To the people giving me medical advice about my son

Working with medical professionals as a parent can be frustrating, even infuriating. You encounter doctors who don’t know what they’re talking about, or maybe do know what they’re talking about but don’t know your child and aren’t listening. You come up against the lack of interdisciplinary knowledge and discourse, the fractured nature of our current medical system. You find yourself caught between specialists who disagree and having to make a decision. You feel helpless, worried, ignorant, and too knowledgeable, all in the same consultation.

But you know what else is infuriating? Laypeople, acquaintances, who tell me that my son’s (carefully selected) doctors don’t know what they’re doing, and that instead of listening to them I should …

-give him probiotics/herbs/homeopathy

-take him to a chiropractor/cranial-sacral therapist/naturopath

-change his diet

… because then everything will be fixed and I won’t need all that stupid allopathic medicine, woohoo!

I’m not against complementary medicine. I’ve been to chiropractors and used probiotics. Essential oils can be nice and I believe good nutrition is important. What I do not believe is that any of these things are a substitute for modern scientific medicine as practiced by mainstream doctors. Monkey gets probiotics whenever he’s on antibiotics and for a while afterward, with the full approval of his evil Western doctors. I’ve tried giving him homeopathic remedies for pain and it didn’t do a damn thing. You know what did? Tylenol. I see no reason to take him to a chiropractor as there is nothing wrong with his spine.

Parents of medically complicated children don’t know everything, but we are experts on our children. We deserve to be treated as such, not only by the medical professionals taking care of our kids, but by the people in our everyday lives whom we confide in. Instead, we get advice from people who don’t even know enough to know how profoundly ignorant their advice sounds to our ears.

To those people, I have this to say: You show your ignorance when you belittle or dismiss wholesale the profession that is keeping our kids alive and healthy. People who spend a lot of time at hospitals see both the worst and the best of contemporary medicine. We see how much scientists and doctors still don’t understand, but we also see how much they do understand. We’ve been awe-inspired by what these doctors can do in the OR, by the available technologies, knowing that in another era our child would be pale and sickly or simply dead. When we’re not banging our heads against a wall, we’re on our knees in gratitude for what medicine can do.

To those who tell me I shouldn’t trust his doctors or the medical profession: Would you trust someone who saved your life?

To those who tell me “he’ll be fine” or “he’ll grow out of it” without intervention: Where’d you get your crystal ball? Can I borrow it?

To those who tell me he needs probiotics when I’ve been telling you about respiratory distress and congenital tumors: Do you actually listen to what other people say?

To those who tell me his problems are being caused by processed foods (incuding nutritional beverages): Let’s trade places and you can watch your child starve because they won’t or can’t eat the foods you think they should.

To those who tell me to “do my research”: What the hell do you think I’ve been doing for the last two years? By the way, how many nights do you stay up late reading articles in medical journals? How much time do you spend corresponding with parents who share your child’s condition(s)? How many specialists do you consult before you make a medical decision?

Doctors who condescend to me and treat me like an idiot get fired from my son’s team. So all of you acquaintances out there who think you know more about my son’s health and development from talking to me for five minutes and seeing him for ten than I do, you who are instant experts on subjects his specialists have spent decades researching and treating and are still learning and consulting with each other about, guess what?

You’re fired, too.

Social conditioning and parental expectations

Yesterday, during Monkey’s therapy session, I found myself trying to choke back tears about his upcoming medical procedures and everything that he’s been through already. He is certainly not the most disabled child – he appears more or less “typical” – but he has been through and continues to go through far more than typical children do. He’s not two yet and I’ve lost count of how many times he’s been under general anesthesia or will be by the end of this summer (7? 8?). Trying to figure out the best way to group together his upcoming surgeries and dental work while watching the therapist try to get him to touch applesauce, I felt suddenly overwhelmed. In fact, I felt grief. As fortunate as I know we are, I wished that our life, his life, could be a little easier.

