First Things First

Ron Johnson emotional maturity, Feelings, grief, men's issues, mindfulness, Self-Awareness

Over the last few days I have had the privilege of visiting with several men who presented with complex situations in their lives:

  • Sam is in the midst of an extended legal/court/attorney situation where there are problems with his wanting to have joint custody with children and a fair settlement with his former wife regarding their joint property in addition to her reportedly violating several court orders regarding money and custody. Oh yes, he weighs 300-plus pounds and would like to lose weight. He admits to having no friends
  • Jim is a professional person and good at his profession but quite dissatisfied with his current position and seeking to change positions. Additionally, he is in a long-term, largely unsatisfactory marriage with someone who has not contributed anything to the family income but has used thousands of dollars of their joint account to fund several failed businesses. Jim also faces some challenges with contacts with his two adult children and his grandchildren
  • Ben is quite overwhelmed in life, so he tells me leading to a “breakdown” that he had over the weekend. He just “can’t get all done that needs to be done” and he falls into despair, depression, anxiety, and occasional anger as he attempts to migrate through these challenging waters. He is in graduate school, a couple classes being very demanding. He is working about half time. He has a wife and house. And he works a bit with the family business. Additionally, he will be taking a drug test soon due to his profession and has given up his daily dosage of pot to pass the test, which increases his anxiety.
  • Mack has been dissatisfied with his job for some time, mostly because his subordinates and co-workers are not as efficient and can’t seem to take his directions. He has had some trouble with his girlfriend. As a result he has been anxious and irritable
  • Paul is a professional person who has found himself in a position of making a lot of money but not being satisfied with the work, which used to be quite rewarding. Additionally, he has been in an unsatisfactory marriage for many years. He admits to having no friends.
  • Peter, a pastor, has found himself in his retirement under a huge burden of debt, much of due to his lifelong tendency to say “yes” to his wife on buying and traveling. He wants to be in the pulpit again but at his age, this seems impossible. He has great trouble with his computer in order to get some kind of exact accounting of their indebtedness and payment schedule.
  • 40 years ago I was in a dilemma of having financial, professional, and interpersonal challenges in the midst of some very important things that I needed to for my kids.

 

I have seen many people with similar dilemmas during my years of practice, almost all of them men because I just see men in my practice. In all of these cases these men have felt overwhelmed in some way and unable to progress through the complexities of their lives. I have often found that it is valuable for me to help these men do “first things first.” But what does that mean? Does it mean having a list to go through every day following the necessary things? Does it mean giving up on one or more of these challenges? Does it mean complaining more?  Does it mean that the best way to cope with these challenges is to engage in some kind of addiction? None of above. It means doing the right thing. Whatever that means. Maybe I can help these men find ways to do the right thing by doing “first things first.” This means discovering what is most important to do and finding a way to do it.

 

What is most important?

This is the first and most important question to answer, but discovering what is most important is not always easy to do. It is not easy to do because there is always a good deal of emotion related to the many things that a person feels the need to do. Sometimes, people have fallen into necessities and opportunities without thinking clearly, and as a result have bitten off more than they can chew. More often, things just happen, sometimes from oneself, sometimes from someone else, and sometimes from circumstances themselves. We all felt the pressure of Covid restrictions and associated fear for three years running, and no one was immune to Covid and the fears associated with this disease.

 

Making a tally of what needs to be done is the first task. This might be as simple as writing down the things that require attention or numbering them in your mind. The difficulty of this procedure is that if you “hold them in your mind,” you will likely fall into some kind of anxiety or anger that is not helpful. Better, is for you to write these things down, leave the list alone for a while and then look at it occasionally for a few days. Writing a list may relieve your mind a bit. When you fall back into feeling overwhelmed and worried, you can say to yourself something like, “I’ll find the right thing to do and then do it? In the meantime, you need to muse about how important each of these things is. You might discover that something big isn’t really important while something small seems to be much more important. You might discover that something that looks like it will take a lot of time might be really important or not really important, whereas something that might take you minutes is important or not so important. You don’t decide these things. You discover them. If you approach this process of looking at what is important, you will discover that something needs to be done today and something else doesn’t really need to be done at all. Furthermore, you might discover that what really needs to be done is something that you really don’t want to do. That can present a challenge because this process is discovering the right thing for you to do is difficult

 

Doing the right thing

How do you decide what the “right thing” is? You don’t “decide.” You “discover”. What in the world does this mean? It means what I just said:”

  • You think of all the things you need to do
  • You write them down
  • You leave the list alone for a couple days
  • You then look at it occasionally
  • You note how you feel when you look at each item
  • You discover that one or two things stare you in the face, like saying, “I need to do this,” perhaps, “I need to do this whether I want to do it or not.”
  • You grieve. Really?

