Blog – Page 2 – Desert Wise

My Psychology License is a Glorified Food-Handler’s Permit – And Other Notes on Self-Worth

It’s happened before that I’ve told a person that my psychology license is a glorified food-handler’s permit, and they let out an audible gasp and trip over themselves to offer blanket reassurances. They seem to respond with the assumption that I’m being self-deprecating in making this statement. But I’m doing quite the opposite, actually.

For many professions, there are government agencies designed to standardize, regulate, and monitor the credentialing and activities of those professions. To work in the food service industry in New Mexico, for example, prospective employees are required to meet standards established by the Environmental Health Bureau. They must complete a certified food handler class, which covers basic food safety, personal hygiene, cross-contamination and allergens, time and temperature, and cleaning and sanitation. They then take a proficiency test and must achieve a score of 75% or above, after which they can be issued a food-handler’s permit. This system is designed to protect public health and safety.

Sure, I’d like to think that in my 40s I have the common sense to know how to properly handle food, but just because I do, doesn’t mean my neighbor does. I mean, there’s a reason why I never ate Janet’s casseroles at the work potlucks.

To break the process down to its simplest form: In the interest of public health and safety, a government agency establishes minimum standards for what has to be learned, how this acquired knowledge has to be assessed, and what documentation is required to prove that these standards have been met. This is true for driving a semi, cutting hair, nursing, operating a forklift, shoring up construction trenches, and a wide range of other professions.

This is also true for the field of psychology.

I was required to complete an American Psychological Association (APA)-accredited doctoral program in clinical psychology, as well as an APA-accredited internship program. I was then required to get a billion* hours of post-doctoral supervised clinical experience, after which I had to complete a thousand-page* application, pass a jurisprudence exam, and pay hundreds of dollars to be approved to “sit” for the licensure exam (i.e., Examination for the Professional Practice of Psychology). After my life flashed before my eyes when I hit submit on that exam, I got a passing score, and eventually my “permit” to practice psychology arrived in the mail.

So, the same principle applied here: In the interest of public health and safety, a government agency establishes minimum standards for what has to be learned, how this acquired knowledge has to be assessed, and what documentation is required to prove that these standards have been met.

The only real differences between a food-handler’s permit and a psychology license are: (1) the specified area of expertise, (2) the amount of time required to get the blessing of the government agency, and (3) the amount of debt one racks up in the process.

There are numerous reasons why this clarification has value, but for the purposes of this post, the importance of the clarification relates to self-worth. The permit under which I operate does not define my worth or who I am as a person. It doesn’t tell you what my values are, how I exercise integrity, or how I relate to people. It doesn’t tell you what fears I may have, what bad habits I struggle with, or what my flaws are. My profession doesn’t tell my story, tell you what I bring to the table, or tell you what my family would miss about me if I died tomorrow. (And if my obituary turns into a post-mortem resume, I’ll roll over in my urn.) My profession doesn’t even tell you how smart I am (or am not) or what areas of intelligence I have strengths in. All it tells you is that I have a specific expertise in the field of psychology, for which I am sanctioned to deliver services. It tells you that I jumped through the prerequisites (aka: fiery hoops) necessary to get the license.

Similarly, having a permit to handle food, drive a semi, cut hair, nurse, operate a forklift, or shore up a construction trench doesn’t define the worth or value (or intelligence or capabilities or character) of the people with those permits.

Back in grad school, I was heading to an academic conference in Toronto. I was on a small commuter plane headed to my layover in Detroit. When I found my assigned seat, I plopped down next to a well-groomed woman in a full suit. Being an introvert, I hoped she wouldn’t speak to me, as 30,000-foot small talk is about as pleasant to me as facing a morning with no coffee. We made it about two-thirds of the way through the flight before she started talking to me. Why now? We were almost there! It started with the typical niceties: Where are you from? Where are you going? What do you do? When I answered that last question (i.e., I’m a doctoral student in clinical psychology.), her posture and interest visibly changed. Suddenly, she wanted to talk in depth and offered to “get lunch” with me on our layover. We determined that we wouldn’t have enough time during our layover, so instead she handed me her card and told me to call her when I got back home. Without looking at it, I stuffed the card in my pocket and exited the plane. It wasn’t until that night in my hotel room that I looked at the card. Turns out, she was a three-letter executive at the world’s wealthiest corporation.

