Alaina Mabaso's Blog

Fiction Need Not Apply.

I don’t need your damn dream dictionary

Sometime last year I had a dream about a guinea pig — perhaps a psychic remnant of Pete, a brown-and-white childhood rodent who boasted both astonishing volume and longevity. But according to a dream dictionary, the dream was a sign of my “need to be more responsible and attentive.” Alternatively, the pig of my somnolence could have represented the fact that “through experimentation and taking risks, you learn how and how not to do something. You learn from your mistakes.”

"You need to try a little harder, young lady."

“You need to try a little harder, young lady.”

Now if my dad had had a dream about a guinea pig, and dream dictionaries have any shred of psychological merit (who decides this shit? How much more money could I make if I decided to interpret dreams instead of being a freelance journalist?), this would all come together in a nugget of breathtaking clarity: that deafening guinea pig, who lived years longer than Dad thought any one-kilogram cavy ever could, was no doubt one of the enduring mistakes of his parenting career.

But my real problem isn’t that I need to know the meaning of my guinea pig dream. It’s that a dream about a goddamn guinea pig — and whatever else I happen to dream about any night of the week — can seem as real as my waking life and lodge in my memory, forever, just like something that actually happened to me. After about thirty years, I wish a brain could be selectively cleared out like a computer hard drive.

The group therapy nightmare, among others

Several times a week, I burst out of sleep in the morning feeling dizzy, disoriented, and with my head clanging, as if I’ve been sitting in an IMAX theater all night.

A friend mounts a Fringe Festival play in my apartment without asking. The next night, I’m plunged into a steamy murder mystery at a British bed-and-breakfast villa in India (the pompous owner of the hotel killed a kitchen staffer and thought he could get away with it). The next night, a giant pine tree grows through the floorboards of my living room. The night after that, I’m back in college, sophomore year, and my big orange goldfish has jumped out of its tank onto my dorm-room duvet and I can’t scoop it back in.

The next night? Take your pick. I’ll spare you too many of the details, like how my optometrist came to be located inside a Wendy’s (after the exam, she did tell me I have “great blue eyes, for a human being.”

I also dreamed I was starting a new course of therapy and was riding a hospital elevator with a group of ten friends, co-workers, and childhood bullies. We navigated our way through three floors of the hospital until we found the balding, bespectacled therapist’s office, where I discovered that the entire therapeutic hour, horribly, would consist of each of us sharing, in a five-minute verbal statement, our essential selves with the whole group. When someone did so, the therapist would reward him or her with a white linen tunic.

I immediately thought to spare myself by asking for the restroom. I tried to dawdle but when I got back, everyone else in the group was wearing white shirts and looking expectantly at me. Instead of saving myself, I walked into a worst-case scenario: I had to make a personal statement without having heard anyone else’s.

But the therapist was looking at me the way therapists do. “Well, I’m Alaina,” I said. “I grew up in Maryland but have lived near Philly since I was 17 or so. I have some mental health issues. I have some chronic illnesses that can make my life pretty miserable day to day. And I’m a freelance journalist, copywriter, and editor. Actually I edit some of the people in this room.”

I felt this was a terribly inadequate personal statement, with the last part being superfluous at best and totally embarrassing at worst, but couldn’t say anything else. The whole room stared at me, silent.

I woke up.

T-Rex and whales

The oldest dream on the hard drive is from when I was five years old (a nightmare about a lion in the family dog house). The most surprising was when the T-rex from Jurassic Park chased me around a mansion, and just when he caught up with me on the grand staircase and I thought I was dino meat, he bent down and kissed my cheek. The best dream is the time I biked St. Lucia from end to end and then plunged into the ocean to swim with whales. It’s hard to pick a worst dream because the nightmares are pretty constant (and I won’t include the times I’ve taken narcotics, which for some reason turn my dreams into slasher movies), but I could go with the one where I was being buried alive in a coffin, screaming. I’ll spare you the worse parts. My own real sleep-strangled yell woke me up.

After a childhood friend died when we were in boarding school, I dreamed I walked into the dining hall and there he was, giving me a hug. He cheerfully waved the news of his death away with his hand and for a moment, the dream was real life and real life was the nightmare. I ached with grief when I woke up, and to this day, the vividness of the dream competes with my actual last memories of my friend, as if I was able to see him one more time.

Better than therapy

There’s a moment just after I wake up every morning when I make a decision about whether or not to bring my most recent dreams up into consciousness with me, to look inward and see what “happened” overnight, think it through, and decide if there are any lessons for me in it. Because dreams can be marvelously instructive: they sometimes tell me, in ways I can’t or won’t grasp while conscious, what I’m really afraid of, what I really want, the true dynamics of my relationships with other people, and when I’m being too hard on myself.

Not that I really have a choice about whether or not those types of dreams seep into my consciousness and memory. If I don’t let them bubble up in the morning, they will crash my thoughts at some point during the day, like a TV that goes on when you accidentally nudge the remote.

Try this: don’t see your dreams as you would your ordinary life, with other characters appearing in your own point of view. However zany or well-populated they are, dreams have a cast and crew of one: your own brain. Try re-imagining every person in your dream as a version of yourself — probably one you keep on the back burner when you’re awake.

The 90 percent

So one reason I don’t want anything to do with dream dictionaries is that I don’t have time to look up and try to interpret everything I dream about, and risk lodging it all further into my memory. Yes, some dreams are allegories for toxic or beneficial scenarios in my life; others are just the result of too many episodes of The Walking Dead, my love for cannoli, or my centipede phobia.

Yes, yes, enough hours of this and you will have nightmares. No regrets.

Yes, yes, enough hours of this and you will have nightmares. No regrets.

I try to casually ask other people about this — “do you remember your dreams?”  Occasionally I’ll hear from another hyperactive dreamer, but usually folks just shrug and say they don’t remember much once they wake up. This is in line with the (no doubt peer-reviewed) resource, which claims that we forget 90 percent of our dreams.

So maybe that’s why dream dictionaries are popular: bringing a clear image with you out of sleep is apparently a rare and notable experience that demands explanation.

Say I did look up everything I’ve dreamed about in, say, the last week — theater, glassware, the seashore, ice cream, conifers, kissing, a hospital, keychains, samosas, an eye exam, and goldfish, to name a few — how could that possibly add up to a coherent statement about my life?

Did you know?

Plus, look at the “Interesting Facts About Dreams” heading at

“Did you know blind people dream?” You mean people with a physical disability retain the basic mental phenomena of being human? WOW.

And there’s no shame in it, guys: “Everybody dreams.” (Just don’t do it in public.)

“Dreams prevent psychosis.” I assume this is based on a piece of research I saw somewhere demonstrating that people repeatedly woken from REM sleep quickly go mad. Should we also infer that people with psychosis don’t dream? Or that we could treat psychosis by inducing dreams?

Finally, and most stupidly because it is not an interesting fact but a question: “Can dreams predict the future?” In my case, I hope not, because that means I will one day be wondering around a college campus desperately trying to figure out where my class is being held.

Forget your pet, go back to school

Which brings me to another sleepy-time problem: recurring dreams. Do you have them? I have two, classified not so much by specific content as by theme.

First, there are the forgotten-pet dreams. They’re awful, and they can be about anything from a hermit crab to a hamster to a dog to a plant. Basically, it’s a dream where I suddenly realize I have been bumping happily along for months while forgetting to give food and water to some creature that depends on me. (One variation has me agreeing to pet-sit for someone, and then realizing in a panic that I’ve forgotten to feed the animal for an entire week.) says we can dream only about “what we know and see in life.” So what the hell? I love animals, never forgot a pet’s meal, and have a reputation as a great pet-sitter going back almost two decades. I never starved some poor gerbil to death. So why can’t I get free of this dream?

Then there’s the one about school, and it comes in a couple different varieties. Sometimes I’m striding back and forth across a strange university campus, knowing there’s a class I’m supposed to be in, but not able to find it anywhere. Sometimes I realize that I enrolled in a course months ago and then forgot about it until just before the exams. Sometimes, I’m sitting in class paging through the textbook and realizing I’ve forgotten to do any of the reading or homework, and have no idea what the professor is talking about.

This gives me grief similar to the dreams about pets. I was an excellent student. So what the fuck, dream-brain?

Here I am at the beginning of my freshman year of college, before I realized how little SAT scores and GPAs have to do with real life.