 

Yes, really. You grieve. Deb and I wrote a whole book on grieving, The Positive Power of Sadness, in which we discussed the centrality of grieving. We talked about “big sads,” i.e. things that were terribly sad and “small sads,” things that were difficult but not terrible. So, when you discover (not decide, remember) what you need to do, you will need to grieve what you don’t do. Or, when you do something that you have discovered to be really important, you will see that you can’t do something that you might really want to do but isn’t as important to be done, at least at this moment of time in your life. This grieving, i.e. just feeling sad, is essential if you are to proceed with doing the right thing. There is a tendency, especially for people of a certain personality type or temperament, to “re-think” what should be done, but this is usually a delay tactic that your brain conjures up to prevent you from grieving. Your brain would much rather that you be somewhat happy doing nothing than doing something that you don’t want to do that really needs to be done. This is a place a lot of worriers find themselves: stuck in hopes and dreams but not in reality. Hopes and dreams are wonderful, and I am all for them, but there comes a time when you have to discover what the right thing to do is.

 

You will not be successful in getting advice from friends on what you should do. You might have people in your life that think you’re lazy or work too much or don’t work enough. They also have their own values, and hence things that are important to you might not be important to you. So, if you seek counsel from friends, make sure you say that you just want to talk, that you don’t want their advice.

 

Then you do something. And, as has been said by many fine and wise people, you will be right or you will be wrong. More likely, you will be mostly right and slightly wrong. You assess what you have done and it will soon be obvious: I did the right thing, the wrong thing, or a bit of both.

 

So what happened to the guys I talked about?

  • Sam has discovered that he needs to fight the good fight for joint custody of his children. All else, including his weight, smoking, and drinking need to be tackled at another time. He simply has too much stress with the kids/custody thing to put any effort in correcting his diet and habits.
  • Jim quit his job, found a different position making a lot less money, and moved out of town. He just emailed me, and I was glad to hear from him because when I last saw him almost a year ago, he was pretty stuck. I hope he can now face his marriage and find comfort in what he discovers there.
  • Ben has decided that he has to focus on finishing his degree, which primarily means that he has to put the time into doing this very difficult course even though he would much rather do something else. He told me he has only a month to go before the course is over and he will be putting all his effort into doing it. His marriage, his drinking, his pot, and all the rest will have to rest.
  • Mack has found a way to accept that he is smarter than the people he works with but does not have a feeling of superiority. He has found a way to look at his work knowing that he probably will eventually need to have his own business (he has some experience), but now is not the time. His girlfriend is now in therapy and they are better for all the changes they have made
  • Paul is a guy I’ve just seen for a month or two. The last time he came in to see me, he said that he was feeling a bit better, that he has begun to have a sense of who he is and how he can mature emotionally. His job, money, and marriage have not changed, but his perspective has.
  • Peter remains pretty stuck in his situation. He yet focuses on his medical conditions and those of his wife, frankly because it is easier to do than focus on himself and what he needs to do. He did say recently that he had a new way of looking at his marriage, i.e. to look at what his wife felt rather than what he thought. I hope for more maturity.
  • When I focused on my kids, i.e. finding a way to have joint custody, I felt better, and the other matters of my life slowly and consistently improved. But that is a short answer. We need a cup of coffee and a conversation to hear more.

 

 

 

I Want to Be Tested

Ron Johnson Uncategorized

I am somewhat in the testing business. No, I don’t test for Lyme disease or cancer or most things that are medical in nature even though most physical and medical ailments have an important psychological origin. In fact, I actually do a fair amount of testing in psychological matters, sometimes personality features, sometimes diagnostic features like depression and anxiety, and more than anything neuropsychological testing. Until recently, about 30% do my practice was in the business of these kinds of testing, but my style of testing is substantially different from my psychologist colleagues and very much different from a psychiatric evaluation.

