client envy

I am adjusting to my one and one-quarter vision for the next few months, but I am functioning, going to work, doing all of the stuff I need to, and some of the stuff I want.

This week I caught up with one of my clients. She is an attractive, rather volatile thirty-nine year-old divorced woman. She has a rather responsible job with one of the larger public bureaucracies, which she seems to manage very well despite the instability in the rest of her life.

Last week she got home late from work and then received a call from her current, sometime boyfriend. He is about fifteen years older and works odd hours doing vague things that are probably just over the line from being legal. So at ten-thirty she goes out with him, pushing passed her mother who stood questioning at the door.

It was the night the Red Sox, Celtics and Bruins were all on TV. I guess the boyfriend had too much money riding on the Bruins, so when they lost he got in a bad mood and started dumping on my client. She told him to shut-up and when he didn't she demanded to be taken home. But he kept it up in the car, so at a red light she got out, slammed the door and walked away.

She realized she was about three miles from home and it was around midnight, so not wanting to walk, she went into another bar that was lively and close by. There she ran into the ex-husband of the woman who was now married to her ex-husband. He was there with a few friends. She sat down and had a few drinks with him.

An hour later, as the place began to empty out, the four of them left and found another place downtown. There she met three old friends from long ago and she had a few drinks with them, leaving the other group behind. When it got to be closing time there, they all went to a "private club" downtown, where they drank until three. She then got a ride home from a guy there, who I think she had dated while she was still married, ten years ago. He took her home, and probably stayed the rest of the night, but she was not too clear on that and I didn't push for details.

She said the next morning, which must have been about an hour and a half later, she got up and went to work, making major policy decisions.'

Now, from this behavior, I can give this woman about four different diagnoses. But, I wonder, is this a problem or is it just a good time?

Bonk!

Been a while for me. Most of that is because two weeks ago, at first game of my long anticipated return to he mound for the Pub Team softball. Bonk. It came from out of left field -- except I was talking to the first baseman at the time.

The ball hit me on the side of the head. That really wouldn't have been a significant blow if I hadn't had cornea transplants 40 years ago. The old stitches ripped apart, the eye bagan to fall apart, and now, two weeks and one two day stay at the best eye hospital in the world later, I am on the mend.

I have good vision in one eye and will most likely get as good vision back in the other eye - in eight or nine months.

Until then. Don't stand on my right side as I will either ignore you or walk right into you.

The lesson from all of this is that if you live long enough, and push your luck long enough eventually, usually, you get caught.

The solution of course is to be Dick Cheney, and expect that everyone is coming after you and everything is a danger. Then you can sit in a bunker with a shot-gun on your lap, drinking pomegranate juice and remaining hyper-vigilant that no one, or no thing can even begin to threaten you.

Of course, this may sometimes lead to shooting your friend in the head, but who can you really trust anyway. My real friends know not to make any sudden moves. A sudden move means you're a terrorist.

time passes

Yes, the picture is of Italy, in Tuscany, just outside of Lucca. Not a bad place to be.


I got back from being away for a week and then had the pay-back week, which often, but doesn't always happen. Seems like too many people needed attention, and too much water was delivered and no one else could do anything about it. We almost ran out of paper too. Can't anyone else take care of anything?

Today I drove into the parking lot of the building in which I have been working for the last ten years. It is basically a medical building. For ten years before that we were in a nicer building in a nicer office, but it was full of software designers, and unless they were clients, and many were, it made people uncomfortable, and they got rid of us when they finally could.

The parking lot sits on a bit of a rise and I can see the morning sun shining on the gray, red and brown buildings that make up the downtown. It's a hard-working, sometimes prospering, sometime suffering small city. Sometimes it feels as if I know at least thirty per-cent of population, even though I don't live too close to here and hardly have time to leave my office. Those I don't know I have heard about. I get before it reaches the paper.

I have been here almost thirty years. It's kind of weird to think that I have devoted so my of my life to this. Yes, there are more things I hope to accomplish, and probably will, but when I think of "what have I done with my life?" this has been pretty much it.

It's very interesting, and I still enjoy it here, although I sometimes wish the city was a bit more prosperous, but how many cities are these days? But it was kind of a weird moment to think -- this was what it was.

so much stuff

I was away, now I'm back.

It was too cold for too long up here in the North, so we took off to the South to find the Spring, and for the most part we did. It was a bit breezy in Augusta when we were there, but all the flowers were ready for the big tournament, everything was in bloom. We drove north to the Blue Ridge Mountains and found a bit of snow, but that faded the next day and it was warm and friendly. Those mountains are beautiful and accessible and fun as you can still get creamy, cheesy grits, that you can't find up here.

But then I returned and had to catch-up with the bills, the paper-work, the cleaning, the shopping, the sorting and the arranging. It all kind of sucks.

I have a couple of clients who refuse to do that. Yes, they are in debt, on the verge of being homeless and live in clutter, some in filth, but I can see their point. There is so much stuff to do, just to stay where you are. It is so time consuming and boring. Someone should do it for me!

I see how much time, expense and effort it takes for a family when one of their members can't, or won't do their part, at least for themselves. It can exhaust everyone. At what point do you cut them loose and let them sink, especially it it is your own kid.

I am very grateful that those who I have brought into the world have been able to fly off on their own. They seem to be quite able to slog through the necessities of getting their stuff done.

However, they best not forget from whence they came.

Liars and drunks

Me, Me! After all these God-Damn years I still get sucked in.

He is 53 years-old for Chrissakes. He has been seeing me for almost two years, the length of his probation. He got put on probation for trying to hit a cop. He tried to hit the cop because the cop was laughing at him when he was staggering down the front stairs of his house screaming at his neighbors. Then the cop flipped him on his chest, cuffed him, and brought him to jail. It was his third arrest in ten years for drunken/disorderly so they put assaulting a police office on top of it. He got two years probation. He had six weeks to go.

