Book Review: I Hardly Ever Wash My Hands - The Other Side of OCD by J.J. Keeler

Hello Friends:

Yes, I too am on the book-tour wagon-train for "I Hardly Ever Wash My Hands - The Other Side of OCD" by J.J. Keeler!

This book gets 3.8 out of a possible 5 "wings" from Your Adventure Hostess.  I know, I said I wouldn't split wings on book reviews, but I really had to for this one.  Three was way too low, and four was a touch too high.  So 3.8 it is.

Full disclosure - I was asked to review this book, and then I was sent a copy.  I haven't read any other reviews of this book (yet), either on websites or other blogs.  Everything in this review is only my opinion.  I am not a medical professional (that is actually a fact, not just opinion :)

Some of What's in the Book

"Other Side" (as I shall call this book) is 173 pages long, with 11 interesting chapters having such names as "When AIDS Came Out" and "The Bomb In My Teddy Bear."  It is not an informational book per se, but a memoir of one person's experience with OCD.  As the title suggests, it presents lesser known aspects of the illness.  Hand washing is often connected with OCD, but straight obsessions and intrusive thoughts are just as much a part.  No one has all the possible symptoms and manifestations of OCD - how it can present in any individual can be very surprising, even to another sufferer.
 
What I Liked

Given my own use of humor as a coping mechanism, it does not surprise me that I enjoyed the humor in this book.  Keeler's humor ranges from silly to ironic to emotional, and it almost always serves to enhance whatever is being discussed.  The humor starts on the first page of the prologue, and had me chuckling right away.  "Why am I telling you all this?  You're not my therapist.  Unless my therapist is reading this.  In that case, hello."   

The tone is friendly and approachable.  Keeler writes sincerely about her experiences, and does not leave out the painful or difficult moments.  She does not pull punches, "Still, no mental illness is a picnic - unless you tend to picnic in the depths of Hell."

There were several sentences and phrases that sounded like the voice in my head - the experiences were so similar to those I have, myself.  "I became obsessed with getting AIDS by merely walking." For me, just hearing the word ... wow, I can hardly write it ... 'rabies' ... makes me catch it (as I've noted in the blog here on more than one occasion).

"Other Side" goes into excruciating, agonizing detail about how an intrusive thought pops up, and then all the machinations a person goes through to try to deal with it.  The fear alone is horrifically disabling, and the behaviors can utterly consume your life.  It is one of the aspects of OCD that is so hard to explain - that it completely overwhelms and completely controls - and that it causes terrible pain in the process.

I give props to the publisher for taking this manuscript.  I think honest, even-handed books about mental illness from a sufferer's perspective remain too few.  It's nice to see one like this.  Also, I simply like this publisher in general because of some of their more unusual, even experimental, titles.
 
What I Didn't Like

The "Random OCD Facts" that show up needed to highlight more important points about OCD.  I found them superfluous, and even distracting, i.e., "Random OCD Fact Number 4:  OCD can interfere with the ability to sleep."

The short intermission chapter "It's Not Always OCD" seemed out of place, and even misleading.  The chapter provides a list of topics/issues that ostensibly "have nothing to do with mental illness or really anything else."  The first on the list is Keeler's fear of spiders.  Given that I have an acute Specific Phobia of spiders that plays directly into my General Anxiety Disorder, I disagree that it does not relate to mental illness, at least for me personally.  I say this even stronger for number seven on the list where the author states "I am very afraid of getting rabies."  The "R" even comes up again in number nine.  Given my own terror of the big "R" I was unhappy both to see it listed as "having nothing to do with mental illness" as well as the author's apparent denial that this may be another aspect of her own OCD.  The whole list is so tinged with anxiety disorder issues I'm wondering if I missed a key bit of irony about the entire chapter.  Still, I found it alienating and wished the intermission had not been in the book.

The tone of the book is a bit too chatty for me.  I found I had to force myself to read some of the lengthy setups and exposition for certain scenarios, instead of jumping ahead to find out "the point."  Sometimes "the point" was not enough of a payoff to feel as though reading through the background was justified. 

I simply did not find enough scholarly references to back up some of the main points.  I don't mean to imply that a memoir needs to be written by a psychologist.  It is that when statements are made without scientific data or scholarly reference, then they are entirely subjective to the writer.  It was disconcerting for me to read statements directed towards OCD in general that were not grounded in data (remember, I'm a scientist, so my own bias is freely noted.)  I might simply be too jaded after decades of dealing with my OCD's, but I think this book will be of most help to those just beginning to deal with their own OCDs.  Many of us who have been in the trenches of therapy for decades might find less meat (data, new ideas, innovative approaches to coping) here to chew on. 

Overall, the text felt somewhat unpolished, as if it needed one more edit to remove some extra verbiage, smooth the flow from one idea or section to the next, and to ensure a consistent voice.

Summary and Final Comments

There are many people who have OCD symptoms like those discussed in this memoir (me included) and who have not found many sources of validation.  "Other Side" helps those sufferers validate their experience in an accessible, often humorous, and always sincere way.  The book is particularly powerful when discussing harming obsessions.  I personally thought "Other Side" would have been improved by a more scholarly treatment, as well as a more informed tone of voice, but others will prefer it exactly as it is.

Side note - Sometimes I do not understand publishers.  Book covers are really very important.  This cover is not appropriate for the book.  It attempts to make literal the figurative language in the title, but does so by sacrificing readability and any coherent link between the design elements.  I also thought it wasn't a good idea to put hands being washed on the cover, when that is exactly what the book is not about.  So many other designs, symbols, and even fonts would have had greater impact, and helped convey the true themes and emotion of the book.

Your Hostess With Neuroses

Image credit/info:  Front cover of "I Hardly Ever Wash My Hands" from Paragon House

Book Review: The Mindful Way Through Depression by Mark Williams et al.

Hello Friends:

This book gets four out of five 'wings' from your Adventure Hostess.

As you know from my previous posts, I've been trying to include meditation and mindfulness regularly in my life. I got the idea from reading about BPD (Borderline Personality Disorder) and DBT (Dialectical Behavior Therapy). I don't happen to have BPD - I exhibit only a few of the characteristics, but I do exhibit some of them. And I was raised by a person with BPD. So I figured I would plumb the workings of DBT and see if there were pieces I could successfully apply to myself. The mindfulness component struck me immediately as portable to therapy for almost any mental illness (or really to anybody for any reason at all).

