Why Puberty Blockers Are Essential Healthcare Tools

Let’s talk about puberty blockers, an essential element of safe and successful gender-affirming care for transgender youth. Social media, politicians, and news outlets have shared a great deal of misleading information about what these drugs do, how they work, and whether they’re dangerous or reversible. This has even led some U.S. cities and regions to enact legislation against their use. Tragically, some localities have even established punitive measures against trans children and the parents who allow them this life-improving and sometimes even life-sustaining care. So let’s take a look at what they really are, how they really work, and why they’re such important mental and physical health tools for many trans kids. 

Puberty-blocking drugs don’t stop puberty for all time; they just stop it for right now. Their results are reversible. If kids stop using them, puberty resumes. There is no evidence that puberty blockers affect future fertility, though taking estrogen or testosterone with them may impact the ability to have children later.

Puberty blockers were approved by the FDA in 1993. According to Cedars Sinai Medical Centers, they’re considered very safe by the medical community. They may possibly affect height (they may delay growth-plate closure, which can lead to taller adult height), and may slightly lower bone density for some. But so far, research shows the effects to be minimal. Doctors and hospitals are required to provide detailed information about risks and downsides to children and their families before providing them with these medications. People with severe gender dysphoria (i.e., who feel their genders to be different that the one assigned to them at birth) usually feel that living in a body that feels more like them is worth being a little taller, or worth taking bone-strengthening minerals and drugs to avoid osteoporosis later in life.

When children feel strongly that their genders don’t match the ones assigned to them at birth, going through puberty can feel crushing and tragic—a permanent sign to the world to treat them as someone they know they’re not. According to the Mayo Clinic, puberty blocking drugs keep kids from going through major changes (some irreversible) like the development of breasts, body hair, and male genitalia; deepening of the voice; and menstruation.

To get rid of those signs, many people go through painful, expensive, and difficult surgery later. But there are certain things that happen to the body at puberty that may not be reversible even with surgery. Those who undergo surgery later often experience complications, pain, great expense, and all the risks that come with surgery and anesthesia. Yet they still don’t have physical outcomes as successful as they might have if given puberty blockers at the first signs of puberty.

Many trans children who go through puberty and see their bodies undergoing distressing, permanent changes suffer severe depression and other negative mental health challenges, according to the National Institutes of Health. Some engage in self-harm such as cutting, substance abuse, or suicide. If given access to puberty blockers, they can delay or stop many of those changes, buying them time until they’re adults and can decide legally how they want to present and identify themselves. Puberty blockers have been shown to significantly reduce depression and suicidality in trans children.

Puberty blockers have led to improved mental health, better social interactions with other kids, and sometimes avoidance of future gender-confirmation surgeries.

The physician information portal HCPLive (which is part of the MJH Life Sciences publishing company) writes, “Investigators said that previous data showed gender-affirming hormones (GAH), puberty blockers (PBs), and gender-affirming surgeries have been found to be independently associated with reduced depression, anxiety and additional adverse mental health outcomes. Puberty blockers administered during puberty can actually reduce suicide risk in this population. A decreased lifetime incidence of suicidal ideation was also found among adults who received access to puberty blockers during adolescence.”

In short, puberty blockers improve and even save lives. They don’t poison children, or take away their choices later. These drugs give children the freedom to delay major health and life choices until adulthood. They align physical and psychological health, and let children feel more like themselves. Providing them to children whose lives could be immeasurably improved—even saved—by them makes them an essential element of pediatric healthcare.

Wayne Shorter’s Luscious, Lyrical Sound

Wayne Shorter played on a number of Joni Mitchell’s best songs, including three tunes on her 1982 album Wild Things Run Fast

Jazz saxophonist and composer Wayne Shorter, who has died at age 89, played with many legends over his long career. An 11-time Grammy Award winner, Shorter played with Art Blakey’s Jazz Messengers, Miles Davis, and Steely Dan, among many others, and he co-founded the jazz instrumental group Weather Report. Although Shorter’s style is distinctive, he was versatile enough to integrate his sound seamlessly with straight-ahead jazz, fusion, progressive, and alternative jazz stylists, as well as with folk and pop soloists and groups.

Some of my favorite Wayne Shorter performances were with Joni Mitchell. Shorter joined Mitchell on ten of her albums, primarily during her middle and later period, after she replaced much of her early, reedy folk sound with a warm, intricate jazz style. As Mitchell’s voice moved into a lower, darker range, Shorter’s sax lines, soaring and sinuous, flew above her voice, tying it together with all the instrumental voices that swirled around her.

A fine example of their collaborative style is the song “Moon at the Window” from Mitchell’s 1982 album Wild Things Run Fast. Another is the moody, marvelous song “Yvette in English,” cowritten by Joni Mitchell and David Crosby for Mitchell’s Grammy Award-winning 1994 album Turbulent Indigo. I can’t imagine this song without Shorter’s trills, floating overhead like Yvette’s cigarette smoke.

