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'Modern Youth and Chastity: Freeing Yourself from Sexual Repression'
by Joseph McBride
February 24, 2016
When I read my memoir of that tumultuous period in my life, The Broken Places, I tend to look at my younger self as a boy I once knew, someone I like and wish I could help, as me-but-not-me. That kind of distancing is one reason you write a memoir. It also helps you understand your past and exorcise your obsessions. Although that is a helpful process, it doesn’t entirely work, since there is no such thing as “closure.” But I hope that my experiences in the sexual Dark Ages will be of some benefit to younger readers today. I offer here five hard-won lessons I gleaned from my struggles with sexuality in the days before the Sexual Revolution of the late 1960s.That advice didn’t prove very helpful to me at the time. My anxieties over how to reconcile the repressive teachings of the church with my naturally developing sexual desires led me to a physical and psychological breakdown in my senior year. I learned some valuable lessons in that process about how not to deny the sexual impulses common to us all, but it took me longer to learn how to handle them. Today, we like to think we live in a more enlightened age, but the old specter of sexual repression has reared its vicious head in new ways, so our “modern youth” often are caught in a similarly painful vise between what their bodies demand and what society tells them.
1) Don’t Do It is advice that simply does not work.
Today we hear of the “abstinence movement” being foisted on young people. Sure, they need to learn how to handle sexual desires responsibly and carefully, especially in a time when sexually transmitted diseases are more rampant. But counseling the denial of basic sexual impulses is a fool’s errand. It can only lead to terrible fear and confusion, as well as to evasiveness and rebellion. Few people today become priests or nuns, and even in the Catholic Church, as we’ve seen, celibacy often is honored more in the breach than in the observance. Leveling with young people about their changing bodies and emotions is much more valuable advice than the kind of warnings we received in Modern Youth and Chastity and its variant edition, Instructions on Dating for High School Boys.
That pamphlet, which I read while attending Marquette University High School in Milwaukee, was taught to us by its author, our school disciplinarian, the late Father Jerome Boyle, S.J., a grinning sadist who also whipped our asses with a sawed-off golf club for all manner of transgressions.
It’s obvious that there was a strong sadomasochistic component in that kind of discipline, which would get an educator arrested today but was approved of by our parents in a misguided attempt to keep us in line. Father Boyle’s sex manual, or anti-sex manual, warned against becoming aroused by the near occasions of sin, which lurked just about everywhere: “A few cannot read a decent book, or a magazine like the Catholic Digest, without getting into a tizzy.” His apocalyptic rhetoric took on familiarly harrowing Cold War overtones. “Controlling sex,” our rod-wagging school disciplinarian pointed out, is “like controlling an atomic bomb.”
As I write in The Broken Places, “What Instructions on Dating for High School Boys drilled most indelibly into my mind was its explanation of how one can tell when kissing becomes mortally sinful. This was known as ‘THE FEAR RULE.’ That rule came into play whenever I found myself in dangerous proximity to a girl: ‘The first three letters stand for frequent, enduring, and ardent. The final letter R stands for the reason. The rule says that kissing, or, for that matter, any physical expressions of affections that are frequent, enduring, and ardent, are invariably directly stimulating. Therefore, no reason apart from marriage can justify them. Bestow such marks of affection, and you appropriate to yourself privileges to which you are not entitled. You are putting your sex faculty into actual operation. This reasoning is hard for many young couples to see. It is still harder for them to accept. But accept it they must. It is God’s law.’
“So what I took from this sacred formula was that kissing passionately was mortally sinful, and you would burn in Hell for it, at least if it was Frequent, Enduring, and Ardent: FEAR. As Father Boyle told us personally when we timidly queried him in class, all three states had to occur simultaneously: Kissing was not mortally sinful if it was frequent but not enduring, or if it was enduring but not ardent. Apparently ‘THE FEAR RULE’ sanctioned occasional, brief, tepid kisses. At least that way you wouldn’t burn in Hell just for making out; you’d only go to Purgatory for a couple of years.” I took this all mumbo-jumbo very seriously.
2) Prior evidence that repression doesn’t work began to accumulate for me in Catholic grade school.
It was bad enough we were given hellfire-and-brimstone indoctrination that sex was evil per se (I never really understood why there had be two commandments out of ten warning against sex, but I got the point). But I also had an insane nun in third grade at St. Bernard’s Grade School in Wauwatosa, a disturbingly attractive woman named Sister Magdalena, who took out on me her obscure frustrations (probably at least partly sexual in nature; the word “sadomasochism” again comes to mind). She assigned each girl in the class a long wooden ruler to whack me over the head if I did anything wrong; all day for the first semester I was being beaten over the head by the bruiser of a girl sitting next to me and other girls passing my desk.
