A Pound of Flesh?

 

I’m retired now, and my kids have long since passed the age when, even if I were so disposed, I would dare lay a hand on either them or their children. But of course I wouldn’t -parenting wasn’t like that in my family.

I suspect I rarely hung out in the Goldilocks zone in childhood. I was prey to all of the usual temptations on offer in a 1950ies Winnipeg, but it’s unclear to me just what things I would have to have done to require corporal punishments. I realize that sounds naïve, even all these years later, but my father was not quick with the hand. In fact, on the one occasion he resorted to it, he seemed more upset by it than me, his recalcitrant offspring. And anyway, I think it was my mother’s idea that he wreak some stronger retribution than she could inflict on me with her voice.

My mother was into noise, actually. I imagine I was a frustrating child for her and she would resort to yelling fits when things didn’t go well. Clearly I have a limited, and no doubt statistically insignificant data set when it comes to the effects of corporal punishment, but I would venture to say that I feared my mother’s mouth far more than my father’s hand. My mother’s facial expression bespoke rage, my father’s, though, suggested sorrow -betrayal…

But I do not mean to disparage either of them, nor to suggest that they meted out cruel and unusual punishments under duress -I’m sure they were well-intentioned. And anyway, anecdotal evidence is a poor substitute for well-designed research, so I was pleased to see a more recent attempt to summarize what has been learned about the effects of, in this case, corporally disciplining children: https://theconversation.com/why-parents-should-never-spank-children-85962 The article was co-written by Tracie O. Afifi, Associate Professor, University of Manitoba, and Elisa Romano, Full Professor of Clinical Psychology, University of Ottawa.

‘The use of spanking has been hotly debated over the last several decades. Supporters state that it is safe, necessary and effective; opponents argue that spanking is harmful to children and violates their human rights to protection.’ But despite how common and widespread its use, it has been banned in 53 countries and states throughout the world. ‘The research clearly shows that spanking is related to an increased likelihood of many poor health, social and developmental outcomes. These poor outcomes include mental health problems, substance use, suicide attempts and physical health conditions along with developmental, behavioural, social and cognitive problems. Equally important, there are no research studies showing that spanking is beneficial for children.’ And, indeed,  ‘An updated meta-analysis was most recently published in 2016. This reviewed and analyzed 75 studies from the previous 13 years, concluding that there was no evidence that spanking improved child behaviour and that spanking was associated with an increased risk of 13 detrimental outcomes. These include aggression, antisocial behaviour, mental health problems and negative relationships with parents.’ I suspect there were other things going on in both intent and degree that might have confounded these studies and led to the negative outcomes, though -apples are simply not oranges, and beating or assaulting someone is not the same as striking a buttock with an open hand as a way to deter an unwanted behaviour.

Of course, the researchers hasten to add that ‘this does not make parents who have used spanking bad parents. In the past, we simply did not know the risks.’ I think that lets my father off the hook; I’m not so sure about my mother, though. It seems to me that it is all too easy to condemn corporal punishments, while ignoring –or, perhaps, paying less attention to- the other forms of discipline that, intuitively at least, might be expected to result in equally detrimental  consequences for a developing child. One of these, of course, is verbal haranguing.

I don’t believe that I was ever subject to verbal abuse, however. I was never demeaned, or insulted by my mother –just confronted with my miscreant behaviour, and anointed with the requisite guilt- but I can understand how it could get out of hand under different circumstances and with different personalities. I find that worrisome –alarming, in fact. It is a behaviour that could all too easily slip under the radar. Be explained away.

I recognize that parenting is stressful, and that we all come to it with different temperaments, different abilities to tolerate stress, and different support structures that could be called upon in times of intolerable tension, but I suppose that is just the point. I wrote about this a while ago: https://musingsonwomenshealth.com/2017/05/17/time-out-eh/

But I fear that it sometimes requires the patience of Job to stand-down enough to be able to socially isolate the misbehaving child with a time-out. It is clearly preferable to spanking, to be sure, but I still wonder if what precedes it may be just that verbal abuse it seeks to avoid.

So, given our human propensity to react unpredictably and often adversely to stress, what am I advocating? Well, I have to admit that I have neither the background, nor the temerity to suggest that I have any productive answers. But although the Conversation article I quoted above was focused on spanking –physical punishment- it contains some suggestions that I think would be applicable to other punitive modalities like verbal abuse and insults.

‘Research already shows some evidence that parenting programs specifically aimed at preventing physical punishment can be successful. Some evidence for reducing harsh parenting and physical punishment has been found for Parent-Child Interaction Therapy (PCIT), the Incredible Years (IY) program and the Nurse Family Partnership (NFP). Other promising home visiting initiatives and interventions taking place in community and paediatric settings are also being examined for proven effectiveness.’

