How Do You Want to be Told of Your Imminent Death?

A 78-year-old man at a California medical center was told that he was going to die within a few days. This was unusual in that he was informed of this news by a doctor utilizing a robot and a video screen. A robot came to the door, outfitted with a video screen in which the doctor appeared to be sitting in a chair in a room somewhere else. The patient was told that he has no lungs left and the only option was comfort care. They would remove the mask that helped him breathe and put him on a morphine drip until he died. A social media post said that this was “not the way to show value and compassion to a patient.” The hospital expressed regret for falling short of the family’s expectations.

Being informed by a robot lacks sensitivity. But there was a time when patients would not be told at all. As late as the 1970’s many physicians in North America would avoid telling patients they had a potentially lethal disease. Ninety percent of doctors in Chicago opted against divulging a cancer diagnosis in a 1961 survey. The tide has changed in favor of patient autonomy. Patients now have a right to be fully informed and make healthcare decisions free of undue influence from medical professionals. Most doctors walk a fine line between upholding hope and being realistic.

Telling someone they are likely to die soon is one of the hardest parts of being a doctor. My niece, a physician assistant, was recently in a quandary of whether to call a patient with the news that lab results indicate they have cancer. Should she wait to call on a Monday, and let the patient enjoy a pleasant weekend, or call immediately? Should she tell the patient over the phone, or ask them to come to the office for a follow-up consultation? In fact, she did wait a few days until she had more information, then told the patient the news over the phone. The patient’s wife objected to the insensitivity of a phone conversation. Other patients have complained that they would’ve wanted to be told via the phone rather than take a day off work. She feels that she can’t get it right.

Hearing the bad news is not easy either. Some patients say they don’t want to know anything, when asked. Forcing others to know what they don’t want to know can be harmful. Others want all the information the doctor has. Typical reactions to the news of imminent death may be shock, denial, anger, depression, bargaining, or acceptance. These reactions may cycle from one to the other.

Personally, I will want the truth of my medical condition and its progression when the time comes for my death. I will not likely face death bravely, but will appreciate relief from uncertainty and the possibility of time for reflection and discussion of the course of events with those close to me. I will want the opportunity to take stock, mend bridges, make farewells, rehome my pets, and get my affairs in order. And I prefer to be told sooner than later, particularly if I am expected to have a short time to live. For the record, I prefer to be immediately informed by a robot, or over the phone, if the alternative is to wait for an available appointment with the doctor.

Here’s what I don’t want. I don’t want my end of life process to be determined by the comfort level of my physician. If they can’t have awkward conversations, they may rob me of my choices. Instead, I hope for a trusting relationship with my physician in which I will know what she knows, when she knows it.

So, what is the proper way to tell someone they may die soon? Palliative care specialists have expertise when it comes to these difficult conversations. The first step is asking the patient their understanding of their health status. Ask “What do you know?” And “What do you want to know?” If they do want to know the prognosis of their condition, include a spouse, friend or relative for support. The conversation may shift from finding a cure to managing illness. Janet Abrahm, a Harvard Medical School professor who trains physicians, says doctors should avoid phrases like “nothing more can be done”. Instead, convey the message that there are no more options for cures. And then you have to shut up. Abrahm coaches people to count to 20 before speaking again. This may be a very uncomfortable silence. Then ask, “How are you doing?” And, “What can I do for you?” Then say, “We have work to do. There are many effective treatments to prevent pain and suffering.” Then, realize that this is not a once and done conversation, but the beginning of ongoing communication.

My niece made the decision to ask her patients how they would like to be informed of bad news. She will then act accordingly. My question to you is, how do you want to be informed of bad news?

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Would You Lie for Your Children?

Lying to the Nazis to hide Jews, absolutely. Lying to an abusive husband to protect a child, yes. Lying to protect your child from the consequences of their actions? No. Most people wouldn’t think twice about lying to protect their child from real harm. Would you lie, cheat and steal to get your child into a top Ivy League university?