In the second semester, my desk was moved to the front of the classroom, with my back to the other students, which was even worse because I felt so ostracized. And one day the nun shoved me into the broom closet and had the rest of the class push on the door to keep me inside. Part of me feels as if I am still in that closet.
Just as damaging in my early days was the strict segregation of the sexes. We were discouraged from talking with girls, and once when I walked a girl home at lunch for a few days, I was warned by the pastor not to do so again. And we were warned by the nuns not to look at “dirty pictures.” There was a drugstore down the hill from our school that sold magazines with semi-nude pictures of women, the tame sort allowed in the fifties. Naturally, because they were prohibited, this piqued my interest, and I began studying the skin mags intently every day after school.
My fascination would become an obsession with what passed for pornography in my high school years (1961-65), i.e., the girl-next-door nudes in Playboy and airbrushed nudist magazines. I was learning how unhealthy it is to be discouraged from having curiosity about seeing what the other half of the human race looks like in its natural state. Prohibiting such curiosity leads to both guilt and rampant prurient obsession as a substitute for actual interaction with girls. Because I hadn’t been able to talk with girls in grade school and was physically abused by them, I naturally was inept and afraid about dealing with the opposite sex in high school. I went to a couple of dances, but when the girls behaved rudely, I stopped going and never talked to a girl again until I had the good fortune to crack up and be put in a mental hospital.
3) That experience saved my life. Partly because a girl came up and talked to me.
Kathy Wolf was a troubled but brilliant young woman who in that benighted age had been poorly diagnosed. She was labeled as “schizophrenic,” had been subjected to shock treatments, and was suicidal. We had a giddy romance that turned sour by the end of that summer, when her demons became more and more uncontrollable. She had three personalities; for two weeks, she thought she was Barbra Streisand. But in my process of relaxing with her and sharing thoughts and feelings, and enjoying making out with a young woman who had few sexual inhibitions, I was learning about life. Unfortunately, Kathy was too troubled to survive. While I was getting better, she was destroying herself. But I owe everything to her.
4) Although our relationship inevitably fell apart, it readied me for the Sexual Revolution of the sixties.
I did a lot of sexual experimenting in college and beyond, after I moved to Hollywood in the seventies, but I was still overly fixated on sex as fallout from my earlier warping. My libido was spinning out of control in other ways; too much liberation can be as daunting and confusing as too much repression. Eventually I managed to find some balance between my uncontrollable impulses and the realities of dealing with adult women with needs of their own and with whom I could develop a more mature way of relating. I learned how to treat sex as a natural component but only one aspect of a healthy relationship.
5) My nightmarish early experiences with sexual repression in an era that systematically misrepresented human nature might seem more troubling than what most young people go through today.
But human nature doesn’t fundamentally change, and adolescents in every time and place have many challenges to deal with as their bodies and emotions evolve and society fights back against those natural impulses. Today’s youth may not often be given chastity manuals (except in certain fundamentalist circles), but they are inundated with sexual imagery that must seem bewildering. They also are faced with questions about gender identity that most kids in my generation didn’t have to deal with because we didn’t know they even existed. Gay, lesbian, and transgender youths now face issues more complex than we most of us could have imagined in the days when masturbation was considered the most urgent sexual problem for Catholic teenage boys.
I can only advise frankness between parents and children and teachers and the most generously understanding attitude by parents toward what their kids are going through as they struggle toward adulthood. Any attempt to stifle that process is doomed to failure and runs the risk of damaging and even destroying a young person. The choices between “Modern Youth and Chastity” are not that simple. In a world full of psychological imperatives and social choices that seem to keep multiplying every year, when we deal with youthful sexuality, we need to be open to complexities and careful experimentation and, above all, to absolute honesty rather than indulging in evasion and denial.
'Sharing Your History of Trauma: Overcoming the Danger of Silence'
by Joseph McBride
March 23, 2016
Writers are particularly fortunate in that we can find a public forum for sharing our stories. In that too, the advantages, in my view, outweigh the risks. We do our best writing when we are most ourselves. We can overcome our traumas to a large degree by remembering them honestly and deeply, putting them together into a meaningful structure, and exposing them to the world. But the same process applies also to non-writers. There are many ways of sharing your story. They will all do you some good, even if some people may be put off (the old social prejudices die hard) and the sense of catharsis we hope to find may never fully come. Still, it is well worth the effort, as I found in spending decades writing a memoir called The Broken Places.
