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24 September 2009

The “Bic Syndrome”

There is a phenomenon in contemporary American culture that appears to be at least 20 years old. As a counselor who both teaches and practices the art of counseling, I have observed this phenomenon in both my students and the individuals with whom I do counseling throughout this period. I refer to this “quirk” in contemporary human behavior as the "Bic Syndrome."

While I must admit that I most frequently observe this phenomenon in clients who seek counseling to address a personal problem or students in the classroom who are more interested in a degree than the knowledge afforded by education, I have also noted the Bic Syndrome in part time employees in entry level positions, couples in relationships where the initial passion of the pursuit gives way to the challenges of learning to live together, and even those who believe that life’s offerings by a particular birthday are not fulfilling, boring, or just plain dull. The "Bic Syndrome" takes its name from the popular disposable razor so successfully marketed for the past 15 to 20 years.

The beauty of the disposable razor is that its relative economy allows one to simply discard the razor when it is perceived to be dull and replace it with another "new" and sharper one. There's no muss, no fuss, and no one thinks twice about the practice. Now with razors--and cigarette lighters for that matter--this may be convenient and economical. It would seem, however, that we have become something of a "disposable" society. It often seems easier and more convenient to discard an item that becomes “dull” or is “old” when compared to the latest model. Sometimes it even seems that we would rather discard and replace an item than invest the effort or time necessary to properly maintain or fix it. If this is true on any level, does it suggest that we have become a pleasure-seeking culture that believes it is somehow our right to expect immediate gratification and not have to tolerate things “inconvenient, dull or tedious”? To discard razors and lighters may be a relatively harmless practice in the grand scheme of things, but what happens if this “consumer’s view” of convenience affects our commitment to jobs, friends, or relationships, especially at those times that will always surface when they become dull or tedious or are in need of maintenance?

To a large extent, we humans know what we have learned and learn what we have been taught. Now, this does not mean that one cannot predetermine her/his own course in life and pursue the learning that permits the pursuit of a dream, but if one is overly involved in the Bic Syndrome, the desire for the newest, sharpest, brightest reality can undermine one's resolution to work on a problem relationship rather than to simply discard it and move one.

I have often overheared the rumblings of students about "how hard" school is and how "professors should know we have jobs and personal lives" when receiving an assignment that requires significant reading, field work, or unyielding demands for quality in papers or other assignments that require significant investments of time or effort. The expectation is that professors should "lighten-up" and required standards should be driven by the convenience of the student rather than the professor’s expectation of scholarship. While this may be a minority of students, I question if the "Bic Syndrome" has not affected our next generation of students. And what of the impact of the Bic Syndrome on relationships? What relationship maintains the same level of passion and intensity through month and years of togetherness that was present when the parties first became involved? How is it possible to avoid differences of opinion or the problems related to blending two independent personalities into the intimacy of a maturing relationship?

There is something to be said for the old "straight edge and razor strop" approach to maintaining the edge on one’s personal relationships. Richard Bach perhaps said it best in his book, Illusions, “There is no such thing as a problem without its gift inside. The reason we have problems is because we need their gifts.” To discover that my Bic razor no longer has an edge and I risk cutting myself if I shave with it may justify discarding the blade and replacing with a new one. But if I discover that my relationship with my kids or spouse or lover is strained or dull or requires maintenance, I think I will consider the lesson of the straight-edge and barber’s strop.

What do you think?

16 September 2009

Changing collegiate drinking is a lot like ridding a lawn of dandelions: nothing changes until you address the taproot.

There is an interesting piece on collegiate drinking in the latest edition of Hazelden’s Recovery Matters – see http://www.hazelden.org/web/public/prev70430.page It is “sort of” right, in MHO :) To a certain extent, the article proffers what those of us familiar with the field of collegiate drinking might tend to view as “same ole, same ole.” The impetus for changing collegiate drinking is placed on changing the campus culture that supports that drinking. This is, as far as it goes, fine and not something of concern to me...there are things that campuses and communities can and should be doing to address this concern. What is of greater concern to me is the fact that the focus for such interventions and strategies to affect change is placed on external factors controlled by the administrators and other “adults,” that is, the “dominant culture” on campus, e.g., environmental management, and again this is good. But to solve the collegiate drinking problem is for “us” (adults) to change “them” (students)—and to suggest that all collegiate drinking is a problem necessitating a solution is perhaps misguided and another argument I have outlined in my 3rd monograph on collegiate drinking, “Is Collegiate Drinking the Problem We Think It Is?” (see http://bit.ly/DeeCg).

