Personal Reflections, Tough Kids Cool Counseling

The Long Road to Eagle Pass Texas

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Hi.

I’m re-posting this because today, exactly one year since I made my long trek to Eagle Pass from Montana . . . I’m back again. The drive was just as long as before, but I’m back because the folks in the Eagle Pass School District are pretty darn fun to hang out with. And so here’s the original post from last year:

 

It’s a very long way from Missoula, Montana to Eagle Pass, Texas.

Just saying.

This epiphany swept over me after the early morning Missoula to Denver flight and after the Denver to San Antonio flight and right about when, after driving from San Antonio in a rental car for about an hour, I finally saw a green mileage sign that said: Eagle Pass – 95 miles. I just laughed out loud. And even though I was all by myself, I said, “It’s a long way from Missoula to Eagle Pass.” This is just a small taste of the profound thoughts I think while traveling alone.

But time and space are relative and so I entertained myself by listening to a radio station, en Espanol. Given that I have the Spanish vocabulary of a toddler, I was quite delighted with myself when I discerned that I’d tuned in to a Christian radio station. The repeated use of the words, palabra, familia, and Dios helped me make that revelation. I also monitored the temperature via my rental car thermometer and happily observed that the outside temperature never rose above 104 degrees during my drive from San Antonio to Eagle Pass.

I like to think of myself as navigationally skilled; then again, it’s also good to remind myself that denial is more than just a river in Egypt. What I did manage to efficiently find were the Texas road construction crews. Getting to my hotel was harder. I had planned to use my internet telephone GPS, which would have been a great idea had there been internet access in Eagle Pass. This prospect began dawning on me when I passed the sign saying: Eagle Pass, pop. 26,864. At that point it was still unclear to me exactly how the Eagle Pass School District (conveniently located on the Rio Grande River) decided to have me come from Montana to do a full-day Tough Kids, Cool Counseling workshop. But, given that I’d never been to Texas before and they happened to want to pay me and then they decided to purchase 45 copies of Tough Kids, Cool Counseling, I found myself faced with an offer I couldn’t refuse.

And so, I decided to engage in a bit of disoriented driving, while studiously avoiding the bridge to Mexico. I finally found a man from India at a random hotel, who spoke English in addition to Punjab and Spanish. He was kind enough to let me use his Internet because he’d never heard of the hotel I’d booked. Then, a few wrong turns later and following an episode where my rental car transformed itself from an automatic into a manual transmission, I finally made it to the bargain Microtel hotel where they obviously take the term “micro” very seriously. Staying there required that I change into my secret Ant-man identity, thereby shrinking my expectations for Internet access, pool length, fitness facilities, and room into the size of an ant while retaining the physical strength and intellectual functioning of an adult male (I should note that I intentionally selected this hotel because it’s relatively green and was happy with my choice, despite my lightly mocking tone). The good news was that Taco-Morales was right across the street and I got to experience some authentic fajitas and red rice at prices an ant could afford.

The next day, in a coffee-free state (there are no Starbucks in Eagle Pass), I found my way to the Eagle Pass Junior High library (home of the Eagles—what a surprising team name!). That was when I discovered how they’d chosen me as their School Counseling Workshop leader. As it turns out, Montana Street is just a block or two from Eagle Pass Junior High and so they had apparently thought I lived right there ON Montana Street (and not IN the State of Montana). . . which is probably why they chose to pay me a flat rate and let me cover my own travel.

But very soon I discovered everything wonderful about Eagle Pass. I got to spend the day with Mr. Salinas, Ms. Gutierrez, Mr. Lopez, Connie, Karla, Luis, Toyoko, three women named Dora, and just enough School Counselors to scoop up 45 copies of Tough Kids, Cool Counseling. This was a group with immense compassion and dedication to making the lives of their students better. They teased me, laughed at my jokes, gently corrected my Spanish mis-pronunciations, asked for me to sign their books, and treated me with mucho mas respeto than I could ever deserve. By lunchtime they began talking about when I’d come back (I gently suggested January instead of August for my next visit). After lunch, Luis beat me at the Hand-Pushing game (I was depleted and distracted from all the energy it took to keep intermittently changing into an ant-sized person to fit into my hotel). However, one of the three Doras made an excellent volunteer for my mental set riddles (thank you Dora, for demonstrating in front of your peers that, in fact, learning can happen).

In the end, I return from Eagle Pass with renewed and sustained faith and hope in the human race. The big hearts and amazing dedication of the Eagle Pass School Counselors was inspiring. Thank-you Eagle Pass, for helping to expand my world. . . while simultaneously shrinking my expectations for hotel accommodations.

