8.12.2010

Pedantry and Gray Thinking

I am normally a bit pedantic (perhaps a lot pedantic). I try to avoid absolutes. I tease people when they say things slightly grammatically incorrectly, especially when it leads to a very different, often humorous, literal meaning than they meant. ("I saw that terrible movie in theaters." Really, why did you see it in multiple theaters if it was so awful?) I'm able to exercise restraint with this, I don't tease like this at work or in serious situations. Usually I do know what people actually mean to say, but just tease them to be silly. Sometimes I genuinely don't know what someone is saying when it is ambiguous or I suspect they misspoke. ("Walmart employees asked to stay behind while flood waters rise" Did the employees ask or were they asked?)

When I am a patient in a mental health care situation, I become pedantic to the extreme. I don't do this to tease, I don't do it to be annoying, I do it in an attempt to avoid trouble. It doesn't really work.

In a staffing I said I felt yelled at. They said they didn't yell, being a bit pedantic. I only said I felt yelled at, so whether I really was or not is immaterial. Also, yes, I might take that pedantic approach to tease, but this is not a teasing situation, and it is a common colloquialism for people to say they were yelled at when no voices were actually raised. I revised to say I felt they were reprimanding me. They said it wasn't a reprimand. I revised to say that they had confronted me because they thought I had done something that they thought was sub-optimal, sub-par, damaging, eating-disordered, inadequate and the confrontation caused me to feel crummy especially because I hadn't actually done the thing they were confronting me over. My final explanation was incredibly pedantic, but they necessitated it with their blanket dismissals of my previous explanations. I had to go to a level of irrefutable, literal fact just to avoid getting dismissed. Many patients would give up without being understood, some might not be able to explain themselves sufficiently pedantically. The professionals could have responded differently to me, in a way that wouldn't be so prone to shutting down conversation. (They tell us how important it is to feel heard, but when they shut down conversations like this, they are making it doubly difficult to be heard. If I didn't insist on clarifying, what lesson do they think I would have come away with? The lesson I did come away with is bad enough.) They could have said, "No one here actually raised their voices to you. What do you mean by feeling yelled at? Did you feel insulted or scared or like we were angry, or what?" They did not express interest in understanding me, just dismissed my statements because they were not literally true (although I would argue that, too). I am pedantic for the sake of understanding (or humor), this seems like pedantry for the sake of evasion.

Depressed people are often overly pessimistic and sometimes make unqualified negative statements. ("Today is going to be awful.") Staff often challenge patients when they make those unqualified negative statements, usually with the argument that they do not know for certain that the day will be awful because they cannot know the future. I can deal with that, they are correct and I see their point. But the staff often make unqualified positive statements. They say "today is going to be great" or tell patients to tell themselves that. I confronted a staff member once who made an unqualified positive statement not five minutes after chiding a patient for an unqualified negative statement. I told her that she didn't know that day would be great anymore than I knew that day would be awful. She said, "I'm just trying to get you guys to think positive," and walked away. In similar situations, I have been told I'm just being pedantic. I am perhaps being a bit devious and trying to make a point in these situations, I don't think that excuses their evasive responses. It doesn't change the fact that we are being equally pedantic, but the rules appear differ between positive and negative, patient and professional. There is still this internally inconsistent system of logic being promoted, one that leaves patients entirely dependent on the staff to do their thinking. It is impossible for me to know where they will be reasonable and logical and where they will be arbitrary. Based on my experience, I tend to assume they will eschew logic at most opportunities, leaving me genuinely surprised and in disbelief when I encounter a professional who acts consistently logically and reasonably.

Professionals harp on and on about avoiding black-and-white thinking. Live in the gray! Live in the rainbow! Black thinking and making unqualified negative statements are confronted and refuted. "You can't possibly know that today will be awful because you can't foretell the future." Okay, your pedantic rules. So if I am to avoid black-and-white thinking, yet still express how I feel, I say, "I feel like today is going to be awful, I don't expect anything to go well" I have not expressed an absolute! I have used an "I" statement! I have done exactly what they have told me to do! What sort of response do I get? "You can't possibly know that today will be awful." I know that, but I still feel hopeless, which is why I used an "I" statement and said "I feel" rather than making an absolute statement. "I don't remember what words you used, I don't want to argue semantics." Wait, what? You nitpicked about my words being black-and-white, I conformed to your rules, you accused me of still being black-and-white, I pointed out that I had followed your rules, and then you dismiss me for arguing semantics? (And I'm the crazy one?) If it is that they are focusing on black-and-white thinking over black-and-white speaking, the situation is no better because I acknowledge uncertainty in thought even when I don't acknowledge it in word. How can they know that I do not? They don't ask; they focus on what I say. I can't win if I don't follow their rules because I get a lecture. I can't win if I do follow their rules because they don't notice, I still get a lecture, and they dismiss me when I point out that I followed the rules.

