Beyond the Stigma

This is a part of a series of blog posts from members of the LifeSpring Brand Ambassadors program. Staff members in this program write about a topic they are passionate about relating to LifeSpring and/or mental health.


Depression is a real and serious condition that requires treatment and longtime support. It is often accompanied by a fear of stigma from those who experience it. This article is designed to dispel the myth that a person who experiences depression is “faulty” and “abnormal.”

There are multiple causes, both situational and organic, for depression. In addition, the severity of symptoms differ greatly from person to person.


Recognition of the issue is not a cause for shame or embarrassment.

The first step is to recognize and understand the signs and symptoms of depression. Here are just the tip of the iceberg:

            *feelings of hopelessness

            *trouble concentrating

            *thoughts of death or suicide

            *inability to make even simple decisions

            *sleep disturbance (too much or too little)

            *weight fluctuations (gains or losses)


This, in no way, is a representation of all the noticeable signs of depression. In and of themselves, each one can be manageable. However, in combination, these symptoms may denote a serious condition that does not just need to be “dealt with” but treated.

Seeking treatment from a qualified mental health professional can help someone distinguish between the type and severity of the depression they are experiencing. Treatment options can include individual therapy and/or medication management. Treatment, combined with a system of support, can help someone with depression live a productive and happy life.


Susan Bugh, LCSW

Staff Therapist (Washington County Office)

ADHD: A Family Issue

This is a part of a series of blog posts from members of the LifeSpring Brand Ambassadors program. Staff members in this program write about a topic they are passionate about relating to LifeSpring and/or mental health.

ADHD: A Family Issue

We have heard a lot in our society about ADHD, otherwise known as Attention Deficit Hyperactivity Disorder. It can present as predominately inattentive type, predominately hyperactive type, or combined. It is characterized by having 6 or more of the symptoms of each type. We have all probably been touched in some way by a child who has been diagnosed with this disorder and know how, if untreated, it can impair an individual’s function. However, it also has a dramatic effect on how the family unit as a whole functions and operates.

Common themes that have emerged from the families I work with, as well as my own personal experience include “Do you know how many times I have to say ‘Floss, brush, and Rinse’ each night?” or “I get the excuse ‘I forgot’ over twenty times this week!” As much as a child with ADHD is disorganized and forgetful, we as parents need to remember and be organized.

The first thing I tell the families I work with is that a new normal must be found. It is proven that structure and consistency are the best factors in improving overall functioning of a child with ADHD. This can be just as hard on parents/families at it can be on the patient. Charts, schedules, post-it notes, and verbal reminders are necessary components of effective treatment. Instead of thinking of these things as coddling or enabling, parents need to understand these are necessary keys to independence and success.

It is important to work with a trusted professional to develop a clear understanding of this issue. Next, finding support from friends or others having the same experience can help to normalize everyday stressors. Finally, remember that ADHD is not something to be “cured” in your child but accepted. When dealt with effectively, these challenges can make a family stronger!

Susan Walker Bugh, LCSW

Therapist, Washington County Office

Mad or Sad?

This is a part of a series of blog posts from members of the newly-created LifeSpring Brand Ambassadors program. Staff members in this program will write about a topic they are passionate about relating to LifeSpring and/or mental health.



Understanding Depression in Children


Depression is defined as “feelings of severe despondency and dejection.” If you asked the average American, most could identify knowing someone who is depressed or being depressed themselves.   However, many are unaware that symptoms of depression in children can be very different.


Children are not “smaller adults” which is a common misconception. Depression often presents in children in the form of anger. Many parents and teacher think “This is one angry kid!” This confusion can often lead to misdiagnoses and children not getting the help they need.


Symptoms of depression in children can include the typical depressed mood, isolation, and crying spells.   However, it can also include inattention, difficulty concentrating, sleep disruption, irritability, anger/verbal outbursts, sensitivity, and eating disturbances. Depression is becoming more prevalent in those under the age of 18. According to the American Academy of Child and Adolescent Psychiatry “2 % of young children and 8% of adolescents suffer from depression.” These children can be classified as moody, irresponsible, and trouble makers and go without the treatment warranted and needed.


So remember, sad and mad are not just rhyming words. They could also be the telltale signs of children in need of treatment for depression.


Susan Bugh, LCSW


Sage Advice for Thanksgiving


Like many holidays, Thanksgiving can evoke strong emotions. I know a fellow who told me how much he dreaded Thanksgiving, ever since the year he allowed himself to be baited into a knife fight with his brother-in-law. His story reminded me of a character in the movie “The Ladies Man,” who said that he always carried at least two knives and a gun to Thanksgiving dinner.