Parenting, Personal Reflections

Sweating my Way through Charlotte, North Carolina

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As my sister likes to say, “we’ve got excellent pores in our family.” By “excellent” she means to say that our pores open up and leak like the Titanic. One time, way back when I was teaching at the University of Portland, I didn’t let enough time pass between playing noon-time basketball and lecturing in an Introductory Psychology class and ended up sweating so much that my glasses fogged up.

And so you can imagine how much my pores enjoyed being in Charlotte, NC in August.

When I showed up at the Ice Cream Social on Tuesday evening I was sweating so much that I was sure everyone was thinking, “Great. It’s the night before he’s scheduled to speak and our keynote for Wednesday morning is ALREADY having a panic attack.” [It’s funny how self-consciousness about something like sweating can suddenly turn on my psychic powers, because I’m pretty sure I was able to accurately read everyone’s mind at that Ice Cream Social.] But really, it wasn’t that terrible because I only had to retreat to my room to change my shirt once during the 20 minutes I spent at the Ice Cream Social.

Note to self: When visiting high humidity regions, always pack clothing that doesn’t accentuate my excellent sweating ability of my pores.

But the real point of this blog post isn’t my personal struggle with perspiration—despite the fact that writing about my sweating is, I’m sure, intrinsically interesting as well as cathartic and desensitizing. The real point is to do some flat out bragging about the Communities In Schools of North Carolina (CIS-NC) programs.

If you don’t know about the Communities in Schools organization, you should. In North Carolina this organization includes an amazing staff with boundless positive energy that they direct toward dropout prevention. If you click on the link to their organization you’ll find a cool website with excellent information http://www.cisnc.org/. Here’s their mission statement:

The mission of Communities In Schools is to surround students with a community of support, empowering them to stay in school and achieve in life. We are part of the national Communities In Schools network, which is the leading dropout prevention organization in the country, and the only such organization that is proven to decrease the dropout rate and increase on-time graduation rates.

I have to admit that before I arrived in Charlotte, I was skeptical about their claims of being “the only organization proven to decrease the dropout rate and increase on-time graduation rates.” This skepticism came from two sources: (1) decreasing drop-out rates is just extremely difficult for everyone, and (2) I’m skeptical about everything. But, after being with the ABSOLUTELY AMAZING administration and staff of CIS-NC for only a few hours, it was clear to me how and why they’re able to help students succeed. Here are a few things I learned.

  • Not only is the staff positive, energetic, and funny, they’re also smart, savvy, and fully dedicated to improving the lives of young people.
  • They utilize a rational balance of evidence-based approaches in combination with approaches that are designed to meet the unique needs of individual schools, staff, students, and settings.
  • They operate using the “5 Basics of Communities in Schools.” These common sense AND evidence-based principles include:
  1. A one-on-one relationship with a caring adult.
  2. A safe place to learn and grow.
  3. A healthy start and a healthy future.
  4. A marketable skill to use upon graduation.
  5. A chance to give back to peers and community.

In addition to all that, I learned that their staff is sensitive, supportive, and compassionate. After all, when I delivered the keynote, they nodded and smiled (showing their listening skills), laughed at all of my jokes at exactly the right time (laughing with special vigor when I did my exorcist voice), and gave me lots of positive feedback for the rest of the morning.

Now it’s up to me to determine if they were just being especially kind to their sweaty keynote speaker or whether they really enjoyed the presentations. I’m hoping for the latter.

Parenting, Therapy with Adolescents

Hello to the Communities in Schools of North Carolina

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Tomorrow I head to Billings to fly to Charlotte, North Carolina to speak at the annual training conference for the Communities in Schools of North Carolina (CIS-NC). CIS-NC is an awesome organization that helps prevent and reduce school drop-outs. I’m honored to be a part of their annual training. You can learn more about CIS-NC at: http://www.cisnc.org/

Attached to this post is the powerpoint presentation for the Wednesday opening session.

NC CIS Warts to Wings Final REV no cartoons

And here’s the one page summary from the opening session.

From Warts to Wings Handout

And here’s the powerpoint for the break-out session on “How to Listen so Parents will Talk”

How to Listen for CIS

And the one page summary for the break-out session.

How to Listen Handout

Clinical Interviewing, Counseling and Psychotherapy Theory and Practice

Strategies for Working Effectively with Challenging Clients

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Working with clients who are reluctant or resistant to counseling can be very challenging . . . unless you use skills to help minimize resistance and maximize cooperation. The following is adapted from Chapter 12: Challenging Clients and Demanding Situations of the forthcoming 5th edition of Clinical Interviewing. Remember, these skills have to come from a foundation of therapist genuineness.