I threw the card in the trash.

Why? She didn’t want to do lunch or stay in contact until she knew what I did for a living. Her affect and attention markedly changed when I told her what I did for a living. It seemingly wasn’t me she was interested in; it was my title.

In fairness, she may have been a perfectly nice, well-meaning woman, but I threw the card away because of what it represented. When I was a child growing up in poverty, people generally believed I wouldn’t amount to much. When I worked for a decade in the telecommunications industry, doctors, attorneys, and executives didn’t give me the time of day (unless I was paying them for their services). The class and status divide in our society has always been evident to me, so having this interaction that suggested that I was now “worthy” of someone’s time by virtue of my title was off-putting. I hadn’t changed. My value as a person hadn’t changed. I was just nearing the end of the process required to get my glorified food-handler’s permit.

If I were to entertain the idea that my license/title/degree makes me more worthwhile, I would also have to logically entertain the idea that pre-license/title/degree, I was less worthwhile. Similarly, I would have to entertain the idea that if I were to leave my profession, that I would return to being less worthwhile.

When I think of the ten most important adults in my personal life (I literally made a list), the highest educational degree obtained by 60% of them is a high school diploma. The other 40% have an associate’s degree or technical certificate. Yet I guarantee that not one of them thinks I believe I am more worthwhile than them by virtue of my license.

See, here’s the thing: If any one of those ten people were in a catastrophic car accident tomorrow and was rendered quadriplegic (i.e., unable to work/provide, completely reliant on others for care), I would be overwhelmed with gratitude that they survived. Why? They can’t work or produce. But, so what, right? That’s not why I love and value them. That’s not what they’re bringing to the table. They’re bringing to the table who they are…their strengths and weaknesses, their character, their mind, their love, their way of relating, etc.

I think when most of us consider our loved ones, it’s a no-brainer that we’d be grateful for their survival in such a situation. But here’s the real test: What if YOU were the one in the catastrophic car accident tomorrow, were rendered unable to work/provide, and were completely reliant on others for care? Who would you be? What would be your value? Would you be grateful you survived? Your answers to these questions can tell you a great deal about your sense of self-worth and from where you derive your sense of worth.

Once upon a time, I would’ve answered those questions like this: <Throws papers up in the air> No one. Nothing. No.

But that was back before I understood what I was bringing to the table as a person. I had long bought into a warped illusion that my worth was based on what I achieved, accomplished, and provided to others. (There are many variations of worth illusions: codependency, self-depreciation, pathological self-sacrifice, materialism, etc.) Trying to fill a void of worth with achievement, accomplishment, and generosity was unsustainable, however. It was exhausting. It was lonely. It was nonreciprocal. And it was never enough. The void always needed to be fed more.

In the early stages of me figuring out the unhealthy way in which I perceived my worth, my husband forced me to sit idly beside him while he folded laundry. I made a New Year’s resolution to do zero volunteer work for a year. I distanced myself from the many takers in my life. I was like an alcoholic going through detox.

A handful of years later, I still have to monitor myself and can easily find myself backsliding into old habits. So, I intentionally allow others to pay for coffee or do me favors. I sit with the discomfort of feeling like the scales have somehow been catastrophically imbalanced. I remind myself that my loved ones would want me to survive a car accident – but not because I’m a psychologist – only because I’m me.

So, here’s your come-to-Jesus question: Is it time for you to reevaluate and detox?

Joye L. Henrie, PhD

January 2018

*Surely y’all know I’m exaggerating (slightly).

An Optimist, a Cynic, and a Realist Walked into a Bar…

Ok, they didn’t actually. But they do often walk into my office…especially the optimists and the cynics. A great many of my patients over the years fell squarely into one category or the other.

The cynics are typically snarky and bitter. They’re heavy and dreary to sit in a room with. They describe the world and interpret events in unilaterally negative terms: “Oh of course it’s raining; I just washed my car. That’s how it always happens.” The cynics are quite convinced they’re right, and they tend to view anyone who sees the world differently as naïve peasants. They claim that their thinking style is a functional protective strategy, because they don’t like to get their hopes up…only to be let down.

