Psychology Today Blogs - Embracing the Dark Side

Singlehood: A normative discontent?

Jenna Baddeley — Fri, 19 Dec 2008 15:12:16 -0800

Single adults are a growing demographic as people now marry later and divorce more frequently than in previous times. Women owe it to the feminist movement that we now have more freedom to make choices in our love lives, including the choice to remain single. Bella DePaulo has written eloquently and passionately in support of the idea that singlehood is a valid life choice, despite the fact that it still violates cultural norms (see her blog, Living Single, http://blogs.psychologytoday.com/blog/living-single).

Yet there is an undercurrent of self-doubt among many of the single women that I know. Acknowledgement of the desire to be in a good romantic relationship is all well and good, and expression of disappointment with not being in such a relationship is perfectly understandable as well. What disturbs me is how frequently - to the point of being truly generic - single women (and perhaps men, as well) arrive at the question, "what's wrong with me?"

The implication, of course, is that one's personal flaws must be responsible for one's present lack of a romantic partner. Why make this attribution rather than one of the other available attributions, such as, "I just haven't met the right person"? One explanation is that blaming things on oneself provides one with a sense of predictability and control that blaming things on chance or circumstances does not.

Nevertheless, the "what's wrong with me" question strikes me as singularly counterproductive, given that (a) all successful romantic relationships have involved two imperfect people, (b) whatever is "wrong" with a person may or may not be changeable anyway, and (c) if you believe the advice columnists, the route to success in romantic relationships is self-confidence rather than self-doubt (although I have seen virtually no empirical evidence supporting this claim).

Women's self doubt over singlehood reminds me of girls' and women's self-doubt over bodily imperfections (especially not being sufficiently thin). Both forms of self-doubt strike me as unfortunate consequences of normative pressures to conform to societal ideals. And both strike me as terrible wastes of perfectly good mental energy.

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Depression and its metaphors

Jenna Baddeley — Mon, 03 Nov 2008 00:18:22 -0800

Depression is commonly referred to as the "common cold" of mental illness. This metaphor refers to high prevalence of depression, and given depression's especially high prevalence among people seeking help from primary care physicians (10% or more of primary care patients are depressed), it makes sense that it would look quite mundane to doctors. But the metaphor is in many ways misleading: you don't catch depression from someone else and you don't recover from a major depressive episode after a couple days of rest. The metaphor trivializes a mental illness with profound and concrete consequences -- loss of work productivity, severe unhappiness, suicidal thoughts and actions -- for its sufferers.

If not the common cold, is there any good parallel to depression in the realm of physical illnesses? Researcher and psychotherapist Jon Adler has told me that he compares depression to diabetes. The diabetes metaphor has an elegance that the common cold metaphor does not. Both diabetes and depression are diseases of modern life. Their courses are chronic, and they need to be managed behaviorally. Diabetes is an especially good metaphor to use with clients in the course of behavior therapy because diabetes management requires a lot of self-monitoring and self-care, just as depression treatment does. The metaphor can encourage clients to do the tasks (e.g., scheduling doing pleasurable activities) that behavior therapy entails.

In the end, though, metaphors are always flawed. What all of us in the mental health community would really like would be to have depression recognized more widely as a legitimate illness in its own right -- high in prevalence as well as high in severity -- so that we can rely less on other disease metaphors.

The medical view of depression: good for patients, or just for doctors?

Jenna Baddeley — Sun, 05 Oct 2008 21:37:13 -0700

It is popular these days to explain depression as a medical problem caused by chemistry: an imbalance of serotonin and other neurotransmitters. Many mental health care providers favor this explanation of depression's causes, supposedly because it destigmatizes the illness and shifts blame away from the patient. The problem is, it may benefit providers more than patients.

When depressed people seek treatment, they want relief from their psychological pain, but they also want their experience, their concerns, to be acknowledged. In other words, what they are looking for is to be empathized with, not just not to be blamed. Unfortunately, there is good evidence that doctors aren't very good at responding empathically to their patients' concerns. A recent study reported in the popular press found that the physicians responded empathically to only 10% of patients' concerns. They frequently discussed biological processes and medical treatment options in lieu of empathizing.

The truth is, one of the most difficult parts of a healthcare provider's job is having to listen to patients reveal heart-wrenching problems and the strong negative emotions that accompany them. Psychiatrists are alone among medical doctors in that hearing and treating emotional problems is precisely their line of work. They sometimes deflect the difficulty by asking canned diagnostic questions, explaining biological causes, and prescribing medications. In such encounters, it is hard to imagine that the depressed patients -- who typically feel alienated and vulnerable to begin with -- are being listened to as if their human experience mattered. And that is troubling. As mental health treatment providers, we are privileged to receive confidences that our clients might not give even to some of their closest friends. When we retreat to a view of our clients as clusters of symptoms to be differentially diagnosed or neurotransmitter systems to be rebalanced, we dishonor our clients' personhood and we miss an opportunity to provide care in the fullest sense of the word.

Unfashionable Advice to the Bereaved

Jenna Baddeley — Sat, 02 Aug 2008 07:03:52 -0700

Bereaved people carry a double burden: the pain of loss, and the pain and awkwardness of living in sadness among people who almost invariably would prefer not to hear about it. Bereaved people are acutely sensitive to others’ anxiety and avoidance and discomfort around their suffering. Many choose to remain silent rather than to disturb others.

