Markham's Behavioral Health

Suicidal soliders is not so much a mental health problem as a spiritual crisis

Reading about the increased incidence of sucides in the military and the huge numbers of soldiers with PTSD has gotten me interested in something which very few people in American society talk about and that is what Dr. Rachel MacNair calls "Perpetration-Induced Traumatic Stress", PITS.

PITS is the anguish and guilt which one human being feels when he/she kills another human being. This has been increasinly labeled as a mental health problem which it surely is, but even more, it is a spiritual problem in my view. All the mental health treatment in the world, and all the medications cannot absolve the guilt induced by the willful, deliberate killing of another human being.

There is a good article that attempts to describe this problem which was published in the Seattle Times 4 years ago on July 21, 2004. Here is a snippet:

Tucked behind a gleaming machine gun, Sgt. Joseph Hall grins at his two companions in the Humvee.

"I want to know if I killed that guy yesterday," Hall says. "I saw blood spurt from his leg, but I want to be sure I killed him."

The vehicle goes silent as the driver, Spc. Joshua Dubois, swerves around asphalt previously uprooted by a blast.

"I'm confused about how I should feel about killing," says Dubois, who has a toddler back home. "The first time I shot someone, it was the most exhilarating thing I'd ever felt."

Dubois turns back to the road. "We talk about killing all the time," he says. "I never used to talk this way. I'm not proud of it, but it's like I can't stop. I'm worried what I will be like when I get home."

The men aren't Special Forces soldiers. They're troops with the Army's 2nd Armored Cavalry Regiment serving their 14th month in Iraq, much of it in daily battles. In 20 minutes, they will come under attack again.

Many soldiers and Army psychiatrists say these constant conversations about death help troops come to grips with the trauma of combat. But mental-health professionals within and outside the military point to the chatter as evidence of preventable anguish.

It is very difficult for us as a nation to face up to the immoral and illegal war which we have perpetrated and are paying for which was based on lies and deceit by our government, let alone for our soldiers who have actually killed other human beings, civilians, women, children, for reasons that are not clear at behest of psychopathic and irresponsible leaders. What does this killing do to a person's soul other than lead to anguish, revulsion, self-recrimination, and too often self destruction in one form or another.

Families of these suffering souls have wanted to be proud of their relative's service and to believe it was for a good cause, but the truth does not match the delusion. The inability of people back home to "understand", let alone accept, the truth, leaves the suffering soldier even more isolated and tormented.

What is the answer to the spiritual suffering? The truth and repentence. Will McCain or Obama lead us there? I doubt it very much unless we as a country are willing to face our demons and admit that what has been done in our name is wrong. Witnessing the suicides and PTSD of our returning soldiers fortunately or unfortunately won't let us ignore or forget the heinous acts they have been asked and compelled to do in our name. The guilt belongs to us all not just to the perpetrators, but they are the more active participants while we just watch, cheer them on, and lie to them telling them they are doing grand, honroable, and glorious things when deep in their souls they know better.

I intend to write more on this topic so I am adding a new category to my blog today called Perpetration induced stress.

Nation & World | Soldiers trained to kill, not to cope | Seattle Times Newspaper.

 

Praying for clients?

Continuing with the discussion of spirituality in therapy I was struck by Lorraine Wright's statement that she sometimes prays for her clients. Here is part of what she writes in her article, “Spirituality, Suffering, and Beliefs”,

“ Over the past few years, I have on occasion, independently adopted Dossey’s (1993) practice of praying for, although not with, clients and families with whom I work. As Dossey (1993) suggested, if a health professional believes that prayer works, not to use it is analogous to withholding a potent medication or surgical procedure: ‘Both prayer and belief are nonlocal manifestations of consciousness, because both can operate at a distance, sometimes outside the patient’s awareness. Both affirm that, “it’s not all physical”, and both can be used adjunctively with other forms of therapy.” (p.141) In praying for our clients, we perhaps also heighten our connection with them and our investment in their recovery and well-being.”