My reply? “Well given that you’re now sitting on a therapy couch, how well has that been working out for you?”

The self-professed optimists incessantly use the catch phrase, “I just try to think positive,” and in this effort, they’ll quip with a smile, “It kind of sucks that it’s raining on the same day that I washed my car, but at least that means that the flowers will bloom soon!” (Yes, they usually end with some excitatory punctuation.) They tend to describe the world in flighty, candy-coated terms, and when a difficult therapy subject is broached, they often show some level of discomfort and quickly wiggle out of the topic by citing a quote or cliché. When I call them out on this, they stubbornly state, “My mom [or uncle or friend or cat] used to always tell me to think positive, so that’s what I try to do.”

My reply? “Well given that you’re now sitting on a therapy couch, how well has that been working out for you?”

My initial approach for both the cynic and the optimist is the same: I give them a crash course in the scientific method. (Yes, I take them all the way back to middle school.) “Science is a systematic and logical approach to discovering how things in the universe work,”¹ and the scientific method “is an organized way that helps scientists (or anyone…) answer a question or begin to solve a problem.”²

So neither the cynic or the optimist is being a good scientist. Both are viewing the world and interpreting data through a biased lens. Neither are demonstrating thinking styles that demonstrate objectivity or logic. I usually introduce them to their own bias by drawing an image on a white board for them:

Except, I’m going to be honest with y’all. What my patients see in real life looks more like this:

Cynicism and optimism are just different ends of the same spectrum. Cynicism is biased to see all things negatively, whereas optimism is biased to see all things positively. Neither is accurate or objective. Neither is in touch with reality. In reality, things aren’t all bad or all good. Life is generally an intricate series of “bad,” “good,” and neutral events. Therein lies realism. The true realists of the world observe and account for all data – irrespective of its positive or negative quality. (Cynics often pass themselves off as realists by saying, “I’m just being a realist,” but their use of the term is a bastardization of its definition.) Actual realists take into account all information without a predisposition to interpret it or predict outcomes in one direction or the other. That is an accurate rendition of the scientific method.

As for the application of the scientific method to daily living, I once had a patient (not unlike many people) who had the tendency to mentally beat himself down. His thoughts were riddled with self-doubt. He gave an example of a fitness instructor commenting that the patient was strong. The patient’s automatic assumption was that the fitness instructor was just being nice. I had this patient put his (cynical) hypothesis to the test using a similar graphic³ to the one below:

The patient’s question was, “Was the fitness instructor just being nice?” The patient completely skipped background research and jumped to developing the hypothesis that the fitness instructor was being nice. The patient also skipped the last three steps. So I took him back to testing his hypothesis. I had him develop a list of evidence for and against his hypothesis. In the list of evidence for his hypothesis, he only wrote, “Maybe people are more likely to go back to this fitness instructor if he tells them what they want to hear.” In the list of evidence against his hypothesis, he wrote, “I have been working out regularly. I’ve been able to lift more weight over time. He probably doesn’t actually have anything to gain from lying to me. He probably wouldn’t get much ongoing business if he lied to everyone.” At the end of the exercise, the patient had come up with far more evidence against his hypothesis than for it, so ultimately, he changed his mind and threw out his assumption that the fitness instructor was just being nice.

This is a basic (but solid) example of being a realist. The realist considers all information, whether it supports their existing hypothesis or not. In being a realist, we allow ourselves to experience the world, others, and ourselves more authentically, which can help us better cope with life’s stressors and bad news.

Joye L. Henrie, PhD

November 2017

Bradford, A. (2017) What Is Science? Live Science. https://www.livescience.com/20896-science-scientific-method.html
ScienceBob (Ukn) The Scientific Method. https://sciencebob.com/science-fair-ideas/the-scientific-method/
Learner (Ukn) The Scientific Method. https://www.learner.org/jnorth/tm/handouts/anchor_chart_sci_method.html

What are You Saying? The Communication of Emotions between Men and Women

Imagine a six-year-old, first grade girl on a playground at recess. She falls and skins her knee. Then she starts crying. What do all the little girls do? They run to her, help her up, inspect her wound, hold her hand, and walk her to the nurse’s office. It’s also likely that a full two hours later, they’re giving her an extra cookie at lunch and asking her if she’s ok.