Gained in translation

This is probably the biggest reason I don’t want a dream dictionary. I don’t need some hypnagogic psychobabble to tell me what these dreams mean, and why they’ll never stop.

The nightmares about pets aren’t about animals at all, or even some rational fear of neglecting an animal. They’re just symbols for my terror of ever dropping the ball and my own over-inflated sense of importance, which haunted me into an illustrious yet miserable A-student mold, and now, make my guts churn with anxiety any time I try to take a day off work.

The nightmares about school aren’t about school at all. They’re about what school represents, at least in my brain: ability, preparation, and readiness. They’re the screaming fear, quieted during the day by my penchant for keeping busy, that I’m not prepared for this — “this” being my whole adult life, but I have an inkling that I’m not the only professional writer to brew this perpetual panic.

Hearing that I’m competent, reliable, and maybe even pretty good at my job doesn’t make a speck of difference when I’m asleep, and maybe it never will. Dammit, maybe the dream dictionary is right after all, and that guinea pig was all about my need to be more responsible.

Bedtime is coming up in a couple hours. Despite the nightmares and the screeching inadequacy complex lurking in my subconscious, it is always interesting to wonder. What will I dream about tonight?

What do you dream about? If you remember, will you tell me?

Always a bride, never the bridesmaid: the best friend failure

According to the Huffington Post, I met life's ultimate goal by being that girl in the middle before I was halfway through my twenties.

What’s it like to be a bridesmaid? I wouldn’t know.

At age 31, I’m afraid it says a lot about me that the last people who asked me to be in their weddings were my aunts. That was about twenty years ago.

While most other women in their twenties were doing permanent damage to their credit scores buying satiny dresses and throwing destination bachelorette parties, the closest I ever came to being a bridesmaid was several years ago, when a college roommate got married.

Envy this ass

During our sophomore year, she threatened to murder my “creepy” pet sea urchins (which I begged from our biology lab teacher after a singularly heartless morning spent studying gametes), left piles of hair under my desk when she absentmindedly pulled her braids out while borrowing my computer, and always managed to beat me into our bathroom when we both had a morning class.

She said she was jealous of my big butt and, as a Ghanaian unfettered by pre-Nicki Minaj/Iggy Azalea US beauty standards, genuinely meant it as a compliment. She stood up to anyone on campus who tried to push her around, including the faculty, magically produced endless pots of Jollof rice and oily red peanut butter soup in the dorm’s tiny kitchen, and didn’t mind that I hated fufu no matter how many times I tried it. She was one of my bridesmaids — even though the wedding happened to be on her birthday.

When she got engaged, she asked if I would help decorate the church for her wedding. I immediately said yes. She added that she had thought of asking me to be a bridesmaid, but knew I would probably be too busy.

I was equal parts relieved and disappointed. It’s been a few years since I’ve seen her.

No bridesmaids’ dresses

As this terrible, terrible article called “7 reasons why you’re always the bridesmaid” claims (with tips like focusing less on your career so you can carve out date nights in advance just in case Mr. Right comes along and feels threatened by your work hours), nobody really wants to be a bridesmaid. We’re all just waiting for our “turn to wear white.”

Somehow, having reached adulthood without a best friend to my name, I have the opposite problem. I had my glorified day in white at age 23, but no-one has ever asked me to line up at the altar behind her, holding a modest bouquet and emergency Kleenex. I’ve never been to a bachelorette party.

Even the supremely arrogant, misanthropic Vicodin addict Dr. Gregory House gets a best friend in the long-suffering oncologist James Wilson. Larry McMurtry, my favorite novelist, specializes in inventing best friends so close that they can’t manage a proper romance. Gus McCrae and Woodrow Call always have each other’s backs, to their lovers’ lifelong chagrin. So what’s wrong with me?

Good Christian bullies

I grew up in a small private religious school, and over the years, my friends and I took turns bullying each other as only good Christian girls can. We’re scattered throughout a few US states now, but have occasional nostalgic get-togethers. The inescapable bond of years of sleeping-bag squeal-fests over Leo, JTT, and Prince Will still pulls us out of the crowd and into our own little orbit at holiday church services.

Friendship's earliest bonds. I'm the blondie in the dress.

Friendship’s earliest bonds. I’m the front-row blondie in the dress.

I had a long-distance best friend in high school who would compulsively fold the clothes in my exploded suitcase when she came on family trips. This was before Facebook, kids, and we wrote reams of letters. She loved She-Ra and coffee; I loved reading and my golden retriever.

In retrospect, I’m willing to take some blame for the day things fell apart. She called me at work in a bit of a panic one summer day. She had booked a jaunt out of town and told her family she was staying with me. I had no word of this plan until the universe suddenly threatened to have our parents cross paths at a funeral on that very weekend. Could I, uh, convince my parents to lie to her parents about her being at my house?

I refused. Today, I’m not sure if I was pissed (or was I hurt?) because I suspected she was doing something risky, or because she’d used me as her cover story without confiding in me.

Years later, neither of us attended the other’s wedding.

Best friend monogamy

My parents, who got married in 1981 and still do almost everything together, have a framed quotation on the wall: “Happiness is being married to your best friend.”

Instead of inspiring me, it weighs on me. Making a marriage work is quite a feat. Now that I’ve hit my thirties, we may be heading for an even split between weddings and female friends returning to their maiden names (no judgment; I can’t see the inside of anyone else’s life). And as I now know, finding and keeping a best friend is no easy task, either. Are we really supposed to have it all rolled up into one person for life?

If figuring out whether or not you’re really “in love” can be a minefield once you’re a few months or years into a promising romance, is bestowing that “best friend” label any less fraught? Does it just happen naturally? Or does someone broach the question before you decide to commit?

A note from my freshman year roommate.

Sometimes, with items like this BuzzFeed list of “27 Texts You’d Only get From Your Best Friend” (implying that best-friend-hood is a natural, hilarious, universal experience), I wonder if our culture’s obsession with marriage and monogamy hasn’t leaked into our concept of friendship, because our destiny as someone’s best friend seems almost as important as getting married. Nowadays, there are as many rom-coms about actual couples as there are movies about watching a best friend go to the altar in a crucial, debauched, painfully hilarious ritual of love and letting go.

What are you doing here?

Today, though best-friend-less, I don’t have any major social deficiencies that I’m aware of (although when I was in high school, someone did advise that more girls would be friends with me if I was less openly opinionated). I have a wide circle of friends, some of them fairly close, partly due to my work as a freelance writer and editor.

Because of my job, and because I’m very outgoing, I realize that some acquaintances are probably rolling their eyes at my lonely self-concept.

My husband laughed when he joined me at a gallery opening and watched people come up to me all night in the crowd. He knew it wasn’t because people want to talk to me. I never was and never will be the popular kid (when my husband and I began dating in college, it seriously lowered his capital with the cool girls on campus).

College costume party, circa 2003. ("I can't believe he's dating HER.")

College costume party, circa 2003. (“I can’t believe he’s dating HER.”)

Nowadays, nobody (at least out loud) seems to be following the lead of a guy I grew up with (in the school picture above), who said “what are you doing here?” when I had the temerity to say hello that time we ended up at the same freshman year house party. A decade or so later, people either know I’m a writer or they spot my notebook, and they’re thrilled to see me…because they have a great story idea.

The power of plus one

I often wonder if I’d go out with friends as much as I do if my job didn’t involve attending events, and I didn’t have a steady stream of passes to plays, concerts, and previews. Would they be so keen to get together if I wasn’t a fount of free tickets?

Does it matter? Don’t we all use each other to a certain degree?

“The +1 thing sometimes creates interesting dilemmas,” a friend and writing colleague said in an e-mail when we decided to attend a show together. “I wind up trying to figure out which friend might want to go to what show without creating expectations that they will always be invited. Often I just go on my own to avoid the whole issue.”

This struck me, because I have never once worried about this. Is it because I’m insensitive to others’ feelings? Or because I do not have any friends so close that they would expect an invitation? My plus ones are generally first come, first served via social media (if I like you), or I’ll invite people based on their interests, not their closeness to me (my spouse could not possibly attend all the events that I cover — my guess is that being married to a writer is no picnic, on many levels).

Stay gold.