I’m putting this out there so that parents who read what follows have some context for my thoughts. I’ve also been a professional caregiver for individuals with more severe disabilities. I’ve watched clients’ basic life skills deteriorate. My son has regressed a couple of times and although he has since gained those skills back, it is heartbreaking to watch your child go backwards at a time when they should be soaking things up like a sponge. It’s heartbreaking to watch your child suffer, to see them experience pain they can’t describe to you. There’s no doubt that having a child who’s disabled and/or medically complex comes with a big helping of grief.

But there’s something I hear other parents of kids with special needs say, which I find odd. This is that they want a “normal parenting experience.” It usually comes up in the context of wanting to have another child so they can have this experience. Or they may tell each other it’s OK to grieve the “normal child” they thought they were going to have. That only makes sense if you expect to have a “normal child” in the first place.

I don’t want to judge or police anyone’s feelings, but I am curious where this idea comes from. It seems like a very contemporary idea. In the past, I imagine people whose first child had disabilities would have more children so they’d have someone to work on the farm. Now we do it because we want a certain experience of parenting. Interesting.

It’s similar to women who’ve had c-sections wanting to experience natural childbirth. I had a c-section (after a couple days of labor on a magnesium drip) and am not a candidate for VBAC so this wouldn’t be an option for me anyway. But many women feel that they must have a VBAC, either because they think their c-section was a failure somehow, or they want to have a particular experience of childbirth. They want to experience childbirth without medical interventions, in their home, in a tub, etc. They want immediate skin-to-skin. (Monkey was rushed out of the OR before I got a chance to see him.) They don’t just wish these things had happened, they feel a need to make them happen, to re-do the experience. Again, interesting.

My attitude towards life is much less oriented towards having certain experiences and more oriented towards surviving the ones I do have.

I didn’t have a “normal” childhood, or “normal” college years, so why should I expect a “normal” parenting experience? Nothing in my life has set me up for this expectation. On the contrary, life has prepared me to expect that my mind and body will malfunction in various ways and that human kindness will be balanced by plenty of infuriating human stupidity, meanness, and even abuse. This may sound pessimistic, but to me it’s realistic. I always find it a bit funny when people ask in shock “Why me?” because they had a child with Down Syndrome (or whatever). Why not you? This is life. Life is not a series of perfect experiences. Previous generations understood that. Other societies understand it. How incredibly spoiled we are to ask this question, we who don’t experience daily bombings or famines or continual civil war, who are so well equipped for survival that we expect experience to cater to our desires.

My birth experience was traumatic in the full sense of the word, but Monkey and I both survived it, which is the goal of childbirth. I don’t feel the need for a do-over. If I have another child, I hope that the birth won’t be like that, but that’s because I don’t want to go through it again, not because I want some other particular experience.

Monkey comes with a lot of complications, but I love being his mother. I don’t feel the need for another child simply so that I can experience on-time milestones and 15-minute routine doctor’s visits. Aside from all the ways in which my son is awesome, I’ve learned a lot about hospitals, medical conditions and equipment, and child development that I would never have learned with a typical child. I’m learning English signs and AAC techniques. Doesn’t that have value, too? Why aren’t parents of typical children jealous of my parenting experience?

“Man, I wish I had therapists coming to my house almost every day. I get so lonely sometimes.”

“I wish I had so much medical knowledge just from parenting my child that doctors and NPs asked if I work in the medical field!”

“I wish I knew as much sign as you do!” (One mom we had a playdate with actually complained that her son wasn’t signing as much as mine. I had to bite my tongue to keep from saying, “That’s probably because your son has comprehensible speech and mine doesn’t!”)

“I wish my kid ate the same foods every day, predictably, like yours.” (This is because Monkey only eats about 5 solid foods. He doesn’t have the luxury of changing his mind every day.)

“I wish I got to spend weekends in the hospital regularly. Did they really bring a therapy dog to play with him while he was inpatient?”

“It must be cool to have a group of specialists photograph your child and discuss him at national conferences. I wish my child got that kind of attention!”

This is tongue-in-cheek, but there’s a grain of truth in it. Being difficult or painful does not make an experience not worthwhile. In fact, although too often we ignore and silence them, there are also times when we specifically turn to people with such experiences – experiences of war, discrimination, chronic or terminal illness, abuse – for insight. Experiences like this can lead to great works of art, or to advocacy that achieves real social change. It doesn’t mean we covet such experiences for ourselves, or that we shouldn’t try to eliminate the causes (violence, disease, prejudice); but those who have survived them without asking to should realize that they have something which is valuable to others.