I promised to review this book over a year ago, I think.  So here, finally, is the always-glorious, never-trivial, certain-to-be-mind-bogglingly-useful review.  

The Mindful Way Through Depression by Mark Williams et al. was published in 2007, and spans 273 pages. It presents the reasoning behind, and the basic course for, MBCT (Mindfulness Based Cognitive Therapy). MBCT was developed by Zindel Segal, Mark Williams and John Teasdale, working from Jon Kabat-Zinn's already existing MBSR program (Mindfulness Based Stress Reduction). 

Mindful Way, as I am going to call it in this review, appears to be the popular level incarnation of a previous book, Mindfulness Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, that was published in 2001. This earlier book was directed more towards psychologists and such, including discussion of the research supporting use of MBCT in the arena of depression.

Some of What's in the Book

This book falls into four sections, and includes a final list of resources and an accompanying CD.  The sections are "Mind, Body, and Emotion", "Moment by Moment", "Transforming Unhappiness", and "Reclaiming Your Life". The CD has guided narration for six practices, including "The Body Scan" at 29 minutes, and "Mindful Standing Yoga" at about 11 minutes.  Overall, the CD is more than 77 minutes long.

The first section describes the authors' ideas behind the connection between mind, body, and emotion - how our moods and feelings are influenced by thoughts - and how becoming more aware and mindful can make a difference. The second section details the meditation focus points, such as the body and breath, and how to become more mindful of them. The third section is anchored by the passages that point out how our own thoughts are creations of the mind, are neither 'true' nor 'untrue', and that they do not define who we are. The final section brings together all the points from the book and tries integrate them into a coherent plan. This includes a breakdown of the full eight week program, with exercises, worksheets, and meditations on the CD.

The time commitment for the full program is substantial, as much as an hour a day some weeks, to do the required meditations, worksheets, and whatnot. Much of this is the Body Scan meditation, taking almost a half hour.

What I Liked

The authors recognize that we can't begin to think in new ways without new tools. Using what you have always used, you'll get what you have always gotten. Their eight week plan is designed to provide the necessary tools, by way of a step-by-step immersion into the world of meditation and mindfulness. This is a huge improvement over other CBT approaches, since mindfulness really does alter your perception of the world, and your place in it. And the authors offer their program as a way to manifest this opportunity.

For a systematic approach, I feel like all the pieces are in place. Specifically, the included CD makes it trivial to follow along with the specifics of what they want you to do. While you might wonder if the therapy is "working" you won't have to wonder what it is you are supposed to be doing today to be on track.

The personal anecdotes from people who have done the program are very useful, and show a good range of possible reactions to each stage.

Some of what they present helped me to make sense of certain things for the first time. While I disagree with some of their cause-effect reasoning, at least in two cases I was struck with a new idea that helped me a great deal. The first was one I have written about before, the idea that avoiding something is exactly what makes it impossible to avoid (Suppressing Does Not Work Part I and Part II). This is the whole "spend a minute and don't think about a white bear" thing that makes it clear you will spend that minute thinking about nothing but white bears. Mindful Way helps the reader to understand that engaging painful thoughts with a gentle curiosity is actually better at getting rid of them than trying to avoid them completely.

The second thing that grabbed me was the discussion of a list of automatic thoughts of those who are depressed (Kendall and Hollon, 1980). Although the list is a classic in the literature for depression, I simply had never considered the implications. They present this list of thirty automatic thoughts, like "What's wrong with me?", "I hate myself", "It's just not worth it", and "I can't finish anything." The program participants are asked how many of the thoughts they believe right now, and how many they believed in the middle of their last deep depression. The book goes on to say, "When they all answer 'Yes - all of them' ... something remarkable happens. A moment of realization that, 'This is depression, not me.'" I had the same realization when I read it. My negative thoughts are actually the symptom of an illness, and all depressed people have them. This list a chance to stare directly at that truth, and it was liberating.

What I Didn't Like

I am so, so glad I read Brach's book Radical Acceptance before I read Mindful Way (here's my review of Radical Acceptance). If I had read Mindful Way first, I think I would have looked at it as just another self-help book, with another five or eight or ten week course of stuff, another worksheet to fill out, and another eight steps to follow to cosmic enlightenment or optimum turbo libido or whatever (okay that last is just me being snarky). Either way, I'm sick of those kinds of books.

Fortunately, I had read Radical Acceptance, which artfully presents meditation, mindfulness, and compassion in a way that feels whole, connected, and meaningful. Radical Acceptance successfully walks the line between the mysterious/spiritual side of mindfulness, and the practical/daily side. In comparison, Mindful Way feels sterile. It presents only the clinical aspects of meditation, broken down into the authors' idea of a workable course/schedule. It cuts out much of the more compelling, mysterious, and motivating context to be found in Buddhism, and thereby saps the practice of an integral source of vibrancy.

I do not agree with some of the authors' ideas about the relationship between mood-thoughts-feelings-body. They very nearly fall into the whole trap of "you are depressed because you keep thinking depressed thoughts, so depression is your fault." They try to avoid this by blaming rumination and such on the "critical thinking part of the brain volunteering for a job it can't do",  and by admitting that thinking new things is really hard.  Yet it is still thinking = depression.  Too close to "it's all in your head" for my taste. I shouldn't be surprised, given the CBT roots of this kind of therapy, and even some of the worksheets that go with it.

They could have missed this near-accusation entirely had they included the important aspects of brain chemistry in the book. They say they recognize the existence of thinking ruts, patterns, and habits.  But they miss the opportunity to say how this manifests in brain chemistry, and how that in turn links directly to overall body chemistry. Thinking is, after all, nothing more than biochemistry. It is hard to think in new ways because our old thought patterns are actually "burned" in biochemically by past trauma, trauma responses, and years of repetition. Early childhood trauma can even inhibit development of certain aspects of the brain. These things are not mentioned.

Yes, we can change the path our thoughts follow from more negative ones to more positive ones by working for extended periods with the variables that alter brain chemistry.  Over time, this allows new preferred thought pathways to be electrochemically "burned" into our brains.  Successfully making those changes requires a complex combination of many possible approaches, including: good nutrition, stable sleep, social connections, support networks, talk therapy, meds, exercise, meditation, body knowledge, somatic therapies, massage, and on and on.  While I personally believe that mediation is a hugely powerful tool, this book presents it too disconnected from all other possible sources of an integrated plan for mental wellness.  The old CBT message of "just think your way out if it" remains, and I am very wary of that message.