P. 64 in Spiritual Resources In Family Therapy edited by Froma Walsh

In further research, Dossey's claims have not been affirmed and it appears that there is no physical benefit to praying for someone who does not know they are being prayed for.

However, I wonder if praying for clients detracts from the psychotherapy? Is this a counter transference issue that would enhance the therapeutic alliance or interfere with it in some ways? If you had a student or supervisee who told you in clinical supervision that he/she was praying for his clients without the client's knowledge how would you handle it? Supposing it was with the client's knowledge?

Is praying for clients something that should be encouraged or discouraged? 

I, myself, sometimes pray for my clients and if wishing them well is considered praying, I pray for them all. I think that whether a therapist or a health care provider prays for clients would depend on the therapist's beliefs and spiritual practices. Certainly, clients pay a health care professional for a professional service and not for prayer, but I think that most clients would want their therapist to wish them well and care about their lives and the outcome of the therapy and not just be in it for the money.

Unfortunately, health care has turned into a business. It has become a commercial enterprise and is no longer a human service or a ministry in the broad sense of the word. I do not run my practice only as a business enterprise. I want to be of service to my clients and my community and take a number of clients pro bono and at reduced fees. I could make more money if I only served the more affluent who could pay me full fee, but that is not why I became a therapist and that is not what I believe God has called me to do with my professional skills.

Perhaps it is this desire to serve that is a prayer in and of itself.

Happiness more or less constant over the course of life

An interesting study done in Germany and reported on the BBC found that happiness is more or less constant over the course of a person's life. Here is a snippet from the article:

Momentous events in your life such as having children, or getting married, may make you happier, but only temporarily, say researchers.

Our basic happiness level essentially stays the same throughout adult life, the Economic Journal reports.

Economists from the UK, US and France based their conclusions on a 20-year analysis of the life satisfaction of hundreds of people from Germany.

Even after traumatic events, overall mood dipped but then recovered.

BBC NEWS | Health | Happiness 'immune to life events'.

Psychotherapy involves a sense of reverence

Lorraine Wright in her article, Spirituality, Suffering, and Beliefs writes about an incident that occurred when she was being observed working with a family behind a one way mirror. A team member who was observing said to Lorraine that

"...what he believed to be the most powerful aspect of my clinical work with families: the notion of 'reverencing' that occurred between families/clients and myself. In those moments of reverencing, there is a profound awe and respect for the individuals seated in front of you. It is not a linear phenomenon in these moments. I feel that same reverencing from family members being given back to me. In those moments of reverencing in clinical work something very special happens between the therapist and the family; it is something felt by all - a deep emotional connection. I know and have felt these moments in therapy, both in the therapy room and from behind the one-way mirror as a supervisor or team member."

Spiritual Resources in Family Therapy edited by Froma Walsh, p. 63

I am reminded of Jesus' statement that where two or three are gathered in my name, there I will be. There is something about psychotherapy that can be sacred not in a religious sense but in a spiritual sense.

Psychotherapy is a trust between the therapist and the client(s) where the psychotherapist is duty bound to put the clients needs ahead of his/her own. The psychotherapist is ethically bound to use his/her personality in a purposeful way to help the client get the clients' needs met. There is a deep listening that is empathically profound and an attentiveness that goes way beyond the ordinary. It is the conscientious attentiveness on the part of the therapist that makes psychotherapy hard work in the sense that it takes discipline to set aside one's own narcissistic preferences and desires in service of another. This "being there" for another is what begins to make the rapport sacred and the quality of reverencing begins to emerge.

Discussing clients spiritual beliefs as part of therapy

I have been reading Spiritual Resources In Family Therapy edited by Froma Walsh and there is an article in the book by Lorraine Wright entitled, "Spirituality, Suffering, and Beliefs: The Soul Of Healing With Families."