The Washington Post obituary for Wayne Shorter describes him as “regarded throughout his career as a nurturer more than a leader.” While his distinctive playing certainly influenced untold jazz musicians over the past seven decades, he may well be best known for how beautifully he integrated his sound and style with others. His collaborations were made so much more beautiful, powerful, and lasting because of Shorter’s willingness to be part of a song’s tapestry, instead of needing to have all eyes and ears on him alone. Jazz and pop music are so much the richer for it.

The Quiet Beatle

We all know how important George Harrison was to the Beatles’ sound and legacy. But he was also a generous friend, a major philanthropist, and a supporter of children and the arts who came to the aid of others time and time again. George was responsible for inspiring musicians to use their talents and influence to raise awareness and money for people in need, and he founded and funded major charities as well as several classic comedic and dramatic films. Here are just a few examples of George Harrison’s influence above and beyond his musical talents.

Ringo’s Big Brother

A young George Harrison with short hair and a big black eye sits on a black chair and looks off to the left. He holds an electric guitar, and wears a white collared shirt, black skinny tie, and black skinny trousers.
George sported a black eye during his first Abbey Road Studios session in 1962 after protecting Ringo from a violent fan.

During The Beatles’ very first recording session at Abbey Road Studios in 1962, George sported a black eye after getting into a fight defending Ringo from a violent fan who preferred The Beatles’ original drummer, Pete Best. George always had Ringo’s back.


The Concert for Bangladesh

The cover for The Concert for Bangladesh album features a black and white photo of a thin, naked Bangladeshi baby sitting before a large empty food bowl. The photo has an arched top, and the title is printed in white letters on a brown background in a border around the photo. The background of most of the album color is dark orange.
The cover of the three-record album The Concert for Bangla Desh. The concert, film, and album together raised over $12 million for refugees.

In 1971, Ravi Shankar told George about the dire genocidal situation in Bangladesh, and the refugees left homeless by the war there. He asked George if he could think of some way to help them. George said yes, he thought he could do something. That something turned out to be the world’s first giant musical benefit.

The Concert for Bangladesh (actually a pair of concerts) became a huge success and was the inspiration for later benefit events like Live Aid and Farm Aid. The concert and the live album of music performed there by major artists raised millions.

George’s idea inspired other musicians to use their talents to raise money to help others, and produced a megahit three-disc album featuring George, Ravi, Bob Dylan, Ringo Starr, Eric Clapton, Billy Preston, and Leon Russell.

George went on to be involved in a number of other awareness-raising and fundraising efforts as well, including raising money for and recording a song with the supergroup he co-founded, The Traveling Wilburys, to benefit Romanian orphans. He also donated income from several hit songs to Médecins Sans Frontières (Doctors Without Borders), Great Ormond Street Hospital (a major London children’s hospital), and Britain’s National Society for the Prevention of Cruelty to Children.

Major Film Producer

A scene from Monty Python's Life of Brian with a smiling Eric Idle in a striped head-covering shawl; a serious-looking George Harrison, also in a shawl, with long hair, moustache, and beard; and John Clease in a simple grey shirt and a yarmulke.
George’s cameo in Life of Brian—Eric Idle is at left, John Cleese is at right.

George befriended the members of Monty Python in the 1970s. He created the production company HandMade Films to produce the film Monty Python’s Life of Brian. His company also produced 22 other films, including The Long Good Friday, Time Bandits, and Withnail and I.

George was a brilliant artist and composer, a loyal friend, a major philanthropist, an example to and supporter of other artists, a popularizer of world music, and a kind and generous soul.

Happy 80th birthday, George. We miss you.

With the Lights Out It’s Less Dangerous

NirvanaPhotos

Above: Dave Grohl, Kurt Cobain and Krist Novoselic of Nirvana.

[Revised from the version originally published on this site in 2014.]

With the lights out, it’s less dangerous
Here we are now, entertain us
I feel stupid and contagious
Here we are now, entertain us
A mulatto
An albino
A mosquito
My libido
Yay!

When Nirvana released the song “Smells Like Teen Spirit” in 1991, it helped make them into rock gods. Ironic, isn’t it, since the song was Kurt Cobain’s dig at mainstream culture. According to Nirvana bassist Krist Novoselic, “Kurt really despised the mainstream. That’s what ‘Smells Like Teen Spirit’ was all about: the mass mentality of conformity.” But the song, which Rolling Stone magazine ranked ninth in its list of the 500 Greatest Songs of All Time, was too catchy, sexy, moody, hard to understand, hard-edged, frayed and nearly perfect to escape the clutches of the mainstream. Its hard-to-decipher lyrics were skewered by Weird Al Yankovic in his parody, “Smells Like Nirvana,” which featured lines like:

What is this song all about?
Can’t figure any lyrics out
How do the words to it go?
I wish you’d tell me, I don’t know

In a 1994 MTV interview, Kurt Cobain said of the parody, “Oh, I laughed my butt off. I thought it was one of the funniest things I ever saw. He has some good people working for him. . . . They really know how to reproduce things to the T. He had the exact same setup. It’s the same video with him in it. It’s great.”

