Category Archives: Mental Health

Halloween Needs More Death

As Halloween approaches, it brings a tide of childhood memories: handmade princess costumes, the joy of free candy, the rule among my peers to hold our breath when passing a cemetery so we wouldn’t ‘catch’ death. As children, it seemed that simple not to die, and secular America hasn’t outgrown that belief. But by ignoring and hiding death, we remain helpless against our fundamental fear of it. Through my practice of mindfulness meditation I have discovered just how fearful and resistant I am to the concept of death as I develop a mindful approach to facing it.

Thanks to longer lifespans and smaller families, I, like many Americans, have not had a death in my close family in years. The last time I attended a funeral I was ten years old. Three decades after my grandmother died, the mere mention of her name makes me teary. Rarely do I have to confront human mortality, and as a result, I haven’t accepted it.

We treat death as a contagion to which the strong and successful are impervious. Witness the current mania for vampires – e.g., Twilight and The Vampire Diaries – in which the protagonists live forever. It is as though we are above death, and on Halloween we celebrate our conquest, laughing at silly dancing skeletons or telling tall tales of headless horsemen that banish mortality beyond the pale of plausibility; ghosts aren’t real, and by extension, neither is death.

Publications as diverse as Psychology Today and Huffington Post have examined that fear of death and how it hurts us. Such fears can cause anxiety disorders and prolonged mourning, such as the extended grief I have for my grandmother, and they can even prevent people from going to the doctor when they should. But there is a better way: confronting mortality head-on, in a spirit of acceptance. Halloween is a missed opportunity to do just that.

Other societies and religions have embraced death as an inevitable part of life, grappling regularly with, and thus defusing, fear. The ancient Romans made a daily practice of “memento mori,” or “remember death.” At feasts, a skeleton or skull would be present to remind revelers that their levity and good fortune were transient. This didn’t necessarily dampen a good time – it encouraged them to pack in as much fun as they could in the time they had.

Western Europe once adopted memento mori customs. Timepieces, some of which remain from the 16th-19th centuries, included design elements like images of skulls or Latin inscriptions meaning “perhaps the last hour.”

Of course, there is Dia de Los Muertos, Day of the Dead, primarily a tradition of Latin cultures and especially important in Mexico. The two-day event combines the celebrations of All Saints Day (November 1) and All Souls Day (November 2). Families gather to remember their dead relatives with sugar skulls, Catrinas (skill dolls), marigolds and the favorite food and drink of the departed. Instead of holding their breath through the cemeteries, they will often hold feasts atop the very graves of family members who have passed on. Similar traditions exist in Asian and African cultures and although Dios de Los Muertos dates back to Aztec culture, it now incorporates symbols of Catholicism, such as the Virgin Mary and Jesus, as well.

In fact, religion is one of the few places we face death today. The impermanence of this life is easier to swallow when it comes with the promise of an afterlife, which faith traditions tend to provide. But even those who don’t believe in an afterlife can benefit from a religious approach to our transience. For instance, Catholics’ liberal display of crucifixes and art depicting martyrdom surround churchgoers (and art museum visitors) with visual reminders of our inescapable fates: if even the exceptionally virtuous and divine die, there really is no out.

There is merit in the requirement of my religion, Judaism, that mourners attend services and recite prayers for deceased relatives daily for 11 months and annually thereafter, keeping death on our minds and calendars. Buddhism and some other schools of meditation advise practitioners to meditate on the inevitability of death, even to contemplate corpses, in order to overcome the painful tension of fear.

As a Jew, I appreciate the rituals of my religion, but I have not found in them a road to accepting my own lot. Meditating mindfully on my own mortality seems to me like the most effective path, facilitating calm and promoting tranquility. That state of mind doesn’t come easily, but I believe that with practice, meditation can help one make peace with the physical limits of the human condition.

Halloween’s clownish skeletons, costumes, and piles of candy sugarcoat mortality, while the frightening ghouls and ghost stories keep it unrealistic – death is either too silly or too supernatural to worry about. Then we drop the topic for the rest of the year, as the dying are hidden in hospitals and hospices, and talk of death seems overwrought.

