordering country is becoming aggressive and needs to be dealt with by a show of force.  The agriculture advisor and domestic advisor may team up and offer critical information about that same country's trade status.  A military show of force would likely result in a loss of needed foodstuffs.  The President weighs all the available information and makes the decision that is best for the whole.  Things quickly become unbalanced when one advisor is allowed to decide for the whole based on that advisor's perspective.  In our emotional governance, this is all too often the case.

Think about the phenomenon of lovesickness.  Even this pleasurable emotion of love can be destructive if it blinds a person's reason.  A lovesick teen may be told by friends, "That guy is a jerk and treats everyone badly."  Being flooded with emotion toward her beau, she minimizes his behaviors or explains them away, "Well, he's only mean to people who are mean to him.  He treats me like a queen!"  Before long, the lovesickness wears off and she changes her mind.  It is important to recognize our feelings and even listen to them, but not to allow them to make the decisions that our reasoning mind should be making. 

Have you ever been on a roller-coaster of emotion?  Know someone who has acted on their intense feelings and been burned?  Consider doing things differently: allow your emotions to serve in an advisory capacity and slow things down so you can think about your decisions.

Some famous quotations for your consideration (I neither support or decry these quotes, I just found them interesting):

All great movements are popular movements. They are the volcanic eruptions of human passions and emotions, stirred into activity by the ruthless Goddess of Distress or by the torch of the spoken word cast into the midst of the people.
Adolf Hitler

How fortunate for governments that the people they administer don't think.
Adolf Hitler 


Comfort in expressing your emotions will allow you to share the best of yourself with others, but not being able to control your emotions will reveal your worst.
Bryant H. McGill

Emotions have taught mankind to reason.
Marquis De Vauvenargues 


Feelings are not supposed to be logical. Dangerous is the man who has rationalized his emotions.
David Borenstein

I can't say I have control over my emotions; I don't know my mind. I'm lost like everyone else. I'm certainly not a leader.
Richard Gere 


I loved her. I still love her, though I curse her in my sleep, so nearly one are love and hate, the two most powerful and devasting emotions that control man, nations, life.
Edgar Rice Burroghs

I think the smartest thing for people to do to manage very distressing emotions is to take a medication if it helps, but don't do only that. You also need to train your mind.
Daniel Goleman 


I understand that it's hard for everyone, but one cannot give in to emotions... we'll have to draw lessons from the current crisis and now we'll have to work on overcoming it.
Boris Yeltsin

I'm just basically spillin' out my emotions to the world. 'Cause rap is about emotion. And I want you to feel what I'm feelin', 'cause that's what it's all about.
Ludacris

If your emotional abilities aren't in hand, if you don't have self-awareness, if you are not able to manage your distressing emotions, if you can't have empathy and have effective relationships, then no matter how smart you are, you are not going to get very far.
Daniel Goleman

Just as your car runs more smoothly and requires less energy to go faster and farther when the wheels are in perfect alignment, you perform better when your thoughts, feelings, emotions, goals, and values are in balance.
Brian Tracy

Markets as well as mobs respond to human emotions; markets as well as mobs can be inflamed to their own destruction.
Owen D. Young

One is certain of nothing but the truth of one's own emotions.
E. M. Forster

Romantic love is an illusion. Most of us discover this truth at the end of a love affair or else when the sweet emotions of love lead us into marriage and then turn down their flames.
Thomas Moore

The advantage of the emotions is that they lead us astray.
Oscar Wilde

Your intellect may be confused, but your emotions will never lie to you.
Roger Ebert  

Practicing what I preach

Okay, full disclosure here... I am a work in progress. I do not feel like I often get to the point that I actually have to use the tools that I advocate in my therapy practice. I would like to think that I am self-aware and practicing enough discipline in my everyday life that I hardly ever get to the point that I enter the blame-game and the justification for anger cycle. But I did this last week. Here's what happened.

The company I work for holds a contract with the State of Texas to provide crisis counseling for at-risk youth and their families. Because it is a state contract, the company is required to undergo an annual audit to make certain that the contract is being carried out. Our audit starts next week. This year, I resolved to recognize that anxiety, like so much other stuff, flows downhill and that I would decline any invitation to be as anxious as the administrators about the audit. I would just keep doing my job the way I do my job and let them worry about whether the i's are dotted and t's are crossed.

