Suicide: Why do we do it?

One of the most interesting classes that I took as a patient at McLean Hospital was given by Dr. Taylor. In it, I learned a theory why people commit suicide. This class was unusual for many reasons. First it was unusual, because as we sat in the room, Dr. Taylor walked in with a few interns, who proceeded to close the door and guard it. The door was normally left open for classes.

Dr. Taylor proceeded to tell us that he was going to give a talk about feelings. He told us that when he had first started teaching the class the door was left open and this had been a problem. One patient hearing his talk left and tried to kill himself within minutes. Dr. Taylor explained that what he was about to teach us, was so powerful that, that we need to learn about it in order to keep from killing ourselves or doing something drastically.

First, he reviewed the cognitive behavior therapy(CBT) model, which states that our psychology can loosely be classified into three components: our feelings, our thoughts/beliefs, and our behaviors. Each influences the other. The one thing we cannot control is our feelings. Emotional health is defined in part as having an ability to recognize these three aspects of our thinking as well as learn how to use our thoughts and behaviors to regulate our feelings.

Dr. Taylor then began to explain the concept of emotive dissonance. Many people who are brought up in less than ideal conditions struggle because they do not know how to regulate their emotions and are often unaware of them. Emotional awareness and expression were repressed. As a result many people grow up relying on external cues to try to figure out how they feel.

Have you ever heard someone say “I think I feel…” That is emotive dissonance. Feelings are not thoughts. When people do this, it is because they don’t know how they feel, and their mind is actually thinking and trying to figure out how we feel. Our mind generates a feeling based upon an interpretation of the environment. Feelings are not something we figure out, they are something we just are aware of.

He explained that most of us were in the hospital because something major probably happened to us within the last two months. This statement received quizzical looks as people polled their lives and quickly nodded in understanding and agreement.

The reason this is the case, he explained, is that we relied on something external in our lives to help us figure out how we feel or to provide us with emotional regulation. When that thing is removed, we lose our ability to regulate and we find emotional distress.

People can go their whole lives relying on something. For example it can happen in a marriage when a partner dies, the survivor suddenly loses their ability to regulate.

When this external thing is lost, for many people their minds quickly begin to try find their emotions, and not being able to find them, the mind gets confused. There is a disconnect between our mind which says we are alive and our feelings which do not exist and we seem to feel dead. We conclude we are emotionally dead, and to fix this contradiction, our brain desires to make us physically dead to provide consistency.

It can be tempting as Dr. Taylor explained upon hearing this to try and understand your feelings, if you don’t, and that this is dangerous if you don’t have professional guidance. So his suggestion was don’t do it. Live with not understanding.

Get a Discount: Anywhere

One of the secrets of the business world is that if you label something people think it's not negotiable. Do you want to save some money? Try this trick. The next 10 times you go shopping, ask the cashier or clerk if there is any way you can get a discount. See what happens. This includes any place you buy things including online and at hotels.

Here are a few examples of my own experience. I went in to Banana Republic and bought a few things. I asked at the counter, "Is there any way I can get a discount?" The sales clerk looks puzzled, and then thinks and says "It wasn't folded properly, so I suppose we can give you a damaged good discount of 20%."

Whenever I order from King Arthur Flour, I call them or chat online and ask for a discount. Often they will give me free shipping ($20-50 savings).

Hotel room rates are often negotiable. The next time you book a hotel ask for a discount. I just booked a hotel room in China that was normally over $200/night. I told them I was staying a month (even though I am only here 21 days) and they gave me the room for $2900, which is $138/night (21 days) or   $93/night (31 days).

I asked at a cafe once, and they gave me a free cookie.

Gandhi Rule: One Way to Respond When Feeling Violated, Disrespected, or Angry.

This is a lesson about compassion that I learned the hard way, but wish I had learned earlier. For those of you who I have not been kind to or patient with, I apologize. I share this in the hope that others may benefit and learn from my mistakes.