It was a painful story to tell and re-experience in my memory and writing, a form of self-psychoanalysis that required ruthless, no-punches-pulled honesty. I told the story of how I had a physical and psychological breakdown in 1965 as a Milwaukee teenager suffering from the accumulated effects of family dysfunction, sexual repression, pressure to succeed in school, and damaging overwork. My breakdown sent me into a mental hospital. But as a friend of our family wrote me at the time, what at first seemed a terrible setback was actually “a fantastic stroke of good fortune.” Not only did I benefit from getting out of the house, getting out of school, and learning to relax and live more freely, I finally had the advantage of some enlightened psychotherapy. And most of all, I had the good fortune to meet a young woman who helped bring me out of my shell of inhibitions and fears and to teach me how to live.
Sadly, she was so troubled and shattered, felt so stigmatized about her condition, was so poorly diagnosed and treated by doctors, and felt so conflicted about her own afflictions and her ethnic identity that she was unable to help herself. I survived and went on to a productive life, but she did not. This extraordinary series of events was not easy for me to talk about for quite some time. I had to cope with the feelings of embarrassment and shame that often afflict people who make such experiences known. Particularly in that era, a terrible stigma surrounded mental illness. Some people I tried to talk to didn’t want to hear about it or harshly judged me or made such ignorant comments that I began to retreat from the subject. Since I am fortunate to be a professional writer, I realized that the best way to deal with it was to write about it.
My experiences with psychiatrists in my early years were not always beneficial; one of them was so troubled that he killed himself, and another Milwaukee doctor who saw me during the weeks before my breakdown thought I was “no more neurotic than the average Marquette [University High School] senior.” I realized that even if a patient finds some professional help, as I did, he ultimately has to heal himself. So my writing of a memoir was my own form of prolonged self-psychoanalysis. The process of writing is similar to unburdening yourself to a psychotherapist, since you have to dig frankly and candidly and bravely into your feelings, your psyche, and your past in order to come up with insights into your blocks and conflicts. Some of these realizations can be brutally unpleasant. Some can affect your dealings with your family and others. But the process is necessary if you are to start healing.
Many people are unable to take that first step Freud counseled — facing up to your problems without blinders on — and instead condemn themselves to lives of psychological impoverishment, denial, or delusion. But if you can summon up the strength to study yourself honestly and write about it, you are taking steps toward recovery. Those who are not professional writers can write diaries or private letters to themselves, or short accounts of key incidents in their lives and reflections on them, and then, perhaps, share these insights with trusted friends and family members. Those of us who write for a living are able to write about our lives at length and shape our memories and stories into a well-structured form that enables us to examine them with richness and depth. And if a memoir is professionally written and candid, it can be published and shared with others.
Though my process of self-exposure took decades, it was worth it. And the response has been gratifying. I didn’t know what to expect from sharing the secrets of my inner life, but it is gratifying that people have largely been sympathetic. There have been a couple of exceptions; you have to take the knocks along with the praise. That’s life and it’s something we must face if we share our stories. Perhaps most gratifying is that many people who have read the book are inspired to share their own traumas and problems with me. Most readers connect with The Broken Places because any truly honest memoir will enable us to see ourselves in it. Such a response shows that when you open up, other people will too, and all of us will benefit.
My late writer friend John Sanford, wrote several books about his wife, screenwriter Marguerite Roberts, after she died. I asked John why he kept writing about her, and he said, “Since I can’t bring her back to life, I write books about her.” I realized that John also wrote about Maggie, to the exclusion of his other writing, because he had to do so. He had to find a way to express and work through the trauma of losing his longtime love and companion.
That was a major reason I wrote my story, to pay tribute to the young woman who saved me and bring her back to life in the only way I knew how. The other reason I wrote about my breakdown and the events that led up to it and followed it was more selfish: to make sense of these events for myself and help myself heal in the process. Without doing so, I don’t think I could have begun to heal myself as much as I have. That process is imperfect and incomplete, of course. We hope for catharsis in unburdening ourselves of our traumas. Did I find it?
