Wednesday, May 16, 2012


Following a trip to a North American city, a native New Orleanian and old friend commented that the people in that other city which will not be named here just didn’t get it.  He added that there was no Lagniappe there.  Lagniappe being a French-Creole word denoting something extra typically provided by a merchant upon request so as to aid positive mutual recognition within a transaction, thereby increasing the pro-social aspects of business. Mark Twain called Lagniappe, "a word worth traveling to New Orleans to get."

The significance of the word itself continues to be felt within contemporary New Orleans culture as evidenced by the local newspaper’s weekly entertainment guide being called Lagniappe.  This is to say that the word enjoys a reference point beyond mercantile transactions within contemporary culture, as it also points to general cultural heritage and entertainment. Some have referred to it as “a mini philosophy that reminds us to give just a bit more in our lives, relationships, and joie de vivre!”

A philosophical position that supports giving as important is especially timely now that increasing privatization and depressed economics appear to be the norm.  Simply, when Peggy Noonan takes time away from economics to focus on psychological factors within the Wall Street Journal, we should all be paying attention.  She writes of having “long thought that public dissatisfaction is about more than the economy, that it's also about our culture,” and in that same article she refers to the culture of the United States as flat and brut.  Noonan considers living in a flat and brut culture that has no Lagniappe (no, sadly she does not use the word) to have led to a crisis of character.
As a psychologist I know a bit about character and crisis, and want to take some time to discuss it as it happens to be mental health month Present a monkey with an unwelcoming situation and it wants to find a receptive tactile place to feel held.  Furthermore, if the environment is flat and brut as Noonan describes – that is unrewarding and experienced as impossible, one may begin to stop the active search for an experience of security.  Some call this learned helplessness, and it is considered to be a behavioral model of depression. Its counterpart of course, is resiliency, which requires some sense of faith.  Within the urban landscape, the loss of assertive engagement due to a displacement of faith has been documented.  One oft cited example is the by-stander effect (Click here to read of Amy Winehouse’s death as an example of this).  The effect is so named as by-standers rationalize a lack of engagement via the faith based assumption that someone else will respond to a crisis. 

Noonan is responding to a level of apathy and cynicism that goes beyond the by-stander effect as she describes a perversion of selfishness in which some appear to have no concern that someone else will respond.  To the extent that her concern is warranted, we might say that our collective character has become severely depressed.  The smart-phone using isolationist bubble she describes sounds much like what Sigmund Freud considered a hallmark of severe depression – the shadow of the ego falls upon itself.  That is to say, social or interpersonal activity is lost to fetishistic or severely limited engagement.  We may question if this is due to a loss of viewing anyone else as being fully human, a failure to recognize suffering, or a cynical combination of these factors leading to a failure to experience empathy or compassion.  This would then be considered a narcissistic or self-occupied depression.

In her latest book Alone Together, Sherry Turkle follows Hannah Arendt’s concern that we may not be able to benefit from our technological advances due to our culture’s repudiation of creativity and social engagement over technical know how.  Without a creative society there is little room to value engagement with difference much less recognize human cultural interaction as valuable in its own right.  The illusion that being alone without community is O.K. is different than being  able to work with feeling alone or lonely while also being connected to a community.

About one week ago , Arlie Hochschild also expressed concern regarding our national character in the New York Times – From her Sociologist perspective she makes an argument of lost autonomy due to a chronic desensitization to one's feelings resulting from a perceived need to present a false social self.  This dovetails with Noonan’s concern that we don’t take enough personal responsibility – that like a passive by-stander we settle for being told that someone else will take care of it - us - as opposed to risking creative self expression and responsibility.

Unfortunately Hochschild also suggests that psychotherapy trades in securing such an inauthentic self  as opposed to working to foster autonomy and resilency within the clinical encounter.  Her generalization is unfortunate as it misses that psychotherapy is complex and that there is variance among practitioners (by discipline and skill) in addition to there being difference among patients. Her argument arises I think due to an old problem within the social sciences.  Namely, pointing out that individual differences exist within groups of people complicates matters.  Hochschild does little to support the idea that folks attend psychotherapy for a variety of reasons; much less that treatment could help to benefit a productive and engaged society.  Despite those short comings, I am pleased that she is addressing social isolation, market penetration into emotional life, and the difficulty of creative thought.  As a provider of psychotherapy, I know as many studies show – it works and often requires time.  Further, there are many reasons (dignity for one) that it occurs outside of the public square.