Using Emotional Validation, Radical Acceptance, Reframing, and Genuine Feedback

Clients sometimes begin interviews with expressions of hostility, anger, or resentment. If this is handled well, these clients may eventually open up and cooperate. The key is to refrain from lecturing, scolding, or retaliating when clients express hostility. Speaking from the consultation-liaison psychiatry perspective, Knesper (2007) noted: “Chastising and blaming the difficult patient for misbehavior seems only to make matters worse” (p. 246).

Instead, empathy, emotional validation, and concession are more effective responses. We often coach graduate students on how to use concession when power struggles emerge, especially when they’re working with adolescent clients (J. Sommers-Flanagan & Sommers-Flanagan, 2007b). For example, if a young client opens a session with, “I’m not talking and you can’t make me,” we recommend responding with complete concession of power and control: “You’re absolutely right. I can’t make you talk, and I definitely can’t make you talk about anything you don’t want to talk about.” This statement validates the client’s need for power and control and concedes an initial victory in what the client might be viewing as a struggle for power.

Empathy and Emotional Validation

Empathic, emotionally validating statements are also important. If clients express anger at meeting with you, a reflection of feeling and/or feeling validation response can let them know you hear their emotional message loud and clear. In some cases, as in the following example, therapists might go beyond empathy and emotional validation and actually join clients with a parallel emotional response:

  • “Of course you feel angry about being here.”
  • “I don’t blame you for feeling pissed about having to see me.”
  • “I hear you saying you don’t trust me, which is totally normal. After all, I’m a stranger, and you shouldn’t trust me until you get to know me.”
  • “It pretty much sucks to have a judge require you to meet with me.”
  • “I know we’re being forced to meet, but we’re not being forced to have a bad time together.”

Radical Acceptance

Radical acceptance is a dialectical behavior therapy principle and technique based on person-centered theory (Linehan, 1993). It involves consciously accepting and actively welcoming any and all client comments—even odd, disturbing, or blatantly provocative comments (J. Sommers-Flanagan & Sommers-Flanagan, 2007a). For example, we’ve had experiences where clients begin their sessions with angry statements about the evils of psychology or counseling:

Opening Client Volley: I don’t need no stupid-ass counseling. I’m only here because my wife is forcing me. This counseling shit is worthless. It’s for pansy-ass wimps like you who need to sit around and talk rather than doing any real work.

Radical Acceptance Return: Wow. Thanks for being so honest about what you’re thinking. Lots of people really hate psychologists but they just sit here and pretend to cooperate. So I really appreciate you telling me exactly what you’re thinking.

Radical acceptance can be combined with reframing to communicate a deeper understanding about why clients have come for therapy. Our favorite version of this is the “Love reframe” (J. Sommers-Flanagan & Barr, 2005).

Client: This is total bullshit. I don’t need counseling. The judge required this. Otherwise, I can’t see my daughter for unsupervised visitation. So let’s just get this over with.

Therapist: I hear you saying this is bullshit. You must really love your daughter . . . to come here even when you think it’s a worthless waste of your time.

Client: (Softening) Yeah. I do love my daughter.

The magic of the love reframe is that clients nearly always agree with the positive observation about loving someone, which turns the interview toward a more pleasant focus.

Genuine Feedback

Often, when working with angry or hostile clients, there’s no better approach than reflecting and validating feelings . . . pausing . . . and then following with honest feedback and a solution-focused question.

“I hear you saying you hate the idea of talking with me, and I don’t blame you for that. I’d hate to be forced to talk to a stranger about my personal life too. But can I be honest with you for a minute? [Client nods in assent]. You know, you’re in legal trouble. I’d like to try to be helpful—even just a little. We’re stuck meeting together. We can either sit and stare at each other and have a miserable hour or we can talk about how you might dig yourself out of this legal hole you’re in. I can go either way. What do you think . . . if we had a good meeting today, what would we accomplish?”

Think about how you can incorporate, empathy, emotional validation, concession, radical acceptance, and genuine feedback into your clinical practice. For more on this, check out the 5th edition of Clinical Interviewing.

Clinical Interviewing

A General Guide to Using Stages of Change Principles in Clinical Interviewing

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This week I’ve been working on reading and editing the page proofs for the forthcoming 5th edition of Clinical Interviewing (John Wiley & Sons). The information below is from a “Putting It Into Practice” box from the 4th chapter. It focuses on a brief Q&A regarding the application of Prochaska and DiClemente’s “Stages of Change” concept in clinical interviewing and presupposes that you have basic knowledge of that particular piece of their Transtheoretical Model.

A General Guide to Using Stages of Change Principles in Clinical Interviewing

Below we pose and answer four basic questions about how to apply stages of change principles (Prochaska & DiClemente, 2005) to guide the techniques and responses you choose to use within a clinical interviewing context.

Q1: When should I use directive techniques like psychoeducation or advice?

