Friday, September 30, 2016

Stem Cells

It’s HubWeek in Boston.
What’s that?
That is Boston’s festival of science, medicine, art and technology.  They call it a Festival of the Future.  It is sponsored by Harvard, MIT, Mass General Hospital and the Boston Globe.  It lasts a week and has a few hundred events, ranging from breathing exercises to groups of scientists explaining their work to the general public.  
The “general public” in Boston and Cambridge is not very representative of what is usually considered the “general public.”  The group at these meetings are generally very informed, very intellectual, very scientifically involved. The people in the audience are either quite young and academic, or older and successful. The presenters and the audience at these meeting is also very diverse.  People from literally all over the world.  These are people who not only represent every continent and race, but often several continents and races are combined in one person (not very diverse politically, however).
The first event I went to was a discussion by a panel of doctors and scientists who are developing a cure, not just a treatment but a cure, for Type-1 diabetes.  They already have learned how to take stem cells and get them to evolve into the beta cells that make insulin.  In Type-1 diabetes these beta cells have been destroyed by the patient’s own auto-immune system. The presenters had formed a team from Harvard, The Joslin Clinic, Brigham and Women’s Hospital, and a bio-tech laboratory that will do the manufacturing.  
They were working on a method to take a persons’ blood and from that produce stem cells with that person’s own DNA.  Then they then use the proper enzymes and RNA procedures to turn those stem cells into the kind of beta cells that make insulin.  These cells had been destroyed by the person’s own immune system, and thus created the Type-1 diabetes. The beta cells would then be injected into the person so they could again be able to naturally monitor their own glucose level and produce their own insulin to convert glucose into the kind of molecules the body needs for energy.  They have already done this for mice, and now they are beginning to see if it can work in humans.
Obviously, this is very complex.  The panel members were all excited about their progress and felt that they will be able to overcome the many obstacles they still face. They also made it clear that the availability of this treatment is still years away.
To me, this is one of the many examples of how we are entering into a new world.  We are on the brink of really understanding how we are constructed, and how we can get into the most basic structures and fix some of the flaws.  This is radically different from how medicine has worked until now, which has been to do our best to treat the symptoms. I have a close family member who has Type-1 diabetes and I see every day how she has to treat her symptoms.  It also feels as if the companies that have worked on the medicines she uses see her as much as a revenue stream as they do as a patient.  The treatments of so many diseases these days are designed to have a patient take medicine regularly to stay healthy, thereby keeping a life-long revenue stream going for the company.  There are very few actual “cures” for chronic diseases so far.  
I realize, in part, that is because finding the underlying, causal mechanism for any such disease is very complex, as these people made clear.  Still, the profit motive does play a role in what kind of medicine is developed.  The presenters on this panel are not paid by any drug company.  They work for universities and hospitals.  They had to fund their own company to make the supplies they will need, and that company will lose money for a long time.
Unfortunately, another factor that has delayed the progress of this group has been politics.  Again, it was objections from the right-wing, anti-scientific community.  As I said, these people feel that their methods are still five to ten years away from application.  But for the eight years of the Bush administration they were prevented from using any government money to develop stem cells.  Somehow Vice-President Cheney decided that developing stem-cells encouraged abortion and had to be stopped. Therefore people who were alive would have to continue to suffer and possibly die, due to the misconception that this was protecting some unborn zygotes.
Of course, it seems nuts and foolish.  But as a psychologist I know better than most people that logic and reason is not how any of us make decisions.  So much depends upon the people we hang around with, the information we get, the lens through which we view the world, and how comfortable we are with change.

A lot is changing now. We all feel it.  This is one, very positive example. But, as I said, we are beginning to deal with the basic building structures of humanity.  It is very complex.  That makes it all a bit unpredictable, exciting, yet also frightening.

