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The first amendment to our constitution prohibits the making of any law abridging the freedom of speech.  The supreme court has clarified the extent of the protection for free speech.  This applies only to speech against the government and more recently has been broadened to allow for more political dissent.  Of significance lately is concern about protests on college campuses that are against certain speakers that the students disagree with.  This has involved violence at times.  The concern is that the stuent protests will have the impact of supressing free speech. This then has led to concern about any effort to restrict speech such as those who are spreading hate comments on the internet and those who bully others on the internet via social media. There has been increasing concern expressed about bullying as it is connected to increased risk of suicide [many studies indicate an increased risk for suicide in children and adolescents who are being bullied although it is difficult to be precise about the impact of bullying on suicides].  So is it free speech vs increased risk of suicide?  Or is it free speech vs chronic stress traumatizing our brain cells that can lead to cell death. [This will be clarified below.]

Dr. Lisa Feldman Barrett, a professor of psychology at Northeastern University, wrote an opinion piece in the July 16, 2017 edition of the New York Times, entitled: "When is Speech Violence?' She makes the point that some speech is abusive while other speech is offensive but not abusive.  She considers bullying to be abusive as well as when people trade insults with each other over and over. Dr. Barrett considers prejudiced and judgmental views to be offensive but not abusive as these views do not create a prolonged stress for people and therefore do not trigger brain reactions that can be destructive.  It is like the difference between acute, temporary stress where the brain copes without leading to any damage to the brain.  On the other hand, abusive stresses lead to prolonged stress in people who are traumatized by these speech patterns and this leads to challenges to their immune systems that can compromise their DNA and even lead to neuron [brain cell] death. This repetitive abusive speech can lead to someone developing a post traumatic stress disorder [PTSD]. They often cope by blaming themselves and trying to keep things from getting worse. This on going stress reaction damages their immune systems. In addition, since they feel hopeless and like they have no control over their lives, they are at risk for suicidal behavior.

So, some speech is violent in the way other people respond to it. The abusive nature of the speech seems connected to it being repetitive and ongoing even if intermittant. So, free speech would not seem to include this type of speech.  What do you think?



I was listening to a TED talk by Anne Lamott [from June, 2017] and she mentioned that "there is almost nothing outside of you that will help in a lasting way."  Ms. Lamott believes that "it's an inside job." We are responsible for helping ourselves in lasting ways. This idea is complemented by her other message that "others need to find their own way" and it would be good if we stopped helping others so much. Ms. Lamott noted that "help" can be defined as "the sunny side of control." So, helping others can be a way to control them.  I have repeatedly blogged about the importance of not feeling or acting responsible for others as others need to be responsible for themselves and it is really impossible to be responsible for others.

Anne Lamott emphasizes the importance of our being responsible for ourselves and not "controlling" others by helping them.  I want to focus on this because people who have had repeated stressful experiences often do take responsibility for others as a way of trying to prevent things from getting worse.  This way of coping seemed to work when they were younger and had to deal with people who were not being responsible and not protecting them and things did get worse. However, now they don't need to worry about things getting worse related to past experiences and yet it is very hard to stop this type of worry. I have blogged before about the fact that the amygdala part of our brain responds to emergencies in nanoseconds [billionths of a second] and keeps us stressed about the past before we are even aware that a memory has been triggered.  If we can calmly tell ourselves that we don't need to be stressed about a memory while recalling the memory, our brain can start not reacting to the memory.  Often, this is also difficult to do.  This situation is one reason I have started to prescribe propranolol to help separate stress from past memories. if people who have been traumatized can stop feeling stressed by past memories, they can then focus on themselves and realize that it is a good truth that "almost nothing outside ourselves can help in a lasting way." It is up to us to help ourselves in lasting ways and we are up to the task. Really. 

What do you think?



The American Academy of Child and Adolescent Psychiatry [AACAP] has a new initiative called "Break the Cycle" to fund new research; increase the number of child psychiatrists; and help mentally ill children to get the treatment they need. The May/June 2017 issue of the  AACAP News contains statistics including that: 50% of all mental illness cases are diagnosed by age 14; 79% of children ages 6-17 with mental illness do not receive treatment; more than 50% of children age 14+ with mental illness drop out of school [a very high rate]; and 13% of 8-15 year olds have severe enough mental illness that they have trouble with day to day living. Importantly, on average it takes 8-10 years for treatment to start after symptoms begin and sadly, more than 4600 children die from suicide. Of these deaths, it is estimated that 80% [3680 children] could be saved.

What can we do to help our children? Well, we can be open about our own needs and things that we have done to help ourselves.  Also, we can then encourage children to feel that they deserve to get help and do not need to feel embarrassed.  It is important to share your experiences with parents as they need to be ok about their children getting help.  You don't need to know if children have mental illnesses as encouraging people seeking help and not being ashamed is vey important to share with everyone.  Regarding the risk of suicide, if people, including children, talk about suicidal feelings, they are much less likely to act on these thoughts. So, if you are worried about someone, even a child, ask them if they have been thinking about hurting or killing themselves.  You can also ask if they have felt that life is not worth living.  A yes to any of these justifies talking to the child's parent[s] or to a significant other, best if the person who has said yes to one of these is with you when you tell someone else. I will do the same thing with my patient's as I let them all know that I am strict about confidentiality except when it involves their safety.