It seems to me however, that when psychotherapy goes well, that it does have a positive impact on life beyond the consulting room.  Disclaimer: Lagniappe here is implicit that is to say subjective.  A test to examine what is happening in a particular therapy relationship at a particular moment in therapy:   Is it an end in itself (if so why?) or does the therapy relationship have other aims in regard to how one finds meaning and engagement in general (that is past, present, and future).  To consider a particular therapy an end in itself would be to suggest that intensive critical care is needed for an individual or to trade in the crisis of character (loss of individual responsibility) that Hochschild and Noonan lament.  Fortunately, I don’t know any professionals that would consider maintaining much less fostering isolation and dependency as opposed to facilitating growth to be good treatment.  Closer to the mark is a recent Huffington Post entry by another provider of psychotherapy -  Robert Stolorow.  There he defines character as “the array of a person's pre-reflective organizing principles and the corresponding horizons of emotional experiencing,” and considers that psychotherapy can alter these organizing principles – in part by helping one to become aware – that is reflective in regard to their own organizing principles so that increasing freedom and maturity may be found. 

So, if you are shopping for a psychotherapist consider asking if the  practitioner you are meeting with believes that living in a democracy comprised of thriving communities populated and maintained by diverse and motivated individuals is a sign of mental health.   By extension, should one’s desire and ability or lack thereof to engage or seek out such connected activity be part of the focus of treatment?

Recently, mindfulness has is enjoying a second look as an explicit companion to the psychotherapy journey. I say a second look as Freud’s conception of associating to what had been disassociated may be viewed as a mindful practice in its own right.  However, the focus is somewhat different within the mindfulness practice that typifies Zen.  One element that stands out in Eastern practice is an understanding that autonomy and dependency may co-exist in an integrated as opposed to hostile fashion. Related to this is cultivating compassion in the face of suffering.  For that to happen one has to be able to recognize suffering. This is often difficult, and is according to Noonan possibly harder outside of the consulting room or meditation hall due to the absence of a helpful other to initiate a different way of seeing.

A UC Berkeley study found that individuals in the upper middle and upper classes were less able to detect and respond to the distress signals of others, and one of the studies authors suggests that due to a lack of difficulty among the affluent that there may be a subsequent lack of implicit sensitization to signals of suffering.  The idea of sensitization is important, and here that means a conscious awareness that someone might require help - that is that they are alone and that they are not OK being alone and that the observer of such suffering is in a position to respond with compassion.  So, in addition to the recognition of suffering compassion requires conscious autonomy, a feeling of connection, and a faith or hope  in a capacity to provided soothing care.  

Mindfulness practice is about explicitly working to become aware of what is happening in the present moment.  To that end, the musician Jay Z’s lyrics have been recognized as sounding, well, Eastern.  He sings of connecting to the moment, now, and moving forward.  Moving forward fosters connection when engaging suffering mindfully.  That is having an open heart and mind, and eventually by applying the discipline of looking deeply at whatever is happening with the tools that may be developed in meditation and/or psychotherapy - a willingness to working with if not through stuck points.  Otherwise, we maintain a crisis of character.

As a new version of the psychiatric diagnostic guide is presently under construction, maybe we should consider a new disease syndrome within psychiatry: Lagniappe Deficit Disorder.  Signs and symptoms of LDD would entail – averting eye contact, not smiling, and a general sense that community is irrelevant occurring more days than not for at least two weeks.  This would of course be found to commonly co-occur with anxiety and depression.  We might debate at what age an individual could reliably be diagnosed with this syndrome and if such a disorder could occur in childhood.  Treatment could be pharmacologically based, but would hopefully entail making contact and cultivating compassion through giving a little something extra.  Maybe the only thing wrong headed about that is the suggestion that Lagniappe is extra – my stance here is that extra is not extra, that it is essential.  It might also be considered that such work may be found at the smallest level, but that in order to rehabilitate the culture at large we simultaneously consider what large scale democratic and compassionate change might look like.  I for one want to live in a version of the United States that Mark Twain would appreciate and want to occupy. 
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