Commentary on Hope Theory and More Griping on What We Are Getting Wrong

Commentary on Hope Theory and More Griping on What We Are Getting Wrong

              I am posting this piece as a part of the series of writings I am doing in relation to pursuit of my dissertation.  They are also an effort to document and process the thoughts and experiences of the last decade.  They will also reflect the deep concern that I feel presently, that almost every institution is failing us.  As a Father of three I am terribly concerned I am most concerned about the education system and healthcare.  Since, I am not an expert in education I will not spend as much attention there.  But, I will start with a gripe to illustrate my concern.  I have sat with my son and worked on math homework.  I have no fucking idea what he is doing.  Not math.  I know math.  I know how to teach someone math.  I don’t know how to put a number in a magical box that blends with another number that you put into an acorn and feed to the squirrel illustration at the output of the magical box.  That’s not even how squirrels find acorns and it’s my guess that we aren’t doing well in biology either.

              What was wrong with the abacus? I am also concerned about reading.  At the risk of sounding horribly pretentious, I wonder how will my children encounter Shakespeare, Whitman, Frost, e.e cummings, Plath (we will hold off on her for a bit)?  I found these in 11^th grade, and literature has probably sustained me to this point in my life.  However, this was incidental to the larger picture.  At that time, I was disengaged almost entirely with the education system.  I was increasingly alienated from what would have been considered normal or average social behavior, if that even means anything in high school.  But, I had this interest in literature that blended with my delinquency—I recall shoplifting Robert Frost.  Sometimes, a pang of guilt hits me and I think of B. Dalton going out of business and that I may have contributed to it, but that is probably grandiosity.  This is mostly digression, but does illustrate my larger point that I want my children to have something they are passionate about, and I worry that they may not have the luck that I had in just happening on it. 

              I remember concluding, I guess it is on me then.  I can’t expect that the children will be exposed to the content that I would hope, because I am increasingly losing hope that the education system in its present trajectory is going to do that.  And this pisses me off, because I pay a shit ton in local taxes.  And, it pisses me off because I am a single parent, and there is literally only so much time in the day, and between dinner and other activities I simply don’t have time to learn magical math.  I know how to carry numbers, I can do long division.  And, I am fortunate enough that I have another parent.  I have a number of friends that are 24/7 single parenting.  I really have no idea how you do it.  I want you to know that I think of you often when I am at my lowest, and unable to find motivation to read another journal article, take the daughter to girl scouts, attend to the youngest who just punched his brother who has mastered playing Mr. Innocent. 

              I know that I sometimes express gratitude openly, emotionally, and unabashedly, to the point that some might suspect I am getting at something.  But, I can tell you that it is because of pure recognition of how lucky I am.  None of what I have achieved was possible without others, and I have been so close to failure at times, and so close to giving up, exhausted physically and emotionally to points that it was a struggle to get out of bed. Yet, I get to pick up and start again, step ever closer to the thousand daydreams that occupy my mind.  I am increasingly convinced that I find this “hope” because of the interdependence and stability afforded to me by the network around me.  I get to pursue this dissertation because I have a remarkable degree of freedom, and that comes from trust in family and friends, which in turn creates accountability.  I express gratitude because it is so easy to miss, ignore, or dismiss the countless good deeds and gestures that others offer me daily.

              All of this is on my mind because I have been reading on Hope Theory.  It comprises one of the four cornerstones of my dissertation project.  I have been reading on it for the past three years.  Sometimes, it morphs into something different than what I assumed it was saying.  I come back to it, sometimes an insight occurs that I never noted before, or it combines with an experience that crystalizes everything.  This is where I am at, and I am sharing because of concerns that emerged from my own experiences as a parent and because of the past 20 years working in the behavioral health system, which comprises one of the poorest areas of functioning in our healthcare system.   I also see similar parallels with the education system that I anecdotally described at the outset.

              First, do not pin your hopes on the mental health system.  It is under resourced and not up to the task that society sets before it.  It might work in an ideal condition where the social safety net was not a cruel joke.  And this is not to say that there are not outstanding providers or good treatment available.  It is, and I have seen enough people make remarkable progress.  Acute mental illness is often responsive to medication.  I have seen people make remarkable progress in therapy as well.  My concern is much more systemic and that is where a great deal of the present suffering is inadequately addressed. 

