“Happy families are all alike; Every unhappy family is unhappy in its own way.”

    I’m sure you’ve heard this quote before. 

    It’s the opening line from Anna Karenina by Leo Tolstoy, first published in serial form between 1873 and 1877. This quote has been repeated so often that it has actually taken the form of an operational principle: ‘The Anna Karenina Principle’. Briefly, the principle claims that we can articulate several basic reasons why a species or a process may be successful, but it becomes much more complex to articulate why a species or a process may fail. 

    Whether Tolstoy knew it or not, Aristotle stated something similar in the ' Nichomachean Ethics', Book 2:

    "Again, it is possible to fail in many ways (for evil belongs to the class of the unlimited, as the Pythagoreans conjectured, and good to that of the limited), while to succeed is possible only in one way..."

    While this may be intuitively satisfying and may have represented the best wisdom of the times for Aristotle and Pythagoras, it is almost completely not accurate when it comes to the reality of unhappy families.

    What’s more, it’s a red herring. 

    Bear with me. 

    Let's assume that 'family unhappiness' (or as we might say these days, family dysfunction) is distributed much like most characteristics throughout a population - in a normal distribution curve (Illustration 1). At the 50th percentile, 50% of families are unhappier (to the right side of the mean) and 50% are happier (to the left side of the mean). There are worse places on the curve (there are almost always worse places than ours on the curve...). For example, if your family had the misfortune to be at the 90th percentile, only 10% of families in the population would be unhappier than yours.

    With that in mind, it seems pretty clear that the quote from Tolstoy shines a light on the wrong road. It suggests unilaterally that each unhappy family has a unique psychology, unrelated to the general impacts of cultural history, social class, environmental degradation, and neighborhood trauma. I'm not suggesting that a percentage of unhappy families do not suffer from comparatively unique clusters of debilitating vulnerabilities. In terms of family dysfunction or unhappiness, however, they are the outliers, located somewhere to the right of the 90th percentile, plus or minus. These are Tolstoy's comparatively rare Unhappy Families - the ones about whom, theoretically, we are unable to generalize. 

    The point here, however, is that it is possible, and much more important, to generalize about the other 90% of us located on the rest of the curve, below the 90th percentile, who still struggle with varying degrees of distress.

Illustration 1: The hypothetical distribution of family unhappiness throughout a population.

after http://www.learneasy.info/MDME/MEMmods/MEM30012A/statistics.html

    In the social sciences, 'The Anna Karenina Principle' draws our attention to the outliers, the 10%, diverting us from understanding how discriminatory practices inherent in our institutional lives act as catalysts for family despair and dysfunction in the larger body of the curve. We stop studying the effects of pervasive social and economic marginalization and, instead, focus on the sickness of individual families, i.e. commercially profitable evidence based therapies, criminal justice and family services interventions (which often save lives, but, more often, coming as late as they do, create a subset of their own problems), and pharmacological solutions, instead of investing in more comprehensive social policies and levels of community organization. 

    And the principle does not help to illuminate some of the more recent research which informs us more adequately about the epidemiology of dangerous and extremely costly psycho-social pathogens in the deeper structures of our society. 

    One such piece of research, the Adverse Childhood Experiences Study (ACEs), originally published by Vincent Felitti and Robert Anda, as "The Relationship of Adult Health Status to Childhood Abuse and Household Dysfunction", in the American Journal of Preventive Medicine in 1998, Volume 14, pages 245–258, examines the impact of 10 specific and widely prevalent adverse childhood events. This study propels us to some stunning conclusions about where our social and health sciences should be taking us (see Illustration 2). These 10 events, which are most toxic before the age of 18, include:

• substance abuse

• mental illness

• criminal behavior

• parental divorce/separation

• battered mother

• psychological abuse

• physical abuse

• sexual abuse

• emotional neglect

• physical neglect

     When we look at research like this, we are empowered as professionand as a society, if we so choose, to move towards more honest, more relevant, and potentially far more effective change. Summarizing Robert Anda:

