Every parent’s nightmare

All good parents – and most not-very-good-at-it parents – want what is good for their children. They would like them to grow up happy and healthy, to have a comfortable life, stay out of jail, etc. A few grandchildren and regular calls and visits would be nice.
Often unspoken, but definitely there, is the desire that their child not be what they might call “crazy.” It’s not my word – I’d use depressed or anxious, or having a psychotic episode – but for parents, one of the greatest fears of all is that their child grows up to be mentally ill, with hallucinations and delusional beliefs – to be out of touch with reality, to be, in short, psychotic.
Psychotic doesn’t mean “violent and crazy,” as it is so often misused. It means to be out of touch with reality, often with some sort of hallucination (hearing voices, seeing things that aren’t there, or some other sensory misinformation) and/or delusional beliefs (paranoia, which may mean being persecuted or it may mean an unrealistic arrogance, belief in one’s special powers, or that one is in fact someone of great power and importance).
And, it turns out, psychotic symptoms are a risk factor for two common substances in the lives of young people: methylphenidate, a commonly prescribed drug for ADD/ADHD, and cannabis.
The research on methylphenidate has been ongoing, in some cases for decades, and while you cannot do experiments to “prove it” (who would volunteer to try to have their child rendered psychotic just to see about a drug’s effects?), researchers scour multiple studies following up on children and teens prescribed methylphenidate, and find that 1 to 2.5% develop psychotic symptoms. That’s up to more than one in 50. The latest meta-analysis was published this summer in the Scandinavian Journal of Child Psychiatry and Psychology, using multiple studies with over 77,000 young people in all.
The link between cannabis and later psychotic symptoms, as well as anxiety, for young people has been known for years, but often studies began in the mid- to late-teen years and it was difficult to determine if those who were prone to mental disturbances were more attracted to cannabis than healthy teens, or if otherwise healthy teens were developing psychosis as a result of cannabis use. With studies beginning earlier – in 7th grade – researchers feel confident asserting there is an increased risk for psychotic symptoms within a year after a teen begins using cannabis. This is for all teens, not just those with family histories of psychotic illnesses such as schizophrenia.
What should parents and other caregivers do?
If your child is being treated with methylphenidate, work closely with the prescribing physician to monitor side effects, be honest about what you observe, and do not panic. Remember that counseling and neurofeedback, provided by experts, can help someone diagnosed with attention deficits develop skills and neurological adaptations to reduce symptoms. Seek a referral from your child’s physician.
In terms of illegal drug use…assume no “safe” amount of an illegal substance. The fact that many states have legalized or decriminalized marijuana has misled many people to believe it is “safe.” It is not. The American Medical Association and the American Psychiatric Association both have published strong positions warning about the use of marijuana.
Parents and caregivers also need to be mindful that the drugs used for ADD/ADHD, and methylphenidate as an illegal substance, are popularly misused, sold, or shared among young people. According to studies published as recently as last autumn, 5 to 10% of high school students and 5 to 35% of college students use, or have used, prescriptions for ADD/ADHD illegally as “smart” or “study” drugs. This may be regular use, or may be occasional to get through end-of-term crunches with minimal sleep. Side effects include sleeplessness, agitation, anxiety, dizziness, headache, sweating, appetite loss, elevated blood pressure, and psychosis.
Be alert for subtle changes in behavior and do not be afraid to be assertive about this. Your child’s physical and mental health may depend upon it.