A1: When clients are in the action or maintenance stages of change you’re free to be more directive (provided you have useful information to share that fits with what the client recognizes as his or her problem).

Q2: When should I use less directive listening responses like paraphrasing, reflection of feeling, and summarization?

A2: As a general rule, if your client is in the precontemplative or contemplative stages of change, you should primarily use nondirective listening skills to help the client look at his or her own motivations for change. This would include: (a) attending behaviors, (b) paraphrasing, (c) clarification, (d) reflection of feeling, and (e) summarizing. Many questions, especially open questions and solution-focused or therapeutic questions, may be appropriate for clients who are precontemplative or contemplative. When you’re with clients who present as precontemplative or contemplative, your best theoretical orientation choices will likely be person-centered, motivational interviewing, and/or solution-focused. Using more directive approaches can produce defensiveness or resistance with clients in precontemplative or contemplative stages.

Q3: How do I know what stage of change my client is in?

A3: We’re tempted to suggest you’ll know it when you see it . . . and there’s some truth to that. If you try directly recommending a strategy for change and the client responds defensively, you may be moving forward too fast and it’s advisable to retreat to using reflective listening skills. Conversely, if your client seems frustrated with your nondirective listening and expresses interest in changing now, then you’ve got the green light to be more directive. Also, we recommend using George Kelly’s (1955) credulous approach to assessment, meaning you can always just directly ask clients what they prefer. In our work with parents we do this explicitly by stating something like:

“I want to emphasize that this is your consultation. And so if I’m talking too much, just tell me to be quiet and listen and I will. Or, if you start feeling like you want more advice and suggestions, let me know that as well.” (J. Sommers-Flanagan & Sommers-Flanagan, 2011, p. 60)

There are also standardized methods for assessing clients’ readiness for change. Interestingly, most of these involve asking clients very direct questions about their motivation to change, how difficult they expect change to be, and how ready they are to change (all of which seem in the spirit of George Kelly’s credulous approach; for example, see (Chung et al., 2011) for a study on the predictive validity of four different measures assessing client readiness to stop smoking cigarettes).

Q4: Is the stages of change concept supported by empirical evidence?

A4: The data are mixed on whether and how much attending to and using interventions that fit your clients’ stages of change makes a difference. Of course, this is true for nearly every phenomenon in counseling and psychotherapy.  Overall, some studies show strong support for gearing your interviewing techniques to your clients’ stage of change (Johnson et al., 2008). Other studies show that stages of change focused interventions do no better than interventions that don’t tune into clients’ particular motivational stage (Salmela, Poskiparta, Kasila, Vähäsarja, & Vanhala, 2009). We recognize this isn’t the clear and decisive research outcome you might hope for, but such is the nature of our profession.

For more information on Clinical Interviewing, 5th edition, go to: http://www.wiley.com/WileyCDA/WileyTitle/productCd-1118270045.html

 

Boys and Men, Personal Reflections

What I Learned About Male Sexuality Today

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Learning is cool. As Rylee and I work on our boys and sexual development project, we get to do lots of reading. Even better, lots of the reading is about sex.

As you may recall, last week Rylee and fell in love with Cordelia Fine’s Myths of Gender. Today, I had a different experience reading a 2007 book titled “7 Things He’ll Never Tell You {but you need to know}” written by Kevin Leman, a psychologist and “New York Times best-selling author.”

Here are a few of “Dr.” Leman’s comments and tips . . . combined with some clearly spiteful commentary from Rita and Rylee.

“The wise woman realizes that a man is wired to want things now. [Rita stops me here and says, “Wait. That’s me! I’m the one who wants things now!] And she will realize that a man who is constantly thwarted in his desires will begin to look for gratification elsewhere.” (Leman, p. 35)

Right now I’m thinking about raspberry pie. If Rita doesn’t get it for me NOW, I’ll be looking elsewhere . . . I hope she recognizes that. This is pretty good stuff. No more thwarting . . . or else! [Rylee says, “Or else you’ll get it yourself.”]

Then he says:
“. . . men . . . are not relationally centered. They identify more with things. They are visually stimulated by looking. That means whatever your guy sees is imprinted on his mind. So if he sees a sexy woman in a red dress on the subway, he may see that same woman in his thoughts again later that night, a week later, even a month later. . . . Men, on the average, have 33 sexual thoughts a day” (p. 104)

Oh my, 33 sexual thoughts a day. And how many sexual thoughts a day does a woman have. He doesn’t really address this directly, but at the end of the book he has a little quiz and one of the items goes like this: “How much does a man think about sex? . . . 33 times as much as you” (p. 177).

This is a serious math problem. And so if Rita has 5 sexual thoughts in a day, it means I’ll have 165? Now we’re talking!

