Self-awareness – A millennial's musings

Don’t ask why?…

A reader kindly sent me this article.

I don’t agree with its analysis, but it has some interesting points about using what vs why can have a significantly different effect.

During my stint in psychiatry, I learnt perhaps the most helpful question: what makes you say that? Notably, not a why question even though it asks about the same thing.

I also remember a brilliant psychiatrist giving a patient advice. The patient had a personality disorder and started reading about them to understand why she has it. He told her that at that point reading that could make it worse – and that interventions such as mindfulness and therapy were superior.

As for my disagreement. The article suggests introspective people are unhappy. It assumes and, with a very simple experiment, shows that asking why causes people to be sad. I think that introspective people aren’t sad because they are introspective, but sad and poorly self-aware people turn to introspection. And Negative Capability is still a thing.

Another reason to be less demanding

“I weep because, each time he knelt beside my banks, I could see, in the depths of his eyes, my own beauty reflected.”

I came across the idea that our self-esteem is equal to our opinion of others.

Sounds esoteric, but I reflected on it and there may be something to it.

Assumption:

A mentally well person accepts that she is an ordinary human being and that most people who surround her are ordinary human beings.

Hence,

a) if she is highly critical of most ordinary human beings, on an average day she is critical of herself

b) if she is accepting of others’ faults,on an average day she accepts her own faults

Doesn’t this add up?

I sort of talked about this when I hypothesised that people criticise others for the things they hate about themselves. Reading over it, it seems naive and slightly needy, but I still think there was a grain of truth in it.

“Yet another reason to not be a demanding pig”, I gently remind myself.

Four reasons why daydreams scare off mindfulness

Complex problems have simple easy to understand wrong answers.

Henry Louis Mencken

I have recently been very interested in what it is that makes mindfulness feel quite difficult at times.

Up to 96% of adults daydream every day.

I am using the term daydreaming in the broadest possible way. There are ways in which it is positive (visualisation, rehearsal, creativity), but we all know that it can get out of hand very easily. These so called self-generated thoughts (SGTs) interfere with external task performance and can signal unhappiness and even mental health issues. They also occupy our thoughts for upwards of half of the time. In appropriate contexts, SGTs

allow us to connect our past and future selves together,
help us make successful long-term plans and
can provide a source of creative inspiration.

Given the time dedicated to the task, it seems natural to suggest that there must be an evolutionary advantage to being preoccupied with a daydream.

Contrary to the mindfulness rhetoric, daydreams can be seen as a mechanism for the consciousness gain freedom from the here and now – reflecting a key evolutionary adaptation for the mind.

There is evidence that SGTs are normal and may even be beneficial, so our natural inclination to dismiss mind-wandering – and recent odes to the benefits mindfulness – are perhaps oversimplifying the problem.

For the moment, however, I will focus on the negative aspects of daydreaming. In 2016, the Journal of Conscious Cognition did a study on self-identified “maladaptive daydreamers”. These guys had more daydreams that involved fictional characters and elaborate plots and spent 56% of their waking hours fantasising.

Maladaptive daydreaming caused significant distress to the affected and was associated with higher rates of ADHD and OCD.

Another study echoed the findings and showed that the daydreams were typified by complex fantasised mental scenarios that were often laced with emotionally compensatory themes involving competency, social recognition, and support.

Of note, solitude is required for elaborate daydreams – worsening any existing social dysfunction.

Mind-wandering is situations when attention is required is obviously negative: it can signify performance disruptions, cognitive problems, risk taking or low motivation to perform a task. At the same time, the question arises: how do we define a situation that requires attention? The resolution here is obvious. The capacity to regulate the occurrence of SGTs so as to reduce the risk of derailing on-going task performance is a marker of properly functioning, well-adjusted cognition. It is context-dependent – and requires self-awareness. Indeed, a brain trained with the practice of mindfulness would seem better equipped to recognise appropriate situations and adapt more quickly.

On a more philosophical note, however, what’s to say one isn’t missing out on some important unknown unknown in an apparent “safe-to-daydream zone”?

Based on some research and a preliminary Twitter poll, I have come up with 4 main feelings that trigger daydreams. If none of the four describe what it is like for you, please do comment, I am very keen to find out!

The importance of self-awareness

I often think of The Great Gatsby. While everything in it has been said before, it seems like a particularly easy-to-understand piece on human nature – not least because it seems to be reflective of what our society looks like almost 100 years on. Gatsby was great because he was motivated by love and incredibly focused and resourceful in his quest. There were also many reasons why he wasn’t great: he lied about his origin, he lied about his name, he was a criminal, he had no problem seducing a married woman with a child… Most of all he got carried away from reality. He didn’t see Daisy for who she really was even though it should have been obvious. He suffered from infatuation, limerence and obsession.

There’s an interesting dichotomy that arises from obsession. On the one hand, it is a way to get motivated like nothing else. I was recently listening to an interview with Travis Kalanick, the CEO and co-founder of Uber, who talked about how he chose his idea. He said he was in love with the idea of Uber. He also said that after you fall in love with your idea the hard part is to adjust it to the world so that it is exactly the best it can be. It seemed that all great entrepreneurs develop their businesses for some kind of personal reason. Mark Zuckerberg said that Facebook was something he would have wanted to use for himself. He seems fascinated with how people have huge areas of the cortex dedicated to deciphering the meaning of facial expressions, seemingly minor detail. The kind of motivation that’s required to spend every waking hour you’re not doing coursework in one of the top universities working on social websites means intense interest. Whether it is obsession or not, it’s close to it. Our culture seems to value obsession. In fact, the word has connotations of real dedication and martyrdom. There are gyms called Crossfit Obsession. A “normal” person couldn’t have the level of dedication that these entrepreneurs have, or a particular variety within the men and women of Crossfit – we’ve all met them. A healthcare professional would surely class them as having traits of OCPD, or find a way in which their activity is a form of escapism.