I know –education, education, education… But sometimes education is merely making people aware that alternatives exist. That there could be support out there of which they may not have been aware -both with friends and in the community. Remember that African proverb: It takes a village to raise a child

 

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The Idea of Ideal

Just when you think that you have a handle on what you’re supposed to look like, just when you’ve lost the weight, dyed your hair, and even forsworn relaxing at the beach on your days off, they up and change it on you. And the worst part: you don’t even know who ‘they’ are so you can’t post something against them on Facebook. But fads are like that, I guess. You never know when somebody is going to start one. You never know when the train is going to leave the station -with or without you.

Fitspiration -a neologism presumably coined to inspire fitness- would seem to encourage not just fitness, but a particularly muscular form of fitness: brawny fitness. Not only should you aspire to being fit, but also to looking fit. Thinspiration, fortunately, is in decline -unless, of course, it is accompanied by visibly toned muscles that reassure anybody who cares to observe, that the wearer is healthy and vigorous. Just dieting can’t do that.

But as an elderly male, I have to be careful here. Presumably I represent the dark side of the equation -or more accurately, I am non-representative of the case at issue. I have observer status at best. And yet, as detached from the fray as I am, I can claim to have witnessed a similar phenomenon in my admittedly testosterone-sodden brethren. I am old enough (barely) to remember those comic book ads for chest-expander-springs that promised relief for thin, but otherwise healthy young men who were constantly having sand kicked in their faces by muscular bullies on beaches populated by attractive, and admiring young women. Laughable in today’s world, they nonetheless suggested that the route to popularity, and attractiveness, was a physical one. A buff one.

And it seems to me that this undue emphasis on muscularity -on power, if you will- is a seductive trope that is no longer gendered. There is no compelling reason why it should ever have been, I suppose, although I have to say that physical power is illusory. It is what those people actually in control -the Mafia dons, for example- hire to protect them. Not command them.

I am clearly a product of my era: a consequence of the prevailing Weltanschauung on offer at the time. I suppose I was conditioned by those around me to view muscularity as a marker of fitness in athletes -male and female- but neither particularly desirable nor realistically attainable in the average person. Some men, to be fair, seemed to flaunt burl as signs of their masculinity, but apart from avoiding them on sandy beaches, I did not feel overly disadvantaged. Of course, they out-competed me for women, but so did everybody else.

My point, if I have to admit it, is that I have grown used to muscularity in men over the years. It seemed a natural thing, I guess, not an ostentatious badge of physicality. But I find it interesting that the fitspiration trend in women has now been noticed by the scientific community, as I discovered in an article written by two PhD candidates, Frances Bozsik at the University of Missouri-Kansas City, and Brooke L. Bennett at the University of Hawaii for the Conversation: https://theconversation.com/the-ideal-female-body-type-is-getting-even-harder-to-attain-91373

‘By now, most women are probably aware of the discrepancy between their bodies and the impossibly thin women who appear on TV and in magazines. This disparity was first identified in a 1980 study that compared the body weights of regular American women to prominent media figures … The researchers found that between 1959 and 1978, average female weights in the general population increased, while the women appearing in the media were actually getting thinner.

‘This matters because, particularly for women, exposure to thinner bodies contributes to body dissatisfaction, which can worsen your mood and lead to lower self-esteem. Those who aspire to this ideal figure can end up engaging in negative behaviors like restrictive eating or purging.’

So, ‘One trend that has gained traction is “fitspiration.” These are images and videos that depict women engaged in workouts or poses that highlight particular muscle groups like the abdomen or buttocks. In promoting muscularity, these images seem to be promoting healthy exercise. But analyses of the text accompanying the images have found that they often include guilt-inducing messages that focus on body image (e.g. “Suck it up now, so you don’t have to suck it in later”). In fact, one study has shown that an overwhelming percentage (72 percent) of these posts emphasize appearance, rather than health (22 percent). And it’s an appearance that’s not only muscular, but also thin.’

The authors go further: ‘You might wonder: Isn’t it healthy that women are increasingly preferring muscularity? Studies have examined the impact of viewing thin and toned bodies, and have found that they have a negative impact on the body image of female viewers. Just like the previous studies on media images that promote thinness, seeing thin, muscular women can lead to a negative mood and decreased body satisfaction.’

I think the aspect of the fitspiration movement that concerns me the most is its emphasis on appearance rather than health. I mean, believe me, I’m all for beauty, but not if it is at the expense of well-being. Not if an inability to live up to some ideal female body form leads to dysfunctional consequences. Heaven only knows there are enough things out there to admire, without requiring membership.

