Survivor: The Isle of Holiday Celebrations

Television etiquette experts recently suggested routes to avoid potential family conflicts at our upcoming holiday celebrations. I had to laugh--my extended family celebrations don't end UNTIL there's a conflict a-brewing, just hopefully not involving firearms or flying crockery. (My mother still publicly mourns the death of her favorite gravy boat each time we sit down for Thanksgiving dinner). The (clearly) more civiled pros offered ideas like "focus on what the family is grateful for this year" or rehearsing conversation-diverting remarks designed to thwart Aunt Rita's criticism of cousin Jordan's green Rasta locks from evolving into a full-on family throw-down. "Avoid contentious topics" was another gem tossed out by the Etiquette Mafia. No talk of religion, politics, or sensitive social issues once the bird is on the table. Yeah, good luck getting my clan to sign on to that plan. What are we left with: should baby Jessica be enrolled in the Montessori school or the arts academy that requires child AND parent interviews? My family has had more heated debates over loyalty to the Sox versus the Cubs, or fake vs. real Christmas trees than about any political stance. Seriously, we suffered a decades-long cutoff when my uncle challenged my aunt's claim that Frank Sinatrs was the finest singer who ever lived. (To this day, I experience searing pain behind my eyes at the first bars of "My Way.") I can't imagine the stares of incomprehension I'd receive if I tried to whittle down the topics of "acceptable" dinner conversation. That act, in itself, would guarantee a few choice hand gestures in my direction. But, before you go thinking my family is a bunch of boorish, backwards heathens without the sense to come in out of a snowstorm, I maintain that we are also fiercely devoted to our -- and each other's -- kids; always willing to bring a meal or run an errand for a sick sister or nephew; and slavishly committed to a range of sentimental, heart-tugging rituals and traditions that brand our family as uniquely our own. This holiday season, I've decided to make one change, and like the church hymn says, "let it begin with me." Rather than dictate others' discussion parameters, or take responsibility to diffuse an insult from hitting its intended mark, I've decided to approach this year's festivities with an energy of openness. All the rules and recommendations, ultimately, come from a place of fear and anxiety, and we all carry enough of that baggage already. Sure, gathering around the table is akin to an open invitation to fisticuffs in my families' domiciles, but I doubt I help the process when I approach my family girding for the worst. I can't change them, and I'm not respecting their autonomy when I try to run interference. But perhaps, stepping across the threshold with an air of positive anticipation and joy at our motley gathering, rather than adopting the protective stance of a defensive lineman, may alter the course of the evening's energy for the better. Still, I'll probably choose the seat closest to my older brother: his bodybuilder girth is good cover if the salad plates go flying.

The Scars of Self-Injury

Few of us can imagine inflicting the kind of physical pain and damage that self-injurers inflict on their own bodies. For many people, the concept of self-injury is as foreign as imagining picnicking on the moon. But in our counseling rooms, we see the reality of self-injury far too often. Cutting, burning, poking, slapping -- these violent behaviors can be regular occurrences in the lives of some of our clients. What would drive someone to hurt him- or herself? Isn't self-injury just a bid for attention? Is there a difference between self-injury and suicidal ideation? Loved ones of those who self-injure struggle with these questions. And while the specific instigating factors behind one's self-injurious behaviors are as varied as the individuals themselves, some commonalities can be noted. People who hurt themselves often engage in an addictive-like relationship with this behavior. They initially find some sort of emotional relief -- either in the form of distraction or a sense of release from psychic pain -- from the harming behavior. Later, either due to a lack of appropriate coping resources, or the relative speed with which self-harm usually provides relief, the person continues to use these actions to deal with more distressful life situations over time.

Most of us can recall a moment of self-loathing or a period of hopelessness in our histories. For those who self-harm, self-hatred, a sense of continuous personal failure and a fear of relinquishing the tool that has brought them relief are constant companions. And while the behavior can appear dramatic and attention-seeking, self-injury is rarely a casual choice by the individual. Due to the addictive nature of the dynamic, someone who hurts himself can quickly become reliant on this maladaptive coping skill. We can understand someone getting a sense of relaxation, increased well-being, a distancing from their problems, by drinking alcohol. Tobacco smokers often report feeling instantly calmed and/or energized, not just from that first puff, but even through the rituals of igniting their lighter or smelling the sulphur of a dying match. Similarly, self-injurers can experience a lowering of stress via the habit of self harm.

People who self-injure are at a higher risk of suicide, not only due to their struggles with depression and hopelessness, but because the risky behaviors associated with self-harm could inadvertently creat a risk to one's life, even if she isn't intending to end her life. Self-injurers have mistakenly nicked a major vein or artery, causing them to hemorrhage before help could be obtained. Some wounds can get so infected they can lead to sepsis, a potentially life-threatening blood infection.

The treatment for self-injury almost always involves a holistic approach, including individual therapy, medication, group therapy to teach skills like stress management, frustration tolerance, emotion regulation and appropriate self-care. Centering skills like mindfulness and meditation are other helpful tools that can help clients to learn to manage their painful life experiences without resorting to self-harm. Occassionally, hospitalization is necessary to ensure an individual's continued safety.

