All posts by johnsommersflanagan

Happy Afternoon at ACES in Seattle: Now, Let’s Talk About Suicide Assessment and Treatment Planning

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In a few minutes, along with Kelley McHugh, I’ll be doing my second ACES presentation today. This one is titled, “A New Model for Teaching and Learning about Suicide Assessment and Intervention.” Hana Meshesha was scheduled to join in the fun, but she wasn’t able to come today.

Along with our other doc students, Kelley and Hana are fabulous, focused, smart, and they contribute to my learning.

In the following powerpoints, you’ll see how Kelley, Hana, and I are thinking about how counseling students and professionals should be trained in suicide assessment and intervention. As always, we’re interested in your feedback. Here’s a link to the ppts: ACES Suicide Seattle 2019 Final

And here are a couple suicide assessment/treatment journal articles that might be helpful: Conversations About Suicide by JSF 2018 and SF and Shaw Suicide 2017

Happy Saturday Morning at ACES in Seattle

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The Association of Counselor Educators and Supervisors (ACES) conference is underway in Seattle. Seattle is a fabulous location. It’s great to be back in my home state.

It’s also great to be with so many fabulous people. Counselor educators are some of the nicest people on the planet. The conversations are intellectually stimulating, kind, compassionate, and positive relationship skills are on display everywhere.

Speaking of positive relationship skills, this morning, Kim Parrow (a fantastic doc student in our Counseling program at U of Montana) and I are presenting on Evidence-Based Relationship Factors (EBRFs). If you’re not sure what EBRFs are, or want to learn more, then check out the resources below.

The Powerpoints are here: ACES Seattle Kim and John Final REV

A previously published journal article from the Journal of Mental Health Counseling is here: JoMHC EB Article by John SF 2015

In My Great and Unmatched Wisdom

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In my great and unmatched wisdom I hereby proclaim that today Opposite Day.

Never mind that Opposite Day is a fictional children’s holiday and that it’s officially celebrated on January 25. Just because today’s not January 25 and I’m not a child, doesn’t mean I don’t get to say opposite things. I get to say opposite things because I’ve said I get to say opposite things.

When my nephews were little, we never waited for Opposite Day. Instead, we’d suddenly start playing the Opposite Game. It’s just like Opposite Day, but spontaneous. We’d say hello when we meant goodbye. I’d say things like, “Tommy, you’re the smartest person I know!” Or, “Paul, you’re one good looking guy.” I was totally hilarious, maybe the funniest uncle ever to exist on planet Earth.

Sometimes our spontaneous opposite games got a little out of control, but that was the point. One time, when grandma showed up and Tommy and Paul rolled their eyes and said, “It’s terrible to not see you” she looked hurt. We had to call time-out and explain the game to her. Even after the explanation, she didn’t seem to get it.

Funny thing, even when you’re playing at saying things that are the opposite of the truth, sometimes people don’t catch on. People get confused. For example, if the media happened to be listening to us, they might get confused and literally report things we said, even though we meant the opposite. That’s especially funny. When that happens, whether it’s by accident or on purpose, the correct response is to say, “I was only joking.”

After a while, if you intermittently play the Opposite game and mix it with being normal, people won’t know when to take you seriously and when to not take you seriously. For example, the other day I made a phone call, it was a perfect phone call. I said, “Hey dude, I’ll bring you over some of that medicinal plant you’re needing for nausea. It really sucks to feel sick, and I want to help. I’d like you to do me a favor though. If you could spontaneously give my boss a call and tell him how much you appreciate my great and unmatched wisdom, that would be nice.”

To be certain that I’d communicated perfectly, I ended the conversation by saying, “I’m only joking you know. I’m quite the humorist. Never mind what I said before. You look really nice today.”

The best thing about being in charge of the opposite game is that it keeps everybody else off balance. In comparison, I’m always on my game, because I’m the only one who knows when the opposite game rules are in effect.

I remember how that worked with my nephews. At the end of the day, sometimes I’d hug them and yell, “I hate you.” They knew what I really meant.

Oh, and BTW. Thanks for reading this. I value you as a person and I hope you love yourself. You know one thing that might help. If you’d just keep this blog post to yourself. Don’t share it. Seriously. I’m joking.

 

Hacking Affect and Mood in 325 Words

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Affect is how you look to me.

Affect involves me (an outsider) judging your internal emotional state (as it looks from the outside). Whew.

Mood is how you feel to you.

Mood is inherently subjective and limited by your vocabulary, previous experiences, and inclination or disinclination toward feeling your feelings.

Independently, neither affect nor mood makes for a perfect assessment. But let’s be honest, there’s no such thing as a free lunch, and there’s no such thing as a perfect assessment. Even in elegant combination, affect and mood only provide us with limited information about a client’s emotional life.

Our information is limited and always falls short of truth because, not only is there always that pesky standard error of measurement, also, emotion is, by definition, phenomenologically subjective and elusive. Emotion, especially in the form of affect or mood, is a particularly fragile and quirky entrepreneur of physiology and cascading neurochemical caveats. Nothing and everything is or isn’t as it seems.