I suppose I could be accused of cherry-picking, though, of selecting an article that just happens to align rather conveniently with my own apparent biases, but there are many other studies out there with similar findings -for example: https://www.tandfonline.com/doi/full/10.1080/10410236.2016.1140273 or https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.22403

And yes, although I try to remain objective, I find I am still conflicted about the muscular trend in women. Fortunately, in my circle of friends, their numbers are still too small to attract much attention -although I guess it’s quite possible that large muscles bulge unseen beneath an increasing number of coats and designer sweat shirts. Maybe, in fact, I should spend more time on beaches than I do. In truth, I’d love to see if sand-kicking has changed gender over the years.

Beauty is bought by judgement of the eye?

Isn’t it interesting how differently we look at things? How the same bridge crossed by ten people becomes ten bridges? How beauty is so subjective? So ephemeral? Just think of how Shakespeare opened his second sonnet: When forty winters shall besiege thy brow and dig deep trenches in thy beauty’s field, thy youth’s proud livery, so gazed on now, will be a tattered weed, of small worth held.

And yet to some, beauty -however evanescent- seems a prize worth having, no matter the sacrifice. It seems unfair that it should have been doled out to some, but not to others. There are cultures where the inequity of this disparity is taken seriously; there are countries where beauty is felt to be a right to which all should be entitled no matter their social strata.

So accustomed am I to my own cultural mask, I have to admit that I had not realized that Brazil was such a place until I came across an article in the Conversation that addressed the issue. It was written by Alvaro Jarrin, an Assistant Professor of Anthropology, at the College of the Holy Cross in Massachusetts. https://theconversation.com/in-brazil-patients-risk-everything-for-the-right-to-beauty-94159 ‘Brazil considers health to be a basic human right and provides free health care to all its citizens. […] In Brazil […] patients are thought of as having the “right to beauty.” In public hospitals, plastic surgeries are free or low-cost.’ But, ‘public hospitals remain severely underfunded, and most middle-class and upper-class Brazilians prefer to use private medical services.’

Jarrin feels there is a darker side to this medical largesse however, in that the surgeries are frequently performed by more junior surgeons, just learning their techniques (albeit likely under the supervision of more experienced surgeons as is frequently the case even in the USA).

He goes on to say, ‘Yet these patients, most of whom were women, also told me that living without beauty in Brazil was to take an even bigger risk. Beauty is perceived as being so central for the job market, so crucial for finding a spouse and so essential for any chances at upward mobility that many can’t say no to these surgeries.’

‘Plastic surgery is considered an essential service largely due to the efforts of a surgeon named Ivo Pitanguy. In the late 1950s, Pitanguy […] convinced President Juscelino Kubitschek that the “right to beauty” was as basic as any other health need. Pitanguy made the case that ugliness caused so much psychological suffering in Brazil that the medical class could not turn its back on this humanitarian issue. In 1960, he opened the first institute that offered plastic surgery to the poor, one that doubled as a medical school to train new surgeons. It was so successful that it became the educational model followed by most other plastic surgery residencies around the country. In return for free or low-cost surgeries, working-class patients would help surgeons learn and practice their trade.’

The author seems to feel that the reconstructive aspects of plastic surgery -techniques for the treatment of burn victims and those with congenital deformities, etc.- have taken a back seat to techniques geared to aesthetic enhancement, however. ‘Since most of the surgeries in public hospitals are carried out by medical residents who are still training to be plastic surgeons, they have a vested interest in learning aesthetic procedures – skills that they’ll be able to later market as they open private practices. But they have very little interest in learning the reconstructive procedures that actually improve a bodily function or reduce physical pain. Additionally, most of Brazil’s surgical innovations are first tested by plastic surgeons in public hospitals, exposing those patients to more risks than wealthier patients.’

As a retired (gynaecological) surgeon myself, I have to say that I take issue with the naive view Jarrin seems to have about the training of the resident surgeons he reports. After all, clearly it would be better for the young surgeon to learn techniques under the careful guidance of an experienced mentor, than to suddenly be expected to possess the required expertise once she has passed her exams. Indeed, a selection bias is perhaps equally applicable to the anecdotes Jarrin quotes to demonstrate his contention. But, in fairness, I may be guilty of an insidiously perverted form of cultural relativism myself: I see my own world even when it’s not…

Cultural relativism, first popularized in the early twentieth century, attempts to understand and judge other cultures not by our own standards, but by theirs. It is a contextually rooted approach that can be devilishly difficult to achieve. We are all inherently cultural solipsists; we learn customs from the cradle and mistrust or actively disavow any deviations from those to which we have become habituated.

Even beauty itself is fraught. What is beautiful? Surely it is an ill-defined shadow on a rather large spectrum, its position tentative and arbitrary, depending as it must, on time and measurement. Shakespeare knew that. We all know that… Or do we? Are there unequivocal, objective criteria that must be met, or are they entirely subjectively defined? Culturally allotted? Surgically assigned?

