Catharsis

Three hundred and twenty-three days and a significant loss in our family triggered what I call The Great Catharsis. Sometime in early 2020, as the spread of the pandemic reached a critical point, there was a shared sense that something significant was about to happen. For me, this started on March 13, 2020, when my university president announced that, in an attempt to slow the spread of COVID, we would not be returning to campus after spring break. At first, I thought it would be for a few weeks – that was 46 weeks ago.

 

I admit that when I realized that the call for social distancing was being extended indefinitely, I was excited. Summer was rapidly approaching, and I thought that I would escape having to venture outside in hot and humid weather in professional attire. Despite growing up in Miami and having Caribbean ancestors, I never got used to our summer months. Also, I genuinely enjoyed teaching on Zoom. I found new ways of engaging students that have been surprisingly valuable. The effects of social isolation didn’t hit me until two months into it. I was beginning to understand what my northern friends described as winter months cabin fever. To escape the feeling of walls closing in, I took walks in my neighborhood, watched television shows that reminded me of non-pandemic life, and ventured to the supermarket for anything.

 

However, as if the pandemic wasn’t enough, we experienced civil strife grow to levels unseen in my lifetime. First, the senseless killing of George Floyd by police released deep-seated emotions that ignited a national protest. Then there was the frantic race to save our fractured democracy from another four years of a divisive and incompetent president. On the home front, we were experiencing additional stressors. First, our university president announced that they will be laying off staff and faculty to recoup some monies lost from a student-less campus. Although I was fortunate to maintain my position, I did have my salary reduced – a better option than the alternative. My husband’s demands at work kept him in his office late nights, and feeling emotionally and physically exhausted. Moreover, we were hearing news of friends and family who tested positive for COVID, and a colleague who died from the virus. But the worst of it was seeing our daughter change – she was slowly losing the spark that defined her personality. After a while, I felt powerless, which switched on my internal defense mechanism of disassociation. The British-produced World War II poster that unpretentiously declared, “Keep Calm and Carry On,” became my mantra. However, one positive change had a significant impact on my ability to manage my feelings of numbness and confinement. My family decided to adopt a new dog, an adorable English Bulldog and Cairn Terrier mix my daughter named after her favorite poet, Maya Angelou. Maya stood out with her wide-eyed face and shaggy fur. She acclimated to our family and won almost everyone over.

 

Fifteen years ago, my husband and I received Stuart as a gift from my brother-in-law, who had a side business breeding and selling miniature dachshunds. He was the most handsome dog I have ever seen – with unspoiled, soft, penny-colored hair. Throughout our years together, Stuart became a valued member of our family. He was there when we bought our first house, put up our first Christmas tree, and brought our daughter home. But more importantly, Stuart was there for every personal trial. When I was downhearted or anxious, he would sit quietly next to me, allowing me to stroke his head while working on solutions. Stuart tolerated captivity as I tightly hug him until I felt better. He felt reassuring, and I suspected that he knew this. He was a good boy.

 

Stuart did not take to Maya the way the rest of us did. Maya’s constant nudging of Stuart, while he rested quietly in his bed annoyed him. He usually growled as a warning, but she didn’t take the hint as often as he hoped. It was a team effort to keep Maya from Stuart. Everyone kept an eye on her, ready to yell at her to leave Stuart alone. For the most part, it was easy to keep her away from Stuart.

 

Maya demanded a lot of attention, which we were happy to accommodate. Lucia loved playing with Maya, and the feeling was mutual. It was nice to see Lucia’s spark again. There was a new energy in our house, which helped with the mundane daily rituals. Unfortunately, this new energy was overshadowed by Stuart’s decline in health. It was a gradual decline – he slept longer, ate less, and withdrew more. Stuart had difficulty walking and resigned himself to shitting in his sleep. He was unrecognizable – his once healthy girth and beautiful coat were replaced with protruding bones and psoriasis. We felt helpless. We did our best to make sure that he was comfortable, but this became harder to achieve. Stuart was in constant pain, howling at night in discomfort due to the discs in his spine deteriorating. The vet prescribed pain-killers, which we pumped him with, but it wasn’t enough. It was clear that we could not keep him alive much longer. The decision was made to euthanize our sweet Stuart.

 

During the last few days, Stuart’s cries were tearing down my internal defenses, and I felt my stress rising. I wanted to keep my feelings buried, so I walked away from him and stayed away. I went deeper into my disassociation. I abandoned him. I knew this, and he knew this. I saw it in his eyes.

 

Stuart is gone and no longer in pain. He is finally free. I should have felt relief after his death, but I didn’t. I felt an enormous amount of guilt and shame for abandoning him, and I wept for two days. My sorrow was penetrating and deep, and wouldn’t let go. I couldn’t shake the feeling that I failed him. I could have been by his side, the way he was for me all these years. My husband did his best to console me, making the claim that Stuart understood and forgives me. But this didn’t help. I did not feel his forgiveness.

 

On the second day, my body started hurting. My crying was so physical that it battered muscles I didn’t know existed. I also felt different. My sorrow somehow felt broader, yet more intense. There was a shift from feeling shame and guilt to grief. Once I realized this, my grief started mounting. I began to grieve for my loss of a family member and supporter. I grieved for my daughter’s loss. She loved Stuart. They shared a special bond, and now that was gone to her forever. I grieved for my husband, who also grew to love him and was the one to manage Stuart’s end-of-life process. This was hard for him, even though he approached it with stoicism. The awareness of what was affecting me kept unfolding, extending to everything I had bottled up for 323 days. All the stress, anger, sadness, and fears I was trying to run away from, poured out of me. Everything came out, and by the end of a long and exhausting day of grieving, I was done. I felt liberated. I became aware of all the time I had wasted trying to escape.

 

We are approaching our first anniversary of social isolation, and it’s been nothing but a blur. I don’t want to go back to avoiding life. I want to appreciate all experiences, good and bad. I want to be present with my family and friends and to grow from this journey we are all on. It took Stuart’s death to release me from the prison I unknowingly made for myself. I now feel relief for Stuart not suffering anymore. I also feel that deep down, he forgives me. This was his last gift to me. He still is a good boy.