As an interviewer, even a simple emotional observation may be perceived as critical or inaccurate or offensive in ways we can only imagine. Saying, “You seem angry” might be experienced as critical or inaccurate and inspire the affect you’re watching and the mood your client is experiencing to hide, like Jonah, inside the belly of a whale.

Oddly, on another day with the same client, your emotional reflection—whether accurate or inaccurate—might facilitate emotional clarity; affect and mood may re-unite, and your client will experience insight and deepening emotional awareness.

As a clinician, despite your efforts to be a detached, objective observer, you might experience a parallel emotional process. Not only could your understanding of your client deepen, but ironically, because emotional lives resist isolation, you might experience your own emotional epiphany.

Rest assured, as with all emotional epiphanies—including our constitutionally guaranteed inevitable and unenviable pursuit of happiness—you’ll soon find yourself staring at your emotional epiphany through your rear view mirror.

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Just for fun, below I’ve included a link to a brief clip of me doing a mental status examination with a young man named Carl. A longer version of my interview with Carl is available with the 6th edition of Clinical Interviewing. https://www.youtube.com/watch?v=1lu50uciF5Y

 

 

 

On the Road from Suicide to Happiness: Please Send Directions!

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Buddhists often say that life is suffering. Some days, for many of us, that feels about right.

But on other days, the inverse also rings true. Life is joy. Joy is the dialectical sunshine that intermittently breaks through clouds of suffering to interrupt our melancholy.

Don’t worry. Even though there’s currently a September Winter Storm Warning happening in Montana, I’m not going all weather on you. Besides, there’s not much I love more than clouds, rain, and winter storms. Also, to be fair, Buddha and the Buddhists recognized long ago that there’s a road we can take to get away from storms of suffering.

Maybe it’s my penchant for bad weather that’s drawn me, for the past two years, deeply into the professional monsoon of clinical depression, suicide assessment, and suicide interventions. What’s odd about that is that I don’t believe that depression or suicidality should be as pathologized as they have been. I’m a proponent of the right to die. I also find light and hope in the existential perspective that encourages us to embrace and integrate our darker, depressive sides, so we can emerge more whole and, as the existentialist Kirk Schneider likes to say, experience a Rediscovery of Awe.

For the past two years, focusing on suicide has felt very important. Our society isn’t very good at discussing suicide in an open and balanced way. All too often, suicide gets inaccurately conflated with illness or shame or moral weakness. These inaccuracies have inspired me to talk openly about suicide whenever given the opportunity.

But, to be honest, talking and writing about suicide—even from a professional perspective—isn’t all that fun. Those who know me know how much I like to tell funny stories. For years, I’ve had an untreated addiction to showing Far Side and Calvin and Hobbes cartoons during presentations. You wouldn’t believe how hard it is to find suicide cartoons that are workshop-worthy. When I show my cartoon with the white rat in the cage hanging itself and the lab scientist saying, “Looks like discouraging data on the antidepressant” if there’s any laughter it’s a painful and strained laughter, at best.

I do have one amazing depression cartoon; it’s a Gary Larson Far Side scene of a sad looking man on a bed in a messy room with the caption, “The bluebird of happiness long absent from his life, Ned is visited by the Chicken of Depression.”

But let me get out of my addiction and to the point. In my work on suicide prevention and intervention, I’ve slowly realized that we need to paddle upstream. I won’t stop talking about depression and suicide, but I want to more explicitly acknowledge that disabling depression and tragic suicides are often the inverse of well-being or happiness turned upside down. To address this effort at integration, I’m preparing materials to teach and present on the science of happiness. This is where I need your help. Yes, please send more suicide and depression cartoons, but even more importantly, send me happiness cartoons! I’m expanding my focus, and getting ready to spend more time talking about how we can all live happier and more meaningful lives. One way I’m doing this is by teaching a new “Happiness” course this spring at the University of Montana.

As background, I should let you know that I’m familiar with the Yale Happiness Class, the Penn Positive Psychology Center, and other popular resources. Although I’ll use this mainstream material, I want to do something different.

Here’s how you can help.

I’m looking for lecture material and happiness lab activities. Examples include,

Lecture content

  • Video clips
  • Songs with meaning
  • Demonstration activities
  • Quirky/meaningful stories

Lab activities

  • 30-60 minute specific experiential activities that can deepen student learning
  • Evidence-based experiential activities that demonstrate how to counter depression or embrace meaning

Because I’ll be delivering the course to undergraduates, as you contemplate sending me a map with directions to happiness, please put on your 19-year-old hat and help me find destinations with academic substance, but that will still appeal to the college-age generation.

As always, thanks for reading. I wish you a weekend (and life) filled (at least intermittently) with the sort of happiness and joy that’s palpable enough to sustain you until the next bluebird of happiness lands on your shoulder. And if you live in Montana, be sure to stay warm in the winter storm.