Summary and Final Comments

Overall, this is a very good book. I would not recommend it as the first book to read about meditation or mindfulness. Read Radical Acceptance first if you are new to all of this, then Mindful Way. I just think Radical Acceptance is more robust, more compassionate, and more meaningful. Meditation and mindfulness are great, but not everyone is going to approach their practice in the same way. What Mindful Way offers is one possible plan for integrating mindfulness practice into your life. It is systematic, and tailored to those who have suffered at least one major depressive episode. If you respond well to structure, then the one presented here could be very helpful. If you do get the book, make sure the CD is included, since it is critical to the program. Mindful Way underscores the idea that mindfulness is a life-long practice, not an end goal, and offers some new options for developing the tools for dealing with the mental struggles of daily life. Anyone might benefit from reading the book and doing the program, but there is some evidence that for those with depression, it really might prevent another deep episode, or at least help limit its length and severity.

Your Hostess With Neuroses

Book Review: Healing Myths, Healing Magic - By Donald M. Epstein

Hello Friends:

This book gets two out of five 'wings' from your Adventure Hostess.




I've read this book many times since I purchased it, and still find it somewhat useful, somewhat confusing, somewhat uplifting, and somewhat irritating.  I went back and forth between a rating of three or two for a long time.  In the end I chose the two, because although this book has some useful ideas for healing, it might cause as many problems as it solves.  Others might disagree, but I must follow my bliss or whatever.

Healing Myths, Healing Magic by Donald M. Epstein was originally published in 1999. I purchased it about 2002.  I was originally drawn to it because I was looking for new perspectives on healing that were not strictly related to the ideas found in Western health care.  It also seemed to offer a way of looking at 'healing' that did not make it synonymous with 'cure'.  I've re-read it recently because I am, as you know, involved with a somatic energy therapy that I find very effective.  I wanted to take another look at this book now that I understand more about healing in ways that don't require constant thinking, like CBT.

Some of What's in the Book

The premise of the book is that myths are the stories that shape our lives, our perceptions, and our ability to embrace healing.  If we can identify the powerful stories in our lives, and what their implications are for healing, we can readdress them, and then claim more power to heal.  "When our bodymind experiences a new situation or challenge, it resorts to the most familiar story about the situation - the story depicting what we expect will happen.  It does not matter if the story is true, our bodymind responds from the place of a deep cultural hallucination.  When we are frightened, confused or lost in despair, we often turn to our 'myth spinners' to give meaning to our experience.  In contemporary Western society, teachers, doctors, therapists, clergy, attorneys, and legislators are among th the socially empowered storytellers."  

The book is divided into five parts:  The Power of Myth, Social Myths, Biomedical Myths, Religious Myths, and New Age Myths.  Each of the final four parts contains a list of specific myths, which are addressed numerically.  After discussing each myth, and sharing anecdotes, the book provides a paragraph called "Healing Magic" which is an affirmation one can make which counters the myth.

What I Liked

Some of these myths resonate with me.  That is, I believed them to some degree in the past, and now I believe them much less, or not at all.  And that change in belief has helped my healing journey.  These include: Healing requires a trained professional or a highly educated specialist; Healing is not always available; Healing is a destination; and Healing means feeling better.  These days I see healing as a natural process, something that we are always experiencing no matter how we feel, and that can't be taken away from us.  Even if we are actually dying of a disease, we are still healing in some way all the time, no matter what we think, do, or what our treatment might be.  Healing simply is.  This is an idea that works for me.

Some of the statements for "Healing Magic" also resonate with me.  These include: Through movement, breath, and the compassionate touching of my body, I open the door to healing; All my experiences and feelings have a story to share with me, I accept each story's wisdom, whether or not I enjoy the story; What worked for me at one point may no longer serve me today; and I am healing in spite of the imperfections that still appear in my body and my life.

I also simply liked reading something from a different perspective.  All books take a mindset for granted. This one is no exception, but the mindset is different from what I've read in other self-help style books.

What I Didn't Like

There are a few myths listed here in which I believe, at least in part, and I didn't find the arguments against them to be compelling.  One in particular is 'Heaven is only available after this life.'  It turns out the author thinks of heaven as bliss, absolution, joy, sexual ecstasy, and spiritual vision.  I believe anyone can feel these things in the here and now.  But what does that have to do with heaven?  I think there is a bit of a semantics issue here.  In fact, it is often over semantics that the arguments in this book rise or fall.  Either you agree with his definitions of words, or you don't.  And that, to me, makes many of the arguments very weak.

The book does not properly justify some of its conclusions.  I dislike its stance on immunization, for example.  No, that's not strong enough.  I'll go so far as to say the book is spreading some dangerous misinformation.  The author says, "Many studies have shown that the risks versus the benefits of immunization are often questionable."  This statement, already vague to the point of uselessness, goes unsubstantiated, both in the book and in the world at large.  Yes, there are risks to being vaccinated.  There are risks with any shot at all, even a vitamin shot.  The question for one person is how the risk of immunization balances against the risk of getting the disease it protects against.  The question for a society is how the risk of immunization of its population balances against the risk of an epidemic.  And I'm not going to go on and on about it because I'll start ranting.  I better save that for another post altogether.  In any case, if you make a statement like that you better back it up with a citation at the bottom of the page.  There isn't one.  The scientist in me is unimpressed.

I'm also unimpressed with the discussion of the placebo effect, and where the implications lead throughout the book.  We are all familiar with the idea that sugar pills might make us feel better if we think they are something else.  There is no question that what the mind believes is powerful for healing.  But the author allows this to permeate the general recommendations of his work - in other words, stop thinking the stupid stuff you are thinking and you can heal.  Again, it comes down to a change in thinking.  And if it were that easy, CBT therapists would be out of a job.  For people already wallowing in guilt, further guilt about not thinking the right things is counterproductive.