I have come to love principled non-violence over the years, not because I feel bad about hurting others primarily, but because I lose respect for myself when others are hurt due to my actions. It took many years to realize that my feelings of anger towards others and my own irritability came from the fact that I did not respect myself. I lacked internal strength. My negative thoughts towards others hurt me more than they hurt others. My girlfriend has a quote she likes, which is "You have to respect yourself first."

I've heard a few stories about Gandhi, that illustrate this point and serve as a reminder to me. The first story goes something like this. One day Gandhi received a letter from a boy. The boy said, "I was being bullied and I wanted to punch the other boy, but I remembered that I should act non-violently and I decided not to hit him, however, I felt ashamed afterwards."

To which Gandhi replied, "You should have hit him", and added something similar to his famous quote, in fact this might have been the point where it originated, "it is better to be violent, if there is violence in our hearts, than to put on the cloak of nonviolence to cover impotence."

A frequent thing that Gandhi did in regards to being uncertain how to behave when he felt violated or that something was unjust was to choose not to act if he didn't know a better way. 

This can be seen in the Gandhi movie at one point during his South African struggles, when Martin Sheen's character, a reporter, asks "What do you think an important professional should write about your response to General Smut's newest legislation?" 

To which Gandhi replies "I don't know. I am still searching for a response." Not knowing what to do, is okay, and maybe as good as you can get for now.

Gandhi Rule

That leads me what I call my I call my Gandhi rule. Whenever I feel compelled to act to fix a situation or respond to feeling disrespected and my feelings contain anger or malice it means I am allowing others to dictate my self-worth, and that I don't respect myself. Instead, I can choose to do nothing. I must first find respect in myself. If there is a real problem that needs to be addressed, I do can do it later. I can wait until I find a more compassionate solution. If I do not respect myself, there is no action I can take that will create respect in others or create meaningful lasting change. The reason I wait is not to be nice to others, but because I don't like the way that I feel about myself when I don't act from a place of strength, and I am the one who is left unhappy afterwards.

Charging Your Customers an Hourly Rate Can Really Hurt You: Some Ideas on Doing Better

One of the biggest mistakes I think a person or company can make is charging by the hour. Everyone loses. This applies even to employees.

Ultimately when we charge people for our services we want to do two things: make money, and serve our customers. Neither of these things go well when pricing by the hour, because your value is not clearly expressed. If you think about pricing you can really improve how much money you make and the value your customers receive.

One of the first principles of pricing is to frame yourself in comparison to your perceived nearest competition. When you price by the hour, you are perceived as a commodity, and in commodities, low price is of the goal. Keep in mind that customers often think about the total cost, not the hourly cost. That is how they tend to measure value.

One of the biggest problems with pricing by the hour, is that it does not have a multiplier built in. It's very hard to make money when you work once and get paid once. You have to find a way to work once and get paid multiple times, this is a key to doing well. You'll be hard pressed to find people who are successful in any terms who are not applying this principle. For some companies, having a multiplier means producing a product. Design a product, sell it many times. For actors, it's get paid for a movie, sell it many times (royalties).

This is possible even in service related businesses. Hosting companies charge a monthly service, or bandwidth charges. Do you have a dirty yard because of the dogs? Doody Calls (www.doodycalls.com) will clean up for you at various levels and frequencies depending upon what you pay for.

The other problem with pricing by the hour is that you have no flexibility in the quality of work. When I first started, I worked as a software engineer and I tried pricing by the hour and I often struggled because sometimes I wanted do way more work than required because of my quality standards or I enjoyed the project. I cannot charge the client for this. At times I would say that I did more work than required and tell the client that I would not charge them for this, but somehow I found this damaging to my reputation, it sounded like I should just get paid less per hour because I wasn't that good. On other hand, sometimes I was able to work very quickly and perform amazingly well, but in those cases I get paid less because I worked less hours. I was penalized for doing a good job.