 

Lorraine describes herself as a family therapist/nurse educator who works predominantly with families experiencing illness. She says some interesting things like:

 

The influence of family members’ spiritual and religious beliefs on their illness experiences has been one of the most neglected areas in family work.” P. 62

 

I wonder why that would be? What is the fear or the constraining beliefs that therapists have that would make it nonconductive to discussing clients' spiritual beliefs as part of the therapy?

 

Part of the contraints probably have to do with the split between the secular and the sacred, between science and religion, between evidence based practice and the clinical arts, between the psychological helper and the ministry.

 

I have been trained as a psychotherapist not as a pastor and our roles are different and yet without understanding and taking into account my clients' spiritual and religious beliefs especially when they are suffering, I am not likely to be of much help.

 

Thankfully, there is increased interest in the health care professions in the role that spirituality and and religion play in a person's physical health and mental well being. To describe someone as "broken hearted" or as having "killed their spirit" is to describe a person who is in need of some sort of spiritual uplift. There is a difference between a physical cure and a healing of the spirit.

 

My friend and colleague, Ed, recently died on June 30, 2008 at age of 56 of Esophogeal cancer. I last had lunch with him on June 18,2008. Even though physically he was having difficulty his spirits, as always, were good. I am not sure what Ed's religious and spiritual beliefs were, but he loved life, he loved people, and he lived every day up to his last to the best of his ability and for this I am very grateful to Ed for inspiring me with a great example of how to die.

 

Paul Pearsall, the neuropsychoimmunologist, who had four near death experiences himself, said, that no therapist can hope to be of much help to someone unless the therapist understands at least three basic things about the person's world view. The therapist needs to understand how the client would answer these three questions: Why was I born? What is the purpose of my life? What happens to me when I die?

 

I usually don't ask clients directly these 3 questions unless they come up in our conversation but usually by the 3 interview I have some good understandings of how they might answer these questions.

 

"I don't know. I don't know, and I don't know" are not good enough answers and people have to be pushed sometimes to a scarier and more difficult place, but if they trust the therapist enough, they usually can come up with some sort of answer that probably means more than they would like to believe.

 

The purpose of a healthy spirituality is to decrease suffering as both Jesus and Buddha and other spiritual masters have taught. This is the same goal of good psychotherapy.

 

Prosperity preaching is the path to hell

It is ironic that when the economy gets bad people turn to religion.

The major religion in America today, but you will not see it listed as a major religion or denomination in the Pew Research Polls, is consumerism. The God of consumerism is Mammon. President Bush is consumerism's main prophet when he encourages people to engage in the sacred practice of shopping.

Joel Osteen and books such as The Secret promote an economics of spirituality promising people that if they have enough faith and get right with their God material and financial benefits will flow. With a paradoxical theology the proponents of economic spirituality promise that the more money you give to them, the more money the universe will send back to you.

As people have come to believe the economics of spirituality, the rich have gotten richer and the poor have gotten poorer and the middle class has shrunk.

People have not caught on that the economics of spirituality is a scam, a con, worthy of P.T. Barnum and the snake oil salesman of old.

People are not stupid but they are anxious and scared. Scared people will latch on to any hair-brained ideas hoping that by whistling in the dark and being distracted by engaging entertainment and hopeful ideas, no mater how false, will help them feel better and make things better.

None of the great religious leaders preached consumerism, not Jesus, not Buddha, not Krishna, not Mohamed. In fact, they preached the opposite. Jesus said, "It is easier for a camel to pass through the eye of a needle than for a rich person to get into heaven."

It's not that money and material things are bad, it's that they have there place and there are plenty of things more important like loving your neighbor and caring for our planet and mother, Mother Earth.

As J. Paul Getty said, "The meek shall inherit the earth but not the mineral rights." and as Jesus said, it is hard, if not impossible for the rich to get into heaven, but the prosperity preachers who encourage an economics of spirituality create a hell on earth in the long run. As one wag said when asked his definition of Irish Diplomacy, "Irish diplomacy is telling a person to go to hell in such a way that they enjoy the trip." President Bush must be part Irish when he told Americans that the antidote to their worries is to go shopping. By all means shop til you drop, and let the plutocrats and preachers run the world.

