Authority is leadership

The TV spot for a bank showed a 30-something mother with her pre-teen daughter and friends. Instead of talking to each other, they were — what else? — both texting. The daughter was hot on the heels of some boy named Chas, while Mom was in pursuit of financial freedom. At one point, the mother became terribly excited and exclaimed (I am paraphrasing) to her daughter: “The bank is texting me about my checking and letting me know how much we have in our account.”

My husband groaned out loud. Was he in pain?

“Only existential pain,” he said as waved his hand at the screen. “I mean how much information do kids need these days?”

“What do you mean?”

“A healthy, happy family is not a democracy,” he said and changed the channel.

At first I thought it was just his formal Montana upbringing that found the new intimacy between parents and children a bit unwieldy, even awkward. In his family it would have been inconceivable for his parents to place themselves on such an equal footing with the four children. There was an abundance of love and involvement (they were all musicians and played together nearly every night after dinner), but not at the expense of a very clear hierarchy of authority. One’s mother or father was not one’s buddy.

Being from the Northeast, where people stood on stoops and yelled down to the other end of the block at dinnertime and where our emotions were as visible as our shirts, I dismissed his disapproval as an archaic remnant.

But over the course of the day, as I watched parents interacting with their children at supermarkets, hardware stores, in therapy sessions and at school yards, I began to see his perspective differently.

Parents as friends

What I saw was that most parents wanted desperately to be friends with their children. They dressed the same, talked the same, giggled the same with them, jockeyed for position to be cool or hip. No topic was out of bounds. They discussed their sex lives, their finances, their politics, and the issues they had in their social and work relationships.

I thought I would be appalled, but I wasn’t. I was embarrassed. It was a feeling not unlike watching someone leave a bathroom with her dress tucked into her pantyhose or seeing a colleague do something horribly revealing or inappropriate at a party. In those situations, I would have felt like covering my face to avoid being a witness the next day.

I took to wondering why. Why are parents so reluctant to be parents? What has happened in our culture and in our families that we are more worried about whether our kids like us than whether we properly prepare them for a life that is almost always challenging and sometimes damned unfair?

Many adults today have a difficult time with true authority. They vacillate between a laxity that is boundary-less and a sporadic struggle for power. I don’t believe there is just one reason for this. Authority for some of these parents may have been excessive, unyielding, irrational or capricious. Those people would certainly confuse authority with dominance and cruelty. Precisely because they love their children, they naturally want neither to be that way nor for their children to suffer as they did. That’s understandable. But I think it is still erroneous.

Authority for others may be antithetical to their more modern understanding of love, which is easygoing, permissive, unconditional (often in the wrong way), and blooming with constant emotional reassurance and validation. In their minds, authority says no when love says yes.

Anyone who has trained dogs knows that love and “no” are not mutually exclusive. In fact, I believe the only way to truly give unconditional love is to be able to say no, to love the person and loathe the behavior.

Still others seem to have misinterpreted biblical injunctions about authority with children. They have rejected them out of hand because they have mistakenly come to associate them with corporal punishment and shame. The most obvious interpretive error is the popular one which reads the Hebrew for “rod” (as in “spare the rod and spoil the child”) for a reed or a stick. That’s a misinterpretation. A biblical authority is not punitive. Parents are given the injunction to educate their children and to hold them accountable to the performance of all the commandments — after the children have been helped to understand them.

Authority is compassionate

It is a shame that authority has earned itself such a miserable reputation because it is perhaps the most essential element of truly effective and loving parenting. Authority can be quite kind and loving even when it is correcting negative behavior.

Nature abhors a vacuum. So do children. When parents do not provide authority, children assume the dominant position. It is not necessarily a bad thing. It is survival. Someone has to be in control.

So what is a parent to do? Start by revisiting ideas on authority. Authority is calm, sure-footed, firm, confident and compassionate. If you are tentative, hesitant, punitive or vacillating, you are giving mixed messages and can no longer be trusted to lead. Authority is leadership. Children naturally gravitate to leaders, to adults who seem to know what they’re doing. Children want someone to guide them while at the same time allow them to make mistakes and learn. Authority says: Follow me. I know what I’m doing. Authority says: I understand what you need. Authority says: I will keep you safe.

Most parents do not give themselves permission to be the boss and loving at the same time and are terribly relieved to hear that they may. So are most children.

When as a therapist I did behavioral contracts with children I always warned parents of the imminent dangers of setting new limits. “One, you may be a bit awkward at first. Be patient with yourself and your adjustment to a new role,” I urge. “Two, the better you get at it the more your child is going to test you. He is going to rebel. He may fly in the face of your authority. Stay still. Let him spin. Research has shown that there is a predictable learning curve to that reaction and that the tumult will pass — if you are consistent and maintain the authority over time.”

I have done a lot of hand-holding with parents as they experience the back draft of their newfound authority. But when it’s all done and the heat has passed, there is a new relationship to be enjoyed, one in which the parent is the parent and the child is able to relax in their loving, sure hands.

Prescription addiction

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A recent edition of the Journal of The American Medical Association (JAMA) described a report issued by the Centers for Disease Control, in a splendidly titled tome called the Morbidity and Mortality Weekly Report. Subtle sirens of alarm were sounded. The rate of unintentional drug-overdose deaths in the United States has risen over 600% between 1997 and 2007.