Sure, he had some slips, and he told me about some of them. How many he didn't tell me about I can't know. He found a bottle he had hidden and slurped it down and threw up all over his wife. He had a few other such moments, but they all ended privately.

Wednesday he was in my office. He spoke about how much his life had improved since he had stayed sober. He was employee of the month. He was building chairs in his basement. He showed me pictures. He said he would never work with ban-saws if he was drinking, he would cut off his hands.

He also told me how his attitude had changed in so many areas. Last week his car window had been smashed by some punks driving the streets. He told me how clearly he remembered how angry and vengeful he used to feel. So many times he had chased people for miles if they had cut him off. He had confronted people whose car doors had scratched his car. On Wednesday he was telling me how crazy that behavior was and how he relieved he was that he had finally out-grown it. Now he could just shrug it off and remember things he had done when he was a punk kid.

Thursday afternoon I received a call from his wife. She told me that Wednesday night he had been arrested for sitting on his porch and waving bee-bee gun at people. He was drunk and screaming that they had best never touch house and car again.

They arrested him and threw him in jail for thirty days for violating probation. He will probably lose his job.

Usually, when I see someone with an alcohol addiction, and they stay in treatment, they stay sober. I have had many people who drop out and go drink, and that's it. But to have someone who seemed so insightful, so convinced and convincing, yet so addicted.

He had taken all the pills, he had gone to all the programs, he was chairing a meeting every week.

Just say "no."

You can say no 10,000 times, and when the sun goes down you take that flask out of your hip pocket and think no one will notice.

Donald Barthelme

There is a new biography of Donald Barthelme that was reviewed in the NYT this weekend, and has been getting a lot of notice. I probably won't read the book because I already have too much to read, and I mostly only read reviews anyway, but it was good to read that Donald Barthelme is being fondly remembered.

I remember reading his stories and then buying one of his books of stories in the early 80s and reading them over and over, slowly. It was exciting. I knew he was trying very hard to do something, and I felt from the energy of the story that whatever point he was making was a big step. It was something of a turning point, probably very self-consciously.

I don't think I ever really got the point. I don't read enough for that. It was post-modern. It was beyond avant-guard and it was very descriptive of how I felt about the world, and probably still do. But it didn't really make much sense, which was I guess, part of the point. His stories had a beautiful flow, but no story, not even a narrative, hardly a character.

Each sentence was beautifully written, and constructed. But each sentence usually didn't seem to have that much to do with a sentence that was two sentences away.

Reading the review of the new biography made it kind of clear what I had kind of known, that his life was often a mess. A long time ago I had read about how he and his brother lost thousands of dollars gambling in Biloxi. He drank an awful lot, and had been married four times, which is different from me.

I kind of admire people who struggle like that, to find the edge. It takes it's toll.

I have clients like that. I try to find the balance between encouraging them, but making sure it's they who really want to go there, and not just me.

exploring on and on

There was this guy named Pierre-Simon Laplace, a French mathematician who died in 1825. He was one of the first to imagine how a huge IBM mainframe super-computer could be really helpful. He was excited by science and he felt that if someone could get all the information of where all the particles were in the universe and what direction they were moving, then he could predict everything that was going to happen.

It makes sense. There are supposed to be laws of science, they are supposed to be constant, and therefore if we know everything we can predict everything. No one really expects to know everything, but the more we can know, the better we can do.

I have been struggling with that a great deal lately. There are lots and lots of things coming out of new science and technology that could add clarity about what any of clients are doing and why. There are new brain imaging techniques that show what parts of the brain are operating. There are ways of taking blood levels and hormone levels that can show what physical state they are in. Physical and mental correlate much more than you think.

Then there is all this genetic information pouring forth. How much of what we feel and do was determined way back when our parents chromosomes joined? I certainly have evolved to look so much like my father. He also was a blogger in his own way, as I have a few of his tiny notebooks with all kinds of notations.

But now I have read a article about a computer scientist named David Wolpert. He has written a "proof" which demonstrates that you can't know it all, especially if you are part of the system. You can't measure the weight of the earth if you are standing on the earth, you can't know the limits of the universe if you within the universe and, I assume, you can't know exactly what is happening in someone else's mind by using your own mind.

I think that is true, no matter how many machines you have to measure brains, bodies, hearts and heads. It's kind of frustrating, because I always know when I am talking to one of my clients that something more is happening and I don't know what it is. If I knew I could be more helpful, more effective.

On the other hand it is kind of comforting. When I think about it, I really can't predict with any certainly what I will do tomorrow. So how much can I expect to know about anyone else?

Some, but not all.

Gone

Well, he died. I wrote about him back in January (1/10), how he was slipping slowly away, and now he is gone. He died of very natural causes, his heart, his lungs, his mind, all seemed to have had enough. The morphine made him more comfortable, and probably made everything more certain. He had officially been on an "hospice treatment plan" for less than a week.

He was 95, and of all the people I have known, he is one who could say that he achieved most of what he set out to do. He fit the true American ideal mold. He grew up poor, worked hard, made the most of a couple of breaks, kept working hard, and made a good life for himself. He was an older son who tried to care for his younger brothers. He had a wife and two daughters, and he tried to be good to them, in the classic, fatherly way.

He retired to Florida for years, played golf, walked the beach, and was generally pleased with himself, if not with too many others. For me, his son-in-law, he wasn't that easy to get to know, but he was easy enough to get along with. He was a business man and I was a psychologist, and I don't think that any of this "get-to-know someone stuff" made much sense to him anyway.

He was a man of his time, and he enjoyed doing what he was supposed to do. He did it with structure and discipline and that paid off. If his example of how to conduct business was continued by others after he retired in 1980 we certainly would not be in the mess we find ourselves now. He didn't try to get rich quick. He got up and went to work every day and tired to work harder and smarter than the competition, yet without trying to be ruthless enough to put anyone else out of business. And he enjoyed what he did.

Most of the people who knew him have died before him. He had four siblings, now only one remains. Most, but not all, of his marbles had rolled away before his body gave out. It was time for him to go, and you could tell he knew it. he had done almost all of what he set out to do.

