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Sabtu, 05 Agustus 2017

My Take on the Wall Street Journal Article About YA


Yesterday I watched Twitter explode in response to a Wall Street Journal article by Mrs. Meghan Cox Gurdon, entitled "Darkness Too Visible." In the article, the author makes the argument that YA is rife with all flavors of depravity and peddled by editors eager to "bulldoze coarseness and misery into children's lives."

My initial reaction to the article was incredulous amusement--when my agent sent me the link, I assumed I was going to be reading something well-informed and balanced. However, it was immediately apparent by the contemptuous and smugly dismissive tone that this was a completely one-sided opinion piece.

OK. The lady is entitled to her opinion.

The problem I have is if her opinion is mistaken for thorough, well-informed analysis.

Here there be dragons. Or, er,
OCD and depression. BEWARE.
Her argument: YA is full of "hideously distorted portrayals of the way life really is." And then she targets several books (most of which I have read, some of which I have discussed here on this blog) that include main characters grappling with mental illness, trauma, or substance abuse. She implies that describing these struggles in "stomach-clenching detail" is harmful to teens, and further implies  books that either omit or gloss over these conditions are preferable.

To which I say: huh?


Guess what? One in five teens has a diagnosable mental illness. Anxiety? Thirteen percent. Mood disorders? Seven percent. Disruptive behavior disorders (this includes ADHD and conduct disorder)? Ten percent. And that's just a few categories. In EVERY high school classroom, there are at least a few adolescents struggling with one of these conditions, not to mention abuse, bullying, dating violence, or other trauma.

To pretend these individuals don't exist is offensive. To imply books written for teens should not include them--as if their experiences are not real, as if knowing what they really go through is harmful to others, as if reading books full of sunshine and light will fix them--is highly distressing. And, I'll say it: harmful.

I mean, is that the message we want to send to teens? Let's brush kids with problems under the rug? Let's only tell the stories of well-adjusted kids from two-parent homes? If you read about someone doing drugs, having sex, self-mutilating, feeling depressed, going through a trauma,  or living the brutal reality of poverty and violence, you'll be messed up or catch a mental illness like a bad cold?

There's NO empirical evidence to suggest that is true.

Mrs. Gurdon asserts that reading about a behavior, such as self-mutilation, gives teens ideas they do not otherwise have and encourages them to try it. Although she probably didn't know it, she was referring to the concept of social learning, a well-tested theory which postulates that human beings learn through watching others engage in a behavior and get rewarded for it. An example: teenage girls might watch ultra-skinny models vaunted for their beauty and portrayed as living glamorous lives, and get the idea that starving themselves is a good idea. There is evidence to suggest that is, to some extent, true (though the mechanisms behind eating disorders are MORE COMPLICATED than that by far, or every girl in the US would have an eating disorder).

However, is that really the case with YA? For those of you who read this blog regularly, you know the kind of books I read. Nearly all of them are about mental illness or trauma. I've read dozens of them. Not once have I read a YA book that glorified unhealthy behavior. YA authors are brilliant at showing the complex consequences of their protagonists' choices. No, the writers are not preaching. But OH YES are they showing realistic outcomes. Do they cultivate sympathy for their characters? Absolutely. Do they show their characters getting out of situations unscathed? No way.

If someone publishes a peer-reviewed prospective study of how reading specific content in YA leads directly to the portrayed behavior (while controlling for other predictive factors, of course), I will humbly eat these words. Until then ...

Mrs. Gurdon also laments that YA books that realistically portray mental illness or disturbance might normalize this stuff.

To which I say: ARGH.

Again, recall how many teens experience mental illness. Think about what they face. In one study, ninety percent of kids diagnosed with a mental illness (and taking medication) reported experiencing some type of stigma. They were socially isolated and felt ashamed of their conditions. Do increased feelings of shame and isolation help a person to heal? One guess as to the answer.

Research shows that the more middle schoolers and older teens know about mental illness and its treatment, the more healthy their attitudes become. Research also shows that fostering empathy is an important tool to prevent bullying. Based on my observations, YA does two things relevant to those research findings: it shows kids they're not the only ones going through this stuff. And it shows all kids the perspectives and experiences of others with whom they share the world.

But here's the thing: each kid is an individual with strengths and vulnerabilities. So is every parent. What will be good, even redemptive and life-changing, to one teen will be triggering or disturbing to another. Just like everything else, literature isn't one-size-fits-all. When parents come into my office and ask if roughhousing or video games are okay, for example, I do NOT say, "no." I answer based on my knowledge of the child (and the parent). And the answer is not AN ANSWER. It's a discussion. A collaborative consideration of the individual kid, parent, and environment.

With teenagers, it's a more complex conversation. At that point, it becomes a matter of negotiation and problem-solving rather than one of parent-decides-kid-obeys (actually, ideally, parents begin having problem-solving discussions with their children long before adolescence--the earlier you're in the game, the more likely your kid is to keep letting you play). Parent-child communication--and appropriate parental limit-setting-- protects kids from all sorts of risks. Parental autocracy? Doesn't.