Friday, August 12, 2016

My Mission:

During the last few months I have been reading many of the posts one The Mission.  I read how people are trying to help others find pathways improve their careers, their finances, their relationships, and where they fit into the world.  Most are focusing on short and intermediate time frames.  I am older than most of your readers, almost as old as Bernie, and I am interested in the longer term. I wonder about the lives of my children and grandchildren. 
I read how many of your readers are working hard to create a future that will be different in many ways from how we live now, and hopefully, it will be better. 
My Mission, is to start a discussion about that: where are we going?  What are we creating?  Why? What do we want?  What may be the unintended consequences?
I want help people think with a wider perspective.  What will happen to their lives, to their families, to communities, to the world as a result of all of these changes?

I am proposing to write a series of essays, each 1000 to 2000 words, which highlight the many significant changes that are affecting all of us.  These essays will describe changes in areas such as technology, genetics, families, population demographics, the earth’s environment, sources of energy, and medicine.  Most importantly, I will focus on how all of these areas interact with each other to increase the impact on our lives.
At the end of each essay there will be a few questions for people to consider.  These questions are designed to help people clarify how they want to participate and benefit from the opportunities that are being created.  I hope to be able to stimulate a discussion about how each of us can influences the direction and consequences of all of this change.  The flux will always be with us. We can either be swept up and dragged along by the swift current, or we can take some actions now to control the direction of the river, while we each choose the best ways to steer our own kayaks.










Ch-ch-ch Changes

Things are changing. Many things already have.  The world is being disrupted.  More change is coming, and coming faster. Constant change is now the norm.
As we change the world, the world is changing us, as a species.  The type of tasks we need to survive and prosper are different than they were fifty years ago when I was just facing the world as a young adult.  Everything in the world moved much slower.I had to search for information in places well beyond the palm of my hand. The information I could find then, especially in sciences, was probably less than a third of what there is now.  What I was learning in graduate school about Psychology at that time has mostly been disproven or relegated to the archives of “long ago.”
All of the sciences are completely different than fifty years ago.  So are almost all of what happens during the daily lives of everyone in the developed world: how we communicate, how we work, where we work, how we get food, what we eat, how we spend our leisure time, how find mates, how we create our families, what constitutes a family……. Almost every aspect of our lives has been affected by changes in technology, medicine, and the changes in our biological environment and our social environment.
The result of all of these changes is that the people who do well in the future will require different skills than the ones who are doing well now.  In many ways, they will be different kinds of people.
What will you be doing in ten, twenty or thirty years? What about your children or grandchildren?  Do you know how all of these changes will affect you, and them?  Do you think you will be able to choose the benefits these changes offer while avoiding the dangers?  Do you think you know what is coming or will it all just happen to you, and you will have to struggle to cope?

We are living in an fascinating time, a chaotic time.  Many of these new developments are marvelous and fascinating, but so much is happening so quickly that many people are feeling very insecure. I have been a psychotherapist for over forty years and I have witnessed how, even though in many ways our lives are much easier, there still has been a widespread rise in the amount of stress, anxiety and depression in people all over the world. 

On the positive side, it is clear that more than any other time in history, many people are very aware that there is a lot going on. This is good, but we have to take advantage of this realization. We have to ask ourselves many difficult questions, and they are questions that we will each have to answer for ourselves.  There really is no one best way forward. But if you don’t consider many of these questions, you could be swept away and who knows if you will like where you end up.
That is my Mission: to highlight the impact of some of the many changes in our lives, to make the issues clear, and to ask some questions.  My purpose is to start a discussion so that we can all share ideas and perspectives.  We all hope to build a better future. Let’s create the future we want instead of letting it shape who we become.

* * * * *


1. Hey Gottlieb!

Let me begin with a hypothetical:


It’s sometime around 1885.   You are about to attend a meeting with Gottlieb Daimler and a few of his buddies. He is the guy who constructed what is generally recognized as the prototype of the modern, gas-powered, internal combustion engine.
Let’s get all of those innovators together and brainstorm about the long-term consequences of their new product.  Do they have any idea of the effect it could have?  Is there anything they might do differently if they could see how the world looks today?

