Feedback loops and defining the future

We are creatures who live in the world. When the world changes, we humans adjust and adapt, and in so doing, we survive. Yet we also live in our inside world. When our thoughts change how we see the world, we adjust and adapt to that inner world too. This becomes complex when we are trying to work out what we want and what our purpose is.
Living creatures respond to stimuli. For humans, that stimulus can be external – or the world, or internal – of the mind. External stimulation can be things like temperature, a growling dog, falling from a tree and so on. These physical phenomena trigger a safety response within us that often has us acting before we are consciously aware that we have acted. We then find ourselves scrambling to catch up to our actions with sometimes interesting and outlandish explanations.
Looking at a beautiful sun setting over the ocean, the colours a riot of reds, peaches, purples and oranges can trigger a feeling of joy, contentment and a desire to grab a camera or paint brush and render that image for all time. The physical environment that has created this imagery and responding feeling within us is not truly external. The physical environment surely is, but the feeling we have is an internal recognition of the tranquillity of the scene. We are not reflexively acting, pausing afterwards to justify our actions. We are emotionally acting to what we feel now. This scene is a combination of the external stimuli and the internal emotional reflection.
When the stimulus is only internal it is far harder for an external person to perceive and understand why we have changed. It can also be some subtlety that we do not understand ourselves. This can often leave us lost as to why we have acted, sometimes to create interesting and outlandish explanations for our actions. Teenagers often give the answer of “dunno”, and get in trouble for their honest answer.
When we look at ourselves, we see a myriad reflection of the world around us and the world we have travelled through. While we may be born into this world tabula rasa (a clean slate), we don’t remain so for long. We are moulded and changed by the life we have lived. Yet I believe we are more than the experiences we have had. I believe we can guide our behaviours more to the left, or more to the right as we see fit. Our past is an explanation for our present, not an excuse for our future. We decide, right here, and right now: What are we going to do next?
To know what to do next often necessitates having an inkling of where we want to be in the future. I can project from my past a trend that gives me a clue about where I am going to end up, if I make no conscious decisions about my life. If I keep doing what I have always done, then my future is an ongoing repeat of what I have done. That can end in some fairly grisly results, or may end in thoughtless bliss. If I don’t want that future, then I must act now to change that outcome. But change in what way?
It helps to know what I am now. Yet what I am now is a handful of reactions to life now. As a result, when I try to figure out who I am, I mostly see what I am experiencing now rather than that trend to the left or right that I mentioned earlier. I believe that the trend is more me than the specific path I am on. Seeing that trend, however, is hard.
I have been trying to work out what my role in the world is. I have settled recently on the idea that I am me first (whatever that is), a father second, a partner third (although the ladies may disagree about that order), a friend fourth and a worker fifth. Here I am describing roles, not me. These roles are responses to responsibility that has come into my life. I am responsible for and to my child, my partner, my friends and work.
Looking beyond this, I don’t have to be responsible to any of these. I could walk away. Lord knows, sometimes I want to, and I have known many people who have.
My trend is to accept responsibility, to accept that these roles are important and have purpose. My trend is to care about others, the world and what the future may look like. My trend is to be a shoulder to lean on when you are feeling less than you could be and to support you back to being who you want to be.
My next step is to try to work out how I use this me, taken by my trends, as an indicator of what I want my future to look like.
My future could be public or it could be private, or some other location on that spectrum. Clearly, at this stage, I am quietly public. I have blogs that I write on and quietly promote. I draw no income from these (although I would love to). I have pondered recently whether my desire to change the world arises from ill experiences that I have lived through. Am I reacting to the world and then justifying my actions later as “I want to do good”? Am I just blindly responding to stimuli, or am I reasoning a path for my future?

Discussion

Take a look at what you are passionate about and consider whether your passion is incorporated into your life, or whether it is a side line project.

If you have incorporated your passion into your life, how did you manage to do it?

If it is a side line, are you happy with that? If so, why and if not, what can you do about it?

Depression and Time

About 6 weeks ago I broke my hand. It was a little thing, one small bone in my right little finger, but it affected my life fairly significantly. For a start, I wasn’t allowed to work, do any physical activity and had to shower with my hand in a sealed plastic bag. Sleeping was uncomfortable, I was told I couldn’t drive and typing was excruciatingly slow and frustrating. Writing with a pen was pretty much impossible.

The second week I was in a cast, I got really depressed. My motivation to do anything was pretty much gone and I claimed success when I did one task in a day. There were days that I didn’t claim any success.

