ShrinkRap Podcast

Kernan Manion, MD

A clinical psychiatrist-turned-coach muses out loud on all manner of things 'shrinky' and 'psych-ey.' An independent thinker, he's not afraid to challenge paradigms, including the ones he's embraced. He definitely doesn't toe the party line and that's how he became intimately familiar with the road less taken. shrinkrap.substack.com

Episodes

  1. 03/25/2022

    Witnessing Atrocity

    (Below is the transcript of the podcast.) Hello and welcome. I'm Dr. Kernan Manion and you're listening to ShrinkRap. The title of today's piece is Witnessing Atrocity – Moving Beyond Shock, Horror, and Disbelief And it's about countering our human tendency to shut down in response to anguish and perceived helplessness. Now, I suspect I speak for many in calling attention to how we have been preoccupied with witnessing the events, the atrocities, happening in the war against Ukraine. And I find myself repeating over and over again this sense of unreality, this sense of disbelief, and this sense of horror. And likewise accompanying that a sense of helplessness, of not knowing what to do. And as I talk with others, I find the same response – disbelief, horror, and helplessness. And it got me to thinking about how powerful this response is for us and how in the face of dealing with an overwhelming atrocity, we end up shutting down, and we don't seem to have the vocabulary or the methodology to move forward. Shock and Horror Are Like Psychological Trauma And so what I want to stress in this podcast, and I'll cut to the quick here about where I'm going with all of this, and that is that shock and horror leave us immobilized. They're very similar to the trauma response. They are an assault on the psyche in the same way that trauma is and trauma causes that shut down. It causes an avoidance so that we are not ever able to fully access the traumatic event and its underpinnings. And likewise, with regard to atrocity. And apart from venting and sharing our incredulity and the fact of our being immobilized, we just don't have the vehicles and the practices in our lives to help us move beyond that expression. Our Reflexive Shutdown May Be Counterproductive So it seems that we have this ingrained pattern of denial and avoidance, and this seems to be a reflex that is part of our mental apparatus. And I think it's important now that we look at how that mental apparatus is actually serving us ill. It is our duty, our human duty, to care for those who are being harmed. It’s also in our self-interest. That which is causing the shock, the events and issues and situations that are causing this disbelief and resulting in this experience of horror, those events are not going away. And it is our duty, our human duty to care for those who are being harmed. And besides, it's somewhat self-interested to say that the harm that is coming to them is also harmed that is going to be going to others and possibly to ourselves. And so it is in our best interest to move beyond disbelief and horror. We have to get beyond the immobilization. So what I'm suggesting here is that slowing this process down and really taking the time to reflect about is going to be very important. Pondering, reflecting, deconstructing this whole sequence of emotional response and immobility is really essential to our taking a thoughtful course of action. The very process of making sense, however, the very process of looking at each of these individual components that coalesce into our disbelief and coalesce into our horror, actually threatens to throw us again into an avoidance response. That's the nature of the avoidance response - that we end up going into shutdown. And so therefore we really need to be attentive to every piece of the events, issues, and situations and feelings that are coming forward that are threatening to shut us down. Making Sense Requires Interactive Dialog Now, these various events and situations are immense and they require us to look at them and they also require interactive dialogue, not just dialogue with ourselves, but they require interactive dialogue to make sense of, a process that I call collaborative sense-making. Now that collaborative dialogue, however, has to get beyond the shock, disbelief and horror response of the other. So in other words, when we're having a dialogue with others, we have to help them get beyond the shock, disbelief, horror, and helplessness. So this exploration here is about the dismantling of that response, understanding what it is that goes on and how we can then move beyond it. Venting Only Goes So Far Now you've heard the term venting. Well, we all have that process of venting and it can be very helpful. When you think about venting, you think about, for example, a steam kettle and letting off steam as there's been a buildup of heat. When you're thinking about venting anger, you are talking about letting the anger out in some way. (Now that may or may not be a helpful process. And it turns out that the overall advice about letting people vent their anger may actually be incorrect. And it may actually embed a process of holding onto anger and not really getting rid of it.) When we also think about venting, we think about venting toxic odors, not just bathroom, but also chemical factories. And again, what we're talking about is releasing something that has been contained so that we can try to detoxify it. But it turns out that this venting process is not really allowing us to understand what is creating the toxicity. And so simply venting to one another about our experience of disbelief and horror is not really helping us move the ball down the court, if you will. Why is it then that we have this experience? Shocking the Psychic System Let's take a look for a moment at the concept of shock, psychological shock, that results in immobilization. Now, many of us have had that experience of being immobilized by something very powerful. And we'll see that the immobilization response is generally associated with overload of the system, the psychic system, in some way. Now I'm going to be referring to the "psychic system" and what I mean by that psychic system is all of the processes that go along with regard to our thinking and feeling and making sense of, and from making sense of, guiding our behavior. Now, that's a lot, a lot of things that are going on in this psychic system and the psychic system is not the sort of thing that you really want to shut down apart from times for sleep. And even there in an environment of unsafety, as we know, the psychic system really does not shut down when it senses unsafety. So our psychic apparatus is really vital, and yet we are not allowing ourselves to get beyond the shutdown process. The Causes of Psychological Shutdown So what is it that causes shutdown? Let's take a look at how the mind takes in information. I'm working on a book on emotional intelligence, a new approach, a very practical approach that I've been working on for a number of years. It is I believe a new take on how the mind works. And so what we see here is that the mind, the brain and the mind are two separate operations, by the way, stand here in reality and they then see events, issues, and situations in the external world. Now, the only way that we interact with the external world is by taking some representation of it internally. And that's what we call perception. So that any event out there, we actually take it in through our senses: sight, sound, taste, touch, smell, and I would argue body position being a sixth sense. So every issue event and the situation is internalized into our minds and we then interact with it there. Now I'm going to abbreviate event, issue, and situation with the letters E I S - event, issue, and situation. Chaos - Too Many Events, Issues, and Situations To Deal With So what happens is that sometimes we have too many events, issues and situations that are going on that caused us to get jammed up. You know how it is when you have a computer, that's got too much stuff going on in it and it's got too many programs, open, too many documents open. You may be watching a movie. All of that stuff is using up precious memory space, working memory space, and too many things happen, and it just gets jammed up. And the computer doesn't have enough RAM space in order to navigate it. And so it shuts you down. Those who may have the Microsoft version of computers operating system, the Windows system, may get the infamous blue screen of death that's called “fatal error.” You know, "you've lost everything and you're going to have to restart the computer." Those who are of the Apple Mac persuasion instead get a beach ball, a spinning beach ball, everything else is frozen. And the beach ball there is just continuing to spin, I guess, trying to give you the appearance that somebody else is having fun and you're not because your screen is frozen. And in any event, what you see is that the error results in your having to restart the computer. It got jammed up. Now imagine this for a moment when it gets jammed up, when you start it, you got the same problem, again, you can imagine the frustration that mounts there. And that actually is one of the other drivers of what's causing us to continue to shut down. So we have too many issues, events, and situations and we can't tease them apart. That is a state of mind that I call chaos. Let me give you a kind of a working definition of what I am describing here as intra-psychic chaos. Now, again, intra-psychic is in that psychic operating system of our mind that controls all of our thoughts and feelings and our sense-making and our courses of action. So what's happening here is that we take in those events, issues and situations and they are sitting there and we don't have enough space to sort them out. Chaos is too many events, issues, and situations occurring in too compressed a space and time and some or many of which might have immense psychological relevance and potential adverse impact. But we don’t have the capacity to tease them apart and yet recognize the urgent need to make sense of them. And so instead of shutting down in the sense of a computer where our lights go out, we basically get them off of our plate and put them aside. We just don't know what to do with them. Now we've all had that situation where we