No one has defined beauty more bewitchingly, in my opinion, than the poet, Kahlil Gibran, a Lebanese-American writer and artist in The Prophet. When the prophet is asked about beauty, he replies:

… beauty is not a need but an ecstasy.
It is not a mouth thirsting nor an empty hand stretched forth,
But rather a heart enflamed and a soul enchanted.

It is not the image you would see nor the song you would hear,
But rather an image you see though you close your eyes and a song you hear though you shut your ears.
It is not the sap within the furrowed bark, nor a wing attached to a claw,
But rather a garden for ever in bloom and a flock of angels for ever in flight.

… beauty is life when life unveils her holy face.
But you are life and you are the veil.
Beauty is eternity gazing at itself in a mirror.
But you are eternity and you are the mirror.

I cannot criticize the cultural ethos of Brazil, or its need for beauty; I can only wonder whether they will ever find what they are so desperately seeking. Who can touch a rainbow just by reaching?

 

 

This Thing of Darkness

We all walk the earth in egg-shell armour at the whim of Nature. There is little of any of us that will not break if chaos strikes, or heal without a scar. You’d think that, given our fragility, we would opt for conciliation or compromise, and yet more often we challenge those who are not us, and seek to conquer those we cannot otherwise convince to join. It has become a point of honour not to yield, and so we glorify those who suffer grievous injury for causes dear to us, and our stories magnify their deeds, and exploit their hardships. We call them heroes…

But not all who suffer are our heroes, even though they may also have demonstrated equal courage for their positions, or found themselves inadvertently damaged in the crossfire of our wrath. We call them victims -if we notice them at all -and often deny guilt, even if we do.

Despite Steven Pinker’s contention in his The Better Angels of Our Nature that violence has been diminishing ‘over long stretches of time’ and that ‘today we may be living in the most peaceable era in our species’ existence’, I am still troubled by the violence that continues around us. Of course he may be correct in pointing out a lack of current, or at least, local internecine wars that would affect our daily lives, and suggesting that our improved communication systems highlight and magnify our knowledge of more distant conflicts without our having to experience the trauma ourselves. So, is it our arguably decreasing experience of violence that makes something like domestic cruelty stand out? At any rate, when this form of abuse seems all too apparent around us, it is impossible to ignore. Immoral to accept.

And often hidden beneath the more obvious traumatic injuries are the long-term effects. Of course we have all read about the ramifications of continuing abuse, and about how difficult it is to know whether the injuries are purposefully inflicted or the accidents they are often claimed to be, but what about the often more subtle and cumulative effects of traumatic brain injury?

Two articles caught my eye when I was trying to learn more about the subject. The first was an op-ed in the Los Angeles Times of a few years ago: http://www.latimes.com/opinion/op-ed/la-oe-1012-garayserratos-tbi-domestic-abuse-20151012-story.html ‘In recent years, medical science has uncovered the high risk and devastating effects of traumatic brain injury, or TBI, among U.S. combat soldiers and athletes, especially football and hockey players. What if a vastly greater population were also suffering these effects: women and children living with the consequences of domestic violence?’

At that time, ‘There [were] few empirical studies on the prevalence of TBI among women and children affected by domestic violence. But evidence so far strongly indicates a silent epidemic, with major public health ramifications. A 2001 study found that 67% of women seeking emergency medical support for injuries stemming from domestic violence had symptoms related to TBI, and 30% reported loss of consciousness.’

A more recent article, with links to this op-ed was in the online Conversation: https://theconversation.com/traumatic-brain-injury-the-unseen-impact-of-domestic-violence-92730 ‘The statistics are terrifying: In Canada, one woman is killed every week by her partner, globally, one third of women will suffer violence at the hands of someone they love in their lifetime.’

The article was written by Paul van Donkelaar, a professor in the Faculty of Health and Social Development and a neuroscientist at the University of British Columbia. He goes on to ask, ‘But what if survivors […] are also dealing with the effects of a traumatic brain injury along with the fear and trauma of finally having escaped a long-term abusive relationship? […] the impacts of this injury can be devastating — ranging from headaches, double vision and nausea to difficulty concentrating, remembering things and completing simple tasks. It’s also clear the effects tend to be worse when the trauma occurs repeatedly over time, with symptoms lasting for months to years.’

And, ‘Unlike athletes who have suffered a sport-related concussion, survivors of intimate partner violence also quite often experience emotional difficulties such as post-traumatic stress disorder (PTSD), depression and anxiety.’

‘[…]the U.S. Centers for Disease Control and Prevention, reports each year, 2.3 per cent of women over the age of 18 experience severe physical violence including “being slammed against something” or “being hit with a fist or something hard.” Furthermore, up to 90 percent of survivors of intimate partner violence report head, neck and face injuries at least once and typically on multiple occasions.’