I want to tell you what I actually do with a neuropsychological evaluation, which I will do a few lines later, but I want to explain the “I want to be tested” title of this blog. This title is meant to identify what is all the rage in society lately, namely being “tested” for everything from warts on your fingers to some kind of psychological disorder. This craze of a desire to be tested is partly due to the medical community selling its wares as exact and more largely due to people’s desire for some kind of exact diagnosis for what ails them in life so they can then hopefully find some exact treatment for this ailment and find some kind of cure. You might know that I did a blog a few years back entitled, “I Want to be Sick,” in which I dealt with the desire for people to find some kind of exact psychological diagnosis and some exact treatment for some exact cure. I proposed there, and I propose again here, that there is no exact diagnosis for anything psychological, not exact testing for it, no exact treatment for it, and certainly no exact cure. I call this the “magic of psychotherapy” as if you could come to me, or to any therapist for that matter, find out what is “wrong” with you (or the person you’re living with, more likely), and then find some exact treatment for this thing that is wrong. No such thing exists.

But the desire for testing for exact diagnosis, treatment, and cure remains secure in American society. Some of the experiences I have had in my office with this looking for the magic bullet include:

  • A man who was found to have a certain kind of cancer, went through treatment for this cancer (radiology) and was disappointed that his oncologist said that they would have to wait a “couple of months” after the radiation to determine whether the treatment was successful. He thought he should have an MRI, a CT scan, or some blood test to determine for sure that his cancer was cured or was not cured. No such test exists. He was disappointed that the doctor said that they would just see how he was doing and then determine whether they needed to further radiation.
  • Many, many people come to offices like mine seeking to be “tested for ADHD” thinking that there is some exact test to render an exact treatment and exact cure. There are no such thing. There are self-report or parent-report “tests” that you can find on the internet. There is one test, PASAT, that is a “continuous performance” test that can be helpful, and there are some DVDs out that may work. When I have someone come in for “testing for ADD,” I do a large battery of tests including IQ, neurological, and personality tests and try to arrive at a diagnosis.
  • A young woman is “very concerned” about her husband’s driving because he once turned into the wrong lane and ran a stop sign at another time. I actually had done a large neuropsychological test battery previously and found very little of significance. She wanted some kind of concrete evidence of something being wrong with his brain.
  • I am unfamiliar with most medical tests, like blood tests, MRIs, and CT scans, but the general understanding is that these tests are way over used and very expensive. Even blood tests do not indicate some kind of exact finding. For instance, some people can come up very high on cholesterol but show no signs of heart problems
  • I just read that there is “zero evidence” that mammograms and colonoscopies are effective in accurately identifying dangerous cancer, this coming from Dr. Zorba who is on local NPR and has a regular spot in the local newspaper.
  • It was valuable for me to be tested for Lyme disease, get an exact treatment, and a quick cure. I had previously contacted a clinic who said I would need to do a $1500 evaluation given my symptoms, which were primarily fatigue. I found a local group that did my Lyme test for $68, which by the way, would have cost me $300 at a medical clinic.

Deb and I regularly administer a rather large battery of personality tests, some of which we have created, and some formal tests that others have created. We find the results of this kind of testing very valuable in understanding people, primarily their normal personality characteristics, but even this testing is not exact and sometimes we find that the individual’s perception of him/herself is not what they showed on the test or what we think of them. There is the “gregarious introvert” who is introverted by nature but well-spoken, just as there is the “shy extravert” who is outgoing but shy in the sense of a bit unsure of him/self.

The testing that we do find helpful, if it is accurate can assist people in valuing their basic nature and avoid the self-critical elements of most diagnoses. I just saw a man who is a well-spoken introvert among other personality characteristic who has erroneously been diagnosed as “schizoid personality disorder” or “avoidant personality disorder” where in fact the combination of his personality characteristics is introversion, analysis, and rational thinking. Indeed, he has difficulties, particularly social and intimate difficulties, but these can be understood as “a strength to a fault.” Introversion to a fault is hiding, but introversion by its nature is quality, perception, and privacy.