The original “Smells Like Teen Spirit” is a perfect blending of droning, captivating, chant-like repetition; buzzing power chords; barely understandable but still compelling lyrics and ragged-voiced angst. It encapsulates suffering, cynicism, dry humor and teen alienation. It felt fresh 15 years ago, and it still sounds fresh and raw today, despite being named the Most Played Video on MTV Europe in the 2000 Guinness Book of World Records. Even though it’s one second over five minutes long, it doesn’t feel drawn out; its pacing, its bridges, even its repetition make it somehow stronger rather than monotonous. The layering of instruments makes for a great, pulsing wash of sound, but within the layers are subtleties, long-held and echoing guitar notes, a threatening bass line, and Cobain’s growling voice matching the bending notes and jagged timbre of the instruments around him, so his voice becomes an instrument to match them. The melding of his own voice and the growling guitar when he says “Yay!” is spookily satisfying, and gave me the same little shiver after the hundredth listen that it gave me the first time.

While the music on Nirvana’s second album, “Nevermind,” from which “Smells Like Teen Spirit” comes, is classified as grunge, it’s really just a polished, pure and more accessible form of punk, slowed down enough to be grabbed and ridden on, but it channels the anarchic spirit of British punks like the Sex Pistols, whose seminal album “Never Mind the Bollocks, Here’s the Sex Pistols” probably inspired Cobain to name the Nirvana album “Nevermind” in their honor. (Some say it’s also a tribute to the Replacements song “Nevermind.”) Unlike American punk bands like the wonderful Ramones, whose screamingly fast-paced songs about sniffing glue and teenage lobotomy patients, punk rockers and beating on brats with baseball bats were essentially all in good, mindless fun, the Sex Pistols really were about anarchy, giving the finger to the establishment, protesting the moral bankruptcy of middle- and upper-class British twits, the monarchy and the conservative political leaders of the 1970s and 1980s. They were the real deal, and Cobain admired that twisted, angry, anarchic vibe.

That punk vibe was bent, reformed and polished into some of Nirvana’s best work, and their songs were musically inventive and attractively melodic enough to grab people who would never give straight punk a second thought while being honest enough to appeal to pure punks as well. “Smells Like Teen Spirit” was essentially a crossover hit, and its success rather embarrassed Cobain, since it made him and Nirvana superstars beyond imagining and, it seems, beyond Cobain’s ability to handle the attention, the adulation, and being co-opted by the mainstream until he became a media darling largely against his will. His drug problems and ultimate suicide of course only fueled his legend and turned him into a mythic figure of alienated youth and artistic purity tarnished by too much interaction with the filthy mainstream, the same mainstream which his widow Courtney Love alternately woos and trashes.

So where does the title come from? Kurt Cobain dated Tobi Vail of the group Bikini Kill, she used Teen Spirit, a deodorant marketed to teen girls. Bikini Kill member Kathleen Hanna painted “Kurt Smells Like Teen Spirit” on his wall to imply that he was marked with his girlfriend’s scent, but Cobain didn’t realize the reference and thought he was being complimented on his spirit of youthful rebellion. Again, how ironic: his anti-mainstream screed also served as inadvertent advertising for a Colgate-Palmolive product aimed at the teen masses.

[2014 version revised from an article originally published in Laura Grey’s Little Hopping Bird blog.]

Kurt Cobain: Beauty Born of Pain

[Revised from version originally published in April 2015.]

Load up on guns, bring your friends
It’s fun to lose and to pretend
She’s over bored and self assured
Oh no, I know a dirty word

Long before Kurt Cobain displayed the depth of his hopelessness to the world by taking his own life, his fans had known he was suffering. Anyone who has listened to Kurt Cobain sing “Smells Like Teen Spirit” has heard the pain in his voice. Every Nirvana song is built upon a platform of angst—the music, the lyrics, the growls and wails all make the turmoil and drama inside Cobain’s head quite clear and accessible for anyone to hear. This transparency of feeling is what makes Nirvana’s music great and greatly beloved: it taps into a primordial well of anxiety, anger, longing and disillusionment in listeners and makes us feel as if our own personal, raw feelings are being scooped up, wallowed in and worn like warpaint by a rock god for all the world to see.

The obviousness of Cobain’s extreme pain was so evident to millions of people years before his suicide in 1994, so it comes as a shock to watch interviews with his friends and family and see how many cries for help they ignored, how little aid they sought for him, how limited were their resources in guiding him toward hope even after he became one of the most famous people in the world. The very elements of his psyche that made his art so powerful and meaningful to others were the parts that caused him the most misery. His charisma, stubbornness, insularity and difficult personality seem to have paralyzed those who should have seen him clearly and helped him most directly. These same characteristics and his remarkable ability to build a bridge between himself and other disaffected souls brought him a level of scrutiny that made him feel trapped in a dangerous tidal wave of success that he was constantly trying to ignore and retreat from. It’s as if he was hiding in plain sight.

With the lights out, it’s less dangerous
Here we are now, entertain us
I feel stupid and contagious
Here we are now, entertain us

All of this becomes devastatingly clear in Brett Morgen’s excellent HBO documentary Kurt Cobain: Montage of Heck. The first film about Cobain to have the support of his daughter Frances Bean Cobain (who is also one of the film’s executive producers) and her mother, Kurt’s widow Courtney Love, this documentary could never have been made without their treasure trove of audio recordings, videos, home movies, drawings and family photos and access to Cobain’s diaries and notebooks. All of these elements come to life in stunning animated montages that make us feel as if we’re in the room with Kurt, his mom, his wife, his baby and bandmates Krist Novoselic and Dave Grohl. Sometimes we feel as if we’re inside Kurt’s head as well.