Americans are not stupid, but emotional disturbed and morally corrupt

"I have treated many patients who have been painfully gaslighted in family, work, or organizational settings. I have seen whole organizations undercut by manipulative CEOs. But when gaslighting is done to an entire country as it has been done to the United States, the stakes are chilling. The political use of gaslighting has led to a psychologically impaired and unstable American electorate. The resulting policy decisions have had devastating implications for all Americans and the world."

Dr. Bryant Welch, The Assault On The American Mind, pp. 6-7

Rick Shenkman's book is entitled, Just How Stupid Are We? I have come to understand that it is not that Americans are stupid but that they are emotionally unstable and morally corrupt. We usually don't think of ourselves that way but if this were not true how do you explain the acquiescence to the nation's policies over the last 8 years?

How could Americans support a disastrous and immoral war in Iraq, the abandonment of 1 million fellow citizens in Katrina, the lack of health insurance for over 46 million Americans, the destruction of our planet by driving gas guzzling SUVs, a President who tells the citizens to cope with their anxiety about the terrorist threat which he overplayed by going shopping?

It is immoral to not help one another and the dog eat dog mentality where every person is expected to shift for himself is destroying our sense of security and thereby our emotional stability and moral fitness.

Further, there is a cognitive and intellectual belief in creationism denying evolution, faith based policies have taken over for good public health programs such as abstinence based sex education, a dismantling of governmental programs and then when they don't work because they are underfunded and under resourced turning them over to private contractors with no-bid contacts at exorbitant costs.

When we vote for our leaders and representatives, we pick appallingly unfit candidates. These choices are based on bogus emotional and moral issues and America as a nation has lost its way. We vote against our interests when it comes to financial policy, foreign relations, domestic policy over silly issues like gay marriage and reproductive rights.

A nation which is frightened of bogeymen, impoverishment, inability to obtain health care, education, and a prosperous future for their children is a nation easily manipulated by gaslighters.

A frightened nation is a nation at high risk for harming itself and others. We need to build a nation which is secure, where there is a safety net, where we care for one another, and overcome the dog eat dog mentality where it is every person for himself. We can help each other and in so doing build a better today for ourselves and tomorrow for our children and grandchildren. It is in the security of community which comes from helping each other that our emotional health and positive morality will be restored.

This emotional instability and moral corruption is a curious thing. How is it that two DUI offenders get chosen to be President and Vice President? How does a man who is a self admitted drug abuser until he was 40, who bankrupted several businesses, and was a lackluster student only admitted to Ivy League schools because of legacy admission policies get to lead the richest, most powerful nation on earth into a disastrous war? The whole thing seems nuts, and it is.

Video lasts 24 seconds

McClellan is finally getting it right about how the Bush administration has gotten it wrong. Illuminating the gaslighting being perpetrated against the American people

Former Press Secretary Scott McClellan now thinks telling the truth is important even though Republicans suggest he is disloyal and should have taken the lies to his grave. Really. They really suggest this. Watch the associated press video which lasts 1:50 seconds.

In some ways this is good therapy. It is time, in the United States for the truth. The gaslighting which has been going on for 7 years is finally being exposed. Do Americans have the stomach for the truth or do they still want to be lied to? I sure hope they have the courage to face up to the truth. These hearings are a form of national psychotherapy which is good for the national soul.

America, as a nation, is badly in need of psychotherapy

"Why did Americans become so vulnerable to divisive political tactics? Why did America get dragged into such an unwise war in Iraq? Wy have fundamentalist groups, Fox News, and hate-filled right wing radio played such influential roles in America's landscape? Why are long accepted scientific ideas like evolution under siege? These questions and others puzzle people from all points on the American political spectrum and from all points around the world. What has happened to the American mind?" p.2

Dr. Bryant Welch, State of Confusion: Political Manipulation and the Assault On The American Mind

The answer is that certain politicians, religious leaders, and media celebrities have deliberatedly manipulated the emotionally vulnerable by suggesting a false reality so that the perpetrator can control this emotionally vulnerable population in order to pursue their own devious purposes. The examples of this behavior are plentiful and it goes by the name of gaslighting or what I have called mystification.