I did ponder quite a bit about how I was feeling and what I could do about it. In short, not much. That is, I could do a lot, if I had the energy, enthusiasm and no broken hand. The last was optional, but it sure didn’t feel that way. Because of the need to give my hand every opportunity to heal, there were a range of things I would not allow myself to risk, a range of things my partner would not allow me to risk, and a range of things work wouldn’t let me do. This last left me financially quite vulnerable as I had not built up anywhere near 4 weeks of paid sick leave (I only actually had 1 day).

There were small victories. I thought to myself – what do one handed people do? What if you are born right handed, biologically speaking, and lose your right hand? Well, most things must be possible, since I am sure that not all one handed people have personal carers. So I experimented and learned to do things one handed. Washing dishes, for example, is possible one handed, but tricky. You need to use some fingers to anchor the plates and bowls down, while your other fingers swish the cloth/scrubber. Cutlery requires a different technique and so on. Hanging clothes was tricky, but once you get the hang of pre-grabbing a peg and then pinning the clothing to the line with your small fingers and opening and pegging with your index finger and thumb, it becomes not such a bad thing to do. Some tasks were not practically safe enough. Chopping vegetables was out, working in the shed on any number of projects was too risky and exercise would jar my hand (not to mention the fear of being stuck and in pain).

What slowed me down was not inability, but rather enthusiasm. My sleep cycle crashed and whizzed out of my control. Even now I have insomnia problems and my hand is mostly healed, and being really tired all of the time is really crap. I had constant background pain – not enough to take pain killers for, but enough to be annoying. Additionally there were many things I wanted to do, but wouldn’t let myself do. Some of this restriction was safety based, some practical and quite a few financial.
With a rapid drop in my physical activity, my body didn’t know what to do with itself. I have empirically seen this happen before: athletic people who suddenly stop physical activity become depressed. I have not seen any tests on it, so can’t scientifically state the two are related. However if you consider that exercise creates endorphins and keeps your body streamlined and energetic, having all this drop out of your daily routine is likely to mess up your mood. It certainly messed up my appetite and digestive system, which I am fairly confident messed up my energy levels.
I pre-emptively tried to prevent the effects of cabin fever by looking for something to learn. I succeeded in the first week by launching into an investigation into music/sound theory as it affects the brain (and I highly recommend that you check out Daniel Levinson’s “This is your brain on music”). By week two, this had faded out for me as my physical lethargy reached new heights and I found I needed to sleep every couple of hours. No matter how much I slept, I just couldn’t seem to wake up enough to feel energetic.
Without energy and drive I found that my diet changed. At least I think that was the order. I couldn’t be bothered to make meals, especially with how hard it was to actually make them. My partner was working and wasn’t always there. Additionally my pride was leading me to find short cuts rather than ‘be pathetic’. This dropped my nutrition level down, which I am sure didn’t help with my depression.
Another factor that didn’t help was a mild existential crisis. In our western world, men are measured as successful if we earn money. Here I was on unpaid sick leave, not earning money. While I logically know that this is a farce, it didn’t help me to not feel really bad about not earning money and paying our bills. I found myself very reluctant to spend anything on anything, which combined to make me feel powerless. If I am not the money earner, who am I? Which then lead to thoughts about the work I do. Professionally I am a social worker, and I have specialised in mental health, or more to the point, Wellbeing and Thriving. My current paid employment doesn’t really tap into this speciality and so I feel somewhat out of sorts about it. (As an aside, I did this to increase my foundation strength in social work, but can’t help but question a whole bunch of things).
In my private life, I help out quite a few people who are somewhat lost or unsure about their lives. I do this as a non-religious Seva (service to the public). I have the skills, they need the help, and so long as I don’t do it for ego or foster dependency, I might as well help out.
I also perform circus skills (which I get the occasional paid gig for) and play with a medieval group (all unpaid, and surprisingly expensive on the whole). I enjoy the social contact these give me and the skills I learn from them.
Circus skills (twirling, fire, juggling and contact) are the only thing I have very little doubt about. I enjoy it and I don’t feel that I am out of balance about it. Everything else leaves me wondering “Should I be doing this? Am I enjoying this? Do I have to do this? Where is it getting me? Am I doing too much?”
Theoretically I know all the things one ‘should’ do to break depression. I found that for the first week of depression I thought “this is natural; I will allow it to be”. The second week of depression I thought “this is annoying; I should do something to stop it”. The third week of depression I got quite worried, because I was still doing nothing about it except feel like crap and worrying. Knowing how to fix it wasn’t enough. I had to both want to do something and also have the personal resources to actually do it. Somewhere around the fourth week I finally hit that tipping point. I had enough energy to do things to create more energy to keep on doing things that would pull me out of the depression. I am comfortably out of the other side now. I am also out of my cast and able to do things.
I am wondering whether any of my actions actually made a whit of difference. When I was in the depression hole, being sucked into the gravitational morass of darkness, I really could not do much of anything. It was only after skimming the outside skirts of my depression centre that I started leaving that behind. Did I really pull myself out, or did I get flung out naturally? I am sure there are things I could have done to make things worse, and I am quite aware of several that I did do (fearing sleep, over dosing on caffeine and sugar, eating poorly, not walking when I could have). Was my escape from depression pretty much define by the external factor of the type of cast I was wearing?
It seems to me that a great deal of theory was actually quite useless to me. Knowing what I should do seemed to have very little effect on what ended up happening to me. It was very frustrating to watch myself and not actually bring myself to do anything useful about it. In hindsight, I think “surely I could have…” but at the time, no, I couldn’t. So, instead of saying to people “what you should do now is…” I am going to say “when you find that you can, here is a list of things that may help”.