Intent vs. Impact

One of my most stressful jobs as a husband and father is the occasional and obligatory weekend visits to our extended families. What makes family visits (on both sides) stressful is not the responsibility of having to pack for my family or coordinating everyone to move out of the house and into the car. No, I got this down to a science. What makes it stressful is having to be present with family whose values are diametrically opposed to my own family’s values and worst yet, our existence. It’s not that their underlying beliefs support long-held systems of oppression (which is undoubtedly contemptible), it’s that they embrace these beliefs with a sense of defiance and superiority. They are unaware of how their values affect us (same-sex, multi-ethnic couple with a socially conscious feminist daughter). Honestly, they don’t seem to care about it.

This discord makes visits with them a dreadful experience, which dampens my mood a week before the visit. It’s not enough that I find myself always on heightened alert (activated amygdala?) that only a healthy level of disassociation can cure, but there is nowhere I can go to find a sense of safety. On top of this, I find myself carefully assessing each social interaction in preparation in case I need to steer any potential political conversations quickly. I have a collection of benign topics that can be conjured in case the conversation reaches code yellow.

All of this is exhausting, but it must be done for my own mental health. I’m usually good at managing it, but once in a while, I am too late to stop an offensive comment from being made. This past weekend, as we were all hanging out in the main family room, I overheard a family member casually use the word “oriental” to describe people with an Asian identity (as if the descriptor was necessary in the first place). At that moment, my eyes instinctively widened as I tried to think of something to say. I went over every possible response, including; correct him, say nothing, change the subject, or provide a history and geography lecture. Luckily, I didn’t have to make a decision, thanks to my socially conscious husband, who, with calmness and sureness, chose a double routed response. He first corrected him by saying that the preferred and more accurate term is Asian. My eyes relaxed a little. His simple correction could have been “enough,” given the circumstances, however – and this is where the sense of defiance and superiority comes in – he responded by saying with a hint of annoyance, “what’s the difference?” Eyes widened again. This is when my husband chose the second route of providing a history and geography lesson. Our family member then made another unnecessary comment. Eyes rolling.

It was just irritating to hear his “what’s the difference” response because, in this day in age, he should know better. This ignorance speaks to his privilege as a White person who doesn’t have to know the difference. There is no excuse for not knowing something as familiar as this, especially for someone who claims to be “better” at understanding true diversity. Anyways, what moved me from irritation to just pure anger was his response after the history and geography lesson.

But, before I share this, I want to take a step back and provide some context to my anger. I am usually very tolerant of people’s ignorance, especially when they are sincere in their mistakes and make an effort to correct their language or behaviors. I can appreciate this, since I am human too, and I have had my share of “oops” moments. Heck, I still struggle to undo 40 years of using the gender identifying “Latina/o” in favor of the more gender-neutral Latinx. I occasionally slip up; however, I am mindful of correcting my misstep. It’s frustrating when a person, especially someone with a privileged identity, shows a disregard for their misstep and seems inconvenienced by having to modify anything to accommodate “others.” How dare we!

So what did he say? Alright, I will not delay this, he said, “well, no offense intended.”

Okay, I know you may be thinking that this is an innocuous response and that I am being too sensitive and blowing this out of proportion. However, there is a lot of background information that only a person who has a history with him would understand. Let’s say that I wouldn’t be surprised if he uses Oriental again. Plus, it wasn’t just what he said, but how he said it. You know what I mean; that subtle insincerity in their comment that is intended to “make it all better” when, in fact, exacerbates it. It’s the response someone gives after you tell them that what they did hurt you…” Well, I’m sorry you feel that way.” Yes, this one!

It’s not necessary or even a good idea to ever respond with a defense of your motivation. It really doesn’t matter. The language or behavior has an undeniable impact, regardless of intention. Would you defend your motivation if you accidentally break a friend’s possession? “Well, I didn’t intend to bump into your favorite vase, causing it to smash into little pieces.” This comment would do very little to comfort your friend, so don’t even think about it. The best response in this situation would be a sincere apology, followed by an offer to correct the situation (perhaps the vase could be repaired or replaced?). This response is sensible and more compassionate.

At this point, I do not expect much from some of my relatives. It would have been better if he had embraced the correction as a valuable contribution to his ongoing development as a human being. He could have just apologized for the misstep, gave thanks for the correction, and make a sincere and conscious effort to change. But, for this to happen, one must move beyond self-interest and into the broader social-interest.

 

New Year, New Goal

For the new 2020 year, I have decided to forgo my usual resolutions to work out more and eat healthier. Like many people, I see the New Year as a new opportunity to make positive changes and improve my physical health. I start with great intentions and enthusiasm. It begins with a commitment to going to the gym three times a week, drink more water, and cut back on sweets. However, like every year, I start strong and begin to peter out around the beginning of March, and by the end of April, I am back to my old habits. But not this time! This time I have decided to try another resolution and one that I believe will be easier to keep and with equal, if not better, health results. This year I have decided to improve my brain and mental health.

To accomplish this, I plan to use The Healthy Mind Platter as my daily guide. Much like our food pyramid, The Healthy Mind Platter is a model developed by two neuroscientists, Drs. David Rock and Dan Siegel, for optimizing your brain and mental health. The model consists of seven daily mental activities necessary for engaging different parts of the brain, which improve brain integration. By being mindful of these activities and balancing your daily activities, you are working on strengthening your brain’s functions and connection with other people.   

These are the daily activities (from https://www.drdansiegel.com/resources/healthy_mind_platter/)

Focus Time

When we closely focus on tasks in a goal-oriented way, we take on challenges that make deep connections in the brain.

Play Time

When we allow ourselves to be spontaneous or creative, playfully enjoying novel experiences, we help make new connections in the brain.

Connecting Time

When we connect with other people, ideally in person, and when we take time to appreciate our connection to the natural world around us, we activate and reinforce the brain’s relational circuitry.