So I go out with a lot of different people. But I often feel intensely lonely. Is it the same for everyone? Friends have shared their secrets, cried on me, and told me I felt like a sister. I’ve cared for them when they’re sick or heartbroken. But when I’m in the trenches of my depression — and I’m talking the mud-caked, front-line, WWI trenches here — I think of who I could call and come up blank, even though, especially since I took my mental health story on the radio, a few people fondly urged me to reach out anytime.

For some reason, this always seems impossible in the moment.

If there was someone I was willing to call — someone with whom I could bear to share a real tear-soaked glimpse of myself — does that mean I’ve found a best friend? Someone incapable of being offended via text message? Someone you’re not having sex with who’d share your profile photo? At least until, like a lot of married couples do, we drifted apart?

Last weekend, a close friend introduced me to one of her other friends. I’m “one of [her] best friends from college,” and the other woman is “one of [her] best friends from high school.” I was touched. Also, this girl is on to something. Screw BuzzFeed. Can best-friend-ship be an open relationship?

Because by now, pleased as I would be to budget for a strapless bra and dyed-to-match shoes the instant a friend got engaged, I’m beginning to think that just like some people aren’t cut out for marriage, some people aren’t BFF material. It’s not you. It’s me.

But I am definitely getting another golden retriever.

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A little perspective for all the freaks of nature known as “morning people.”

There are times in your life when you just want to listen to music all day, because oh my God, those lyrics or that tune are your life. Like when you’re in the crazy, fluttering swoop of a new love. Or when you’ve got a migraine so bad that even looking at the computer screen makes you feel about two microns from vomiting and you can’t handle anything but turning on a very, very quiet Pandora station and lying there like road kill that somehow managed to crawl inside your apartment. My mind never goes as deep into a song as when I’m in blinding pain and will do anything to escape it.

I need music when I write, but also when I do things like clean the fish tank or grill hamburgers. The constant tunes are a dinghy for my depressive brains. And sometimes my mind pauses its perpetual tangle of words thrashing across the screen, to grab onto some song lyric like an overtired toddler hoarding a Tonka: MINE.

For example, I’ve been listening nostalgically to Sublime since high school, but the song “Garden Grove” was playing yesterday, and suddenly I thought: yes. YES.

Bradley Nowell sings “there’s a reason why my soul’s unsound,” and boy does he have the definitive list, including “that smell inside the van,” “my bedsheet covered with sand,” “sitting through a shitty band,” “getting hassled by the man,” “waking up to an alarm,” “sticking needles up your arm,” “feeling depressed ev-ER-ee day,” “getting yelled at by my dad,” “saying I’m happy when I’m not,” and other grungy complaints.

Without trivializing his tragedy, I want to point out that Nowell knew what he was talking about, before he died of a heroin overdose when I was still in junior high. What strikes me this week about this litany of 90’s misery preserved forever in song? Nowell lines up depression, parental disapproval, drug use, shitty bands, and ultimately fatal lies about your overall well-being right alongside the total injustice of waking up to an alarm clock.

And I get it.

Who needs Satan when we've got alarm clocks? Image via Wikimedia Commons.

Who needs Satan when we’ve got alarm clocks? Image via Wikimedia Commons.

For every person who is waiting for me to give in, be sensible, buy a bunch of tasteful sweaters and blouses, and find a full-time job in someone else’s office, I can give you a reason why being a freelance writer is best for me. But I need to be honest. It’s not all about the writing.

After years upon years of waking up to alarm clocks, from junior high through my last “day job” in 2010, there is nothing — NOTHING —like the bliss of telling almost everyone that I’m not available for  any meetings until after 10am, going to sleep, and waking up the next morning when I’m damn well ready to.

Does that mean work goes til midnight? Fine. I will tap away at my keyboard in flagrant nightly disregard of every lecture on “sleep hygiene” I ever got from psychiatric nurses and my more well-adjusted friends.

Because no matter how many hours of sleep I get, my body feels like a badly-glued model plane in the morning, and there are gremlins in my apartment who inject my joints with sand overnight. It scrapes my insides from toes to trochanters when I get out of bed, while invisible pinpricks flare across the soles of my feet. I realize all this may be the purview of my “fibromyalgia,” that dastardly, desultory diagnosis, and that it’s not normal to feel like the twelve feet between my side of the bed and the bathroom is my own daily constitutional in Hades. I’m just trying to give all you “morning people” a little perspective.

Most importantly, if I have to stand up before 9am, I realize beyond a shadow of a doubt that absolutely everything in the world except keeping my head on the pillow is a terrible, terrible idea. It does not matter how much money I have spent or stand to earn. An early-morning trip to Norristown, New York City, or Johannesburg, a perfectly reasonable scheme the day before, is revealed for what it truly is under the horrible peachy-pink streamers of dawn: the mistake of the century compared to the utterly sensible pleasure of closing my eyes again and rolling over.

My husband seems to have an easier time of it, routinely leaving the house for work before 7am, as I did for years, without any sign of violently resenting his lot in life. I am sometimes aware of his departure, and behind my eyelids, abject sympathy bubbles alongside the relief of lying here in the dark for another hour or two.

Maybe my problems are compounded by my inability to consume the world’s morning drug of choice. Just when I need the most help, caffeine will do nothing but make my heart race, nausea churning my stomach as if the poor organ is lashed to a raft in a stormy sea. The next morning, my bladder will feel like it’s full of NASA ignition fire instead of pee.

No thanks.

So I do my best to carve out an alarm-clock free life, but there’s only so much a girl can do. A couple times each month, with a heavy heart, I set my alarm for an ungodly hour like 7:30am. This usually results in a solid spate of anxiety dreams, beginning around 5am, that the alarm has failed to go off and I have missed my meeting. I wake up at 6:30, heart pounding, and seize my phone. Slowly, slowly, I sink back into unconsciousness, and just as I re-achieve that true blessed blackness, the alarm rips it away.

All I can do is hit snooze three times at minimum, forcing my eyes to stay open for that last nine- minute stretch, and then feel on the nightstand for my glasses, and stagger to the bathroom for a cool shower with the treacly twang of Mumford and Sons turned almost migraine-low and the bathroom light OFF. Oops, can’t shampoo with my glasses still on. One wet shaky hand puts them where I know the sink is.

By the time I dry off, it’s still hard to remember why I would ever consider eating anything again. But when I have an early meeting, I choke down an egg or a piece of wheat toast, almost gagging with the effort while I wait for a train full of other people’s stingingly fresh cologne and coffee breath.

I face the world dressed nicely enough but without a trace of eye shadow or lipstick, hair pulled into a damp ponytail because giving me a choice between two extra slams of the snooze button and a stint with the hairdryer is like asking whether I’d rather eat a caramel sundae, or be bitten by a recluse spider.

After more than three years of freelancing full-time, I don’t know how the good employees of the world do it. Mornings are meant for at least an hour in bed between regaining consciousness and regaining your feet, with plenty of stretching and enough meditative diaphragmatic breaths to make a college theater professor weep.

How much can you really get done before 10am anyway, provided writers and editors who shall remain nameless haven’t been e-mailing you at 6am with pitches and questions that need attention? By the time I get to a massive homemade smoothie with yogurt and frozen blueberries, the thing might as well be lunch.

But my pitches are rolling. My deadlines are on track. My edits are smooth. The afternoon flashes by. And when illness and the umpteen pitfalls of my life flare up, I find one seed of utter contentment besides old Sublime songs or Yo-Yo Ma playing Bach yesterday, today, and tomorrow: no alarm clock.


Why do we eliminate cancer cells, but not depression symptoms? Talking with author Jonathan Rottenberg (part III)

Welcome to the last installment of our chat with author and psychology expert Jonathan Rottenberg. (Here are part I and part II if you missed them, or want to learn more about The Depths: The Evolutionary Origins of the Depression Epidemic, and the writer.)

Today, we look towards recovery from depression: what do we know? What don’t we know? And how can ordinary folks help? Here are excerpts of our conversation.

Adenocarcinoma cells. If you had them, wouldn't your doctor try to get rid of them all?

Adenocarcinoma cells. If you had them, wouldn’t your doctor try to get rid of them all?

Alaina Mabaso: Psychiatrists are doing a really hard job obviously, and I’m interested in the practical application of what you say in The Depths about “wellness.”