You’ve probably read of the college admissions scandal in which 33 parents received federal indictments for paying off schools and falsifying information in exchange for their child’s admission. The parents are wealthy CEOs, lawyers, industry leaders and Hollywood stars. In some cases, their children did not know they had a hand up from their parent’s actions. The parents want the best for their children, and are prepared to pay for it through unscrupulous means. They were not concerned with ethics or morality. These parents paid great sums of money, or had test scores altered, or lied about sports achievements in order receive athletic recruitments. Why? Power, status and earning potential. It is thought that graduates of elite schools have more earning power after graduation.

This is not just a United States problem. For example, Chinese parents also go to extreme lengths to boost their children’s academic success. Around 2,000 parents protested in 2013 to demonstrate against measures imposed to stop their children from cheating. (Yes, you read that correctly.) Apparently cheating is so common in Chinese society that not cheating would put children at a disadvantage.

Dan Ariely, author of The (Honest) Truth About Dishonesty, says that very few people lie a lot, but almost everyone lies a little. Ariely wrote “We want to view ourselves as honest, wonderful people and when we cheat . . . as long as we cheat just a little bit, we can still view ourselves as good people, but once we start cheating too much . . . we can’t view ourselves as good people and therefore we stop. So this model of trying to balance the ability to view ourselves as good people on one hand and the ability to cheat on the other hand predicts that people will cheat a little bit and they will still feel good about themselves . . . That’s what we see across many, many experiments.”

It turns out that rich people are more likely to lie, cheat and steal than people of lesser means. Dacher Keltner, a psychologist at the University of California at Berkeley studied wealth, power and privilege. The rich are more likely to cheat on their taxes, cheat on their romantic partners, and are more likely to shoplift. They are often less empathic. In studies of charitable giving, it is often the lower-income households that donate higher proportions of their income than middle and upper income people. Studies suggest that wealth and power decrease inhibitions, increase risk taking and increase feelings of entitlement and invulnerability. Power makes people less able to see others’ perspectives.

The great lengths that celebrities and CEOs go through to advance their children’s education may actually be a waste of money. In 2014, economists Dale and Krueger published an analysis of the benefits of attending a highly selective college. Students who are poised to succeed tend to do so even if they don’t get into the Ivy League. But there was a crucial exception. There are strong benefits for the subset of black and Hispanic students, and for those whose parents had few educational credentials. It turns out that students who come from less privileged backgrounds benefit greatly from selective colleges. Elite higher education gives them social capital they didn’t already have.

Are the prestige and status granted to students of elite schools worth the price of arrest? Not for most of us.

Do you ever lie for your children? Under what circumstances?

Do You Have a Conspiracy Theory?

A conspiracy theory is a belief that an event or situation is the result of a secret plan made by powerful people. Don’t most of us subscribe to a conspiracy theory from time to time? We’re just sure that the US government is hiding evidence of extraterrestrial life on earth. Or, we’re confident that multiple gunmen shot John F Kennedy. And some of us believe that the Illuminati is secretly promoting a New World Order. According to anthropologists Todd Sanders and Harry G. West, evidence suggests that a broad cross-section of Americans today give credence to at least some conspiracy theories. A person who believes in one conspiracy theory tends to believe in others, even when one theory contradicts the other. Once we form a belief, the tendency to look for information that confirms our beliefs and disregard information that challenges them (confirmation bias), can cement them.

Is there a connection between conspiracy theories and mental illness? We have a non pathological need to search for meaning. In fact, one study by scientists discovered a link between conspiracy belief and the tendency of the mind to see order where none exists, called “illusory pattern perception.” But gone too far, conspiracy theories could be the product of a thought disorder, such as paranoid ideation. Human behavior is placed on a spectrum from psychologically healthy to a diagnosable mental illness. The strongest correlation between a diagnosable mental illness and conspiracy theorists, is found in DSM-5 (Diagnostic and Statistical Manual), Schizotypal Personality Disorder. This set of traits includes a tendency to mistrust others, eccentricity, odd or deviant ideas, a need for uniqueness, and strange ways of viewing things.