Comedian Al Franken once said that his family celebrated holidays by sitting in the living room viciously criticizing one another, until someone had a seizure and then they had pie. Thanksgiving is often a time when family members, who manage to successfully avoid each other all year, are suddenly forced to spend an entire afternoon together. It is not coincidental that Hollywood chose Thanksgiving as the backdrop for dysfunctional family movies like “Hannah and Her Sisters,” “Avalon,” and “Home for the Holidays.”


Although this is a time when we should set aside our petty grievances to give thanks, the nerve-wracking nature of the occasion often puts everyone’s teeth on edge. At one family gathering it was suggested to my overweight brother that perhaps he was eating too much. He responded by throwing a plate of spaghetti against the wall. Perhaps you also remember my story about how my father pitched a roasted turkey out the kitchen door one New Year’s day. Throwing food unfortunately is one Stawar holiday tradition that Martha Stewart never considered, even while in prison.


Holiday stress often reaches its peak during dinner conversation, which frequently serves as a trigger event. Seemingly innocent remarks can quickly escalate into open warfare. For mystified outsiders, with no person experience of dysfunction to fall back on, I have decoded several classic dinner table comments below: 

  1. How’s work going?

Translation: If you are working, you deadbeat, when are you going to pay me back the money you owe me?

  1. Who made the lime Jell-O mold?

Translation: What could they have possibly been thinking?

  1. What’s your boy Jimmy up to these days?

Translation: Still on probation?

  1. Cousin Billy, what a surprise to see you here.

Translation: Is your television broken?

  1. And just exactly how much whipped cream do you intend to put on that thing anyway?

Translation: Don’t count on me administering CPR.

  1. How’s your Atkinson’s “diet” coming along?

Translation: Hey, everybody, doesn’t he look just like a balloon in the Macy’s Thanksgiving Day Parade?

  1. How does little Johnny like junior high?

Translation: Is the little monster any smarter than that dimwitted husband of yours?

  1. How is your writing “career” coming along?

Translation: Have you got them up to $10 dollars a column yet?

  1. Isn’t this turkey really moist, honey?

Translation: You’ll never be able to cook as good as my mother.

  1. This wine is great, Bill.

Translation: I didn’t know Wal-Mart had a wine cellar.

  1. Did you make this pumpkin pie?

Translation: We can’t expect much in terms of domestic skills from an overeducated egghead like you.

  1. No thanks, I don’t need any help.

Translation: As a daughter-in-law you are not qualified to handle actual food.

  1. It’s amazing how all this stuff just magically appears every year.

Translation: The fact that you are exhausted from cooking since 3:00AM this morning has completely eluded me.

  1. No children yet?

Translation: You may have a big successful career, smarty pants, but you will never be the woman I am.


Good luck making it through the minefield that is the dinner conversation, and here are a few final tips to help you survive Thanksgiving:

  1. Remember this is not a marathon family therapy session and not the best time to resolve lifelong resentments.
  2. Keep communications superficial. According to some of Randy Newman’s lyrics “Feelings might go unexpressed. I think that’s probably for the best. Dig too deep who knows what you will find.”
  3. Discourage alcohol consumption since that generally promotes uncensored disclosure, aggression, or flirtatious behavior, none which is particularly constructive at a family gathering.
  4. Unless you have been up all night making stuffing and baking rolls, don’t rhapsodize about how much you just love Thanksgiving. That could engender some resentment on the part of the food preparer. Forty seconds of carving a turkey is not the same as actually fixing the meal.
  5. Keep everyone busy. Watching parades or holiday movies usually puts everyone in a good mood. They limit actual interaction and avoid the latent hostilities that competitive activities bring out. Tryptophan-induced naps can also serve this purpose.
  6. Although it may annoy many women, marathon football watching is usually ok, so long as everyone is rooting for the same team or doesn’t care who wins.
  7. Avoid touch football, Twister or any other activity that might involve physical contact of any sort.
  8. And keep in mind the cardinal rule, no weapons allowed.


Terry L. Stawar, Ed.D.

LifeSpring Health Systems President/CEO

Thanksgiving Through a Psychologist’s Eyes

              Thanksgiving is just around the corner and I am looking over my favorite Thanksgiving reading. It’s something called, We Gather Together: Consumption Rituals of Thanksgiving Day by Melanie Wallendorf and Eric J. Arnould. Wallendorf is from the Marketing Department at the University of Arizona while Dr. Arno is in the Department of Anthropology and Sociology at the University of Colorado. They wrote this piece for the Journal of Consumer Research.