But society continues to tell us that “normal” – in the sense of easy, painless, and uncomplicated – is not only what we should look to and desire, but what we should expect. As if life were all about achieving certain norms.

Individual vs community (3): the sociopath

The last two posts were about what happens when the community overtakes the individual. When the individual is lost in a collective, we have a crowd or a mob. So what is an individual without community? An introvert?

No. Introverts, while they may have few relationships, tend to value them highly. (I probably value my friendships more than most people, because I don’t have many.) A hermit, then?

No. Hermits are actually social beings even if they spend little or no time interacting with other people. Religious hermits tend to conceptualize their work of prayer or enlightenment as benefiting humanity or all beings.

What matters here is not the amount of time spent in a community with others, but the quality of interaction and whether the individual conceptualizes herself as part of the community. I suppose that the person who comes closest to an individual stripped of community must be a sociopath. Sociopaths are “antisocial.” (Which is different from asocial. Introverts are generally somewhat asocial but not antisocial.) Sociopathic traits include defiance of authority, disregard for social norms, lack of empathy, and lack of meaningful connection with others. Although sociopathy is listed in diagnostic manuals as a mental disorder, and appears to be caused by some combination of heredity and environmental factors, rather than political environment, I can’t think of any better parallel to the Mob than the Sociopath.

Now, if communism tends to privilege the collective at the cost of the individual, then presumably capitalism tends to privilege the individual at the cost of the collective. Right?

Well, not exactly. Capitalists like to think of themselves as individualists, just as the more extreme among them like to call themselves anarchists. In reality, they are interested in markets, not in people. They don’t care about creating an environment in which the talents, minds, or personalities of workers can develop fully, they just care about how much the workers can produce (not an individual worker, since he can be easily replaced, but workers added together and averaged). What could be less individualistic than giving corporations (not even a group of people, but a legal concept applied to a group of people) the same rights and status as an individual human being?

But then, it’s been convincingly argued that corporations, when personified, display sociopathic traits; and I’m not the only person to suspect that some CEOs of large corporations are successful sociopaths. So for these reasons, I am willing to cede capitalism the distinction of being individualistic. (That was a backhanded compliment.)

But socialist anarchism is, I think, the only political/economic philosophy that is truly interested in individuals. It’s not individualistic in the sense of capitalism or Ayn Rand’s objectivism, which reduces community to an aggregation of individuals pursuing their own self-interests, perhaps helping, perhaps hurting each other in the process. Rather, an individual is someone in relationship with other individuals.

Small children explore further from their parents when they are securely bonded to them, when they are confident the parent will still be there for them when they return. Children who are not secure in the parent-child relationship are too anxious and clingy, too preoccupied with the parent who at any moment may or may not be there for them, to do much independent exploration. Couldn’t this dynamic work on a larger scale? Perhaps if we were truly secure in our community, if we knew it would be there for us whatever happened, we would be freer to be creative and original, to take risks. Instead of the desperate, neurotic “independence” of American capitalism, in which one is expected to pull oneself up by one’s bootstraps and never depend on one’s community for anything, (and if one must depend on it, it’s very uncertain whether the social safety net will be there at any given moment), we might find that acknowledged interdependence fostered a more secure and generous form of independent thought and action.

What do you think?

Individual vs community (2): majority rule and our neighbors’ opinions

Ursula Le Guin does (I think) a marvelous job of exploring the tension between individual and collective in a specifically anarchist context in her book The Dispossessed: An Ambiguous Utopia (which some day I hope will be taught in high schools alongside Orwell). The main character is an introvert, a brilliant physicist, who believes in the ideals of anarchism but finds his talents and personality in tension with the anarchist society in which he lives. As a child, Shevek’s tendency to monologue about philosophical problems too sophisticated for his classmates is denounced by a teacher as “egoizing” and immaturity. As an adult, his pioneering work in physics is suppressed by a jealous rival on the grounds that it amounts to “impractical hypotheses without social organic utility.”