Come as you are, as you were
As I want you to be
As a friend, as a friend
As an old enemy

His violent and disturbing drawings, his remembrances of distressing moments in his personal history and the pained, sad stories of those with whom he lived and worked make abundantly clear how lonely, frightened and angry he was from a very early age. But the home movies of him as a baby and child show a heartbreakingly sweet and pretty little boy with a beautiful voice. He was hungry for attention and constantly in need of deep soothing that he rarely received. It hurts to see him so fresh and so loved, and to know that his overwhelmed parents, stepmother, siblings and friends had no idea how to deal with his enormous kinetic energy, his destructive impulses or his lack of self-control. The things he needed most—stability, understanding, unconditional love and safe ways to soothe himself—seemed nearly always out of reach, so he went for one dangerous activity, addiction or relationship after another, and that resulted in self-loathing and mental disintegration.

kurt

Two interviews really stand out among those in the film. One was with his stepmother, with whom he had a very difficult relationship. She recognized how abandoned and unwanted he must have felt when he was kicked out of his parents’ houses and moved from one to the other, then went off to a grandparent and moved back around through the family again. She expressed regret that she hadn’t recognized his pain at the time but could only be frustrated by his acting out and worried about the effect of his behavior on his siblings. Bandmate Krist Novocelic, long his close friend, expressed great sadness that he was unaware of how serious Kurt’s problems were during his life even though he saw evidence of Kurt’s rage and watched him self-destruct. He says in hindsight it is obvious that Kurt was in extreme pain and that there were numerous red flags and cries for help, but he wasn’t able to recognize their seriousness at the time.

Novocelic also noted something crucial to an understanding of Kurt’s enormous antipathy toward fame and success: he said Kurt had a huge fear of being humiliated. As we watch Kurt in films and videos and hear his words, it becomes clear that he hid his fears with bravado, dark humor, dramatic performances, drugs and acting out. He derided establishment values and behaviors and deliberately set up barriers between himself and those who might have been best able to recognize and help him. And of course, it is that raw, urgent ugliness inside of him that sometimes comes out in gruesome drawings, in his bashing his guitar to smithereens on the battered wood floor of his own house, or in refusing to bathe or wash his hair for days, or living in squalor and backing out of major tours so he could go home to do little but play guitar, have sex and shoot up for days or weeks on end.

It is that very grunginess in his personal life that bled, sometimes almost literally, into his music, and made it so accessible, thrilling and fresh to a youthful audience tired of the smooth, highly produced technopop of the 1980s. Cobain’s squalor and literal stink combined with a vulnerability, a gritty poetic streak and a compulsion to create helped him build a dirtily sexy persona, but they also pushed him into a dangerously intense public world that made him endlessly terrified of being exposed, embarrassed, ridiculed, overadored and ultimately used up. So he used himself up in a hurry before life had a chance to do it to him.

I found it hard, it’s hard to find
Oh well, whatever, never mind

The urge to create and the urge to destroy, including the urge to self-destruct, were always living side by side within Kurt Cobain, and his overwhelmed family members shunted him back and forth among houses a number of times during his childhood, recognizing his neediness but experiencing it always as a destabilizing and dangerous force that they couldn’t control and couldn’t stand. He also had a long history of serious and excruciating abdominal pains that caused extreme and frequent pain and sometimes bloody vomiting, but there was little money available until the end of his life for psychological help or appropriate medical care. So he developed dangerous ways of self-medicating with food, drink and drugs that exacerbated his ill health. By the time he had the money for proper mental health support and medical care, his dangerous habits were well ingrained, and his beloved companion and wife Courtney Love was herself so drug-addled, angry and self-destructive that she could only feed into his addictions and his rejection of others’ attempts to offer help. When her eye started to wander and he recognized that even she, the partner whom he thought understood and loved him better than anyone, was on the verge of betraying him, he lost all hope, attempted suicide, and then successfully finished the job with a gun a few days later.

Hey, wait, I’ve got a new complaint
Forever in debt to your priceless advice

Why would someone want to sit through two hours of this dark story with so many regretful loved ones sitting stricken in front of the interviewer and recounting their memories with wringing hands and guilty eyes? Because the pain of his story, like the pain in his music, is compelling even as the details are sometimes repellent. Some of his memories, words and images are grim and disturbing, but watching the intimate dynamic between him and Courtney, drug-addled and gritty as it often was, shows why they were drawn to each other—admiration, understanding and humor are all evident, as is a certain pleasure in courting death and mayhem. It hurts to watch him hold his baby Frances with such loving tenderness and read and hear his words of devotion, then later  see him  barely able to hold her on his lap, so drugged-out and nearly incoherent is he in one awful scene. It is hard to watch knowing that Courtney, a friend filming the scene and another helping with the baby were all present, and, like everyone else in the film, they observed the clear self-destruction of the man but no one either would or perhaps could do anything to pull him back from the brink.