              This article is sort of what might be produced if anthropologists from Mars came to earth to observe how we celebrate Thanksgiving. It reminds me of the Conehead movie in which Dan Aykroyd (playing the role of Beldar, a stranded space traveler from the planet Remulak) says to Chris Farley (dressed in a tux) when he comes to pick up Beldar’s daughter for the prom, “You looked especially handsome in ‘your pubescent ceremonial garb’.”

              I love how Wallendorf and Arnould sentimentally declare, “Thanksgiving Day is a collective ritual that celebrates material abundance enacted through feasting. Prototypical consumption of the meal occurs within nuclear and extended family units and private households.”

              According to Wallendorf and Arnould Thanksgiving Day has a number of close symbolic links to infancy. Historically Thanksgiving is closely associated with the beginning or infancy of America. They say: “Thanksgiving allows each participant to return to the contentment and security of an infant wearing comfortable clothing who falls asleep after being well fed. Sitting in relative silence, each participant is fed plain soft food by a nurturing woman and then is taken outside for a walk.” Wallendorf and Arnould, claim that in the traditional American Calendar of Rituals, Thanksgiving is the equivalent of Sigmund Freud’s oral-incorporative stage of development. As such it comes before the anal-retentive conflict of Christmas and the genital-sexually charged New Year’s Extravaganza—your classic oral-anal-phallic sequence.

              This connection with infancy can even be seen in the way people dress. Generally folks wear soft and forgiving fabrics such as jeans and sweaters, fleece sweat suits, and sneakers to Thanksgiving dinner. Elasticized waistbands and other comfortable clothing features are very common. Wallendorf and Arnould say our typical Thanksgiving wardrobes “recall the contemporary one-piece, all-purpose infant garment, sometimes known as ‘Dr. Dentons’. This is clothing that can move from meal time to play time to naptime without a change.”

              Besides the centerpiece turkey, soft pliant foods are customarily served at Thanksgiving time such as mashed potatoes, stuffing, yams, jello molds, cranberry sauce, etc. In addition many people end up smooshing their food altogether on their plates at this meal, just as infants are prone to do. While this may symbolize family togetherness, it also transforms food into a pabulum-like consistency usually associated with infantile consumption.

              I’m not sure I really believe all this psychoanalytic stuff, but it can give you something to think about as you lie swaddle in your sweat suit, on the couch, in a tryptophan-induced coma, snoozing as the Lions get their traditional Thanksgiving drubbing. In any case have yourself a happy, although possibly regressive, Thanksgiving.


Terry L. Stawar, Ed.D.

President/CEO of LifeSpring Health Systems

Depression in Males

This is a part of a series of blog posts from members of the newly-created LifeSpring Brand Ambassadors program. Staff members in this program will write about a topic they are passionate about relating to LifeSpring and/or mental health.


“You know what the worst part of all of this is? I can’t remember the last time I was happy. Like, I can tell when I’m supposed to feel that way—but I don’t. I just can’t bring myself to care and I hate myself for it.”

            I work at the Integrated Treatment Center and mostly work with individuals that have substance abuse problems. Many of my clients have been in and out of jail, have long criminal records, and are on probation or are involved with the Department of Child Services. Yet when we look beyond their battles with heroin, alcohol, or methamphetamine, I have found that many of my male clients are fighting another battle entirely. With the few words summarized above, Adam*, one client that I had been seeing for months, summed up what seems to underlie problems that bring many men to my office in the first place—depression.

            Depression is one of the biggest health problems nationwide. According to the National Institutes of Health, 6.9 percent of adults in the United States, approximately 16 million people, reported depression in 2012. Antidepressants are some of the most prescribed medicines in the country. Women are treated for depression at higher rates than men are, yet conversely the suicide rate has been 4 times higher among men than among women for many years. One of the best ways that I’ve found to explain that difference is in the distinct ways that men and women experience depression and emotional pain.

            In I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression, author and therapist Terrence Real writes, “Depressed women tend to have pain; depressed men have trouble … We tend to not recognize depression in men because the disorder itself is seen as unmanly. Depression carries, to many, a double stain—the stigma of mental illness and also the stigma of ‘feminine’ emotionality.” Real believes that undiagnosed depression can find its way out through an “unholy triad” of damaging acts, including self-medicating, isolation, and abuse and violence. He writes, “It is clear that the stable ratio of women in therapy and men in prison has something to teach us about the ways in which each sex is taught by our culture to handle pain.” Call it what you may—major depression, dysthymia, Persistent Depressive Disorder, covert depression—a correct diagnosis for depression can be key when a man first arrives for mental health treatment.