Some people, in some circumstances are more likely to believe in conspiracy theories. If people have little or no control over their current situation, they are more likely to see patterns in random images and believe in the supernatural. We are subconsciously reaching for a method of ordering this chaos, even if the connections are totally random. Humans have a tendency to give importance to negative emotions, thoughts and situations because it increases survival. Horrible things aren’t always conspiracies. They can be real. You may draw attention to an important concern that if not checked, could become a danger.

What’s the harm? One’s personal beliefs are not always benign. Consider witch hunts which were based on the belief that young women gathered in the woods to conspire with the devil. Personal beliefs that become collective action, can cause irreversible harm.

If you want to judge whether you have a tendency toward conspiracy theorizing, ask yourself the following questions:
How dangerous do I think the world is?
Am I comfortable with ambiguity or do I need certainty?
Do I feel powerless and insecure?
Do I have a need for uniqueness?
What sources do I reference for information and do they have a bias?
Do I have enough social support to feel valuable and maintain positive self regard?

Once you have reflected on these questions, I urge you to fact check your theories and look for alternative explanations. If nothing else, you’ll have a stronger position for debate.

A Scarcity Mind Set Pits Us Against Each Other

The fear of not getting enough is deeply ingrained in our society. Signs of fear are a belief that there is not enough for everyone. Since there is not enough for everyone, you need to fight for resources. You have to protect what is yours from others getting it. When we are focused on scarcity, we become more anxious and negative in our reactions.

The above meme  “If Methadone is free to addicts because they have a disease, Why is chemo not free for cancer patients?” went viral. This particular meme regarding Methadone is an example of a scarcity mind set. It is assumed that there are not enough resources, financial or otherwise, available to assist both cancer treatment and addiction treatment.

The meme may also imply that cancer patients are more valuable than people who are dependent upon opioids. This stigma is based upon the idea that drug abuse is amoral, antisocial behavior based upon a choice to become addicted. Is the same stigma applied to the person with lung cancer who made a conscious decision to pick up their first cigarette? One is not more worthy of treatment than the other. It’s a race to the bottom deciding who is worthy to live. Besides, the person dependent on opioids could be the next person to discover a cure for cancer.

I saw a post of the same meme with a comment, “At least cancer patients want to live and addicts don’t” or something to that effect. Although there are exceptions, opioid dependent persons do not have a death wish. Their lives are consumed with finding the substance they need to avoid withdrawal symptoms. They are doing everything they can to live pain free hour by hour, day by day.

Let’s clear up the facts. First, the opioid epidemic is a public health issue and the use of methadone maintenance is a harm-reduction strategy. Rates of drug related deaths are skyrocketing and medication assisted treatment has cut death rates by 50% or more. Methadone and Suboxone treatments are the gold standard of treatment.

Second, Methadone is not free. Why do some patients pay for their treatment and others pay nothing? It depends on the patient’s income and insurance status, the state’s funding programs, private or public grants, and whether the treatment clinic is profit or not-for-profit. All medical treatment, including cancer, varies across these lines.

Every time you see a meme that belittles addiction treatment, think twice before sharing it. No good comes from shaming people, and in fact, may prevent someone from entering treatment.

Those with a scarcity mind set believe that there are not enough resources to go around, leading to over-competitiveness. We don’t need to elbow our way to get the front-row seat. We could all join forces, not pitting against each other, to highlight the growing cost of medical care. Let’s unify to fight the same battle for all.

Secrets, Lies and Double Lives

“Oh, what a tangled web we weave, when first we practice to deceive!” (Sir Walter Scott, 1808).

Perhaps you read the best-selling book The Woman in the Window by author Dan Mallory, writing under the pseudonym AJ Finn. Apparently Mallory got caught up in a tangled web after creating a false persona in the editing field. He lied about his professional skills and experiences, falsely stating that he had earned a PhD from Oxford. He fabricated lies about having brain cancer on a university application and told the same to publishing colleagues. He wore an eyepatch claiming to lose sight in one eye after an operation on a brain tumor. His cancer provided an explanation for long work absences. His brain tumor “sort of cleared up,” baffling co-workers. Although his family was alive and well, he claimed that they were all dead as an explanation for his grades while completing his master’s degree.