Meanwhile, in another patch of our wonderfully diverse culture we encourage people to buck these inhibiting forces and to express their pain fully and frequently (fully, frequently, even elaborately). Confessional shows like Oprah go so far as to recruit people to express their personal pain to a television audience, i.e., completely without regard for the potential fear or flight of others.

Most people think that disclosing a negative experience like bereavement helps lessen its emotional burden, although the inherent benefits of bereavement disclosure are hotly debated in the psychology literature. What seems clear is that bereaved people’s disclosures often meet with unhelpful responses from others. In this course of my own research done on how people talk about bereavement experiences, my participants have often expressed anger about how others respond to them – about others’ lack of understanding, or lack of empathy, or excess of cloying pity. It is certainly true that others often don’t know how to say the right thing.

People who are trying to give comfort and support to the bereaved can learn from this advice. There are so many ways to say the wrong thing – which may be why the Jewish mourning tradition, among others, emphasizes just sitting with a griever in silence rather than attempting to offer verbal consolation.

It may not be fashionable to give advice to the bereaved, who deserve to be, for a time, the recipients rather than the givers of care. But I will give some advice anyway: expect discomfort and misunderstanding from some listeners, and recognize that you are in a perfect position to educate them about what about what kind of support and comfort you need. You can only do that if you can step back enough to understand the difficulty of their position along with the pain of your own. More important than that, though, is to appreciate the willingness of your friends to overcome their own barriers and reach out to you.

Perhaps grievers, rather than (just) their listeners, need to extend empathy to mend themselves and their relationships after loss.

Give negative emotions a place at the table

Jenna Baddeley — Wed, 09 Jul 2008 20:17:31 -0700

In the eponymous fairytale, Sleeping Beauty's parents throw a joyous party to celebrate her long-awaited birth. They only have twelve place settings, so they invite twelve of the kingdom's thirteen wise women. The thirteenth wise woman, who is ill-tempered and lives in a remote corner of the kingdom, is not invited to the party.

The twelve sisters bestow blessings on the baby, but the thirteenth - enraged at being excluded - curses the child to an early death, a sentence which one of the other twelve sisters commutes to a one-hundred year sleep.

As the parents did with twelve of the wise women, we eagerly invite the positive emotions - happiness, excitement, pleasure - into our lives. We do what we can to encourage them to stay. Regardless of how well we treat them, our positive feelings are only guests; they come and go.

The way that the parents treated the thirteenth sister is the way many of us treat sadness and other negative emotions. We are not so eager to invite negative emotions - sadness, anger, fear -- into our lives. But like the thirteenth sister; they come anyway. And they do not take kindly to being excluded - avoided, ignored, or suppressed. Are we prepared to acknowledge these emotions and even to honor their wisdom - to give them a place at the table?

I am not suggesting that we turn over all of the seats at the table to negative emotions, to the exclusion of the positive ones. But to lay a place for negative emotions is a powerful gesture of inclusion, a way of embracing more completely the facets of human experience. Perhaps if the thirteenth sister had been invited, she would have offered Sleeping Beauty a healthy sense of skepticism alongside the sweetness bestowed by the other sisters, a sharp tongue to match her daintiness, or a groundedness beneath her angelic spirit.

The pursuit of happiness and its dark side

Jenna Baddeley — Sat, 05 Jul 2008 10:51:35 -0700

Mainstream American culture has a real thing for happiness. We believe happiness to be the most important goal of human life. We also believe that people (at least those who are strong, self-reliant, hard-working, and virtuous enough) can achieve happiness if they pursue it. Neither belief is completely true, but most of us are motivated to remain convinced of both of them.

Fortunately, these beliefs have powerful social benefits: they lead to a broad acceptance of differences in human lifestyles and behavior. Common expressions like "different strokes for different folks" or "whatever floats your boat" acknowledge that different people seek different paths to happiness and that we won't always understand the choices that others make along the way. However, we can accept and even applaud any number of unusual behaviors if we can see them as ways of pursuing and achieving happiness. For example, if I leave a high-ranking position in a big corporation for a life raising chickens on a small farm, my friends will ignore their initial misgivings if they believe this life change could make me happy.

Unfortunately, our beliefs in the importance and achievability of happiness result in dysfunctional beliefs about the meaning of unhappiness. Here are some of them:

Because we believe happiness to be an important achievement, unhappiness is a sign of failure.

Because we believe happiness to be attainable by strong, self-reliant, hard-working, and virtuous people, we believe that unhappy people are weak, dependent, lazy, and morally flawed.

Because we believe happiness to be both desirable and achievable, we question whether unhappy people actually want to be happy. Because happiness is such a defining cultural value, those who appear not to want it are alien to us.

So unhappy people are morally bankrupt foreigners who are failures at life. No wonder we have a hard time accepting people who are experiencing unhappiness, even if those people are ourselves. But just because it's understandable doesn't mean it's adaptive or healthy. Let's by all means pursue happiness – but let's not let our love of happiness make us miserable.