            Nevertheless, it is important not to misdiagnose a client with depression, especially when there are other concerns at play. Substance abuse should be treated as a primary issue, as should any other mental health or behavioral concern. Notably, depression, in all of its forms, is never an excuse for hurting or abusing others. Yet it is just as important, in the ruckus of modern mental health care, to identify when a man is exhibiting symptoms of depression in ways that may seem culturally appropriate to him: anger, irritability, insomnia, restlessness, workaholism, changes in appetite, and, all too often, drug and alcohol abuse.

            A combination of therapy and medication can help 80 to 90 percent of depressed clients find relief—if they ask for it. It should be a duty of all of us to reduce the stigma and prejudice that all too often accompanies mental health treatment.


Brett Hammond, LSW, MSSW, CCTP



*Name has been changed

We All Have A Story – Giving A Voice To Someone With An Illness

This is the first in a series of blog posts from members of the newly-created LifeSpring Brand Ambassadors program. Staff members in this program will write about a topic they are passionate about relating to LifeSpring and/or mental health.


We All Have A Story – Giving A Voice To Someone With An Illness


I feel much honored to work with and assist clients that struggle with different aspects of life, mostly pertaining to some form of mental illness. This is my story as to what inspired and led to a groundbreaking project we have recently completed.

In my professional career, I have been fortunate enough to assist others in some form or another. Before that, I can remember being in high school, offering to give a great friend of mine with disabilities rides to and from sporting events so he could be the “team manager”. We developed a bond built on friendship and respect, and it came full circle when “Larry” expressed to me his desire to become Prom King our senior year. Since I was a class officer, I knew he would never become eligible for King since he didn’t attend certain events, etc., required to earn the crown. Rules are rules, and while I did completely understand why they were put into place, it really spoke volumes to a somewhat hidden message in our society – some folks will never have the same opportunities that others will.

The night of prom came along and before I knew it, I was crowned Prom King. I held the title for about 47secs…..enough for me to get up out of my seat, make my way to the front, have the crown placed on my head, and for me to grab the mic to announce I was handing over the crown to “Larry”. No one knew of my intentions ahead of time – I probably didn’t even know them until the moment arrived to be honest. I was thrilled personally for my achievements, but once that crown was place upon “Larry’s” head, I knew the real King had arrived. The student body cheered, “Larry” blushed, and he felt like a million bucks. He had his picture taken for the newspaper, he had a dance with the beautiful Queen, and afterwards, he came up to me with his broken sentences and offered me the crown back….he just wanted the title. Truthfully, he probably just wanted the chance to become King. That night he made it and the crown is stored away to this day with other high school keepsakes in my closet.

Fast forward to November of 2013. I began a new group at LifeSpring titled “The Storytellers”. I think my creative flare was itching to do something groundbreaking that pushed the envelope in our field of work. Up until this point, I had already produced over 150 student lead videos for my local school system. I had the knowledge and the talent to make it happen, but really never thought it was possible due to the strict client confidentiality rules that need to exist. I guess my stubborn self just kept pushing until it happened.

The Storytellers group is made up of roughly 6-8 clients who meet religiously twice weekly to use the art of self-expression to share their story in some form or another. The Storytellers have been very successful – we have published our own “in-house” Christmas book, created motivational posters for our building, designed and created over 90 bookmarks for a Louisville area elementary school, and recently, completed our first video project, “We All Have A Story…”.

While all of these projects sound fun, I was able to sneak in the development of social skills much needed for the clients of LifeSpring, into the mix – developing friendships, positive communication, coping skills, relaxation techniques, completion of tasks, etc. In turn, my clients have become more confident in themselves and their own abilities.

The motivation to start this group came from statements made by two of the founding and still attending members. Simply put, one states he “wished he had a chance to write and draw, but no one would ever give him the time of day” while the other client stated he was told in school that “there are two types of learners in the world, slow and fast. I was told I am a slow learner and could never do it”.

The Storytellers has given these clients an outlet to express their own voices.   We have created a Facebook page in which a client selects a ‘Daily Thought’ every morning I see him. We have developed our clients into leaders of our building and in our community. We are teaching social development skills needed to be successful in life. We are networking with others and slipping out of the places we hide because we were forced into these hidden corners of the world. We are working to provide a voice for individuals with mental illness and/or personal struggles.