Physical Time

When we move our bodies, aerobically if medically possible, we strengthen the brain in many ways.

Time In

When we quietly reflect internally, focusing on sensations, images, feelings and thoughts, we help to better integrate the brain.

Down Time

When we are non-focused, without any specific goal, and let our mind wander or simply relax, we help the brain recharge.

Sleep Time

When we give the brain the rest it needs, we consolidate learning and recover from the experiences of the day.

   

After assessing my daily lifestyle, I realized there are a few activities that I am lacking, and other activities I may be overdoing. For example, as an academic and writer, I have plenty of focus time built in my day. I also have no problem with down time – after my daughter goes to bed, I naturally collapse into a comfortable position on my sofa and do nothing. This is one of my favorite times. On the other side, I am a creature of habit and have a daily routine, which does not include enough play time or connecting time. These areas need my attention the most. I hope that they will not be too challenging to incorporate. After all, it involves increasing fun, creativity, and socializing. How hard can that be? Let’s see.  

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Bringing 2019 to a Close

As the 2019 year ends, I cannot help but reflect back on this amazing year. I had what I call “a year of personal growth.” I experienced a lot of awakening moments, which lead me to reflect more on my life as a whole. This led to more waking moments.

I recently came across a video of someone reading a letter aloud that she wrote to her younger self. It was a heartwarming letter, and I was moved by how she had gone through so many adversities, mostly through her own regretful choices. She took the opportunity to write this letter to forgive herself for her past mistakes, recognizing that she was young and influenced by her environment and upbringing. She is obviously older now and wiser and is doing her own self-healing. I could tell writing this letter helped her make sense of everything she was thinking and feeling. It was an exercise that allowed her to reflect on her life and find closure where needed.

Anyways, I decided to write my own letter, which I share below. It was helpful and brought up many memories I had pushed back, way way back. I have also decided to write more letters to myself at different periods as a way of making sense of who I am today. It’s a great exercise, especially as you bring another year to a close.

Dear Brave Starry-Eyed Young Man,

Here you are, 19 years old, and living on your own for the first time. You are a college sophomore at the University of Florida and just spent the last two years completing your Associate’s Degree in your home city, Miami. In a matter of days, you packed your essentials, loaded a van with your family in tow, drove 5 hours to Gainesville, located a place to live, and said good-bye to your old life. You will never forget the image of your mother fighting back her tears as the van drove off, leaving you behind.

I know how confused you are at this moment. Although you are excited about where this new adventure will take you, you have overwhelming sadness for “abandoning” your family. You also have a numbing fear for giving up the security your old life provided. You do not realize it at this time, but you will never return to Miami, despite your mother’s hope that you will eventually come home to be with her. She missed you deeply but kept it to herself so that you would not feel guilty. And you will feel guilty for this, especially when she is gone. But, you will have to live with this feeling as a sacrifice for what you had to do.

Growing up in Miami during the 70s and 80s was not easy. The sudden political and social demographic changes happening in Miami resulted in significant challenges and growing pains including racial tension, riots, gang violence, and crime. The threat of physical violence was always present, and you were always on alert. You took alleys walking home from school to avoid being beaten up by classmates who saw you as less than, and as a deviant. Your home life did little to relieve this stress. You experienced and witnessed ongoing physical and emotional abuse, You rarely left your room and often relied on the excitement of fantasy and adventure stories to escape painful realities. These experiences will forever shape you, especially how you relate to yourself and the world. 

Yes, life was not easy, especially for an openly gay Puertorican kid from an underclass working family. However, despite these experiences leaving a permanent mark, it did give you the determination to make a better life for yourself.

I call you a brave starry-eyed young man because you have an enormous amount of courage to leave your family to be on your own. You are not prepared for this new life, which is reflected in the years that are about to follow. In your fear and loneliness, you will attach to the first person who shows any interest and kindness. He will introduce you to others who show the same attention, and soon you will lose your way. They will fill a void in you and become a surrogate, albeit dysfunctional family. They will not have your best interest in mind, but you will be eager to belong, so you will put aside your dreams, change your values, and deny your true self to fit in. It will be years before you see this, but you will eventually free yourself and find your path again.

But do not fret, this minor derailment will serve as a reminder of what is important to you and will provide you with newfound determination. This determination will get you through college (Bachelors), your first job working at Nationwide Insurance, college again (Masters) and again (Doctorate), and your first job as a clinician and as an academic. You start a successful private practice while managing not one, not two, not three, but four academic programs at a university. Whew! You publish scholarly articles, teach at a prestigious university, and even present at an international conference. But your most significant accomplishment will be meeting and marrying your best friend. Together you will build a beautiful life for yourselves, full of love, fun, friends, and friends. You will have many adventures together, and your greatest will be raising a beautiful, intelligent, and joyful daughter who will fill you with inspire you and fill you with pride. 

I want to take this moment to tell you how proud I am of you. You are a hard worker and know how to hustle (You should especially be proud of this skill). I also want to take this moment to give you some important advice. Throughout your early life, you will keep your eyes fixed on a goal. This will serve you well; however, you will not take the time to enjoy yourself and you will not take the time to learn more about who you really are. You miss opportunities to reflect on your life and to understand better how your childhood experiences shaped you. This is important because you will reach a point in your life when these experiences will finally surface and send you down a path of self-doubt and disquiet. Your soul will feel increasingly uneasy, which will lead to an overreliance on distractions. You will disassociate, as you did as a child, and spend each day just going through the motions. Do not worry, though; you will eventually begin the process of emotional healing and enjoy life more. After all, that is what you will train to do. However, it will take you a few years to realize this, but you will eventually start being more present, regain your confidence, and reclaim your sense of self. So, this is my advice to you; slow down, reflect, and be present. Do not be so eager to reach the end and enjoy your journey more. You will do great in life, so relax.

Love, and I mean it,

Your Future Self. 

What’s This About Dueling Neurosurgeons?

