Wednesday, June 27, 2012

Enough is Enough

    "Enough is enough!" It's a phrase that we have all heard since we were children. Our parents have said it when they're tired of what we get ourselves into. Our friends say it when they've had too much to drink. We even say it on occasion when we've eaten too much for dinner. It's a phrase with a very clear meaning- it's time to stop. Still, the question arises, as adults, when is enough really enough?
    I mean this not so much in the negative way of doing or having too much of something, but rather as a question of self-fulfillment. We create goals for ourselves and set out to achieve them. We work hard to make ourselves and those who matter to us proud. When we hit milestones and achieve our goals we set new ones. It makes sense, and according to certain psychological schools of thought a person can never be "finished" with this process and be happy. We have to continue changing and developing, adapting to our surroundings and working to become a person we are pleased with.
    When is it enough though? How far do we have to go before we can stop working so hard, or at least stop working on changes and advancements of great magnitude? I know people who seem to be ok with who they are and where they are in their lives, and for the most part I think that's great. I'm even a little bit jealous. I feel this jealousy because I've achieved most of the goals I've set for myself, and within the timeline I wanted as well, but every time I do something that I've set out to do I feel compelled to go after something else. Something new, bigger, harder, and more impressive.
    By 24 I've achieved a masters degree in the field that I love (Just to clarify how awesome I am, I was only 23 when I got the degree). I've completed internships and specializations to deepen my knowledge and skill level. I'm lucky enough to have not one, but two jobs in this field, one of which is doing what I've wanted to do since I remember choosing this field, outpatient therapy. This job provides me with competitive compensation and opportunities for advancement. In my personal life I've met a man that outshines any other I've met in the past and have accepted a marriage proposal (regardless of how much I may be dragging my feet on the planning process!). I've taken the tough steps to clear out my inner circle and recognize the truly wonderful friends I have, helping me to appreciate them more than I ever have before. I've continued to strengthen relationships with my family, being the best sister and daughter that I can be. I have pets that I love and care for. I'm planning a future that involves the American dream modified for what I want: a home, a husband, children and a career. By 24 I've created a life that some people can only hope will become a possibility some day.
    Even so, it doesn't seem to be enough for me. I crave further advancements in almost every area. It is not necessarily that I want these things right now, just that I want them. I always want to be better, go farther, and do more. I try to figure out why, what it is that drives me. It's not competition, I've never been too competitive. It's not external pressure, the people in my world don't seem to attached to these accomplishments or live vicariously through me. For now I just convince myself that the drive comes simply from a desire for self improvement, and that I can live with.

Just in case you haven't seen this yet, it's hilarious, and you've been missing out.

Wednesday, June 6, 2012

Poeple Help Create Humanity

    I think we can all agree that we are who we have become  has a lot to do with the people that have been a part of our lives. As children we have less control of whom we have in our lives, the control in this situation is generally more of the choice of our parents or guardians. They set up play dates that we may or may not request. The people in our lives end up there without us generally choosing, sometimes without us actually wanting it. As we get older we are generally surrounded by peers in school. We have less opportunity to interact with people outside of this group due to our location and lack of mobility... we still rely on our parents to take us places. We grow older and gain independence. We learn to drive and can expand our social circles. If we are fortunate enough we may go to college, expanding our potential social circles to the entire student body, perhaps even some faculty, although most of us restrict our friend group to those that we have classes with, dorm with, join clubs with, or have some other thing in common. We most likely miss out on some great social interactions because of the restrictions that manifest. This particular entry is not about what we've missed out on, though. It's about what we have experienced and how it has shaped us.
    Every interaction we have helps to shape who we become. We meet people and learn things. We learn about them, their interests, the knowledge that they have is shared with us and we grow. We gather information about what we like and do not like, and we use that information to help us determine what we'd like to have and do in the future. Some of us quickly realize what we like and attempt to continue experiencing things that fall into that category. Others of us simply start to notice things that we don't like, note the things we do, and attempt to continue to gather more information through more experiences. I'm generally in the second group. I find things I like and don't like, avoid things I know I don't like (not always very successfully), but most of my focus is set on finding new experiences and meeting new people so that I can keep finding out what I like or do not enjoy, so that I can continue growing and learning forever! Stagnation is frightening to me, so I would rather keep doing new things than stick to something comfortable.
     Of course, as a part of this process people come in and out of our lives. So often the loss of a person can be painful or unpleasant, like in the event of a break up or death. When we begin to associate this extreme negative feeling with the individual that has left our life many of us wish that we could remove all memory of the person from our minds. People wish for an Eternal Sunshine of a Spotless Mind situation. Unfortunately I can't fully understand this. Sure, it can be painful to be reminded of a person once they have left our lives, especially if it was a nonconsensual parting. Still, why would we want to remove a person from memory? At one point we enjoyed their company, they have helped us to become who we are today. Unless you are truly unhappy with whom you have become there is no need to try and forget these people. Furthermore, if you are unhappy with the person you have become, you cannot blame this on others. Taking responsibility for the person you are is a necessary part of maturing.
    To personalize this issue I will mention a few specifics. I invited my ex to my graduation a year ago even though we were no longer together. He helped me get to where I am, being somewhat supportive, encouraging me to pursue my dreams to an extent. Our ending even helped me to a point. By realizing that our relationship would not work out, for whatever reason, I was pushed to be more independent and to find myself, find what I wanted out of life and go after it. Over the years my ex and I have been forced farther and farther apart, and now we do not even speak. I hear he is expecting a child. He will be a loving father and I have only the best wishes for he and his girlfriend. My only wish for myself in that situation is for him to know how much hope I have for him to find happiness, especially given the happiness that his role in my life has helped me to find the same.
    Now, I am sure that anyone who has read this blog from the beginning would be interested in how I feel about the individual that inspired the creation of this blog. There is a person that I gave so much to, that my family opened their home and their hearts to, that I invested time, energy and money into with the only return being a painful, borderline cruel slap in the face. This individual left with hundreds (perhaps even thousands) of dollars of money that she owed (which adds to the irony, since we took her in so she could pay off some of the debt that she felt so overwhelmed by) to me and my family. She walked out of our lives with not so much as a "thank you" or a "goodbye" after we had struggled to give her everything she needed to be comfortable and start her life the way she wanted it. All of this after being in my life for 18 years. She claimed that she felt like we were the family she wished she had, and that I was the best friend she ever could have hoped for. She filled my world with lies and deceit, taking everything she could and giving nothing but pain in return. So wouldn't I want to erase this person from my memory completely?
    Parts of me would love to have no memory of her at all. She gave my faith in humanity a huge blow. I couldn't understand how someone could be so incredibly thankless and inconsiderate, especially with people continually handing her what she wanted, bending over backwards to try and give her what she wanted because they felt bad for her, although all of the sympathy she built for herself was a lie as well. This person has made themselves almost the worst person I've ever known in my head. Every time I hear about her hurting someone else I just shake my head, almost wishing I could have warned them, but I know it's not my place by any means to interfere with other people's relationships. Also, people tried to warn me that she was a liar and not to be trusted, not to mention that I watched her talk about people behind their backs while they helped her on such a regular basis. In retrospect, anything that happened was my own fault. I take responsibility for being so giving and getting walked on. I could have, or should have, been more guarded and kept myself safe, but I chose not to. I have been fortunate enough to learn from this situation.
    The take home message? I know that relationships are hard. I recognize that after these relationships end we can learn from them much better than when we are in them. Good or bad, long or short, ended or not, we are shaped by the people we have interactions with. Some people make us happy and build us up, others make us doubt our judgement and bring us down, occasionally even hurting our faith in humanity. Even with all of this, we have to recognize our own part of this process. We can't blame other people for our lives and how they end up.