You write “the vast enterprise of depression treatment research inspired by defect models has virtually nothing to say about wellness or thriving.” So does that mean that most therapists and doctors are kind of only doing half of what their job should be, or does it mean we need a different kind of practitioner or coach to oversee the latter stages of someone’s recovery into that actual stage of well-being?

Jonathan Rottenberg: There certainly are psychotherapists…who would be interested in broader visions of wellness.

It isn’t really studied very much in any formal sense, that’s one problem, and definitely, when we’re talking about treatment and evaluating treatment, the only outcomes are whether or not the symptoms decrease, which is great, but I challenge you to find any treatment studies that look at broader measures of human functioning, let alone the squishy things like “purpose” and “meaning in life,” even just things like interpersonal functioning or the broader measures of psychosocial functioning.

Ninety-nine or 100 percent of the time, they’re just measuring how much do the symptoms go down, which I think is a good place to start; but there can be two people who have low symptoms who are very very different, and til recently, there hasn’t been a lot of interest in differentiating between low symptoms and total extirpation of [an episode of] depression. Turns out it really is very important, because people who have residual symptoms tend to have depression that comes back a lot sooner, and the longer that someone can be in an asymptomatic state, that is going to predict that the recovery is going to take, it’s going to last; [the depression] may not even come back ever.

Certainly in other branches of medicine…they’re very interested in those residual cancer cells, you know, we can’t have those; but with depression, basically the standard [in recovery] is when they say someone has responded with greater than 50 percent symptom reduction. If you were spectacularly depressed, you’re still pretty depressed… That [outcome is] not good enough.

I’m not doing psychotherapy, but I do know of psychotherapists, and there are not a lot of people who can afford to pay for psychotherapy on an ongoing basis, so that it would be useful… Insurers [are] not convinced that people should have treatment once their symptoms have substantially improved; there’s limits to how long you can see a therapist and so forth.

To me, [wellbeing] is just a far more logical goal than simply “my goal in life is to not be depressed.” That’s not going to be enough.

AM: It’s a negative statement. It’s not what you want; it’s what you don’t want.

JR: Right.

AM: I want to come back to what you said about the importance of speaking to people who are in that struggle, instead of clamming up. Some writers or filmmakers or whoever, they might address the topic of depression as you have, in this hindsight model: I was depressed; I came through it, now I’m better, and I’m going to stand up and talk about it. What about doing that in the public forum when you’re still in the mess of treating it and trying to figure it out? Not coming at it from the perspective of “I battled this, and here’s my wisdom,” but “I’m in this right now.” [I was first inspired in this line of thought by Terry Gross’s excellent Fresh Air interview with author and blogger Allie Brosh.]

JR: Well, that takes even more courage, I think, and it’s beyond a lot of people’s capabilities in the sense that when someone feels really depressed, they feel that they have nothing of value to say and…usually retreat from other people rather than approaching other people. There aren’t a lot of forums for these kinds of things.

AM: That’s what I’m finding.

JR: In my own case, I would say that I certainly have a tremendous amount of shame, and felt that I didn’t have anything to say during the depression…I think that one thing that would be terribly therapeutic is if we could change how other people typically react to depressed people.

A person thinks, “I’m socially toxic because I’m depressed,” and if just enough people in the environment affirm that by acting weird and unable to cope with the fact that their friend or acquaintance is depressed, that reinforces this view that “I’m defective, I’m not worthy,” and makes the person even less willing and able to share this part of their experience. I think that the solution to depression in the US is going to involve social change a lot more than it’s going to involve a new drug, and part of that is changing the social field around the depressed person. Not to say, hey, it’s great, join the land of depressed people, but just acknowledge that this is a part of life that almost anyone might have.

If everyone in the person’s social field said, “look, I know this is really hard…I know a lot of people with depression,”… it would make the burden of having depression a lot [lighter]. I feel like part of why people don’t get better is they get socially isolated, and they end up 100 percent in their own head.

If someone had the strength to talk about their depression while they’re still depressed, that can be great, but that’s going to be more than a lot of people can do, and enough people are going to experience really bad reactions [from] other people.

But I agree with you that often the dialogue is that the [former sufferer] is in a really safe place and they have a narrative of having overcome: that’s kind of more easily assimilated by other people [than the question of] whether or not the treatment was important.

AM: Like getting over the flu or something.

JR: Yeah… I have deep respect for severe depression, and think that it is quite scary…and I don’t think that just talking about it makes these states evaporate…but there’s a whole bunch of things that are sustaining these states, and the social environment in our culture is definitely one of the substrates for why there’s such a ridiculous amount of depression now in our country.

AM: My experience, and the experience of some people whom I know who have struggled with this, is a sort of cut-off, like, “you’re in this state, obviously I can’t talk to you, and I’m just going to let you alone until you come out of this,” which is just devastating to the person who’s already in a fragile place.

JR: I think [this topic has] a lot of potential, in spite of all the negative things that I would say about the current state of play… I’m hoping that there’ll be other things besides my book that will shake things up… I think that we haven’t yet had the kind of mobilization that the problem deserves, but I think that there will be more. I’m just not sure what it’s going to take.

AM: I’ve struggled with these problems for many years, and I think if people can see someone else talking honestly about how rotten this place really is, that really does help everyone.

JR: I admire what you’re doing, and I think it really does have good effects, so keep it up.

Thanks for reading this special interview series with The Depths author Jonathan Rottenberg, and thanks to Jon for chatting with us. You can find out more about his book at, and follow him on Twitter and Facebook.

If you missed them, here are part I and part II of the interview.

Also of interest:

I apologize for this outbreak of the total jerk who lives inside my head.

It’s not always interviews, and it’s not always depression, but the conversation from readers is always interesting. Scroll down to the bottom to subscribe to the blog, or keep up on Twitter


Is psychiatry intellectual fraud? Talking about depression with author Jonathan Rottenberg (part II)

Welcome to part II of our chat with The Depths author Jonathan Rottenberg. (If you missed part I and want to catch up, and learn more about the book and writer, click here.)

Lock the doors: Today, we’re taking on the psychiatry establishment. Here are excerpts of our conversation.

Author Jon Rottenberg. Don't let the smile fool you. He was a psych patient. (Photo by Robert Rottenberg, via

Author Jon Rottenberg. Don’t let the smile fool you. He was a psych patient. (Photo by Robert Rottenberg, via

Alaina Mabaso: I wanted to ask you about something in your book that you touch on a little bit. I was just interested because of some of the crossover with my own experience. You mentioned your own sojourn in inpatient care at Johns Hopkins Hospital. I also was a patient at Johns Hopkins earlier this year for depression. It was not a good experience. Given your view of depression as an evolutionary mood system that we should try listening to and approaching in interdisciplinary ways, what do you think about inpatient or hospital stays for people who are depressed?

The blogger, another psych patient! Where will it end??

The blogger, another psych patient! Where will it end??

Jonathan Rottenberg: No-one normally hospitalizes anyone these days because of the difficulty of paying for it, so it really is, in our current system, an absolute last resort, and I think in my case [several years ago], it was still pretty hard to get admitted.

It was sort of an admission of defeat that all these other therapies hadn’t helped me…and the hospital offered a break… It didn’t really make a big difference for me, but was really very frightening: the idea of going to a hospital for a psychiatric problem. I think in certain cases it can be helpful; if someone’s environment is really chaotic and is interfering with any hope of stabilizing the person.

I’m just saying more generally that I would agree that mainstream psychiatry and even pretty good psychiatry isn’t that good. I just don’t think depression is like having diabetes, which is one of the main metaphors that’s typically used in really any sense, but really even in a treatment sense, where you can find out to what extent your therapy for diabetes is making a difference on the targets that you’re interested in; you can draw blood, you get different measures of people’s reactions to sugar, but you can’t do that with depression. There’s no biological test that would tell you whether or not your treatment is working, and so that’s pretty horrible [as an analogy that] breaks down as soon as you look at it.

It’s true that insults to the body can cause depression. It’s really not a shock from the evolutionary perspective either, that if you sustain a head trauma, or are sick with cancer, that that can have profound effects on your mood…but fundamentally I don’t think that’s the right approach for most people.

AM: My experience with many psychiatrists is a refusal to look at my underlying physical issues. The thing that landed me in inpatient care is I have an extremely painful chronic illness that nobody can cure; I grew very, very depressed and expressed that I wanted to die, because I was in so much pain, and I was locked up. There was this disconnect: the idea that my body being extremely painful and debilitated was not a valid reason to be feeling bad, and I needed to be locked up and put under guard.