Now imagine the same playground, but this time, it’s a six-year-old, first grade boy. He falls and skins his knee. Then he starts crying. What do all the little boys do? They laugh and point and call him names. It’s also likely that a full two hours later, they’re still shunning him…keeping their distance to avoid being associated with the ‘crybaby.’

Why does this difference happen? Are little boys inherently mean? ‘No’ is the simple answer.

Here’s how it works: People (as much as we fancy ourselves a sophisticated bunch) learn in essentially the same way as our pet dogs. When we want to teach our dog to sit in response to the command ‘sit,’ we pair the command and the behavior of sitting with a treat, a hardy petting, or some other desirable motivating feedback for the dog.

Similarly, we humans tend to repeat behavior that is rewarded, and we tend to avoid behavior that is punished. From the time the typical American boy is born, he is barraged with messages about toughness, not crying, and avoiding anything that is cast as ‘feminine.’ He learns this at home, in the extended family circle, among peers, at church, etc. By the time a boy enters grade school, he’s already keenly aware of the rules of engagement for his gender, and he unknowingly becomes a propagator of these rules of engagement.

Over the course of the years of the boy’s life, he is consistently confronted with messages regarding what is considered acceptable and unacceptable emotional expression for a male. Most common among these messages is that any negatively-valenced male expression of emotion should be anger. Frustrated? Anger. Scared? Anger. Tired? Anger. Sad? Anger. Defeated? Anger. The free expression of sadness or fear in male adolescence is potential social suicide.

Meanwhile, the course of the girl’s life is painted with reward for the free expression of emotion. The tears are permitted to flow openly. She is encouraged by her home, extended family, peers, church, etc. to articulate her emotional experience on a nearly infinite range of topics. In fact, females are often relationally punished for not doing so – facing labels such as b*tch, cold, or ice queen if her free expression of emotion isn’t deemed robust enough.

Bottom line, boys tend to be punished for emotional expression and rewarded for presenting as stoically flatlined. Girls tend to be punished for not being emotionally expressive enough and rewarded for the free and unbridled expression of emotion.

While this discussion could go many directions (e.g., that it can be damaging to rob boys of healthy emotional expression, that it can be professionally impairing to fail to teach girls time-and-place with regard to emotional expression), my point in writing it is to illuminate the ways in which these reward-and-punishment paradigms can erode effective relationship communication.

By the time the little girl and little boy have grown into a woman and man and decide to leap head-first into a relationship, the woman has a vast and deep emotional vocabulary – the equivalent of a dictionary. She quickly senses when she feels different, and she has been taught to communicate these feelings, their changes, her hypotheses about them, etc. Meanwhile, the man has the equivalent of a trifold brochure of emotion-related vocabulary. He’s been taught to ignore emotional changes, not investigate their origins, and deny their existence. So when the woman talks to him readily, frankly, and extensively about her emotional experience, he might be hearing something akin to white noise.

Here’s a flip-side example: My husband of 23 years is mechanically inclined. Over the years, he has worked on all of our cars – usually out of abject necessity. I’ve learned a lot from him about engines, car maintenance, etc. But he always has to speak at my level – build a knowledge foundation and expand from there. As soon as he says words like “camshaft synchronizer,” my brain short circuits, and I’m no longer following what he’s saying. And if I don’t understand the words in his sentence, my brain just kind of checks out. I feel myself getting agitated as he talks, because I know the loving and respectful thing to do is to pay attention to what he’s saying – but he’s not speaking my language. [It’d be like me staring intently and with sustained enthusiasm while someone is speaking to me in Korean. (I don’t speak Korean.)] Lately I’ve gotten better at stopping my husband when I don’t understand and asking him to translate. Then he says words like “the thing that tells the computer how to time the spark.” Suddenly, I’m following; I’m reengaged…and he doesn’t feel like I’m disinterested in what he’s saying.