It would be healthier if we spent Halloween – or some other time, lest we deprive children of candy on this much-loved holiday – meditating on death with an open mind and heart, even working towards welcoming it. Meditation is a practice, not a quick fix, but it can help foster calm coexistence with the knowledge that our end approaches. An excellent book on this topic is Living in the Light of Death: On the Art of Being Truly Alive by Larry Rosenberg.

On a more practical level, once meditation has facilitated a degree of calm in the face of our own mortality, we should consider matter-of-factly how, like the ancient Romans, each of us personally can make the most of life without taking it too seriously. Because no one here gets out alive.

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Are Children Necessary?

Article first published as Are Children Necessary? on Blogcritics.

Why do many parents insist that having children is indispensable to human fulfillment, when the number of fulfilled childfree adults proves that it clearly isn’t? I considered this question in my first post on this blog, “The Preachers of Parenthood.” I made some speculations about the explanation, but now there is an actual scientific study that offers a new and intriguing explanation: cognitive dissonance.

The study, conducted by two scientists at the University of Waterloo, published in Psychological Science, and reported by Wray Herbert at The Huffington Post, concluded that parents convince themselves that parenthood is a joyous, “don’t miss” experience to avoid their true feelings about it, which may be mixed or even negative. This should give pause to anyone who is on the fence about whether to have kids.

Herbert, a parent himself, makes a fascinating point about the emotional and intellectual gymnastics some parents do to be (or seem) as happy as they are “supposed” to be about parenthood. In the not-so-long-ago past, he notes, “emotional relationships between parents and children were less affectionate…and childhood was much less sentimentalized.” The notion that parenthood should be joyous arose only when children no longer added value to the family economy – implying that parents’ personal fulfillment emerged as a substitute reason for people to keep breeding once the financial incentive disappeared.

Of course this study doesn’t show that all parents are deluding themselves or that they would all be unhappy if they were honest with themselves, though it is worth noting (as the study’s authors do) that “raising children has largely negative effects on parents’ emotional well-being.” For instance, Harvard psychologist Daniel Gilbert writes in his book Stumbling on Happiness that “careful studies of how women feel as they go about their daily activities show that they are less happy when taking care of their children than when eating, exercising, shopping, napping, or watching television.” Jennifer Senior reports in New York Magazine that “a wide variety of academic research shows that parents are not happier than their childless peers, and in many cases are less so. This finding is surprisingly consistent, showing up across a range of disciplines.” This raises the question whether these studies found a way to cut through the cognitive dissonance that was documented in Psychological Science to reveal deeply-buried dissatisfaction, or whether the parents experiencing cognitive dissonance showed up as happy in the other studies, or whether cognitive dissonance is even the right explanation for the Waterloo findings.

One thing is certain: more studies on parental happiness are to come, and my bet is that they will offer even more affirmation to people who suspect they would prefer a life without kids. Making “non-parenting” more socially acceptable can only increase the choices young adults have in shaping their lives, and that makes me honestly, non-dissonantly happy.

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A New Side to Work Anxiety

American workers have few rights in the workplace, and those afflicted with mental health disorders are among the most vulnerable.  Any worker can be fired, demoted, transferred, etc. at any time for just about any reason.  There are very few areas of refuge: employers can’t discriminate on the basis of race, color, national origin, sex, religion, age, and disability (on the federal level – some states and cities have additional protections, including marital status, sexual orientation, and others).  Mental disorders can qualify as disabilities, but workers who suffer from them often miss out on the legal protections available to them. 

Approximately 57.7 million American adults experience a mental health disorder, from a single bout with depression to schizophrenia, in any given year.  http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Mental_Illness.htm.  That is about one in every four adults.  Not every one of these individuals is too disabled to work, and many of them need only a temporary leave.  But for many reasons these workers do not get that accommodation.

The Americans with Disabilities Act (ADA) prohibits discrimination on the basis of disability and requires reasonable accommodations of disabled employees, and the Family Medical Leave Act (FMLA) requires some employers to provide some employees with up to 12 weeks of unpaid leave if it is medically necessary.  The FMLA applies only to employers with 50 or more employees (the ADA applies to employers with 15 or more employees), and only to employees who have worked for that employer for at least a year and worked at least 1,250 hours during the year before the leave. 