The past few weeks, my email inbox has been busting at the seams with emails about meeting our numbers, documenting our work and efforts to meet with Youth and Primary Caregivers. "Best Practice" dictates that we should complete paperwork in a timely manner and with the looming audit, that has meant increased scrutiny on our files. I can be quite honest about my attitude toward paperwork: I hate it. (Therapist Jeff says: Jeff's feelings about paperwork reflect his insecurity with his own efforts. Because he projects self-confidence, his lackadaisical performance in keeping up with his paperwork reflects his fear that people will see him for his true self: lazy and lacking internal motivation concerning small details) Yes, I hate paperwork. I justify my hatred of paperwork with a complex series of arguments about small minded bureaucrats who developed the guidelines for our program without any insight to what the actual job entails. Anyhow, the short story is that I have my own timeframe for getting my paperwork finished that does not always match up with deadlines that I have been given.

I feel that because it has been previously established in supervisory sessions with the people who are in charge of my program, that this should be taken into account when evaluating my efforts. Read: it has caused problems before. Truth is, my supervisors have all been reasonably flexible in allowing me leeway with my paperwork deadlines. However, with the added anxiety and desire to present the best possible filing for the auditors, the grace extended to me regarding my timeliness vanished. And that is what it has always been: grace. Now, understand, I am a good worker. I believe the outcome of my efforts readily reflect that I am a great therapist and gifted clinician. I get my work done, and I do make most of my deadlines, but paperwork and time management continue to be growth areas for me.

I was up at the office late on Thursday making sure all my paperwork was done, all my files were in compliance. I looked over the bevy of emails regarding requests from my supervisor and, confident that I answered them all, I stumbled off to bed to get a few hours sleep before I got up to do it all over again. Friday morning, I attended several meetings and then prepared to go meet with some more of my families, I stopped off at my supervisor's office to show off at how caught up I was on all my paperwork. "What about those extra notes I'd asked about on your closed files? The ones the auditors requested...?" D'OH! I'd somehow overlooked those! Despite the fact I was on my way out the door to a school to meet with a family, I promised I'd get them done immediately.

I rushed back to my desk and banged out the four notes. Now, my files were not incomplete or in bad shape. The notes were simply to assist the auditors and invite them to not scrutinize the file and nit-pick it. It took me about 25 minutes to update the files and I carried them back to my supervisor, feeling good that I was being a team player and done my best to be helpful. My supervisor thanked me for my efforts and then handed me a note to sign. It was a written notice that I'd been given a verbal warning due to not having those extra notes by 11:00 AM. It would go in my HR record. It had been emailed to the program director.

Suddenly, my feelings of helpful pride shifted to seething anger that I was being reprimanded for missing a deadline by an hour and a half. In my mind, my self-talk went something like this: "Why? I know that I missed the deadline, but it was an arbitrary one made up for this occasion... it is not like there were dire consequences... This doesn't have to be done, I'm being singled out for this... It is unfair... It is mean spirited... I would have handled this totally differently if I were the supervisor... this is how you go about ruining morale... I'm being set up to fail..." and on and on in this fashion.

For several long minutes, I stared at the paper, weighing whether to make a big scene about it or suck it up, sign it and let it go. The minutes stretched out and I knew that my silence and inaction were communicating to my supervisor that I was struggling about how to respond. I knew that anything I said would sound defensive and self-justifying. I knew that my supervisor had the technical truth to support the reprimand. I had a choice to make.

Now, I want to point out that this whole thought process took several minutes. I stood there like a idiot while I literally thought all this through and came to my decision point. I surrendered the thought that my supervisor was responsible for my anger. I swallowed the blame I wanted to level and let go of the self-justifying arguments that popped up in my head. I signed the form and left the office.

I decided to not be angry. It was harder than I thought it would be! I kept wanting to step back in my anger box and allow it to dictate the rest of my day. But the more I thought about it, the more I clung to the notion that if I teach others this stuff about being responsible for one's own emotions and behavior, then I better be able to back it up with my own experience.

Was my supervisor wrong to reprimand me? Technically, no. Subjectively? Maybe. It is possible to do the right thing but to go about it in a way that invites defensiveness. Was it within my supervisor's power to let it go and to not document the incident? Yes, but that is not the point. Truth is, by not being more proactive with my own behavior and attitude toward the paperwork, I was inviting my supervisor to see me as lazy with my paperwork. Doing my part to help out with the audit was all well and good, but really has very little to do with my own previous behavior. It is just a handy self-justifying argument I tucked away to allow me to blame someone else for my angry feelings.