On p. 106, Leman writes: “It’s been said that women need a reason for sex. Men only need a place. Men really need sex and are designed to need sex, to think about it, and to pursue it. A physically healthy married man cannot be fulfilled without it.” (p. 106) [Rylee says: Only for married men? What about all those monks? No fulfillment for them?]

Hmmm . . . sounds like sex is pretty important for guys. No fulfillment . . . period? Nothing else is fulfilling? Well, I guess if I’ve got 165 sexual thoughts in a day, maybe there’s no time to think of anything else fulfilling. Even though this isn’t really all that consistent with any other psychological theories, especially existentialism, I guess if Dr. Leman says it, it must be true.

And here’s the coup de gras . . .

“Sex is the great equalizer in a man’s life. If he meets with the accountant and is short on funds for his income tax or he got a bad job review, coming home to a willing wife makes it all better. It’s amazing what things great sex can cure for men—everything from viruses, bacterial infections, impetigo, chicken pox, the flu, and most importantly, any problem in marriage. For example if he has a fight with his wife and later that day they have sex, all of his issues are gone. They’ve resolved themselves. The problem is that for the other half of the relationship—the female—the issues aren’t resolved until they’re talked about!” (p. 107)

So sex cures the chicken pox. [Rita says: “But only for men?”] I say I wish I’d known that last summer when I had the coxsackie virus. [Rita says, “Like that was gonna happen.”] [Rylee says: “So women can cure men by sacrificing themselves to whatever disease a man has.”] [Rita says, “Women are true healers.”]

See, you learn something new every day. And sometimes it’s actually useful . . . or true.

Boys and Men, Personal Reflections

A Sneak Peek at the Boys and Sex Project

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This summer I’m working on a writing project with my daughter Rylee on boys and their sexual development. This is a draft of an excerpt (aka sneak peek) from a chapter focusing on myths of male sexual development. Check it out. Like it if you like it and provide constructive feedback if you don’t. Thanks. Here we go:

We all should know better.

We should know that it doesn’t make good sense to use animal behavior—observations of fruit flies, rats, hamsters, sheep, and other animals—as an explanation or justification for gender-based human behavior. Unless we’re a fancy scientist who can maintain clear objectivity, using animal behavioral models to help explain why boys and girls and men and women behave the way they do is too subjective, self-serving, and risky. But when it involves humor and irony and helps us make a point, resisting this temptation is very difficult.

What Happens When Rams Watch Porn

On a sunny morning in late June, I (John) received a porn ping about Gary Wilson’s TEDx talk titled, “The Great Porn Experiment.” Wilson is an adjunct faculty member at Southern Oregon State University. He’s also co-host, with his wife Marnia Robinson (author of Cupid’s Poisoned Arrow) of the “Your Brain on Porn” website. Wilson’s areas of interest are neuroscience, pornography, and internet porn addiction. In his work he emphasizes the negative neurological and physical consequences of internet porn addiction.

Given all of the above, I was unable to suppress my curiosity and immediately clicked on the link. I was immediately transported to that amazing internet dimension where I could watch and listen to Gary Wilson tell me about The Great Porn Experiment.

Less than 90 seconds into his TEDx talk, Wilson wandered away from talking about humans, moving to something that he obviously found much more interesting—1960 research data on the sexual behavior of rams and ewes (male and female sheep). He stated: “Mother nature likes to keep a male fertilizing willing females as long as any new ones are around.” [He then began discussing a graph of the “minutes to ejaculation” for rams with either the “same old ewe” or with fresh new ewe partners].

Wilson continued: “In that top line, the ram, he needs more and more time to mate with the same old ewe. But if you keep switching females, the bottom line, he, well, it’s just not the same (audience laughter). He can get the job done in two minutes flat and get the job done until he is utterly exhausted. This is known as the Coolidge effect.” (We’ll get to the story about the Coolidge effect later; for now we’re sticking with Wilson and his sheep story).

Reflections on Ram-Ewe Sexual Behavior

Okay. After less than 2 minutes of Wilson’s TEDx talk (ironically, about the same amount of time it took the rams to “get the job done”), I could no longer focus and had to turn off the video to reflect on my thoughts and feelings. I found myself both intellectually stimulated and emotionally annoyed. Intellectually, I began wondering if perhaps it’s perfectly normal and evolutionarily natural for me to find females—other than my wife—more sexually stimulating. I wondered if maybe I should want to behave like a ram and ejaculate every 2 minutes with a new sexual partner (preferably human) until I’m exhausted—because, after all, that’s apparently what Mother Nature wants. Although this sounded intriguing, I instantly decided that due to the sexual partnering messages I’ve gotten for 50+ years through the media, for this arrangement to work, I would need to have the new available sexual partners be supermodels with no pores who are solely interested in my personal sexual stimulation and gratification (with no lingering conversation required subsequent to my 2 minute ejaculations).