              I recall an opinion piece in the New York Times written by a psychologist who lamented that we were losing the ability to treat despair.  This was when I was about 15 years ago, when I was entering a master’s degree in counseling.  It remains prescient and timely.  Again, acute depression responds well to medication and therapy, and this is about the only thing that our mental health system seems capable of delivering.  As such, you may manage to recovery from the physical symptoms of depression—your sleep cycle may adjust, you may become less fidgety, less bothered by intrusive thoughts.  But, I probably have done little to treat the underlying conditions driving despair—broken communities, drug addiction, trauma, etc.  You come to my office, you get 50 minutes, I teach you how to toy with your cognitions, I provide you a label that insurance mandates in order that I get paid, so I can be effective and not worried about continuously slipping out of the middle class myself, the next person will be at the door shortly, you will leave with some type of gnawing issue that is incompletely resolved, but you can return next week, and pretty soon we will celebrate your success and graduate you from the program.  I will make sure to document it all, so as not to be sued or fired, and if you have a problem I will direct you to the grievance policy.  And truthfully, throughout this process I will never have actually known you.      

              So, what am I getting at?  Like, the education issue, it’s on us.  I hate to sound so incredibly bleak.  It’s not that psychology, or counseling, or psychiatry is failing us, it does reduce a significant amount of suffering.  It is that it is failing in its present delivery.  Professional experience and research led me to conclude that we are not effectively addressing suicidality, trauma, and addiction.  I think everyone is aware of this.  It was only in stepping outside of direct practice that I began to recognize how horribly misaligned we are. The market ideology that dominates healthcare delivery produces a system further removed from care.  We spend an enormous amount to maintain a system that produces health outcomes beneath countries that spend a fraction.  What do I mean when I say don’t depend on the system?  I am concerned that it provides false comfort.  You drop your loved one off for treatment of depression (when it is actually despair) or you check them into a rehab for treatment.  Far too often the outcome is suicide or overdose.  And families are left to pick up and now respond to trauma, and puzzle over what was missed. 

              I was fortunate enough to be pouring over this research at the right time in my life to make sense of where I think we are failing.  It is my hope that I can provide some insights to friends and family because I am optimistic about certain features in positive psychology that have simply been underdeveloped.  First, the research on hope and optimism has solid scientific evidence that we are on to something even if the present system is failing in its delivery.  I was reading in The Psychology of Hope by C.R. Snyder that in experiments hope was more predictive of success in treatment when depression was controlled for.  In other words, interventions aimed at boosting hope may be more effective than standard treatment.  Seligman has done extensive work on optimism, and has similarly found that optimism is also more predictive of wellbeing.

              These books, and streams of research are now 20-30 years old.  I thought about this the other night, as I continue to dwell on what has gone so horribly wrong in our practice.  The Snyder book was published in 1992.  For me, this roughly coincides with the takeoff of managed care.  When I speak to former therapists, I often hear that they left the field because it was either no longer profitable, or no longer enjoyable, or too much of a burden, etc.  You will hear roughly the same sentiments when you speak to educators and their beliefs about No Child Left Behind.  Did you know that there is increasing alarm about the presence of suicide and burnout amongst medical professionals and recent medical school graduates?  If you read my previous post on self-determination, you will see that each of these systems moves its practitioners further from autonomy, relatedness, and competence.  Autonomy—we are beholden to some metric of “accountability.”  Relatedness—we have no time to work with the actual human being before us.  Competence—I have no time to develop my practice because I am checking boxes, avoiding lawsuits, or documenting.  I may be required to leave the profession altogether if I cannot endure it long enough to pay off my loans.

              We should be hopeful for what exactly?  Well, keep in mind that this is a system, that while it is stressful, it says very little about you as a human being and your innate ability to generate hope.  This is a capacity in each of us, it is just presently difficult to achieve due to the multitude of complaints and gripes that I leveled in the previous paragraphs.  Hope Theory suggests that hope is a byproduct of two iterative cognitive processes a) agency thinking and b) pathways thinking.  This is sometimes referred to as waypower and willpower.   Hope is the product of effective agency thinking—I can accomplish this, and pathway thinking—this is the path to reaching my goal.  My next essay in this series will address goal-setting because despite what we may intuitively believe—that we know and excel at setting our own goals, there is a great deal of illusion present.  In fact, goal-setting way more complicated than people appreciate.  The cognitive mechanisms and their inherent biases that have been illuminated by behavioral economists are pervasive in the arena of decision-making.

To recap: hope—is the product of agency and pathway.

Toy with setting small achievable goals. It builds from this point.

Find someone for whom you are thankful and express gratitude.  Research support that gratitude increases hope.

Feel free to pm me on any of this, even if you disagree, it will force me to know the material better.  I will be grateful.