When Mallory’s lies were discovered, he admitted that he never had cancer, and had used the illness to cover up for a mental illness. He was ashamed of his bipolar disorder and kept it a secret. He stated that depression, delusional thoughts, morbid obsessions, and memory problems forced him into periods of absence from work. Assuming that he is finally telling the truth, this doesn’t explain his unnecessary lies about his family and accomplishments.

Did you watch the movie Catch Me If You Can? It is based on the life of Frank W. Abagnale, alias Frank Williams, Robert Conrad, Frank Adams, and Robert Monjo. He was one of the most famous con men, forgers, imposters, and escape artists in history. Among his many personas, Abagnale co-piloted a Pan Am jet, masqueraded as a supervising resident of a hospital, practiced law without a license, passed himself off as a college sociology professor, and cashed more than $2.5 million in forged checks, all before he was twenty-one.

Why did he do it? In an interview he said the following, “It begins with my parents’ divorce and its dramatic effect on me. I ran away and suddenly found myself a teenager alone in the world. I had to grow up very quickly and become very creative in order to survive. But what started out as survival became more and more of a game. I was an opportunist, so when I saw an opening I asked myself, Could I get away with that? Then there was the satisfaction of actually getting away with it. The more I got away with, the more of a game it became a game I knew I would ultimately lose, but a game I was going to have fun playing until I did.”

It turns out that many people will lead a double life based upon secrets and lies. Lots of people have fantasies of being wealthier, more accomplished, or more admired than they currently are. False personas bolster the ego. But when deception is taken to the level of a dual life it can damage relationships, careers, and lead to criminal consequences. This behavior can spiral out of control, creating high-risk situations that are dangerous to themselves and others.

Are these signs of mental illness? Not necessarily. You don’t have to have a mental disorder to lead a double life. Consider people who make a living out of having a secret life such as spies, undercover police, and certain military personnel. They mean no harm.

If not mental illness, why do people create a life of deception? Both Abagnale and Mallory give clues as to reasons people might live a double life: shame, a need to survive, opportunity, and the enjoyment of playing a game and the satisfaction of playing it well. Some people are just greedy hedonists who believe they feel entitled. Personal pleasure is their primary life objective. They may not intend to hurt other people, but don’t get in their way. They may feel that rules don’t apply to them and that morals are more fluid than set.

My heart goes out to the innocent partners or family members who find that they have been betrayed. They may be entirely surprised to learn of this double life after years together in what they thought was a stable, honest and open relationship based upon trust. Perhaps they didn’t know that their partner gambled, was a substance abuser, was sexually unfaithful, committed fraud, or was hiding money in multiple accounts. The betrayed partner will never trust the same way again.

The truth is that some people are so good at secrets, lies and deception that there is little you can do to protect yourself. You may find yourself the victim in a tangled web. Deception is fostered by secrets. I recommend that you seek social support and voice your suspicions rather than be bound by secrets. You don’t need solid proof of wrongdoing. Close relationships should be based upon full disclosure. If you suspect that your partner is hiding something, talk it out rather than be silenced.

Do you suspect someone is leading a double life? Protect yourself if possible.

Do You Take Direction?

I am writing this column from LA, where I am visiting family. Getting to LA from Galena, IL is not an easy task. I left home at 4:30 am to find parking near O’Hare and make a 9:30 flight.

While on the long drive to Chicago at an early hour, with insufficient sleep, I was not an especially attentive driver. My car beeped once, then displayed a message “Do you want to take a rest?” My reaction alternated between “Is my car talking to me?” to “What does my car know that I don’t know?” I didn’t realize that my driving was at all impaired. Then my mind processed this information with the pros and cons of stopping to rest. I needed to make a flight, wasn’t sure how much time I needed to find parking and take a shuttle, and I wanted to avoid Chicago traffic. I ultimately chose to pull over for a Chai Latte mixed with cold air and was immediately refreshed. At that point I congratulated myself for being smart enough to take direction from my smart car.