A few weeks ago he said to his daughter, " I have had a good life." and he really did. That's the best anyone can say.

stuck 3

Well, Dr. Therapist sir, what makes you so special that you can go about writing how other people get stuck in mind traps of their own making? Look at your life, look how repetitive and stuck you are, how you make the same mistakes over and over, each time thinking you have figured things out, when lo and behold, you haven't.

I have been doing my taxes over the last few days, and it's not fun. First I always hate the tediousness of going through all the stuff. I've been running this business for years and it's basically the same stuff with minor various in each line, from income to supplies, to answering service expenses.

Then look at my stock market returns. Of course, this year they were miserable, I guess that can be forgiven, but should it? I had years when I was doing marvelous, but that was when they moved the target in front of my arrow. Now I make the same mistakes over and over. Stuck. I chose the right stocks to buy, I buy them at the wrong time and then wait until just the wrong moment and sell them. I use the same logic to make these decisions, and each time I do I tell myself I'm not, but it really is the same.

And other things too. Each year I start a new project, but it really the same project over and over. I vary the way it sounds or looks, but I work on it for a couple of months and convince myself that I have found the right way, and then I take a month to re-consider, and I see that it really isn't that different. Then I stop, and shrug it off, and put it away. Two seasons later I get an inspiration and start over again, convinced that this time I can do it differently.

Is this the insanity that comes from doing the same thing over and over and expecting different results, or is it the dogged persistence and tenacity it takes to succeed.

We won't know until it's over, and I guess it's not over yet.

Half the fun is in trying, but half the misery is in being stuck.

Twitter?

Most of my friends and I can remember when TV first came out, and we were thrilled with color TV, almost twenty years later. Now, of course there are all kinds of new media, and everyone is a star and a celebrity, and everyone's thoughts and actions need to be monitored and recorded.

Wanting to be hip(is that still a word?) and not left behind some of us got on Twitter for a while to see how exciting out lives are.

The initials have been changed here to protect the guilty.)

7:15
AB; home eating cookie, drinking decaf.

BC: home, watching CNN

DE: home, reading The New Yorker

FG: home, hanging around waiting.

HI: driving home

JK: Home,watching re nun of Cheers

LM: home drinking 2nd Scotch


7:55
AB: finished eating, cutting skin off my corns.

BC: home, watching CNN

DE: Home, asleep with The New Yorker on my lap

FG: Home, my wife went shopping so I'm having sex with my sister-in-law who moved in last month.

HI: home, eating cold steak-sub

JK: home watching rerun of Seinfeld


LM: 4th scotch, yelling at bad memories

9:17

AB: home,reading about illness on Web MD

BC: asleep watching CNN

DE: in bed

FG: My wife is home. We are one big happy family, having a glass of wine together.

HI: home, arguing with wife, but I don't know what it's about

JK: watching rerun of Matlack.

LM: no message

fascinating -- maybe everyone should embellish their reports, just like JK.

trapped

Sometimes minds don't just get stuck, they get trapped. Trapped in an endless obsessive loop. the worst of these traps is when it becomes physical, then it's called an addiction. An addiction takes over your life, it becomes the focus of your thoughts and actions and you don't care about anything else. You drive your friends away and you steal from your family. You are out of control, way out of control, and you know it, don't like it, but there is little you can do about it.

There are harmful, but not physical addictions, such to your Blackberry, work,exercise, being thin, or the opposite, eating.

There are the obvious addictions: alcohol, drugs, gambling, sex, risky behavior,bulimia, things that give that dopamine rush, or things that just make you numb.

I work with people at all levels of addictions. Addictions are insidious because they come in so many forms and that allows for denial and excuses. The addict loses any chance at self-determination. They are worse than stuck. they are trapped.

But, treatment can work. All kinds of treatments for all kinds of people. You've got to find your own special key thatwill begin to set you free. It's very difficult and often painful. It's great when people get their lives back, or even parts of them. It great when you can see brains beginning to work and minds clearing up and becoming reasonable.

Those folks are very gratifying.

The others just stop showing up.

effective mumbling

So she came into my office today for the first time. She was composed but looked a little scared. She had never done anything like this before and wasn't sure what was going to happen. She hadn't even watched "In Treatment." I guess she didn't have HBO.

So I asked her if she had any trouble finding my office and she talked about the traffic and then she said she came from work so she talked about the stress from work, so I asked a couple of questions about work and about stress, and then about the pressure she felt being the most successful daughter in the family, and how her father was quiet and her mother always tried to solve every one's problems bu was always getting it wrong. And she kept talking about work, and her family and then her boyfriend who she like but thought he was lazy, and she didn't know how much that really bothered her, so she cried. Near the end of the session she began to talk about how she was realizing how much pressure she had been living with, and how it has been coming from all directions, and now she has to lay people off in her department and that is braking her heart and mind.

I mumbled (I really do mumble) a few off-handed comments near the end to lighten the mood so she could go back out into the world feeling decent. She thanked me and said this was much different than she ever expected, and she couldn't believe how much just talking about something could be so helpful.

"That's what we do," I said.

Next week I will make quarters disappear while juggling.

stuck

I tell you what's wrong with my clients, almost all of them. They're stuck. Their minds got stuck. I can't see what is wrong with their brains but I get to understand what goes on in their mind, and it's stuck.

I got back to work today and two of the folks are still having anxiety attacks. With anxiety, you're mind is stuck in worry and fear mode. Your body is tense and everything looks like a danger. Now, these are smart, insightful people, and they know that eating prepared food or driving on a highway, or walking to the back of a supermarket won't make them keel over, but to them, it sure feels like it. They want to turn their minds off, but they can't, it's stuck.

My job is to figure out how to get their mind out of the trench it is in, to break the loop that constantly repeats itself, and to free up their mind to do other, more fun, things.