The invention of the internal combustion engine was the beginning of one of the great technological transformations of the world. That technology changed the world dramatically in ways that we take for granted today.  Almost all of the those changes are seen as “progress,” but many of the secondary consequences are a bit troubling. 
Here are a few of the obvious changes: 
— There has been a great reduction in the need for backbreaking human and animal labor.  
— The improvement in the transportation of people and goods has totally transformed how people live, work, and relate.  
— People are now spread across the world and still get to wherever they need to go, rapidly and easily.  We have cars, trains, planes, buses, trucks, and boats. 
— We have billions of miles of paved roads to help us get places.  We can live in suburbs or exurbs and still work in cities.
— Internal combustion engines now do our farming, build our buildings, pave our roads, fight our wars and blow our leaves away. 
— There is no part of our lives that has not not been affected, and in may ways made much easier.

Of course, there have been some unintended consequences:

— The burning of fossil fuel has been a major contributor to changing the atmosphere and heating our planet. There is now the possibility that it will cause great harm to many people.
— Easy, rapid travel and big machines have allowed people to live in climates and environments such as deserts, jungles  and mountain tops in a way that has destroyed a great deal of the natural balance between the flora and fauna of our planet,  
— There has been an unmeasurable amount of corruption and a great many wars fought to insure access to the gas and oil needed to run these internal combustion engines.  Many of the poorest and most oppressive countries in the world have become unbelievably rich due to having vast deposits of oil and gas.
— Wars have been fought involving the entire planet, resulting in the deaths of millions of people, mostly due to the more destructive power of the planes, battleships and tanks that have been powered by internal combustion engines.  

No one would think to place the blame for the destruction, corruption and pollution on  the people who designed and built those early engines. They had no way of even imagining what was gong to transpire in fifty, or a hundred years after their spark-plugs began to ignite the fuel in those cylinders.  They were really just trying to find something that was stronger, easier to care for, and more dependable than a horse or an ox. 
But perhaps, if there was a way of trying to consider the long-term possibilities, some small revision may have been made the could have kept many of the strengths while avoiding many of the difficulties.  A man named J. J. √Čtienne Lenoir tried, in 1858  to make an engine using hydrogen as fuel.  Perhaps we should have stuck with that.

Today, we are in the early stages of many such transformational technological creations. Due to the interactions of science, technology, entrepreneurship, and rapid communications, many of these new creations are appearing at once.   We are developing digital technology, nano-technology, and quantum technology.  We are making amazing advances in genetics, engineering, medicine , brain science, robotics, virtual reality, and human/machine combinations. We are working on new, clean sources of energy that will be necessary to keep all these things operating   We are also seeing huge migrations of people who are blending together to create new communities. This is leading to large shifts in the values, expectations and behaviors of everyone, all over the world.
We have the opportunity to use many of these advances in communications and technology to anticipate, in ways that no one possibly could have back in 1885, what the consequences of all of these changes could possibly be. Since we are at such an early stage in so many of these advances we should try to use our new powers of analysis and prediction to help us make choices of what we want to achieve and how we want to use it?  
How can each of us determine which parts of this new world we want in our lives?  We have learned that we cannot depend on governments or corporations or any institutions to be watching out for our best interests. We have to be able to watch over them. 
There will be scientific studies, algorithms and protocols to direct us, but we need to be sophisticated enough to understand them and know what they are designed to do. The hope for the future is that we will gain more freedom and prosperity.  These changes will affect our lives and the lives of future generations, Now is the time to choose, and we need to choose as wisely as possible.
That is why I am writing this series of essays.  They will contain descriptions of many of aspects of our lives which are rapidly changing.  At the end of each section will be questions 
i hope you ask yourself, and discuss with your family and friends. I hope you will add your comments here.  It should help you decide, as much as possible, which of all of the new possibilities you want in your life, and which ones would lead you away from the kind of life you hope for. I hope you will pose your own questions.  The more people who are involved, the more successful we will be. We should all be part of the process of making the new world a better place to live in, and one in which we can all live there together, in peace, with freedom, prosperity, health and happiness.