I did find along the way that my life history became more emotionally manageable. Not only did I come to understand it more clearly in remembering and researching and structuring it; doing so helped immensely in dealing with my present life. I also found myself looking back at my younger self almost as a different person, a boy I could sympathize with and wish I could have helped, but who was no longer quite me. And yet I found there is no such thing as complete catharsis — or, to use that dangerously misleading modern buzzword, closure. As William Faulkner wrote, “The past is never dead. It’s not even the past.” Even as I read the book now, the pain of some of those past events pierces me anew, and suppressed memories keep coming to the fore. But what I found in my long process of self-scrutiny and self-exposure is that we can find a partial sense of catharsis and healing by sharing our stories. Having put myself through that long process, I recommend it strongly to any of you who wants to learn from your suffering and not let it control your life.
'What Will People Think?: Confronting the Shame Surrounding Trauma'
by Joseph McBride
May 4, 2016
Shame is an emotion that can stifle our lives if it gets out of control. There are some positive aspects of shame; when we do something that is unfair or unduly offensive or hurtful to others, it’s appropriate to feel shame. But too often society imposes shame on us for who we are, for elements of our backgrounds and personalities we can’t entirely control — elements that often should be a cause for celebration. Our ethnic backgrounds, physical traits, personal quirks, family lives, jobs, and psychological problems can all lead to our feeling ashamed. We need to find ways of getting past that feeling to lead healthy lives. One of the most damaging forms of shame that persists in our society surrounds mental illness. Many people and their families have to cope with that social stigma, the inner sense of shame stemming from lack of understanding, poor diagnoses, and unfair moral judgments about mental illness compounds the problems and inhibits progress toward solving them.
Fortunately, our society has made some great advances in its attitudes toward psychological problems in the last forty or so years. People suffering from such problems are less often stigmatised as “crazy” or shunned as frightening figures. There is greater understanding of the physical conditions underlying psychological illness and of the roles family and society at large often play in causing or exacerbating it. But many people who suffer from mental illness are still judged harshly and ignorantly. A lack of understanding of the causes of such illness, and lingering primitive attitudes toward treatment can lead to ostracisation and intensification of the debilitating effects of shame.
How do we get beyond all this, as a society and in our personal lives? As I’ve found in writing my memoir, being open about psychological problems, coming out of the closet publicly, is a boon in leading a happier life. Writers benefit from having a public forum. But sharing your story with your family and friends is a powerful step toward overcoming shame. It took me quite a while to be willing to take that step. Embarrassment was still a problem when I began my memoir back in the late 1960s. I had to overcome inhibitions about “What will people think?” as I dug more deeply into dark episodes of my life and my feelings about myself, my family, and others. But I took the plunge because I felt I had to. If I had not, I knew I couldn’t grow beyond the problems that were still inhibiting my psychological development and hindering my personal relationships.
Many years of work on The Broken Places enabled me to shed feelings of embarrassment and learn a great deal about myself. But there still remained that final push of letting the book be published. Some embarrassment would be inevitable; what would people think of me? How would it affect my career and people’s perceptions of me? Fortunately, I am too old now to care, and I have achieved enough success that I felt confident I could overcome any lingering embarrassment. But I took that initial step long ago. It was essential to my wellbeing to let people know who I really was and to pay tribute to the troubled young woman who helped save me even if she could not save herself. She was a victim of that era’s poor psychological treatment and social prejudice toward her illness and ethnicity. The response to the story has been gratifyingly positive, with a couple of exceptions; you have to accept some knocks if you expose your inner life.
When I was in the hospital, I received an extraordinarily moving and helpful letter from a friend of my mother’s named Marty Parnelli, who barely knew me but was kind enough to offer both sympathy and advice gleaned from his own life experiences. At the time I received his letter, I was too engrossed in my dilemmas and too immature to fully understand its wisdom. But as I have gone back to that letter repeatedly over the years, and incorporated it into my book, I am profoundly impressed and grateful for its wisdom. I share these words from the letter as a form of encouragement to any of you who worry about exposing your own problems to the world:
“But before we get to the issue of ‘What do I do when I get out of here?,’ there is a more insidious and subtle question, namely, ‘What do people think who know about this now, and what will people think when they do find out about this?’ I don’t give a damn what they think. And neither should you. This is your life, and nobody else’s; and yet the recognition that it is your life is one that you must come to yourself. In fact, until you recognise it I doubt that you will be released from the hospital.”