JR: Did they address what your reactions were to the pain? Were they simply saying that having depression in this context was maladaptive and we were going to treat the depression? Did they give you any tools for thinking about the pain and reacting to it differently or anything like that?

AM: No, it was a short stay. They forced me onto a couple different drugs, and after my release, required me to see an outpatient psychiatrist who specializes in pain management. He essentially ignored the chronic pain history, and diagnosed me with a personality disorder, based partly on the fact that in his opinion, I write too much: my devotion to writing is pathological, therefore I have a mental illness. And for me, that connects with what you write in your book about part of what you think the key to overcoming depression is: a sense of purpose in your life, a sense of passion about something that you like to do. What happens when there’s this disconnect in a medical scenario, and your doctor sees something that’s your passion, and calls it a symptom of a disease?

JR: In any field, there are people who don’t know what they’re doing…psychiatry maybe more than some other fields of medicine where it’s a lot easier to quantify the outcomes… If someone’s replacing knees, I think they can grade difficult and easy cases, and look at success rates, but I think in psychiatry that’s a lot harder to do.

There are people who were trained a long time ago and didn’t keep up [or] people who are just intellectually not very strong, and they’re left in a position of incredible power. [Patients] are trained to defer to [psychiatrists’] expertise. I think that in addition to purpose, I’d argue it’s really important for people to take control of their treatment, if they’re in treatment (which I don’t think is a bad thing).

We’re better consumers of things like toasters and what airline to fly on than something as important as mental health. There’s amazingly poor data for the consumer. It’s a huge issue. If you want to buy a toaster, you can go to underwriters’ laboratories and consumer reports and find out about all these toasters you can buy, and all their features… With psychiatry or other areas of mental health, there’s very little reputational information you can get, and people can do things that are borderline unethical, and it’s very difficult to sue. But if your toaster doesn’t toast the toast, you can take it back and get your money back.

AM: When I was at Hopkins, part of the problem that landed me there was my physical illness. I have to stick to a very strict diet because of it, but the doctors and practitioners on the ward would not accommodate my diet… To me, it seemed like this extremely basic disconnect from care and human dignity, like here you’re claiming to cure my psychiatric illness, and you’re failing to even give me food that I can eat. And this is supposedly one of the top hospitals in the country, so how does this reflect on psychiatric care in general? It’s scary to me.

JR: I want my book to be more than just anti-psychiatry — I feel like that’s kind of too easy. I agree with everything you’re saying, and that a lot of that is pretty shameful and we need to do better. There are some good psychiatrists out there. There are even a lot of psychiatrists who share these same kinds of critiques.

Psychiatrists have a tough job in the sense that [they’re dealing] with the most difficult patients that haven’t gotten better on their own, or with the help of their families…I think the thing that would kill me if I were doing that job is just that there’s a certain intellectual fraudulence to it, especially when prescribing the drugs.

Therapy’s another matter; that’s a real art form. Some people are probably magicians and can have some pretty remarkable results (of course a lot of terrible ones too), but [with] drug treatment, I just think you have to tell the patient a series of white lies about what’s going on…the whole thing is shrouded in mystery: how you’ll get better and when you’ll know that there’s any benefit.

AM: When I was in Hopkins, and I was in a conference with my psychiatrists, forced onto a [psychotropic] medication that I didn’t want to take and that had disastrous consequences for me, I asked the doctor, “Why are you putting me on this medication versus another one?” And she said, “it’s more anti-cholinergic.” And I’m like, here I am, a psych patient, a layperson, and you’re just going to tell me that as the answer for why you’re making me swallow this pill?

JR: Well, they don’t know. There’s no rational basis for…prescribing a drug [based on its side-effects]… If someone is potentially dying of cancer, you would not prescribe medicine based on whether it’s more sedating or less sedating. [But psychiatrists] prescribe medicine to people who are wanting to kill themselves, [a] life-threatening problem, on the basis of things like side-effects.

It’s all just completely seat-of-the-pants type decisions, and that’s why I’m saying that I would find it hard if I were in psychiatry; that it’s kind of an intellectual fraud. It’s intellectually weak.

[There may be more progress in other types of medicine like imaging and diagnostics]…but in psychiatry it seems like it’s been pretty much a steady state, no progress, and yet more and more market share and mind share. That’s really ugly.

I had a similar experience in the system, that I was a smart person being told a bunch of stupid things by smart people who should have known better. I just felt that they weren’t sufficiently humble.

AM: that’s one way to put it.

JR: A critique of where we are now has got to be the place to start…the current dominant approach is really part of why we’re in such a bad place.

AM: I remember being on the ward, and they’re serving dinner to the patients, and my attending psychiatrist comes up, and begins to talk to me about my medication dosage, in the middle of the kitchen, in earshot of all the other patients and guards and nurses. How dehumanizing is this? You would not do that in any other field of medicine: discuss someone’s most intimate problems and medication regime in front of thirty other people you don’t know.

JR: Yeah, that’s a good point. I think that on some level, there is a view that if you’re having these sorts of problems, you’re a very compromised human being. If you’re in a psychiatric hospital, even if you’ve consented…I think it is hard to accord the same status, the same respect, that you would [otherwise get].

I think that again, in terms of really changing things, a first position is to say that people who have problems with depression are people who are just about as flawed as people who don’t have depression, and just say, ok, they’re not fundamentally flawed, they’re flawed like everyone else is flawed.

I don’t think it means that you’re superior or that you’re inferior, it means that your mood is not within bounds that you would like, and that’s important to know, and could be a real challenge to get in better bounds, but the thing is, when people are overtaken by these moods, the moods themselves cry out these kind of judgments, so it’s very easy for the culture to act on and say, well, [the patients] say that they’re no good, so they must be no good.

In part III of our interview with Jonathan Rottenberg, we discuss treating depression versus learning to thrive, and society’s role in ending the epidemic. Comment below, scroll down to the bottom of the page to subscribe, and stay tuned. Miss part I? Read it here.

Also of interest:

 It would be better if I’d never been born: Depression and parenthood

Depression and the self-help book disaster: talking with ‘The Depths’ author Jonathan Rottenberg (part I)

Look out. We’ve both seen the inside of the psych ward, we survived, and now we’re talking about it in public.

This is the start of a special three-part conversation with psychology professor Jonathan Rottenberg, Ph.D., author of The Depths: the Evolutionary Origins of the Depression Epidemic, published in 2014 by Basic Books. It’s been reviewed in outlets including The Daily Beast and The Economist, excerpted in Salon, and will appear in the New York Times Book Review next month.

Jon takes a fresh approach, arguing that the prevailing “defect model” of studying and treating depression is all wrong. We should not be trying to find and fix some fatal personal or biological flaw that leads to depression, but trying to understand the deep evolutionary roots of depression, and how low mood can be a natural signal to stop throwing ourselves against goals we can’t achieve.

He brings a lot to light, from how depression may have evolved in our animal forebears, to how people overcome depression (that’s right, you can recover, he should know), to how deep its stigma actually goes. Here are excerpts of our conversation.

I told Jon that I knew his book was good because I had a lot of questions as soon as I’d finished it.

Jonathan Rottenberg: I’m glad you had that reaction, and I’m hoping that other people will, because I think we need to shake up our ideas and our whole approach to depression, because we’re not making a whole lot of progress as far as I can tell.

Alaina Mabaso: Can you tell me a bit about the reception of your book? You’re coming out with some pretty fresh ideas, so what has been the response?

JR: I’ve been waiting for someone somewhere to throw rocks at me or call me horrible because [of] the implications of [the idea] that a lot of people are wasting their time, and are misguided with respect to depression, and I’m still waiting for [Listening to Prozac author] Peter Kramer to firebomb my house or something.

I get nice messages from people who read the book, who are like, “wow, this really changed how I think about depression, and thanks.”

AM: You mention a lot of lab studies about human moods in your book. Can studies which artificially and temporarily affect participants’ mood really tell us about the true-life experience of low mood and depression?