Why is it that Wilson’s TEDx talk annoyed me in less time than it takes male sheep to move on to a new partner? Well, because of the amazing processing skills and speed of the human brain, I can formulate my answer to that question even faster than I can click a mouse. My annoyance rose up because there are so many things wrong with taking a research study on the sexual behavior of sheep and generalizing it to humans that hearing the story produced a negative emotional reaction. And what makes this even worse is the fact that I support Wilson’s conclusions (too much internet porn is bad for male sexuality and sexual performance), but lament his intellectual methods.

An Alternative Interpretation (or Are Human Males Only Interested in Ejaculation?)

Let’s start with one, among many, alternative interpretation of the 1960 sheep sex data. If you recall, Wilson noted that the rams “needed more and more time to mate with the same old ewe.” The way he stated this implies that the ONLY or EXCLUSIVE goal in this sexual situation is for the ram to ejaculate. Funny thing: I shared the research results with my wife and she suggested that perhaps the ram felt more comfortable, less anxious, and was able to therefore last longer with his regular ewe-partner. Perhaps they lingered together because, although ejaculation may have been one of their goals, the process of their ram-ewe lovemaking was enjoyable in-and-of-itself?

In fact, if ejaculation is really the only goal for human males—as it appears to be for sheep—then masturbating to internet pornography seems an appropriate venue (and unless my editor snips out this comment, I’d be inclined to suggest that sex with sheep may also be in play). However, it seems that based on 21st century coupling behavior, most human males are also interested in establishing and maintaining sexual and intimate relationships with human females (while some are interested in sexual and intimate relationships with other human males). Alyssa Royse, a freelance writer, Seattle-based sex educator, and Good Men Project, noted that, similar to Wilson, the popular culture also has emphasized that when it comes to sex and intimacy, human males are perhaps more ram-like than may be desirable. In a post on the Good Men Project website, she wrote:

I could go on and on, but that point is that popular culture sets up this idea that men are sexual predators who need to resort to trickery and cologne to fulfill their one and only mission, which is sticking their penis in a girl. (Alyssa Royse, http://goodmenproject.com/featured-content/the-danger-in-demonizing-male-sexuality/)

Royse is observing that popular culture also seems to project the idea that males are more ram-like than human.

Seriously . . . What If Human Males Were Like Wilson’s Rams?

Like Wilson, many scientists, journalists, and people on the street fall prey to the temptation to generalize observations of various female and male animals to human gender-based behaviors. Despite the fact that we (both John and Rylee) think that generalizing the results from sheep research to human males can be silly, we also believe it’s important to take these possible generalizations and implications very seriously. Consequently, we will now look closely at and deconstruct Wilson’s sheep-based generalizations to determine just how well they fit humans. Based on the initial 2 minutes of his TEDx talk, here’s our best effort to take his message and translate it into human male sexual behavior:

  • IF a human male happens to have a frontal lobe the size of a ram and therefore cannot consider the pleasure or interests of a partner or future implications of impregnating multiple females . . .
  • AND IF a human male is in the rather unusual and remarkable situation of having several willing human females available. . .
  • AND IF the available and willing human females happen to have the ample breasts, long legs, plump red lips, full lashes, and lack of pores that human males have been conditioned to find attractive . . .
  • AND IF a human male has no moral or social or health inhibitions about sexual behavior with multiple partners
  • AND IF, like our ram brothers, a human male has repeated ejaculation as his ultimate and exclusive goal . . .
  • THEN it would be highly natural (as deemed by Mother Nature) to ejaculate every two minutes with a different woman until reaching a state of exhaustion (presuming the human refractory period—during which a second ejaculation isn’t possible—cooperates and that the human male doesn’t fall asleep after his first ejaculation).

Another way of making the point we’re trying to make is to say: There is very little serious, relevant, or helpful take home message (for humans) from this research on rams and ewes. However, despite its minimal relevance for humans, these research results may be very serious, relevant, and helpful for rams and ewes, scientists who study rams and ewes, and ranchers who want to breed rams and ewes.