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Go and Do, for Me and You

Verbs, like “go” and “do”
In a recent on-air segment, Jamie and I (he’s the afternoon radio talent for Spirit FM, the local Catholic radio station/Christian pop music station where I’ve been volunteering since 2009) were discussing various social protests. He had asked me how to handle the flood of social media, with people posting/re-posting/re-re-posting, and the pressure to have some sort of opinion/assert some stand on perpetually protesting celebrity.
I try, but don’t always succeed, in preferring action verbs. Like, “go” and “do.” I don’t much care for meetings. I don’t like sitting around talking about how we can help the homeless and severely mentally ill. I went and did (full time work, almost 5 years). Jesus didn’t say, sit around and have lots of committee meetings. He said, pretty much, Go… (He also had something to say about babbling on and on, so I will move along.) I would rather teach than talk about teaching, do art than sit around talking about art…you get the idea.
So my thoughts are, go and do. It would be far more helpful – if, for example, we are talking about the real and obvious pain in poor neighborhoods – to go and do. Mentor a kid. Be a Big Brother/Big Sister. Organize a community watch organization. Do pro bono work in your field. Provide free tutoring. Be a Guardian ad Litem. Etc., etc. Go and do. Standing around getting attention for taking a public position that costs nothing seems a little self-serving.
It reminds me of the time a woman I knew criticized me for failing to wear red on some arbitrary date publicly announced to be the day to wear red to support women’s heart health. The only woman whose heart I have much influence over is my own. I had already exercised, gone to church, had good conversation with my husband, eaten a healthy breakfast – in other words, it was 8 AM and I had done all I could for THIS woman’s heart health. Nothing I was going to do, besides pray and try to set a half-decent example, would help anyone else.
It also brings to mind the big test for reports of visions of the Blessed Virgin Mary. Such a report requires much evidence, but a primary benchmark requires that Mary points towards Jesus. There is no credibility if the reported vision does not direct people towards Jesus. Such an experience is not something from the Good side. It might be a well-intentioned, innocent delusion, but it is not Mary. Mary doesn’t showboat.
So…if terrible injustice moves you, go and do something concrete, specific and clearly helpful for one particular person. Keep the meme to yourself.
…and more on “Go” and “Do”
Teen and young adult mental health took a drastic, terrifying turn for the worse beginning in 2007 – and the stats keep worsening, especially since 2012. This, according to a lot of research, can be traced back to the smart phone, according to San Diego State University professor, researcher and author Jean Twenge. Her recent book, “iGen: Why Today’s Super-connected Kids are Growing Up Less Rebellious, More Tolerant, Less Happy – and Completely Unprepared for Adulthood – and What that Means for the Rest of Us,” provides the results of not just her original research but meta-analysis of generations of data on the pattern of mental health and activity for youth.
It seems like constant connectivity has led to less “go” and “do” and more detachment and isolation. It’s a double-dose of negative: the ineluctable distance created by screen-based communication and a deficit of direct experiences. We were not designed to sit and click; we are made to go and do.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

Posts are for entertainment and not meant to be construed as treatment or professional recommendations. If you need mental health assistance, please contact a licensed professional in your area.

To Live Long, To Live Well: The Ongoing Research

Cognitive decline – dementia – Alzheimer’s disease – senility – to lose our independence, our memories, our minds – our “selves.” This is one of our greatest nightmares. But, what if this precipice – the thing people seem to fear worse than death – is almost entirely avoidable by changing how we live?

The Alzheimer’s Solution: by Dean Sherzai, MD, PhD and Ayesha Sherzai, MD (2017) asserts that this is indeed the case. You won’t find wishes, a few convenient anecdotes and flimsy, recent research. The doctors Sherzai tie together decades of substantive research from multiple, credible sources (including ongoing Blue Zones research) and their own research and medical practice. The result of this work: a straightforward and remarkably simple (albeit not easy) recipe for long, healthy mental functioning.

Unfortunately, it requires that we do stuff. Differently. In a lot of cases, way, way differently.

Here’s a synopsis:

They use the helpful and appropriate acronym NEURO: Nutrition, Exercise, Unwind, Restore, Optimize

Nutrition: quite specific nutritional guidance – recommending a largely vegetarian diet high in specific types of nutrients.

Exercise: not just a regular appointment at the running path or the gym, the research emphasizes activity throughout the day on a frequent basis.

Unwind: Managing stress healthfully and living with purpose.

Restore: Enough good quality sleep (this is a tough one for me). There is no substitute for sufficient sleep in terms of long-term brain health

Optimize: a lifetime process, and never too late to start: complex, creative, learning and doing. While the puzzles we encourage elders to do to keep their minds nimble are a small part, greater benefit comes from ongoing learning, complex tasks, mentoring/teaching and other activities that use multiple skills.