    "What all this means, is that we need to prevent adverse childhood experiences and, at the same time, change our systems – educational, criminal justice, healthcare, mental health, public health, workplace – so that we don’t further traumatize someone who’s already traumatized. You can’t do one or the other and hope to make any progress."*1 (Notice the title of the article referenced)

    Put another way, children are undamaged by the monster in the occasional nightmare, but certainly damaged by the monster returning home from the bar every night to assault and otherwise terrify the household. The resulting sustained stress response has real, physiological  impacts on a child's developmental trajectory, impacts which epigenetic research is only beginning to elucidate (epigenetics is a golden link in this chain of research).*2

    Research like that of Anda and Felitti and others, and the resulting interventions, should be: 

            - fundamental to the development of social and economic policy,

            - critical to program development in criminal justice 

            - at the heart of efforts to improve public education,

            - primary to the mission of public health agencies.

    Tolstoy, and those who mistake literary device for wisdom in the sciences, give us primarily self serving and irrelevant political rhetoric (reinforcing the privilege at the root of alienation for substantial populations), the further victimization of those already victimized by institutionalized injustices, superficial and self defeating education reform, costly and unending 'therapeutic' interventions of little, if any value, and, what is perhaps most distressing, bad science.

_________________________________________

    *1 from http://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

    *2 For those of you who may not be familiar with this, epigenetics is the study of the way in which the expression of inherited traits are modified by environmental influences without a change to the DNA sequence.

Six Word Stories

Grieving

Losing you. Your flesh become word.

Envy

Wish you were here, I there.

You and Me

Loving you. So much spilled milk.

Audio File

The Beatles: And In The End The Love You Take Is Equal to the Love You Make 

And In The End The Love You Take Is Equal To The Love You Make

Unpacking the finale of Abbey Road

And In The End

“In the end, nothing is really different”, Conrad said, his arms resting on the railing of the overpass. We had just left his office on the fourth floor of the Smith Tower and had decided to savor some late evening summer by speculating on those small, blurred lives piloting the cars and trucks streaming northbound below us on the interstate.

“You say to yourself, well, I’m not going to be like them, and I’m sure as hell not going to parent my kids like they did me and my sister. And for a while, you think you might actually pull it off. But the years go by, and, eventually, the seal fails or something, and the old shit just comes oozing out, and there you are. You’re him, your father, and you’ve just inserted your two children into the black hole of your childhood and the house is on fire. That’s probably why it’s foolish to expect too much from us. As a group, I mean. It’s as if our collective ignorance, generation after generation, distills and eventually crystallizes in our institutional lives….”

“Conrad,” I interrupted, “you make, what is it? Six figures? Have prime downtown office space, a beautiful house on the lake. Those crystallized institutions have been pretty bloody good to you, don’t you think?”

He was a big guy, something over six feet, and bulky from worship at 24 Hour Fitness, pretty much used to having the last word. I didn’t know him really well, so talk like this was a bit gutsy.

His eyes locked against mine for a second or two, then he laughed. “Well, there is that.” And after a moment, “But I’m talking big picture here, Rubin. Open that over educated mind of yours. I’m talking about the propaganda, even mine and your own mental healthy stuff. We put it out there to keep our clients and everyone else hanging on to a civilization going nowhere faster. La esperanza muere ultima, you know. Hope dies last.”

This kind of talk is why Conrad was so interesting to me. That and the crush I had on his sister, Mac.

“Well, there is more to life than just going faster. I think Gandhi said that.”

“Nice, Rubin. And look what happened to Gandhi...”

Then we both paused to watch a ferry, outlined by light leaking from the lives inside, slip over the black water towards the terminal.

The Love You Take

Mac and I had dinner at an Italian restaurant. Then we walked the waterfront, telling stories about when we were both growing up in Seattle with our families. I asked about her name, Mac. She said it was short for MacAfee. Her parents met while acting in a community production of “Bye Bye Birdie”, and tried to hang on to those days by naming their children after the leads – Conrad, the Elvis character, and MacAfee, the sweet teeny bopper for whom one kiss from the king meant the kingdom. We marveled at how much parents wanted for their children and how poorly prepared they were to deliver.