Chance, luck, or misfortune has played an essential role in scientific advancements. Approximately 30 to 50% of all scientific discoveries are in some way the result of accidents or what opportunistic scientists call serendipity. This phenomenon is especially true for the mental health fields. For example, any denizen who partook in the psychedelic scene of the 1960s counterculture owes some level of gratitude to an accidental discovery. In the 1930s, Albert Hoffman, a Swiss chemist interested in the chemistry of plants and animals, was experimenting with a chemical found in ergot, a fungus that some historians believe was associated with the hysteria present during the Salem witch trials of 1692. The primary purpose of his experiment was to develop a treatment for women experiencing respiratory depression and other symptoms due to complications during pregnancy. In his experiment, Hoffman combined the nucleus common in all ergot alkaloids (lysergic acid) with a derivative (dimethylamine) and created what we now know as LSD. Hoffman was not aware of the powerful hallucinogen effects of LSD until he accidentally absorbed the drug through his skin. He continued to use the drug throughout his life and never gave up the hope of finding a medical purpose for the drug. 

This tale is one of the many stories of accidental scientific discoveries highlighted in Sam Kean’s book, The Tale of the Dueling Neurosurgeons. Kean is a writer and contributor to Psychology Today, The New York Times Magazine, Slate, and The New Scientist. He has also published five books, which focus on various scientific discoveries. In this book, Kean takes the reader on a historical journey of accidents and misfortunes that have led to critical neurological advancements. One of the fundamental questions about the brain that underlines this book is whether specific regions affect certain thoughts and perceptions. We know the answer to this question now; however, it is quite interesting to read about how these discoveries happened.  

Each chapter was fascinating and easy to comprehend. Kean avoids technical details about brain functioning but instead relies on good storytelling. Anyone who is interested in neuroscience or is just curious about science and history will find The Tale of the Dueling Neurosurgeons a must-read. I know I did. Just don’t plan on taking LSD before embarking on this journey through history. 

It’s My Birthmonth

.I have a confession, I love birthdays and I’m not ashamed to admit it. I love birthdays so much that one day is not enough, so I celebrate my birth month. This month is a time when I embrace the joys of regressing to my childhood by demanding attention and many (never enough) gifts from my family. Fortunately, I have a tolerant family who obliges me every year, especially my daughter, who feeds off my excitement and takes pleasure in creating one of a kind works of art that she insists on giving to me as soon immediately upon completion. My husband, on the other hand, struggles with finding meaningful gifts that I will use. His gifts are hit or miss. One year he ran out of ideas and ended up wrapping a box of batteries for a digital SLR camera he bought me the year before. Miss! This year, he got me a beautiful state of the art, washer, and dryer set. Hit!

For some, my delight for birthdays is an unfamiliar experience; they would rather ignore their own. I’ve witnessed family and friends threaten anyone who even thinks about surprising them with a party. Others ignore their birthday, hoping that no one will notice. They seem to forget about Facebook’s reminder system. I suspect that birthdays increase existential anxiety by serving as a reminder of our mortality. With this approach to birthdays, I wonder if others see me as having morbid fantasies. By the way, for those with a penchant for somber matters, there is a website you can visit that will remind you of your impending death by counting down the weeks you have left to live based on an estimated life expectancy.

Given that this is my birth month, I started to think about humans’ relationship with birthdays. Why we even celebrate them. When and how did this practice begin? What do we gain from recognizing the day of our birth? Is there an evolutionary explanation? After all, there is no evidence of birthday recognition within the animal kingdom. More importantly, why do some people enjoy birthdays while others dread them? These questions inspired some internet sleuthing, which lead me down a rabbit hole of interesting theories and facts about birthdays. However, to understand our connection to birthdays, we need to go back to when our ancestors began keeping time.

(Really) Quick History of Timekeeping

The ability to conceptualize and measure time is, perhaps, one of the most significant achievements of humankind. Keeping track of the year, or more specifically, the seasons, was essential for human survival. The ability to track weather and animal migration patterns was vital to both agriculture and hunter and gatherer societies. However, measuring a year without access to modern timekeeping devices was difficult. Nature does not provide us with a method of pinpointing exactly when the new year begins. Prehistoric societies relied more on broad indicators, like seasonal changes. The need for future planning enhanced when humans shifted to the agricultural age, and societies started to form. This need resulted in the development of more sophisticated time tracking methods. Scientists speculate that there have been some prehistorical structures, dating back to the Neolithic period approximately 12,000 years ago, that was used to keep track of the year. These structures consisted mainly of carefully placed stones that tracked the earth’s rotation around the moon or sun. This and other time measuring devices (i.e., sundials) were the central systems used. It wasn’t until several thousand years later that calendars would be invented.

Calendars

There is inconclusive evidence of who started using calendars because many ancient societies had their version. However, some anthropologists believe the Egyptians were the first to use a solar calendar, which was more accurate than the lunar calendar. Today most countries use the Gregorian calendar, named after Pope Gregory XIII, who introduced it in 1582. This calendar was a modification of earlier existing versions to correct a problem with celebrating the Easter holiday. Although considered the worldwide standard, the Gregorian calendar is hardly the authority on timekeeping. The measurement of time is a human invention and not a natural construction. Some countries use other versions of the calendar (e.g., Afghanistan, Iran, and Nepal) while other countries use a modified version of the Gregorian calendar (e.g., Taiwan, North Korea, and Japan). There are approximately 40 calendars in use throughout the world. Our use of the Gregorian calendar has less to do with precision and more to do with the Catholic Church’s power over societies.

What Does This Have to Do with Birthdays?

Okay, you might be wondering what all of this has to do with birthdays. Well, as humans evolved, they not only developed consciousness for time and planning; they developed consciousness for the divine. Although open to debate, some scholars believe birthdays have their roots from paganism. Ancient Egyptians believed that when crowning a pharaoh, he or she transformed into a god. This coronation date marked the pharaoh’s “birth day” into the divine. The Greeks soon adopted this practice by celebrating the birthdays of their goddesses and gods. The Romans, however, were the first civilization to celebrate secular birthdays, which included family and friends. Unfortunately, the Romans excluded women from this recognition and would not include them until several years later.

