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. 

inexact metaphors

A year ago I planned that I would close my practice this week.  I announced my decision to the people I worked with, and I slowly, slowly worked my way through the year. And, just like everything else that is set for a designated time in the future, it came to pass. I had planned for this to happen on the solstice; that seemed somehow to make it all be a part of the natural flow of things.

So, this evening, I took a slow walk at a few minutes after eight, waiting for 8:23, which was the official time that the sun would set on this, the longest day of the year. It was a beautiful day here in Southern New England.  The temperature was in the mid-seventies, the sky had  few big white clouds, the air was clear, the greens of the mid-June flowers, grasses and tress were all bright and fresh and came in a dozen different hues.

The sunset did not disappoint. The sky turned a darker shade of blue, the clouds turned to pink, rimed with silver.  The sun was going down on the longest day of the year, and also on the longest stretch of my career.

Except of course, the sun isn't really going down. As you know, it just the earth, still turning on it's axis, and right then our part of New England has turned away from the sun and is entering into the shadows.  The days are all almost exactly the same length, down to the micro-second.  Today it was just that we got more sunlight than on any other day of the year. The earth continues to circle the sun; well, it's really an ellipse. The sun continues to move around the center of the galaxy, and the galaxy is moving in a gravitational dance with the other galaxies in our cluster.

To most of us on earth it really doesn't feel that way.  It really feels as if the sun rises in the morning, gets pulled across the sky by a chariot, and then sets over on the other side of the neighborhood. That's the way it is with a lot of things: they feel like they're something meaningful, metaphorical, and magical -- but they're not, it's really just the same stuff happening over and over.  It's really just physics.

Just like me closing my practice.  But that's not physics as much as it's biology.  I'm getting older and I don't want to do that any more.

still in transition

Spring is turning to summer. The sun stays longer in the sky.  We, up here in the colder states, are freer to roam outside and become active.  The pollen fills our sinuses and causes water to run from our eyes.

A year ago I  set the date of the Summer Solstice to mostly end my practice of psychotherapy. I have been attempting, in various ways, to help people deal with their lives and make helpful changes for over forty years.

Now it is my turn to try to make some significant changes.  This is proving to be an interesting experience.  To me it is a very mild form of what happened to Jill Bolte Taylor, the neurologist who realized she was having a stroke.  She had studied the brain for years, and now she was experiencing this phenomenon phenomenologically.  You can Google her TED talk.

What I am going through is much more mundane.  It happens every day; more frequently now as the population ages. What is good is that I have chosen to do this.  I have not been laid off or fired, or told not to practice because I reached the point where I couldn't remember any one's name.

Still, for me the time is filled with ambivalence, with both excitement and disappointment, with anticipation of freedom, but also the loss of direction that comes with the breaking of habits and routines.

My life has already changed in ways I didn't anticipate.  My wife and I have four new people in our lives ( well, three and half, it will be four in September).  This was something we knew would be coming but the reality is that, if we wish, these new beings could take up a great deal of time. And we do wish, mostly.

There are other things I really want to do.  Some of them are inexplicable to other people who think of retirement as a play time.  In my mind this could be a time to do the things that I was unable to do because my work took up so much time and effort.

These are things that for me are fascinating, but not necessarily easy.  No one is expecting anything from me, so I will have to do it on my own.  It is challenging, and kind of makes me anxious.  It's funny how I seem to avoid doing the things that I say I really want to do.

This is so much like so many of the patients I have seen over the last forty years.  It is the kind of thing I want to be studying.

or not.