by Joseph McBride
June 26, 2016
A stigma is defined as “a set of negative and often unfair beliefs that a society or group of people have about something.” We’ve made some progress from the days when it was considered socially acceptable to publicly label people as “nuts” or “crazy” and to view mental illness as a moral failing, much as alcoholism and drug addiction usually were regarded. But we haven’t come far enough. In many ways, such language has simply been massaged to make it sound less harsh. Society often views psychologically troubled people as objects to be shunned, mocked, or treated with condescension. We are much more aware of and empathetic toward people who suffer from development disabilities — such as autism, dyslexia, and ADHD — and we have learned not to blame abused people for the abuse they suffer. When I realized in 2000 that many of my early troubles probably had stemmed from a borderline case of Asperger’s syndrome, I was relieved and somewhat delighted; it’s almost become fashionable today to have that condition, and it made me feel less alone. But the primitive fear of “losing one’s mind” still leads us to stereotype people with various degrees of psychological disturbance.
My institutionalization in a mental hospital for four months during my senior year at Milwaukee’s Marquette University High School in 1965 followed years of family dysfunction, physical and psychological abuse in schools, and damaging sexual repression. My sexual guilt was tearing me apart as my adolescent body grew toward manhood in that puritanical period just before the Sexual Revolution. Having a breakdown was the best thing that ever happened to me: It enabled me to get out of the house, school, and the Catholic Church, and it was the only way I could meet a girl. In the hospital I met a teenager named Kathy Wolf, who was half Native American and half Irish. She was brilliant but even more troubled than I was. She saved me by opening me up to a freer, more relaxed way of looking at life. The sad part was that while I was getting better, she was getting worse. Kathy, who had family problems and conflicts over her cultural identity, as well as undiagnosed physiological problems with her brain, had been vaguely stigmatized for years as “schizophrenic”; she was overmedicated and subjected to shock treatment. She was sexually abused by her psychiatrist (unfortunately not an uncommon occurrence in those days) and fired by an employer who learned of her psychological problems. That sent her into a downward spiral that ended in suicide.
When I was in the hospital, I received a letter from a friend of my mother’s I barely knew. I didn’t fully understand the wisdom of his advice then, but it has meant a lot to me over the years. Marty Parnelli wrote me about my incarceration, “Perhaps strangely to you, I think it is a great grace. There are two immediate benefits: (1) Until one is isolated from the nuts who roam the streets he tends to look upon these nuts as being perfectly sane. When you leave the hospital you will have the advantage of being able to recognize which of your fellow men have been so unlucky as not to have experienced what you are now going through. (2) The fact of psychotherapy is a fantastic stroke of good fortune. The ultimate good of this present situation is that, like a man who knows he has a heart condition and who is not likely to drop dead of a heart attack because he knows how to take care of himself, so do you have a greater chance of living a more happy life than would otherwise be likely.”
Without the good fortune of cracking up, I would have spent many years, perhaps my whole life, repeating the self-destructive patterns of my youth. But as I went back out into the world after my release from the hospital and naturally tried to share my experiences with friends and family, I found that people didn’t want to hear about it. It made them uncomfortable, and when I expressed unorthodox viewpoints, as I am prone to do, I often felt myself being treated as a “nut” to be avoided. Marty had already warned me of this: “But before we get to the issue of ‘What do I do when I get out of here?,’ there is a more insidious and subtle question, namely, ‘What do people think who know about this now, and what will people think when they do find out about this?’ I don’t give a damn what they think. And neither should you. This is your life, and nobody else’s; and yet, the recognition that it is your life is one that you must come to yourself.”
Freud said the first step to mental health is realizing you have a problem. Many people never come to that realization, and so they are unable to get treatment and keep repeating their neurotic behavior. Even as I gradually came to recognize that I was largely responsible for my own wellbeing, some of the old patterns of behavior persisted. I had such anger over what I had been through with my parents, teachers, and classmates that I finally realized I had to perform a sustained form of self-psychoanalysis by writing about it. Doing so forced me to confront hard truths and dig deeply into my memories as well as challenging my parents and doing other research to piece the story together in a way that made it more understandable. I thought the process would be cathartic and therapeutic, and to some extent it has been, though I found that there is no such thing as “closure.” Now when I look back at those days, I see that troubled boy as someone I can look at from the outside, with dispassion and sympathy (if not “objectivity,” another chimerical word). That kind of dual perspective is what we gain from writing a memoir, or from undergoing psychotherapy with the right doctor.
I hoped my story would find an audience and, by sharing my experiences, strike a chord in others who have suffered. I have had many positive reactions from people who share similar experiences and express gratitude for being given a candid window onto psychological problems. That reward has been a long time coming — the writing process took decades, off and on, as I wrestled the manuscript into the form it needed — and there has been some negative feedback along the way. A few people have found such self-scrutiny a form of self-indulgence or self-pity and have expressed other ignorant reactions, mocking my sexual repression, making harsh judgments toward Kathy, or simply indicating they don’t want to hear such stories.