The “We All Have A Story…” video project has provided the clients with a voice to educate the world about the struggles anyone in this great land may relate with. The feedback has been tremendous and each time one of the stories are viewed, another part of that given clients dream comes true. We, as a group, soak up the attention this project has given us while we begin our next project to be released in the coming months. It builds the confidence and the mission of the group. Each internet click is a “virtual crown” earned in our minds…

I want to publicly thank my bosses, Ellen Kelley and Dennis Crandell, for allowing me to use my creative juices to make this possible for our clients. I also want to give a shout out to my former co-leaders Robin Jordan, who is now in with our CFS department, and Danica Lott, who is working to continue her own educational goals, for all the help along the way. I am excited to now have one of our own LS Therapist, Kim Parish, join our weekly meetings to offer a more therapeutic understanding behind the mission of the projects. And of course none of this would ever matter if you the reader, and viewer, didn’t take the time to view our 8 part series titled “We All Have A Story…”.

Stay tuned, we are just getting started, and be sure to check out our presentation at



Steve Mahoney & ABS The Storytellers Group

Abracadabra: Why it Reaches Out and Grabs Ya

I recently attended a silent auction and was the high bidder on a walking stick that I added to my small collection.  Although I don’t really like walking all that much, I was attracted to this stick because of its unique design and because it reminded me of the sumac walking stick that Emma Thompson use in the Nanny McPhee movies. Whenever Nanny McPhee needed to conjure up some magic to teach naughty children a lesson, all she had to do was tap her stick twice on the floor. Oh, if it were only that easy! 

Oklahoma State University social psychologist and Psychology Today blogger, Melissa Burkley refers to the continuing popularly of magic as the “Harry Potter Effect”  after  J. K. Rawling’s hero from her immensely popular series of books and movies.  According to Burkley, “If there is one thing psychologists can learn from the Harry Potter phenomenon, it is that people love magic.”

 Part of our attraction may stem from the fact that all of us have had experience with magical thinking.  Magical thinking is defined as believing that one event takes place as a result of a second event, without any plausible connection.   From ages two to seven years of age, magical thinking predominates and youngsters have considerable difficulty with logical thought. 

Magic may also appeal to people who feel powerless or lacking in control over their environment and circumstances.  This may be especially true for adolescents and young people who struggle with interpersonal situations. Harry Potter, the Lord of the Rings, and on-line and other role playing games such as Dungeons and Dragons, can provide an alternative magical universe where they have limitless power in contrast to their everyday life.

But do people really believe in real world magic?  According to Burkley, “Recent research suggests that not only do people believe in magic, it is likely hard-wired into our brains…”.  We often see this in everyday superstitions.

Just the other day my wife Diane and I were discussing the “knock on wood” superstition and also how our granddaughters play the childhood “jinx” game.  Various cultures have different explanations for the “knock on wood” custom.  It is one of many forms of “apotropaic magic” which is intended to “turn away” evil influences. According to one explanation at the website, the ancients druids, worshipped trees, believing that spirits lived in all wooden objects.  To encourage these spirits to work on their behalf, they would knock on wood.  Thus, whenever we want a good thing to continue or to prevent a bad thing from happening, we rouse these elemental  spirits by knocking on the nearest piece of wood. Diane and I also recently received a clock and a bracelet, that came from Turkey as a gift, and both of them were decorated with the traditional apotropaic blue eyes, for protection. 

The “knock on wood” superstition also reflects the magical belief that just talking about something good happening can cause bad luck, since it tempts fate. Athletes tend to be very superstitious in this regard. For examples in baseball, it is widely held that you can jinx a no-hitter by talking about while the game is still in process.  A recent study by Jane Risen from the University of Chicago and Cornell psychologist Thomas Gilovich explored the magical thinking  behind the belief that is bad luck to “tempt fate”.  They theorized that this belief stems from two sources.  First is the strong human tendency to be disproportionately attracted to negative events.  They contend that, “negative events simply “pack a bigger psychological punch” than positive ones, probably because of evolutionary associations  with survival.  Second research has consistently shown that thinking about an event makes it seem to us more likely to take place.  Combining these two phenomena, the researchers then hypothesized that since the bad outcomes that might result from tempting fate are very negative, we automatically think more about them.  Next, because we think more about them, we also conclude that they are more likely to occur, than the bad outcomes resulting from not tempting fate.  Their studies clearly demonstrate that people are predisposed to expect the ironic. An example might be the careless college applicant, who ostentatiously wears a sweatshirt from the college to which he wants to be admitted, only to be rejected.

