books


Tilke Elkins’ long-awaited second book is coming out this winter for backers of  her Kickstarter campaign:

If you are not familiar with Tilke, check out her website and instagram, plus both my wife (here) and I (here) have written about her in this blog.

I am super excited to see this book. Back in the aughts I got to watch her create her magazine, All Round. Each issue was a beautiful, interesting and charming work of art––researched, written, drawn, painted and lettered by Tilke over the course of six months. She spent years rather than months on How to Eat Color & Paint Who You Are, and from the glimpses I’ve seen, just a few spreads, it’s been worth it. The pages glow with Tilke’s love, fascination and skill with color.

Bayless cover

I bought Authentic Mexican: Regional Cooking From the Heart of Mexico because it was the highest-rated Mexican cookbook on Amazon. It was part of an effort to build a great cookbook library and to create a food culture for my family. It was also to turn my wife, Reanna, on to Mexican food. I grew up in southern California and love Mexican food. She grew up in Vancouver, BC, and never developed a taste for it. My limited sampling of Canadian Mexican food made it clear why: It was not very good.

Because I imagined referring to this book for several decades, I almost bought the second-highest rated book because the cover was so much better, but I realized that both images were probably on dust covers, which I hate and throw away immediately. I stuck with the Bayless’s book.

I am so glad I did. Everything I’ve cooked out of this book so far has been very, very good. Surprisingly good. This food tastes like fine dining–nothing fast-food about it. My wife has had “food-gasms” on several occasions and agreed that we would have been happy to have paid top dollar at a restaurant for what we just ate.

I’m a good prep cook, an OK cook cook, and not much of a real chef. I love that I can follow these recipes exactly and produce inspiring food. I also believe that going through this book is teaching me how to cook. I’m learning the architecture of the cuisine–the staples, the flavors, the dishes, the variations. I can imagine eventually being able to stock our fridge intuitively and improvise great food from whatever we have. What more can you ask for in a cookbook?

A few weeks ago, one of my posts received a comment that was worth a whole post:

I am also a therapist (though I’m still in training). I’m wondering if you would be willing/able to recommend some family therapy books you’ve found helpful. My program is very focused on the individual and I’m trying to fill in some gaps and find your perspective on therapy to be very resonant with my own.

I’d love to recommend some family therapy books! My program was extremely family-systems focused, which I’ve been grateful for since leaving school. If you want to see an exhaustive reading list (I can’t remember having been assigned a real dud), you can see reverse-order lists of everything I read in my first year here and my second year here.

I’ll try to create a bare-bones list for you here—much more useful for you and a good exercise for me. I should warn you before I begin that I am super nerdy when it comes to family therapy reading and I can imagine many in my cohort rolling their eyes at my “must-read” list. If you are nerdy like me, though, here goes:

Pragmatics of Human Communication: A classic and profound book by Bateson’s MRI team, the first and probably still the best attempt to apply system theory to human relationships.

Susan Johnson’s books The Practice of Emotionally Focused Couple Therapy and Emotionally Focused Couple Therapy for Trauma Survivors. Johnson combines system-thinking, Rogers-style experiential therapy, and attachment theory, creating one of my most-used therapy models.

John Gottman’s books, especially The Marriage Clinic and The Science of Trust. Gottman has taken up the project started with Pragmatics, largely abandoned by family therapy, and is doing it in fine style, with solid science.

Metaframeworks: This book presents my favorite meta-model of family therapy, combining the best parts of the many family therapy models.

A major work by each family therapy model-builder is also important reading: Haley, Madanes, Satir, Whitaker, Minuchin, Bowen, Selvini-Palazolli/Milan group, Weakland/Fisch/MRI group, deShazer/Insoo-Berg, Epson/White, and Hubble/Duncan/Miller. Keep in mind that their books are presentations of informed opinion, not science. Every one of these folks have got some things right and some wrong. They have also advanced the field significantly, and are the largest part the conversation on how to think about families.

Finally, a couple things that I was not assigned in school, but I found extremely helpful in making sense of the flood of information. First, a grounding in systems/complexity theory: Family therapists think of themselves as system-theory experts and throw around a lot of lingo that they may or may not really understand. It’s easy to get confused in this situation. The best introduction to modern system thinking is still Capra’s The Web of Life (though we’re overdue for an update). Also, check out Bateson’s books Steps to an Ecology of Mind and Mind and Nature. Second, familiarity with Wilber’s integral theory really helped me navigate the heated arguments about modernism vs. post-modernism and intervention at the level of individuals vs. family systems vs. larger systems. Check out Integral Psychology or A Theory of Everything.

I read Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America as a counterpoint assignment in one of the diagnosis classes in my Couples & Family Therapy program. It was an excellent book about the history and science of several psychological problems, both as phenomena and diagnoses, including depression, depression, bipolar disorder, ADHD, and schizophrenia. As a university student, I had the opportunity to check out for free any of the many academic citations in the book that piqued my interest, and each one that I looked at seemed indeed to provide the evidence he claimed. I haven’t read anything like all of them (there are nearly 700), but enough to satisfy myself that Whitaker has done some good journalism here, and that his hypotheses are credible.

Two of these hypotheses is about childhood bipolar disorder, the first of which he calls the “ADHD to bipolar pathway.” The side effects of stimulants such as those used to treat ADHD are substantially similar to bipolar symptoms, as shown in the table below, from p. 238. (The formatting is slightly different than Whitaker’s, thanks to an Open Office/Wordpress interaction.) Multiplying the estimated rate of stimulant-induced bipolar-like symptoms by the 3,500,000 children and teens taking those medications, Whitaker estimates we should see approximately 400,000 “bipolar youth” as a result.