Things become darker still when Shevek and his friends begin their own syndicate and printing press; although the people of the planet Anarres are descendants of anarchist revolutionaries called Odonians, they are hostile to Shevek’s revolutionary activity. His partner Takver is ostracized by her coworkers, and a woman on the sanitation committee says with typical anti-intellectualism, “Don’t you try to come into this room, I know you, you damned traitors, you intellectuals, you egoizers.” Even their ten-year-old daughter is ostracized as a “traitor” by the other children in the dormitory.

However, although threats of violence and death are made, the people of Anarres never assemble themselves into an actual mob. They are too much the products of anarchism for that. When Shevek boards a freighter taking him to the capitalist country of A-Io on the planet Urras, people gather to jeer, to throw rocks; some even intend to kill him. But they are disorganized, they get in each other’s way.

If the foreman had no experience in bossing a mob, they had no experience in being one. Members of a community, not elements of a collectivity, they were not moved by mass feeling; there were as many emotions as there were people.

In short, they are too much individuals to disappear into the lethal crowd of Auden’s Horae Canonicae.

Nevertheless, this individualism is in danger from various forces: creeping bureaucracy; the struggle to survive in an inhospitable climate; continuing technological dependence on the capitalists of Urras; and most of all, perhaps, the basic human tendency to find safety in ideology and tribalism. Towards the end of the novel (which is actually somewhere in the middle of the timeline it covers), Shevek observes that although they are free from written laws, they are heavily governed by convention:

“We keep our initiative tucked away safe in our mind like a room where we can come and say, ‘I don’t have to do anything, I make my own choices, I’m free.’ And then we leave the little room in our mind, and go where PDC posts us, and stay till we’re reposted.”

As in a democracy, there is an illusion of freedom which sustains the status quo. Americans do the same. We say to each other, “You’re free. You have no right to complain. If you don’t like something, then vote, get involved in politics.” But we know well enough that our votes are limited to certain occasions, that one must have certain connections and financial resources to have a political career, and that our society is not set up to enable the average person to be very involved in local politics. Forced to work more and more simply to survive, we have less and less time to work towards changing the policies that place us in this position. It’s a vicious cycle. And still we say to ourselves, “This is a free country. I could do something about it if I really wanted to.” And then, mollified by this comfortable illusion, we don’t do anything.

Speaking of a friend named Tir who went insane after being criticized for a satirical play he’d written, Shevek goes on:

“The social conscience completely dominates the individual conscience, instead of striking a balance with it. We don’t cooperate – we obey. We fear being outcast, being called lazy, dysfunctional, egoizing. We fear our neighbor’s opinion more than we respect our own freedom of choice. You don’t believe me, Tak, but try, just try stepping over the line, just in imagination, and see how you feel. […] We have created crime, just as the propertarians did. We force a man outside the sphere of our approval, and then condemn him for it. We’ve made laws, laws of conventional behavior, built walls all around ourselves, and we can’t see them, because they’re part of our thinking. Tir never did that […] he never could built walls. He was a natural rebel. He was a natural Odonian – a real one! He was a free man, and the rest of us, his brothers, drove him insane in punishment for his first free act.”

“I don’t think,” Takver said, muffled in the bed, and defensively, “that Tir was a very strong person.”

“No, he was extremely vulnerable.”

When Shevek says that Tir is a “real Odonian,” he means that he’s a true anarchist, like the original settlers who came to Anarres to live out their dream of a society without coercion. I suspect that in Shevek’s remark that Tir was also “extremely vulnerable,” Le Guin is observing the vulnerability of anarchism itself. Anarres in Shevek’s time, two hundred years after it was colonized, is not the Anarres of the original settlers. How long can pure political idealism be sustained in practice? Society will always tend towards some form of authoritarianism; anarchism is always an impulse within that society, against that tendency.