Our granddaughter’s “jinx game”, which also purportedly brings bad luck, is initiated when two people simultaneously say the same words. The rules vary on just how to resolved the jinx created, but usually it ends when one child pronounces the name of the other, who is then considered the jinxed party. The historic penalty for violating a jinx, is a “pinch or a poke” in the arm or buying the other person a drink, hence the phrase, “Pinch and a Poke! You owe me a Coke!” San Francisco psychoanalyst Jerome Oremland has described the game as a ritualized expression of preadolescent conflicts over their emerging new identities.

One of Diane’s aunts once wrote a family history of her mother’s side of the family, who were German farmers in east central Wisconsin. In this narrative there were several references to “hexes”, which were spells casted by neighbors to account for unfortunate events, such as cows going dry, bad crops, and at least one fretful baby.  Historically such beliefs are common as prescientific explanations for events with unknown causes. When Diane questioned her mother about this she said, “Yes, it was true.”

Such magical thinking is still present in various forms.   In a 2006 Princeton University psychologist Emily Pronin and her colleagues conducted a study to determine if college students  could be lead to believe that they possessed magical abilities.  The participants were first introduced to a confederate of the experimenter, who posed as a fellow student. With half of the subjects, he acted extremely cordial and friendly.  With the other half, however, he acted as obnoxiously as possible, in an attempt to evoke hostility.  Then the subjects were given a voodoo doll and directed to stick pins in it, in the presence of the confederate, who was the intended “victim”.  The “victim” feigned having a headache and then the participants were asked how much they believed they had actually caused the headache. As predicted, the people who had interacted with the obnoxious confederate were more much more likely to believe that they had   actually caused the headache.

According to evolutionary psychologists, the human mind is especially adept at identifying patterns, since such casual links are critical for survival.  Unfortunately this process is far from perfect, so we often believe that events are connected when they are not, resulting in magical thinking and superstitious behavior.  It may well be that we are so receptive to magic because as Burkley asserts , “…we are hard-wired to overestimate our control over external events”.

Although I enjoy magic as entertainment, personally I’m not a superstitious person and I’m keeping my fingers crossed that I stay that way.    

Terry L. Stawar, Ed.D., lives in Georgetown and is the CEO of LifeSpring the local community mental health center in Jeffersonville. He can be reached at Checkout his Welcome to Planet-Terry blog and podcast at

Bigger Than A Breadbox

The September 15th issue of Time Magazine reported that intrepid Mississippi alligator hunters recently bagged a 727 pound gator, setting a new state record. Time said that the alligator weighed as much as a Harley Davidson motorcycle and was almost as long as a Jeep Cherokee. I found myself struck by this report. It wasn’t because the alligator was so large. When I lived briefly in Mississippi, I quickly learned that it was no exaggeration that every irrigation ditch in the state contained at least one big alligator.  It was the specific comparisons to the motorcycle and the Jeep that interested me. I wondered what motivated the writer to use these two mechanical comparisons. 

Were these objects very familiar ones to the writer, or was it assumed that these comparisons would have the most impact, prompting the readers to think, “Wow, that’s one huge alligator.” I would also be interested in knowing the gender of the writer. These seemed like especially masculine comparisons.  I would guess that most women writers might use the car analogy, but not specifying the make and model.    I   don’t believe many of them would   use the Harley Davidson comparison at all. 

Personally I had no idea how much a Harley weighs.  In any case, it is not a very precise comparison, since a 2012 Electra Glide weighs 889 lbs. while a 2006 Sportster 883C is only 562 lbs.  For the record, up until last Monday you could have seen an even larger alligator (Mighty Mike) at the Newport Aquarium.  Mike, who is now off to a Michigan zoo, weighed in about the same as a Harley Road King at 812 lbs.

All of this, of course is about how best to communicate the relative size of something. People use a wide variety of metaphors and similes for such comparative purposes.  As our culture has becomes more technology oriented, it seems like we tend to use more technological artifacts as analogies to help us describe the natural world, especially animals.  

Looking at some recent headlines I discovered there is Venezuelan oil pit  that contains  the remains of various extinct animals, “including a giant armadillo as big as a car” and a “bus-sized crocodile.” Last year at  Mobile, Alabama’s Gulf Coast Exploreum there was an exhibit featuring  a  Megladon, a school bus sized” ancient shark. A Blue whale’s heart is as big as a “small car” and in the Philippine’s a volcano was said to have spewed “rocks  as big as a living room”.  Since we are all familiar with cars, buses, and living rooms, these comparison function  fairly well for us.   I wonder if this process works in reverse.  For example when Native Americans saw their first automobile, did they said to each other, “Gee, this thing  is as big as a buffalo.”