The book, published this past summer, includes interesting case studies, questionnaires and specific recommendations to make changes as needed on a case-by-case study. It’s helpful to remember that, all over the world, there are “Blue Zone” communities – places where most people live long, robust lives free of chronic diseases and dementia – where these lifestyle choices are just “normal,” not sacrifices. At least, I tell myself it’s helpful.

My challenge, which I share and dare towards you: do some investigating on this. If you’re intrepid – seek your physician’s guidance and take it from there. If you’re a little timid, hesitant or just plain skeptical, pick one piece that’s easy to do, get the medical OK, and go for it.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

 

Posts are for entertainment and not meant to be construed as treatment or professional recommendations. If you need mental health assistance, please contact a licensed professional in your area.

Duck, Duck, Goose

Muscovy ducks are ugly.

There’s simply no getting around it. Perhaps some find them in the category of, “So ugly, they’re cute,” the befuddling phrase used to describe certain regrettable-looking breeds of dog with what seems to be a permanent, long drip of slime on their maws. I don’t see it, in either the dog or the duck.

Muscovy are also an invasive species here in west-central Florida, driving out our adorable and good-natured native ducks. Thus, they are unwelcome both in, and by, appearance.

During an Emmaus retreat at the Franciscan Center in Tampa, I was able to observe a female Muscovy along the river last weekend. She was waddling along, looking into the river on her right and then to the ground on her left, seeking food. She was followed closely by one, then two, then four, large, ugly and showy Muscovy males. She seemed oblivious. They were posturing: just short of chest-bumping one another, fluffing up their feathers, strutting in circles and then, realizing she had waddled on further ahead, scuttling up closer to the object of their desire before devolving into posturing observed only by one another, and me.

Ms. Muscovy did not feel obliged to wear shorter feathers in her nether region or walk on her webbed toes to gain their attention, and indeed, it was apparently unnecessary. She had the power of her femininity, and that was sufficient. God knows how large the flock of males out-strutting each other got before she made her selection; the bells rang and I hurried off to join my fellow retreatants for Morning Prayer.

Flash back to the 1980s, when wearing brassieres over one’s clothing, instead of under, was all the rage for a few unfortunate years. During a lunch conversation, a male colleague (middle-aged, recently divorced and apparently adjusting with difficulty) mentioned his amazement at seeing this while out in a nightclub. A few of the females opined we would never do such a thing. If we weren’t married, he said, and had to be out there, competing for male attention…whoa, whoa, WHOA. A man, I said, for whom I was to “compete” by wearing my underwear over my clothes would not be the man for me. My female cohorts agreed. Divorced-dude was amazed.

Alas, times have, apparently, changed. Somehow the power to vote, own property, and be paid the same for the same work (let’s not go to where we compare part-time clerical staff with chemical engineers and whine about salary differences, okay?) seems cast aside for the “power” to wear vagina-hats in public, insist that tights are business trousers, and gain fame by posting indecent pictures of oneself to (anti)social media.

In our little yard, I cannot, from a respectful distance, tell Mrs. Bunny from Mr. Bunny, but apparently they can, and so things work just fine. Mrs. Cardinal is subtle compared to her (to human eyes) flashy husband, but trust me, when the six or seven species of birds – almost all larger – are sharing the seeds I have flung onto the front yard, it’s little, softly hued Mrs. Cardinal who commands attention and sets the rules. Mr. Cardinal does not seem to have any objections about being partnered up with his gently-toned, energetic little mate. Likewise the pair of black snakes, the ever-expanding clan of blue jays, or our resident crows, Poe and Annabelle Lee, and their hapless but fun-to-watch adolescent offspring: all seem content without the females doing strange and torturous things in a craven attempt for male attention.

Why are humans so singularly dysfunctional when it comes to male-female relationships? Can we blame it simply on the Fall and the impact of a long history of bad choices that have turned us slowly away from what we could have, and might still be, towards this strange situation in which much of our culture finds itself?