So, if you want to be “tested” for something, use caution. For most diseases, testing is only partly valuable. In psychology testing for ADHD and many other so-called mental health disorders, is approximate at best. More importantly, look at your strengths, like introversion or extraversion and see that you may being operating from something “good but good to a fault.”

The Basic Anxiety in All Men

Ron Johnson addictions, Development, emotional maturity, Feelings, men's issues, mindfulness, Self-Awareness

Since my practice is composed of entirely men, I frequently hear similar things from these men, and surprisingly from men of very different ages. I have come to believe that the central ingredient that men where when they get distress in some way is some form of anxiety. I will discuss the various faces of anxiety in this blog a bit. We will also talk about the secondary effects that these other “faces” of anxiety cause in their lives. I want most importantly to identify what I think is the basic building block of this anxiety, which is not anxiety itself but rather a very important element of manhood. This is not something wrong with men, nor is it something wrong with women or with society in general. We want to look at the causes of men’s anxiety and most importantly look at what can be done to reduce it to zero.

The faces of anxiety

  • Anger. This is, of course, one of the most obvious challenges that most men face. We tend to get angry too easily, speak too loudly, yell and scream, or, God forbid, become physically aggressive in some way.
  • Avoidance. This is the second most common thing men do when they are anxious. If they don’t yell and scream, they go into the man cave, whether that is a real physical place or whether it is just sitting silently on the couch or in front of some kind of screen.
  • Addiction. This is the third most common form of men feeling anxiety without an understanding of what to do about it. Addictions can be chemical or behavioral. Chemical addictions include marijuana, alcohol, or script drugs. Behavioral addictions include gambling, some form of excessive sexual expression, overeating, working too much, not working enough, or playing video games.
  • Physical and medical abnormalities. This would include the simplest headache to the serious heart attack or cancer. With little doubt, anxiety aggravates a man’s inclination to some kind of physical abnormality. Not every man will have headaches, nor will everyone have heart attacks.
  • Dishonesty. Dishonesty is usually not in the form of stealing or outright criminality but rather hiding some activity or outright lying about some small thing in life by a man who otherwise might be a man of quite good character
  • Depression. I don’t not use the term depression, like anxiety, as a “diagnosis” of a mental disorder but rather the extended realm of a man’s unhappiness. A man can become increasingly unhappy with one or more elements of his life, like work, relationships, play, or life in general. They all stem from anxiety.
  • Helplessness. There is a helpless component of depression, but the more serious helplessness is when a man feels that he just can’t do what he knows that he should do. As a result many men work all the time, while others do nothing at all.

Statements that men make regarding their anxiety

I use the term anxiety with care because it don’t see anxiety as a mental disorder that needs to be treated. I see it as a result of men not knowing who they are, how they feel, how to speak, and what to do about the causes of anxiety. Nevertheless, I have heard the following from various men:

  • From a very successful professional man, 55, when I asked him what he felt when he thought his wife might be mad at him: “terrified,” he said
  • From another successful man, 65, when I asked him what he felt when he thought his wife might find out something he did that she didn’t approve of: “terrified.”
  • From many men including a man of 32, many men in their 40’s, and some in their 20’s:

“I feel a constant feeling of anxiety in my stomach (chest, back).”

  • From many men of various ages: “I feel some kind of anxiety every time I make any decision. This could be turning my car into an unfamiliar driveway or deciding what to eat at a restaurant.”
  • “I might have some kind of death fear. I think of the possibility of my dying all the time.”
  • “I think I made some dumb choices in my early years that still cause me anxiety, almost like I think I can turn the clock back and make different choices.”
  • For some parents: “I can’t seem to shake the fear that my son will die for some reason>
  • “I am afraid that they will discover some mistake I made at work and demote me or fire me.”
  • “I’m afraid that they (whoever the unknown “they” might be) might discover that I am a fraud in some way.”
  • “I am afraid that will be impotent in bed with my wife.”
  • “I am afraid that I am a failure in life, despite my apparent success and accolades.”
  • “I just don’t know what to do so much of the time. This could be if to take a shower, go to work today, or tell my wife that I love her.”