Questions:

1.   How much time do you spend on social media (Facebook, Twitter, Snapchat, Linked-In, Google+, Pinterest, YouTube,Tumblr, Instagram, etc)?
Do you control it, or does it control you?
Are you getting what you want more than you are bothered?
How many apps do you have to help manage your other apps?
Can you stay away?  FOMO?

2.   If you are experiencing some strange physical symptoms, would you rather have your diagnosis be determined by a your personal doctor? a Watson computer? or a combination of the two?
Which would your doctor prefer?
How old is your doctor?

3.  How much different will our lives be in 2045, the year I turn 100? There are many predictions you can look at: Ray Kurzweil, Kevin Kelly, Michael Bess, Steven Kotler, many VC people, as well as Mad Max. Many others such as sci-fi writers or corporate think tanks.
What are some of the things we do now that will amaze people in 2045?
That we:
— Let humans drive cars and fly planes?
— Eat food that comes directly out of the ground or the ocean?
— Work more than fifteen hours a week?

All of these questions, and many more will be discussed in the weeks ahead.
Please join me by pushing the green heart and adding a comment in the discussion.




Thursday, August 11, 2016


I'm back.
I'm starting to write about new things.  The past was prologue.  
I'm putting some test drafts here for the 20 of your to read.  I have not done anything to broaden the readership of this blog, but that may happen.  We'll see.

Something’s Happening Here

1. Realization

Way back In the Spring of 2012 I was sitting across across from  Carrie, an attractive, articulate, sixteen year-old young woman.  She had come to me because she was having panic attacks. These attacks often came when she was studying for exams at school.  She said sometimes she felt as if her head was going to explode, and at other times that she couldn’t breathe.  Carrie spoke in a very animated fashion about how difficult it was for her to maintain her excellent grades and still keep up with the constant influx from her social connections.  As she spoke her voice cracked a little and her dark hair fell in front of her dark eyes that would fill, but not overflow with tears.  Her parents, Sandra and Joyce, were sitting in my waiting room, while her friends, many of them, were wondering where she was and why she was not answering their text messages that were making her phone ping every thirty seconds.
I have been a psychotherapist for over forty years and have been closely involved in thousands of people’s lives, yet that was the memorable moment when it became undeniably obvious to me that I was living in a new world; a world that is not only creating changes in how we all live, it is creating changes in who we all are. Changes that will alter the basic make-up of our species,.
The changes are technological, environmental, genetic, and societal.  The most powerful changes are the result of how all of those factors interact.  This new world will increasingly require  people to learn different skills in order to adapt and succeed.  Many of the ways of thinking and acting that were adaptive and helpful two or three generations ago, are no longer useful; others are now counter-productive. The time and effort that our ancestors needed to learn how to hunt or to grow for food has been replaced by knowing how to talk to Siri or an Amazon Echo.
Our grandparents lived in a world that was very different from the one that their grandparents lived in.  The early twentieth century was a time of change, especially compared to the early nineteenth century. It was a time of significant industrial and mechanical advances. The pace of that change has continued to increase so that now, in the early twenty-first century, we live with constant change.  We expect it to continue. But as we are changing the world, the world is changing us. 