For almost three decades now, mental health professionals have dealt with body-image and sexuality issues created by a pornographic culture so pervasive that too many young women believe they should engage in sexual activity whether they feel like it or not, and many young males have incurred physical damage on themselves due to excessive masturbation with porn as the stimulant. Conditioned to images on electronic devices, a normal, living female is just not as attractive and too much trouble. We’ve all, no doubt, heard of the teen magazine that explained sodomy in how-to terms. In my work, this isn’t some abstract issue; I listen to young women wrestle with their discomfort and shame over what they feel obliged to do and the fear that their hesitancy to engage in impersonal sexual acts means there is something “wrong” with them. I help couples whose relationship has been torn apart by the husband’s pornography addiction and disengagement from his wife.

I used to pity my male college students, assuming the heterosexuals had their ability to focus on psychology (endlessly interesting to me but, I realize, not to all) cruelly challenged because, for a healthy straight young male, the proximity of female peers would normally be distracting. Now the female peers are often dressed in revealing clothing. I assumed (naively) that this placed an unfair, even uncharitable, if you will, burden on the males. Now I wonder. I wonder if, drowned since childhood in a flood of hypersexualized images, the presence in the next seat of a young woman with her breasts pushed up to her collar bone is…nothing. Now I feel sad about that; they are both missing something about the joy of being human: they have lost the capacity to appreciate one another.

He may be sentenced, until he works to change it, to a life of seeking ever-more extreme forms of sexual stimulation, and she will be reduced to claiming that her power comes from the right to have sex indiscriminately and wear unflattering pink hats in parades.

Meanwhile, Ms. Muscovy is enjoying the riverbank and may eventually pick some posturing, squawking, ugly drake from among her admirers.

The ducks have it figured out. Guess who gets to be the silly, sad goose?

 

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

Not So Complicated

I channeled Mary Poppins: resplendent with unwavering decisiveness and spit-spot, lickety-split efficiency, two of us turned the spare-bedroom/storage-room into comfy guest quarters in less than 45 minutes. Easy-peasy…

…because it was not MY spare bedroom. No emotional investment, no weariness at once again facing the task at hand, it was, actually, fun. Change is refreshingly simple when it doesn’t cost you a thing.

When it costs something, change seems complicated and hard, even impossible.

Almost everyone I know has argued, in vain, with newspaper articles, the radio or television newscasts. As if briefly overcome with psychoses, they shout at the television and argue with the radio in their car. (Me, too). Whatever their position – progressive or conservative, libertarian or statist – they are frustrated and amazed, over and over, at officials’ protestations of how hard it is to make change happen.

Everyone has ideas on how to make change happen. Some are terrifying; others are naïve. Many, however, have the ring of common sense, and it makes one wonder, why are these officials, whether elected or snugly sinecured, acting as if everything is so complicated?

There are many different government programs aimed at moving people from one place to another. Why many? Who knows? Could it be simplified? Yes, and probably elegantly. Everyone on Medicare, for whatever reason, use service A; everyone who meets whatever clearly established criteria (such as Medicaid) for need, use service B. Give every participant a chipped card to use, require photo ID (or put it on the card) to be sure the cards don’t turn into underground currency like food stamps sometimes do, and then the details entered into the program (A or B) for that individual will determine: medical taxi, van assistance, reduced or free bus fare? A bright STEM high school senior could write the bulk of the program in a day or so. If you immediately imagined the most complicated possible situations just to pick a fight with me: sure, those exist. If someone needs a wheelchair-accessible van, then that goes into the electronic info on their card; if they merely need a cab for doctor appointments, that’s on the card. As circumstances change, someone in a remote office can input the update. When Mr. X no longer needs a wheelchair van to get to his appointments, his account can (spit-spot, lickety-split) be adjusted to provide for the appropriate transportation benefit. Plus, with GPS it won’t be hard to figure out if the beneficiary had the cab drop them at Dr. K’s or at K-Mart: auditing for abuse becomes simple. Ta-da: not easy, but simple.