They want us to avoid black-and-white thinking, so when we are prone to unqualified negative statements, shouldn't the counter be gray statements of possibility rather than blindingly white statements of unqualified positivity? I would say yes. Realism is (part of) the gray area between pessimism and optimism. But whenever I would try to establish a realistic perspective with a staff person, a compromise between my black and their white, they would still tell me I was being negative. I was attempting to bring them into the gray zone by compromising and finding realism, but they called it pessimism and insisted on unqualified optimism. If they are going to teach me to avoid black-and-white thinking, it would be nice if they modeled it for me.

6 comments:

  1. "I tend to assume they will eschew logic at most opportunities"

    It's such a safe assumption! So many people do! That's how I end up in shouting matches with the newspaper in the mornings - not that it's particularly logical to shout at the newspaper, but it does make me feel better...

    It sounds to me as though you are experiencing a classic double-bind situation. I wonder whether telling them that (since it's a psych. term itself) might help. Sometimes making a meta-communication about a situation can be effective when trying to communicate within the terms of a given situation (as you have tried) does not work. Or it might just make them mad - hard to say in advance. Might be worth trying, though.

    In either case - I understand your frustration. I'm sorry that you're having to put up with that.

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  2. I've tried to have those meta-conversations with the professionals while I am a patient, a little while after the situation. Only a therapy intern and my current therapist have ever been willing to play ball. On the patient and family advisory board, they would say, "oh we don't do that, we never did, it was just that program that rented space from us," or "I'm so sorry, but I assure you that was an aberration," or "we allow vegetarianism now so that isn't an issue anymore." That was all before my recent tendril-squishing stay. I feel rather betrayed because they either lied to me, are out of touch with what their staff actually does, or unable to imagine how what their staff does could be perceived by patients, even when they are told.

    It is frustrating. I'm glad to have a therapist who can understand that, too. It means she doesn't do this stuff, or, if she does, I can point it out and she will understand.

    I don't mean to disregard your suggestions, just tell you how doing those things has worked for me. I still want to get through to them somehow, but right now I'm taking a step back from trying to actively engage while I work through some of the hurtness some of the professionals caused/prolonged.

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  3. As I've been reading your blog, a question keeps popping up in my mind: are you autistic? You haven't mentioned it, but between the pedantry, literalness, mix-ups, misunderstandings, trouble being understood despite precision, and trouble telling when someone isn't understanding you, confusion that people are shocked when you do what they told you to do, combined with the indications that more than 20% of anorexics have undiagnosed autism spectrum disorders (http://autismaspergerssyndrome.suite101.com/article.cfm/aspergers_syndrome_and_anorexia) I can't help but wonder if you've considered the possibility. Since the stereotypical features of autism and eating disorders tend to be perceived as mutually exclusive, eating disorder professionals never seem to consider autism as a possibility, even after they've decided that they can't possibly bother to understand you.

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  4. Maggie,
    The last time I was in the hospital, I did look into this, kind of by accident. I was super anxious all the time and found a weighted blanket very soothing. I looked up weighted blankets on the internet to find other things that might be similarly soothing. One thing led to another and I ended up looking up "Asperger's adults". From what I read, I seem to have a lot of similar characteristics, like you mention, but not the defining characteristics, or not as strongly. I did bring this up while I was in the hospital, not looking for a diagnosis, but more to put a bug in their brains so that they might understand me better. It didn't really work.

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  5. Another thing to remember is that the autism spectrum is changing. It's not just that you meet the criteria or you don't, and it's not just the criteria for specific disorders. As I understand it, the plan for the DSM-V is to reclassify autism into an actual spectum, including sub-clinical autism and the "broader autism phenotype." The non-disorder types wouldn't be actual disorders (duh) but would still be part of the spectrum, more of a definition of non-disordered thought patterns. It's not particularly surprising that nobody in the hospital would listen (you've "beautifully" detailed their inability to listen or use logic) but it might be a useful aspect to look at in real therapy. Things that are autism features are frequently viewed as eating disorder symptoms, and in many people, they may be. But if you have autistic features separately from your eating disorder, it would be counter-productive not to figure out the difference between those features and the eating disorder symptoms; you'd end up fighting things that you don't need to fight, things that you could actually use as advantages.

    (I hope that made sense and wasn't too ridiculously obvious..)

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  6. You've not disregarded me at all. I've often found it difficult to communicate with MH professionals for a variety of reasons and I think you're wise to consider how much and when you want to engage them over this. It took me a while to figure out how to do that myself.

    It's a very frustrating situation, as you say. I've spent a lot of time wondering what can or should be done about it and how anything might be done about if so many MH professionals are resistant to trying to understand it. I'm glad you have a therapist who takes it seriously!

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