The Christian Church initially rejected the practice of celebrating birthdays because they believed people are born into “original sin” and are “reborn” only after confirming belief and loyalty to Jesus. In addition, the early Christian Church rejected the idea of adopting a celebratory practice that had its origins in “paganism”; however, after a few hundred years, the Christian Church reconsidered. They realized that they could strategically recruit more followers by celebrating a specific birthday. The Romans were already celebrating Saturnalia, the god Saturn, during December, and the Christian Church took advantage of this opportunity by celebrating Jesus’ birthday around this date. Early Jewish faith also rejected the idea of birthdays; however, the reasoning was more practical. Because there was no mention of celebrating birthdays in the Old Testament, other than the Pharaoh’s (Gen 40:20), there was no precedent for engaging in this practice.

Yes, but Get to the Good Part about Birthdays

Fast forward to modern-day and birthdays are celebrated in almost every part of the world (there are some cultures and religions who consider the celebration of birthdays as bad luck or unholy). Most people in the U.S. have fully embraced birthdays and celebrate them with untethered enthusiasm…or do they? The answer may depend on the person’s age, social support system, and disposition.

Children’s feelings about birthdays are easy to uncover. We all know they look forward to their day with excitement. My daughter starts planning for her birthday at least six months in advance. She has her guest list, party theme, and location picked out. She updated these every month, depending on her mood. In many ways, the planning of her birthday party is more exciting than the actual event. It is when we are older that we start to develop a different relationship with birthdays. For some adults, birthdays are a stressful and depressing time. There is even a term for this experience on Urban Dictionary, “birthday blues.” There are a few theories on why people experience birthday blues. For example, birthdays may be a time for personal reflection. Reaching another age milestone may cause us to think about who we have become and what we have accomplished during our existence. General dissatisfaction with life can make birthdays seem dreadful.

Another theory connects the experience of birthday blues to our social system. Celebrating a birthday with loved ones can bring joy, but for many who are lonely or isolated, it can also be a difficult time. Studies have shown that birthdays can increase the chances of dying. One revealing study postulated that people 60 years or older are 14% more likely to die on their birthdays as opposed to other days in the year (Ajdacic, et al, 2012). The causes of death include accidents, suicides, and illnesses. This is a period in life that individuals are more likely to experience solitude living. Another study (Saposnik, et al. 2006), discovered that vascular events such as strokes and heart attacks are more common on birthdays and chronic stress is one of the main culprits of heart disease.

A third theory involves certain natural encounters to aging, which affect existential anxiety. As people age, they are more likely to come across reminders of their mortality: Friends and loved ones die, the body experiences a decline in health and energy, and life becomes more predictable. Of course, general life dissatisfaction and social isolation exacerbate these experiences. Irvin Yalom, a prominent existential psychiatrist, shared his perception of the experiences of birthdays. He observed that as humans age, they naturally suppress thoughts and feelings of death, pushing it into the unconscious and that every birthday serves as a reminder that our time here has limits. How discouraging.

Fortunately, the process of aging does not automatically come with the development of these existential issues. Aging can be an enjoyable experience, filled with deep appreciation and stability. Of course, if we reverse the previous theories, we can conclude that if a person is satisfied with her or his quality of life, has meaningful relationships, and possesses a positive disposition about death, then they would have fewer aversions to birthdays. However, there is another human experience, we can conclude that if a person is satisfied with her or his quality of life, has meaningful relationships, and possesses a positive disposition about death, then they would have fewer aversions to birthdays. However, there is another human experience to look forward to when we age, our brain’s natural process of preparing us for death. A neurological study on emotional development and aging discovered that as people age, their brain undergoes important changes. By examining the brain’s responses of 242 healthy people ages 12 to 79, the researchers found that individuals become less neurotic with age (Hooker, et al., 2006). The researchers showed images of distressed and happy faces to participants and measured their brain responses with functional MRI scans and EEGs. The researchers discovered that older individuals were less affected and more emotionally stable when viewing these images. They hypothesized that the amygdala – the brain’s alarm center that processes emotions, especially fear – tends to become less reactive as we age. A less reactive amygdala allows other parts of the brain (i.e., prefrontal cortex) to engage more. This adaptive response to aging leads to improved rational thinking, intentional socialization, and, more importantly, mindful reflections, which can lead to a greater appreciation of life. In other words, by reducing neurotic reactions to life’s experiences, we can focus more on our relationships and quality of life, making the most of the time we have left.

Decreasing our brain’s emotional reactions is nature’s way of easing us into old age; however, environmental factors (i.e., poverty, abuse, systemic oppression, isolation, etc.) can interfere with this process. I recognize how fortunate I am to have family and friends in which to share my birthdays, and I am grateful for the opportunities and freedoms I had to pursue my life path. I know that not everyone shares this privilege. There is a lot of work that still needs to happen to help older people enjoy the time they have left. Of course, we can start by building meaningful relationships and reaching out to those who are isolated. We could also enhance mindful living by living in the moment and being present. We can also strengthen our social activism by tackling those social barriers that lead to poverty and social isolation for so many. Nature has done its part; it is time to do ours.

References

Ajdacic, V., Knopfli, D., Landolt, K., Gostynski, M., Engelter, S.T., Lyrer, P.A., Gutzwiller, F., & Rossler, W. (2012). Death has a preference for birthdays—an analysis of death time series, Annals of Epidemiology, 22, 8, pp. 603-606.

Hooker, C.I., Germine, L.T., Knight, R.T., & D’Esposito, M. (2006). Amygdala response to facial expressions reflects emotional learning. Journal of Neuroscience, 26, 35, 8915-8922.

Saposnik G, Baibergenova A, Dang J, Hachinski V. (2006). Does a birthday predispose to vascular events? Neurology, 67 pp. 300–304.

 

Gay or Hispanic?