I saw the film in Seattle’s Egyptian Theater, which is right in the neighborhood where Cobain had his last meal. One block from the theater is Linda’s Tavern, where he was last seen alive on the night before he shot himself through the head. The film is currently in a few theaters around the U.S. and in the U.K., and is garnering high praise for its intimate portrayal of the man and his life and his ardent, nearly compulsive need to create. I’m glad to have enjoyed it in a cinema where the never-before-seen concert footage was especially powerful and immersive and the intimate moments felt even more immediate. I’m even gladder that it will be available to so many more via HBO television showings.

I’m so ugly, but that’s okay, cause so are you
We’ve broken our mirrors
Sunday morning is everyday for all I care
And I’m not scared

While the film has received mostly very good reviews, some have complained that it is uneven and a bit jumbled because of the lack of a narrator and the sometimes abrupt switches between interviews with those who knew him, private film footage, concert footage, images of his writing and art and montages of animation and recordings. Boyd van Hoeij of The Hollywood Reporter wrote that the film is “impressive in parts, but wildly uneven as a whole.” I found this unevenness and the montage style particularly appropriate for the story of a hyperkinetic, often drugged-out man with serious mental and emotional problems. I might have found the style more annoyingly disjointed had it been used to tell the story of a different subject, but in this case the style illustrates how overwhelming it must have felt to live inside of Cobain’s brain and body. The barrage of images and sounds approximate the cacophany of a grunge concert, a life of rock and roll excess and the disabling and endless waves of chronic and extreme physical and emotional pain he felt. All of that is shown amid reminders of how much love and admiration those around him felt and wanted to share with him alongside the frustration and confusion they felt over his extreme emotions and behaviors.

A denial, a denial, a denial, a denial.

The film, which gets its name from a musical collage made by Cobain with a four-track cassette recorder before Nirvana became famous, is no feel-good movie. It is often funny, sometimes darkly beautiful and occasionally mesmerizing, but it is also a very raw view of the life of a dangerously mentally ill and emotionally damaged human being. Even though it shows how difficult and ugly he and his life could be, it also helps us see his vulnerability, humanity and his hunger to create, and it makes clear his devotion to his wife and child.

This film helps to humanize Kurt Cobain without lionizing him. Seeing how far back his deep emotional illnesses went also helps us to empathize with him and feel sympathy along with the disgust his actions sometimes inspire. The film shows how off-puttingly, determinedly filthy, squalid and unhealthy his lifestyle often was (though he and Courtney did sometimes live in luxury hotels in Seattle and elsewhere once they became wealthy), and interviews with his mother and his widow give some glimpse into their own sometimes impaired ability to see how much of a part each of them played in his feeling unsupported and betrayed.

He’s the one
Who likes all the pretty songs
And he likes to sing along
And he likes to shoot his gun

David Fear of Rolling Stone described the film as “the unfiltered Kurt experience,” noting that Cobain is shown “not [as] a spokesman for a generation,” but as “a human being, and a husband, and a father.” Frances Bean Cobain said at the documentary’s premiere in Los Angeles, “After seeing it, I thought I could only watch it once. But the film that [Morgen] made—I didn’t know Kurt, but he would be exceptionally proud of it. It touches some dark subjects, but it provides a basic understanding of who he was as a human, and that’s been lost.”

I agree.

Stop Beating Yourself Up

“The Last Judgment” by Michelangelo

Looking for effective ways to stop self-defeating behaviors, discover and acknowledge underlying fears and motivations, and build new thought patterns that will improve your confidence and lower stress levels?  I know, I know—this sounds like a snake-oil spiel. Actually, cognitive behavioral therapy can teach you to recognize patterns of negative self-talk, then respond to those nasty voices in your head with realistic, fact-based positive alternatives.

By acknowledging your challenges and history, and recognizing the positive elements in the steps you’ve already taken, you can discover hidden strengths and build on unacknowledged successes. You can recognize skills you didn’t realize you had, set realistic goals, and attain them more readily. You’ll learn to recognize negative, judgmental, or defeatist thought patterns, then adjust the way you respond to things that used to trigger you. Building these new skills allows you to be more accepting and kind to yourself and to others. This improves relationships, increases empathy, helps you create stronger bonds with others, and even boosts productivity.

Don’t feel you’re ready to see a therapist? I highly recommend reading the work of psychiatrist and cognitive therapist David D. Burns, MD. His behavioral modification methods have been at the heart of many cognitive behavior programs for over 30 years. His techniques involve recognizing and altering negative and self-defeating behavioral patterns, and you can learn them easily from his book Feeling Good

Burns, who has taught at Stanford’s School of Medicine, has written several excellent best-selling books on fighting negative self-talk with realistic, fact-based positive alternatives. Years ago, my own therapist recommended his book Feeling Good to me, and I have found his techniques hugely helpful in my own life.

Burns’s work is not about spewing mindless platitudes and bland I-can-do-it positivism. It requires looking directly at the negative things we say to ourselves (and others), then peeking underneath to see what fears and distorted thinking cause such situations. Burns shows us how to counter automatic negative thoughts with relevant, accurate, truthful alternatives; he teaches that we can train ourselves to limit our unconscious and automatic negative self-talk. He shows that there are nearly always alternative ways to see situations that can lead to more positive outcomes in the future.