Although what is suggested in the Hazelden article is sound and appropriate to pursue, it is not all there is that needs to be pursued regarding high-risk and dangerous collegiate drinking. My argument has been that until and unless we understand: (1) the symbolic meaning that alcohol and drinking hold for contemporary collegians, (2) the process by which that meaning is ascribed by students...and more to the point, re-ascribed, and (3) how to employ that information to hasten the process by which students pass through the period of high-risk and dangerous drinking, “the problem” is not going to change. Because students essentially disagree with us that “any” drinking is a problem they will resist efforts by schools and their administrators to change their involvement in this behavior. And because what administrators are trying to change and what students perceived administrators trying to change are two different things, there will be continued resistance.

We need individual-based, campus-based, and community-based intervention as suggested in the article, but until and unless we acknowledge that what students perceive alcohol and drinking to be as icons of collegiate life and recognize the different from what administrators and parents and law enforcement professionals perceive them to be, we will continue to generate more heat than light when attempting to change the campus culture.

It is hubris on the part of administrators to think that they can ever end the use of all alcohol by college students--change how and when and where it is used, yes, but end it, not likely. And it is naïve to state that students do not arrive on campus already prepped if not preordained to engage in the type of drinking that has come to be described as “binge drinking.” The irony is that the very factor that fans the flames of collegiate drinking goes unnoticed if not ignored as an important determinant of this collegiate behavior. It is like the conflict that has existed in PA for sometime regarding efforts to regulate gun sales in Philadelphia.

For 20-years, the City of Philadelphia has tried to regulate the sale of guns. Each time this happens, Philly is told by Harrisburg that such regulation is not within the City’s purview. When the issue is then introduced in Harrisburg by Philly legislators, such efforts are soundly defeated. It would seem that “Philly” hates guns and “Harrisburg” loves them, but that is a biased and overly simplistic assessment of the difference. The issue is that Philly views guns as “weapons,” which it seeks to regulate for purposes of public safety, and Harrisburg views them as “recreational equipment” that are a right for residents to possess, use, and enjoy.

The language used by the legislators in Philly and in Harrisburg is the same, but the perception of these legislators as regards the symbolic meaning of the term being debated is different. A “gun” in Philly is used to break the law and reek havoc on the public whereas in most of the rest of PA, a gun is a sporting person's recreational device used in licensed hunting and recreational target shooting. In short, a gun is what the person referring to it says it is. This understanding will, in turn, affect how that person uses the gun and also how that individual responds to the efforts of another to “change the culture” surrounding the gun and its users. It is no different when we look at alcohol, drinking, and collegiate life.

It would seem logical that we can operationally define “alcohol” and “consumption/drinking,” but we would be wrong. Ask students, as I have for the past 20-years, what alcohol is and what drinking is and what these icons of collegiate life are and how they affect one’s collegiate experience and you will discover a different perspective than if asking student affairs professionals, law enforcement professionals, parents, and residents whose properties are contiguous to campus or student-occupied housing.

To end as I began, I do not take exception with most of what is suggested in the Hazelden article. What I suggest is that it does not look at the root of the issue. Like trying to clear your lawn of dandelions by just picking the blossoms, the next day the lawn is again full of dandelions. Until and unless the taproot is addressed, nothing changes...and the number of dandelions may actually expand. The “taproot” in collegiate drinking is the meaning students give to alcohol and drinking and therefore, the way to change the campus drinking culture is to change this meaning. Study what these icons of collegiate life mean, understand the dynamic that generates that meaning so we can better affect it and you will see a change in student behavior and many such individual changes equals a change in the campus culture. The irony is, this happens naturally in the maturing out phenomenon—I write about this in the 2nd of the 3 monographs I have written on collegiate drinking (see http://bit.ly/qrpJA). The problem is that this maturing out takes 2 to 3 years and a lot of the untoward consequences of collegiate drinking that are showcased on the NIAAA web page cited in the Hazelden article can happen during that time. If we can hasten this process we will not only reduce the untoward consequences, but change the campus culture. As experienced students change their behavior sooner they will influence less experienced students and instead of the negative peer pressure mentioned in the article, positive peer pressure can increase the likelihood of moderating behavior, a.k.a., change the campus drinking culture.