A recent decision by the federal Court of Appeals for the Eighth Circuit held that an employer did not violate the ADA or FMLA when it invited an employee with an anxiety disorder to resign with two weeks of severance pay rather than granting him medical leave or a reasonable accommodation.  (The case is called Kobus v. College of St. Scholastica, Inc.: http://www.ca8.uscourts.gov/opndir/10/06/091583P.pdf).  The employee made two big mistakes, according to the court: first, he did not inform his employer that he had a disability or a medical condition that required leave; second, he did not request a leave. 

On the surface those sound like good reasons: it isn’t reasonable to expect an employer to provide leave or another accommodation to an employee that it doesn’t know is ill, or to provide leave to an employee who doesn’t ask for it.  But if you dig a little deeper this case reveals how the laws protecting ill and disabled workers let people with mental disorders fall through the cracks.

First, is it really any surprise that an employee wouldn’t tell his employer that he was suffering from a mental disorder?  There is an enormous stigma in this country (at least outside of Manhattan) to admitting that one is seeing a therapist or is on psychotropic medication.  Often people don’t tell their family or close friends these things.  There is even less reason for them to risk the repercussions of telling their employers, who might question their ability to do their jobs or even demote or fire them rather than keep a “crazy” person around.  The employee in this case testified that he didn’t tell his employer that he was taking medication because he “wasn’t real proud of that fact.”

But the employee did tell his employer about his illness.  After he was diagnosed with an anxiety disorder and prescribed Paxil, he “began” (suggesting he did it more than once) telling his supervisor that he was suffering from anxiety and stress.  In the recent past the poor guy had endured “the illness and death of [his] mother after an apparent medical mistake; the serious illness of his brother; his ex-wife’s cancer diagnosis; and news that his son had been diagnosed with bipolar disorder and had subsequently dropped out of college.”  Despite all this, the court focused on the fact that he did not tell his employer that he was taking medication for his condition or that he was depressed.  In contrast the Equal Employment Opportunity Commission, which is the federal agency responsible for enforcing the ADA, recommends that “an employee’s request for time off because he is ‘depressed and stressed’” should be “sufficient to put the employer on notice that the employee is requesting reasonable accommodation,” which could include a leave of absence.  My guess is that “anxious and stressed,” which is what the employee in this case told his supervisor, would be sufficient for the EEOC, meaning that the employer did know that the employee was ill.  But the federal appeals court can choose to ignore the EEOC’s recommendation, and so it did.

Second, the employee did request a leave, specifically a “mental health leave.”  But he had no vacation or sick leave available, which illustrates an important gap in the laws: employers are not required to provide paid vacation or paid sick leave (although in this case he may have just used all his leave).  Even for salaried employees, an employer can choose not to provide any paid leave at all.  On top of that, the 12 weeks of FMLA leave (assuming one is even eligible for them) are unpaid.  And, the FMLA allows employers to require an employee to provide a doctor’s certification that they are ill and cannot work, but seeing a doctor requires health insurance (in this case, the employee said that he did not have a doctor and therefore could not meet the requirements for FMLA leave), cash, or both.  A sick employee who should take a leave but can’t afford to forego the income might rationally choose not to request a leave.  That doesn’t mean the employer should lose a lawsuit because the employee didn’t request leave.  It means that the laws need to change so that people don’t have to choose between their health and four weeks of pay plus the cost of a doctor’s visit. 

The disabled (whether through a physical or mental disorder) are among the populations least able to absorb that loss of income.  32% of disabled adults fall below the poverty line.  http://www.spotlightonpoverty.org/ExclusiveCommentary.aspx?id=0e1ca1a2-e921-4349-866b-273a2216c664.  But people with mental disorders may be the worst off financially.  People “in the lowest socioeconomic strata are about two and a half times more likely than those in the highest strata to have a mental disorder.” http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec8.html#introduction, Those disorders are serious: approximately 80% of people with depression find that it interferes with their ability to work.  http://www.cdc.gov/nchs/data/databriefs/db07.pdf

Workers need more protections in the workplace, and the most vulnerable need them most of all.  For that to happen, we must change the laws.  Individuals with mental disorders need more acceptance in society so they can ask for what they need and exercise their rights.  For that to happen, we must change our minds.  Visit www.nami.org for more information.