This book doesn’t take the place of a strong relationship with an excellent therapist. That can go much farther in helping you to develop important insights into your history and your behavior patterns. But Feeling Good is a great place to start, and will give you a wealth of valuable information that you can put into immediate use. And it’s readily available online for under $10.

Feeling Good can help you to better understand the power of cognitive reframing, and discover methods that can help you permanently improve your relationship with yourself and others.

Avoid Bullies During (and After) the Holidays

[Originally published in November 2016.]

As the holidays approach, I’m reminded of multiple painful Thanksgiving dinners years ago during which I felt forced to spend time with a relative who repeatedly bullied me. She insulted me in my own house, picked fights with me in front of others and blamed me for actions I hadn’t taken, and for words I never said. Ultimately, I refused to be treated that way anymore, and stopped spending holidays with someone who insisted on telling lies about me and attacking me for things I didn’t do. Having to refuse to see her at holidays was very painful, but spending time with someone who claimed to love me yet also berated, insulted and lied to me and about me was worse.

If you find yourself in a situation in which you are dreading holidays because you fear that you will be insulted or attacked, or worry that you will feel trapped and helpless, remember: there is no rule that says you must be with other people at holiday time. We have all been told that spending a holiday alone is terrifying and awful, and that holiday solitude means we are bad or worthless, unloved or unloving. None of that is true.

If you dread the holidays because you fear you have no alternative but to walk into the lion’s den and be eaten, know that it is perfectly okay to stay home (or go away someplace) and celebrate the day in your own way. You can be thankful and be a good person even if you eat a bowl of soup by yourself or with only your partner or immediate family, then take yourself out to a movie. You can sleep in and catch up on your novel, or binge watch your favorite TV show, or listen to podcasts while you do puzzles, or take a long walk with your favorite dog. You can eat spaghetti instead of turkey. You always have options.

The biggest concern about opting out of powerfully painful social interactions is often about how others will view you afterwards: will they shun you, punish you, talk about you behind your back if you don’t attend? They might. Your refusing to attend an event could cause a family rift. Not attending Thanksgiving with your in-laws or sister or dad might mean getting angry phone calls about it later, so there is a trade-off and a risk of future pain. But if you are miserable being with other people because they treat you with contempt or disregard, is that a healthy dynamic to perpetuate? If they (or you) become abusive when provoked, especially in the current political climate when so many of us are fragile, thin-skinned and worried about the future, engaging with others in anger after one too many glasses of holiday wine could be not only emotionally but physically unsafe.

If being with a person, even one whom you love, makes you feel sick, sad, worthless, angry or frustrated and efforts to interact in a healthier way haven’t worked, clinging to that relationship even though it brings out the worst in you and others can be very damaging. Being unwilling to accept another’s bad behavior just because it comes from a family member does not make you monstrous. Avoiding abusive situations is just good self care.

Depression is often exacerbated over the holidays when we compare what we think we need to feel fulfilled with what seems to be available to us. We may be reminded of past hurts, losses, shame and regrets, and they may overwhelm our feelings of love, happiness or safety. If you fear that being with certain people is not safe for you and will bring on destructive feelings toward yourself (or them), remember: you don’t have to engage. You don’t have to attend events. You can have a quiet holiday on your own without falling apart. Others may respond with hurt feelings, and you may have to deal with your own feelings of guilt (often not deserved) if you prioritize your own mental health above placating those who cause you distress. But if you’re an adult, you do have a choice about where you spend your time and with whom. Please don’t put yourself or others in harm’s way.

Dionne Warwick’s Effortless Grace

The melding of Dionne Warwick’s voice with songs by Burt Bacharach and Hal David was one of the loveliest things to happen to music in the 1960s. Like her younger cousin Whitney Houston, Miss Warwick had a natural elegance and seeming effortlessness to her performances that belied the skill and preparation behind her work. This serene stylishness was played up in studio recordings and TV appearances. In an exciting video of a very young star performing the hit “Walk on By” live in 1964, that cool grace is mixed with a freshness and verve that really makes me wish I’d seen her perform in person.

But we can still enjoy her wit—her Twitter feed shows that the superstar now affectionately known by many as “Auntie Dionne,” still has plenty of humor and joie de vivre to go around.

The Founders’ Intent

Declaration of Independence, an 1819 painting by John Trumble, shows Jefferson at the center of a group of men presenting their draft on June 28, 1776

Thomas Jefferson was a brilliant but deeply flawed man who viewed only white men as being deserving of the rights of full citizenship. To further his expansionist plans, he began the process of Indian tribal removal from the newly acquired Northwest Territory, which began genocidal policies that ravaged native populations and stripped native people of their rights, homes, and lives. Knowing that slavery was evil, he forced his children born of Sally Hemings, whom he enslaved and impregnated, to live their lives as slaves instead of freeing them.