Self-injury is always a sign of deep distress and a loosening of one's ability to manage their pain in effective ways. But clinical and medical intervention can help these clients regain control of their lives, and offer a path of hope and recovery into a life marked by positive self regard, rather than haunting scars.

The Gifts in Gratitude

November is marked by colorful leaves, falling temperatures, an abundance of turkey-related products at the supermarket and the varied modes giving thanks takes. Recently online, I've seen groups of people daily enumerating the things in their lives for which they are grateful. From sentimental to sublime, folks are counting their lucky stars for their spouses, a warm home to return to after a busy day, a full refrigerator, health and autonomy, even a close parking space at the crowded Target on a rainy Saturday. These sentiments are not meant to be a Pollyanna approach to dismissing or minimizing the suffering that goes on in our world everyday. Rather, they are a reminder that there is, indeed, a yin and yang to our lives, times when we are deep in shadow countered with periods of lightness and grace. Being conscious of our blessings will never negate the losses and sadness that mark some days. But those bright spots do provide us with an opportunity to connect with grace, to be reminded that good and love and hope are around us if we choose to look for them. Some days we may need to look long and hard to find the glimmers of sweetness. They may appear hidden deep in the loam, barely visible save for the one small glint that we catch only if the light is right. Or they may appear as evident as a gold star on a spelling test. Resilience is found in remembering to grasp the good, risking the reaching. By training our eyes to view life through the lens of gratitude, we discover, like the many-hued leaves at our feet, gifts unending.

Hiding in Plain Sight

My wife took our son Halloween costume-shopping over the weekend. They kept me in the loop, messaging me photos of themselves in all kinds of getups: as Wild West Cowboys, chefs in aprons and torques, spooky witches complete with brooms and black hats. They seemed to favor the masks, though-- political figures, celebrity faces, spooky goblins. In the pictures, the masks were so detailed and enveloping that I didn't know whether my wife or my son was the model. He finally settled on a creepy clown mask, which he customized at home with gruesome splashes of fake blood. In his mask, my son could be anyone, a stranger I'd never know or a neighbor down the street. Kind of unnerving to think about. But not all that different from the masks we wear everyday. Whether its the confident face of a businessperson as we enter a sales meeting, or the calm expression we adopt to ease the tantrum of a wailing child, we may adopt different faces to fit the range of experiences that fill our day. And certainly, many of those masks are truly functional, moving us forward or producing a benefit in the end. When we approach our child's teacher to discuss a failing grade, we're most likely to experience a positive outcome from that interaction if we approach the teacher with an expression of openness, seriousness and concern rather than with the outrae we may be feeling beneath the surface. Or if we are considering asking the boss for a raise, we're better primed for success if we enter his office with a pleasant affect and energized demeanor, even if we are fearful about the rumors of layoffs or frustrated by a coworker not pulling his weight. But, just as easily, we may find ourselves adopting a mask that holds us back from taking risks, connecting, or speaking our truth. I've seen couples "put on their best face" for each other, trying to avoid painful losses or minimize the chance of conflict. Similarly, I've worked with teens whose masks of bravado and insolence hide the deep pain of rejection and the fear of failure. But only through authenticity can another truly know And empathize with our experience. We may think its kinder to "smile and nod" when asked for our honest opinions, but we may actually be communicating subtle disrespect by giving someone less than our real truth. Manners, grace and politics will always have their place. But showing the world our true selves is a courageous choice that can bring us closer to one another, and build connections with the potential for deeper intimacy, for a truer knowing of each other and ourselves. That's a treat that will last through countless seasons.

The Pursuit of Happiness

Our practice resides in a part of Chicagoland with many benefits: beautiful homes, excellent schools, relative proximity to downtown attractions, vibrant shopping and dining options. But alongside these positive attributes comes, at times, a focus on material success and financial, academic and occupational achievement. Although I am a proud social worker and strong believer in equality and parity in opportunities and options for all folks, I am far from a Marxist. I believe in capitalism, self-responsibility and working hard for our goals. However, I am consistently faced with young clients struggling beneath the burden of the achievement-oriented philosophy so rampant amongst most of America. In some of the communities I serve, kids in middle school are already more aware of the impact of ACT scores on their educational opportunities than I was when I took my ACT at 17. I've heard young clients describe anxiety and somatic symptoms created by a belief that taking less than 4 honors or AP classes will doom them to a second-rate college. And, sadly, I have counseled some parents who have vehemently defended their focus on Junior achieving straight As as a reflection of their inherent parenting responsibilities. Perhaps my perspective is a function of my age, or of the current prediction touted by the media that no longer can future generations expect to do better socioeconomically than their parents. But it seems to ring true, time and again, that academic and professional achievement is not the only road to a happy, fulfilled life. Should a child choose to be a clerk at the electric company rather than an electrical engineer, is he or she doomed to a life of physical and emotional squalor? Or is it possible that a life rich with rewarding relationships, a solid spiritual life and a desire to improve the world can be a path just as desirable? Indeed, no parent looks forward to their children struggling in adulthood. But any counselor can recount ad nauseum story upon story of people whose emotional,spiritual and relational struggles were as devastating to them as living on a paltry paycheck. Our responsibilities as parents includes not only offering our children the finest educations and career exploration opportunities we can find, but also to guide our children into developing the life skills of relationship-mending, spiritual development and emotional resilience. I'll admit, it's easy for me to adopt a laizze faire attitude toward my child aiming for the Ivy League. After all, when my adolescent son scored a 50% on his biology exam, his (completely non-ironic) response was, "Hey, that's halfway to 100%!" Still, I'd like to think that, even if my child dreamed of a career in the operating theatre rather than the Broadway venue, I'd still try to communicate the importance of less-material trappings as being vital to his happiness. Achievement may be one road to happiness; our children can benefit from being shown that other paths can lead to their own happy ending.