Although I’d like to hope that we live in somewhat different conditions from our neighbours to the south, ‘Assuming similar percentages in Canada, this translates into approximately 276,000 women per year who will suffer a traumatic brain injury as a result of intimate partner violence.’

One of the many disturbing things about this trauma is the possibility of subsequent cognitive deficits -some of which may be severe, and because they may have occurred years before, difficult to remedy, let alone reliably assign attribution. As the author of that op-ed in the L. A. Times, Maria Garay-Serratos, wrote of her mother: ‘For as long as I can remember, my mother took aspirin every day, complaining of unbearable headaches. Sometimes she locked herself in the bedroom with the lights off, asking me to take my siblings outside because she couldn’t tolerate the noise. As she got older, her naps grew longer and her sensitivity to light and noise intensified. By her 50s, her memory had begun to fail.

‘On the day she finally asked me to take her away from my father, I found her in a worse state than I had ever seen her. She could barely stand. She was crawling from room to room while my father ignored her. […] When all the tests were finished, the neurologist told us my mother was suffering from moderate to severe Alzheimer’s disease. The head trauma had been so great and so consistent that there was little they could do.’

Unfortunately, it’s all too easy to focus on simply treating the physical symptoms -and, of course, rescuing the victim from further harm. This is obviously important, and yet woefully insufficient; there is also a need to be alert to problems that seem temporally unrelated. The link to head trauma may be more evident with events like automobile and athletic or combat injuries, but less so in a woman who escaped from an abusive relationship years ago.

Maybe Pinker really has spotted an inexorable trend towards less violence in our society. In the meantime, however, I think ongoing surveillance and counselling for the effects of head trauma might help the abused victims to live a better life while we await an actual treatment for what we now call CTE (Chronic Traumatic Encephalopathy). Oh, and an effective prevention strategy, too -in case those better angels lose their jobs…

 

 

 

 

 

 

 

 

 

 

Life would not yield to Age

There are times I think I’ve missed out on a lot. It seems to me that in my day, if a man re-chose a woman, he would almost always go for someone younger than himself. The reasons were obvious even then: overweening hubris, and expectations beyond capability. Indeed, dating sites online still seem to confirm my impression, and often -if not usually- the man’s eyes prove bigger than his stomach and the meal seldom lasts.

But retrospection is a stew of disappointments often sprinkled with only the barest soupçon of hope. Age is, well, age after all, and things happen as we get older. So, especially if one partner is significantly younger when they meet, the inevitable will occur -and worsen- in the older, and so you can guess who will become the default caretaker. Despite the best and most honourable intentions, this strikes me as unfair, albeit easily predictable by anyone watching from the sidelines.

And yet, although I concede that I am a creature of my era, I am still willing to be a witness to the triumph of hope over experience, so I was drawn to an article written by Gary Karantzas, an associate professor in Social Psychology/Relationship Science, at Deakin University (Australia) in the Conversation online magazine: https://theconversation.com/mind-the-gap-does-age-difference-in-relationships-matter-94132?

‘Across Western countries, about 8% of all heterosexual married couples can be classified as having a large age gap (ten years or more). These generally involve older men partnered with younger women. About 1% of age-gap couples involve an older woman partnered with a younger man. About 25% of male-male unions and 15% of female-female unions demonstrate a large age gap.

‘But what these trends tell us is that the majority of the population is likely to partner with someone of similar age. This largely has to do with having social circles that generally include peers of similar ages and being attracted to others who are similar. Similarity entails many things, including personality, interests and values, life goals and stage of life, and physical traits (age being a marker of physical appearance).’

If the article had stopped there I imagine I would have learned nothing new, and I might have remained an insufferable avocat du diable at dinner parties. But, fortunately for both me and my friends, I read further. ‘Many people assume that age-gap couples fare poorly when it comes to relationship outcomes. But some studies find the relationship satisfaction reported by age-gap couples is higher. These couples also seem to report greater trust and commitment and lower jealousy than similar-age couples. Over three-quarters of couples where younger women are partnered with older men report satisfying romantic relationships.

‘A factor that does impact on the relationship outcomes of age-gap couples is their perceptions of social disapproval. That is, if people in age-gap couples believe their family, friends and wider community disapprove of their union, then relationship commitment decreases and the risk of break-up increases. These effects appear to apply to heterosexual and same-sex couples.’

‘Another factor at play may have to do with the stage of life each partner is experiencing. For instance, a ten-year gap between a 20-year-old and a 30-year-old may bring up different challenges and issues than for a ten-year gap where one partner is 53 and the other is 63. This is because our lives are made up of different stages, and each stage consists of particular life tasks we need to master. And we give priority to the mastery of different tasks during these distinct stages of our lives.’

And he concludes that ‘The success of a relationship depends on the extent to which partners share similar values, beliefs and goals about their relationship; support each other in achieving personal goals; foster relationship commitment, trust and intimacy; and resolve problems in constructive ways. These factors have little do with age.’