In short, knowing wasn’t enough. By the same token, having some energy without knowing wasn’t good either. I needed both knowledge of what to do AND energy to do it, and for that, I had to wait.

Five phases of grief

Elizabeth Kübler-Ross was a doctor in Switzerland who studied the effects of grief on people who learned they had a terminal illness. Her studies showed a trend for people to experience five distinct phases of emotion and reactions. Not all people experience all five phases, nor do people necessarily take them in order.

I will cover these stages and some of their meanings and implications soon. First I would like to discuss what this model can help with and what it isn’t designed to assist.

The Kübler-Ross model is probably the most famous model of grief. It is well used in television and pop psychology as a script that people will go through (youtube example from The Simpsons). To take it out of the pop psychology script and bring it back to real life, consider the following.
Being a model, it describes common experience. Outliers and other oddities are taken out of the data such that an “average” can be created. This means that this model may, or may not, apply to you or the situation you are aiding in. This doesn’t mean that someone who doesn’t follow this model is wrong, weird or faulty. It just means this model doesn’t apply.

The model was based on observing people who knew they were going to die. It can be extended to any up coming expectation of loss, such as a job, a partnership, house, country and so on. While this model may be applicable to sudden and unexpected loss, it often does not apply to it, nor was it based on observing people who experienced sudden and unexpected loss. In practical terms, that means if you know you are going to lose something (life, job, partner etc), this model is likely to be useful, whereas if you find yourself unexpected affected by the loss of something (life, job, partner), this model is probably not useful to you.

I see a large proportion of people who are going through the end stages of their relationship go through phases of this model while they are coming to terms with the cessation of their partnership. Often their partners, who had very little idea it had come to this, go through another grief process as their relationship unexpectedly ends.

On with the phases/stages/levels or whatever you choose to call it.

Anger
Anger is a response to your perception of personal power being decreased. Often this is due to someone or something crossing a boundary, but in this case, it is the knowledge of the upcoming loss. You are going to lose something and you are not only unhappy about it, you are angry.

People who experience this stage will often be very down on themselves, lash out seemingly irrationally at those around them, push people away and may act quite aggressively. A great deal of this aggression is transferred anger at the situation being passed to others and self. It is an attempt to compensate for the perceived loss of power.

Anger can drive efforts to change the situation and avoid the loss. It is a great fuel if balanced, but it often clouds the issue and you can miss opportunities that can change the situation. That is the risk if the anger goes too far.

Summary: Anger is an emotional response to the impact of loss and how that changes the self. Aggression can be transferred away from the loss to bystanders. Anger can be channeled towards positive outcomes. Anger is not wrong or bad.

Denial
Some say that Denial is a river in Egypt, but it is more than that. It is an attempt to hide from the severity of the loss, a dulling down of the pain associated and the impact it is going to have on ones life. Denial is a safety mechanism to avoid being overwhelmed by loss.

It can be easy to mis-diagnose someone as being in denial because they do not appear to be doing anything about the upcoming loss. We may feel that something should be done about the situation and we see no action, the individual doesn’t want to discuss the expected loss, and seems to be determined to get on with their life. What we may not see is the internal battle to understand the enormity of the loss and internal processing of how that loss is going to affect the world, both subjectively and objectively. For example, if you learn you are going to die, who will feed the dog, look after the children and will you go to a better place? Some people prefer to do a great deal of this processing internally rather than talking about it. You don’t have to talk.

In balanced doses, denial is useful for continuing the life process while the mundanity of life continues. At some stage, someone has to cook dinner, wash the clothes and so on. Becoming lost in the process of life can be a respite from grappling with the expectation of loss and how that is going to affect the world.