This made me wonder whether I am normally one to accept guidance from others.

Author Gretchen Rubin developed a framework to describe how we respond to expectations. She identified four tendencies that explain why we act and why we don’t act in many situations. These are:

The Upholder: “I do what others expect of me and what I expect from myself.”

The Questioner: “I do what I think is best, according to my judgment. If it doesn’t make sense, I won’t do it.”

The Obliger: “I do what I have to do. I don’t want to let others down, but I may let myself down.”

The Rebel: “I do what I want, in my own way. If you try to make me do something, even if I try to make myself do something, I’m less likely to do it.”

So, my process of debating whether to follow guidance from my car, seemed to indicate that I am a questioner. I had to process the cars advise with my own judgment. However, upon taking the “Four Tendencies” quiz, my primary dominant tendency is Rebel. I thought this was probably inaccurate, but my sister, as only a sister does, provided a number of examples of my being a Rebel. Upon reflection, it does seem to be an apt description of my dominant approach to life.

Many people cannot follow instructions in spite of their best intentions, whether it is assembling furniture or learning how to use software. In fact, the more intelligent people are, the less likely they are to follow instructions.

If you want to understand your own tendency toward expectations, take the quiz at quiz.gretchenrubin.com.

Are You Comfortable with Clutter?

We are a materialistic society. Americans love to acquire consumer goods. Even after purging our belongings in garage sales or donations, we tend to replace these possessions with newer, more fashionable items. Americans have a hard time gauging the extent of our belongings because of the size of our living spaces. The average size of American homes in 2018 was 2,641 square feet, about double that of Japanese homes.

Marie Kondo is the author of “The Life Changing Magic of Tidying Up: the Japanese Art of Decluttering and Organizing.” It is now a Netflix reality show directly in opposition to “Hoarders.” I only had to watch one show to become motivated to get organized. At the conclusion of the first show, I immediately organized my dresser drawers. Yesterday, I tackled my old photos. Although I love this new approach, I wonder if it is sustainable. Or, do we return to our set point after a length of time? Marie Kondo promises that you will never return to clutter again.

So the question is “Can people change?” The answer is yes, and no. We can change our habits and behaviors but our personality tends to be rather fixed. Personality is a pattern of thoughts, behavior and feelings that make up who we are. It is partly genetic, partially formed by early childhood experiences, traumatic events or from deeply held values. Once formed, personality doesn’t change dramatically.

The clean-freak will never be comfortable in a dirty house and vice-versa. Tidy people feel most at ease when their external world is organized. It gives peace of mind, helping them feel lighter and freer. On the other hand, more relaxed people might feel that a home that resembles a doctor’s office waiting room is sterile and cold. For them, Marie Kondo’s methods might increase stress, rather than inner peace.

Personality can be influenced by a break in your patterns – by new life changing experiences or trauma – but only so much change is possible. Motivation, effort and repetition are required to change. One needs motivation in order to make lasting change. You have to want to change in order to avoid negative consequences or achieve important rewards. Change requires effort to place yourself outside of your comfort zone. Repetition builds new pathways in the brain so that new patterns are more solidly formed. Otherwise, people tend to go back to their set points.

Marie Kondo would have you sort through your belongings, keeping only what sparks joy. In order for this to be a sustainable change, we need to look at the reason you are unhappy with your clutter. Is there an underlying depression, shopping addiction, or some other kind of unhealthy relationship with material things? If so, you will likely find your home cluttered again in short order.

Although you can’t change your basic personality, you can and should change the aspects of your personality that you are unhappy with. If you are not happy with your attachment to material things, give Marie Kondo’s method a try.

Are People Inherently Good or Bad?