To do this I have to create an experience that will detach the strong emotion of fear from the thought, whatever that thought is. Sometimes, medication will help do this, as it will, depending upon what it is, either relax the body, so that the emotion doesn't feel as strong,or slow the thought process, or keep the happy chemicals on the brain longer. Besides medicine, there are lots of experiences that I try to create right in my office, that will help people feel differently, and see that they can move out of their rut.

It is important that I don't get stuck. Everyone is different. Minds are different. There is a big movement on for 'evidenced based" treatments, which are pretty standardized for each diagnosis. I am not a big fan of those because, first the diagnoses are not too accurate, and second, everybody's case is different. Anxiety isn't like a broken nose.

Although it does have the similarity that when it is fixed, you can make it look prettier.

So, relax, don't get stuck. Things will work out. And don't say "What IF..... that only makes it all worse.

In-sight?

I am away, watching the sun set over the Gulf of Mexico, beautiful shades of orange, purple, dark blue and black. I love sunsets. What I don't like is freezing my ass off, but that is what we have been blessed with her in the Sunshine State. Yes, the sun is shining, but it is glistening off of the frost.

The good part is that I can it clearly. I got my new glasses just before we left. They are in new frames and make me look a bit cooler, but I also got a new prescription. I can see better. After all these years I got an improvement. My vision has never been great. My vision, while not terrible, is certainly no where near fighter-pilot clarity, so when I tried on my new glasses I immediately noticed that I could see a couple of notches better -- vision being graded on a scale of notches. That's good and bad. I can read better, even at night, but the news I read still isn't good. I can look in the mirror and see my new cool frames, but the face they are sitting on has aged considerably since the last time I could see this clearly. Look at those crags and wrinkles and jowls, who wants to see that so clearly.

Reality, not the best place to live.

slightly baffled

Sometimes things are so fascinating, so complex that even I, 50,000 hours later am still amazed.

I've seen this woman three times now. She is in her mid-forties. She is very articulate, very in touch with her often scary, often overwhelming feelings, and can describe things in glowing, flowing detail. She says she has skills in reading, writing, synthesizing ideas, and creating images.

Yet, she she says her house is a total disgrace. She has piles and piles of stuff and she is afraid to put things away because she doesn't know where they go. Also, she has no sense of spacial relationships. I have never seen anything like it. She has trouble finding her way from the parking lot into my office. I can see her hesitate in the waiting room, trying to figure out which door leads to my office. She told me that if I had a pile of pens and told her to put the red ones in one pile, the green in another and the blue in a third, she could do that. But if I said, organize those pens, she would stare at them for hours and not know where to start.

The causes of this could be anywhere and everywhere and I am certain it is both. It is psychological, neurological, genetic, and the result of familial deprivation. She has had a terrible life, having been in an orphanage until three and then adopted by a caring but crazy mother. That lead to terrible, abusive relationships.

But those are over. Now she is just a total mound of exhaustion and anxiety. And yet she is charming, outgoing, friendly and very caring to her friends and the world at large.

I would love to run about $100,000 of neurological and physiological tests on her. I doubt that they would find anything definitive.

Still cold

Now, the guy has been President for almost thirty-six hours and it's still cold. I guess he's not going to live up to expectations. But then, few people do.

I have that problem with clients. I see all the potential. Hey, if they weren't so screwed-up there is no end to what they could be doing. Sometimes I get all excited when I think of the possibilities. This one could be an artist, this one could be a teacher, that one could be governor with a little bit of energy-- it certainly doesn't take too much to be governor in lots of states.

But, then I have to back off. It scars them to feel expectations. Mostly they just want the fear to subside or the depression to lift. If they could sit and watch TV without having a panic attack or thinking about how miserable they feel, that would be enough.

But it's not. The only way you really get better is to get active. Get up, move, get your blood going, think about what you need to do, do some planning, plan to be good to someone else.

Aim high.
It's the process
Success really doesn't matter

Then you can watch TV

incidents

So you think that this job is all about sitting here, nodding and saying "how do you feel about that?" Sure it is. That's why we get paid the $4.50 an hour by UBH, but only if we get our forms in on time, with all the correct boxes checked.

But here are a few other things I had to squeeze in today.

I have a literally poor client, on SSI, Medicare/Medicaid,who received a letter saying that since she turned 65, and since she got a cost of living raise on her SSI check from $996 to $1026, she is no longer eligible for Medicaid as her supplemental insurance. To keep her policy she will have to spend $465 a MONTH for a deductible. So, she came in crying and we ended up calling the State Senator. We have to wait to see what he can do.

Another client who suffers panic attacks was pulled over by the police for something minor. She had a panic attack and couldn't talk or make sense. The cop thought she was on drugs and wanted to put her in his cruiser and arrest her. That really freaked her out. I had to talk to the cops and a lawyer for her. That one got resolved.

I have a guy who lost his job working for the state because of what was going on at work. They have stopped paying him and he is waiting for a hearing. He has been waiting for two years and is about to lose his house. The State knows he has a good case that is probably relevant to several other people so they don't want to settle it, or something. He is becoming desperate, depressed and kind of crazy. I had to try to make sense out of what his lawyer was, or wasn't telling him. No real progress has been made on that.

I have been working with another woman with panic attacks for months. Part of her problem, which is common, is that she is afraid to take a pill, as the pill might do something to her mind that she didn't expect and that would make her panic. But now she is ready to take the pill. I had spoken to her PCP three months ago to explain to him why the medication would be helpful. He was very agreeable. Today she went to him to get the prescription. He had nothing in his notes. I had to call him. He was at lunch, he was at the hospital, he was cutting his finger nails. Finally, I think that one got resolved.

I still have an hour left to sit and say "how do you feel about that." I am afraid to pick up any more messages.

The older old man

I was trying on my new glasses to show my daughter. They are gray on top, silver on the sides, slightly curved with no bottom. They are current. My daughter, who had closed her eyes so that showing could be more dramatic, open them and announced, "You look old."