08 September 2009

Conducting Assessments of Drinking/Substance Use

A reader contacted me asking my thoughts on conducting assessment and which instruments I might recommend...good topic and question, although I may not have “the” answer...I do have an opinion and a couple thoughts...

I find the BASICS (Brief Alcohol Screening and Intervention with College Students) approach to provide the best “assessment.” Although it does not yield a “likelihood” of a particular pathology or individual scales that can be indicative of co-occurring issues like the SASSI (Substance Abuse Subtle Screening Inventory), its opportunity to provide genuine feedback in a “what do you think” manner open more conversations and ultimate referrals than other “instruments.” That said, I do like the ASI (Addiction Severity Index) as it is relatively non-invasive when administered by a trained practitioner and its results tie in nicely with the development of a formal treatment plan, although it is something of a bear to administer and can take time. It is also not likely that a pre-contemplative or even a contemplative (early stage of readiness to change) client will be very helpful/compliant in completing the ASI.

I have found that the old standards work quite well too – MAST, CAGE, etc. — but I have modified their use. Instead of ask the questions associated with these screening tools, I answer them for the client after having invited the client to share his/her story. This “narrative” approach accomplished 2 things: (1) it recognizes that clients are “more willing to share their stories” with someone willing to listen than to “tell an ‘interrogator’ their business” and, (2) I can always answer questions like the closed-ended MAST or CAGE based on a history in which the client has addressed these “areas” in response to individual open-ended questions intended to facilitate conversation. Coincidentally, by the time I have listened to a client’s story, perhaps through 2 sessions, I have often earned my “street creds” that enable me to provide the feedback, including an interpretation of the MAST and CAGE without having the client, “up and run.”

Almost as an aside, how one looks at assessments is as important a determinant affecting outcome as is what is done during the assessment. For example, if I am interested in uncovering pathology and categorizing problems, I will approach the individual with whom I am working in a different manner than if I am interested in encouraging that individual to look at the “facts” in his or her life from a different perspective in order to better answer the basic question, “Is what I am getting worth what I have to pay to get it.” The “old objective” suggests that it is “me,” the practitioner, who needs to know what is really going on with a client so that I can then “fix the problem.” This works well when the ‘patient’ has shoulder problems and a diagnosis of a torn rotator cuff is made and a surgical intervention is planned to fix the problem. Such an approach, I believe, is not quite so well suited to interacting with a substance using individual in order to “address the drug problem.”

We know from the literature and research done on Motivational Interviewing that the old “you have a problem and I know this because of these diagnostic symptoms and this is how you can fix it” approach does not work well...as a matter of fact this results in counseling being more about “wrestling” with clients than “dancing” with them to borrow from Wm. Miller’s metaphor. If I approach assessment as not so much the pursuit of what “I need” to “fix your problem,” but rather a process by which I invite the individual to consider the facts related to personal use in such as to more accurately answer the question, “is what you get worth what it costs you to get it,” then the outcome can be much different. It is something akin to the City Slicker’s experience in this old “Pa and Pa Kettle” movie clip from the 40s – see http://www.youtube.com/watch?v=yG7vq0EMvgE In the clip Ma & Pa argue their position much like individuals with no intention of changing behavior argue theirs, in other words, like many collegians when approached about their drinking...I do not need to change because you are wrong in your assertion that a problem exists. If the goal of counseling is to show the client the errors of his or her way, then this is a contest where someone can only win by someone else losing. Traditional assessment tools often facilitate this “battle of the wills” approach to addressing questions related to drinking “problems.”

To summarize, we professional counselors have to assess client needs before attempting to treat them. But the onus is on us to determine why we are doing this. If it is so I know if John or Mary has problem “X” or not, that may yield an entirely different result—mind you, not necessarily “wrong,” just different—than if my quest is to invite John and Mary to looks at the facts in their lives from a different perspective. Remember Sandra Anise Barnes’ quote, “It’s so hard when I have to, and so easy when I want to.” It is like someone living in Boston considering how to get to Philadelphia...is I-95 always (ever?) the best way? The answer is, “it depends.” If the assessment process helps us better articulate the variables that affect the admonition, “it depends,” I submit that the assessment process will be beneficial. If, however, the assessment is to stockpile facts and evidence to prove why the client is wrong or quantify “the problem,” I am not so sure the result is the same.

What do you think?