For thousands of years the personalities, beliefs, and behaviors of all people have been shaped by the same basic forces: our genetics, then our families, then our communities, and we are all also limited or enhanced by our general health.
Who we all are, as individuals, begins with our own genetic structure, 99.9% of which we share with every other member of our homo sapiens family. We are all the product of millions of years of evolution. All human babies are born with the genetic scripts that have been passed from generation to generation, with occasional mutations, for two-hundred thousand years. 
Next, we are all plunked into a family grouping, whatever shape  takes:  two parents, a tribe, a refugee camp, a single parent, a mother and a sperm donor, whatever.  This “family” immediately begins to teach us their version of how the world works.  We all quickly begin to understand how we are expected to behave in order to get what we need.. We have to adapt to that specific environment to survive.  Babies are very dependent so we all had to learn fast.
The third powerful influence on our behavior is the community, the subculture in which we find ourselves as we emerge into the world.  This consists of our friends, our school, our church, our neighborhood, our diet, the climate,  and all of the experiences that we find outside of our family, which now, of course, includes all of the Internet and social media.
These three factors interact with each other to shape us all. To this mix of influences we have to add our health.  If we are strong and robust we can partake in much of what we wish.  If we have a major illness or deformity, our lives will be different, not worse necessarily, but different. If we are obviously different in some way it will cause many people to react to us differently. Most people will be kind and helpful, but others will be mean, many will just look away.  We, in turn, will react to their reactions to us. Everything interacts.
Combined, these influences shape what we  believe, and how we think, feel and act.  It has been this way since our ancestors first walked upright and formed groups.
To me, Carrie is the symbol of how these basic, long-standing forces are beginning to change. The pace of these changes will only increase.  Carrie was conceived in a petri dish.  An egg was taken from one of her mothers and fertilized with sperm from an anonymous man who was selected from a profile in a data base.  Her parents were not allowed to be married at the time, but they were living together. As soon as the law was changed they got married. Carrie has a little brother now, and they all live in a happy, caring family.  The community in which Carrie lives accepts her family without question. These are circumstances that her grandparents would not have believed possible.
The visit with Carrie happened in 2012, and already so much from that time seems out of date. This is mainly due to new technologies, and to the new scientific knowledge that these technologies have helped us acquire.  The aspects of Carrie’s life that seemed unusual then are commonplace and well accepted now. In just the past few years there  have been changes in all of the basic powerful forces.  There has been constant scientific advances in our understanding our own genetics., many new variations in the definition of a family; major shifts in demographics and composition of societies around the world, and significant advances in medicine.
All of these changes have affected the expectations of how Carrie will live her life. The skills she is learning, and how she learns them, are changing.   Her life will be vastly different than the life I lived, growing up in the middle of the twentieth century.  All of these things are not only changing how people behave, they are changing our DNA, our bodies and our minds.  Some of it is intentional; most of it is not.  The more we all are aware of what is happening to us, the better prepared we will be to make good use of the changes we feel are beneficial.  We also need to stay vigilant,so that we can avoid the ones we don’t wish to have thrust upon us.

Questions:
1. Do you know anyone who has two mothers or two fathers?
What do think of it?  How old are you?
Are there some kinds of family combinations that would make you uncomfortable?
Polygamy?  Three fathers with six children?
2, Take a look at yourself in a mirror.
Are you White?  Do you realize how that has affected your life?
Are you tall?  Well endowed? Have a symmetrical face?

3, How close are you to the members of your family?
Do you feel you have absorbed their values, or have you explicitly rejected them?

4.  What is your favorite piece of digital equipment?
How long have you had it?
When will you need to replace it?

Did you think you needed it before you learned there was one?

Thursday, June 09, 2016

Transition, But First, Going Away


I am pretty sure that I am finished being a hands-on, face to face psychotherapist.  I cleaned out my desk.  The office is being rented to someone else.  I have kissed all of my patients good-bye. 
It was difficult, kind of earth-shattering in a very personal way, but now it’s done.