She quickly added that I did look cooler, and more with it, and that I should not go back to my old frames, but that fact is, I look old. At least older than the people she has become accustomed to looking at, who are mostly twenty-five to thirty-five, and now bring along with them a new generation, who are mostly two months to two years. They look young, with rosely cheeks, dewy skin and sparkling eyes.

But, it was later, when we went to the nursing home to visit the older old man, that my daughter could no longer keep the tears from running down her cheeks, although nothing was really happening except age.

The older old man is 95, and after 03 years of holding together he is now afflicted with what is now considered the disease of deterioration, dementia and dying. The older old man was pleasant, and even seemed to kind of figure out who my daughter was, or at least he was able to fake his way through it, relying on his well established social skills, much the same way years ago when this very daughter had mastered the skill of appearing to read by learning all the words to "Fred and Ted."

But his presentation of holding it together had too many flaws as he asked, about every thirty seconds about his wife, who has been dead for nine years. He also, in a friendly, personable way, turned to my wife, his daughter, and asked her how her parents were.

And that was it. He was tired. He tried valiantly, and succeeded to get himself up out of his chair, and staggered in small, very quick steps traversing the three feet from the chair to his bed, grabbing my wife's arm so that he would not pitch himself full force into a frontal forced landing. But we got him safely into bed, clicked on an alarm gizmo, which is designed to call an aid if he tries to get himself up.

We put on our coats, and before we were out of the room he was asleep. He will spend the last of his days more asleep than awake before he slips over into eternal rest. It is very difficult to watch, as much for him as it is for ourselves. Especially those of us who will put on a new pair of current style glasses than make us look kool, but old.

It Begins again

I am here, still away from work, watching the new year begin.

It has been cold here. We were with friends and ate blueberries. We were safe and warm.

The next day the stock market went up as a sign of hope.

Today Israel marched into Gaza as a sign that nothing has changed there for sixty years, really for three thousand years.

From this distance it is difficult to tell what exactly keeps those people so entrenched in their "My Way or Death" positions. The Israelis have treated the Palestinians terribly. The Palestinians have never accepted Israel. The large majority of both populations are caught in the middle, until hostilities break out and then they cling to their side. They fight for power and pride, fostered by some kind of religious justification.

For someone in my profession, who labors for hours to help one person relieve their anxiety, it is difficult to watch hundreds of people be blown out of existence during a ten minute air-raid. But this kind of thing is not new to the world. That is what becomes so discouraging as we age,

Never give an eighteen year-old a weapon and visions of glory for using it. But every culture does. So it goes on.

The issues were too complex for President Bush, who believed in right or wrong. Perhaps a new administration, with more ideas, can bring the pressure of the whole world to bear on this conflict.

If the world can truly be different, the changes have to begin right there. Perhaps that is why it is happening now, just to show where the bleeding starts.

It's Dark

Look out the window. It's 8:30 and it's dark. It's been dark for hours.

And it's cold. Not actually that cold, but it's cold and getting colder and soon it will be very cold again.

It's New England, and it's winter. It supposed to be like this. We didn't move south to play in the hot humid. We stay here and watch the sun disappear behind the slate gray clouds. Then we go to bed under thick down comforters.

There is a condition called SAD, seasonal affective disorder. But, in 99.97% ( a rough estimate) of the time it's not a condition, it's reality. The dark affects people. It's so primitive, so visceral, it's a great thing.

Feel it.

Don't be afraid of you emotions. They are here to protect you. They tell you instantly what to like and what to fear. They have been wired into us over hundreds of thousands of years. Trust them. Don't try to hide from them or chase them away.

It's dark and it's cold. It's uncomfortable. It's even a little scary.

Have a little rum and go to bed with someone you love.

Make the winter work for you.

Greetings!

I hope that all of you out there in The Blogosphere are enjoying this season of a succession of holidays. The Solstice has passed, and slowly the light will be returned to us who reside here in the Northern Hemisphere. We expect it will help shed light on the truth and bring a rebirth of hope, honestly, caring and integrity. Hope springs eternal. That is one thing that humans do well.

So gather around those who are near and dear. I have read in respectable journals that two major aids to keeping you brain functioning well past four score and seven years are blueberries and friends.

So rejoice! Embrace and look to the light!

Me and the Medical world (again)

I had another incident of medical depression, and I wasn't even sick. I had an appointment to get my eyes checked by a new and more skilled specialist at a new place. The place turned out to be six floor medical factory, very efficiently run, but huge and depressing.

The staff were mostly nice, some more than others. They shuffle hundreds of people through each day, so it can't be too personal. They lead people through the maze of hallways , with the people following obediently behind, like mules on tethers. Most of the people, of course, are sick so that isn't too uplifting. Many are old and crumbling, and them come to be taped together for another six months, or six days. It is clear that so much of our medical expenses go to constantly slapping band-aids on what is really just natural deterioration.

I went from this waiting room to that sitting area, to this little room, to that next waiting room to the next little room. I was examined by very nice people and very high-tech equipment that beeped and flashed and spit out pictures and pages of printouts.

I sat and looked at the artwork on the walls of abstract local nature. I wondered if the artist had imagined that their heartfelt emotion laden images would end up here.

I heard a woman somewhere down the hall with the worst cough I had ever heard, and she continued her straining and hacking on and on, as nurses walked with frozen smiles down the corridor. I wondered how much coming here put me in danger of being sicker than I ever have been.

After an hour of this, the very competent doctor showed me some of the pictures and told me that my status was the same as the last visit with my previous doctor. She then offered me some new, very expensive treatments that I probably don't need, but are available. I asked how much they could help and she explained very clearly that they could be an improvement, but they may not actually work and then they would have to be re-done. She couldn't predict.

I thanked everyone and went home. It took me about four hours to shake the depression. It is clear to me how much worse I would feel if I actually were sick, and how powerful the psychological aspects of illness are.

My own office is not like this. I greet all my patients myself. We talk in a cozy room, with comfortable chairs for an hour. I do not in-put everything into a computer as we talk. I listen and smile and make little jokes.