However, all great entrepreneurs are sufficiently in touch with reality so as to know how to adapt. This brings me to the second part – obsession needs to be balanced with reality. For anyone who knows the feeling, they know that this is much easier said than done. When one tries to reflect on reality, it is easy to slip into denial. Alternatively, it can be easy to see the flaws, decide that you obsession is silly and give up on it. It is much harder to see the flaws and incorporate this information meaningfully into your quest.

This idea of either idealising or damning your quest first came to me when I was dealing with patients who had emotionally unstable personality disorder as a doctor. People with EUPD tend to undergo something called splitting: something/someone is either perfect, or they aren’t worth thinking about at all. In fact, this is characteristic of many personality disorders. For example, people with narcissistic traits are very quick to decide that someone’s opinion is worthless if they don’t like something about this person.

How is it that some people are able to benefit from the momentum of obsession, but not dragged down by the unhelpful ignoring or reality or give up on their idea at the first sign of imperfection?

Are these great entrepreneurs necessarily all free from toxic personality traits? Not at all. It must be possible, however, to be sufficiently self-aware so as to let those parts of your personality that you need the most at a given moment to fully express themselves. After all, all these personality traits that we regard as vulnerable – and put them down as traits of personality disorders – evolved for a reason. They made sense in a context. They are only called abnormal because they stopped being adaptive when the environment changed, but the person who developed them lacks the self-awareness required to acknowledge that they are using legacy software – never mind adjust again. So it’s not like there’s just one personality type, not one strategy that will carry you through, but like Darwin said – it is the most adaptable that makes it through. Adaptability is completely a function of self-awareness.

So, how could we hook up with some of that self-awareness? My hypothesis is, as always, by paying attention to it. It is surprising how commonly people are unable to describe how they feel. How do you feel right now? Is it easy for you to answer? In normal life – and in psychiatry – I’ve met pretty high functioning people who are unable to answer that question. Really and truly, they look at you like you are an alien, look away and after about 10 seconds they say, I don’t really know. It’s obviously a spectrum and it’s not uncommon. Some of these people will try and assess how they should feel, making cognitive judgements about their circumstances. It’s called alexithymia. I think this is the first step. Ask the question – how does it feel? Putting words on it is a good place to start. Tackling physical sensations first could be an even better idea. When you notice that you are hungry – how does it feel? Is there a pain in your abdomen? Where? What kind of pain? Is it a cramp or a dull ache? Is there some nausea that comes with it? Does your abdomen feel warm or cold? Essentially, it is a form of mindfulness. With some practice it will be easier to put words on your feelings, or your inner state. It’s not a case of needing to soul-search. It’s not cognitive, it’s all about feelings. Whether we like it or not, emotions play a decisive role in our behaviour – they give rise to our behaviour, that’s what the word means. I think that mindfulness has the potential to increase self-awareness like no other instrument at our disposal. Mindfulness is known to increase empathy. Self-awareness is no less important. People who lack empathy are probably lacking insight into their own feelings to begin with. It may even make sense to think of self-awareness as a form of inner empathy.

If there was one thing that I think would advance someone’s personal development by leaps and bounds – it would be self-awareness. It doesn’t matter that you aren’t the strongest, the tallest, the smartest – or whatever, but if you able to be sufficiently self-aware so as to surround yourself with the right people – you can compensate for those weaknesses – and focus on your strengths.

What’s it all for if…

I often say on my blog for secondary school students that it’s all about balance. I feel wishy washy about it when I say it, so I wanted to tell this story to explain.

I recall spending some time with a dear friend of mine. She is a hugely successful physician now in one of the world’s top universities. This is way back when we were about 19 – in the throes of medical student life.

My friend, let’s call her Angela, is a particularly classy lady. She grew up in one of the finest neighbourhoods in a nice Irish city, educated privately, fancy extracurricular activities, the whole thing. She’s a gunner though, that girl. Being wealthy doesn’t automatically make you soft, and she’s the perfect example of that.

We were probably the only 19 year olds in Marks & Spencer’s buying things like dark chocolate and fresh linguini while our college classmates were out drinking 2 for 1 cocktails or Dutch Gold and eating frozen pizza. We spent our afternoons watching Gray’s Anatomy, The Other Boleyn Girl, Marie Antoinette, Coco Before Chanel, Gilmore Girls… And studying (her way more than me). You get the gist.

I never judge people for indulging. It would never occur to me to begrudge someone their luxuries or criticise them for being wasteful. So when I remarked on the fact that she has expensive taste, she was relaxed about it and said: If you can’t eat properly, what’s it all for?

This throwaway remark got etched on my brain. What’s it all for if you can’t be with your family? What’s it all for if you can’t sit and meditate for 10 minutes? What’s it all for if you can’t enjoy yourself for even a little part of the day? I don’t think she meant it that existentially. The way I took it was more in the stoic philosophy sense: live every day like it’s your last. As a true medical student workaholic fanatic, who was ready to give up everything for success, I never thought that living each day like it’s your last is about more than just achieving. I think if you work really hard, weirdly, sometimes it is easy to lose respect for yourself in a certain way. You become your own slave, the executive of your dreams, but not the person who actually gets to live them. That’s what I mean by balance.