I did this gradually, over a two year period, so I think it went as well as possible.  It also gave me time to transition to the next phase.  I have worked with so many people who needed to navigate through difficult transitions,  They had many different reasons: job loss, death of loved ones, illness, accidents, divorce, recovery, new job, new move, new partner. I tried to help them develop new skills. Now it’s my turn.
What I seem to be doing, just by having the time now to do so, is to step back and look around. I had been focused on so many individuals who each had to deal with unique situations. Now I want to look up at the sky.  I want to try to put everything in some kind of perspective, to see how everything ties together. The world is changing very rapidly.  It is creating a great deal of excitement and hope, but also disruption and fear.  You can se e that in the politics that are in such turmoil.
I also see so many educated, dedicated, creative, caring people who are doing exciting, transformative, world changing things in so many areas, such as genetics, brains science, communications, space exploration, immunology, business management, sustainable energy, product development, medicine, food science ….. on and on in almost every field, even psychology.
I guess what I’d like to do is help everyone take a moment to step back and see how all of these changes interact with each other, and what kind of a new world we are creating. How do electric cars relate to genetic editing, to transgender marriages, to sustainable energy, to drone warfare, to on-line education, to a mars landing, to guided meditation?
Is all of this taking us where we want to go or is it just keeping everyone busy and making some people very rich?
I have become very aware that everyone’s lives will be very different in just twenty five years.  I have also become very aware that, if I’m here, I will be 96 in twenty five years.(WTF?)

Therefore, before I ask the two hundred basic questions I have been thinking about, and try to generate a discussion about how we should all participate in designing our future, I will be going away.  Far away, to the other side of the world.  Got to do this while we can, ya know.

When I return we will begin the next phase, unless I decide that it’s enough to just play Shoots and Ladders, Pony, trains and ball.

See you in month or so.

Enjoy the summer.

Wednesday, June 01, 2016

The Day After

Now it’’s Thursday, after the Tuesday which was the last day in my office, except for cleaning out the draws.
Tuesday was much more difficult and complex than I thought. I had a full day of appointments.  It was my last meeting, as a therapist, with all of them.  It was my last day of being a professional, in that capacity, after forty-three years.  
Two days ago I was talking about the frustrations, about how I often felt that my job was a lot like having to redirect a tide that has been coming in, every day, for years, over the same path.  There was just so much I could do to change to constant flow of the water, the moon and the earth.  There is also the realization that those forces continue whether I am in my office or not.
Today, the day after, my feelings are much different than I had expected.  Instead of that frustration mixed with relief, I feel much more a sense of loss, mixed with satisfaction.
Each hour I said good-bye to someone I had been intimately involved with ( in a professional way, of course) for anywhere from six months to twelve years.  Two of them I have actually known for almost twenty-five years, as they have returned to visit me through several life changes.  I know the names of their parents, children, lovers and friends better than I know the names of my aunts and cousins.  We have been together through losses, tragedies, addictions, bad decisions, distorted thinking, and serious illnesses.  We have also been able to achieve marvelous successes, in recovering, in business, in relationships, in finding ways to put their lives back together.
During the past two weeks I have said good-bye to my last ten patients.  It is very gratifying to say that they all are doing well.  Only one of them requested a referral to another therapist, which was fine.  But the other’s, even the two who are completely nuts  
(diagnosis code:WOW) feel ready to take on the world on their own.  And they are.  Three have new, better jobs, two have moved to better places and feel secure, two are in new relationships, one is getting married and one is pregnant.  Marvelous stuff!
Don’t let me mislead you here.  There were dozens of others who I have referred out, or let go over the last two years who will not do as well.  They are part of the frustrations that haunt me.  The ones I stayed with until the end are the ones who I knew were doing a lot to pull things together.  

The point I want to make is that while there are still huge problems in our society, and worse problems in the rest of the world, yesterday really made it clear to me that we, as a species, are social creatures.  We live better, feel better, and do more when we feel connected to other humans.  That makes up a large part of what I did for people: I was there for them.  They knew that. I understood them, as best as I could. I didn’t judge them. I helped explain them to themselves, and I tried to nudge them in a better direction. For many of them I was the only one who ever did this for them.  Many had been pushed around, neglected, demeaned, ignored, abused, pressured, rejected and worse.  
It was their responses to me that kept me doing this for over forty years. I know I received so much for almost everyone I saw.  Most of the people I saw came to trust me.  They were able to tell me things that had happened to them, or just about the thoughts that ran through their minds Things they had never told anyone. I took that as an honor.  It was a great feeling to be granted this special privilege.