Jefferson was also a inventor, scholar, writer, and, of course, one of the most prominent of our so-called Founding Fathers. He is considered all-wise and beyond reproach by many Second Amendment fetishists. The so-called originalists on the Supreme Court say we must follow “the founders’ intent,” and base their rulings on the explicitly expressed opinions of rich, white, largely slave-owning men like Jefferson. Justices Alito, Thomas, Gorsuch, and Kavanaugh in particular express a determination to follow the intent of men dead for two centuries unwaveringly, as if they were infallible and holy. This backwards view assumes that no new understanding of humanity or science or the world around us, no historical or cultural shifts—in short, nothing has happened in the past 250 years might justly influence how we see the world.

For all his many grave faults, Jefferson was an educated and worldly man obsessed with expanding his understanding of statecraft, science, human nature, and the world around him. It takes no stretch of the imagination to recognize that the world view of the originalists is antithetical to his values. The idea that all human enlightenment that might influence jurisprudence and improve the new  nation he so cherished should end with his own life experience would have shocked and appalled him.

If we play devil’s advocate and assume for a moment that sticking to “the founders’ intent” is a valid way to mete out justice, what Jefferson actually said he believed is of great consequence. If we are to follow his guidance, shouldn’t we consider his intent as expressed in his own writings?

One prominent example of his intent can be found in the words carved into the Jefferson Memorial itself:

“I am not an advocate for frequent changes in laws and constitutions, but laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy as a civilized society to remain ever under the regimen of their barbarous ancestors.”

An Extraordinary Evening with Jessica Williams

Jessica

[The vastly talented Jessica Williams died on March 12, 2022. I originally published the following essay about her in July 2005. Jessica became my friend the night I first heard her in concert back then, and I was honored that our friendship deepened, and we stayed in touch until just a few months before her passing. Jessica was a remarkable musician and a beautiful human being. Her website is sadly no longer online, but you can still find examples of her exquisite music.—LG ]

Two nights ago I was invited to share in a magical, memorable evening of of music. Jessica Williams, the extraordinary jazz pianist, played an intimate and elegant concert at the home of my friend Richard. He had spoken to her after her concerts in Seattle over the years, and had the good fortune to be seated next to her on a flight from San Jose to Seattle some months back, which gave them time to share a friendly conversation. Richard is a jazz pianist himself and the owner of a fine piano, and he and Jessica spoke about the idea of her performing at his home for a small group of local jazz aficionados after she finished her bigger Seattle gigs. Happily, the idea became a reality. Seattle is a great town for jazz; the jazz community is avid, active, and friendly, and small enough that everyone gets to know everyone else before too long. This little group knew Jessica’s music well, and the buzz of delight and amazement that we could all get so close to a jazz master had us all feeling a little tipsy before anyone had a drop to drink.

Jessica is well-known and loved among jazz fans and players; the frequently repeated question is, why isn’t she better known to the rest of the world? She’s noted for her improvisational brilliance, has played with jazz greats such as Dexter Gordon and Leroy Vinnegar, and has received lavish praise from the likes of Dave Brubeck, McCoy Tyner, and Marian McPartland, on whose NPR radio show, Piano Jazz, Jessica has performed. Her pieces have often been played between interviews on NPR’s Fresh Air with Terry Gross; Terry is a great fan of hers and Jessica was interviewed on Fresh Air and performed an in-studio concert for Terry’s listeners in 1997. I highly recommend listening to the 2002 rebroadcast, available free online, which includes pieces by Monk and Gershwin and some of Jessica’s own beautiful compositions.

What makes her playing unique and exciting is a combination of dazzling technical skill and warm, melodic, lyrical feeling. Her touch is sure, she plays with conviction, and she has the chops to knock any other player out of his socks if she wants to. Yet at the same time, she breathes warmth and life into pieces that can feel cold in other hands. She can take an atonal, dissonant piece that others might treat as an exercise to show off virtuosity and find the spirit at its core, the life force behind the string of impressive notes, the hush in the middle of the chord that a show-off performer would miss.

Jessica finds great inspiration and pleasure in playing compositions by Thelonious Monk, who’s notorious for being tricky to follow or hard to get. Despite having written the accessible but wonderful ballad “‘Round Midnight,” Monk can sometimes be rough, bouncy and dissonant. When Jessica plays him, however, she isn’t afraid to lighten him up, play up the humor behind the notes, to show the subtlety in his compositions so one can feel the thought behind the dissonances, and understand why they’re right and not random.

Jessica was classically trained, so early on she still believed that there were rules that couldn’t be broken and techniques that must be followed when playing piano. She told Terry Gross the first time she heard a record of Monk playing, she thought he sounded like he was wearing boxing gloves at the piano. But with continued listening, she grew to love his openness to new techniques. She incorporated some of them into her own playing and has developed other innovative techniques that amplify the feeling in her music without ever getting lost in tricks for the sake of tricks.