Clinical Interviewing

IS PATH WARM – An Acronym to Guide Suicide Risk Assessment

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Suicide Risk Factors, Acronyms, and the Evidence Base

[This is adapted from our forthcoming 5th edition of Clinical Interviewing]

In 2003, the American Association of Suicidology brought together a group of suicidologists to examine existing research and develop an evidence-based set of near-term signs or signals of immediate suicide intent and risk. These suicidologists came up with an acronym to help professionals and the public better anticipate and address heightened suicide risk. The acronym is: IS PATH WARM and it’s outlined below:

I = Ideation

S = Substance Use

P = Purposelessness

A = Anxiety

T = Trapped

H = Hopelessness

W = Withdrawal

A = Anger

R = Recklessness

M = Mood Change

        IS PATH WARM is typically referred to as evidence-based and, in fact, it was developed based on known risk factors and warning signs. Unfortunately, reminiscent of other acronyms used to help providers identify clients at high risk for suicide, in the only published study we could find that tested this acronym, IS PATH WARM failed to differentiate between genuine and simulated suicide notes (Lester, McSwain, & Gunn, 2011). Although this is hardly convincing evidence against the use of this acronym, it illustrates the inevitably humbling process of trying to predict or anticipate suicidal behavior. In conclusion, we encourage you to use the acronym in conjunction with the comprehensive and collaborative suicide assessment interviewing process described in our chapter in the Clinical Interviewing textbook. See: http://www.amazon.com/Clinical-Interviewing-2012-2013-John-Sommers-Flanagan/dp/1118390113/ref=sr_1_1?s=books&ie=UTF8&qid=1373655813&sr=1-1

After talking about IS PATH WARM in workshops over the past year or so, it seems important to emphasize that these “risk” factors are near-term risk factors. Other, very important longer-term risk factors, are not included. For example, previous attempts and clinical depression aren’t even on the list. And, although they include withdrawal, it seems that words like isolation or loneliness capture this dimension of risk at least as well.

The point of my criticism is to emphasize that even the best suicidologists on the planet struggle in their efforts to identify the most important immediate and longer-term suicide risk factors. This is primarily because suicide is nearly always unpredictable and one of the reasons that it’s unpredictable is because it occurs, on average in the U.S. in 13 people per 100,000. The other side of this dialectical coin is that, of course, we need to try to predict it and prevent it anyway.

You can check out more details about IS PATH WARM on many different internet sites, including a description of its origin provided by the American Association of Suicidology: http://www.suicidology.org/c/document_library/get_file?folderId=231&name=DLFE-598.pdf

Boys and Men, Personal Reflections

My New Favorite Book (for now) and Why I Love Quiche

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In elementary school in the 1960s, my reading almost exclusively included comics. I didn’t just love Captain America, I wanted to BE Captain America.

Unfortunately, I was in high school in the early 1970s, when reading books was apparently in disfavor. We used the SRA Laboratory Reading System and the only real “book” I recall reading in all of high school was “The Andromeda Strain.” Of course, the problem was likely partly due to my preoccupation with athletics over academics, but that’s a different story.

What this means is that most of my book reading has occurred after 1975, which is when my football buddy Barry and I read, “Real Men Don’t Eat Quiche.” The problem with that was that I happened to like quiche . . . a lot . . . and consequently, rather than questioning my sexual identity, I began questioning what society tells real men that they should do and not do.

This leads me to my book pick of the week.

As some of you already know, I’m working on a writing project related to sexual development in young males. This work led me to discover the book “Delusions of Gender” by Cordelia Fine, Ph.D. Dr. Fine is a psychologist in Australia and has written an absolutely awesome book that slices through many of the silly connections people are making between neuroscience and gender. For example, as an opening to chapter 14 “Brain Scams,” she wrote:

“My husband would probably like you to know that, for the sake of my research for this chapter, he has had to put up with an awful lot of contemptuous snorting. For several weeks, our normally quiet hour of reading in bed before lights out became more like dinnertime in the pigsty as I worked my way through popular books about gender difference. As the result of my research, I have come up with four basic pieces of advice for anyone considering incorporating neuroscientific findings into a popular book or article about gender” (p. 155).

You’re probably wondering, what is her excellent advice for those of us considering writing in this area? Well, I’m resisting the temptation within my male brain to type out her advice, other than her fourth piece of advice, which reads: “Don’t make stuff up.”

But that’s exactly what many writers are doing. Here’s an example I found recently. It’s titled, “7 things he’ll never tell you” and written by “Dr.” Kevin Leman. He wrote, “Did you know that scientific studies prove why a woman tends to be more ‘relational” than her male counter part? A woman actually has more connecting fibers than a man does between the verbal and the emotional side of her brain. That means a woman’s feelings and thoughts zip along quickly, like they’re on an expressway, but a man’s tend to poke slowly as if he’s walking and dragging his feet on a dirt road.” (pp. 5-6).

Of course, this is sheer drivel . . . or as Dr. Fine might say, “He just made that up.”

Or as I might say: He’s really just talking about himself here . . . and it’s likely caused by the fact that he didn’t eat enough quiche growing up.

So what’s the evidence? If we look at one of the best relational factors upon which women are supposed to be better than men–empathy–what does the research say?