Neither of us had much affection for dining out. For her, it was usually preceded by the loud, recurring argument between her parents about her father's driving on the slick, dark streets on the edge of downtown. These arguments, like those between my parents, slipped along the skin of their disappointments. Conrad would cover his ears and wait it out, and, as he got older, would invent reasons to be somewhere else, while Mac, five years his junior, was stuck squirming in the backseat. Her dad sold insurance, and her mom was a teacher with a passion for social justice, infusing everything she did in her classrooms with lessons on empathy, equity, and honesty. She was Mac’s first mentor.

Mac had been molested by one of Conrad’s friends when she was eleven, telling no one, even as the kid continued to come and go in Conrad’s life, which left her with literally no place safe to go except into a child’s version of her mother's world of calling out bullies and fighting for the underdog.

I think Conrad had a good heart, but I often wondered if he had any idea how unsafe he had made Mac’s world so many years ago.

My family’s dining adventures amounted to pilgrimages for seafood at Ivar’s Captain’s Table, both because I sang along with Ivar on the Captain Puget show and because my father swore he went to school with him before he became a bigshot. My father was a traveling salesman, selling men’s wear out of sample cases he lugged in and out of a massive Mercury station wagon into small stores in rural Washington, Oregon, and Idaho. He didn’t care much for bigshots. My mother worked off and on, but was mostly a homemaker. And I acknowledge owing them a debt as well: I spent my childhood trying to be a good enough boy to keep my family from blowing apart because of the centrifugal forces tearing at it over the decades of my childhood.  

Mac taught fourth grade at Jefferson Elementary, one of the more multi ethnic schools in the district. It had become her sanctuary. I became a therapist, still trying, I suppose, long after my own family was gone, to keep some family somewhere from self destructing, an occupational hazard for someone like me.

As we talked, we held hands, found other ways to touch one another, a couple of times we even put our arms around one another.

At my place we had some wine. She leaned into me.

“If we don’t have sex, will I see you again?”

     “If we don’t have sex, would you want to?”

     She sat up, settling her blue eyes on me, definite as lasers.

    “In my life,” she said, “sex has rarely been consensual, once not at all. I might have tried to convince myself it was, later, and I might have wanted it to be, but it mostly wasn’t. It was always confusing, difficult psychological work. I never knew for sure which one of me was there. Was I eleven or 23? No matter how hard I concentrated, how much I thought I gave, afterwards, I still had to struggle with a feeling of loss.”

    “So how will you know when it is consensual then?”

  She refilled our glasses. “I’ll feel like someone is touching me now, at twenty eight, not me at eleven or seventeen. I don’t know, but I know I’ll know. And, ha, maybe the little girl will finally be able to get some sleep.” She set her eyes back on me. “I like you, Jacob.”

I took her home, and after a long, hard hug, I left.

Driving across the University Bridge, past my brother’s place, I remembered him in his almost breathless voice channeling Nelson Algren a few days before he died: never play cards with a man called Doc, never eat at a café called Mom’s, and never sleep with a woman whose problems are greater than your own.

Is Equal To

A couple of days later, I walked into the agency and the director called me into her office.

“You’ve been summoned.” she said. “Jefferson Elementary has a fifth grader they want you to interview. Mother signed off. No diagnosis. Just a consult with the teacher, a Grace Lappen. Asked for you specifically, by the way. This is where your friend works, I take it?” She looked at me over the top of her glasses, then let whatever it was go. “Anyway, we’ll give them the hour, see what it gets us.”

“Now?”

“Now. Aricelli said you had some charting time anyway,” she said. “And Jacob,” she said with emphasis, “Don’t be too rough on them. It’s Jefferson. It’s their first time, and it may be a foot in the door.”