My point in posting this is not to gain sympathy or even admiration for my self-analysis. I wanted to point out that handling one's own emotions can be difficult. If I had entered into a blame cycle, who knows where it would have ended up? I can guess at some outcomes: I might have decided that being a team player wasn't worth it if I was going to be treated so badly. I might have started subtly sabotaging efforts to meet our numbers or do things that would put my supervisor in a bad position. I might have subtly started undercutting the management by my own way of being toward the company. I might let bitterness suck the joy out of the job I love.... etc. The end result is that I would also have diminished myself in the process. That is not the person I wish to be, or become.

This experience is another reminder that grace is an amazing gift. I'm thankful that God invites us into His kingdom, where we experience no accusations or blame or guilt, despite our continued deservedness. Over and over, God invites us to be better, accept His perfection and clothe ourselves with it. God's redemption of my broken, sinful heart is not a one-time event, but a continual process whereby I (hopefully) become more like Him each cycle. This time, I hope that I've picked up some pointers about being gracious... not only to myself, but to those that I feel have wronged me (whether they actually have wronged me or not). God is gracious. Thank God.

-jeff

When even "normal" gets overwhelmed...

I had a really great day today. Really great. A good day with the family. We attended worship services at the Abilene Mission church, which was a interesting experience for us. Afterwards, we fellowshipped with two great families all afternoon. Great worship, good food, friendship, swimming and even a nap. Not bad for a Sunday!

So why did I get overwhelmed this evening? Because sometimes it all just catches up with you. Let's rewind....
On Friday, we had our quarterly A1C checkup at OU Children's Hosptial. This checkup allows us to get a glimpse of how Mary Hannah's and Ethan's bodies are handling their blood sugars, and consequentially, allows us to know if we need to make adjustments in our Diabetes Management strategy. In general, we feel like we have a handle on how our family copes with this chronic illness that has afflicted my older two children. When people ask us how we deal with Type 1 Diabetes, my response is usually that it has become our 'normal'. Yes, it was traumatic when we got the diagnosis for Ethan. Yes, it was a kick in the pants when we got Mary Hannah's diagnosis. Yes, if I stop and think about it, we are affected everyday in a million small ways by how Diabetes gets to dictate how we go about living our 'normal' everyday lives. But the truth is that most of the time, we don't stop and think about it, we just do it. I asked Amelia recently what she told people when they asked her about our coping strategy. She said something like, "I tell them that we just do it. People usually are pretty sympathetic and say stuff like, 'I don't know how you do it...' and I always just think, 'The options are: you do it, or :your child dies, so you just do it."

Well, I don't know what combination of factors fed into how I was handling things tonight, but I got a little overwhelmed this evening. After a great time today, we got home and I started making some dinner for Ethan and Eleanor (Mary Hannah was spending the night with a friend). Ethan's blood glucose has been high most of the day, and so I opted for a meal with few carbohydrates. See, this is one of the things that I usually don't think about. As a family, we can't just decide what we want to eat based on what we're hungry for, or what we have on hand to cook. We always, always, have to be aware of how what we eat will affect blood sugars. Because Ethan had been running with high BG all day, it indicated to me that for some reason, he was not getting the insulin he needed to process the sugar in his blood. It could have been an occlusion in his pump. It could be that he is getting sick and despite having insulin to cover his BG, his liver could be dumping extra sugar into his blood to help his immune system. It could be that Ethan was sneaking food and not telling us (doubtful). It could be a ton of different things. Anyhow, I figured that a low carb meal would be best, so we had what we call 'homemade lunchables'. Basically: lunch meat (effectively zero carbs), cheese (again, very low carbs), crackers (just a few carbs each), sugar free pudding (just a few carbs) and flavored water drinks (zero carbs). I told Ethan to go ahead and check his BG again before dinner. Turns out, he left his insulin kit at our friend's house. Now, in our case, leaving the insulin kit isn't a big deal if we are at home. We have extra syringes, extra insulin, extra glucometers, extra everything here at the house. But in principle, we're trying to help Ethan grow in his responsibility for managing his diabetes on his own. Part of that is remembering to take his kit with him wherever he goes. I gave him the ol' pep talk about being responsible and we sat down to eat.