I am not a religious person.  I do not expect to experience a great spiritual awakening. I am very comfortable not having complete explanations for things, yet knowing that somewhere there is a cause for every effect, and that someday it may be made clear and understandable.  I don’t believe in uncaused (miraculous, paranormal) causes.

I have listened to the stories of thousands of people.  I have seen the rich and poor, and everyone in between.  I have seen geniuses and some who take a bit longer to understand things.  I have seen people of all races, creeds, national origins, sexual proclivities, and different levels of power. I have seen many people who have very unique beliefs.   
        I have come to some conclusions.  The most important one is that their is no intrinsic way to rank order who is worth more, or who is more important.  Money and material wealth are clearly false goals.  There is no real meritocracy.  Every soul, every spirit, every mind has the same value. We are a species who are both blessed and cursed by being able to wonder why we are here.  We are all here, and despite the many advances in medicine and science, at some point, we will each be gone.  It is up to each of us to find our place in the world, to try to figure out what we feel is right and important. We each have to do what we need to do to stay alive, stay connected, find some pleasure and find some satisfaction.  
Its not an easy task.  It is a life long process of trying to get it right, without having any idea of what “it” is. Usually we find our answers with other people, in mutually caring relationships.  We do this first with people who are very close to us, and then with others, in our communities, in our societies and in our world.


Now, like all of my former patients, I am movin’ on to the next stage, eager to see what kinds of interactions that will bring. Change is difficult, but it can also be exciting.

Wednesday, May 25, 2016

Last Day Tomorrow!

I wrote this on Monday.
I see that it is a lot like my last post.  Obviously, that's the way that I feel, so I will post this here, now:

This Tuesday will be the last day that I meet with patients in my role as a psychotherapist.  I have been slowly working my way to the end after doing this for over forty years.  I have been closing the practice in slow steps so this ending does not come as a shock or a disappointment.  It is more of a “finally, it’s over.”
I have spent over thirty of those years running my own practice in a mill city in Massachusetts, less than an hour from Boston.  It is a fascinating city with a long history.  It is a city with a constantly changing population of immigrants, who move through a very stable core of long time families.  The city is surrounded by suburban towns which range from working class bedroom communities to towns filled with very wealth families and some large estates.  
During my years here I have seen everybody. I have seen some of everything. It has been a fascinating time.  In many ways I feel that this was what I was meant to do.  From the feedback I received over the years I was reassured that I was good at it, and that the work I did was successful and appreciate.  It has been gratifying that since I have announced that I was not beginning with any new patients I have received many calls from patients I had seen who told me how much I helped them get through difficult times in their lives.  I will certainly miss that.  Of course, there have been many people who I have not heard from.
Another thing I learned through the leaving process was how exhausting and stressful the job was.  I never really felt that when I was in the middle of it.  I remember that for years I would see thirty-five to forty clinical hours a week, and at the end of the week I would be happy to take a break.  But I always felt stimulated by the work.  I always had things to think about, interventions to try, strategies to plan, and puzzles to solve.  I didn’t realize until I had reduced my workload drastically, how totally absorbing and tiring it was.
Some of that of course, is due to my getting older.  But more I think is due to seeing that once I was able to really put the weight of it down, it seemed so much heavier to pick up again.  When I was in stride, and carrying it with me and thinking all the time, it seemed to just flow.
There is still  down-side that I feel more acutely now that I am finishing, and that is the frustration of how difficult the whole process is, and in many ways, how little gets accomplished.  Yes, I was helpful, and many people, over  time, were able to change aspects of their lives to either learn to cope better, change some of their circumstances, or learn many new skills about how to run their lives and make decisions.  But, and it’s a big But, there were so many aspects of a person’ life that I could not touch, change or influence in any way.  So much of mental health difficulties are intertwined with other factors, A person’s genetics, poverty, loss, some kind of victimization, racism, some kind of illness, crazy families, economic pressures, bad jobs, bad bosses, or just some random occurrence in life: luck.   Often it was two three or four of those things happening at once.
And now, I spend more time with friends and family.  I try to spend more time just doing more of the things that are interesting and fun.Still,  I find I can’t get way from that feeling of frustration. I feel that those underlying causes of psychological and emotional distress still surround me.  It’s not just the craziness and tragedies that I see in the news, I see it in my friends who are anxious, in their kids who are struggling, in the city schools that we visit, in the neighborhoods of the city where I worked for so many years, and in almost every city around here.    And what makes it more striking, is that Massachusetts is one of the most prosperous, healthiest, best educated and well governed places on earth. I know how bad it is everywhere else. 
We keep pushing the rock up the mountain, and it keeps rolling back down.
Seeing all this still bothers me, especially with the current craziness going on politically.  In my youth, in the sixties, I felt we were really taking the right path and making a difference.  I do feel that things have moved in the right direction, and that there are a lot of good people who try and who care.  Yet, change always comes with a backlash.  And now change is constant, and change is always hard to accept.  It affects everyone differently. Often, the resistance is powerful.
It’s a shame.  The rock is still there, fifty years later.  The mountain is still there.  I had hoped, especially with all of our new technology and new knowledge, that more of us could agree on some longer lasting solutions.  I had expected that by now we would have broken down the rock and leveled off much of that mountain.  