“I’m always gentle the first time,” I said, regretting it even before the words finished coming out of my mouth. Too much caffeine…

Jefferson was in a neighborhood of older, single family homes slowly sliding into Seattle’s Central District. The city’s hope was to reverse the skid by developing a community police precinct and supporting a nascent gentrification, betting that the Pho shops, liquor stores, tanning salons, and manicurists would yield to the likes of Trader Joe’s, Red Robin, and perhaps even a Marshall’s, the kind of stores that eventually forced the old and poor from their homes.

The school itself was an oasis amid the yards of yellowed grasses and weeds attacking the stairways and porches of the homes, along with a sprinkling of bike tires, wheelless strollers, and tricycles. It had a green, well-tended playground and some well used playground equipment, including a couple tether ball poles and two merry go rounds. A sign above the entrance proclaimed: “Achievement Begins With High Expectations”. Grace Lappen met me at the office.

Grace was short, maybe five feet, petite, with a brow creased from constant intensity, and a long, brown braid down her back. She struck me as an energetic, full throttle, first year teacher with all kinds of terrific ideas and activities just waiting for the right children to drop into her classroom. Her energy filled the room, some remaining even after she’d left.

Now she has Gary, a bright African American ten year old challenging her consistently since school began three weeks ago, but more lately, over this lesson about the conservation of matter and energy. This was the first module in a newly adopted, more rigorous science curriculum, she explained, involving target objectives, target dates, curriculum meetings, etc., the sort of programming Mac likened to “a prescribed burn.” Grace and her colleagues had lined out lessons around simple examples of conservation, basic developmental tasks like twenty pennies in a stack versus the same pennies in a pile, a cup of water in a glass versus the same amount of water in a bowl, back and forth. Something about the idea of essential qualities of objects independent of how they looked.

“And that’s where he’s stuck. The water and the pennies. He claims that they’re not the same. He stops me with questions, makes up his own observations about things. And he won’t let the class move on. I know he gets it. He’s not rude or disrespectful. Just… stuck.”

She stopped and I watched her work on her thought. “This is about more than science, I suspect.”

“That’s a good insight. Do you have any counseling support here?”

“Not this year. I did find out that he has to spend weekends with his grandmother because his mother got a second job. She’s a single mother, working like mad to hold everything together. She invited you to call her if you needed to.”

“Let’s see how it goes,” I said. “If there is a next step, I’m thinking it would be you and me and Gary talking together.”

She left and I put my notes away. Gary entered the small conference room. Big eyes, bright white teeth, just the hint of an Afro, sporting a blue and green Russell Wilson Seahawk’s jersey.

We introduced ourselves, and I invited him to sit across from me. He pulled himself onto the chair, letting his feet dangle. He seemed uncomfortable calling me Jacob, so I told him he could call me Dr. Rubin if he wanted.

“You a doctor?”

“A kind of a doctor, but not a medical doctor like when you have a sore throat.”

“My grandma says you’re a shrink. She said I’m supposed to talk to you. Am I in trouble?”

 “No, Gary, no trouble. And your grandma sounds like a smart woman. I just want to learn about what’s going on with you and Mrs. Lappen, the lesson you’re on now. Conservation, I think? Like with pennies and water?" I said.

He started to pick his nose, thought the better of it, and trapped his hands under his legs. He looked around the office, then started talking, keeping time with the back and forth swing of his legs.

“Well, what’d she tell you, Mrs. Lappen? That water in a glass is the same as water in a bowl? Well, they’re not the same. You drink from a glass, you use a spoon for a bowl. You drop a pebble in a glass and the waves are small little circles, you drop the same pebble in a bowl and the waves are bigger, slower even. You put a bunch of marbles in the bowl and it will spill over, but you put them in the glass and the glass just fills up. A mouse can stand in a pile of pennies, but not on a stack of them. A stack falls down into a pile, but a pile doesn’t fall up into a stack. Everything’s like that. She wants to think all those things aren’t important, that only one thing is. You’re supposed to look at the less obvious first, the most obvious last.”

“Where did you learn that, about looking for the less obvious first?”

“Miss Mac, my teacher last year. She always said it, and we got to talk about all kinds of stuff.” His legs stopped and his shoulders sagged, like someone had just let all the air out of him. I could tell he was forcing back tears. “How come we have to get new teachers every year?”