After dinner, it was time to change Ethan's pump site. For clarification, Ethan has an Omnipod insulin pump. It is a nifty little pump that has all of the component parts contained in a 'pod' that is about the size of a small pager. We fill the 'pod' with insulin and affix it to the site and a spring loaded needle inserts a short 1/4" plastic cannula into the subcutaneous fat tissue and the pump begins delivering insulin to the body. The pump's computer is programmed with all the information about Ethan's insulin needs and does for him what your pancreas and endocrine system do for your body. Back to the story... there are basically only a few sites on the body with enough body fat to serve as sites for the pump: the abdomen, thighs, upper arms and buttocks. Over time, if the same site is used over and over, it builds up a resistance to the insulin absorption and becomes less effective. Thus, it is considered to be 'best practice' to rotate the sites you use. The site is usually changed every three days or so, so if you use all the available sites, each site will only have to bear the burden for three days every couple of weeks. On a little boy who is experiencing growth spurts and losing his baby fat, this process can be challenging. Ethan does not like to use his legs, as he says it is uncomfortable for sitting and when he is lying down. However, after our visit to the Endocrinologist, we were reminded of the necessity of rotating sites. So, I told Ethan that we needed to use his legs, too. He whined and fussed at me because he really didn't want to place the pump on his legs. Incidentally, MH doesn't like to use her abdomen and prefers her legs and arms. Ethan continued fussing at me. I reasoned with him:
Me: Hey buddy, look at your fingers. (he holds up his fingers) How many do you have?
Ethan: Twenty.
Me: Count again, just fingers.
Ethan: Oh, ten.
Me: How many have callouses because of how often you have to prick them to check your sugars?
Ethan: (counting his callouses) Four.
Me: Okay, so those fingers are getting worn out, right? It makes it harder to check your sugar when you overuse those fingers. The same thing happens to your pump sites. We really need to be using your legs, too, buddy.
Ethan: But I don't like it with my 'pod' on my legs!
Me: I know, brother. But, listen, I can't take the Diabetes away from you. All I can do is help you do the best job taking care of it, and I'm telling you that even if you don't like it, this is the best thing to do.
Ethan: (crying now) I hate it. Why did God even have to invent... (he catches himself here...) Why does God allow Diabetes to happen?
Me: ...
Ethan: I hate it. It... (looks at me right in the eyes) it SUCKS!
Me: Yes. Yes it does. But until someone figures out a cure, we just have to do the best we can, alright?

We go on to get the 'pod' affixed to his thigh and the spring loaded needle inserts the cannula with a *pop* and Ethan just explodes with crying and fussing. I know that it hurts to some extent, but we've been doing this for a while now and I know that his crying is out of proportion with the actual pain and has more to do with the mileage he's getting in attention from Daddy, but I'm feeling pretty sympathetic to him right now and so I just let him fuss. I drew him into an embrace and just let him cry. After a few minutes, I sent him back to his room to get ready for bed and promised to come read a story in a few minutes. Ethan left the room and it was as if his emotionality had been transferred to me. All the unfairness of Diabetes, all the sh.. stuff we have to deal with on a day in-day out basis, all of the expense, all of the vigilance, all of the equipment, all of the .... you get the idea... The frustration of having to hold my son and not have an answer for him about why *he* has to suffer from this condition, it all just hit me and I cried. Not for long, and not very loudly, but I cried. Amelia had been watching me and asked if I was okay. I told her that I know we usually just consider all this to be our 'normal', but that the experience of having to reason with my son, to just accept the suck-iness of this disease... it is an experience that I shouldn't have to have. I don't cry about it often, but tonight it just really got to me.

So, Amelia held me for a few minutes while I cried and then I sucked up my fussiness and read my babies a nighttime story and tucked them in to bed. I told them that I love them and that God loves them and that everything is okay. Then I went back into the living room and Amelia and I sat, reading books in companionable silence till the phone rang. It was from Mary Hannah's friend's mom letting us know that MH didn't have extra insulin so that she could change her 'pod'.
Amelia: Do you want me to go?
Me: *sigh* Nah, I'll do it.
Amelia: (lightheartedly) Well, I managed to pack extra test strips for her glucometer and an extra 'pod' for her because I knew she'd need to change sites tonight... I just forgot the insulin.
Me: (kissing Amelia) 'sokay, baby. This is our life. Be back in a bit. You want anything while I'm out?
Amelia: I don't *need* anything, but if you manage to bring home a sweet tea, I wouldn't mind.
Me: Back in a bit...

And I'm back to 'normal'


*I am not looking for sympathy here. My purpose in blogging about this is to heighten awareness about the social/emotional toll of chronic illness. For people who don't deal with it, I hope it will raise your awareness about some of the challenges that families face on an emotional level. For people who read this and identify with the emotions and struggle, I hope that this narrative will reassure you that your feelings are normal and acceptable. Often, caregivers get stuck feeling like they can't express their feelings because they'll be seen as whine-y, or misunderstood, or pitied, etc. I appreciate what you are going through and I hope that you have a way to cope with and find strength in doing what you do best: caring for and loving your families despite the way that the illness tries to tear down and control your daily life. May God richly bless you. - jeff