3 Reasons to Be Tired

#1.
I can tell I am getting tired.  It seeps into my body, my mind and my soul.  This is part of getting ready for vacation, which now is just a week away. To go on vacation it is necessary to be tired.  A vacation should be earned.  For me, it is difficult to just walk away because you can; you have to be tired.

So I am getting tired.

#2
It seems like many of my colleagues are tired also, and a bit scared.  They can see that the landscape is changing.  This whole health care delivery discussion makes everyone wonder what's going to happen.  It is reasonable to assume that those who will be making the decisions will have no idea what they are really talking about -- on a therapist to patient level.  The decisions will be based on money.  Those of us who still bill insurance companies for our services have already seen that the way insurance companies will cut costs is to pay us less. 

The other way will be to not pay us at all.  The model that most psychotherapists use, seeing people in their office for about 50 minutes at a time, once a week, was created about a hundred years ago.  It hardly fits today's world.  Two things are happening.  Well trained, Ph.D, or M.D. therapists are being replaced by Master's level people who are paid less.   Also, technology will enter into the mix.  People will be treated by text messages and Tweets. How much does it matter?  I think it does, but it is very difficult to demonstrate. I am the best therapist in the world and I only help about 62.347% of the people I see.

All of this makes everyone discouraged, and tired.

#3
When I'm rested and on the top of my game, doing therapy is challenging and fascinating. When I begin to get tired I can feel the resistance.  I can still deal with it, but it is there.  What happens is I feel badly when I open the can of worms and really see what's in it.  Today I was working with a guy I have been seeing for about six weeks. I like him.  He is bright, interesting and came to me for anxiety problems.  I am good with anxiety problems, especially if they are , you know, anxiety problems.  But they are not always just anxiety problems, very often they are more than that. It can take a while to find out.

Today, I was doing what I do, which is when someone with anxiety is still just as anxious even after I have sprinkled the first wave of magic dust on them, I probe a bit to find out what' s going on. Now, this is a guy I really like, as it is with most of the people I see.  When I like them I don't want them to be too fucked up.  But I still have to look under the rocks and see what's ticking.  So today, I looked under the rock and found out the the guys isn't just anxious, he's full of self-loathing and has cut himself.

I was tired.  I didn't want to find this out.  I want him to be OK.  I wanted it to be easy.  I can handle it, but then I'll go on vacation.  Now I have to do things to make sure he's OK.

It's not that I'm complaining, because this is what my job is.  It's just that I'm.......
complaining.

Out of office, and out of....it

I am still away.  It's kind of weird to be away this long.  It is good for my head.  I think of some of my clients once in a while and wonder what's going on.  I kind of miss them, mostly just as people, but not really the work of figuring out what to do and how to make it happen. I think of some of them and it seems as if through a fog.  They are from such a different part of my life.  I am here, in this vacation spot with friends and family wandering in and out. I talk or don't talk.  I don't have to pay much attention if I don't feel like it. Some people drone on about whatever.... It's great: I don't have to listen.  When I do respond I don't have to make much sense.  That certainly takes the burden off.

I'm like that.  My mind takes what someone is saying and shoots off, usually in a totally unrelated direction.  It jumps and skips steps.  Then I make a comment about where it has led me.  People kind of look up and then go back to whatever they were talking about.  Most of my friends expect that. They often can comment, and we go on from there.   That's why we are still friends.  The other ones, like my wife's friends' husbands, they don't know quite how to respond, or how the hell to deal with me.

Sometimes we talk about golf.

I have been getting to exercise a lot more.  It surprising how well you can take care of yourself when you don't have to take care of anyone else. I get to stretch, and then to really exert myself in a few ways, which I had not been doing since my eye got messed up.  I was surprised at how much I missed that. Getting my heart pumping and sweating and breathing heavy really makes me feel alive and part of it; whatever "it" is.  Some people hate to feel that way.  I really missed it.

What is sad is how little it takes to make that happen now. But hey, as the song says: " I can go as fast as I used to, and I can go as long as I used to, but I can't go that fast for that long any more."

Sometimes when I take my grand-dog (the one in the picture there) for a walk, and she pulls me around for two miles, I count that as exercise.  I never would have used to do that.

Just trying to stay healthy.  Just trying to stay alive.  Just trying to keep my wits about me without embarrassing my wife too much.

Just sometimes.