JR: I think that the lab literature is helpful. I think the whole discussion about the effects of low mood [has] gotten kind of silly in the sense that people seem to want or argue that low moods are unhelpful and destructive. [But] they’re fine; evolutionarily selected for, when it really does seem to be the case that there are all kinds of benefits, but also costs to these [low mood] situations. You don’t have to decide whether they’re bad or good to see that they have potential. I would submit to you that any negative emotion that you could think of, it’s sort of absurd to say that it’s bad. Is anger bad?

AM: Well, it depends on the context.

JR: Right. It’s certainly useful if you’re trying to rally people against a perceived injustice. Is it good to be chronically angry? Does it help your chances of mating and winning status? Maybe not. But for some reason, people have a much more nuanced appreciation for things like fear or anxiety: people can understand that without a capability for anxiety, you’re not going to make it out for very long, but that too much anxiety or anxiety in the wrong context can be destructive. We don’t apply that same kind of thinking to depression and sadness. That’s one thing that I was trying to do in the book.

AM: This really jives with my personal experience, and I think it also has to do with being a woman, too. If I write passionately about something that I’m angry about, some people say, why are you angry? Don’t be angry! And I say there are reasons to be angry in the world.

JR: Is the goal for there to be no depression, or no sadness? That seems like a pretty absurd goal.

I agree…that there’s too much depression, and that a lot of people who have depression have bad outcomes: not just that they’re unhappy, but [because their] health can be impaired [or they’re at risk for suicide], and I think that the goal can be to better manage these states and see where they come from…They do have some value, but that doesn’t mean that we shouldn’t encourage people to learn how to cope with these effects. And paradoxically, that being better able to accept some degree of depression or sadness is increasingly thought of as a way in the long run to be less tormented and ruled by these kinds of states. [But] it’s not the typical position. You see a lot of how-to books which are often about –

AM: “How to be happy!” “Live your best life!”

JR: Banish depression from your vocabulary; don’t think negatively, things like that.

AM: “Think positive.”

JR: A lot of those books, I think, are really misguided, and I think do a lot of harm. I think I was diplomatic in [The Depths], but my true feeling is that most of self-help is a disaster, and really it doesn’t help people much at all. Some of the problem is that most of these programs are such cartoons: they’re not a valid representation of science, they’re oversimplified. It’s not that it’s bad in principle; most of the execution of these things is disastrous and it’s really driven by commercial interests more than anything else.

AM: I want to get to what was one of my favorite lines in your book, and ask you to expand a little bit on it. I was really interested in your point about the relative silence around the reality that people do recover from depression, and they don’t go on to a life of being debilitated and broken. You write, there’s this unspoken view that depressed people “should not bother to aim so high,” as if they’re never going to climb out of these depths.

So we do hear a lot about the stigma against depression, but in my experience, it’s framed as a social stigma or a public stigma, and you seem to be saying that there is a deep stigma in the medical field as well, that doctors are actually applying to their patients. Do you want to say more about that?

JR: You mean in the sense [of] recommendations that you’re going to need therapy for the rest of your life; you’ll need medication for the rest of your life?

AM: “It’s chronic, you’re just never going to get better.”

JR: It’s clearly not true. We really don’t know very much about the 40% of [depression sufferers] who have one episode of depression… Whether it’s because these people learn things, whether it’s because these people have other countervailing strengths that become more important than whatever liability they had to depression…I think we should be studying these people a lot more, and also I think that these people have a lot to offer the 60% of [depression sufferers] who have repeated [episodes of] depression, not just for raw inspiration (although that’s nice), but [because] their experience is helpful and we don’t hear from them that often.

I think there’s a difference [between our approaches to addiction and depression], where there’s this [idea of addiction relapse] as a big issue. People who have overcome addictions are often very public in reaching out to people who are still struggling, and for whatever reason, that doesn’t seem to happen as much with depression… Maybe [sufferers] are afraid of depression returning; they’re embarrassed about it; they have a fear that they won’t get a job [or] friends.

We are still dominated by this defect model, so it’s all about, “let’s find the defect; when we find the defect, the problem is solved.” [We should be looking at it differently]: why some people, even if they have a supposed defect, have these really good outcomes. It’s not a small number. What is that about? I think that would be a good book.

In part II of our chat with Jonathan Rottenberg, we get real about the morass of modern psychiatry. In Part III, we look at the truth about recovery. Scroll down to the bottom of the page to subscribe, find Jon on Twitter or Facebook, and stay tuned.

Also of interest:

Four pearls of “wisdom” we should outlaw TODAY

Why I hate it when you say, “That’s just the depression talking.”

I apologize for this outbreak of the total jerk who lives inside my head.

That article’s finally done. What should I make for dinner?

If you call that an article.

What’s that supposed to mean?

Oh, nothing. I just thought you were a professional.

Well I am. Aren’t I?

Sure you are. If you didn’t want to read through that mess one more time before filing, that’s your business.

What do you mean, mess? That’s 800 words of solid journalism.

Sure, just like that article from last week when you forgot a preposition in one of the sentences and your editor at NewsWorks had to ask to you fix the sentence before the story could run.

That was totally not a big deal. I’m pretty sure it wasn’t a big deal. He literally said it was a great article.

Maybe when you can remember all your prepositions you could write a great article before robots start doing it for us anyway.

Screw you.

Hey if you don’t want to listen to the voice of reason that’s fine.

Yeah, it is.

So you admit I’m the voice of reason.

That’s not what I meant.

You’re not on TV or the radio.

What the fuck does that have to do with anything?

I’m just saying that your colleagues are getting great regional media exposure while you’re writing essays and local news. It’s not like they’re older or better educated than you are. YOU’RE not breaking stories on NPR. What’s wrong with you?

Just because I like writing better than other kinds of media-gathering doesn’t make me a failure.

So you like listening to the radio and hearing your friends?

Yeah. They’re good reporters and I admire them.

And there’s NO part of you that wonders why you’re constantly stuck in hyper-local coverage?

Shut up.

Geez! Touchy, touchy. I’m sure you’re really good. In your own little way.

Dammit, I’ve done a lot of HuffPost Live segments, a G-Town Radio show, and in August I’m doing a WHYY radio interview about a story I wrote.

Other freelance writers are regularly working for national outlets.

So what? It’s not like they pay any better than local outlets anymore.

Sure, settle for steady pay over a shot at being Zerlina Maxwell.

I could be like Zerlina Maxwell.

How many blog subscribers do you even have? Like, less than two thousand, after FIVE YEARS of weekly toil? Whoop de doo. If you were any good you’d have a book deal by now and you’d be on Fresh Air with Terry Gross making people laugh and cry. You know who’s never, ever calling you? The producers of The Daily Show.

I don’t care that I’m not famous. I like my regular readers and I have fun.

Your friends are publishing novels and memoirs and writing for the New York Times. They’re smarter and harder-working than you are.

Good for them.

Yeah, tell it to all 270 of your Twitter followers. Way to win the internet.

Why can’t I ever just finish a single goddamn story in peace?

Oh come on, you know you’d be nothing without me. I keep you SHARP.

Do you realize I have an illness that hurts so stinkin’ bad it drives people to suicide? And I keep working anyway?

You’re weak.

How am I weak?

You have to take rests during the day.

Oh so lying down for an hour is a crime. This is why I freelance, so I can set my own hours. For my health.

I thought you were ambitious.

Just because I have an illness doesn’t mean I’m not ambitious. If anything, I’m MORE ambitious because I have a lot to overcome.

Ok so do you want ten “Congratulations!” balloons, or 50?

Fuck you. My friends would never talk to me that way.

Good thing I’m already inside your head then.

I don’t have time for your crap.

Yeah, you need to do the dishes and the laundry and mop the kitchen floor.

I WILL as soon as the Advil kicks in.

The sink needs scrubbing.

Yeah, it does.

You’re a rotten wife.


Hm? Sorry, what?

Shut up. I am not.

You’re not what?

I am not a rotten wife.

Tell it to your best friend. Oh wait, you don’t HAVE one, you’re a wary, emotionally withdrawn workaholic.

I wonder how that happened.

You know it’s better not to trust anyone anyway.

I guess.

Oh what are we eating now? A spoon of ice cream without even closing the freezer door?

Look, I really have a lot to do tonight.

No problem. I can wait. When are you doing your meditation and PT exercises?  I’ll come back then.

Like hell you will. I need to do my diaphragmatic breaths.

Yeah, breeeeaathe into that fat tummy of yours.

Newsflash: A writer isn’t an athlete.

It’s pathetic how much time you spend writing.