Out of balance, denying the probability of loss can deny the person of pre-processing the loss and preparing for change. Being lost in denial can interfere with setting up changes in life for the upcoming loss and leave the person in a different form of grief, that which occurs with sudden and unexpected loss. More on that in another post.

Denial can also concatenate with Bargaining to create a search for the miracle solution. I’ll discuss that in more depth in the Bargaining phase.

Summary: Denial in balanced doses allows for the continuation of life before the loss, can be a safety valve when things are too intense and can allow a person to internally process the implications of change. In excess denial can delay change and leave someone dealing with unexpected loss instead. Denial is not a bad thing, or wrong.

Bargaining
In general, bargaining is trying to get what you want for the cheapest price. The harder, more complex, or impossible something is, the more we will offer.

In expected grief, the bargain has a central theme of trying to stop the loss or offset the negative aspects of the loss. It can take the form of offering to do something, pay something or sacrifice something.

In balanced amounts, bargaining can help you to find ways to minimise and offset the negative aspects of the loss and how it will affect you.

When balance is lost with bargaining, one can attempt to find a miracle solution to an impossible problem and offer incredible amounts to effect it. If this combines with denial, one can end up joining cult groups, losing all your assets to a con artist or embarking on an endless search for a way out of the change required by loss. This can be quite damaging to the self and may domino effect harm to others who care about you.

Summary: Bargaining is a natural part of searching for solutions. It is just an extension of problem solving. In moderation it can help find solutions to loss or minimise difficulties created by change. When out of balance, bargaining can lead to significant drama that can distract from the upcoming loss. If bargaining is combined with denial, this drama can become damaging to the self and others.

Depression
The emotions involved with expected loss and change can sometimes feel overwhelming. 

Diagnosis vs Formulation

I went to an autoelectrician the other day to get the headlights for my car fixed. He suggested that it was probably the headlight switch in the colum, but wasn’t going to commit to that without checking it out. He also said it could be a fuse, the relay, wiring, a problem with the Earth and a few other possibilities. After looking at it, he gave a positive diagnosis of a damaged switch. He said I might be able to get a second hand one, or I might be able to purchase it first hand from the manufacturer (I have an old car, kind of like me).


I asked him how he knew and he said he tested the inputs and outputs of the switch and could definately say that the switch was not relaying the proper information. This was his test that validated his diagnosis, which was one of the probable expected diagnosies he had formulated in our initial discussion.


Similarly I went to a doctor (general practitioner) with a really sore throught a few years ago. He listened to my symptoms, took a look at my throat and told me I had tonsillitis. He proscribed some antibiotics specific to this kind of infection as my treatment. I asked him how he knew I had tonsillitis and he described the way to tell inflamed tonsils and the low likelihood of it being anything else. I asked him if there was any actual test he could perform to be certain and he offered to take a sample and have a lab test it. This would prove, conclusively, that I had tonsillitis. 


I went to see a psychiatrist many years ago. He listened to my list of symptoms and told me I had cyclothymia. I asked how he knew and he said I fitted enough of the profile of cyclothymia for him to diagnose it as such. I asked if there as any test he could perform to make sure and he said there was not and pointed out that mental health diagnoses do not work that way. He prescribed medication to fix it. I looked up the medication and it’s primary side effect is that if you don’t have cyclothymia before taking the medication, you probably will after taking it. Not a good selling point. I went back to the psychiatrist and asked for another option.


What gets me is, how can they call it a diagnosis when there is no test to actually prove conclusively that their opinion is correct? Isn’t that a formulation, not a diagnosis?


For example, schizophrenia has an interesting diagnostic criteria. The combinations that this “diagnosis” can demonstrate are huge, the causes are varied. You only have to display two of five major categories, each major category has multiple sub categories which you only need one in to make that category count. What conclusive test is there? No blood test, no scan, no reflex or pain test. Nothing.


Schizophrenia is not an isolated mental illness in this respect. Consider borderline personality disorder. It’s diagnostic criteria are also quite strange. One must demonstrate five of a possible nine symptoms for an extended period of time. Again, there is no actual test. 


This blog does not preclude the possibility that either of these, or many other labels, actually exist. The formulation of these theories for a person quite often give added insight for the practitioner to look for specific indicators, history factors and give guidance for proposed treatment and recovery plans. What I object to is the use of the word “diagnosis” without an actual test. Giving such authoritative chronic diagnoses limits people to believing that they are stuck with this illness for the remainder of their lives and thus cannot get better, lessen their symptoms and get back to leading a worthwhile life.


You can change your behaviours. You can thrive.