In many ways psychotherapy is not medicine in the way the medicine is practiced in America today. That is probably why there is such a demand for it, and why it works so well.

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our next task

I sent this out today to many other psychologists, as part of a discussion about whether to push for a national health insurance plan:


At this time in our history, with "change" taking over our government, and the banks, mortgage companies, auto industry and who can guess what else being nationalized, the question about health care in America is a bigger question than just about National Health Insurance. Hopefully all of our thoughts about this issue are more complex than how much we will get paid for 90806.

IMHO, the best thing that could happen (I am not holding my breath here) is to have a bunch of doctors, therapists, patients, hospital people, non-patients, economists,and bureaucrats locked into a room somewhere. It would be their job to construct a health care system from the bottom up, to design a system that would do the best job of keeping America healthy at the most reasonable cost.

How much of our GNP should we spend keeping us healthy and alive? In this time of socializing everything I do not think we can let the desire for profit be the deciding factor in health care decisions. Every other developed country has found a way to pay for care without having sick people run the risk of going bankrupt.

Who will do triage and on what basis? Should Medicare spend $12K for a demented 97 year-old man to have his teeth removed and dentures built? How much do we spend to keep an infant alive who has a badly damaged cortex?

How much should mind/body interactions be part of the deciding factors? What would be the best education for a mental heath professional in the next twenty years? Is there any chance that someone can be educated to perform that function?

How would we pay for the development of the best new drugs, not just the most profitable ones? How many drugs are good for us anyway? How much should it cost people who don't live a healthy life-style, or is it part of our freedom to smoke and eat Whoppers, and then have the government pay for bariatric surgery?

The country is a mess. The world is a mess. That gives us an opportunity to tear things apart and build a new system Think outside the band-aid. Think outside the fifty-minute hour. Let's have a real discussion.

I think I will send this on to my friend, Barak. He asked for my in-put.

Hour by Hour

Last week I bought an appointment book for 2009. For me, and almost all of my colleagues, at least those over forty, and certainly over fifty, having a concrete, paper and pen, write it down appointment book is so much easier than anything electronic.

I moved my office a couple of months ago. I moved just down the hall. But in doing so I emptied out the shelves of the old office. I put over twenty appointment books into a big box and lugged them home for storage. All of them are Week-At-A-Glance types. My brain is set to see the whole week laid out before me. If the hours are not all filled in a feel a bit guilty, even though now, since I hurt my back, I am trying to leave spaces.

One thing I get from this job is a clear sense of time. Hour by hour, just like it is in the book. I feel the week, the month, the year, my life pass by. If I am sitting and talking to friends I can tell when the conversation has lasted fifty minutes. The timer in my brain goes off. I need to change positions, change topics, talk to someone new.

Yet, I don't feel my life is passing by. It seems much more like it is exactly the same. I am amazed that I have aged. I feel the same. I do the same thing -- although I am much better at it now -- and I just keep going, hour after hour. She is my "nine o'clock,"he is my "ten o'clock." Very often someone will take that spot for six months, a year, sometimes even two years, although usually if they are still coming after a year, they are coming less frequently,but some people last a long time. For a while I had all my ten o'clock appointments trained to bring coffee. But now only one is left. I have to get the new ones up to speed.

I picked up one of the appointment books that was ten years old. The hours were filled in. I could remember about ninety per-cent of the people; their faces, their dilemmas, and how they were when they left. About five people are seeing me now, although they all had been away for at least a couple of years, some have come back a few times But for most of them, I don't know where they are now. Their stories continue without me.

I'd love to have a big reunion and see how everything turned out. But HIPAA won't allow that.

creeping changes

This economic stuff is bad. Many people are either losing their jobs, or afraid that they could. Money is tight. People are finally afraid of credit cards/

These are not bad things.

Many of the couples I see who usually fought about money-- using it as one of their flash points, even if it wasn't the real issue they were fighting about, which is usually control, recognition, and who should carry the emotional load -- now they talk about survival.

In some ways people are very tense about making the bills. In some ways people are more relaxed because the pressure to make tons of money, to keep up, to buy more and bigger, is gone. Even the people who have money, have less.

Making tons of money is not trendy any more. It looks bad. If this were France in 1787 all those auto execs, and big bankers would be on their way to the guillotine. There is a lot of popular support for that.

There are signs that things are changing. Having a job seems more important than just making money. How you get your money is beginning to matter again.

May there will even be a return of things like ethics and integrity.

Well, let's not get carried away.

More about that

Thinking about my last couple of posting has made some things clearer about what is so compelling and also so difficult about this job.

It becomes clearer at holiday time when I am even busier than usual, both socially, and at work. What becomes clearer is that while I can really enjoy my time off, I often feel that when I am with people, it can be pretty boring. I mean, I like many, if not most of my friends and relatives, and it is good to see them, but in truth, no one has much to say. Or at least they don't say it.

My own kids kid me about the types of questions I ask. What are you doing? What are you reading? What are you listening to? What are you thinking about? What is really going on?!!

Yes, the politics are finally encouraging, the Celtics are doing well, adding the cranberries into the wine and then into the sauce makes it more interesting, but WHO are you and what are you BECOMING?!

Then I go to work and people tell me everything. They tell me things that they don't tell anyone. They tell me things that they have never told anyone. They tell me things that they don't even want to tell themselves. To me, these are the most intriguing and engaging conversations anyone can have.

Today I had a session with a very bright, attractive woman who told me that last night she spent an hour sitting on her kitchen floor with a knife placed just under her heart wondering if she could go through with it. She felt she had done things that if anyone found out about, she couldn't live knowing they knew. Then her husband came home and she jumped up and set the table. Today she went to work and no one had any idea what she had been thinking. She then told me why she had felt so badly.(I'm not going to tell you).

Yesterday I met a new young man who seemed like he had just come in from the wilderness. He had been out of school for two years and had been doing basically nothing but hiding in his room. But six months ago he read something on the Internet that opened an interest in psychology and philosophy and he has been reading and thinking since then. He was incredibly insightful, articulate and self-possessed, and yet he never knew his father and his mother has been screwing with guys in the other room for years, and no one knows how this kid thinks, or even that he can.