Well, as it turns out, using the best and most rigorous laboratory empathy measure available, empathy researcher William Ickes found no differences between males and females in seven consecutive studies. And then, when he did find differences, he found women did better only in situations where they are primed by “situational cues that remind them that they, as women, are expected to excel at empathy-related tasks.” (Fine, p. 21).

Anyway, it’s late and I’m going to stop writing . . . but not before I put in a link to a Cordelia Fine speech you can watch online. Here it is:  http://fora.tv/2010/10/02/Cordelia_Fine_Delusions_of_Gender

Now I’m off to bake myself a quiche.

Clinical Interviewing, Counseling and Psychotherapy Theory and Practice, Therapy with Adolescents

A Summary Checklist of Strategies and Techniques for Managing Client Resistance

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One friend of mine who is a therapist has a very deep voice. Years ago, we were both seeing lots of boys who were often angry. These boys were also, no big surprise, resisting the advice and direction of authority figures, like parents and teachers. Several times I got a chance to work with young male clients who had “blown out” of therapy with my friend.

They described him as frightening. They said he would joke about having a “rack” in the back room in his office building and threaten to take them there if they wouldn’t talk. For young clients who got his sense of humor and who could see past his deep voice, his style worked very well. But for other youth, a kinder and gentler approach with less room for misinterpretation was needed.

In the following excerpt from Clinical Interviewing (5th edition), Rita and I are just finishing our discussion of why clients lie and resist counseling. Most of our thinking in this are is based on a combination of motivational interviewing and our own counseling and psychotherapy experiences-like the one described above. Following the end of our brief comments about lying and resistance, we include a summary table listing strategies and techniques for dealing with resistant clients that might be helpful to you. If you want more information about this, feel free to email me at john.sf@mso.umt.edu and I can send you an article or a chapter on working with resistant youth. Here’s the excerpt:

. . . . There are many reasons why clients lie, most involving some form of self-protection or the belief that they profit from lying. As a general rule (with exceptions), people tend to lie more if they feel the need to lie and tend to lie less when they experience trust. As a consequence, your goal is to build an alliance that includes enough trust to facilitate honesty. Confrontation of obvious or subtle lying behavior may be less productive than waiting for rapport and trust to build and for honest disclosure to flow more naturally. This perspective or stance can be a relief; when in the role of therapist (and not judge) facts are usually less important than feelings. To summarize, resistance, or whatever we choose to call it, is a natural part of the change process. In fact, research suggests that client resistance is an opportunity for deeper work. When resistance is worked through, the likelihood for positive outcomes is increased (Mahalik, 2002).

In the end, it’s helpful to remember that resistance emanates from the very center of a person and is part of the force that gives people stability and predictability in their interactions with others. Resistance exists because change and pain are often frightening and more difficult to face than retaining the old ways of being, even when the old ways are maladaptive. Finally, with culturally or developmentally different clients, resistance may actually be caused when the therapist refuses or fails to make culturally or developmentally sensitive modifications in his or her approach (J. Sommers-Flanagan & Sommers-Flanagan, 2007b). Table 12.1 includes a summary of strategies and techniques for managing resistance.

 

Table 12.1 Summary Checklist of Strategies and Techniques for Managing Resistance
____  1. Adopt an attitude of acceptance and understanding because developing a therapeutic alliance is almost always a higher priority than confrontation.
____  2. Recognize that clients will feel some ambivalence about working toward and achieving positive change.
____  3. Resist your impulses to teach, preach, and persuade clients to make “healthy” decisions.
____  4. In the beginning and throughout the session, ask open-ended questions that are linked to potential positive goals.
____  5. Look for positive goals that are underlying your clients emotional pain and discouragement—and then help your client be the one who articulates those goals.
____  6. Use simple reflection to reduce clients’ needs to exhibit resistance.
____   7. Use concession “You’re right. I can’t make you talk with me” to affirm to clients that they’re in control of what they say to you.
____  8. Use amplified reflection to encourage clients to discuss the healthier side of their ambivalence.
____  9. Use emotional validation when clients are angry or hostile.
____ 10. Use radical acceptance to compliment clients for their openness—even though the openness may be aggressive or disturbing.
____ 11. Reframe client hostility and negativity into more positive impulses whenever possible.
____ 12. Provide genuine feedback related to your concerns to your clients.
____ 13. Use paradox carefully to respectfully come up alongside clients’ resistance.
____ 14. If you’re concerned about truthfulness, get signed consent and then interview a significant other to help you get an accurate story.
____ 15. When clients ask “Do you believe me?” use a response that will encourage more disclosure, like, “I’m not here to judge the truth, but just to listen and try to be of help.”
____ 16. Remember (and be glad) that you’re a mental health professional and not a judge.

From Clinical Interviewing (5th edition). See: http://www.wiley.com/WileyCDA/Section/id-302475.html?query=John+Sommers-Flanagan

 

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