Just like with anyone we are with, listening to a child without our own reactions, then sharing our own experiences with fears, anxieties, sadness and any support we have received, can help that child to choose to seek and accept help for themselves. 






It has become clear in my work with people that when they are interacting with others and feel exhausted or drained that something is wrong in how they are interacting. This may seem obvious but fairly often people tell me that they are exhausted by being with certain people. Now it may be only certain people but often I have seen where people are exhausted interacting with some people and then tend to not interact with others. It also seems obvious that people at times need more help and that this can be exhausting. So, does that mean that helping people is wrong, or is there something wrong with helping in a way that leads to feeling exhausted?

I have seen repeatedly that when people feel responsible for others or take on responsibility for others, they frequently end up feeling exhausted.  It is hard to stop "helping" others as they still seem to need help and to not be able to manage for themselves. Frequently my patients tell me that if they stop "helping" others, in other words stop taking responsibility for them, they will get angry.  Also, if my patients have pressing needs of their own, the people they are "helping" will often still get angry as if my patient's needs do not count as much.

No wonder it is exhausting. It seems like it is never ending. Why is that? Well, it seems that once a pattern is established where one person is "helping" [taking on responsibility for] another person, that person depends on it and feels that they are entitled to the help. So, if it stops for any reason [including any obvious need for help of the person helping] the person who has been helped is upset, often angry, and frequently will feel and act self-righteously.  This is often confusing and painful to the person who has been helping as they thought that the person being helped would be more than happy to help them if they needed help. Not so as the person being helped still feels the same needs to be helped and they are not easily put aside to then return the favor and help the person who had always helped them. It frequently does not occur to them that the person helping them would ever actually need help.

So what are you supposed to do.  Well, it is good to become more aware of the tendency to feel responsible for others and not let yourself fall into this trap.  Being aware of the stress involved can help, however, the stress of stopping this is a factor as well.  If you are feeling or acting responsible for others you are likely someone who does not like to see other people struggling.  You might have a tendency to jump in to help.  Well, you may need to redefine help for yourself.  Help is not doing for others or protecting them from feelings or stress. Helping is being encouraging and supportive as you are able to see their strengths and coping abilities and can be encouraging and supportive of them using these.  Believing in others and their ability to manage is very helpful and supportive. Doing things for them can undermine their self-confidence as they can interpret your help as meaning that you don't believe that they can manage. However, not doing things for others can seem cold and uncaring.  

To see a depiction of the importance of believing in others you could watch a short film entitled "The Butterfly Circus." 



I have previously blogged about the importance of not feeling responsible for others and not taking responsibility for others as this inevitably leads to stress and anxiety.  Why does it? Well, it is actually not possible to be responsible for others as they are separate human beings.  I know, as a parent or even as an innocent bystander, you can feel responsible for the welfare of children.  Yet even then, is it really being responsible for them or is it offering more literal support until they can do more for themselves while still encouraging them to make decisions for themselves so they can actually choose to go along with your support? Plus, it is likely that anyone you are taking responsibility for [or even just feeling responsible for] will at some point be resentful as you will not do a good job being responsible for them [how could you really] and it will start to feel to them like you do not have faith in their ability to take responsibility for themselves.

So why do we take on responsibility for others? Well, for the people who come to me for help, it is to prevent things from getting worse or simply to keep bad things from happening. These seem like good reasons. However, even if in the past [often years ago] things would get worse, that was not true now, but it seems like it is still true.  This seeming like there is still a risk that things will get worse is partly due to the fact that your past memories of things getting worsse tell you that the risk is real and the person that you are taking responsiblity for are acting like they will not do well if you stop acting responsbile for them.  So, what is one to do?

One can choose to recognize that they really don't have to worry about things getting worse as that is a thing of the past that does not apply any more.  They can also recognize that the person they feel or act responsible for can manage on their own, even if they don't act like it.  Hopefully, they will also recognize that they must not think they can wait for that person to start acting like they can manage.  This is not likely to happen.  

Well, this is where the idea that "no" is a term of endearment comes in as actually saying no and not taking on responsibility for others is an indication that you care about that person and believe that they can manage on their own.  Therefore, no becomes a term of endearment.. This does seem harsh though.  So my pateints have helpled me to come up with modifications of this.  These include: "I love you and I think you can manage."  It should be noted that it is worded think you can manage because even if you know they are capable of managing you do not know if they will choose to manage.  Other modifications of no include "I love parts of you and I think you can manage." Also, [Click] which is the sound of you hanging up the phone instead of repeating over and over that you are going to hang up.  So, click is a sound of endearment. Get it? Of course, you will have to keep saying no to help increae the likelihood that the persons you are believing in will start believing in themselves. It is definitely worth it. Seeing the strength in others when they are doubting themselves is a gift to them...so keep giving it. If you can let go of your feeling or acting responsible for others you will feel a lot less stressed.