What I've seen many, many YA authors suggest is that parents should read alongside their kids. These authors are NOT saying every kid should read every book. Rather, they are saying parents should talk to their kids. Decide together (and the older the teen, the more freedom he/she has to make independent decisions). Have frank discussions about the material. Be open and receptive and don't freak out. This is the approach mental health professionals happen to advocate as well.
All right, I'm done.

Have you read the WSJ article? What did you think? Are you concerned about teens being desensitized? That mental illness or substance abuse will be "normalized"? Do you find there is a dearth of light-hearted or "innocent" books out there? Are you a parent? Are you having to negotiate the world of books with your kid, and how are you accomplishing that?

Kamis, 06 April 2017

The Extremely Quick and Dirty on Personality Disorders


What do you guys know about personality disorders? My guess: not a whole lot. And not because you're not a well-informed bunch of people, because of course you are! It's just ... I think there's a lot of confusion out there about them.

First, let me explain something. When we diagnose (using the DSM-IV, which is not the only diagnostic system, but is the most commonly used among American mental health professionals), we do so on five "axes". I'll explain the whole system in a future post, but basically:
  • Axis I disorders are considered "clinical" disorders, that is, in need of clinical attention. Things like anxiety, depression, schizophrenia, and bipolar disorder are Axis I disorders.
  • Axis II disorders are of two types: mental retardation and personality disorders.

Personality disorders signal that a person is showing a relatively inflexible pattern of behaviors, thoughts, and emotions across most of his/her environments, and that inflexible pattern is almost certainly causing the person some trouble in terms of occupational, personal, and relational functioning.

There are three "clusters" of personality disorders outlined in the DSM-IV (and a few more identified in other diagnostic systems, but I won't get in to those today). Below is a tiny snippet about each--keep in mind that, to be diagnosed with a personality disorder, the behavior has to cause impairment, AND it has to be out of the norm for one's culture and society.

Cluster A (the odd or eccentric patterns):
  • Paranoid Personality Disorder--irrational suspicions and extreme distrust of others
  • Schizoid Personality Disorder--extreme lack of interest in other people and relationships
  • Schizotypal Personality Disorder--odd behavior and thinking

Cluster B (the dramatic, emotional, or erratic patterns):
  • Antisocial Personality Disorder--pervasive disregard for the law and rights of others
  • Histrionic Personality Disorder--pervasive attention-seeking behavior (i.e., inappropriate sexual seductiveness and shallow, exaggerated emotions)
  • Borderline Personality Disorder--instability in self-image, relationships, and identity often resulting in impulsivity and self-harm (I'll bet nearly all of y'all have heard of this one)
  • Narcissistic Personality Disorder--grandiosity, need for admiration, lack of empathy

Cluster C (the anxious or fearful patterns):
  • Avoidant Personality Disorder--social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation
  • Obsessive-Compulsive Personality Disorder--precoccupation with orderliness and interpersonal control at the expense of flexibility, openness, and efficiency
  • Dependent Personality Disorder--extreme psychological dependence on other people

These disorders really shouldn't be diagnosed until late adolescence or adulthood. The prognosis depends on the disorder. Most people with these disorders don't seek treatment until their behaviors have caused them some real suffering and turmoil in their lives. Studies show that adolescents with personality disorders are twice as likely to develop an Axis I disorder (like depression or anxiety) in adulthood when compared to their non-personality-disordered peers.

In other words, personality disorders make a person more vulnerable to other bad stuff. And also harder to treat.

I'll be doing posts on nearly every one of these personality disorders at some point. Although these disorders are not pleasant in real life, they could really make for some powerful, interesting characters in a novel, and you'll see an example of this Wednesday, when I will post about Obsessive-Compulsive Personality Disorder.

So ... are you familiar with the term "personality disorder"? Were you aware it was actually numerous disorders? Which ones have you heard of, and which ones are new to you? Are there any in particular you'd like to know more about sooner rather than later? Have you ever written a character with a personality disorder (either intentionally or unintentionally)?

Today's Monday, so remember to visit Lydia to read her Medical Monday post, and Laura for her Mental Health Monday post.

Minggu, 26 Maret 2017

Comedian Adam Ferrera on panic attacks




This guy is funny:
I started getting panic attacks. Yeah, that's a nice way to go through life. "What a lovely day. ARGHHHHH!"
The only way to get rid of panic is to talk about it. Yeah, like I'm gonna call my friends and say, "I think I'm getting panic attacks." "Really?" they'd say. "Ever think you might be a pussy? It sounds like acute pussy syndrome to me. Check your urine; is it pink?"

I'm such an Italian. My friends are like, "So how's it going with the shrink?" I answer, "He didn't get nothing outta me. I love my mother; I ain't gonna roll on her."

Sabtu, 25 Maret 2017

More panic on YouTube


Here is a vid by a guy talking about recent panic attacks in his life, with the description "a panic attack sandwich with a filling of drunk."

An informational video about panic disorder. A student project.

Acupressure for Anxiety, Panic Attacks, Palpitations

Here is the first in a series of videos about dealing with panic by a guy named J.P. Diamond.

Nifty, artful vid about panic.

A self-described "rant" about panic.

Another guy talks about his experience of panic.