But this is not to say that all societies are equally unfree, or that the degree to which authoritarian and anarchist impulses are expressed within a given society doesn’t matter. It matters, of course, very much. And for all Anarres’ faults, it is the utopia of the title. Its ideals and values are upheld. By the end of Shevek’s time in the capitalist state A-Io, it appears to him as Hell. But even before that, he contrasts the two in a drunken speech at a party:

“Everything is beautiful, here. Only not the faces. On Anarres nothing is beautiful, nothing but the faces. The other faces, the men and women. We have nothing but that, nothing but each other. Here you see the jewels, there you see the eyes. And in the eyes you see the splendor, the splendor the human spirit. Because our men and women are free.”

Even to have ideals, to be inwardly free enough to hold them and believe in them, is radical and difficult. In the United States today, we are terribly short on idealism. We can see small surges of it in the Occupy movement, in the grassroots support for Senator Sanders, but there is a constant pressure not only from the government itself but from the people around us, our neighbors, our colleagues, our relatives, our friends, pressing inward, saying, “No. You must not dream. You must not hope for something better. At best, you can hope for incremental improvements in the status quo. To dream for anything more is suicide.”

We are told that idealism leads inevitably to the totalitarian states of the twentieth century; to Stalin, to Hitler. We are told that to vote our conscience makes us responsible for whatever sickening candidate may be elected. And because everyone is constantly saying this to each other, very few people dare to vote their conscience, or perhaps they dare but are persuaded it’s futile, and the prophecy of futility fulfills itself.

The Dispossessed is at once a clear-sighted exploration of the potential pitfalls of an anarchist society (and the real beauties, as well as horrors, of a capitalist one), and a celebration of the anarchic impulse of the human spirit. Ultimately, the problem with Anarres that leads to a stifling of the individual is not that it’s anarchic, but that it’s not anarchic enough. It has convinced itself that the victories it’s already achieved are the fulfillment of its idealism; it has laid aside the dream of becoming more. So solidarity ossifies into tribalism.

I’ll wrap up with another quote from Shevek:

“If we must all agree, all work together, we’re no better than a machine. If an individual can’t work in solidarity with his fellows, it’s his duty to work alone. His duty and his right. We have been denying people that right. We’ve been saying, more and more often, you must work with the others, you must accept the rule of the majority. But any rule is tyranny. The duty of the individual is to accept no rule, to be the initiator of his own acts, to be responsible. Only if he does so will the society live, and change, and adapt, and survive.”

Individual vs community (1): the mob

Back in the dark ages before I understood that anarchism was a type of socialism (I’m not sure how I missed that for so long, given that I read Kropotkin and similar in my teens; maybe I’d been brainwashed by the media, or maybe I’m just slow), I used to wrestle with the contradiction of being an introverted individualist concerned with social justice and community building. I still wrestle with this contradiction, but it’s less lonely now that I know others have wrestled with it before me. In fact it’s one of, if not the, great problem of anarchism, and different schools of anarchist thought can be distinguished by the extent to which they privilege the individual or the collective. As I asked in my last post, “Is the fullest development of the individual inherently at odds with that of the community?”

When we speak idealistically of self-organization instead of governance imposed from without, we are liable to forget the ugliest possibility of human self-organization: the Mob. I don’t mean the mafia; I mean, simply, the Mob, wherever it arises. The Mob bullies middle schoolers to the point of suicide, hunts witches, cheers public executions, lynches blacks. The Mob is the total submersion and loss of the individual in the collective; the abdication of individual freedom and, thus, of individual responsibility. And since no one is responsible, one may do anything. Auden, in his poem Horae Canonicae, calls it “the crowd”:

The crowd does not see (what everyone sees)
a boxing match, a train wreck,

a battleship being launched,
does not wonder (as everyone wonders)

who will win, what flag she will fly,
how many will be burned alive

[…]

Whatever god a person believes in,
in whatever way he believes,

(no two are exactly alike)
as one of the crowd he believes

and only believes in that
in which there is only one way of believing.

The parentheses express the individual’s experience and response to events as opposed to the crowd’s, highlighting the stark difference between who each person is as an individual and as a member of the crowd. They are the same person, of course, and yet they are not, because they neither believe the same things nor behave in the same way. In Auden’s poem, it is the crowd that crucifies Jesus, that stands triumphant on the hill at noon to watch him die. A few hours later – at the next canonical hour for prayer – none of those “faceless many who always/Collect when any world is to be wrecked” can remember what their shouting was about.

