Crazy Books, Continued

One of the wonderful (and possibly self-fulfilling or even egotistical) aspects of blogging about books is that some of their authors are alive, a smaller percentage of those authors are on social media, and an even smaller number of them actually respond when mentioned in a tweet. Well, lucky me, that happened! In my post earlier this week on books related to mental health, I mentioned two of Dr. Julie Holland's books. I included her twitter handle in my tweet about the post, and she favorited it. I have no idea if she read it, but I still feel like that is pretty nifty. 

So that makes me hesitant to mention some of the drawbacks to her earlier book. (What if she is actually reading this? Does that make her cool and in tune with her readers? Or overly concerned about public opinion? Or does that just make me seem paranoid?) Anyway, I feel like I need to qualify my earlier praise of Weekends at Bellevue. At some points, I was appalled by her hastiness and tough-guy attitude toward her patients. To be fair, she realizes that this attitude is problematic and off-putting to some, and she does work to change it. Nevertheless, it's concerning to see a physician relate patient stories in such a callous tone. Here's an example: 

“After I spoke with the hand surgeon and got him to agree to come down, the patient changed his mind, and decided he didn’t want anyone to touch his hand. I got really pissed off then. I argued with him for a while and got nowhere, and then I called him a pussy ... “You’re just chickenshit to have the surgeons sew your hand.” I ridiculously believed I could double-dog dare him into having sutures. He was handcuffed to the chair.”

— Holland, 65

It's admirable that she allows herself to be this vulnerable, on the one hand; though on the other, it's disarming and worrisome to see a doctor--a psychiatrist no less--not only think, but also express, such contempt for a patient. She writes more about her "need for self control" with her therapist, Mary. 

Medical school seems to be part of the problem, as she discusses early in the book: "Everywhere, instead of people, I learned to see pathology. I was learning to think like a doctor" (25). I want my doctors to see me as a person! To see only my pathology is to see only a small piece of who I am, and it may even mean missing out on key information that could lead to a diagnosis. 

Her softer side emerges at times. She conveys her conflicted feelings about leaving patients locked up all week while she went about her business in the outside world. She tells other stories of how she exceeded her duties to make sure a patient remained safe from him or her self. I was confused about her references to her attraction to other doctors and her brazen efforts to have sex with male doctors at the hospital. 

But what drew me in were the intense stories she tells of other people's madness. Stories of people who lose grasp of reality due to severe circumstances or childhood abuse are disheartening and frightening. We don't know what will put us over the edge and, possibly, into the hospital. On this subject, Holland writes, 

“There is a diaphanous membrane between sane and insane. It is the flimsiest of barriers, and because any one of us can break through at any given time, it scares all of us. We all lie somewhere on the spectrum, and our position can shift gradually or suddenly. There is no predicting which of us will be afflicted with dementia or schizophrenia, who will become incapacitated with depression or panic attacks, or become suicidal, manic, or addicted. None of these states of mind are uncommon, and all of us have friends and family who are suffering with some degree of psychiatric illness. ”

— Holland, 292

Despite a few reservations, I truly applaud Dr. Holland for sharing her personal journey, as well as the experiences of so many psychiatric patients, with the world. By revealing all these stories, she helps to diminish the stigma that some people feel for having or seeking treatment for mental illness. 

Three Crazy Books

A few weeks ago, I went to see Dr. Julie Holland talk about her most recent book, Moody Bitches, at Sixth & I Historic Synagogue. (I discovered her thanks to her February NY Times piece.) In a room almost entirely full of women, Holland spoke about her journey to the realization that many more women than men take antidepressants. She argued that the fact that 1 in 4 women take this class of medication reveals something deeper, something sinister even, about society's values, and especially about workplace norms. Because my friend Elissa is going to read the hard copy and then pass it along to me, and because I wanted to know more about this lady right away, I looked online and found that she had written a book a few years ago about about her tenure as a psychiatrist at the Bellevue Psych ER. Of course I was going to read this. 