And some of the "Healing Magic" affirmations are confusing, not useful, really weird, or downright scary.  In fact, they seem to simply represent a new spiritual view that has much in common with the "New Age" view the author debunks.  Other times they seem to reflect a kind of watered down Buddhism.  Here are some examples, My commitment to heal is a natural process requiring no work or special focus on my part; As my bodymind heals, my awareness shifts, and old wounds dissolve into nothingness; My symptoms and pain remind me of my need to participate more fully in the world; In faith, I receive messages that are broadcast from the Divine; My body resonates with love for every part of my bodymind, and broadcasts this energy through my being and into the world; and When I am attentive to where I am in the moment I am magically carried to a new stage of healing.  Some of these may work for you, they don't work for me.  They are either meaningless because of semantic issues (use of the word 'magic' for example) or rely on a mindset I simply do not share.

Summary and Final Comments

This is an interesting book to read if you are searching for some different perspectives on the nature of healing, particularly in comparison with more traditional Western ideas.  Some of the points made are thought-provoking, but many others are not made with arguments compelling enough to hold the reader's attention.  Some of the ideas for 'new' myths and magic are more terrifying than the 'old' ideas.  And many of these new myths require you to - once again - think yourself well.  I have no doubt the author would say I miss the point or don't understand what he means.  I think I do understand - I also think the reason why is that I translated his use of words, that I've been learning a great deal about alternate therapies, and that I'm not so depressed right now that I can't do some creative thinking.  BUT for many people with mental illnesses, none of these things are true.  I just don't think the author can expect this book to be correctly interpreted by some of the very people he might want to help.  I think it might rattle those who are particularly vulnerable, suggestible, or in a confused place right now.  Otherwise, it can be an interesting read for gleaning a few new ideas.

Your Hostess With Neuroses

Book Review: The Year of Living Biblically by A.J. Jacobs

Hello Friends:

This book gets three out of five 'wings' from your Adventure Hostess.

Rating this was nearly impossible.  Three or four?  I went back and forth.  I ended up giving it a three.  I can see that someone else would like it quite a bit more, and give it a four or higher.  But ratings are subjective ... I just couldn't give it a four.  As you'll see below, in spite of plenty of good stuff the book had to offer, there were a few things that drove me nuts.

Before I get into the details of the review, I need to tell you why I read this book, and why it is relevant for this blog.  It goes back to the post OCD's and Scrupulosity: Obsessive Religion.  There I discussed some of my confusion and pain over trying to figure out what commands in the bible had to be followed to be saved, and which ones didn't.  That is part of the reason I gave up on the bible entirely.  There is always another person showing you how what you are doing is wrong, and how their version is right.  My OCDs make this situation intolerable for me.  I need an unequivocal answer.

For example, most Christian women in the US do not cover their heads in church.  And yet in 1st Corinthians it says, "But every woman who has her head uncovered while praying or prophesying disgraces her head."  Even in the fundamentalist church I used to frequent, women did not cover their heads unless it was with a massive Sunday-best sort of hat.  So isn't that picking and choosing what commands to follow and which to ignore?  And yet the bible also says, "You shall not add to the word that I am commanding you, nor take away from it."  (Deuteronomy 4:2)

So I discussed this with my therapist.  And I'm making this sound like it was a nice, happy little conversation.  But this subject gets me really bent.  Very sad and very scared.  My therapist said, "Nobody follows the bible literally.  Nobody.  No matter how fundamentalist or orthodox, everyone chooses what commands they follow, and how they interpret them."  I wasn't sure I believed that, so he suggested I read this book and see if it offered a little perspective.

Right.  Onto the review.

The Year of Living Bibically by A.J. Jacobs was published in September of 2008.  The premise is that the author spends a little over a year of his life trying to follow the bible as literally as he possibly can.  In practice, he realizes immediately that such a task is impossible, but he tries hard to follow each rule at least once, no matter how strange or obscure.  It is largely a book of humor, and that's probably the section you'd find it in if looking in the bookstore.  But it has poignant aspects, as well as some not-too-shabby religious scholarship.

Some of What's in the Book

The book is written like a dairy, with short entries, each dated, and then compiled into chapters.  Every entry is accompanied by a relevant passage from the Bible.  The author does not have an entry for each and every day, but he does try to keep a chronological record of his attempts to live the bible literally.  Each entry highlights one command, experience, or lesson learned.  He spends most of his time attempting to follow the Old Testament (Torah) where most of the bible's commands are found.  And then he adds on a few months to attempt to include the New Testament commands.

What I Liked

The author has OCD issues, and he admits this up front.  They are pronounced enough that his wife has developed a code phrase for when the author is trying too hard to shield their son from the contagious and pointy aspects of life.  She says "helmet" and he knows he needs to back off.  His OCDs play into his own reasons for wanting to investigate the commands of the bible, and bear some resemblance to my own.  So this made the subject and the author immediately sympathetic to me.

The book is simply enjoyable to read, well written, and entertaining.  The author's style is conversational and low stress.  One thing leads into another, and you find yourself not putting the book down.

What I most needed from the book was found early, a passage on page nineteen that helped me see more clearly what we all really mean by 'following the bible literally.'  "In fact, the very first command that God gives to Adam is 'Be fruitful and multiply.'  It's the Alpha Rule of the Bible.  Now, if I were taking the Bible absolutely literally, I could be 'fruitful' by loading up on peaches at Whole Foods Market and 'multiply' by helping my niece with her algebra homework."  "This hammers home a simple but profound lesson:  When it comes to the Bible, there is always - but always - some level of interpretation, even on the most seemingly basic rules.  In this case, I'm pretty sure that the Bible was talking about fertility, not math, so that's what I'll continue to pursue."  It's where he says "I'm pretty sure ..." that it comes home most strongly.  No one would disagree with him in his interpretation, but it is, in fact, interpretation.  This all might seem silly and obvious to you, but honestly, it was useful for me to read.

What I Didn't Like

The author writes very short chapters/sections.  He gets into an idea and then drops it before he really flushes it out or explores the consequences.  This is my major gripe with the book, that it could have been profound, but instead was often sadly shallow.

The tone of the book is a little cynical; not always, it is sometimes very moving.  But one gets the distinct impression that aside from the author's OCDs, the main reason he took on this project was so that he'd have something to write another book about.  Because of this, he intentionally puts himself in 'interesting' situations, things that might be considered very bizarre or controversial, so that his book will be interesting.  He does this instead of developing some of the aspects of his search that would have naturally been very interesting and not at all contrived.  One small example comes from his attempts to always tell the truth.  He sometimes uses this as an excuse to say something biting or off the wall, rather than finding a way to demure.