All if challenged would reply
– ‘It was a monster with one red eye,
A crowd that saw him die, not I.’

The strengthening of the individual, unique and free and responsible for her actions, is the safeguard against this one-eyed monster. One of the dangers of state communism – aside from its willingness to place government in the hands of a small group – is the submersion of the individual in the commune. In Anarchism: From Theory to Practice, Daniel Guerin writes:

As [Max] Stirner saw it, in a communist system the worker remains subject to the rule of a society of workers. His work is imposed on him by society, and remains for him a task. Did not the communist Weitling write: “Faculties can only be developed in so far as they do not disrupt the harmony of society”? To which Stirner replied: “Whether I were to be ‘loyal’ to a tyrant or to Weitling’s ‘society’ I would suffer the same absence of rights.”

According to Stirner, the communist does not think of the man behind the worker. He overlooks the most important issue: to give man the opportunity to enjoy himself as an individual after he has fulfilled his task as a producer.

The quote from Weitling is particularly terrifying and a perfect example of how social harmony itself can be totalitarian.

But capitalism also nourishes Mob tendencies. Is a system that treats the vast majority of people as replaceable cogs in a machine, to be swapped out as soon as a cheaper cog becomes available (here or in China or anywhere else), really a bastion of individuality? At best, capitalism celebrates the individuality of a few privileged persons. It suppresses and destroys the individuality of those it designates “the masses.”

I guess I’ll break off here and let this be Part One of this post, since it’s already getting long and I’ve barely started. I’ll pick up with Ursula Le Guin in Part Two.

Rant about board books: The Rainbow Fish

Monkey is at the stage where he wants every book read to him 10 times in a row. So as I read the same book over and over, I find myself thinking (and free-associating) about its implications.

He received a board book version of The Rainbow Fish by Marcus Pfister from a relative. He likes it because it has a finger puppet. The first time I read it, I thought, “OK, I guess this is supposed to be about sharing, although I don’t usually share my body parts.” The second time I read it, I thought, “There must be something lost in this abridged edition. This can’t be how the original book actually goes.” The fiftieth time I read it, I thought, “Wow, this book is messed up. Why am I still reading it to my child?”

It turns out that the original book is indeed messed up for the same reasons as the abridged version and that I’m not the only person to have noticed (as evidenced by reviews on Amazon.com). Yes, the book is about a fish who is ostracized for having shiny rainbow scales, but gains friends when he gives his scales away. It teaches children that:

1) Having friends is more important than anything else and is the only way to be happy.

2) It’s fine if these “friends” are only interested in you because you give them stuff.

3) You must even rip parts off of your body in order to be the same as them.

In summation, being different in ways that attract the jealousy of others is automatically vain and bad and the only way to morally redeem yourself is to engage in self-mutilation. I can’t help but think of the scene in Jane Eyre when the minister decides that Helen Burns’ naturally curly red hair is a sign of her “vanity” and that it must be publicly cut off in order to redeem her soul.

I don’t think I need to explain why this ethos is disturbing to those of us trying to teach our children that diversity is good, that it’s OK to be yourself even when it leads to social rejection, that real friends value you for who you are and don’t expect you to buy their friendship with material goods, etc. Since I doubt Pfister consciously intended to promote these precise ideas, and since many people think highly of the book, there’s evidently a fine and often overlooked line between social values such as sharing and coerced conformity.

Pfister’s story represents a nightmare version of socialism: the individual must destroy herself in the process of conforming, or be ostracized from the community. But is this what socialism is? Does anarchism merely replace external laws with the law of peer pressure, control by the government with control by the mob? Society depends on a social conscience; an anarchist society even more so; what happens when this social conscience become twisted and destructive?