One of the courses I enjoy teaching is multicultural and social justice issues in therapy. It’s a powerful course that has many challenges; mainly, how to get students to understand the realities of inequality in our society and its impact on target populations while managing a variety of emotional reactions and resistance. As a result, I’m always trying to come up with innovated ways of engaging students. For example, last year, I came up with a brilliant idea on how to increase students’ awareness of the adverse effects that preconceived stereotypes have on certain targeted groups. 

I asked students to list characteristics that they knew about me (through observations, what I have said about myself or what they have heard about me), write them on the board, and compare them to an already established list of gay male stereotypes. I thought for sure there would be listed aspects that challenged these stereotypes, but I was wrong. Amongst the characteristics students registered were; good dancer (I’m known to dance in class), love of dance music and visual arts (expressed in class before), and stylish (well, this is just obvious). I had to think quick on how to make this unexpected turn of events into a teaching moment. It wasn’t easy, but I managed.

Anyways, as I was packing up after class and getting ready to clear the whiteboard, I stood back and looked at the list one more time. I began to question whether some of these characteristics were related to my identity as a gay male or to other identities I held. Was my ability to move with rhythm connected to my involvement in the gay community, or was it due to growing up in a Hispanic household where salsa dancing was a favorite past time? One particular listed “stereotype” stood out the most was being “stylish.” 

There are many reasons for clothing: To protect us from the elements, to display modesty, to express our individualization, and to affiliate ourselves with specific social groups. Our choice of dress is also used to express our social position, power and prestige, and moral standards. Clothing can also suggest the economic status or occupational role has in society. Consider our use of the term blue-collar and white-collar to indicate professional status. The use of blue-collar to mean working class originated in the early 1900s to describe manual laborers who used durable denim or chambray shirts for work. Eventually, white-collar to describe an office worker or administrative person who wore dress shirts for their work. We can look at our evolutionary history of life and know that all societies have used clothing to establish a social hierarchy. For example, Chinese emperors used specific color robes to show their status and special connection to the earth. Pharaohs in ancient Egypt wore different colors and shapes of headdresses to express their various roles in power. In certain Polynesian cultures, only high-ranking chiefs of both sexes could wear a lei niho palaoa, a neck ornament consisting of twisted hair and usually adorned by whale ivory. In fact, ancient societies around the world have used sumptuary laws to control consumption. These laws were regulated trade and controlled who had access to expensive goods. These laws also made it easy to identify social rank for discrimination purposes.

With this contextual understanding, I started to think more about my association with clothing and kept thinking about the messages I received from my mother about the importance of appearance. Like many Hispanic families, we experienced economic and social challenges because of a long history of institutionalized oppression, which can be traced to the colonialization of South America and the Caribbean from European settlers. It was important to my mother that we presented ourselves in public in a way that would not draw unwanted attention. She wanted to disguise any evidence of our working-class status. She knew that our cultural identity as Puertoricans before the Cuban migration to Miami in the early 1980s was different from the dominant culture at that time, and that being different opened us to criticism and “othering.” It was unacceptable for us, her children, to have soiled clothing or tousled hair, despite other White children in our neighborhood running around in this state. For my mother, we had to appear impeccable to minimize the perception that Puertorican children were squalid, a stereotypical judgment she was used to hearing. Although we could not afford fine clothing, my mother was a “seamstress” (a gender-biased term that was the norm at the time) and would bring home scraps of materials from her factory job and sew new clothes for us. I remember her working long hours and for days with her sisters to sew my confirmation suit, which included white pants, a vest, and a slightly oversized jacket. It wasn’t perfect, but she felt confident that no one would notice that it was homemade. 

Throughout my life and to the time of her death, she would notice and comment on my style. She approved much of what I wore and even kept me up to date on the latest fashions. She would point out well-known Puertorican celebrities as a model of how I should dress. I laughed at this and would often brush off her sartorialist advice with an “I know, I know” with a frustrated eye roll. Nevertheless, here I was, facing a whiteboard of “gay” stereotypes and analyzing the word stylish in the context of my Hispanic upbringing. I can imagine my mother sitting in this class and disagreeing with the students’ assessment with pride. 

Social Isolation and Brain Development

Neuroscientists have long understood the impact that social isolation in childhood has on brain development. For example, previous research has shown that socially isolated children are more likely to struggle with educational achievement, have difficulty making meaningful connections with others, and experience psychological distress in adulthood. While the brain is malleable and continues to mature until the mid-twenties, most neural connections are established by adolescence. We know that social relationships play a significant role in the development of our brains and the shaping of social behavior: How we feel, think, and behave with others.

Now, a new study has added to our understanding of the impact social isolation has on brain development, especially when it comes to habit-based behaviors. Researchers at Emory University set out to investigate how isolation during the adolescent years, a critical period in brain development, affects neurobehaviors later in life. By isolating rodents during their adolescence, the researchers were able to link early-life adversities to long-term habit-forming behaviors, even in lieu of more adaptive goal-oriented behaviors. They also learned that these early hardships have deep roots in brain functioning, which makes interventions, like social reintegration in adulthood, difficult to correct. This study is an important discovery for the mental health field since it reinforces the need for early intervention strategies.

Hinton, EA., Li, DC., Allen, AG. & Gourley, S.L. (2019). Social isolation in adolescence disrupts cortical development and goal-dependent decision-making in adulthood, despite social reintegration. eNeuro, 23, 6(5).

Sex and Autism

Every once in a while, I have an impulse to watch a documentary film. I find that documentaries satisfy my occasional need for passive entertainment while providing the benefit of learning; it’s a win-win situation. Anyways, I came across a particularly compelling documentary called Dina on Hulu, and after reading the description, I settled on it. This 2017 award-winning documentary, by Santini and Sickles, profiles Dina Buno, an outspoken woman of Jewish descent who lives with a variety of mental health issues including autism, obsessive-compulsive disorder, and post-traumatic stress disorder. The film follows Dina and her fiancé, Scott Levin, who is also on the autism spectrum, as they prepare for their wedding and the challenges of merging their lives.