As far as genre, the book just does not know what it wants to be.  Is this a book of humor?  A memoir?  A travel essay?  A religious or inspirational work?  It is all of these things at one time or another.  For some this might be a plus, but it didn't work for me.  It was humorous in places, but not funny enough to be a book of humor.  It was moving in places, but not compelling enough to be a memoir.  It was scholarly in places, but not developed enough to be taken seriously from a religious standpoint.  I was glad I read it, but yet when I put the book down I felt vaguely unsatisfied.

Summary and Final Comments

The book does make the point that one cannot follow the bible completely literally.  No one can follow each and every command of the bible in the original sense it was intended, and on a daily basis.  There must be some sort of picking and choosing about what commands are more important than others.  Our current culture (which denounces rape, which tries to protect animals from abuse, etc.) is not welcoming to ritual sacrifices, nor to the idea that 'you raped her, but it's okay as long as you marry her'.  And this is good; some of the bible is barbaric.  I think we have a more compassionate idea of human (and animal) rights, including rights for women, minorities, and more.  This does beg the question of how to determine for one's self which commands to follow, and in what priority.  But that's a different problem.  I recommend the book for anyone who enjoys ironic humor, who does not mind irreverence in their literature, and who has the same curiosity I did about what it might mean to try to live the bible literally.

Your Hostess With Neuroses

Book Review: Radical Acceptance - Embracing Your Life With the Heart of a Buddha by Tara Brach

Hello Friends:

This book gets five out of five 'wings' from your Adventure Hostess.




One of the best books on 'healing' I've read in ages.  The 'self-help' book that tells you that you are not broken, and even gets you to believe it.  However, calling this a 'self-help' book is a disservice, as the text grapples with our views on life and death, grasping and denial, love and self-hatred, and much more.  It might have really rated a 4.8, since no book is perfect, but rounding up the score is pretty obvious in this case. 

Radical Acceptance - Embracing Your Life With the Heart of a Buddha by Tara Brach was published in 2003, and I wished I'd found it earlier than 2009.  But until this year I would not have picked up a book with the word 'Buddha' on the cover, thinking it would only apply to people with that mindset or that religious perspective.  But I was wrong.  It has a lot to say to anyone interested in what it means to start accepting yourself for who you are right now.  I also would not have picked up a book with 'Radical' in the title, since I would have assumed it was one of those misguided 'Optimal Health' type books that get my perfectionism hackles up.  But don't be put off, there are no 'ten steps to perfect' anything in this book.  This is real life.

Some of What's in the Book

The subject of the book is obviously the author's idea of finding 'radical acceptance' with ourselves based on the idea that we are, inside, already exactly who we are meant to be.  She works from a premise called 'The Trance of Unworthiness'; that people who feel the need to 'fix' themselves are actually responding to a storyline in which they are always unworthy.  They are always trying to measure up, to be better, to earn the right to be treated with respect and compassion, especially by themselves.  We all come by our belief in this story in different ways.  But in the end, the 'Trance' comes down to the unshakable conviction that 'something is wrong with me.'  Brach writes, "Underneath our fear of being flawed is a more primal fear that something is wrong with life, that something bad is going to happen."

Brach makes convincing arguments that this is not true.  And shows some ways to begin to think and feel differently. "The two parts of genuine acceptance are ... seeing clearly (mindfulness) and holding our experience with compassion."  Brach's text gives concrete suggestions for manifesting both of these parts, including meditations, pausing, reflections, listening to body messages, and more.

This is a long read.  The book is a dense, idea packed 330 pages that I've now read four times and I am still finding passages I didn't absorb on previous reads.  The list of chapters is wordy, but gives some good insight into the content and so I'm going to list them here.

The Trance of Unworthiness
Awakening from the Trance: The Path of Radical Acceptance
The Sacred Pause: Resting Under the Bodhi Tree
Unconditional Friendliness: The Spirit of Radical Acceptance
Coming Home to Our Body: The Ground of Radical Acceptance
Radical Acceptance and Desire: Awakening to the Source of Our Longing
Opening our Heart in the Face of Fear
Awakening Compassion for Ourselves: Becoming the Holder and the Held
Widening the Circles of Compassion:  The Bodhisattva's Path
Awakening Together:  Practicing Radical Acceptance in Relationship
Realizing Our True Nature

Every chapter contains stories and anecdotes from the author, friends and family, and patients in her psychotherapy practice.  Each chapter ends with a guided reflection or meditation.  And these are not afterthoughts, but important exercises that help bring about the change she discusses in the chapters.  And so that you don't end up thumbing through the book trying to find that mediation you liked, she has them listed at the front of the book right after the table of contents.

Yes, the book is built off of the key ideas in Buddhism and from the nature of insight meditation as a practice.  But if you are not of that (or any) religious bent, don't be scared off.  The book does not challenge or force a religious perspective.  Other doctors-as-authors simply excise what they want from a religion and pretend they don't know where they got it from.  Brach presents the context happily and keeps a deep sense of reverence and respect for all religious traditions but without any preaching.

The author states that radical acceptance is "... accepting our human existence and all of life as it is.  Imperfection is not our personal problem - it is a natural part of existing."  She is quick to point out that acceptance does not mean giving up.  "Radical acceptance is not resignation ... Our deepest nature is to awaken and flower."  The book guides us through our natural fears of loss and even death, as well as our habits of "clinging to experience, that must, by nature, pass away".  The reverse of this is being so terrified of any kind of pain that we run from it the instant we spot a trace.  And some of my earlier posts deal with the complete uselessness of suppressing and avoidance, and how mindfulness-based therapies (the guts of which we see in Brach's text) help counter that.

What I Liked

Almost everything.  A key idea in Buddhism, especially Zen, is 'don't take my word for it, don't take anyone's word for it, experience it for yourself.'  Radical Acceptance follows that theme - you don't have to take the author's word for anything.  You can read the text, practice the meditations, and see how the world appears to you.  Do what works, and ditch what doesn't.  The author suggests, "In making choices on our path, it is important to ask ourselves whether or not they will serve awakening and freedom."

The tone is accessible without talking down to the reader.  Scholarly without being cold and distant.  The author speaks from personal experience of 'being in the Trance' so she presents the material with compassion for the reader.  I feel that the author cares about people who are suffering from all the results of being sure they are wrong, mutated, and broken.