Of course there are downsides. These are very one-sided relationships. I realize that. The people I talk to come to me for help. that makes me feel good My friends don't put me in that position, but then, I don't have to help them. The responsibilities are different. But often, I don't need too much contact with people after thirty to forty hours of this. I get all listened out.

I'd rather watch a game.

Ring-ting-a-ling

Well it sure is holiday time. Many of my clients were out there last Friday at 5 AM ready and eager to spend money they don't have. At least no one was trampled to death in my area. That is kind of sick, don'tcha think? That shoppers have rally gotten that desperate.

This is always one of the busiest times for me. Some family gatherings are really great and nurturing and communal. Everyone gathers and buys gifts to show heir love and appreciation for each other. The warmth and love is what chases away the cold of the long winter nights. I actually see some people who have a family like that. The family has grand-parents who had eight kids and they all have kids, many of whom have kids, and they all get together for Christmas and share good tiding.

I actually have two members of that family who see me, and they give me very different views of what goes on, and who really likes whom, and what the underlying tensions and rivalries are. But at least everyone manages to pull it off for a day.

Most of my clients dread the holidays. I see about four Elanor Rigbys who will be alone unless a fourth cousin has some compassion, or the old man on the third floor invites them in. But if he serves wine they get nervous about his intentions and make sure they keep their knees tightly held together.

For many it is the guilt that brings families together. A mother can squeeze feelings of guilt an inadequacy out of a child for fifty years if she has the talent. And many do.

I also have two families in which one sister is now married to the former husband of another sister. That can make things a bit tense, unless families are rally into sharing.

So, if you have a therapist, make your appointments early. Therapy times fill up quickly around the holidays. Many of us therapists fill up many hours with appointments. It's better than being with our cousins.

The Letter

Before I get to wishing everyone a happy and healthy Thanksgiving, I would like to say, once again, that the job I have is "endlessly fascinating" {that's something my mother always said when she couldn't figure out what was going on} and also, often, a bit weird.

I worked hard this week for two days, getting people set to deal with whatever variation of family they have to co-exist with, when I got a letter. This is not the way I am usually introduced to people. These days a phone call, and now more often an email, is the method most people use to try to arrange a first appointment.

This letter was about seven single spaced typed pages. It gave pretty graphic descriptions of stuff that is supposedly going on in private in a town close to where I work. None of the exact details were included that would allow me to verify that the people mentioned actually exist.

The situation described in the letter was not actually that unique or that terrible. It was the letter itself, it's format, language and detail that makes me wonder what is really going on. who would write all this and why? I have my ideas, but ... those are just hypotheses.

At the end of the letter the writer said I would get a call after Thanksgiving to set up an appointment.

Perhaps things will be revealed.

Now, it is time to wish you all a Happy, Healthy and Prosperous, even in these times,
Thanksgiving.

Remember, appreciate the people around you. They are doing the best they can.

results of financial meltdown

I get to see some of the unexpected fallout from the downturn in American personal wealth. Yes, I have to deal with couples who have re-financed to pay their credit cards and now they can't pay their mortgage and their house isn't worth what they owe. Then they get tense and blame each other for it. All that stuff is commonplace.

What I see now are some things that are a bit unusual. I have two (2) situations in which there are three adults living in one house. In one case a man and two women, and the other a woman with two men. In both cases there was a marriage that was not going well. The resulting emotional distance morphed into one person becoming involved with a person outside the marriage. What followed were the usual hurt, anger, arguments, threats and general disruption

Then, as is often the case, one person threatens to move out. The other says fine, I am bringing my lover in. BUT, there is not enough money to move out and pay for another place to live.

In one case a man is living in the basement while his wife is screwing some guy in what once was his bedroom. In the other case the "other" woman is sleeping on the couch, while the family, kids and all, goes on with life as usual, treating this woman as if she is invisible.

Not a very emotionally enriching situation, but it does show that diplomacy and compromise is better than living at the shelter.

I am not sure how either of these will end.

Too much

As a discipline I try to post here every two or three days. It's supposed to be good for my brain, and it should help to live a more "considered life." But often, life gets in the way.

At those time I have so much to say and so much to sort out, but ther isn't time to do it.

Right now I have several personal and family experiences that illustrate how complex health care has become here in the U.S. of A. It's a mess but there are reasons for that, but it don't have time to get into that.

There is also so much going on with the family, and even more going on at work, and the world is going through a great deal of flux in politics, in the economy, and this has its ramifications on everyone, and everyone has their effects on the economy and politics.

And then the Internet connection won't even work for a while, for reasons that I totally can't understand, so I can't even get started.

"Still,tomorrow is going to be another working day,
and I'm trying to get some rest,
That's all I'm trying to get some rest."
P. Simon

More though times

Beside the financial crisis there seem to be other bad things that just pop up in clusters. Maybe it has to do with everyone being tense, but these things don't seem related.

My father-in-law, who I have mentioned here before, is 95 and has really been a tough old bird for many years. But now his body and mind are slipping away. It is taking a long time and is tough to watch. He fell and is in the hospital, but he isn't sure if he is in jail or visiting one of his old customers. When the nurse asked him what year it was he answered 1980, which was the last year he worked.

A good friend of ours is back taking chemo-therapy for a re-occurrence of her cancer. It is very difficult to know how well she will do. Then today, my son told me that one of his friends who had moved away and started a new life in a far-off land was shot and killed in a robbery.

We don't live in Baghdad or Mumbai but there are times when it feels like the world is crumbling around me. My wife gets upset, as well she should. I think I have developed too much of a clinical detachment. I have a circle of about six people, and if anything happened to them I would be rocked to the core, but beyond that, I can feel bad, but I have learned to just kind of shrug and go on.

It could be from working with so many people, and getting to care about them, at least to a point, and still realizing that in many cases, their lives are not going to improve that much.