John S-F

Without a Trace of Shame: Looking Back at Trump’s Personality

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Donald Trump told another joke today. Problem is, his jokes frequently include death threats. I recall back in the day when he implied that his 2nd amendment supporters might want to stop Hillary from appointing Supreme Court justices. He played that off as a joke. Today the joke was about how America used to treat spies.

Like most things Donald Trump, what he says is usually half-impulse, half-informed, half-truths, half-ass, but wholly designed to trumpet his dominance.

The focus right now is on Trump’s Mafioso-like negotiation with Ukraine’s President. The press and politicians call it a “quid pro quo.” I think they’re using their fancy Latin to refer to a shake-down, which, if you read the transcript is obviously happening. To be more accurate, the Latin refers to “this for that.” But the Urban Dictionary might put it clearer with, “I want something, you want something. You give me what I want, I’ll give you what you want.” Even better, if you want to really know what’s going on, check out Urban Dictionary’s definition for “Quid pro quo-job” (which, because of my PG-13 rating, I’m unable to share here).

Some people act surprised that Donald Trump’s behaviors are so reminiscent of the Godfather. I’d say Mafioso, but Trump’s not Italian and consequently cannot qualify . . . which is probably at least partly why he’s acting so much like he’s trying to gain Mafioso status without having it. As Alfred Adler would say, that’s the way psychological compensation works.

If you’re a conscious and sentient being, there’s nothing particularly surprising here. Trump was being Trump. To review (which us academics do all the time, mostly because we’re forgetful), let’s look at the personality traits I wrote about in Slate Magazine last year around this time.

The following descriptions are summarized or paraphrased from the famous personality psychologist, Theodore Millon. Millon’s work was immense and immensely interesting. Read the following descriptions and contemplate two things:

  1. Do they fit Trump?
  2. What might the future of a Trump Presidency hold?

As I said last year, Trump has virtually all the qualities of someone with narcissistic personality disorder. But that’s not particularly interesting because most big-time politicians, media personalities, and rock stars have at least some narcissistic qualities. What’s unusual (and dangerous) is that Trump also has antisocial personality traits.

Generally, Millon summarized antisocial personalities as:

“Driven by a need to . . . achieve superiority.” They act “to counter expectation of derogation and disloyalty at the hands of others,” and do this by “actively engaging in clever, duplicitous, or illegal behaviors in which they seek to exploit others for self-gain.”

With that general description as backdrop, here are specifics.

Impulsive Imprudence. Antisocial personalities are “. . . shortsighted, incautious, and imprudent. There is minimal planning, limited consideration of alternative actions, and consequences are rarely examined.”

Blaming Others for Shirked Obligations. Antisocial personalities “frequently fail to meet or intentionally negate obligations of a marital, parental, employment, or financial nature.” This is the equivalent of a personal philosophy in direct opposition to President Harry Truman’s, “The buck stops here.”

Pathological Lying. Millon wrote, “Untroubled by guilt and loyalty, they develop a talent for pathological lying. Unconstrained by honesty and truth, they weave impressive talks of competency and reliability. Many . . . become skillful swindlers and imposters.”

Declarations of Innocence. During times of trouble, antisocial personality types employ an innocence strategy. “When . . . caught in obvious and repeated lies and dishonesties, many will affect an air of total innocence, claiming without a trace of shame that they have been unfairly accused.”

Empathy Deficits. Antisocial personalities are devoid of empathy and compassion. Millon called this “A wide-ranging deficit in social charitability, in human compassion, and in personal remorse and sensitivity.” He added that “many have a seeming disdain for human compassion.”

Counterattacks. Millon noted that antisocial personalities are hyper-alert to criticism. He “sees himself as the victim, an indignant bystander subjected to unjust persecution and hostility” feeling “free to counterattack and gain restitution and vindication.”

Moral Emptiness. Antisocial personalities have no ethical or moral compass. As Millon described, they “are contemptuous of conventional ethics and values” and “right and wrong are irrelevant abstractions.” Antisocials may feign religiosity—when it suits their purpose. But the moral litmus test will always involve whether they stand to gain from a particular behavior, policy, or government action.

Whether you think Donald Trump’s personality is captured in this short list of descriptions probably depends on your politics. I should also add that it’s perfectly possible for someone to have all these qualities and still have positive qualities as well. We’ve known—probably since the beginning of time—that people with antisocial personalities can be quite charming and charismatic. What’s crucial, and also intuitive, is that we the people recognize that despite his intermittent charm and charisma, Donald Trump is not to be trusted . . . which is likely why one of his favorite lines is “Trust me.”

My perspective is precisely the opposite. Please don’t trust me. Do the work, think about Trump’s pattern of behavior. It’s about far more than this latest incident regarding Ukraine. Take a look at the long list of behaviors that are consistent with Millon’s criteria. And then decide where you stand on a future with Donald Trump.

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The views expressed here are my own. They’re not representative of anyone else. They’re also not part of a quid pro quo.

For the whole long version of the Millon and Trump’s personality article, go here: https://johnsommersflanagan.com/2018/09/03/the-long-version-of-the-trump-personality-slate-magazine-article/