Over the weekend, I finished Belzhar, a YA (young adult) book by Meg Wolitzer, author of, most recently, The Interestings. In Belzhar, the young protagonist Jam suffers from depression after her boyfriend Reeve dies mysteriously. Sent by her parents to a boarding school for "emotionally fragile" teens, Jam struggles to find the will to recover her earlier self. I don't usually enjoy YA books, but this one felt especially deep and genuine. Near the end of the book, Jam reflects: 

“Words matter. This is what Mrs. Q has basically been saying from the start. Words matter. All semester, we were looking for the words to say what we needed to say. We were all looking for our voice.”

Today, as I was poring over Holland's earlier book, Weekends at Bellevue: Nine Years on the Night Shift, it occured to me that there was a theme in the books I'd read recently: craziness. That's not the PC term, of course, but rather the sensation or the feeling one has when one's mind decides to work against oneself. As I began to write this post, I looked back to the "finished" folder on my Kindle to see if there was anything else I should include. Sure enough, Irvin Yalom's 1989 book, Love's Executioner, topped the list. He chronicles his experiences with a variety of patients, struggling to figure out the most effective way to help each one. 

Why is it so fascinating to read about other people's mental struggles? Why is it so enticing to watch other people waffle between sanity and psychosis? Why do we want to know what psychiatrists and therapists really think? 

Well, why wouldn't we? They're the experts on thinking and feeling, so of course we want to know what they think of other people. It's a shortcut to our own thoughts and feelings. It's like gossip, but deep. And true. Also, It's much easier, much less intense, to inhabit someone else's mind for a little and learn something than to dwell in your own experiences. Feeling grief vicariously seems immensely preferable to feeling it firsthand.

These books provide, in their own way--Holland's through personal narratives of a Psych ER, Wolitzer's through first-person fictional chronicle of a girl's depression, and Yalom's through a psychotherapist's interactions with 10 patients over several years--an immersion into emotions that can seem too oppressive, too uncomfortable, or too frightening to abide with on our own. I heartily recommend all three.

What Fills My Head

Enchanting Podcasts: Or, How I Motivate Myself To Walk Schroeder In The Rain 

I used to judge people who wore earbuds while walking their dogs. However, now that I've found some awesome podcasts that I actively want to listen to, I get why people do it. Not listening to anything can mean that I spend too much time in my own head, which isn't always good, or that I start talking to Schroeder in "Schroed voice," which can make for some embarrassing moments when other humans materialize.

So, here are some of my favorite podcasts, both new and old: 

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Being Boss with Emily Thompson & Kathleen Shannon 

These are two creative lady entrepreneurs who talk all about their work and give great advice while being hilarious and authentic. I don't have a favorite episode; they're all SO good. I even listen to the ones about issues that are not at all related to me (like motherhood) because they are just so empowering. Emily does not mince words! Kathleen is so endearing. They make anything feel possible. 

Dear Sugar with Cheryl Strayed & Steve Almond 

These two dish out life advice relating to love, identity, etc. They receive and read letters from listeners who ask deep questions and then give thoughtful responses. I always feel like I'm listening in on someone else's therapy session--for free! 

Good Life Project with Jonathan Fields  

I've only listened to one and a half episodes so far, but the gist is that Fields interviews fascinating people, people who have endured huge trials or happened upon fascinating discoveries, and asks them hard questions. The podcasts are long enough to delve into tough issues. It's like Fresh Air, but for those interested in psychology and health. 

Starr Struck Radio with Mary Catherine & Ben 

What a funny couple! They talk about all sorts of things, but my favorite episodes so far have been about morning routines and motivation. I tried the whole morning routine thing and see its value, but I still cannot force myself out of bed. You can read more about that experiment here. And as for motivation, well, they made me realize a lot of mine is negative. Eeks! 

Disdain For Public Event in Capital City

This week, the assignment for my online class with The Writer's Studio was to write a lyric poem that described a public event or space. The goal was to capture the feeling of the public event as well as the speaker's attitude toward the event using descriptive language. I don't particularly care for most public events: crowds make me uncomfortable, and I can't handle loud noises. I couldn't come up with anything warm and fuzzy about parades or ball games. But I do have a few feelings about crowds and tourists in DC. 