You have people like James Dobson, the founder of Focus On The Family, the largest right wing religious organization in America who says things like "Tolerance is a kind of watchword of those who reject the concept of right and worng. It's a kind of a desensitization to evil of all varieties. Everything has become acceptable to those who are tolerant."

Dobson is a demogoge who is preaching hate, distrust, paranoia to the emotionally vulnerable under the guise of religion. Forget the fact that Jesus said to love your enemies, be kind to those who persecute you, and died that way to demonstrate his teaching. Dobson has set himself up opposite of Jesus and yet people love Dobson and follow him and he has tremendous influence along with Falwell, Robertson, and the other false teachers who have gained such popularity in a confused and vulnerable American mind.

Dobson has said, "State universities are breeding grounds, quite literally, for sexually transmitted diseases (including HIV), homosexual behavior, unwanted pregnancies, abortions, alcoholism, and drug abuse."

To an uneducated, lower class population, this is music to their ears to learn that better educated people have been contaminated at State Universities. This subtle appeal to classism is a divisive and destructive tactic in the United States and leads to dependence on religious authorities rather than on education of the free and developing mind.

The point is that there is an element in the United States fueled by ignorance and fear that is ripe for manipulation by psychopaths who would pry on the emotionally vulnerable for their own gain. This is not only a huge mental health issue but a huge moral issue as well. We as a society need to raise our level of consciousness so that we are aware of the psychopaths among us who would exploit us for their own purposes. These psychopathic terrorists are not abroad as they would have us believe but right here at home taking advantage of us daily. They are among us killing and injuring our soldiers, impoverishing all but the very rich, trashing our environment, destroying our commons, and manipulating our democracy for the advantage of the corporations and the very rich.

There are a few of us, but unfortunately not many, who realize that the emperor has no clothes on. We understand their crazy making tactics and watch our fellow citizens become "dumbed down" every day. We see the fear in our fellow citizens eyes as they pay over $4.00 at the gas pump, and are told that the Iraq war will go on for a 100 years. We see the demonizing that is perpetrated against us blaming the immigrant, the poor, the gay, women who want to have control over their own bodies and their reproductive health to distract us from their devious behavior and purposes.

America is badly in need of psychotherapy, a therapy which will make the unconscious conscious so that the gaslighting and mystification is illuminated and labeled, help the nation make better decisions that are reality based not fantasy based, and improve national functioning so that we can live in a society with one another which is much more satisfying and fulfilling.

Facts and opinions - making our own reality

The New Agers tell us that we can create our own reality.

What they mean is, as best as I can determine, that we can make our own meaning.

We usually cannot change the facts or the circumstances.

As the proverb says, "You have a right to your own opinion, but you do not have a right to your own facts."

As the bumper sticker says, "Reality is when it happens to you."

The facts can be tough sometimes. The truth can hurt. Shit happens.

In the United States we have lived though a delusional period in our national politics when policies were based on ideology not on reality. Many people are now calling for a reality based politics not an ideologically based politics.

In our personal lives, we probably function more effectively and efficiently, if not not more happily, when our decisions and choices are based on reality rather than fantasy.

If a 12 oz. can of soda has 6 oz. left it it, it is a fact that there are 6 oz. gone, but whether you choose to interpret this fact as the can being half empy or half full is up to you and the expectations of others for how they would like you to interpret the fact.

The events of your personal life and our national life roll on. These events are facts and indesputable, but you get to write the history and the history you write will influence how future events and facts are perceived.

As Bobby McFerrin sang in his great song, "Don't worry, be happy." Video lasts 3:43