The use of such comparatives are large part of our popular culture and frequently  show up in the media. In the early days of television, there were game shows such as I’ve Got a Secret and What’s My Line, where celebrities had to determine some fact about a challenger by asking questions.  The standard question used to help estimate the size of something was, “Is it bigger than a breadbox?”  Comedian Steve Allen claims to have originated this question, which never failed to get a laugh, probably because even back then, breadboxes were considered a bit old-fashioned.  For my younger readers, breadboxes were containers usually made from metal that were intended to keep bread fresh,  In modern terms, they were the size of small microwave.  

Commenting on a phenomena that many people have noticed, Daun Thompson, a  Dallas-based comedienne says she is fascinated by the fact that “hail is usually described as the size of a sports ball, while tumors are usually described as the size of a breakfast fruit.” In the her blog “The Assertive Cancer Patient” ( writer Jeanne Sather notes that a Google search for “tumor grapefruit” turned up 214,000 matches referencing articles with titles like, “Grapefruit-sized tumor removed from giraffe’s head in  historic operation…”.  Her search for “pea-sized tumor” turned up over 25,900 matches.  She says, “I’m still trying to find a psychiatrist who can explain oncologists’ fixation with fruit.”   

Some people believe that fruit analogies are used because tumors are usually described in centimeters and most of  us Americans  don’t understand the metric system.  Even if standard measurements are use it’s still difficult for most of us to visualize something that is said to have diameter of two inches or circumferences of 6 inches, but we all know what a grapefruit looks like. Comedian Gary Gulman, has a popular routine in which he rants about how awful grapefruit tastes. He concludes that God created grapefruits for the sole purpose that doctors would have a way to describe tumors.  But the comparison only is used one way, as comedian  Janeane Garofalo observed  saying  “Have you ever noticed nobody has ever ordered a grapefruit the size of a tumor?  There’s no reciprocity” 

When it comes to the weather, sports balls are the ticket especially to describe the size  of hail. The National Weather Service’s actual chart of hail sizes includes:  Ping Pong Ball, Golf Ball,  Tennis Ball, Baseball, and Softball sizes. Sports balls, however don’t adequately  cover all the  possibilities, so they’re  supplemented by other objects such as Peas, Plain M&Ms, Pennies, Nickels, Quarters, Walnuts,  Half Dollars, Limes, Teacups, Large Apples, the ever popular Grapefruits, and the modern Computer CD-DVD. Hen eggs are also  used in reference to hail,  while goose eggs seem reserved for describing bumps on the head. .  

There is occasionally some overlap in and  sports ball are used to describe health issues such as when  Cancer survivor Liz Holzemer’s wrote a book entitle Curveball: When Life Throws You a Brain Tumor.  This memoir is about a meningioma the size of a baseball. A former boss of mine once told me that his brother had an abdominals cyst the size of a football—one image that I would gladly forget.       

In a more upbeat vein, the website uses fruit and vegetables to give expecting couples some idea as to how fetal development is progressing.  For example at 4 weeks the average embryo is the size of a poppy seed, at 7 weeks a blueberry, and  at 9 weeks  the size of a grape. By 40 weeks, however, the fetus is said to be te  size of a small pumpkin. Perhaps that’s why we use it as an affectionate pet name.

Peas, seeds, berries, and BBs seem to among the items most favored for making  small comparisons. When talking about faith, the New Testament employed the analogy of the “mustard seed”.  Appliances are often used for slightly larger things. John Lennon once said that  his grandmother’s radio was as big as a  refrigerator and, of course, there was the very large and bulky Chicago Bears football player William “Refrigerator” Perry who played in the  1980s and 1990s. When we are talking about things larger than cars or buses,  we enter the the realm of things as big as a house, as big as a barn, as big as a football field, or even as big as the state of Rhode Island.

Size comparisons are frequently used  in works of humor to exaggerate things for comic effect, such as the Seinfeld episode in which George Costanzo describes his vision of paradise as  a  place where he is eating “a block of cheese the size of a car battery.”  In the 1977 movie Annie Hall, Woody Allen’s character Alvy Singer says to Diane Keaton, “Honey, there’s a spider in your bathroom the size of a Buick (a car known for its size and bulk).”  Finally there is the very wise nutritional advice from the National Lampoon Magazine to never eat anything “bigger than your head.”