  2. 02/21/2022

    SR Podcast - Welcome to ShrinkRap!

    Hey there and Welcome! I’m Dr. Kernan Manion, a physician retired from the quasi-scientific, artsy-craftsy world of clinical psychiatry and now doing a diversity of engaging things - coaching, consulting, speaking, leading retreats, writing, doing podcasts, leading a physician rights advocacy program …. While I write and podcast on some serious physician rights and related clinician-focused issues on my other newsletter on Substack - Physician Interrupted - this blog and podcast are intended to be a place for a wider range of topics under the broad rubric of “interesting things having to do with the human brain, its mostly attached mind, and people.” Yes, a large canvas, and lots of paint. I decided to start this separate ShrinkRap newsletter and podcast for diverse reasons: There are some things I think about and write on that don’t quite fit in that Physician Interrupted space. Topics like what factors might be driving a country to self-implosion - and what might help abort that; living in ‘da Nile,’ that internal place in our heads where we completely deny the reality of looming threats to our - and our planet’s - existence; the nature of psychological work, of “knowing yourself” … well, ad infinitum. It’s a creative excursion for me, actually a writer’s / podcaster’s playground. It’s a place where I can experiment with ways to share observations, insights (well, I think they are), life coping strategies…. An opportunity to delve into human drama, lighten things up with wry humor, share inspirational pieces like the lovely poetry of the Middle Eastern mystic Rumi (especially as meta-translated or interpreted by Coleman Barks), philosophize, and occasionally be a snide commentator. I absolutely love reading some of the more acerbic commentary from talented writers, pieces that mince another’s positional stance to mush. Not even that I agree with the mincer, just that their swift slices are so deft. It’s especially relishing when the mincee rises to the occasion and ju jitsu’s the mincer. And truth be told, it’s a unique opportunity for me to incrementally publish my long-overdue book / e-course MindSense, a practical approach to emotional intelligence. I’m excited about sharing MindSense because it’s a whole new take on EQ (the accepted abbreviation for emotional intelligence, a cute play on IQ which stood for Intelligence Quotient. I guess EIQ didn’t have the same umph). I keep getting derailed by one life urgency after another but, given that that’s the road I’m on, I just as soon drop off these little packets along the way. Another motivator for me is the great opportunity I get to practice VO - voiceover - work. I’ve been fascinated with the VO world for some time now. My secret aspiration is to do VO for historic documentaries. I’m an absolute groupie when it comes to listening to the voice of Peter Coyote, the narrator of many of Ken Burns’ documentaries. I’m also practicing doing children’s book VO as a dear friend of mine, a fellow whistleblower who also got his career annihilated for speaking truth to power, is a talented children’s storybook author. I’ll soon share one of my first reads I did, then first learning how to mix in music and sound effects (for me, a steep learning curve). Right now, the ShrinkRap podcast will be a read-aloud version of the written pieces. But there may come a time where it diversifies, perhaps having some guests, or sharing something that’s best delivered orally, or just responding to the needs of the medium and its audience. I do hope you’ll enjoy it as much as I am crafting it. Get full access to ShrinkRap at shrinkrap.substack.com/subscribe

    SR Podcast - Welcome to ShrinkRap!

About

A clinical psychiatrist-turned-coach muses out loud on all manner of things 'shrinky' and 'psych-ey.' An independent thinker, he's not afraid to challenge paradigms, including the ones he's embraced. He definitely doesn't toe the party line and that's how he became intimately familiar with the road less taken. shrinkrap.substack.com