Brach uses very compelling language and incisive references to make her points, and many resonated with me.  "In contrast to orthodox notions of climbing up a ladder seeking perfection, Jung describes the spiritual path as an unfolding into wholeness."  Another comment helped me articulate some of my own experience with PTSD, "Dissociation, while protective, creates suffering.  When we leave our bodies, we leave home."  And one I adore, "Longing, felt fully, carries us to belonging."  This isn't a platitude, but a result of the author's own experience of allowing herself to feel terrible longing, rather than running from it and the associated emotional pain.

What I Didn't Like

Not much, but there were a few things.  It's a minor one, but the title drives me nuts.  As I said, anything in a book title like 'optimal power', 'unlocking the code', 'ultimate solution', 'uncovering the secret', 'revolutionary anything' and on and on, will always trip my bull$h!t radar.  'Radical' sounds too much like a word for an extreme sports broadcast.

There are redundancies.  Things said multiple times.  Over and over again.  Sometimes it helps, since the ideas can take time to sink in, but other times the book drags when this happens.

Some of the stories and anecdotes seem to ... miss a little.  They make interesting points, but do not seem to always underscore the point I thought the author was trying to make.  And some of the stories seem to lack depth, sort of present a concept in a somewhat superficial manner.  The book could have been tightened up by removing some of these stories, and thereby reducing the redundancy issues, as well.

Summary and Final Comments

I think this is a great book.  This is a 'mindfulness-based therapy' book that lacks all of the bad aspects of therapy and self-help books in general.  I would recommend it to anyone, even people who may not say they feel the 'Trance' themselves.  The text is informative, uplifting, and original.  The meditations are useful and give the reader some insight :) when practiced.  And for people interested in a different portal for viewing the continued evolution of Buddhist mindfulness in America, it's perfect.

Your Hostess With Neuroses

Book Review: Feeling Good - The New Mood Therapy by David D. Burns

Hello Friends:

This book gets two out of five 'wings' from your Adventure Hostess.





I almost gave it three, but I can't, simply can't, get over my biases against this book. Everybody else loves it. It's sold a ba-gillion copies or some such thing. And is one of the books commonly suggested by therapists to their patients with depression.

Which I find very depressing.

I know I said I would review a more recent book, first. But then I figured I'd go back to the 'beginning' in order to have some kind of a basis for comparison. And I don't want people thinking I only give out four and five wings. Nope.

Feeling Good - The New Mood Therapy by David D. Burns is not a new book. My copy is dated 1980. The most recent version of the book was released in 1999, almost 20 years later, with a new introduction and a guide in the back to anti-depressant drugs. Otherwise it is the same book as mine. How this therefore remains the "new" mood therapy is something of a mystery. It was, in fact, suggested to me by my therapist in '93 as the core book for the general public about Cognitive Behavioral Therapy (CBT). And so I bought a copy, read it, and found it both useful and insulting.

Note that I am specifically reviewing the book, here, not all of CBT. This book is one portal into the understanding and use of CBT to treat depression. It is not the only book, nor does it completely over all the ways and means CBT is used in other diagnoses, such as anxiety, panic and OCD.

Some of What's in the Book

The book is a pretty hefty 450 pages of mass market paperback. It is split into several parts: Theory and Research, Practical Applications, 'Realistic' Depressions, Prevention and Personal Growth, Defeating Hopelessness and Suicide, Coping with the Stresses and Strains of Daily Living, and The Chemistry of Mood. There are a few 'quizzes' you can take while reading the book that help pinpoint if you are in fact depressed, how badly depressed, what areas of your life are the most difficult for you to manage, how easily you get angry, etc. And in true CBT style, there are many examples of different ways to count thoughts, list thoughts, organize thoughts, challenge thoughts, and find new thoughts, all as informal 'worksheets'. The emphasis is on writing it all down in order to become aware of what you are thinking, and then implementing strategies to stop negative thoughts and instead substitute positive ones. Ideally, this breaks the endless cycle of rumination, and allows for a 'cure' for depression. The book maintains a philosophy that if we really and truly see how irrational our negative thoughts are, we can eventually dismiss them and be free of depression.

What I Liked

Early in the book there is a standard multiple choice quiz used as a indicator for the severity of depression. When I first took it in '93 it helped me see immediately how really depressed I was. At the time I was in what I called an "interim" between truly bad depressive episodes. At that point in my life, if I wasn't actively thinking about ways to kill myself, then I figured I probably wasn't that depressed. The quiz was quite valuable as a tool for me to get a handle on just how much pain I was in, and that I was plenty depressed even if I wasn't wishing I was dead each and every moment.

(Interestingly, when I retook the quiz a few days ago, my score was almost exactly the same. Some things seemed better, and others worse. But I'm convinced my score was higher on some items in the past because I was quite ignorant of just how I was thinking. I was quite in denial of how much I hated myself, for example, and I'm not repressing those thoughts anymore. So generally I'd say I was a few points better, overall. Something, anyway.)

If you are looking for a strategy, anything at all, to try, then there are many examples in this book. The author often suggests that the reader suspend disbelief about the efficacy of the methods and simply try them themselves. And some of the suggestions that might seem trivial do have power. For example, the idea that you inevitably have to be less happy if you are alone can be challenged my making predictions and then trying things alone. Then you can see for yourself if you actually do enjoy things less, or if that expectation was not actually correct.

What I Didn't Like

Oh, oh where to begin. Before I start ranting, a few concrete points.

The number of different kinds of strategies and possible variations of approaches is confusing, especially for someone who can barely get out of bed in the morning.

The section on anger management has what I consider to be a key gap. Very little time is spent on how help depressed people who cannot express any anger at all. The section instead deals with people who are constantly irritable, and easily lose their cool. For many of us with depression, we never lose our cool, and have no temper whatsoever. Any time something happens to us that a normal person would get angry about, we immediately translate that to self-hatred. I was not allowed to get angry as a child, or display any sense of irritation or to challenge boundaries. I therefore did not develop good boundaries. If I feel angry, it is because I did something wrong. That's the logic of it. It has taken a lot of work to reach find this anger and feel it when situations arise where one might actually get angry and have it be a positive means of affirming; a means for a functional insistence on healthy boundaries. This aspect of dealing with anger and depression is not addressed in the book.