After a few seconds, he let out a shaky breath, wiped his eyes with the heels of his hands. Then he said, “Mrs. Lappen is nice, but she doesn’t let us really look at things like Miss Mac did.”

Losing Mac, losing his mother on the weekends, all in a matter of a month or so… I wanted to hug him, but that would have been more for me than him (another occupational hazard for people like me). So we just shook hands, and he went back to class.

When I debriefed with Grace afterwards, I mentioned how the theme of loss might be playing out in Gary’s life.

“I should have figured that out,” she said smoothing the stack of papers in front of her.

“Look, Grace, There’s a lot going on with Gary and you that I don’t know, so, in the end, it’s your call. But, based on the little that I do know, here’s what I think. You and Gary each have an end of this conservation thing and you’re pulling against one another, each trying to get the other to let go. He is hanging on as tight as he is, I suspect, because he feels like everything else important has slipped away. Maybe what he’s really hanging on to is last year, when he had both more of his mother and Miss Mac. Anyway, that’s my theory. He can’t let go. You sensed that there was something more going on, there is. So why not just let go? Give him some time to talk about the less obvious. Open it up. He may not be the only kid struggling with loss of one kind or another. Maybe you and he can spend time using Mac’s rule in some lessons, until he feels more at home in your classroom. Then he can help you use a rule of yours in the work of the class. Do you have class meetings?”

“I’m working on it,” she said. It seemed good to her, spending time collaborating with him rather than battling with him.

Then she added, “You know, Dr. Rubin, Jacob, I catch myself sometimes, my blood rising, and I have to ask myself: why? What’s really at stake here? And does it really have anything to do with me? Yes, I have all these great ideas that take time, and I know I like to keep things moving, and I’m supposed to keep things moving. But I am not an industrial educator. I did not become a teacher out of a love for production quotas. I really like children. I like Gary. I guess I just needed to be reminded. And Mac was right about you. Thank you.”

Before I left, I introduced myself to the principal, briefed her about my visit. Principals like that. My boss would have been proud.

The Love You Make

Operation Desert Freedom was over. On the streets of big northern cities like Seattle, Oakland, Chicago, shelters and the cover afforded by their freeway overpasses would soon fill up with the remains of men and women hollowed out by the auger of war. Men, especially, with eyes bloodshot from chasing sleep through the haunted, brown canyons of traumatic memory, their foreheads red from the synapses overheating behind them.

The VA salted clinics like ours with contracts for individual therapy, marriage counseling, groups, substance abuse treatment, medication monitoring, and the like. Masters level therapists fled publicly funded, urban mental health clinics like ours for less brutal work in the suburbs or private practice. Every agency, from law enforcement to food banks, reeled from the unholy karma of the war on terror.

The bits and pieces of their children spilled over into school programs like Title 1 and Special Education. Jefferson Elementary itself would experience a rise in free and reduced lunch eligibilities from forty eight percent to sixty two percent in two years. Title 1 enrollment would rise by eighteen percent. Grace Lappen lasted two years before requesting a transfer to another school.

Teachers like Mac, already accustomed to spending fifty hours a week on their classrooms, parent contacts, and other school related work, would find themselves struggling to meet the needs of their students in fifty five to sixty hours a week. Our agency had worked with the school district to develop one full time counseling position to cover three elementary schools, Jefferson among them. This amounted to little more than battling a wildfire with a fire extinguisher.

Mac became more passionate as the odds against her and her colleagues increased. Her spare hours were devoured by outreach to parents, grandparents, the Department of Social and Health Services, and organizations like the United Indians of All Tribes. She organized study circles around the impacts of poverty, loss, and family violence on children’s academic readiness. She jousted with her principal over learning benchmarks, why they couldn’t afford a reading specialist, and fought like hell against the district’s infatuation with what she called the pornography of standardized testing.  

She was the fire extinguisher.