The causes of male anxiety

This is the most important thing I have to say about anxiety, and it leads to our final discussion: What can we do about it? The essence, the foundation, the cause of male anxiety is around the concept of responsibility. Every man feels a kind of immense load of responsibility in life, no matter how old he is. This feeling of undue responsibility starts in adolescence, develops in his 20’s and accelerates in his 30’s as his responsibilities become larger and harder to manage.

This concept of felt responsibility is very hard for me to communicate, especially to women, and certainly to most men because they don’t think about it consciously, but the feeling that “I have to do something, something important, something significant, something real,” is always there in some form. President Truman said it right when he spoke of the responsibility he had as President: “The buck (bucket) stops here.” Most men are not presidents but they often feel the burden of responsibility

  • Adolescence is difficult for everyone, boys and girls because this is a time of transition from the freedom of childhood and the freedom of early adulthood, which is what adolescence is. There are the general challenges of adolescence for guys like what to do with emerging sexual interest, academic interest (or disinterest), and some initial thoughts about one’s ultimate vocation. There are more specific challenges that every boy faces, like the adolescent who doesn’t like reading in school, doesn’t like sports, really likes music, or can’t find anything that he really likes. However good at one thing, like reading, sports, or music, he feels the insecurity and inferiority associated with not being good at something else.
  • The 20’s is particularly difficult because the guy is now in college or the world of work trying to find his way. He also has to deal with the challenge of how to relate to women (or to men if he happens to be gay). Marriage used to come during the 20’s but many men forestall marriage for a live-in arrangement that can be complicated by pregnancy, the partner’s children from another relationship, or the desire not to have children. All of these responsibilities are on the guy’s shoulders with no one really able to help him through these difficult years. A good deal of addiction begins in the 20’s, whether chemical like alcohol or pot or behavioral like promiscuity, video game-playing, or gambling.
  • I think the 30’s is perhaps the most challenging time for men. Some men I see haven’t been married and desperately want to do so. Many men are in the wrong profession, perhaps something that makes them money but not happiness. Marital struggles usually are at their height at this time of life, and children are now a dominant part of the man’s life.
  • After the 30’s a man’s responsibilities continue to grow including vocational, relational, financial, geographical, and ultimately personal. Few men migrate these waters without some form of addiction, avoidance, and anger. Suicide is four or five times greater for men than for women, often because of the burdens that they have without any guidance.

All of this accelerating responsibility and the results of these responsibilities lead most men to a deep-seated feeling of anxiety:

  • Do I want to stay married to the woman I married 10 or 15 years ago?
  • Do I want to stay in the job that makes me money but I hate?
  • Do I really like my children (of course, I love them)?
  • Do I like my house?
  • How do I deal with the fact that the electric doesn’t work in the bedroom?
  • How do I deal with my gaining weight and all that goes with it?
  • Am I having any fun
  • How do I deal with my addiction(s)?
  • Where’s the guy who could help me navigate these rough waters?

How to deal with the anxiety I feel regarding all my responsibilities and questions?

  1. Admit to it. You can’t get to the bottom of feeling anxious, much less cure it without first admitting that you feel overwhelmed
  2. Observe that you either work too much trying to stave off your anxiety or avoid your responsibilities
  3. Note the addictive tendencies you have: eating, playing, working, drinking, gaming, talking, or perhaps the more serious addictions like alcohol or promiscuity
  4. Find someone to talk to. This should most certainly be a male, perhaps a therapist, perhaps a wise uncle, perhaps a clergyman. But not your neighbor, your brother-in-law, or the guy at the bar. You need someone who understands and can help you through this crisis of feeling overwhelmed
  5. If you have a significant other in your life, tell her (or him) but be careful to keep her from advising you. A good way to develop a later intimacy is to learn to talk about yourself and feel vulnerable. Then you will be able to listen with as much love as has been rendered to you by your loved one.
  6. Avoid anxiolytic medication. It is addictive. More importantly, it covers the symptoms but doesn’t treat the problem. The problem is a very male-centered thing of feeling responsibility for everything and everyone.
  7. Begin to notice that you feel better, less anxious and more content. The more you admit to your feeling of anxiety and all the other steps along the way, the better you will get in talking and reducing your anxiety.