In the early years of our relationship, I was guilty of speaking to him in overly emotional terms that weren’t relatable or translatable to him. His brain short circuited when I communicated things through an emotional lens and/or asked him to be emotionally supportive. (In his mind, the only things that were supportive were I-beams, trusses, rebar, etc. How would something invisible lend support?) I spoke from my perspective – with no consideration of his perspective. But neither of us knew that at the time. You can’t communicate what you don’t know. So I interpreted his nonresponse as uncaring, and while he vehemently denied the accusation that he was uncaring, he didn’t have the words to communicate that I needed to translate for him.

Fast forward 20 years and we have settled somewhere in the middle or our respective societally-influenced worlds. I use less words to describe my emotional experiences (so that his brain doesn’t check out). I try to do a better job of making my explanations relatable to him (so that he doesn’t feel frustrated). I take accountability for my own feelings and for self-soothing (so that I’m not displacing blame onto him). He, rather than defaulting to expressions of anger, has learned to articulate if he’s feeling moody – even if he doesn’t know what the particular mood or emotion is (so that I don’t personalize his mood). He regularly articulates his feelings toward me (so that I developed security in where I stood with him). He listens when I do share my emotions (so that I know my experiences are important to him).

Once we understand the common discrepancies in relational communication, it’s so much easier to fix them.

While writing this blog, I had yet another couple come in and describe their difficulties in communicating. This couple has been married for over 30 years. The wife said, “I know when he gets angry, there’s something going on in his head,” to which the husband responded, “She says that, but there’s nothing going on in my head.” I abruptly stopped them and fetched the draft of this blog from my desk. As I read it to them, they both nodded knowingly…over and over. By the time I finished, they both had smiles (or at least smirks) on their faces. They knew this was indeed the canyon between them, and like any couple, they were tired of professionals and self-help books prematurely concluding that it was one person’s fault or the other.

Is it my fault that I don’t speak Korean? Or the Korean’s fault that they don’t speak English? Neither. It just is. And if we want to learn to communicate effectively, we will work to master one another’s language.

Joye Henrie, PhD

September 2017

(Note: This post contains some generalizations and absolute language. This is not intended to stereotype or be dismissive of outliers. Rather, it is done for expediency in addressing a common issue that arises in the course of psychotherapy.)

The Invisible Creep of PTSD: How Trauma Changes the Way You Experience the World

A long-term patient of mine (who we’ll call Michael) is a combat medic with multiple combat deployments under his belt. When he started treatment with me, he already carried a Posttraumatic Stress Disorder (PTSD) diagnosis – a diagnosis that was spot-on. After we had been working together for several months, Michael was clearly agitated when he came in for his scheduled follow-up. He explained that he had gone into a well-known big box store to return an item. In comedically colorful language, he explained that another driver almost t-boned him on his way to the store, people were walking uncomfortably close to his car in the store’s parking lot, and he crossed paths with some questionable-looking characters as he walked into the store.

By the time he reached the greeter’s podium, he was perspiring and tight-chested. The greeter apparently blew him off, but when Michael attempted to walk past the greeter, the greeter stopped Michael by grabbing him by the shoulder. At this precise moment, approximately 82 of Michael’s brain cells imploded. He went into a blind rage – screaming in the greeter’s face and threatening to annihilate him.

“I’m losing it, doc,” Michael said to me – not even attempting to hide his fear.

Michael’s story is a common story among my military patients with PTSD. And yet, they all think they’re “crazy” or “losing it.” In psychology, it’s common for providers to say, “It’s a normal response to an abnormal situation,” and unbeknownst to folks with PTSD, it’s their daily reality.

It’s like this: The average person walks around with a subconscious threat-management radar operating at all times. If they’re having a picnic in the forest and a bear approaches them, they immediately spring into action and run (or whatever it is you do if you’re unfortunate enough to come face-to-face with a bear). They don’t sit and think, “Hmm. I wonder if that fury mammal will chew on my head?” This is the basis of fight/flight/freeze. Our radar detects threat, and we respond. It’s the same if we’re walking along a city sidewalk and a car comes careening toward us or if we’re standing in a bank when a masked man with a gun yells for everyone to get on the floor.

The threat-management radar of the average person is set at a specificity level to immediately detect clear and overt threat – like the radar-equivalent of a missile.

A person with PTSD, however, has the sensitivity of their threat-management radar turned up as high as it will go. They’re no longer just detecting missiles. They’re detecting mosquitos.

