Sunday, January 17, 2016

Trying to Treat Anomie at Harvard

When first generation Vietnamese immigrant Due Quach got accepted to Harvard she thought she was on the road to Paradise. It turned out that she was entering an Inferno… and without a Virgil, that is, without a trustworthy guide.

Disoriented and dislocated, not understanding the rules or the game Quach developed a condition we shall again call social anomie. As you know, French sociologist Emile Durkheim developed the concept over a hundred years ago. I discussed it and defined it at length in my book The Last Psychoanalyst. Apparently, a century has not been long enough for the therapy culture to discover the importance of anomie.

Quach describes her situation well in The New York Observer:

As a refugee from Vietnam who grew up in inner city Philadelphia and attended a public high school, I felt extremely lucky and blessed when I got my acceptance letter from Harvard. It was an unlikely dream come true. My zip code in Philadelphia had (and continues to have) one of the higher rates of crime, violence, poverty, and trauma scores in the city. In my hood, nearly half the kids drop out of high school, so it is seen as a triumph for a kid to go to community college. Getting into Harvard was like boarding a rocket ship out of the ghetto. My hope was to eventually use my education to support my family and help more poor kids like me break through barriers.

Harvard was my first immersion in an elite upper middle class environment. It was like shell shock. Unlike scholarship kids who attended private schools, I had never spent time with people who were so wealthy before. In contrast, where I came from, violence was normal. My parents ran a take-out restaurant in an area overrun by gangs. There were regular fights and robberies in our store. One time, a customer was shot in the head going out the door. During my freshman year at Harvard, I realized that what I had gone through was really not normal at all. Most of the kids in my class had enjoyed a very sheltered life. As I listened to my classmates whine about their troubles, I wondered how could they possibly understand what I had gone through?

She continues:

It didn’t take long for me to feel completely alienated by the ivory tower academic culture and the self-absorbed drive of my peers and my professors. The administrators preached about lofty goals and celebrated alumni who had changed the world. Yet, I learned the hard way that America’s oldest and most prestigious university makes changes to accommodate no one.

As a result, Quach suffered something resembling what is called a breakdown:

I had no idea that the combination of toxic stress and not having a social support network at Harvard was about to cause all the traumas I had experienced growing up but never fully processed to blow up into post-traumatic stress disorder. I had no idea I was about to experience symptoms that included suicidal depression, dissociation, panic attacks that kept me from sleeping and relaxing, and general cognitive impairment. From freshman to sophomore year, I went from being a Harvard College scholar to not being able to focus in class, do my problem sets, or write papers. By the spring of my sophomore year, as the PTSD took over my life, my goal became to simply survive Harvard with my soul intact. I withdrew even more because whenever I was in that state of mind, I didn’t want to be around people and I didn’t want anyone to know I was falling apart.

Evidently, Quach did experience childhood traumas. To blame her problems at Harvard on experiences that occurred in childhood seems to be therapeutically correct. And she embraced this information when a psychiatrist at the Harvard Student Health Service told her that it explained what ailed her:

While at Harvard, I did seek psychiatric care to deal with the PTSD. It was life changing when the psychiatrist explained to me that my brain development was impacted by the traumatic experiences I went through as an infant when my family escaped Vietnam by boat and spent almost two years in a refugee camp. As heartbreaking as it was to hear that my brain was malfunctioning because of events I had endured as a child which were completely outside my control, it was also empowering to finally have an explanation for what was happening to me. He then recommended I try Zoloft to see if it could rebalance my neurochemistry. He also suggested I start therapy.

This suggests that when you have no idea of what is happening to you, any explanation will help. In other branches of medicine it’s called the placebo effect.

However thrilled Quach was to find a label for her distress, her treatment did not produce very much that she considered positive.

She continues:

The medication stabilized my brain, but left me feeling numb. The therapy made me feel more despondent and helpless. I gave it time, but in the end, I never figured out how talking with a therapist was supposed to be helpful. The most frustrating thing is that the people who treated me didn’t focus on helping me learn effective methods to handle the circumstances causing my high stress: that my family still lived with extreme financial hardship, that I didn’t want to be a burden on them, that I felt responsible for helping them and guilty for not being there to help them, and that going to Harvard did not directly translate into putting me in a better position to financially support them.

A therapy that focused on the mind and the brain ignored the social side of her problems. It did not help her to learn to function in an alien social environment. It did not, as she put it, provide her with the coaching and mentoring she needed:

What I needed was mentorship and coaching to build the life skills I didn’t learn at home, to address my trigger-defense mechanisms that were locking me in negative spirals, and to become financially secure. Since there was no way that Harvard was going to hand these things to me, I realized I needed to figure out how to do these things on my own. Plus, no one seemed to understand that I was not going to take anti-depressants the rest of my life. In fact, I was going to stop as soon as my student health insurance expired when I left Harvard. It was up to me to develop a plan to get off medication without relapsing.

Quach distinguishes clearly between coaching and therapy. One might say that therapy and coaching can be combined, but thinking that the problem lies in your childhood can only distract you from the effort to learn the social skills that will help you navigate your world in the present.


Ares Olympus said...

An excellent story and conclusion, but I'm not sure how the concept of "anomie" applies here.
Anomie is a "condition in which society provides little moral guidance to individuals". It is the breakdown of social bonds between an individual and the community e.g. if under unruly scenarios resulting in fragmentation of social identity and rejection of self-regulatory values.

Ares Olympus said...

Feeling bad about my uncertainty over anomie, I found this short article, including a 4 minute video clip from "The Wire" where a special street was designated where selling and buying drugs or sex or anything was ignored by police, as long as there was no violence. Durkheim, Merton, and Anomie via "The Wire" (Hamsterdam)

The video certainly is terrifying. You can see why everyone would want to escape that terror, and how inner cities can become that way, and all the people with means move away to the safe suburbs, which finishes the process.

But what's strange to me is to consider that "social anomie" might not be the chaos of normlessness, but might also exist in the sheltered isolation of the suburbs, where you don't know your neighbors (unless you have young kids perhaps), and your security is entirely built upon a 2 hour daily commute to a job you may not like, and a mortgage payment that takes over half your income, and perhaps a good fraction of the other half going towards child support payments for a first family that didn't work out. But at least they can sleep at night without gun shots and fear drug-crazed youth are not going to break into their house.

There are so many paths to despair, and maybe most of them in the West exist because of modern hyperindividualism.

So we can see "social institutions" are the key to weakening that curse of hyper-individualism, but there's also a steep learning curve involved to participate, and its easier to assume every little setback or social misstep is proof that you don't belong, that the world is against you, and that you have to do whatever it takes to protect what's yours, or what should be yours.

It makes sense that people who have passed through that transition probably will have the background needed to help others out of the social anomie worlds, whether that's the chaos of the inner cities, or the social isolation of the 'burbs.