So how can you switch into multiplier mode and escape hourly rates? Let's consider some commonly hourly business and the ways in which they could reframe themselves. As an overriding principle focus on what the biggest value you offer to your customers and what customers want most from you. Also consider packages or levels of service. Packages make it harder for your customers to compare you to others, and it encourages the customer to focus on overall value.

If you're web designer an hourly rate can be a problem you will want as many hours as possible while you're client will not.  Consider instead perhaps that you could focus instead on a total fixed project cost. Or consider using a common base design or template and selling this.

Or perhaps you can charge a fixed up front cost and a fixed monthly fee for ongoing maintenance. This could work for you and your customer as most sites require constant maintenance and it is in your best interest to provide a consistently high quality site since the customer is a reference and reflects your reputation.

If you're a therapist consider creating videos or books that you can sell to your clients. Or perhaps you can offer regular lectures to all your patients on a particular topic and charge for these. Or perhaps you could offer a paid video education series on particular health topics.

You could also consider a monthly fee and be more flexible in your services, such as offering various levels of telephone or email support for your clients when they are suffering rather than a weekly session, such as 9-5, or 24x7. Or perhaps they are allowed one out of session emergency call per month. Perhaps you throw in your monthly lecture when they at a certain price point. Or perhaps you could charge for various stages of the treatment process, such as one price for a diagnosis, and another for progress along the treatment path.

On the other hand, if you're in the field of construction or a contractor, consider instead charging a fixed rate for the project, or for various levels of quality. Consider, like the above suggestion for web designers, a monthly or annual maintenance service.

Let's consider some pricing options if you're a music teacher. Like a therapist, consider offering packages of services such as lectures, online instruction, telephone support, or practice reminders. Perhaps you can offer tools to help your students track their progress. Consider group classes. You could also charge based upon time of day or the day of the week. Certain time slots during the day or during the week are more valuable than others, both to you and your client. You could consider having more experienced students teaching less experienced ones. The more experienced students getting a discount or something for what they teach to others, or simply paying them outright.

You could price more like tuition than per individual classes and offer a comprehensive set of things or make a more complex set or requirements in order to be students. For example you could require students to take certain courses (group classes), or required they teach a certain number of other students.

With all these pricing ideas, the overall goal is that pricing by the hour is dangerous and it is very difficult to get ahead with that model. Focus instead on the greatest value you provide. Consider offering packages of services instead. Think about the ways in which you repeat certain aspects of your job over and over and try to capitalize on that with things like videos, books, or lectures.

Do you have a situation in which you are paid hourly and would like to escape? Do you have other to help others who are stuck in the hourly pricing model? Tell me and maybe we can share ideas.

Basics of Health

Health Problems

I am not a doctor, but I play one on the Internet. I believe health problems can be divided into two major categories: symptomatic and chronic.

Symptomatic Problems

Symptomatic problems are those that are generally imposed from outside or involve treating specific symptoms. I heard Dr. Weil says that if is his arm was cut off, he would want to be taken to a hospital. This is the realm of conventional and traditional medicine. 

Crutches are a good symbol of symptomatic medicine. For symptomatic problems we want to support our own bodies ability to heal to bring us back to health.

Chronics Problems

Chronic problems are the ones that last for a long time, and can easily be life long. These include heart burn/reflux, chronic fatigue syndrome, and cardiovascular disease. 

If you look for remedies for chronic conditions you will have a hard time finding clear remedies. The problem is that in most cases there is a fundamental problem with our overall health. 

The exact treatment depends upon the individual, but most people respond best to the same things that make us happy and healthy overall: low stress, a good diet (mostly fruits and vegetables), and moderate exercise (like walking). This is in some sense common sense. We might debate the merits of what exactly a good diet is, but these things are subtleties. 

The other good news is that basic health also minimizes symptomatic health issues as well as prevents them. Stress for example makes you more prone to injury. All of these together minimize your chances of cancer and heart attacks.