If the object was to make sure poor people had good quality healthcare, one might wonder, why not simply work with what we have? One, we have a public health department system and two, we have a VA system to serve as a model for comprehensive (albeit labyrinthine) healthcare. What makes it so complicated to appropriately expand the one, based on what we know from the other? Doctors are leaving, or not going into, private practice and instead signing on as employees in the private sector, so a nice government job with benefits and a pension seems like a tempting offer for many D.O.s, MDs, ARNPs, RNs, dentists, and other healthcare providers angling to be someone’s employee. Yes, we’d need more buildings and more staff, and probably some specialty services would be outsourced (the VA knows all about that, too). Who uses them? How about anyone who meets criteria for transportation assistance, as above? They already have the ID card; add that info. Outsourcing so little of it will lead to much less fraud, the latter a cause of handwringing for the same politicians who resist change.

Oh, I know. I can’t possibly understand. It’s far more complicated than that. Well, no, it’s not. It’s not going to be easy, but that is not the same as complicated. From out here, it is very clear that sometimes what is explained as “complicated” really means “not easy.” These are different things.

A marathon is not complicated. It is a matter of stepping forward and repeating that action for 26.2 miles. I know; I ran 79 of them. They were not easy. They were simple and hard. So are lots of things. It is just easier to see “simple and hard” from the outside than from the inside.

“Complicated” is a euphemism for something along the lines of, “Well, we don’t want to change anything; some people will be unhappy, and maybe we’ll lose some votes, so somehow we must give the appearance of changing things without actually changing anything.” The best we seem to get sometimes is the legislative version of buying storage containers during the January sales. It’s the same pile of junk, but it’s temporarily neat. If the object is to pretend to change, then, yes, everything we shout at the newspaper and radio about is quite complicated. I have no idea how to run AND not run at the same time, so how could a bunch of bureaucrats figure out how to simplify programs while simultaneously avoiding any changes?

Our ambivalent relationship with change makes it simple, and enjoyable, to help other people organize their stuff. The books were not MY books, the stuff was not MY stuff. People who have enough money and stuff hire people to come in and bully them into getting rid of stuff. The theory is that someone else, who is not emotionally invested, will be able to confront me. I can imagine the process:

Professional organizer: “Now, Lori, how many CS Lewis books do you really need?”

Me: “I dunno. How many ARE there? Ought I leave room for more?”

It goes downhill from there.

The analogy ought to fail because the people we elect should not be emotionally attached to ineffective programs. They behave like people suffering the deep heartache that leads to hoarding behavior, but I suspect the attachment is less suffering and more sinister: each entanglement serves a gratifying purpose or two.

Imagine members of Congress clinging, weeping, to the thousands of pages of regulations that describe the several programs to provide fuel (or rather, money for fuel) to poor people in winter. Why would they fret about merging these into one, clear, program? Where is the burning enthusiasm to ensure that the funds to help people stay warm are used prudently and effectively? I don’t want to read about one person collecting fuel benefits from multiple funds and using some of it for frills, while someone else freezes to death. I want everyone to be warm and cozy. If there were one program, would people find a way to abuse it? Surely; but simplicity reduces the camouflage.

I suspect we will all be shouting at the news for a long time. Meanwhile, I have to go pretend to be someone else so that I can impose some order on my stuff: a process that will be simple and hard.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

 

As a friend fades away

Clancy has dementia.

Clancy is a 15-year-old cat, who has been my near-constant companion since he was about 8 weeks old and nearly dead. Our daughter found him while at work; he was lying under a dumpster. Since my beloved cat Chili had died only two months before, she brought this mostly-dead kitten home for me. The rescue process included a transfusion, some medication for a life-threatening flea infestation, a few weeks of hand-feeding and two weeks of my sleeping on the floor so the half-dead kitty could sleep on my chest, feeling the heartbeat and warmth of fellow mammal while he regained some strength. Clancy thrived and enjoyed robust good health.

Clancy met me at the door, tail wagging (yes, he IS a cat) every day. He followed me from room to room; he stood up on his hind legs and patted my hip when I was cooking, looking for a handout. He “helped” me read, do crosswords and yoga. He had a share of every serving of chicken, turkey and fish that I ate for dinner.