Why? PTSD is, as its name states, a trauma-based disorder. It is the result of exposure to a trauma event that threatens life or limb, and the research suggests that exposures to multiple traumatic events exponentially potentiates the development of full-blown PTSD. Subsequent to these traumatic events, the person’s thoughts and beliefs about the world, themselves, and others changes. They may come to believe that the world isn’t a safe place or that people can’t be trusted or that if only they had done X, the trauma wouldn’t have occurred.

These changes lead and/or run parallel to hypervigilance (i.e., hyper-awareness of and hyper-sensitivity to one’s surroundings and its changes, and exaggerated reactions designed to manage one’s surroundings and its changes). In other words, the person with PTSD is likely to study people in their environment, notice exits (aka: escape routes), want full visibility of their surroundings, notice and investigate noises of unknown origins, etc. This is their radar operating in the hyper-sensitive mode. They’re detecting mosquitos and interpreting benign stimuli (e.g., noise, movement) as potentially threatening.

And their history tells them that they need to be ready to respond, because nonresponse can be the difference between life and death.

Now, this super-human radar setting may be periodically useful to a law enforcement officer…or a person sitting in a movie theater who hears the sound of a shotgun being cocked. But it can lead to malfunction in daily living – at a big box store, at work, sitting at home. This person’s responses to common situations are often disproportionate to the actual threat probability. People around them might view them as over-reacting or may start tip-toeing around the person’s “temper.”

The tragedy of this is that the individual with PTSD – as well as their friends, family, and colleagues – often have no idea what’s really going on, which results in the individual with PTSD feeling “other”…disenfranchised from society…standing on the outside looking in.

And let me assure you: living a life with a threat-management radar set on high sensitivity is exhausting (and unpleasant). This, unfortunately – but understandably, leads many individuals with PTSD to seek relief from the constant barrage of noise and movement and threat – whether through substance use, ‘leaning into’ threat by engaging in risky, adrenaline-fueled behaviors, or any other behavior that soothes them and allows their mind to escape and rest.

I explained all of this to Michael, and he was dumbfounded that someone could put words to a reality he’s been trapped in for years. I told him that it’s important that he starts taking mental inventories of the various stimuli coming at him at any given time – the radio blaring, the drivers cutting him off, the firetrucks blasting by with their sirens on, his son trying to talk to him, etc. Michael needs to not only take a conscious inventory of incoming stimuli, but he needs to actively manage stimuli (e.g., turn off the radio, tell his son he’ll talk to him when they get home). And on the days that he doesn’t succeed at his stimuli inventory or managing incoming stimuli, he needs to make conscious decisions about what he can and can’t adaptively do at the moment. (For example, by the time Michael walked in the big box store and encountered the greeter, he was already perspiring and tight-chested. It was unlikely that he was going to handle any other hiccups well.)

To be clear, I’m not suggesting outright avoidance, as avoidance can be the death-spiral of PTSD. Rather, what I’m suggesting is that strategic adaptations are not only wise, but can ensure maintained functionality. I’d rather Michael start going to a different, calmer big box store than end up in jail for assault or murder. I’d rather that another of my patients sets limits with his wife on when he can or can’t adaptively have a conversation, as opposed to ending up a divorced alcoholic and absent father.

Today, Michael is working on taking continuous mental inventories of his surroundings, setting limits when feeling overwhelmed, communicating these needs and strategies to his loved ones, and not seeing every situation or person as a threat. Michael is still a work in progress, but ‘progress’ is the operative word. Michael doesn’t spend as much time today perseverating on beliefs that he’s “crazy” or beliefs that he should forever be alone to protect others from his “crazy.” The world may still feel like a threatening place to Michael, but now he understands and can articulate why – which makes him feel a little more in control of his world. At his last appointment, Michael told me that he started opening his blinds every day, that he hung up motivational posters in his home gym, that he got a flower for his house, that he started having light saber wars with his son, and that he started dating a woman – despite nagging (but increasingly quieter) beliefs that she’ll eventually reject his “crazy.” Michael is now living – one little step at a time, but by god, he’s living.

Joye Henrie, PhD

September 2017