Most damaging over the years, perhaps, has been my own internalizing of such attitudes, which still persists to some extent. I have long felt a hypersensitivity to anyone applying such words as “crazy,” “nuts,” “paranoid,” etc., to something I say or do. Our society often puts such simplistic labels on things it doesn’t understand. And we all worry about how our friends, family, colleagues, and employers will react to us. I didn’t know how people would respond to my process of self-revelation in The Broken Places. Over the years I couldn’t help taking readers’ reactions to this project especially personally. Most of the early readers found the story gripping, but I had to draw another deep breath as publication approached. I am gratified that the response has been so positive, but that’s not the primary reason I write. As Marty Parnelli wisely put it, “I don’t give a damn what they think.”
Since 2000, I have been fortunate to live in the San Francisco Bay Area, which, as the world knows, is sort of the Ground Zero of liberalism. Much more so than in the previous places where I lived, Wisconsin and Southern California, people here tend to be tolerant and accepting. Oddity and nonconformity are seen as virtues rather than frightening aberrations. But nowhere is utopia; our supposed liberal attitudes have their limitations. We can see that in the disparities of wealth and the mistreatment of the often psychologically disturbed homeless people, classism and stigmatization are as present here as anywhere else. I wanted to get more of a sense of how well we manage to overcome stigmatization of the mentally ill and how much progress our culture in general has made in solving that problem. Since I don’t consider myself any kind of expert on that general topic, I asked a psychologist and a psychiatrist who work near me about how they view the subject.
Dr. Ruth O’Hara, a psychologist and associate professor in the Department of Psychiatry and Behavioral Sciences at Stanford University in Palo Alto, told me, “We are still educating the general public about the extent to which mental health reflects real brain changes. In the last twenty years there have been tremendous technological advances which have increased our understanding of mental health. Most mental health disorders are the result of brain dysfunction. For example, impairments to those parts of the brain that control decision-making and/or risk-taking are now believed to contribute to addictions and other behavioral health problems. Yet, as with asthma in decades past, there is a tendency for people to perceive mental health problems as simply emotional control problems rather than recognizing them as having a physiological basis. Mental health professionals and the field of psychiatry are trying to increase education so it’s better understood that mental health disorders are not always under people’s control. That doesn’t mean we should hold people less responsible for seeking treatment. But the ability to seek treatment is to some extent may be tied in with destigmatization. The current research on the brain may well ameliorate the kinds of stigmas and perceptions people have around mental health problems.”
Dr. Michelle Primeau is a psychiatrist who specializes in sleep medicine at the Sutter Health Palo Alto Medical Foundation and a consulting assistant professor at Stanford. She told me that despite the wealth of resources in the Bay Area, people often are still limited in finding treatment because some health insurance plans are inadequate for psychiatric treatment. Many doctors don’t accept certain health insurance plans, which causes some patients to be unable to find treatment or to have to pay themselves for private doctors. This results in what she calls a “tiered” approach to mental health care, favoring more affluent people (the same kind of problem that often causes less affluent people to receive a lesser quality of education). One way Dr. Primeau has found around this Catch-22, she said, is to provide psychiatric care under the umbrella of sleep medicine, because sleep and psychological problems often are interrelated, and insurance companies can be more willing to pay for treatment on that basis.
As for stigmatization hampering people’s ability to find treatment, Dr. Primeau said, “I definitely think stigma still persists. There still is a large amount of secrecy that persists in this area.” She noted that some students at Stanford ask her to refer them to doctors off-campus so no one will know they are being treated. Many people operate under a code of silence, not knowing how to talk about their or their families’ problems or fearing to do so. Some people worry that psychological treatment will go on their record, affecting their employment, even if that’s usually “a bit of irrational anxiety” because of privacy laws. Problems she sees that are particularly acute include the increased prevalence of post-traumatic stress disorder in our society, the pressures for high achievement in college and elsewhere, and an ongoing problem with a high rate of suicides among young people and veterans. Stigmas and silence only exacerbate these problems. Dr. Primeau agreed that education is needed so that people will break through the roadblocks surrounding mental health treatment, including overcoming the remaining social stigmas. As she puts it, “Maybe if you actually talk to someone else,” the fear surrounding such problems can be ameliorated.