Terry L. Stawar, Ed.D., lives in Georgetown and is the CEO of LifeSpring the local community mental health center in Jeffersonville. He can be reached at Checkout his Welcome to Planet-Terry blog and podcast at

Emotional Support Animals: Has ADA Gone too Dog-gone Far

Several months ago a customer walked into a small shop and plunked an unrestrained Chihuahua onto the checkout counter.  The customer handed the manager a card that said according to the Americans with Disabilities Act you can be fined up to $10,000, for refusing to serve disabled people who use emotional support animals.  The employee working at the checkout counter happened to have health problems, and an allergy to dogs, which resulted in a sort of “dueling disabilities” scenario. 

ADA does require that businesses, that serve the public, refrain from discriminating against individuals with disabilities. Business concerns must allow people with disabilities to bring service animals onto their premises in all areas where customers are generally allowed. They cannot segregate people with service animals from other customers. They also cannot charge higher prices, cleaning fees, or require a security deposit. Businesses may charge for damages that service animals cause, as long as it is the usual business practice for any customer who causes damage.

Most of us think of the famous “Seeing Eye” dogs” when we think of service animals, but today a wide variety of animals are used for all sorts of assistive tasks. Animals are used to help people with hearing impairments, detect seizures, obtain help, pull wheelchairs, carry and pick up items, help with balance, and offer emotional support.

If emotional support is included as an assistive task, almost any animal can qualify. In addition to every sort of dog possible, monkeys, goats, miniature horses, ponies, pigs, and even ducks have been used. The duck in question was dressed in doll’s clothing and was routinely taken into places of business. Thankfully some animals such as reptiles, rodents and spiders are exempted from the usual service animal rules.

Service animals are not considered pets and they are trained in their assistive task and generally have official certification.  It has been suggested that some animals should not be subject to certification requirements because they are said to naturally able to provide emotional support without formal training. Some argue that emotional support animals who have not been trained should not qualify as service animals.

ADA requires that the person accompanying a service animal must have a diagnosable disability, and for people using an emotional support animal, there should be a written statement from a healthcare professional indicating that the animal is necessary to assist the person. Businesses cannot, however, refuse service, because the person is unable to provide documentation on site (which seems to make the rule meaningless). This requirement for access has been extended to allow service animals on airplanes and in housing settings that previously did not allow the presence of animals.

If the animal is extremely disruptive to the core aspect of the business, like a dog that barks during a movie, it can be excluded. Likewise an animal that presents a danger to employees or other patrons, such as one that bites, growls, or snaps at people may also be disallowed.

Writer Susan Semmel has described how a woman brought a 300 pound pot-belly pig with her on a plane trip from New Jersey to Washington State. The woman claimed it was a service animal and following ADA guidelines, the airline allow the pig to fly free, despite complaints from other passengers.

ADA guidelines are not very helpful in situations when other people may be allergic to these animals. They suggest separating the animal from the allergic passenger as far as possible, which seems preposterous on a small aircraft. Such cases may quickly evolve into dueling disabilities. These guidelines also suggest that two or more service animals may also be quite legitimate.

Miami Humor columnist Dave Barry has satirized the use of miniature horses as emotional support animals on air flights, after receiving a letter from a mystified flight attendant. Barry wondered if security would require the animals to remove their horseshoes before boarding the plane.

New York Times, writer Beth Landman has described how in the last few years New York City restaurants have become inundated with customers claiming that their dogs are emotional support service animals. She quotes one woman who claims, “I can fine people or have them put in jail if they don’t let me in a restaurant with my dogs.”

Unfortunately some people who want to take their dogs with them everywhere, are not disabled and don’t have a genuine need. A few even seems to go out of their way to be provocative. Also not all professionals are particularly discriminating or judicious in regard to providing letters of verification of need.

Cynthia Dodge the owner of Tutor Service Dogs in Massachusetts is quoted in Landsman’s article as saying that she has met people who try to get their dog certified as a service animal on a whim. She says “This is a total insult to the disabled community. They are ruining it for people who need it.”  Also any one can easily get special cards and even dog vests on line that declare that their animals are service animals.

So what do you think?  Should ADA define emotional support animals as “service animals”? Would you   allow people with emotional support animals in your offices, waiting rooms, lobbies, vans, or houses? Do you think emotional support animals should require certification or evidence that the animal is trained, licensed, vaccinated or healthy?  Do you think that customers should be required to have evidence of a disability that they can immediately produce?  

I know the tremendous value that animals and pets  can have in improving the quality of life,  but do you believe  this a legitimate modality that should be protected by law?   

Terry L. Stawar, Ed.D.