Furthermore, what is the ideal relationship of individual to community? Is the fullest development of the individual inherently at odds with that of the community? Or is this only the case when the community and/or the individual is unhealthy? Granted that being in a community with others limits our ability to do certain things (for instance, defecate wherever we please). But this kind of limitation is helpful to the individual’s development. Ideally, it is in community, in the tension between freedom and commitment to others, that we become ourselves. Pfister’s image of literally ripping pieces off oneself to placate others is a perversion of this ideal.

Anyway, I’ll stop there, but these are the sorts of things I think about while reading board books to my toddler. (Don’t get me started on existential angst in The Monster at the End of this Book.)

Stressed about money? Don’t worry, money will fix it.

So apparently some researchers got together and determined that the reason poor people get divorced more isn’t that they value marriage less than middle class folks, but because being poor is stressful! From this press release:

“Although low-income and high-income respondents reported similar romantic standards and similar problems with relationship processes such as communication, low-income respondents were more likely than affluent couples to report that their romantic relationships were negatively affected by economic and social issues such as money problems, drinking and drug use.

[…]

“The federal government has spent $1 billion on initiatives to strengthen marriage among low-income populations,” said Dr Benjamin Karney. “Often these are based on the assumption that there must be something wrong with how people on low incomes view marriage or that they just are not very good at managing intimate relationships.”

And my favorite:

“The new research suggests that government initiatives to strengthen marriage among low-income populations should move beyond promoting the value of marriage and instead focus on the actual problems that low-income couples face.” [my emphasis]

Hmmm, I dunno. That sounds like communism to me!

Yes, being low income is stressful. And there’s nothing exciting or rewarding about the stress that comes with scraping by financially (as there may be with some high-stress careers). It’s just a daily, grinding worry. And many of the things that could alleviate that stress require the very stuff that’s causing it in the first place.

We live in a world where taunting neon dollar signs appear above just about everything, from toilet paper to dental care. Middle-income folks don’t see a lot of the dollar signs. They see some, of course, but only when the amount after the dollar sign gets to a certain size. So when they try to give advice to low-income people about things like marriage or psychological well-being, this is what happens:

What you say: “Go on a date night.”

What low-income person hears: “Money.”

What you say: “Go out to eat once in a while.”

What low-income person hears: “Money.”

What you say: “Take a vacation.”

What low-income person hears: “Money.”

What you say: “Go to counseling.”

What low-income person hears: “Money.”

What you say: “Find someone to take care of your child for a while and take some time for yourself before you burn out.”

What low-income person hears: “Money.”

What you say: “Take a homeopathic stress remedy.”

What low-income person hears: “Money.”

It’s not that we doubt the wisdom of this advice. It’s not that we don’t want to do those things. It’s just that our whole society is set up in a way where everything costs MONEY. And if you’re thinking (as people have said to me), “What, it’s only a $30 copay” or “You can find a babysitter for $10/an hour,” well, that right there is $50 for just one counseling session and that’s 1/4 of my food/gas/clothing/toiletries budget for the month. Do that twice a month, and it’s half the budget. When things are tight and tense, even a copay for counseling for a substance and/or marital problem can feel like an added stressor.

It’s not that we don’t value our marriages. It’s just that we value things like eating and having heat and water in our homes, too.

If you have a lot of family support – parents or siblings or aunts who can watch your child while you take a date night or a nap or see a marriage counselor – that makes a huge difference. There are low-income communities where that still happens, but for many of us, as our society becomes more fractured, and as jobs increasingly relocate families (I’ve lost several friends to job relocation in the past year alone), we find ourselves in a very stressful, very lonely situation. (Also, if your family is unreliable due to psychological, substance, or other issues, you might not want them taking care of your children.)

Now, suppose that somehow (credit card, relatives, personal loan, fairies, whatever) you come up with the money to pay for a therapist. At some point in your discussion with the therapist (who may otherwise be quite helpful but is addled by middle income dollar-blindness) you’re going to have a conversation where you tell them about how stressed out you are from working all the time and never being able to catch up on your bills and when you come home your toddler is all over you and you just never get a break and you never talk to your spouse anymore because you’re both stretched past your limits … and the therapist will say something like, “Why don’t you hire a babysitter and go on a vacation?”

You see? The solution to stress caused by lack of money is to do things that cost money! Nice how that works, isn’t it?