---

Disdain For Public Event in Capital City

From myriad undetectable sources emanate
tobacco, fresh from anywhere but CVS;
body odor, from the fledgling adolescent,
too old to spurn deodorant,
too young to know the difference;
sweet salty butter, from the sallow vendor,
sickened from the radiation of microwaves;
 
These swirling scents
suffuse the once-breathable air
with the flurry and torrent of the
patriotic visitor enamored with an American pastime,
the zealous hockey fan donning the overpriced, oversized jersey,
 
Bellies splay over snug mom jeans,
Toes out of long-ago-appropriate sandals,
Tiny hands out of last year’s winter garb.
 
The influx,
the hordes and hordes and hordes
who communicate their whereabouts
to each other via speakerphone,
and park hulking bright-white Suburbans in fire lines,
and drive like their grandmothers
down Pennsylvania Avenue
and then
shut down Rock Creek Parkway,
scurry to and fro, unawares and anxious:
to overwhelm the bleachers,
to root for the underdog,
to sing along with the choir,
to cheer for the honoree.
 
Wrinkled, hoary vendors shout
like the forest green Starbucks Siren,
luring in an unsuspecting tourist
to fish in his fanny-pack for cash,
exchanging it for overpriced t-shirts
made in China,
on sale to commemorate said rituals
sponsored by
multinational, multibillion-dollar corporations
that lobby for business tax breaks
and graciously provide unlivable wages to employees,
forcing their children to consume the processed breakfasts,
the packaged peanut butter and jelly pies,
that are distributed every morning
at their crumbling, leaky schools.
 
Ritual after ritual after ritual,
for this hero and that one:
all men
honored in this fair city,
this unrepresented district.
 
The tourists, eager to commemorate said occasion
and justify the expense of air travel
by solidifying the memory of being
at this place in this very moment,
sport those new matching shirts
which boast the clever, turquoise logo of the event.
 
The tourist, together with the rest of the tourists,
builds blockades of ignorance
across the cobblestone sidewalks
and often-out-of-service escalators,
pausing to ask Siri how to navigate
this capital city, this city built on a grid.
 
The anthem, the cheer, the wave, the chant,
the flag, the tweet, the memento, the selfie:
the collective act of commemoration.
 
What if there were
silence and sterility instead;
nothing purchased,
nothing hummed in unison;
no celebration,
no solemnity;
a dearth of earnest guests
without their souvenirs
... no one intruding,
creating nothing, leaving nothing behind?

Learning To Write

What do you remember about learning to write? 

Here's what I remember: 

• extensive checklists 
• "playing" with margins 
• bibliography rules and regulations 
• art prompts 
• "take a side" prompts (for example, Is the death penalty acceptable?) 
• college-ruled paper 
• diagramming sentences 
• The Little, Brown Handbook 
• Times New Roman 
• multicolor uniball gel pens 
• losing 20 points for a comma splice 

Apparently, these are the things I thought about when I was in school. If there were graphic organizers in existence, I never saw one. There was no such thing as dictation. I don't know any teachers who care about the size or lines on a student's paper. The "Add Comment" option had just recently been made available in Microsoft Word. I wrote on an actual keyboard, not a laptop keyboard and definitely not an iPad keyboard, if it's even fair to call it that. 

A slew of graphic organizers, courtsey of Google Image search. 

I am assuming that because I was an avid reader and did what I was told in school, I eventually figured out how to write grammatically correct sentences. I have no recollection of doing any informal or personal writing after 8th grade. I don't remember revising anything, ever. If, as Daniel Wilingham says, "Memory is the residue of thought," then, well, that is rather unfortunate for me. Does that indicate that uniball gel pens consumed my mental energy? That I was so preoccupied with what I was going to write with, that I completely forgot what I was supposed to write about?  