I think I witnessed something like that once. I don’t normally sit on benches, especially occupied ones, even though they’re usually long enough to support a small family. Of course, maybe that’s the idea, because they often have little plaques commemorating someone who has died but used to sit there. So I feel a little uncomfortable sitting beside people who might be related to the deceased. And anyway, the act of sitting on a bench at my age makes me think I should be finding an unplaqued one so my own family can have one printed up.

But, I was tired and the bench that overlooked Vancouver’s English Bay was seductive, even though two people had already discovered it for a rather snuggly chat. They were both gazing lovingly into each other’s eyes and speaking softly to each other. I sat at the far end of the seat so I wouldn’t disturb them. I don’t think it bothered either of them particularly, although one of them, an attractive woman, probably in her early sixties, leaned even closer to her friend to whisper something when I sat down. I have trouble judging ages, but I would think he was  ten or fifteen years her junior, and yet equally enthralled. Anyway, both of their eyes were so entangled I might as well have been a bird sitting on a branch nearby for all they seemed to care.

And then, perhaps thinking they were being rude, they both sat back and stared at the waves breaking on the nearby rocks for a moment. Finally, the woman turned to me and smiled. “Isn’t it a beautiful day?” she asked, as if she suddenly felt a need to welcome me to their bench.

I nodded pleasantly, and we all sat in silence for a while, listening to the cry of a group of seagulls that had landed on the rocks. “I hope I didn’t disturb you,” I suddenly blurted out, embarrassed at choosing an already occupied bench, I suppose, although perhaps more concerned about admitting to myself that I had needed to rest.

The man leaned forward and his eyes circled around my cheeks like butterflies about to settle. “Not at all. We were just reminiscing about how we met on this very bench fifteen years ago -fifteen years ago today, in fact.”

“I’d just finished running around the seawall, and I think it was a bit too far for me, so I needed to sit down… And I happened to see this bench,” the woman said, squeezing his hand as she spoke. She glanced at her friend. “Jeff was…”

“I was sitting at the far end of the bench reading a book when Alice arrived, and…”

“And that was the beginning of a wonderful life,” she finished for him.

It was sweet the way they both finished sentences for each other -like they were completely comfortable being inside the other’s head.

“It’s our fourteenth wedding anniversary today,” he added, and kissed her gently on the cheek.

“We come to this bench each year to remember,” she said snuggling closer to him and sighing contentedly.

“Welcome to our bench, eh?” he chuckled, and winked at her as they both stood up and stretched.

“I’m sorry, I hope I didn’t…” I started to say, but she reached out and clasped my hand, her eyes twinkling in the sunlight for a moment.

“It’s the meeting bench,” Jeff said, hugging her as he spoke, then grasping her free hand he stood quietly with her for a moment, the wind tussling their hair like another hand.

And as they started to walk away, Alice turned towards me and her eyes softened as they rested on my face. “I hope someone sits…”

But just then some friends further down the seawall waved and yelled at them, and her smile caressed me briefly before she shrugged and walked away with Jeff to grace some other lives.

 

 

 

 

 

 

 

 

 

 

 

The Grey Dog

I was once a moody child; I’m still a moody child… sorry, adult. Anyway, I’m also a bit sensitive about the topic. It’s as if being moody means being naughty, or maybe contrary. Not quite right in the head, or something -not well adjusted, at any rate. I take exception to that. I mean, just because I often have trouble mixing with people at parties who only want to make small talk -usually about other people- and then walk away shouldn’t disqualify me from church or anything… Okay, I don’t go to church, but you see what I’m driving at, I hope. Moods are kind of baroque frames around my happiness. They make even run-of-the-mill joy look like ecstasy.

I’m not advocating ignoring the more severe and persistent forms of mood -they may in fact herald something very important. I am saying that not all of us who are occasionally disgruntled, frustrated, or unhappy have some underlying pathology. And to label those occasions as bouts of depression is to dilute the word, mistake the condition, assume everything is the black dog.

I was therefore relieved to find someone who relates to that view:  https://theconversation.com/is-my-child-depressed-being-moody-isnt-a-mental-illness-92789

The author, Dr. Stanley Kutcher, Sun Life Financial Chair in Adolescent Mental Health, at Dalhousie University, Begins by noting that, ‘[…] if the media coverage is to be believed, we are drowning in a sea of mental illness that threatens to overwhelm post-secondary Institutions. […] The prevalence of mental illnesses (defined using clear diagnostic criteria) is not rising in this cohort.

‘Youth self-reports of negative emotions are increasing. But the self-report scales used in studies documenting this have not been calibrated for generational changes in language use. Nor have the results been validated using clear, clinically valid, diagnostic criteria applied by expert clinicians.