The report was not discussing heroin, meth or crack. It was warning doctors about prescribed analgesics. Drug distribution through the pharmaceutical supply chain was the equivalent of 96 mg. of morphine per person in 1997 and approximately 700 mg. per person in 2007. That’s enough for everyone in this country to take a standard five-milligram dose every four hours for three weeks.

According to the report, “Prescription drug abuse is the fastest-growing drug problem in the United States…and has been driven by a class of prescription drugs called opioid analgesics.” The numbers are astounding. “For every unintentional overdose death…nine persons are admitted for substance abuse treatment, 35 visit emergency departments, 161 report drug abuse or dependence, and 461 report non-medical uses of opioid analgesics.”

Did someone say there was a war on drugs? From the CDC’s analysis, it seems the medical industry has been exempt: “In an attempt to treat patient pain better, practitioners have greatly increased their rate of opioid prescribing over the past decade.”

Allow me to share two stories behind these statistics. One is about a patient of mine whose name has been omitted here, and the other involves my own personal experiences after a back injury.

The patient came to me with minor anxieties and some depression in large part due to unresolved grief. She was in her mid-thirties, a nurse, without major medical complications. Almost all her complaints centered on her fear of abandonment in relationships. Early on in treatment, she slipped at work (trying to move a large man from bed to a wheelchair) and injured her shoulder. After MRIs and doctor visits that lasted months, it was finally determined that she had some injured tendons. They put her on Vicodin. They refused her any other form of treatment.

That was 15 years ago. Her dosage increased dramatically over the years, as did her anxiety, her depression. Finally she was able to experience the abandonment she had so feared. Her marriage fell apart. She became so addicted to the Vicodin that the withdrawal was more frightening than the dissolution of her family.

I have seen this scenario in different forms at least a hundred times. I have made phone calls begging physicians please to reconsider their choice of medication and allow for other medical solutions: acupuncture, physical therapy, massage, homeopathy, mindfulness meditation, hypnosis. With the exception of a few truly open-minded practitioners, the answer has been a uniform “no.”

Why would anyone object to an alternative treatment if it brought relief at lower cost and without the risk of addiction and all the associated medical risks?

A few years ago, I fell (hard) and twisted my back. I was more embarrassed than in pain. “Oh, I’ll be fine,” I said. “It’s fine.”

Within the time it took for my adrenal glands to stop pumping, the pain became intolerable. I could not walk. An urgent-care facility told me it must have been a muscle sprain because there was nothing on the x-ray. I was urged (I mean this literally) to take painkillers. I said, “No, thank you.”

The doctor on staff looked at me cross-eyed and said, “What do you mean, No, thank you?”

I said, “I mean no. I don’t want them. How about some aspirin or ibuprofen or something like that?” He reluctantly gave in and wrote the prescription, telling me “You’re going to be sorry.”

The pain was not going away as quickly as I’d hoped, but I had seen what Vicodin could do and was determined to do whatever I had to do to avoid it. After putting up a fight with the insurance company that last two months, I finally went for an MRI, where they found the bulging disc that was impinging on my sciatic nerve.

I found a physical therapist who was a hands-on genius. She relieved the pain with a combination of deep tissue massage and abdominal strengthening. We also used guided meditation. She used to tell me to “imagine the butter melting” as she focused on releasing the iliopsoas, particularly psoas major, the muscle that connects the hip to the spine. As she worked, I felt miraculous and immediate joy.

I was still in pain and not as limber as I used to be, but my condition was moving in the right direction. And I was willing to work hard to get better. Then the insurance company insisted on a new doctor, who looked over my chart and said, “You’re going to need Vicodin.”

I said, “No.”

Once again, that same look: “What do you mean, No?”

I said, “I don’t want dope. The massage and exercise works. Why can’t we continue that and forget the drugs?”

“Because you’re at maximum improvement. You can get the drugs but not the therapy.”

It was my turn to look at him cross-eyed. Much to the amusement of the nurse in the room with us, I said, “Are you crazy? Who are you working for?”

“This is medical standard now.”

“What about your oath?”

“I’m sorry.”

I looked at him and said, “Yes, you are,” and that was that. I walked out. No therapy and no Vicodin.

I had to pay for my own physical training and take responsibility for my own recovery. It was not easy. But it was infinitely better than what I’d seen with my patients: people who had been struggling with aches and pains or broken hearts turned into addicts with broken homes, empty pockets, and symptoms so wildly erratic the patients were sometimes mistakenly diagnosed as bipolar instead of addicted. Rather than getting them off the vicodin, they were given ever-increasing doses of medication that eventually made reaching — or treating — them impossible.

This war on drugs we’re waging? Maybe it should start in the doctor’s office. It seems to be up to us patients. I don’t see the pharmaceutical companies leading the battle.

 

Judith Acosta is a classically trained homeopath, a licensed psychotherapist and a crisis counselor. A resident of New Paltz, she has written several books and is a regular contributor to The Huffington Post, The Journal of Emergency Medical Services and other publications. She may be reached at www.wordsaremedicine or www.thenextosama.com.