Sometimes Jessica reaches into the piano to strum the strings while playing keys, incorporating a sound like an autoharp into her playing, as she did at the beginning and end of “Getting Sentimental Over You” when she played it during her Fresh Air concert. She’s careful not to overuse it, however; she doesn’t want to become gimmicky but likes to explore the variety of sounds that a piano can make and integrate these devices into the tunes to add color. During this week’s concert, she reached into the piano to strum it at several points, and she occasionally shuffled the soles of her shoes across the wood floor to create a sound like a drummer would with a brush, or like a softshoe dancer might. She also likes to quote other jazz compositions when she plays, a common tip of the hat from one jazz musician to another, throwing a few measures of a well-known jazz standard into a piece for humor and as an homage. She improvises these surprises and tosses them as little treats for the audience, each one a lagniappe to lighten the heart when listeners get too earnest and caught up in the piece.

On Monday night, she began with a piece by John Coltrane, “Wise One,” followed by “The Very Thought of You” by Ray Noble, “Paul’s Pal” by Sonny Rollins, and two pieces by Monk, “Ugly Beauty” and “Nutty.” I’ve never enjoyed Monk as much as I did that evening. She has said that record producers have often pushed her to show off more of her impressive technique, focusing on speed and flash, and playing Monk certainly allows her that, but she plays him with more subtlety and insight. There’s intelligence in her playing without cold intellectualism, an awareness of exactly what note, what chord, what sense of space is necessary to make a phrase work while still holding the meaning of the song, its essence, the point of it all, in her heart. For her, the most satisfying playing involves a spiritual element. As she told me, she can emphasize flash and technique when she’s playing in a wild or distracted venue or on a bad piano that can’t hold up to subtlety; she can adapt and please the audience when that’s what’s called for. But when she is in the right space with a good instrument and a receptive audience, this nuanced and spiritual essence of her playing emerges, and a thrilling pleasure in being right there, right then, with her, in the palm of her hand, fills the audience, or, in the case of someone lucky enough to own her CDs, fills the listener sitting alone at home if she or he gives her pieces the attention they deserve.

Jessica’s playing is so lovely and lyrical that it’s more accessible than many jazz pianists without ever crossing over into that scary “lite jazz” territory. She began her second set with Irving Berlin’s “They Say It’s Wonderful” from the musical Annie Get Your Gun—songs don’t come much more accessible than that. And yet in her hands it was anything but trite; it was fresh again, and as pure as it was when Berlin wrote it. One of my favorite moments in the evening came when she played Dexter Gordon’s “Don’t Explain.” I’ve always loved Billie Holiday’s version, so it’s hard for me to give other artists due credit when they play it, it’s so associated with Lady Day in my mind. But I was right there with Jessica, note for note. Her love for Dexter Gordon the man, as well as for his music, was evident in her playing, and it was an emotionally rich piece.

She followed it with her own eloquent ode to her friend, “I Remember Dexter,” and two more of her elegant compositions, “Poem in G minor” and “Sheikh.” She ended with a gorgeous rendition of Duke Ellington’s “Mood Indigo” that left me so touched I had to compose myself before I could shake her hand and tell her what a wonderful evening it had been. Ellington himself would have pronounced her performance “beyond category.” At the end of that second set, I realized I’d been staring rapt at her hands the whole time and hadn’t even looked up once to see the faces of the other people sitting around me. At the end of the concert I saw the same grateful wonder in their eyes that I felt, that we could be sitting 10 feet from greatness and share in this experience.

Before the concert, I had the pleasure of talking with Jessica in the kitchen. For all her skill and mastery, and despite all the swooning and kudos afforded her by fans and fellow artists, she is anything but a diva. She was humble and gracious, and she spoke of the pleasure she takes in her art and in sharing life with friends, of the places around the world in which she’s lived, of the kindnesses shown her by several jazz artists, like Dexter Gordon and his wife. She’d never met me before, but asked me about myself as well, and listened and cared about what I had to say. She was there, standing in a kitchen with a stranger, present in the moment and open to the experience. She showed a respectful, commonsense kindness with me and everyone present which I wish was shared by all people of such accomplishment and fame.

Jessica’s lived courageously and taken risks, turned corners when she was told what a mistake it was and been true to her heart, her music, and her passions. She’s been open to new techniques, to new styles, to resurrecting older ideas or creating new sounds that resonate with her heart. The result is a lovely, gracious, multifaceted woman who creates beauty and cares about the world around her and the people in it.

Andrew Gilbert wrote beautifully of Jessica and her art for the San Jose Mercury News: “A tremendously assured musician, Williams marks her style with ravishing lyricism and daring improvisational flights. But what really sets her solo performances apart is her gift for seamlessly weaving together various jazz keyboard styles, encompassing the highly syncopated stride school of the ’20s and ’30s, the light, effortlessly dancing approach of the swing era, the jagged single-note runs of bebop and the rhythmically diffuse sound perfected by Bill Evans in the ’60s, all integrated into an organic whole by her compelling sense of narrative flow.”

Postscript: When I first met Jessica, her website’s homepage quoted one of her favorite musicians and people, John Coltrane. It said: “I want to be a force for good. I know there are bad forces here that bring suffering to others and misery to the world, but I want to be the force which is truly good.” This quotation was so apt for Jessica; she lived her life in a way that brought pleasure to others, and she shared her remarkable talents and hopes with others through her musical gifts. She lived her values and spoke through her art. Jessica was an extraordinary person; she will always be my cherished friend.