Lessons From a Psychologist

I have learned much from a few of the psychologists I have known.  don't ask me about the others. I will call this one John and tell you three things I learned from him.

Three Shall Be The Number 
When setting up a behavior plan, one can only target three behaviors at a time.  This is not because the patient cannot learn more than three things at a time, but because the staff can't focus on more than three things at a time.  We may set up that we do not want the patient to hit anyone, and reward not hitting anyone with a point every three hours. We might next want the patient to learn the value of keeping busy and being cooperative, and so earn a point for every group or activity he attends. Thirdly, we might think it important that the patient not make sexual remarks to the female staff, and will grant points for refraining from that.  So far, so good, and everyone nods what a great plan this is.  Then, having earned ten points, the patient may be eligible to have one-half hour off the unit unsupervised.  But fifteen minutes before, this patient gets angry and insults a staff member coarsely.  The staff now does not want to give the patient that half-hour privilege, and becomes incensed that anyone thinks the patient has earned it.  Too bad. Behavior plans are to train the staff, not the patient.

This generalises to marital therapy, or getting your children to behave, or independently trying to influence your spouse to change.  Three shall be the number. If you can think of seven things that you believe your spouse or child should have figured out on their own five years ago but didn't, that does not authorise you to clamp down on all seven now.  It's yhour own fault you didn't pick three then, so that you could be working on the others now.  Pick three, or you will just be losing your temper needlessly.

Once they are addicted to tokens, you can train them to do anything.
This is strictly behaviorist, but behaviorism works quite well in a targeted way.  Because it doesn't generalise all that well it can't be used for everything, but token economies are great in their limited way.  The beginning of the program is to get them addicted to the reward.  This is easier if it is an activity they have already demonstrated they care about, whether that is M&Ms* or your attention. It not only works for children, but for many adults.  My wife insists that giving her gold stars on the calendar for something that I am happy about is a great idea, because she laughingly says she loves gold stars.  I can't bring myself to do it, because it seeems demeaning and I am not that sort of husband.  Yet I am wrong.  If she prefers that, I should accommodate myself to it.  But I can't.  At some level I believe I am demeaned by this and so refuse. Clearly, I am considering some abstract ideal more important than the happiness of my own wife, which is wrong.

To take this out of the realm of the personal into the political, this is exactly what has happened with college degrees.  Our society is addicted to the credential as a means of selecting for jobs, mates, status. We therefore jump through any hoop the providers of this token put in front of us, not because we think it is a good idea, but because we know our society requires this drug, like spicers in Dune. They provide less and less value at greater and greater cost every year. The original value of the token sucked us in.  Some of that value remains, however much conservatives rail against it* Yet it hardly matters at some schools.  Because the workplace is addicted to the degree (and, is that the colleges' fault?), the strength of the drug matters less.

Whoever controls a precious resource will become a complete prick about it.
Certain stepdown, supervised, or rehab beds are hard to come by in my field.  Housing in general is a tough issue for the mentally ill anyway. (There is a lot of on-the-one-hand, on-the-other-hand discussion about this I will not insert here.) But specialised housing - sober housing, staffed housing, subsidised housing - is even more precious. Over time, the people who hand out those beds become pricks.  I would be worse. Don't get me wrong here, that I think they are horrible people.  But they can afford to be choosy, so they are. 

This is playing out culturally in powerful ways at this point.  People are addicted to social media and so will put up with anything.  Those who control those bulletin boards have very rapidly become arbitrary about who shall be admitted in the door. "Who's your rabbi?" (Old Tammany Hall phrase.)


*College students can and often do learn valuable stuff.  The problem is the things they must subsequently unlearn.