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. 

"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 passé.

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.

The End is Coming!! At least for me

It’s getting near the end for me as a hands-on clinician.  It’s been a long trip.  I feel almost very good about all I’ve done.  I find it interesting that I still feel very haunted by the people who baffled and frustrated me.  I also feel very gratified by the people who have done well and gone on to better lives.  This is especially true for almost all of the final group of people, I’m seeing, especially the ones I saw today.  The are all ending well.

I still hope to be productive.  I still feel there is so much to be done and that the methods most mental health people use, while very helpful, are also very limited and not really up to the task of meeting the needs of our society.

We are beginning to do better with many physical diseases and disabilities, but psychological and emotional problems are so much more complex.  They rarely, if ever, have just one cause.

We are also living during a very strange and stressful time of transition. Yes, the world has always been stressful, and  for the last hundred years there have been major, dramatic changes in the lives of people all over the world, ever since the beginning of the industrial revolution.  But now the pace of change is accelerating, and the rules of life are changing.  The skills people need to do well and prosper are very different than the ones that were required for me to make a living and raise a family.  Things were much more predictable then.

So many of my patents now live with so much stress because of work and finances.  Companies are being bought every day.  Companies that never make the news, but they are bought and most of the people are let go.  New companies start, but most of them don’t make it.  There is a great deal of loyalty to employees in the beginning, but it can disappear with one bad quarter, or if the company does so well that it gets bought, a few people get rich and the rest get unemployment.

I am thankful my kids seem to be stable and skillful, at least for now.  Even they have a different outlook on the world than I did.  They know that things can change, and they would have no control over it.

My grandchildren are beautiful, charming, creative, brilliant and having fun.  The oldest is 5 1/2.  What will ten years do to her?  Will the stress of school, competition, change, college, social networks, constant media in-put, and robots become overwhelming?  Or will our families, societies, governments and business learn to adjust in ways that make life interesting, meaningful  and fun?

I don’t know.  I think that is the uncertainty that is driving so much of this angry, confusing election cycle.

Will we be scared, mistrustful and selfish, just to save ourselves? Or will we finally overcome some of those interpersonal barriers and use all of our new technologies to make things better for all of us?  

I think we will know a little more in a few months, but the change and the chaos still have a few years before more is figured out.  

In many ways it is a relief for me to become more of an observer and commenter, than to have to try to help everyone navigate through all the uncertainties. 

Keep your eyes open.  Think about what’s coming.  Think about what you want to do.  Think about what you should do after that.  It takes an effort to make sure we take the time to reflect and not just react, especially when things seem to be different than they were ten minutes ago.