‘[…] The above noted self-reports do identify the ups and downs of everyday emotions, but these are not criteria for diagnosis of mental illness. So we can say that youth on campus may report feeling more negative emotions than previously, but this is not the same thing as saying that young people have more mental disorders than previously.’

He cites an interesting example of the lack of application of basic critical thinking and analysis: ‘In late 2017, the study “Mental ill-health among children of the new century: Trends across childhood with the focus on age 14” was published by the National Children’s Bureau in the United Kingdom.

‘This showed that self-reported negative emotions were present in about one quarter of this surveyed group, but this was interpreted as 25 percent of 14-year-old girls in the UK suffer from depression! The fact that parental reports identified about five per cent of this cohort as having significant mood problems was ignored by almost all commentators. This latter number is much more in keeping with known rates of depression in the population.’

I wonder if our expectations of normalcy are to blame. As Dr. Kutcher explains, ‘These concerns are not the result of substantial epidemic increases in the rates of mental illness. They arise, in some part, from poor mental health literacy and unrealistic expectations of the normal emotional states that life challenges elicit.’

He makes some interesting and important points, I think. ‘[…] First, the increased public perception that being well means only having positive feelings is taking over the social discourse on mental health. When the measure of health is simply feeling good, negative emotions become a marker of being unwell. […] Without addressing the life challenges and opportunities that negative emotions signal to us, we can’t develop resilience. Mental health is not a static concept wearing a big smile. There are good days and bad days, good weeks and bad weeks. We still have mental health even if we are having negative emotions.’

‘Second, the use of words originally developed to identify mental illnesses to describe normal negative emotional states has burgeoned. […] Further, the use of terms denoting illness, such as depression, to mean all negative emotions is even more confusing. Now, words like sadness, disappointment, disgruntlement, demoralization and unhappiness are all lumped together as depression.’

He feels that the continued and almost obsessive use of technologies like smart phones for communication-especially by the young- may limit their ability to express complex messages and ideas and hence increase the sense of isolation, of being misunderstood -or perhaps, of even being mislabelled. And since it is adults, by and large, in charge of the classifications, it’s almost a case of two solitudes, two Magisteria, staring at each other -neither the wiser. Neither the winner…

Interestingly, I think I caught a whiff of this while waiting for a bus the other day. Two quite young teenage girls were sitting on the only bench in the little shelter, both clutching their mobile phones like purses. Because the rest of the bench was filled with their back-packs and some school binders, I merely stood outside and leaned against the wooden frame.

“But what did he say, Kitty? Is he, like, mad at you or something?” This from a petite little girl with long, straight dark hair and a big red coat with only a pair of blue boots sticking out from the bottom.

Kitty shook her head and leaned back on the wall of advertising behind her. She also had dark hair, but short and messy. It fit rather well with a large, thick and ragged blue sweater, torn on at least one sleeve to show a thin arm underneath. Her jeans were also fashionably torn, but looking as new as her pink running shoes. “No… Not mad… Just, like, upset. He says I’m moody -and all because I don’t want to, like, talk with him and Mom at the dinner table. I mean, nobody, talks anyway.” She shrugged theatrically and leaned forward on the bench again.

Her friend sighed sympathetically. “Yeah, my mom keeps wanting me to… you know, like communicate with her, too. But I mean, ever since dad left, she’s always either on her phone, or has the TV on.”

Kitty, nodded. “Yeah well, like, my parents think I should see a counsellor at school… They think I’m depressed, eh?” Her friend’s expression tightened, but she stayed silent. “But my dad always has his phone on the table and, like, keeps glancing at the news on his apps or, like, he’s waiting for an important Email, or whatever. And my mom’s a realtor, remember, so she does the same.” Kitty glanced around the wall and saw a bus was coming. “That’s all they talk about, anyway, Jen.”

Jen was staring intently at the ground in front of her. “Well, I think my mom’s depressed, you know, but she won’t go see anybody about it.” She took a little stertorous breath. “She thinks she’s coping… But I think, like, she’s just escaping online and stuff…”

The bus pulled up, and Jen seemed on the verge of tears, so Kitty reached over and hugged her. “We have to be strong for them, you know, Jen…”

That’s all I heard before they quickly gathered their things and walked over to the bus, arm in arm. Kitty must have whispered something else to her, because they both started to giggle before they got on.

I don’t know if it’s the technology, but it did make me wonder whether we really have a handle on mental health yet.

A Childless Motherhood

Well of course! Did we think there would be no consequences? Did we actually think we could get away with it? That there weren’t two sides to the story that we all needed to hear?

Sometimes I think we are so focused on our journey to right a wrong, that we wander off the path to those we hope to save. Things are too partitioned -a modern day rendition of the biblical Matthew 6:3 where the left hand does not know what the right hand is doing… Or, perhaps, is not doing.