Responsibility is something we try to teach children, but so many adults still don't grasp the concept. We are exactly what we are, we've become so by our own choices, even if the only choice we had control over was how we react.

Friday, June 1, 2012

Ethical Lines Drawn Oh So Finely

            Recently NPR ran a story that briefly discussed a historical anecdote involving a young man who suffered an accidental gunshot wound to the abdomen, leaving him with an interesting condition known as a fistula. Essentially, the man’s wound never completely healed, leaving an opening to his stomach covered by a simple skin flap. He continued to live a fairly normal life although his condition obviously prevented him from engaging in certain types of work. A doctor was very interested in this condition and engaged in some experimentation, similar to the work of Galileo in which he would tie a string to a piece of food, swallow it, and then pull it back up at various times after ingestion to observe the progression of digestion. This doctor, however, bypassed the esophagus completely, directly inserting the food item into the stomach, and conducting similar observations by removing the food and documenting stages of digestion. Of course the doctor provided the man with compensation for his participation. Even so, this man decided that he didn’t want to be a guinea pig anymore, left the service of the doctor and attempted to live a normal life.
            As previously noted, this man could not participate in certain types of work. His life was difficult, and at a point it became evident to him that he needed the income provided by the doctor to participate in these experiments to live. He was forced to return to the doctor and allow him to conduct these experiments simply so that he could have enough money to live. The man had no other choice, he could not work and support himself due to his condition so he had to return to a situation that he was extremely uncomfortable with simply to survive.
            Back then we had no disability income. There was no other option that the man knew of, and this benefited the doctor (and in a way science as a whole) because the research could be completed. Even with the wonderful advancements that it provided, it was essentially against the man’s will, and therefore should be considered unethical. Even with the obvious ethical dilemma this situation, even by today’s standards, would provide no issue with any board of ethics since the man came “willingly” and was compensated.
            This situation brings up so many questions regarding ethics in today’s world of psychology. I’ve worked in an inpatient unit. There I learned about the very interesting concept of declaring people incompetent to make decisions for themselves. Given their incompetence the treatment team can force medication on these people. There are certain medications that we can give by injection providing a long term, extended release that can last up to 60 days. Mental health incompetence generally would not last quite that long. A crisis situation can be resolved with less serious medications and therapies within as short of a period as a few days. The interesting thing here is that, during this window of “incompetence” doctors can make the decision to give them a medication, against their will, that would last for 2 months. A mentally competent individual can refuse medication even if it may be helpful.
The choice to struggle with or without medication (for whatever reason) is a right of every man, woman, or child that is confronted with that decision. For us as professionals to rob the individual of this choice, be it for days or months, is an injustice as far as I am concerned. In this field we are here to help, and part of helping is to respect the wishes of those with whom we work, whether we agree or disagree with the decisions that they make.