The author does not show consistent respect for his own patients. He says things which either in real life or in imagined role playing that make a reader wonder what it is he thinks about these people when not in the office. "Not all my patients are as difficult as you!" and "Her contrariness made my work with her challenging and more than a bit frustrating at times."

So now I'm gonna start ranting. When I re-read the book last week so I could do this review, I went through and underlined passages that stuck out, and then bent the corners of the pages so I could find them again. I needn't have bothered since every other page has a bent ear. Example:

"... you can overcome it (depression) by learning some simple methods for mood elevation." The methods may be straightforward, but they are not simple, and even just putting it this way trivializes the problem. The author often makes statements like this, and then backpedals, saying he does not mean it in some kind of bad way. But that retraction is ineffective since the words are already out there and having their effect on the reader. I did all these exercises religiously for years, and while they offered some occasional relief, they did not deal with the underlying problems causing the depression. The methods outlined in this book provide a strategy for symptom control (bad moods) but do not target the core problems created by a childhood of illness, neglect, and abuse.

Over and over, the author describes depressed people as "pouting", "moping", and "whining" (as on page 70 where we are told "Cope - Don't Mope!") I don't think I need to explain why that bothers me. This follows along with the rest of the general tone of the book which comes over as flip and uncaring, not casual and friendly.

More insults for those of us who have nearly busted our rumps working to find a way out:

- "... the most crucial predictor of recovery is a persistent willingness to exert some effort to help yourself. Given this attitude, you will succeed." Exert some effort? That's not a little condescending, is it? This goes along with "If you are willing to commit some regular time and effort to this program, you can expect success proportionate to the effort you put in." Snort. I should be the sanest person on the planet.

- "It doesn't occur to you to challenge the validity of the perceptions that create your feelings." It has. I did. Still depressed. Again, I'm not upset that CBT has limitations, I'm tweaked at the way all of this is presented in this book.

- "When the two don't match (reality and the idea of what it should be), you condemn reality. It doesn't occur to you that it might be infinitely easier simply to change your expectations than to bend and twist reality." This one really gets me. Apparently changing one's expectations, created by twenty five years of abuse, is not terribly difficult. And even so, trying to do so has not occurred to us. So my inability to change my expectations is therefore my fault. Because I haven't put in enough EFFORT.

Dealing with the ideas of what we are responsible for (i.e. we are not responsible for other people's feelings, which is true enough).

- "... it dawned on her that she was acting irresponsibly not because she 'let him down' but because she was allowing herself to become depressed." Allowing. This to me implies we have a lot of control over if we 'choose' to get depressed or not. I do not agree with this. We can certainly choose to fight it, we can't choose to win.

- (emphases are mine) "No wonder you developed the the bad habit of looking down on yourself every time someone disapproved of you. It wasn't your fault you picked up this tendency as a child, and you can't be blamed for growing up with this blind spot. But it is your responsibility as an adult to think this issue through realistically, and take specific steps to outgrow this particular vulnerability." Oh my. So looking down on myself is a bad habit I need to outgrow? Well, I managed to stop biting my nails, so this should be a piece of cake.

- "Keep this in mind. Overcoming your fear of criticism will require a moderate amount of practice." I ... I can't even go there.

On the hit parade of perfectionism, the author offers: "Have the courage to walk away from an unfinished task!" (emphasis his) Yeah, that's what I don't have. Enough courage. Even I'm not depressed enough to believe that. I'm still alive at 41. I'd like him to try that with my starting material. Can you see why I don't like the book? I could go on and on.

Summary and Final Comments

The core principles of CBT are all in this book: the emphasis on lists, plotting, worksheets, tracking, etc.; the 'talk-back' to yourself techniques; the substitution of functional internal messages for dysfunctional ones, and more. If you wanted get a general look at how CBT is used to help those with depression, then it isn't a bad read. If you had never heard of CBT before, and wanted to get the gist of it, it isn't a bad read. Other people think that it is also a good read if you are currently depressed and need help. I am not so certain about that.

I found the book to be insulting and belittling, and lacking in any overt sense of compassion. When I was finished doing all the worksheets and the rest, I was more down than ever, now convinced that it was all my own fault that I was depressed since I couldn't "think" my way out of it as easily as the examples in this book. There are a now lot of books on the market about CBT. And CBT has helped a lot of people, including me. But you don't need this book for that. This is technically the "classic" but as such has been superseded. I can't recommend it without serious reservations.

Your Hostess With Neuroses

Book Review: Poem, Revised - Posted on The Tenacious Writer

Hello Friends:

If you are into writing (and since you are obviously into blogs I'm thinking you like reading other peoples' writing, if not writing yourself) then you might want to check out The Tenacious Writer. This blog has frequent posts to motivate writers of all stripes, and lots of excellent links to other resources.

Tenacious has hosted a post of mine as a guest-blogger where I review my most recent reading material. The link is Review of Poem, Revised by Guest Writer Blue Morpho. So if you like, pop on over and check it out.

Your Hostess With Neuroses

Book Review: Will I Ever Be Good Enough - Healing the Daughters of Narcissistic Mothers by Karyl McBride

Hello Friends:

This book gets four out of five 'wings' from your Adventure Hostess.



I told myself I was going to stop with the self help books. That was almost three years ago, and up until recently I kept off of them. I felt I needed to take a break from it since every book I picked up said the same thing. I've read all the anxiety-books-this and phobia- catalogs-that and done the workbooks-for-the-relaxation-challenged. I have "Learned Optimism" and tried "Feeling Good" and everything in between. I read them all religiously, and after several years of it, I got almost as sick of the books as I was of my disorders.

My original impression was that my GAD and OCD issues were at the heart of all my problems, and I was starting to get very frustrated that all the cognitive-behavioral-blah-blah was still not working for most of my 'anxiety' attacks. But my perspective has shifted in the last six months as I've finally come to understand that the PTSD is really dominating my emotional scene. It was pretty well hidden before, since if you are having multiple panic attacks a day, plus can't do things like use door handles or wash dishes, you are in a pretty acute situation. Now that I have a better grip on those issues (after a decade of CBT and now meds) other, more deeply buried issues are coming forward. I had thought I was having only generalized anxiety attacks; turns out more than half of those 'attacks' are actually PTSD flashbacks. I figured since I wasn't seeing anything weird, I couldn't be flashing back. Wrong-o. PTSD sufferers can experience emotional and even somatic flashbacks. I've been in situations where I can see what's going around me just fine, but I actually feel and even smell things that are from my distant past.