If one side of a page seems to contain all the information I seek, I may miss what’s written on the back. I feel no need to turn it over. An article in the Conversation turned the page for me:

https://theconversation.com/losing-children-to-foster-care-endangers-mothers-lives-93618

The author, Elizabeth Wall-Wieler, a PhD student in Community Health Sciences at the University of Manitoba, writes that ‘Mothers whose children are placed in foster care are at much higher risk of dying young, particularly due to avoidable causes like suicide. When a child is placed in foster care, most of the resources are focused on the child, with little to no support for the mothers who are left behind.’

In retrospect, of  course, it seems obvious -the mother-child bond is not something easily missed, and whether or not we attribute it to physiological changes such as oxytocin levels in her blood, or less reductionist, atavistic mechanisms, it is a powerful thing, dismissed only at her -and our– peril.

The author was involved in two large studies, one of them published in the Canadian Journal of Psychiatry, which ‘[…] looked at suicide attempts and suicide completions among mothers whose children were placed in care.

‘In this study, we compared rates of suicide attempts and suicides between 1,872 mothers who had a child placed in care with sisters whose children were not placed in care. We found that the rate of suicide attempts was 2.82 times higher, and the rate of death by suicide was more than four times higher for mothers whose children were not in their custody. […] Mothers whose children are taken into care often have underlying health conditions, such as mental illness and substance use. In both studies, we took pre-existing health conditions into account, so that was not the reason for the higher mortality rates we found.’

And, the author feels, ‘Most legislation pertaining to child protection services indicates that families should be supported, but the guidelines around what is expected of the child welfare system when it comes to the biological mothers are not clear. The main role of social workers is to ensure that the child is doing well. Social workers are already so busy, so it is often hard for them to justify spending their limited time to help mothers resolve challenges and work with them to address their mental and physical health needs.’

Other studies have also addressed the issue of sending children to foster care: ‘A study in Sweden found that by age 18, more than 16 per cent of children who had been in foster care had lost at least one parent (compared to three per cent of children who had not been in foster care). By age 25, one in four former foster children had lost at least one parent (compared to one in 14 in the general population). This means that many children in foster care don’t get the chance to be reunited with their families.’

I thought that the whole idea of fostering a child was care and sustenance until a more permanent placement was achieved or, ideally, the birthparent was able to reassume custody. This is perhaps more likely if the child can be placed with members of the same family -grandmothers, aunts, etc.- but even then, if the mother does not receive adequate support and treatment for the condition that led to the apprehension of her child, the results are apt to be the same.

In Canada, it seems, the mothers most affected are those from the indigenous community -our First Nations. The Canadian Minister of Indigenous Services, Jane Philpott, addressed indigenous leaders about this issue at a two-day emergency meeting on Indigenous Child and Family Services in Ottawa in January, 2018. http://www.cbc.ca/radio/thecurrent/a-special-edition-of-the-current-for-january-25-2018-1.4503172/we-must-disrupt-the-foster-care-system-and-remove-perverse-incentives-says-minister-jane-philpott-1.4503253 ‘The care system is riddled with “perverse incentives”. Children are being apprehended for reasons ranging from poverty to the health and addiction issues faced by their parents. In some provinces, rules around housing mean that your children can be taken away if you don’t have enough windows. “Right now dollars flow into the child welfare system according to the number of kids that are apprehended.” […] If financial incentives were based on “how many children we were able to keep in homes, how well we were able to support families — then in fact there would be no financial reason why the numbers would escalate.”’

But it’s not too difficult to read something else into all of this, of course. Uncondoned behaviour -behaviour frequently associated with poverty or marginalization- is often penalized isn’t it? Sometimes it is as simple as avoiding the transgressing community, further marginalizing it, but increasingly it is intolerance. Refusal to address the underlying issues. Not even trying to understand.

I admit that it is a difficult journey, and the road that winds between the abused child and its troubled parent is fraught. To empathize with the mother when her conduct may have been so clearly unacceptable, is seen as anathema. And yet, an attempt to understand is not a plea for condonation, merely a search for a solution. Nobody should get away with family neglect -but nothing happens in a vacuum. And there are always unintended consequences, aren’t there? Even our best intentions miss something in retrospect -solve one problem, create another. Our focus is often far too narrow -helping one person misses the one standing beside her.

Perhaps it’s time for us to stand back. As Ms Wall-Wieler puts it, ‘Specific guidelines need to be put in place to make sure that mothers are supported when their child is taken into care. This would improve the chances of reunification. And, by virtue of being a human worthy of treatment with dignity, mothers deserve support, even if it does not directly relate to how she interacts with her child(ren).’

‘Of the good in you I can speak, but not of the evil.
For what is evil but good tortured by its own hunger and thirst?’
Kahlil Gibran