We read of mass shootings, hate crimes, terror attacks, and violence in the news almost daily. We also read of acts of kindness and beauty. What kind of people are we? Humans are capable of unspeakable horror, and are also capable of the highest form of altruism. We’re a complicated species–both moral and immoral as our environment and physiology dictate. Think of a bell curve with most people somewhere in the middle.

Paul Zak, PhD and professor says the biological answer to this question is that we have evolved behaviors that increase our chances of survival and reproduction. He says “When in a stable and safe environment with enough food in our bellies, having a biology of morality sustains our place in the community of humans who help ensure our biological imperatives. In highly stressful, resource poor environments, we’ll step on whoever is in front of us if it helps us survive.” The exceptions to this rule are the roughly 5% of the population on either end of the spectrum. The rest of us vacillate between good and evil.

Recent studies demonstrate that our initial instinct is to help others in need. The vast majority of people, when faced with simple, clear ethical choices, choose good over bad, and even good over neutral. Society rewards altruism. Our parents, educators, and institutions teach us to share, be polite, and consider others.

But some people are mostly bad. Studies show that 2% – 4% of men and .5% – 1% of women have antisocial personality disorders. Antisocial personality disorder is characterized by a pattern of socially irresponsible, exploitive and guiltless behavior. It is chronic and lifelong for most of these people.

Why does it matter whether we think people are naturally good or bad? Messages of good and evil influence how we process the world around us, making us optimistic or pessimistic, hopeful or frightened, stressed or relaxed. Our physiology is triggered to release stress hormones like cortisol and adrenaline. Stress is associated with health issues, such as heart disease and sleep deprivation. Chronic stress can even shorten your life.

Messages of good and bad influence our daily choices and risk taking behaviors. If we believe in the goodness of people, we are more likely to take risks that could potentially put us in harms way. On the other hand, we may be enriched with new experiences.

If we are quick to label some people as evil, we won’t consider the source of their behavior. We might mislabel fear, illness and desperation for evil. Desperation is a natural consequence of abuse, poverty, or illness. We may find that alleviating the source of desperation changes “bad people” to people who have unmet basic needs.

So where do you fall on the good or evil, moral or immoral spectrum? And, how does your view of whether people are inherently good or bad effect your outlook and life choices?

Feeling Safe Is Not the Same Thing as Being Safe

One of our top human needs is security. According to psychologist Abraham Maslow, the first two tiers of human needs are physiological and safety needs. Physiological needs include basic requirements for human survival such as food, water, shelter, and sleep. Safety needs give us protection from elements, security, order, stability and freedom from fear. Maslow proposed a hierarchy of needs in which the basic needs must be more or less met prior to meeting higher level needs of love and belonging, esteem, and self-actualization.

Therefore, it is no surprise that we go to great lengths to feel safe. We spend a good deal of time, energy and financial resources on security. This may be in the form of national defense, home security systems, data security, transportation security, guns for personal protection or building a border wall.

But here’s the deal. We can be secure even though we don’t feel secure. And we can feel secure even though we’re not. The feeling and reality of security are related, but not the same.

As a personal example, I am tempted to build an outdoor fence so that my dogs can run free and unsupervised while I remain inside the comforts of my house. A fence would make me feel secure, but the fence does little to protect my pets from coyotes who can jump a six foot fence. I would still need to supervise them as a measure of protection.

The reality of security is mathematical, based on probability studies of risks and effectiveness of countermeasures. It is a calculation of various factors such as crime rates and personal habits. There is no such thing as absolute security, and any gain in security always involves some sort of trade off. For example, statistics show that more than 530 people were murdered in Chicago in 2018, yet I am unwilling to wear a bullet proof vest each time I visit.

Bruce Schneier in his blog The Psychology of Security, explains that humans are hopelessly bad at making good security trade offs. We get it wrong all the time. We exaggerate some risks while minimizing others. Things that can go wrong are the severity of the risk; the probability of the risk; the magnitude of the costs; how effective the countermeasure is at mitigating the risk; and how well the risks and costs can be compared.