Metta Meditation: Using Love to Help Heal Trauma

I have been diagnosed with complex PTSD and I have a severe history of abuse and neglect.  I have learned many techniques over the years and many have been exceptionally helpful.  These include: support groups, psychodynamic therapy, DBT, CBT, yoga, and vocational therapy among others.

All of these things are like different exercises that you might do at the gym, and like those exercise have some benefits in relation to some aspect of my trauma, but none of them can solve all my problems. Furthermore, each of them has downsides. Psychodynamic therapy is expensive. CBT can get me too into my head. Overall, like exercising your body you often need multiple methods to keep you fit.

There is however one technique that seems to always work for me on some level. This is the meditative practice of cultivating love and compassion called metta. We try to think of people and develop a feeling of warm hearted compassion for them.

Do not confuse this with open acceptance of the rights and wrongs or letting people take advantage of you. In my case, I can develop a feeling of warm heartedness towards my deceased mother who hurt me dearly without supporting the harmful things she did. Developing compassion is about being able to wish the best for any person and develop respect for them even if you don't agree with their point of view.

Here is what I like to do. First, every day I try to set aside at least 15 minutes. I find I can do this when going to bed, during a middle of the night waking, first thing when I wake up in the morning, or anytime I have a few minutes to spare.

Second, I try to come up with a group of people to think about. It could be all of my family members. It could be that I go through the alphabet and try to find one person whom I know for each letter of the alphabet.  It could be old girlfriends, old classmates, people I met yesterday, or parents at school. I like to mix it up to keep it fresh and always be reminded of all the people in this world who I have known.

Then, person by person I bring the person to mind as vividly as I can and I imagine saying the words to the "May you be happy. May you know peace. May you know all the causes and conditions of happiness. May you be truly happy." Sometimes I follow this with personal loving comments directly related to them. Sometimes I add a prayer.

What also helps, is that after each person I also think about how my physical body feels. I notice the entire feeling in my body from my head to my toes. The feelings in my face, my arms, my back, and all over. Sometimes the improvement is almost not noticeable, but as I go through more people and practice regularly there is definite improvement.

Parenting: Half an Hour a Day

I grew up in an extremely abusive and neglectful family and life. So like most people my parents were far from perfect. So I try to think about what could have been different. While the ideal would have been for them to get their act together, that's not realistic.  That's a difficult a disk for any of us. However if there was one thing my parents could have done, it would have been to spend a half an hour a day with me.

By "half an hour a day", I don't me simply being in the room or house with me or watching TV, but just sitting down with me and whatever I was doing. They would not really have had to even talk. They would not have had to play. They could still have their issues. However, I would have wanted them to just be there and not be doing anything else. No cleaning. No household chores. No phone calls.  Just sitting one on one with me. Just present with me.

As a parent sitting like this is hard, but I think it demonstrates many things that are useful to a child. First, it shows that the parents are available physically and to a large degree emotionally. This builds a sense of safety.

Second, it builds stability. Knowing that I would have had some quality time with my parents on a consistent basis provides order to my life. Something I can count on each day.

Third, it nurtures self-esteem. Just being, regardless of what I am doing, would have said that I am okay just as I am, doing whatever it is that I do. As a parent, I find just sitting builds my own self-esteem as well, and that I provide a role model to my children.

Have you tried just sitting with your child for a half an hour and just being without doing anything? It really challenges your sense of self worth and you have to learn to accept that who you are, just as you are, is good enough. This mirrored back to the child.

Fourth, having my parents be there in this way would have allowed my physical body to relax and just sit. No need for constant activity and distracting. Just letting my mind rest. In a way it would have been like a form of childhood meditation.

Even as  I child I think I could have understood how crazy my mother was and separated her craziness from my self-esteem. I could understand how she has other things in life she has to attend to. My self-esteem would have been stronger and I would be much more prepared emotionally for all the trauma that occurred in all aspects of my life. I would have been much more able to survive the abuses from everyone. I would have more strength to face the injustice and realize it wasn't me.

So my goal is to spend at least a half an hour a day with my kids everyday.