Now he has dementia. He lives in a cat-apartment in one room of the house, customized for his comfort with arthritis-friendly ramps to window perches, places to hide, soft places to sleep, quiet music and a chair, where I sit with him every day. He still likes to stretch out on the Sunday crossword puzzle, and he obligingly “helps” with my yoga a few mornings a week.

Sometimes he does not seem to know who I am; he cowers and hides. Other times he is suddenly aggressive. Sometimes he is his old, affectionate, playful self…and then an hour later, I return to find that he has dragged every loose piece of bedding into the litter box.

We have decided that as long as he seems to have a decent quality of life, we will keep on accommodating Clancy. However, we have made the difficult decision to forego any major medical interventions beyond his usual annual checkups and vaccinations. No heroics. How do you know if an animal companion has a good quality of life? When we watch a movie or sit reading and he curls up in my lap, as he has for all these years, it seems so. The next morning, when he hides when I come in with his Chunky Turkey in Gravy and ice water, it is less clear.

If Clancy and I are very, very fortunate, he will slip away from this world in his sleep one night, curled up in the kitty bed he has had for many years, without too much fear or pain.

 

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

Plan B

I am very, very hopeful that, when I leave the office this evening and get into my Ford Fiesta, it will start when I first turn the key and that all four tires will be inflated. It gets regular maintenance and I expect it to start. My plans, including the amount of time I schedule for various commutes, revolve around the expectation (Plan A, as it were) that the little car will be ready to roll.

Sometimes, she is NOT ready to roll. She might have a flat tire, or a dead battery (Florida heat is rough on batteries). So, just in case of various emergencies, I have a jack, spare tire, some tools, a can of tire-inflator, a quart of oil, some water, jumper cables, a fire extinguisher, an owner’s manual and my AAA card. I also have a Bible and Rosaries for other sorts of emergencies. I would vastly prefer not to resort to any of these Plan B’s alone in a parking lot at night, but every so often I have been happy to have them readily available.

On a much more critical scale, military and police personnel have to have plan B at the ready in case of a worst-case scenario. Let’s say you are a special operator and you and your comrades are supposed to slip in silently, extract an American hostage or two, and slip out with the same seamless, silent efficiency. That would be Plan A: no one on your side gets hurt and maybe not even too many of the enemy. If enemies have to be hurt, they cooperate by succumbing very, very quietly. Plan B, entailing air support and extra personnel and a whole lot of messiness, is far from optimal. Plan A is effective if nothing goes wrong. If anything goes wrong, then you need Plan Bs. Plan Bs have a higher likelihood of success in the case of an uh-oh situation than Plan A, but are far less desirable.

Most of us don’t have to worry about extracting hostages or inflicting deserved mayhem on an enemy. We have to muddle through, discerning our purpose and doing our best to live rightly. Do we, who don’t have any expectation of being caught in a gunfight, need a Plan B? It’s become quite popular, especially in the business school world, to assert that a Plan B is an excuse to let Plan A fail.

I would argue that Plan B is part of the backbone of successful planning. Consider, for example:

You have promised your small children that, if everyone cleans up their bedroom by 9 AM Saturday, you will all go to the zoo! Yay! You had better have a Plan B already presented to them, too, in case of rain (as in, if it rains, we will postpone the zoo and have lots of fun doing “X” at home). You do not have control over whether or not it rains on your zoo day, but you have control over creating alternatives that account for circumstances beyond your control. Would you rather have Plan A – a sunny, fun day at the zoo? Absolutely; but if it’s wet, cold and dreary, kids who are able to be disappointed but know that all is not lost are easier to deal with than children who are whining because “you promised we could go to the zoo,” and claim they care not that it is raining and all the animals will be hiding inside, out of the weather. You promised.

There are thousands of possible examples: the college application that is Plan B if the desired, and worked-for, scholarship at your Plan A school doesn’t materialize; the back-up work plan if it takes longer to get a job in your field than you’d expected; the gift you will get for your child if the most popular toy that holiday season is out of stock. Would you rather get a full scholarship to an Ivy League school, a great job that starts exactly two weeks after graduation and be able to score Tickle Me Elmo, the latest Transformer AND the talking pony? Yup, yup and giddy-yup…but those are not all within your control.