This film was remarkable for several reasons. For one, the filmmakers had a particularly appealing approach. There didn’t seem to be a strong social or political message as often seen in other documentary films; instead, it provided an honest and straightforward look at Dina and Scott’s intimate lives, leaving the viewer to take away her or his meaning. Because of my interest in inter and intrapersonal relationship health, I couldn’t help but notice the mature and authentic manner in which they interacted with each other, especially when expressing their feelings and sexual needs. As I sat watching the inherently ordinary life of this couple, I found myself making mental notes for my professional use. They are a great model for a healthy relationship. I was also aware of a presenting issue in the film that does not receive nearly enough attention in society: Sexual identity and desire of individuals with autism. This issue is especially relevant given society’s “eternal child” bias – aversion to seeing individuals with autism as adults with sexuality who are capable of self-determination.

Model Behavior

Like all relationships, Dina and Scott’s relationship is complex and multi-layered; however, their respective conditions add additional complications. The film begins with Steve, who has been living with his parents, moving into Dina’s small Philadelphia apartment above a corner store. Dina has more relationship experiences: she was previously married, outlived her husband, and then entered into an abusive relationship with another man. This abusive relationship left her both physically and emotionally scarred. Despite her traumas, Dina longs for physical intimacy. Scott, on the other hand, is inexperienced and avoidant. He needed reminding and encouragement to show more affection, which he earnestly accepts. At one point in the film, during a trip to the beach, Dina has what I consider the best example of having the “sex talk” with a partner. Dina starts the conversation by asking Scott how he enjoyed their day together. Scott expressed having enjoyed the time, and Dina followed with how glad she was to have shared this experience with him. Dina then proceeded to hand him a copy of The Joy of Sex, which naturally leads to this important talkHow she presented the book was especially thoughtful. She acknowledged the differences in their sexual experiences and wants by stating, “I’ve been around” and as she thumbs through the pages and says, “I think I am more interested in this than you, right”? During this encounter, Scott demonstrates openness and curiosity without a hint of defensiveness. He looks at the book as she flips through the pages and replies with, “I can learn”. Dina moved the conversation by introducing an unconventional sexual activity of interest to her and showing him an image of a biological byproduct usually produced during sex. Scott knows of this as he confidently shares his experience with masturbation. The conversation continues.

There were many tender moments throughout the film; Scott bringing home take-out food for Dina, who is scurrying around her apartment, calling her “dear” as he patiently helps her work through their finances, and sharing random kisses as an expression of their love. It is clear that they love and care for each other, and at times Scott is dutifully by her side as she works through her anxieties, especially when she feels of insecurities due to his indifferent nature. In a final scene, Dina and Scott sit on a park bench, and Dina shares her anxiety about their relationship, rehashing her want for more physical intimacy. She feels terrible about pointing out his detachment, worrying that she’s too critical of him. Scott is quick to accept responsibility for his part in their relationship and displays a remarkable amount of kindness, stressing how inspired he is by her strength for living through some extraordinarily tough times. These words seem to resonate with her, and she asks him to explain what he means. With great clarity and conviction, Scott refers to her surviving a brutal attack from her previous partner. He responds, saying, “you’re still here, inspiring people,” and with that, he leans over to kiss her as to say that he is present and ready to respond to all of her needs.

Disrupting the Eternal Child Narrative

Another aspect of the film that was interesting was the representation of individuals with autism as sexual beings. What I appreciated about the film was the honest and straightforward portrayal of two individuals in love, trying to work through their unique, intimate challenges. It wasn’t a social commentary on whether people who are differently-abled should have the right to have sex or procreate. This unassuming approach is critical since it challenges stereotypes of autism in a relatable way.

Unfortunately, the infantilizing of individuals with autism are all too familiar. For example, an empirically based study on the representation of autism by various outlets revealed that out of 152 photographs used on regional and state chapters of Autism Society of America websites, 95% were of children. The representation of autism in popular media outlets was also disappointing. Out of 105 fictional books, 83 movies and television shows with autistic characters, 90%, and 68% were of children, respectively.

Unfortunately, society’s view of disability, regardless of the nature of the disability, tends to be one of incapability and pity. Individuals are often seen as too innocent and in need of care. To accept that people with disabilities have sexual needs – considering society’s long history of puritanical views about sex – disrupts the eternal child narrative that people are accustomed to having; however, this disruption is necessary. There are serious consequences to infantilizing autism. For one, it is demeaning and insulting. Whether it is intentional or not, people with autism are frustrated with this experience and feel powerless to change it. This dehumanizing experience further affects their development. Second, and to the point of this movie, it prevents healthy discussions about sex and sexuality from happening, which increases the risk of sexual abuse, getting a sexually transmitted infection, and having an unwanted pregnancy. It also interferes with the person’s ability to obtain and maintain healthy romantic relationships, which is a fundamental part of all human existence.

I applaud Santini and Sickles for their respectful approach to making this film and for choosing a truly inspiring couple to profile. I especially applaud Dina and Scott for giving us access to their personal lives and for their part in the ongoing process of bridging the gap that separates our worlds. I think everyone should view this film and learn from it. I plan to require this film for my students. 

Coming out vegan

Coming out as gay to my mother was, as one might expect, difficult. This was in the mid-eighties, I was 12-years old and living in a predominately Latin, Catholic, and working-class community in South Florida. I wasn’t sure what to expect from a woman who leaned more on the emotive side of expressions, but I was at a developmental point in my life where I was sure about my affectional orientation and ready to tell the world. Fortunately, she received the news better than I had hoped. She advanced through the first three stages of Kubler-Ross’ model of grief (denial, anger, and bargaining) and, realizing that depression (fourth) was not her style, skipped this stage and moved straight to the final stage (acceptance) all in about a week. Not bad. 