You JUST said I don’t work hard enough.

When did I say that?

Like two minutes ago!

I’m trying to help you.

Oh yeah?

Yeah. I AM you, you NSAID-popping mental sloth. With a dirty sink.

Oh for God’s sake I am just going to go watch The X Files on Netflix until you shut the fuck up.

Why don’t you just admit the two of us are better together?

There is no ‘us.’

That’s what you told the psychiatrists.

Are you telling me you LIKE antidepressants?

Because I can call outpatient psych right now.


That’s what I thought.

It fucking sucks when we can’t eat anything or get out of bed or write.

So let’s stay off the tricyclics, shall we?

And the SSRI’s.

And the SSRI’s.

Mid-90’s David Duchovny is so handsome.


Hey. You’re married, Don Draper.

Do we need to discuss Hugh Jackman’s campfire scene in Australia? The one where he takes the water bucket —

You know you have another deadline in the morning. If you go over your notes now —

Lay off, bitch. I know.

Geez. Sorry.

No you’re not.

No I’m not.

I know.

Then shut up.



You are gonna write the piece, though?


Three things you shouldn’t say to someone with chronic illness

This is a recent MRI of my lumbar spine. Can you spot the two bad discs?

This is a recent MRI of my lumbar spine. Can you spot the two bad discs? OUCH.

When I read the story about a Danish woman with multiple sclerosis who ran 366 marathons in one year — yes, one marathon every day for 364 days, and then two marathons on the 365th day — I wanted to hurl my computer against the wall, and not just because I’m jealous of her amazing feat.

“I can choose to be, ‘Oh, tell everybody I’m not feeling so well,’ or I can tell myself, ‘No, I want to feel good and tell everybody I’m feeling good.’ It’s my choice. That’s kind of a freedom,” the runner says on CNN.

Negative Nelly alert

I think this case is an extremely unusual one. Most of the time, it’s just not true that wanting to feel good and telling others you feel good when you don’t feel good will free you from your illness.

I understand the need to deny or conceal your medical condition(s). I do it every day.  Some of my doctors are surprised that I work instead of claiming disability for a slew of major health problems. But I love my work, and on most days, I find that You can do it is a better internal mantra than damn I need to get in bed and rest until someone brings me dinner.

But I also need days when it’s safe to acknowledge how tough things are — the days when it’s hard to walk, or when tears hotter than the water pour down my cheeks in the shower, because it’s the only time when nobody else can see me or call me on the phone, and something just slips.

Unfortunately, that safe space can be hard to come by, because it means finding people who are willing to see the pain when they see me, without retreating into fear, pity, contempt, platitudes, or unsolicited advice. In other words, just like cutting the high fructose corn syrup is as important to your diet as eating vegetables, pinpointing the things we don’t need is as necessary as focusing on what we do need.

My unsolicited advice for you

So this is a short and potentially painful, inflammatory list of things not to say to me, a person with a chronic illness.

  • “How do you think this makes me feel?”

This should be saved for when someone healthy is behaving in a cruel, disrespectful, or irresponsible way. It should not be used when a sick person is struggling. A truly debilitating illness, including a mood or mental disorder, causes stress to everyone who loves the sufferer, and the sufferer is very aware of that, even though he or she is no saint.

There may be other people in your life who can be an appropriate ear for the legitimate stress and pain you feel when someone you love is sick, especially when that illness is a lifelong slog, not the flu or appendicitis.

The plain truth is that sometimes, I just can’t handle your stress about my illness on top of my own stress about my illness. I apologize. But it effing sucks to feel sick all the time, and I’m not the emotional reincarnation of Hercules.

  • “Have you tried the [nutritional fad] diet?”

Most of the time, I’m willing to give you a pass on this one, because you have the best intentions. But here’s the thing. If I have been diagnosed with a life-altering and lifelong illness, I’m probably under the care of medical specialists, and a proper diet is already a component of the plan to manage that illness. I appreciate your desire to help, but don’t need diet tips from every corner.

My own diet, to manage problems like migraines, fibromyalgia, and interstitial cystitis, is already restrictive enough to affect every meal. I have spent over a decade on my own mission to track what foods and beverages work for my body.

Plus, I bet you a million dollars that Häagen-Dazs isn’t in whatever diet you saw featured on the raw/gluten-free/paleo/macrobiotic/probiotic/vegan recipe book table at Whole Foods this month. And if you wanna take away my ice cream on a rock-bottom shitty day, what’s left?

So remember, I’m already on a strict diet; stick to your own diet, and zip it, unless you are very, very familiar with my illness, and I ask for your advice.

  • “You’re too young for this!”

This one is the real topper, because I hear it all the time, from friends, family, colleagues, and even doctors.


It’s hard to even list all the reasons this comment makes me feel like crap, but I’ll try.

Yes, I do have some problems that are more common in elderly people than in people just shy of their 31st birthday. But remember — just because something is true does not mean it is appropriate to blurt it out over lunch.

I understand that you’re trying to say something sympathetic and I appreciate that, but really, how is this comment helpful? All it does is remind me of how debilitated I am. Part of the struggle of chronic illness for young people is that our bodies are indeed failing us in ways they ordinarily wouldn’t at this age. (If you dread aging in a healthy body, how do you think it feels when serious pain or limited mobility sets in before age 30, when everyone else is hiking and biking and birthing one cherub after another?)

Also, you may be dead wrong when you say “you’re too young for this.” Yes, pain and debility are usually associated with aging, but in many cases, a chronic illness is a matter of our genes, not our age. If I have the illness, I have the illness, and it doesn’t wait politely to strike until after I’m eligible for Medicare.

Think of adults with attention deficit disorder, something often associated with children. When the adult ADD sufferer has trouble focusing, would you exclaim, “You’re too old for this”? No? Then don’t pass audible judgment on how an illness relates to someone’s age. It’s not comforting and it’s not a compliment.

Beyond positive thinking

This blog post may just be one long example of why I am not as good a person as the Danish marathon runner. But it’s my truth. And it’s ok if you officially do not want to hang out with me, or read my essays.

I can understand the kind of positive thinking that allows a person with multiple sclerosis to run over 26 miles a day. It’s probably similar to what drives me to meet my deadlines and satisfy clients week after week. But positive thinking without an honest assessment of what really hurts — in our bodies and in what other people say — is like a hot air balloon without a basket. It floats uselessly away with nothing to let you get onboard and no way to ground yourself when necessary.

Do you have a chronic illness, or does someone in your life struggle with this? What are the comments that help or hurt you?

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Human health vs Hobby Lobby: Keep those lady-parts in the dark where they belong

I was feeling really sick recently, but I didn’t tell anyone because it wasn’t a human health problem. It was a women’s health problem.

Many of my Christian school teachers wouldn’t have touched sex education with a ten-foot speculum. It was the perfect prelude to entering an entire society which thinks separating reproductive concerns from health care is as easy as removing Mrs. Potato Head’s plastic nose.

Pregnancy: just don’t think about it

When I was nineteen, my middle-aged male urologist answered my questions about my recently diagnosed interstitial cystitis —until I wanted to know whether the condition would complicate pregnancy or childbirth.

He chuckled and said there was really no point in asking about that right now, is there?

Maybe he brushed me off because I was young and unmarried and, in his opinion, not ready for children. Maybe he didn’t care that urinary problems and chronic pelvic pain could impact a future pregnancy — or even the choice to start a family.

Now, I know these are ludicrous reasons to ignore a patient’s concerns. But at the time, I didn’t question my doctors. Cheeks burning, I hastily ended the appointment.

The wormhole to my uterus

I remembered that doctor because the question of corporations’ right to exclude their employees’ birth control from health insurance coverage is in the news again, now that the Supreme Court has ruled that corporations can opt out of the Affordable Care Act’s contraceptives mandate on religious grounds.

A lot of responses to this controversy have popped up, including reports that Hobby Lobby, a Christian family-owned craft store involved in the suit, objects to some types of birth control but invests in companies that make abortion drugs and IUDs, the latter being one of the very contraceptive devices Hobby Lobby healthcare plans deny its employees. Another writer veers into a rant about China and its human rights abuses, the point being Hobby Lobby’s hypocrisy, buying many of its products from a country where forced abortions are rampant, while the company opposes abortion and even some kinds of birth control in the US.