The human brain is wired for fight-or-flight reactions based upon the primitive emotional centers of the brain. This area assesses risk and reacts immediately which works great in some situations, such as being faced by a tiger. Schneier believes the world is actually more complicated than that. “Some scary things are not really as risky as they seem, and others are better handled by staying in the scary situation to set up a more advantageous future response. This means that there’s an evolutionary advantage to being able to hold off the reflexive fight-or-flight response while you work out a more sophisticated analysis of the situation and your options for dealing with it. We humans have a completely different pathway to deal with analyzing risk. It’s the neocortex, a more advanced part of the brain that developed very recently, evolutionarily speaking, and only appears in mammals. It’s intelligent and analytic. It can reason. It can make more nuanced trade offs. It’s also much slower.”

In trying to assess risk, we are best served by utilizing both areas, the emotional and the rational centers of our brain. Take your time, slow your immediate reaction, gather all relevant data. Don’t confuse the feeling of security with the reality of security.

What’s Your Story?

The current state of your life is a result of the stories you tell yourself, about yourself. For example, if you have a story of not being good enough, this narrative will likely play out in aspects of your life – your job, relationships and social life. To change your life, you need to change the limiting beliefs you have about yourself.

Think for a moment of your self limiting beliefs. Many of these beliefs start with “I’m not . . . ”; “I can’t . . . ”; or “I’ll never . . . ” Our thoughts seem to repeat over and over, and the more they repeat, the more believable they seem. They can follow themes for short periods, years or even a lifetime. You may seek confirmation for these beliefs and dismiss events that don’t confirm your belief.

There are schools of therapy and mindfulness practices dedicated to the eradication of negative self talk. For example, Narrative Therapy is a process of ‘re-storying’ your beliefs in more productive ways. The premise is that human beings are constantly interpreting things to make meaning of our experiences. The stories we have about our lives are created through linking certain events in a particular sequence across a time period, and finding a way to make sense of them. This meaning forms the plot of our story. Therapy helps the client create a new narrative about themselves.

According to the Dulwich Center, a clinical practice that specializes in Narrative Therapy in Australia, we all have many stories about our lives and relationships, occurring simultaneously. For example, we have stories about ourselves, our abilities, our struggles, our competencies, our actions, our desires, our relationships, our work, our interests, our conquests, our achievements, our failures. The way we have developed these stories is determined by how we have linked certain events together in a sequence and by the meaning we have attributed to them. Narrative therapy theory suggests that there is no “objective reality” or absolute truth. What is true for us may not be true for another person, or even for ourselves at another point in time.

Thoughts are not facts. They are simply electrochemical impulses in our brain. Cognitive Behavioral Therapy (CBT) recommends that you not believe everything you think. It is not the event which causes our emotional distress and behavioral reactions, but the meaning we give that event that results in particular emotions and behaviors.

Elisha Goldstein, author of Uncovering Happiness, recommends that we put some space between our reactions and our thoughts. Watch your thoughts come and go instead of treating them as facts. If you’re stuck on a negative thought, ask yourself – Is it true? Is it absolutely true? How does this thought make me feel? What would things be like if I didn’t hold this belief? Examining thoughts in this way creates space for a new story to develop.

Want to test out the idea that thoughts are not facts?
• Pick a thought that feels factual to you (e.g., ’I am not very good at my job’ or ‘I’m a great friend’)
• Rate the thought on a scale of 1-10 based on how factual the thought seems (1 = absolutely false, 10 = absolutely true)
• Write down the thought and its rating. Put it in your pocket.
• Rate that same thought again tomorrow and over the course of several days (especially apply attention to it after you experience incidents related to it)
You will likely notice that how factual the thought seems will fluctuate moment to moment, day to day. It becomes apparent with practice that what we see as factual in the thoughts we have is not always trustworthy.

In summary, thoughts are not facts. You are not your negative thoughts. There is more to you than your self limiting story. Believe that it’s only a story and create a new narrative.