Come Together...Right Now

The Beatles were onto something with that idea. Coming together as a community, for a common good or a shared goal, creates benefits that go beyond the efforts extended by the group. Feeling a sense of belonging, of having a "tribe" helps us feel less isolated, lowers anxiety and stress, and provides a sense of identity and purpose. Community can be found anywhere; indeed, expanding our definition of community allows us a more unique and broader menu of opportunities to connect with our fellow travelers on this planet. Some communities are more formal and structured, requiring dues or membership, like a union, a sorority or the health club. Others orbit around a shared interest, like a book club or knitting circle, and others around a shared purpose, including a church's lay ministry team or a group of Meals on Wheels volunteers. Even our workplace can be a place of community, despite it's potential politics and perhaps "bottom-line" mentality. Who recalls the early days of their working life, when the "newbies," often the younger folks in an organization, would regularly meet for beers after work to offer each other support and attempt to navigate through the confusing, overwhelming and sometimes frightening new world of corporate America? Feeling like other people "get" our experience helps us feel known and seen, and therefore more empowered in our lives. Now, I'm the last person you'll see at a PTA meeting, and my job is draining enough that I often balk at opportunities to volunteer that require more than writing a check. But I find myself smiling more through my workout after I use a few minutes pre-elliptical machine to chat with Joe and Bob, two 70-ish retirees who frequent the park district gym the same hours I do. Bob will fill me in on his grandkids' latest sports achievements, and Joe will gently rib me about STILL not following up with his financial advisor to ensure my retirement is well-funded.("You'll be us before you know it!" he says, curling s thumb in his and Bob's direction. "Hopefully with more hair!" I tease back, nodding at their bald pates.) I never see these men anywhere but the gym, despite our shared commitment to some level of fitness and the likelihood that we live in the same town and drive the same streets. But instances like these are potent reminders of how small, seemingly inconsequential connections can bring a sense of "sharedness", of how intertwined our lives truly are, if only we adopt the lens to SEE them that way. This is an age of Skyping and IM-ing, of quick tweets replacing long chats. Still, if we choose to open our eyes to the ways walking through the same door as another can highlight our "sameness", we can recognize that we are never really very far apart at all. The Fab Four were truly sages before their time.

Behind the Shadows

October brings thoughts of children in costumes, overflowing bags of candy, vibrant fall leaves, the crisp taste of apple cider. But October also commemorates a more ominous phenomenon -- this month is National Domestic Violence Awareness Month. The past decades have brought the reality of domestic violence out of the shadows and into the national consciousness. Most people know, or have heard of, someone who has survived domestic abuse, and movies, television, print and digital media regularly provide information or portrayals of family violence. Services for survivors of domestic violence exist in most metropolitan areas, and shelters for victims are present, though sometimes purposely invisible, throughout the country. But despite the increased awareness of domestic violence, may people are unaware of the signs that domestic violence may be occurring in the lives of friends, coworkers, and loved ones. Following are examples of behaviors that signal the presence of domestic violence:

1. Fear of one's partner
2. Yelling, humiliation, criticism
3. Being forced to participate in sexual behavior against one's will
4. Physical abuse (including pushing, shoving, grabbing, restraining, slapping, kicking)
5. The THREAT of physical violence
6. Threats to hurt/limit contact with one's children, friends or family members
7. Attempts to limit one's contact with friends or family
8. Destroying belongings or property
9. Controlling the movement and freedom of a partner
10. Excessive jealousy or possessiveness
11. Limiting one's partner's access to money, phone or the car

These are only a few examples of physical domestic violence that can occur in relationships. Many others exist, and the emotional abuse that inherently accompanies violence can be so subtle as to be difficult for the victim to feel confident that emotional abuse is actually happening. Historically, women have been the main victims of domestic violence, but men and children can easily fall prey to this abuse as well. Violence is ALWAYS the choice of the person perpetrating it. But information and awareness of the forms violence can take can help us to identify this dynamic in our own lives or those of people we care about. Help is available through doctors, mental health professionals, law enforcement, and domestic violence hotlines and shelters, to name a few. If you suspect you or a loved one are experiencing domestic violence in a primary relationship, seek help. Visit the National Resource Center on Domestic Violence website at www.nrcdv.org, talk to your physician (who legally must keep your information confidential), a clergy person, counselor or trusted friend. Perhaps someday the month of October can be associated only with the joy of jumping in a pile of leaves, apple-picking and bonfires.