Judging from the level of anger about what we’ve dubbed the “Hobby Lobby decision,” I’m guessing that a lot of people don’t realize Hobby Lobby isn’t refusing to cover all contraceptives: just the ones it believes, based on faulty knowledge of medical science, to cause the demise of embryos, rather than preventing fertilization itself. Hobby Lobby insurance policies will cover your vasectomy — and your tubal ligation.

That doesn’t make this decision any better, though.

I suspect politicians, CEOs, and bishops who want to thwart people’s access to some kinds of birth control are operating with the same mindset as my former urologist.

To them, reproductive care isn’t like pulmonary, cardiac, neurological, digestive, dermatological, or orthopedic care. It’s as if female reproductive organs exist in some kind of separate dark universe subject to others’ practical and ideological whims.

Git ‘er dead

Catholic hospitals which will let a woman die from a miscarriage gone septic rather than treat her by removing the doomed fetus are one of the most extreme examples of the toxic refusal to integrate female reproductive health with overall human health.

Corporations now trumpeting “religious freedom” to oppose Affordable Care Act provisions requiring comprehensive contraceptive coverage for employee health plans are mired in the same fallacy. Even if you ignore the fact that the decision of whether or not to become pregnant has enormous full-body health implications, these objectors are conveniently forgetting that some contraceptives, particularly the IUDs in question, treat debilitating conditions like endometriosis, Polycystic Ovarian Syndrome, or premenstrual dysphoric disorder. In other words, “birth control” isn’t always about family planning.  Welcome to modern medicine!

But because we’re talking about girl-organs, a fellow human being’s health is your “biblical” corporate objection. And just because the practical outcome at hand is the access to some forms of birth control over others (touted as a minor issue by some commentators in the why-can’t-we-just-all-get-along vein) doesn’t make this decision any less poisonous.

As many other writers have pointed out, I would like to see the courts defend a Jehovah’s Witness who denied his employees coverage for blood transfusions, or a Scientologist CEO who objects to coverage for antidepressants.

Let infants take their chances

When I tried to shop for health insurance before Obamacare, many affordable policies explicitly excluded coverage for pregnancy or maternity-related costs. As a married thirty-year-old woman in a country where a healthy birth routinely costs tens of thousands of dollars, I knew this was a preposterous excuse for insurance. These insurers probably don’t realize it’s an illusion when magicians saw women in half on stage. In real life, you can’t manage your overall health while ignoring your reproductive health.

Take the folks who are angry because the new law requires many insurance policies to cover contraceptives and maternity care. They think a system providing adequate health care for women and their babies places an unfair burden on people with penises, who should be able to buy policies from a pool that excludes women’s care. Is it worth mentioning that woman don’t become pregnant on their own? Or that adequate pre- and post-natal care prevents a host of tragic, expensive medical problems that weigh on the entire system?

Please, show me someone who doesn’t owe his life to Mom’s oh-so-problematic parts. And then continue insisting that “women’s care” is an unfair use of your resources.

Viagra ≠ the Pill

Even people on the liberal side fall into the Magical Segmented Lady trap when they point out the moral and intellectual outrage of denying women some forms of reproductive care by calling for the same insurance policies to drop coverage for the treatment of erectile dysfunction. If you don’t want your female employees to access all birth control options, the argument goes, by gum, you should prevent access to medicine for erectile dysfunction, too.

But men paying out of pocket for better, longer-lasting erections aren’t in the same boat as women who face the risks of pregnancy and motherhood without a budget or support system for proper care. This is a false equivalence that only serves to further compartmentalize human health care, instead of accepting the reality of the whole body, male or female.

Cover your eyes, this is gross

So, back to my recent sickness. My hellacious periods, suffered in silence, remind me twelve times a year that my reproductive organs don’t have the same status as the rest of my body. It feels subversive, tacky, and risky to mention that my periods make me think that God, if God exists, really doesn’t like women.

(Turns out some of the troubles are complications of interstitial cystitis. Coulda mentioned that, oh crappy urologist of my youth.)

After several days of widespread pain and what could at best be called a virulent passive death wish, the real fun starts, usually at dawn on the 28th day. Even with multiple medications and attention to physical and dietary triggers, I am often immobilized for several hours by the pain. Hours of crushing nausea are an occasional bonus, but the eight-hour migraine, more defiant and immovable than Bashar al-Assad, is unavoidable.

This is the first time I’ve ever publicly mentioned this, because one of the only ways we’re allowed to talk about menstruation is memes of female psychopaths demanding chocolate. I don’t know who these people are. I don’t eat chocolate before or during my period because caffeine increases the agony.

(All this is also worth saying here because some of the birth control options corporate insurance policies can now withhold from their employees on religious grounds include devices or medications that can treat symptoms like mine.)

So be ashamed, embarrassed, and misinformed. Mock your period as some kind of alien invasion and don’t reveal that you’re hurting. On the same principle, let your teachers and your doctors ignore your questions about sex and pregnancy. Let your culture and health care system rope those ovaries off from the rest of you. Let clerics, corporate owners, and judges you’ll never meet determine your healthcare options.

Because this is a modern free society.

And reproductive organs don’t deserve the same roster of options as all the other parts of your body.

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I have seen the price of evil, and it’s $7.99

Sometimes, you have to give something the benefit of the doubt. And sometimes, you just know.

With a parent devoted to an extremely eclectic and successful eBay store built on hundreds of items purchased at auctions and garage sales, I see a lot of odd things come and go in my parents’ house.

Antique campaign buttons. Collectible perfume bottles. Unspeakably ugly poodle figurines. A fuzzy brooch in the shape of a skunk.

Internet dating sites (that endless, insufferable pool of encounters that is fodder for every wannabe comic and essayist in America) are trying to prove that there is someone for everyone, and eBay proves that no matter what the item is, somebody somewhere in the world will pay to have it shipped to their door.

You remember that doll from The Conjuring? Of course you do, that shit was creepy as all get out. Some people say there’s a true story behind “Annabelle” in the movie, a frizzled, dirty, glassy-eyed toy that begins to walk around an apartment by itself, write cryptic messages, and eventually trash the place.

There are websites that claim to reveal the real Annabelle, an absurdly large and smiley Raggedy Ann doll from the 70’s, which “demonologists” Ed and Lorraine Warren (of Amityville Horror fame) eventually subdued after making off with it in their car.

As the august publication notes, “Ed agreed to stay off the highway because there was a concern that the demon [in the Raggedy Ann] might fuck with the car.” Good thing, too, because their brakes kept failing, so Ed “sprinkled the doll with holy water” and the car starting working again.

See? Even demon Raggedy Ann knows Jesus, so why don’t you read that Jehovah’s Witness pamphlet on the bus already? Also, I went on a ski trip once, and I shit you not, the host had an entire room full of Raggedy Ann and Andy dolls, just lining the shelves and bureaus, grinning. Like Alfred Hitchcock’s birds but with red yarn hair instead of feathers.

You can bet I pitched my sleeping bag elsewhere.

The point is, clown dolls are bad news, but does my mom care? No. She goes to the auction one night, and she brings this home.

Somebody owned this.

Somebody owned this.

As faithful readers already know, I’ve been staying with my parents more than usual lately because some serious health problems have been getting me down: I have lumbar degenerative disc disease in this mad storm of interstitial cystitis and clinical depression, and last week a psychiatrist told me I have a borderline personality disorder because, in his opinion, I write too much (the note-taking, this writing-for-a-living, it’s obsessive, you see) so I’m in delicate shape overall.

But does my mother, the woman who drives me to the orthopedist and makes me blueberry smoothies and rubs my back and otherwise loves me beyond reason, try to protect me from the clear influence of evil?

No, she does not.

She buys this antique wind-up clown doll with fleshy plastic feet-hands and keeps it in the living room while she lists it on eBay, and I work a mere two or three rooms away, vulnerable and impaired by various physical and psychiatric diseases.

And yes, someone bought the doll on eBay.

Somebody saw this doll online, thought, “I need to bring that thing into my home,” paid my mom the full asking price of $7.99, plus shipping, and had that cloth-and-plastic horror mailed to their house. In (I kid you not) Salem, Massachusetts.

I don’t know whether to be overjoyed that the thing is out of the house, or to whisper a prayer for the clown’s new owner.

Because really.

I know evil when I see it.

bad clown face crop

Sleep well!

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