Fast forward to the age of 32 when I first started noticing my metabolism slowing down and my body taking longer to recover from a night out. I took this as a wakeup call to start being serious about my physical health. A friend recommended Andrew Weil’s book, Eating Well for Optimal Health: The Essential Guide to Food, Diet, and Nutrition (2000). In this book, Dr. Weil thoroughly provided basic facts about food, nutrition, and their effect on our bodies. He also commented on a variety of conventional diets from around the world. For some reason that I cannot recall today, I was drawn to his review of veganism and was convinced by his exposition. I knew it would be difficult, especially since my husband was the cook in our household, and he was very fond of meat.

My new diet also put a damper on social situations since our friends tended to pick restaurants that lacked vegan options. These obstacles were expected, but I was committed to maintaining my vegan diet. What I did not anticipate, however, was how tough it would be to tell my mother. Meat was a considerable part of her cooking. Animal protein headlined every dish she made, even her salads. I had more anxiety about telling her I was vegan than I did telling her I was gay. It felt like the coming out process again, but this time I was less confident. Her progress through the stages of grief was different. At first, my mother was in denial, she thought I was joking. Then she moved to anger and started to bombard me with “facts” about how a vegan diet would lead to starvation and eventual death. Next, she entered the bargaining stage and said that it was a phase and that I would eventually come to my senses. Through it all, I stuck to my convictions. It wasn’t easy visiting my mother. She would nag and swear to me that I would become anemic (this concern was more rational). She would even sneak meat under a pile of rice or drench my vegetables in bacon grease, hoping that I would not notice. I did, and it was exhausting. 

During this period, we were at odds with each other, often arguing about what she saw as a poor lifestyle choice. It was a very stressful time in my life and strained our relationship. In fact, I find my anxiety increasing, just writing this entry. Why was my being vegan more difficult for her to accept than my affectional orientation? Why did this put such a barrier in our relationship? It took me years to realize that my mother wasn’t angry about my vegan diet per se, but confused and saddened by the realization that I established a restriction on how she loved me; through her culture and cooking.

It’s no surprise that food is a significant part of our lives. We certainly need it for sustenance, but how did it become so pleasurable and such an essential part of our social and cultural interactions? How did we develop such an emotional attachment to certain foods? Why don’t we eat just enough in the privacy of our homes to keep us going to the next day? There are biological, psychological, and cultural adaptations throughout our human development that connect us to food. We can start by looking at part of Darwin’s research while at Galapagos Island, which was integral in solidifying his theory of evolution by natural selection. Darwin discovered several species of finches whose bodies and beaks varied from island to island. Each species of finch adapted to a specific type of food that was available on the island; thicker beaks for ground-finches who fed off crunchy seeds and crustaceans and longer beaks for warbler finches who fed off insects found in vegetation.  

Like Darwin’s finches, the need and availability of food shaped human development. There’s evidence of evolutionary changes to the bodies and brains as our hunter-gather ancestors as they adapted to changing climate and increasing populations, which affected available food sources. Humans spent ninety percent of our millions of years on Earth foraging, and most of the day was consumed by gathering and hunting for food. The earliest evidence of bipedalism in early proto-humans (hominins) dates back to approximately 3 million years ago. There are many theories of how humans evolved from walking on knuckles to walking in an upright position. Two prevailing theories center on adapting to available food sources. The postural feeding hypothesis describes hominins developing to an upright position as the need to reach food on trees became more of a necessity while the savanna-based theory describes how their eventual migration into the savanna led to standing upright in search of food over tall grass. Although modern humans (homo sapiens) started to evolve in Africa approximately 200,000 thousand years ago, it wasn’t until about 70,000 years ago that small groups began to leave Africa and spread to other continents out of the changing availability of food sources. Some anthropologists believe it was during this period when humans started to find ways to differentiate themselves with their own set of beliefs, customs, and rituals. Food would have been a fundamental part of this differentiation since available food sources varied across the path of human expansion. Humans developed various dietary adaptations, including food preparations, and those connected with local plant and animal populations. Mothers provided the only source of nourishment for their children. Nursing not only assured the survival of their young but also bonded the mother and child, strengthening psychological and emotional connections. As modern humans transitioned from small hunter and gatherer relationships to agricultural societies, some 12,000 to 23,000 years ago, humans started farming and raising livestock, which increased permanent settlements. These settlements led to job specializations, governing structures, accumulating possessions, and oppressive gender roles. 

Before the agricultural revolution, men and women had equal roles in their lifestyle. The farming lifestyle led to the specific division of responsibilities; men spent most of their time in the fields working with animals while women worked at home tending to their children and preparing foods. Local available vegetation and animals led to the development of unique cuisines. Women had more options for feeding their children, and preparing delicious meals became part of the bonding process, further connecting ourselves to our mother’s cooking. In addition to the responsibility of feeding children, women had a burden of passing on traditions to ensure cultural continuity; women taught their daughters how to prepare foods so that they could feed their children and families. 

As people continued to migrate, they brought their customs and their culinary practices with them, sharing them with other people they encountered. Food shifted from being consumed for sustenance to being consumed for pleasure, expressing cultural uniqueness, celebrations, and connecting with others. Today, in every country and culture, the sharing of food is central to our expression of love. The sharing and receiving of food brings joy and connects us to each other in ways that can only be truly understood and appreciated by knowing our past. We also need to recognize the role of our families, especially our mothers had with our emotional connection to cuisines and why we feel so safe and loved when we eat a home-cooked meal. 

It is no wonder my mother had such difficulty with my new vegan diet, I had taken away part of the way she expressed love. She must have also felt saddened that I had “abandoned” my culture and not continue the long tradition of passing down the love of her selections of Latin cuisine. Coming out as gay was easier for her to accept. It didn’t matter what my affectional orientation was, she could always cook me mofongo, arroz con gandules, and pasteles, and all would be alright. A lot has changed since I came out as a vegan, I eventually went back to eating meat, learned how to cook, sadly buried my mother, and I am proud to say, passing on the love of Latin cuisine to my daughter. In the end, she was the one who knew me best. For me, being vegan was just a phase, and although this period in our lives was stressful, I take comfort in knowing she truly believed that I would eventually come back to her love.