In chapter 3 of Why Don't Students Like School?, Willingham explains why students remember the joke you made or what you were wearing but often don't recall what they were supposedly learning: 

"To teach well, you should pay careful attention to what an assignment will actually make students think about (not what you hope they will think about), because that is what they will remember." (54) 

And then there's this, which makes perfect sense: 

"Whatever you think about, that's what you remember. Indeed, it's a very sensible way to set up a memory system. [...] When we're talking about school, we usually want students to remember what things mean. Sometimes what things look like is important--for example, the beautiful facade of the Parthenon, or the shape of Benin--but much more often we want students to think about meaning. Ninety-five percent of what students learn in school concerns meaning, not what things look like or sound like. Therefore, a teacher's goal should always be to get a student to think about meaning." (61) 

If only it were that easy! So the question is: How do we get students to think about the actual act of writing when there it involves so many complex cognitive processes? If just one of those processes doesn't function in a typical way, then writing becomes a tremendous ordeal. Writing is hard enough for neurotypical kids, and extraordinarily difficult for those with impaired working memory, handwriting, reading skills, phonological abilities, etc. What is one to do? There is hardly any research on teaching high school students with LD to write. A recent article published in Remedial and Special Education found only 14 studies from 1965 to 2011 that explored the use of interventions to improve writing among students with disabilities. And in those 14 studies, only 51 kids were involved! 

Dismayed, I continued searching. Or, rather, wilfing. I stumbled upon a book called Best Practices in Writing Instruction. I downloaded the book in epub format for not-so-instant reading and eventual disappointment. (Note: Adobe Digital Editions, which purports to be an e-book reader app, barely deserves the 1.5 stars it has received on the App Store.) I've read parts of 3 chapters so far; little enlightenment has resulted, though it does make some decent points and provide some reasonable reminders about best practices. 

From the chapter on planning, I learned to see planning as beginning in either one of two ways: a top-down approach where students plan prior to writing and a bottom-up "discovery" approach wherein writers discover new and important ideas while they write (169). It's clear that teacher modeling of either planning process is helpful to students, but it's not clear how to best model planning or pre-writing, or how to convince students that it's worthwhile, especially because "many developing writers are simply unable to plan because of the complexity of the demands of the cognitive processing tasks" (171). Futility, indeed. 

The chapter on revising makes it clear that self-regulation and metacognitive skills are required for this part of the writing process. It provides some insight into useful classroom practices. One example involves teaching students how to evaluate the work of their peers, and then pairing them up to evaluate each other's work. Even thought this is something I have done with students before, it's good to see that there is a legitimate reason for doing it. Another point the authors make is that the criteria for revision need to be specific rather than general. In other words, huge tables that provide generalizations about what constitutes a high score, don't actually help students revise because they aren't specific. Here's an example of one of those unhelpful rubrics from the Common Core: 

Actually, it's not really fair to say they aren't helpful at all, because they can be, if used as a starting point for feedback, or if students make them. They could even be useful for teachers as a starting point or as a reminder of standards, as in the case above. 

The last chapter I read, on sentence construction, is probably the subject that I know least about of the three. It turns out that writing a sentence demands a considerable amount of brainpower (210). All of these cognitive tasks are required: 

• formulate an idea 
• retrieve words to match the idea 
• mentally arrange and rearrange words 
• turn those ideas into a readable structure 
• manipulate text to make the ideas precise 

Teaching sentence combining skills is the best way, according to the author, to teach students how to improve their sentence construction. But to learn how to combine sentences, one must first understand the parts of sentences and the ways those parts work together. 

I wish I could teach an entire course on how to write a sentence, or that I had the time to confer with each student prior to having him or her organize ideas in some kind of planning document or graphic organizer. I know that they should be devloping rubrics with my guidance based on what they observe about their own and their peers' writing. I wish I could convince them that revision is an integral part of the writing process, which itself is a term I kind of despise because it has been co-opted by well-meaning teachers to indicate something other than the organic, self-motivated, reflective process it is supposed to be.

I think that graphic organizers, had I been forced to use them, would have stymied my thinking in the same way that they do for some of my current students. However, I know that had I been taught more writing skills more explictly and in a way that invited me to think about what my writing meant--rather than what color and type of pen I wrote it with, what font it was in, or whether I had a comma splice--I would have not only expanded my sentence-construction repertoire and expedited my revision process, but I also would have found my thinking liberated and my mind poised, ready to examine anything from a text to the world in a different, more flexible way.