This has given me a boost, since it means I can perhaps find new ideas and relief in a whole array of self help books I never bothered to read. And so you'd think this post would be about at PTSD book. Ah, no. Sorry. I ended up moving off into yet another area of emotional fodder as yet uneaten. This would be examining more the real root of my disorders in the first place. In my case, one of the three big nasty things from my past was being raised by a mother with Borderline Personality Disorder and Narcissism. During my searches for new book-fodder, I spotted a recent book on the Narcissism subject, and figured I'd check it out.

And finally ... the actual book review.

Will I Ever Be Good Enough: Healing the Daughters of Narcissistic Mothers by Karyl McBride is relatively recent, published in September of 2008. I was originally drawn to the book by a review written by a reader that talked about how the book helped her understand why she and her brothers had such differing ideas about their mom. This sounded very familiar to me, and so I picked up the book.

Some of What's in the Book

The book is divided into three parts designed to lead daughters raised by Narcissistic mothers into recovery. Part One is about identifying the situation you are in and understanding how it changed you as a child. Part Two demonstrates that the results of the emotional abuse of the past are the pain and difficulties you are dealing with now as an adult. Part Three discusses how you can recover from your traumatic childhood and lead a happier and more fulfilling life.

There are several different kinds of lists in the book; lists of traits, behaviors, steps to healing, and such. These include 'the nine traits of Narcissism', a questionnaire of maternal behaviors, lists of 'daughters' current feelings, ten 'stingers' that are descriptions of mother-daughter dynamics, two 'kinds' of mothers, the six 'Faces of Maternal Narcissism' and more. The book is filled with quotes and anecdotes from other 'daughters' in the author's therapy practice well as from popular culture and the author's own life. In between these is text synthesizing all these data and ideas into a form the reader can (probably) digest and then use to make positive changes in their life. The book closes with some specific strategies for letting go, moving on, and even dealing with your mother again, if you really want to do that sort of thing. I'll say it's certainly not high on my own personal 'to do' list.

What I Liked

The book has a specific and well articulated focus ('Healing the Daughters of Narcissistic Mothers.') Even with this focus that is still an ambitious goal, but the book does generally deliver on that promise. It is well organized and reasonably easy to follow. The writing is solid and engaging. The author is also a 'daughter' of a Narcissistic mother, and so writes from a place of deep understanding.

I found the quotes from other 'daughters' of all ages to be very pertinent, and a highlight of the book. If you have a mother with Narcissism, it is tremendously relieving and validating to see how very closely other people's experiences mirror your own. I felt less crazy after reading the book, which gives it a minimum of three of five 'wings' just for starters :)

The schematics of appropriate family dynamics nearly made me laugh out loud with amused horror, since they were so dead on with my own experience. The one with the Narcissistically dysfunctional family has Mom at the center, and then the Dad totally orbiting around her, and outside of that the kids. The chapter 'Where is Daddy?' is also dead on. It showed me that mine wasn't the only family where the father chose to sacrifice his own kid's mental, emotional, and even physical health to the beast ruling the house in order to save his own skin. The author describes the twisted relationship between the Narcissist mother and the man who enables this behavior as the 'unspoken agreement' and 'the pact'. Again, dead on.

The section called "My Turn" was very interesting - seeing how other people chose to deal with their mothers after they 'recovered.' It is hard for me to imagine why anyone would want to put someone back into their life who has no interest in them, mother or not, after going to the trouble to separate and create an authentic, individual identity. But of course Narcissism is a spectrum disorder, with people ranging from occasionally cruel and self-absorbed to the totally toxic. So those with less dysfunctional mothers may have some hope of a relationship with positive aspects, however small.

Some of the stories resonate so strongly with me, and are just heartrending, especially those of children trying so hard to get love from a mother who is completely incapable. One person gave her mom a plaque saying, "World's Best Mom". This eventually got returned to the daughter since it 'didn't fit her decor'. Another bought her mother an expensive present by saving her lunch money, only to have it flung back in her face with an accusation that she obviously stole it. Such stories are difficult to read, but help underscore how horribly damaging and traumatic it is to be at the mercy of this kind of mother.

What I Didn't Like

There are too many lists, questionnaires, categories, and steps to keep track of in this book. It appears the author was trying to break a difficult topic into bite sized pieces, but for me the result was just one list or categorization after another. I did not think the author made it clear enough that all the categories can overlap; no one box will fit just one person, either for the narcissist or for her daughters. In any case, I felt the listing and categorizing strategy was overused, and ended up obscuring what I thought were important subtleties.

I was really rubbed the wrong way by the author stating that a Narcissistic mother doesn't intentionally hurt her children, and that mostly such people are trying their best. I felt the author was saying that since the Narcissist isn't capable of empathy, they don't really know what the effects of their abuse really are. My own situation is so vastly different I can't believe I am the only one. I do not think it helps to suggest to people that they deny the very real possibility that their mothers knew perfectly well what they were doing, and enjoyed causing suffering. I am certain my own mother knew exactly how her actions affected the people around her, and did it all quite consciously.

The section that I was hoping to read about, the difference in how daughters and sons are treated, turned out to be very short. This and the section about how different daughters are treated were very interesting, and not something I've seen much about in other places. I really feel the book needed to expand these sections, they seemed to introduce ideas without any meaty follow up.

Part Three was also too short. As far as I'm concerned the best part of the book, and the reason I read these self help tomes, is to learn how to change myself. There was not enough guidance here for me. For example, the author talks about forgiveness, but does not do a good job of defining exactly what that is to her. She mentions that it can be different for different people, and that forgiveness is not the same thing as pardoning. The idea of forgiveness as 'letting go' does not make sense to me. I have no model for this, certainly not having seen it modeled as a child, and the text didn't have enough examples to show me how to do this.

Summary and Final Comments

This is a very helpful book if you are the target audience, or I imagine, the spouse of a woman with a Narcissistic mother. It accurately depicts the issues of being one of the 'daughters' and offers some real life ideas for how to cope and how to move on. I'm glad I bought it, and would recommend the purchase to anyone interested in the topic.

Your Hostess With Neuroses