The ADHD to Bipolar Pathway

Stimulant-Induced Symptoms

Bipolar Symptoms

Arousal

Dysphoric

Arousal

Dysphoric

Increased lethargy

Intensified focus

Hyperalertness

Euphoria

Agitation, anxiety

Insomnia

Irritability

Hostility

Hypomania

Mania

Psychosis

Somnolence

Fatigue, lethargy

Social withdrawal, isolation

Decreased spontaneity

Reduced curiosity

Constriction of affect

Depression

Emotional lability

Increased energy

Intensified goal-directed activity

Decreased need for sleep

Severe mood change

Irritability

Agitation

Destructive outbursts

Increased talking

Hypomania

Mania

Sad mood

Loss of energy

Loss of interest in activities

Social isolation

Poor communication

Feelings of worthlessness

Unexplained crying

The second part of Whitaker’s thinking on childhood bipolar disorder is an SSRI to bipolar pathway. Estimates of the rate of the well-know SSRI side effect of mania, multiplied by 2,000,000 children and adolescents on the medications, give us the possibility of producing at least 500,000 SSRI-induced bipolar disorders in young people.

If true, these hypotheses could go a long way to explain the skyrocketing rates of childhood bipolar disorder diagnoses, as most diagnoses of childhood bipolar disorder are made on children who are already taking stimulants and/or SSRIs. The primary alternative, and more mainstream, hypothesis is not that stimulants and SSRIs are iatrogenic, but that since those medications solve the problems of ADHD and depression, the symptoms of bipolar disorder that emerge show that the diagnostician had initially guessed wrong, and that bipolar disorder was the previously-existing and underlying cause of the ADHD and/or depression. This, of course, may be true, but it seems very important to discover for certain whether it is!

John Gottman is a rock star of the science of marriage relationships. He studies them in great detail, minute interactions, facial expressions, heart rate, stress hormones. Using that data he can predict with a high degree of accuracy which relationships are heading for happiness or unhappiness, stability or divorce. I should say that this is prediction in a technical, statistical sense, not in the sense of prophecy. He can’t tell you if your relationship will fail, only whether your relationship behaves in similar ways to those that have failed in the past. Still, that’s a lot better than nothing, and it’s been enough for him to build an exciting theory of relationships.

In his theory, the most important, without-which-all-is-lost part of your relationship is the friendship. By friendship, he means several very specific things. Here is a summary of his summary from his newest book, The Science of Trust:

  1. Track your partner’s inner experience by asking lots of questions and remembering the answers.
  2. Make a habit of finding things to appreciate your partner for and letting them know each time you do.
  3. Notice the things your partner does and says that could be responded to, and respond positively to them. Pretty much all of them—you can miss or fail to respond to at most 3 out of 20.

If you are not doing this work, he says, you are not behaving like couples who manage to sustain satisfying, meaningful, passionate relationships, who manage conflict well enough, and who stay together longer than 6 years. Maintaining friendship in this manner is the bare minimum.

I became aware of Google’s Ngram Viewer a few days ago when Reanna read me the essay “Isn’t the word “feminism” itself gender-biased?” The author used this image:

What? You can do that? Yes, you can, apparently. You can search the frequency of words in all of the books Google has digitized

This is really fun, but be aware that you can sink a lot of time into it. Here are a few randomy ngrams I made. Sorry, but you might have to zoom in to see the text. That’s control-plus for PCs and command-plus for Macs.

The first fiction I read after graduating from my Couples & Family Therapy masters program was the novel by Irvin Yalom, When Nietzsche Wept. I loved it and read it out loud to Reanna directly afterwards. I was fully engaged and deeply moved each time I read it. Yalom imagines a pre-Zarathustra Nietzsche becoming involved therapeutically with a mentor of Freud’s in 1882.

Before rushing out to get it, consider my caveats: I am a therapist and this is a novel about therapy. I am a fan of Yalom’s from having loved two of his clinical books, An Open Letter to New Therapists and The Theory and Practice of Group Psychotherapy. (The Group book split my cohort–most hated it. I never understood why. It was great.) I am also very interested in existential philosophy.

If you do read it, consider a doing a couple things that helped me enjoy it. I created a Pandora station for the 1880s out of Wagner, Mahler, and Strauss. It really shifted the tone of the book to be listening to the ultra-dramatic German music of the time. Second, all of the major characters are historical figures with images available online–Nietzsche and Freud, of course, but also Bertha Pappenheim, Lou Salome, and Josef and Mathilde Breuer. That was fun to see.

I started reading Whitaker and Malone’s 1953 The Roots of Psychotherapy last summer, on the advice of John Miller, one of the heads of my Couples and Family Therapy program. He hadn’t actually read it, but had had it so highly recommended to him by a respected colleague that John wished he had time to read it. It was a difficult read, especially in addition to my regular course-reading, but interesting to see what looked like Whitaker’s explanation of his transition from psychiatry and psychoanalysis to the experiential family therapy of his later career.  You can see elements of existential, experiential, and person-centered therapies emerging in Whitaker, all explained in Freudian language.

My outline is quite sloppy, thanks mostly to Open Office’s awful outlining capabilities, to inserting my own comments, and to my own lack of understanding at times, but the guts of the book as I did understand it are here. I don’t recommend reading it unless you are a therapy nerd, but if you are, and especially if you are interested in Carl Whitaker’s model of therapy and its origins, I do recommend it. In less than an hour you can get the basics and decide if the book is worth reading for you.