The business school model against Plan A, very interestingly researched by Doctors Shin and Milkman, focuses on short-term goals with brief time periods. One test, for example, was that some participants were asked to consider a Plan B if they failed at the brief task while doing the brief task. If you have 10 minutes to unscramble sentences, and the reward for success is a free snack and some are warned up front that, hey, you might want to think about where else on campus you can score some free food in case this doesn’t work out for you, those participants might be a bit distracted from the task at hand. You have given them two tasks. That doesn’t mean they were not motivated for Plan A (the free snack) but rather they had to do two tasks at once: the task for the free snack and figure out where to get free food if the buzzer went off before they finished the first task. This is one of several experiments in their research. Other business writers have emphasized the belief that asking people on a project to have a plan B is like giving them permission to fail at plan A.

This is an interesting perspective and very narrow in its focus. There are risks in over-generalizing the findings of any particular piece of research, something Doctors Shin and Milkman know. Unfortunately, readers who see a non-academic’s cheerful, “Hey, if you develop a plan B you plan to fail,” misstated summary of Doctors’ Shin and Milkman’s work might leap to the conclusion that Plan B means Bad Plan. That is not what the researchers concluded.

I would propose that there are a few common reasons for a bias against adequately thinking through a Plan B when preparing to execute Plan A. These are by no means comprehensive –

1. “I have done everything that success requires and so I am entitled to success.” Ah, the entitlement myth, in which a benign and biased-towards-you universe bestows what you have earned even though there is far less of whatever you want available than there are hard-working and deserving candidates. Hundreds of people might apply for that scholarship, and all of them have great GPAs, hours of non-mandated community service and glowing endorsements from their local Mother Teresa. Yet the committee (and its computer program) can only give the scholarship to one applicant. Scholarship, job, internship…failing to achieve that one, ideal Plan A doesn’t mean you personally failed. It means that you didn’t get Plan A, probably for many reasons outside of your control.
2. “I am terrified of not meeting the expectations of those close to me (parents, often) and so most pour everything into Plan A. Anything less than absolute success means I have failed them – and myself.” This speaks to the narcissistic parent (“I am a perfect parent and you, my ought-to-be-perfect child, are the Exhibit A in proof of my perfection”) projecting the need for boundless success and admiration onto the child. Spouses can do this to one another, and children might fall victim to Pygmalion coaches or teachers.
3. “If I have a Plan B, it will surreptitiously make me turn into a lazy slug who will fail to put in the effort required for Plan A.” This is the, I can’t trust my own strength of character theorem, and one can only say in response to this, “Know thyself.” However, lack of a Plan B is not going to singlehandedly turn an unmotivated sloth into a laser-focused, goal-oriented powerhouse. If you know you need to work on your intrinsic motivation strength, now would be a good time to start.
4. “Plan A is my heart’s desire and I cannot bear to consider life without it…so I will just not consider the fact that Plan B might be necessary.” This is idealistic and romantic, and if you are not a good-hearted male under age 21, you probably need to accept a teaspoon of reality. If you are a good-hearted male under age 21, I will cut you some slack. That is the healthy age range for passionate idealism with a dose of immortality myth. The rest of us have to deal with the reality that life changes constantly. Your robust good health, your vision and hearing, the career you love, your neighborhood…will all change. If there is not a Plan B, you will have the alternative of crushing despair on top of the burden of grief, time after time after time.

I began this essay, spurred by a friend’s report of an adult daughter who, failing to get the job she’d applied for after college, is moving back home without any particular plan. Apparently, there was no Plan B. This led to curiosity about the “Plan B” issue in general, and discovering Shin and Milkman’s research. Not long after I began this essay, the book Option B, by Sheryl Sandberg and Adam Grant was released. I am looking forward to reading Option B and have no idea of its contents other than it was born within the heartbreak of unexpected grief and the part of the grieving process that requires that we shift to an alternative vision of our future.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.