I carried a caseload of five patients in addition to new responsibilities as the agency’s clinical director, supervising the work of eleven full time therapists and five involuntary commitment specialists.

Conrad narrowed himself down to mostly corporate tax work, moving up to a corner office on the eleventh floor of the Smith Tower. What he saw from his aerie was amber waves of grain. He had no idea what life was like for all of us on the threshing floor.

Often, Mac and I would get together with him, his wife Julianne, and their two children. Early on, he had a habit of greeting me with a bear hug, whispering in his version of the Godfather’s rasp, “Jake, I love you like a brother, but if you hurt Mac, I’ll break both your legs.” One time Mac overheard, squared off and said, “Conrad, watch your fucking mouth or Julianne and I will kick your ass.” His kids giggled every time they saw Mac after that, but it never happened again.

As for Mac and I, we were together almost every free moment she could spare. We took art seminars at the Asian Art Museum, went birding with the local Audubon Society, even toyed with the idea of joining the Peace Corps, anything to distract us from the stories pummeling us during the week. Both of us were roiling in the maelstrom, clutching onto one another's hands to avoid being sucked up into the funnel of the storm.

Once, I visited my brother’s grave site. His was next to our mother and father, grandmother and grandfather. Mac, having no knowledge of her family beyond her mother’s mother, came with me, taking an interest in this small, green gathering of Eastern European Jews who left an entire history behind to start again as strangers. Wrestling incessantly with her own past, she was puzzled how they could abandon theirs, or even pretend to.

“And what would they think, grandpa and grandma Rubin, old world Jews, about you and your Methodist?” she said on our first visit to the cemetery.

“Ida and Harry? Well, they’re already dead and, as you can see, there’s not much room to roll over…” She punched me in the arm.

“Okay. I’ll start again. I admit that there was a time when I thought it mattered, that I had to honor some kind of... legacy, out of some loyalty, some responsibility to the sacrifices of previous generations. But I don’t think the Holocaust or the Russian pogroms were about any meaningful sacrifice or martyrdom. They were the acts of barbarians, drunk, fired up on bullshit. And that probably goes for most of the butcheries of history. Gas chambers, machetes, bulldozed homes, it all amounts to the same thing, I think. The stories come later, stories that blame some and glorify others. So all I can do, and I’ve thought about this a lot, all I can do is try to do my best in my own life. And I’m thinking that means you. There’s this great story about an old Rabbi, Rabbi Zusya. He said, ‘In the coming world, they will not ask why were you not Moses? They will ask, why were you not Zusya?’" I stopped and looked at her. " Too much information?” Mac had a smile that knocked me out.

Then we both grew quiet, scanning the expanse of granite markers dappling the hillside. Finally, I said, “Besides, whether they saw it coming or not, you and I are the answer to their question. They shouldn’t have opened the door to the New World unless they were ready to walk through it. So. Ida and Harry, meet MacAfee, the Methodist.”

At the end of the visit, we left our stones on my family's modest markers and left. Mac suggested we stop for milkshakes at the Shake Shed on Queen Anne, toasting my brother who, at the end of his life, would drink them as an easy source of calories.

Neither Mac nor I grew up with much of an operational definition of love, other than when you love someone, you stick it out. What we both took from this, and from the hard won triumphs of those with whom we worked, was a reverence for the healing passage of time, like the steady flow of a river along a new meander, slowly deepening it, widening it, and thinning the resistance presented by those stone age obstacles warning us to keep out. It wasn’t our training that enabled this, any more than hydrogen is responsible for the persistence of water. It was something far larger and more essential.

After eight months, Mac moved in with me. The lease on her apartment ran out two months after we returned from the Aleutians. Our sexual relationship began there, in the Inside Passage, rolling  with the grey heave of seven foot seas in a cabin on the Alaska Car Ferry. And once my lips finally settled against her bare shoulder, everything I had previously imagined about her, about us, seemed no more than the antics of stick figures.

 “Well?” I asked, breaking the soft silence.

“Well yourself,” she said, wrapping herself around me.

Captain Puget and Ivar Haglund 

on board the Windward 4