Sad. I don’t know, Maybe soon.  Not holding my breathe. But still trying. 

Wednesday, May 11, 2016

"Bringing the Future Forward Faster"

Like Forsythia, i have sent letters to my grandchildren.  I have gotten a few drawings, some with stickers, in return.  The older kids, who are not 5 and 4, are beginning to learn to read, so getting a letter will have a bit more meaning. I don’t know if it’s fun for them because it’s rare, and it seems almost magical to have someone deliver something to your house, or if they really feel that it’s more personal, as it is something tangible that was created just for them.  I don’t think they care about that, especially because they have so much stuff.
My kids have so much stuff that not only beeps at them, or plays music, but talks to them and tries to interact with them.  The two year-old sometimes seems surprised when he gets a toy with a lot of colors and he pushes the spots and nothing happens.  He thinks objects are supposed to talk.  The older ones now get totally absorbed watching their iPads.  Their parents have realized they have to limit the time they spend on those things.  Sometimes it seems as if using an iPad becomes addictive, but at other times, I’ve seen the kids get bored with just sitting there and they go do something more active, like actually play with toys.  If they’re tired they stick with the iPad.  If they are still energetic then they leave it and go.
I don’t know if the iPad is worse than TV. My parents limited my TV time. That is after we got a TV, which wasn’t until I was about six. iPads seem a bit more interactive.  My grandkids prefer it to TV.  They also watch TV programs on the iPad.  They can watch them whenever they want. There are now several new games, robots, and classes designed to teach kids, as young as six, to learn to write computer code so that they can eventually learn to design their own digital entertainment, or the next program to unfold proteins, or track galaxies, or compute algorithms that predict stock market trends, or how to build a social network.
Does all of this make the world better?  I think it does, in some ways, but obviously in other ways it clearly doesn’t matter.  The key word that is being thrown at us all the time now is “Innovation.”  Make something new, Be a creator.  The chip company, Qualcom, now has ads all over the place that read, “When will What’s Next become Now?  Why Wait?” They want to bring the “Future Forward Faster.”
They must have paid some group a lot of money for that. The future is where it’s at.  The present is already pass√©.
I guess I’d like to know which future we are talking about. The future with rising tides, pollution, more racial tension, and stress; or the other future of fun, equality, and health and prosperity for all. Or maybe it’s the future where the video games are more realistic and the graphics are better because they were programmed by an eight year-old girl.
I’d like to know a bit more about what’s coming before I rush to get there faster. Right now, it’s beautiful day in May, and I’m pretty happy where I am.