Or it could be that I'm just really not that nice a guy.

Back at it.

The historic week has ended. I am envigrrated for a better world, but right now I have to deal with the one we have. That means that today I got up and went back to the office.

The misery business, as my father-in-law always called it, is booming. Financial pressure puts pressure on relationships; stress is everywhere. People are struggling, people are angry, people are sad. That's OK, that's what I have to deal with.

I'll tell you what's tough. It dealing with the narcissists. When people are in a difficult situation, or have difficulties in their heads, or are just difficult, that's fine. But when someone feels that all the troubles have been heaped upon them, and then they just sit there and complain that no one is lifting them off fast enough, that is when the job seems difficult and taxing.

Understanding your problems is helpful. Explaining is helpful.

Blaming is not.

Hey, don't blame me, I'm just the therapist.

Obama and Psychotherapy

If Mr. Obama can get people together and try to make significant changes in our society, then some of my clients can make the sustained effort necessary to get their lives going in the right direction. His administration can set the tone that we are working together to make things better.

"But," some of my clients will say in one form or another, "my life is difficult, I was dealt a bad hand, my father left when I was young, my mother was a starry-eyed hippie." Obviously, that can no longer be a lasting cause of bad behavior. Now that there is insight, change should follow. These clients may not have a totally devoted grandmother who will last with them until the very threshold of their greatest achievement, but they do have me. I am here, and I am attentive, and I will be at least until their insurance coverage runs out, and with the new parity bill that could be a long time.

So, let's use this as a time of transformation for all of us. Let us pay attention to each other, help each other along and begin to move in a good direction. But, also, let's raise the expectations of each of us, and we will all benefit.

YES!

I will admit that on Sunday I was very confident, but by Tuesday morning I could see a way that the election could be lost.

I sat with friends and family, trying to be friendly without telling everyone just to shut-up and pay attention. When PA was declared fairly quickly I began to relax. An hour later when Ohio was given to Obama I knew, like everyone else, that it was really going to happen. All the TV people seemed to know it all along.

For the first time in eight years I felt hopeful. I drove to work this morning and I did not cringe every time I heard the news. I felt I did not have to be embarrassed about how the people in my government were screwing up the economy, science, world trade, war, energy, the environment, health-care, health,and human relations.

Basically, I have some confidence that the people who will be running this country, while they certainly won't be perfect, and they certainly will be politicians, will at least be smart. They will understand that the world is complex. That it does not just consist of good-guys and bad-guys, and that the problems we have to deal with are difficult. I think they will have a better understanding that even if someone disagrees with them that doesn't make them terrible or stupid (although sometimes they are).

That's all I want, to feel that we have good people who are trying. For eight years I have felt we have had an administration and even a Congress who were stuck in their own mud and couldn't see passed their mind-set, and couldn't understand what they were seeing, and didn't try to understand it.

Now, we will have to wait and see. but I certainly do buy what Mr. Obama is selling, which is hope.

That is really a great deal of what I do in my own work. Get my clients to believe that their lives can be better. I know how necessary that is if any change is to occur.

Finally

It's funny about time, but if you don't do anything the world keeps turning and eventually, things come to pass.

This election has been going on for almost two years. I have really been pretty actively following it since last January. What with the wars never ending, the financial ups and downs and downs and downs, the current idiot President who has allowed the Justice Department, the Energy Department and the FDA to all become inept and corrupt, I have always felt that this is a crucial election.

Now, finally, I have seen my last client before I vote. I have encouraged all my clients to vote, but I don't get into politics unless they start. The election has really aroused more interest than even the Red Sox this year, and that was not the case four years ago. Four years ago many more local folks were intensely involved with the Sox, and their own local Senator was running for President. Now they seem to have awakened.

What happens next is completely unknown. The world is in a great mess, to a large degree because of how this country has been run for the last eight years. It will take years to clean it up. But at least, if the election goes well, the tone of national and international relations can change dramatically. The world will look at America differently, and we could be a bit different with each other.

But that has not happened yet. I am working tomorrow and then I will be watching every channel. Mostly I will be watching Florida. For me, that is the first major indication. Maybe I won't have to stay up until two in the morning.

six days away

The election is coming, so they say. Mr. Obama has been running for 21 months. Mr. McCain has been running, on and off, for eight years. The decisions, soon to be made by millions of Americans, some of whom have already completed the task, is less than a week away.

In many ways people have to decide if they want to protect themselves, their won interests and their own money, or they want o feel that they are a part of a larger society in which each of us has some relationship, and some important interactions with each other.

This economic melt-down is, to a large degree, the result of people not looking at, and not caring about, the consequences their actions may have upon the welfare of others. They trusted that their attempts to make money were basically honest, and although the things they did were risky, they didn't look, understand, or ever think about how inter-related we all are. There was all this talk about some kind of "invisible hand" running through free markets, and that would make everything balance, and determine a real and fair value of things.

Obviously, there were many flaws in that kind of thinking, just as their are flaws in "trickle-down economics."

America is a land of opportunity, but it can also be a very harsh place for those who slip and fall, or for those who never had the chance to stand up in the first place.

Should we look around and care about each other, even if it is at some cost to ourselves? Or, if we each do the best we can for ourselves, will things work out as they should?

To some extent, the people will decide.

The leaves, and times, are changing

Today was one of those days that they put in movies about New England. The was HD clear after the night's rain, the sky was a perfect autumn blue. The temperature was actually warmer than it should be, but no one complained. Here in Southern N. E. the leaves are at their peak, and because of the right amount of rain and temperature changes this is a good year for color. There are reds, yellows, orange, brown and even purple mixed against some still green. My neighborhood has big old trees, maple, oak, beech and pine, with occasional sassafras, walnut, tulip and even willow. The trees reach way up into the blue, each with it's own vibrant color.

As we walked we met other neighbors walking. We talked of the coming election, which seems like it will never come. Everyone in this small city is of the same mind on the election. We talk of the economy, and joke about keeping our jobs for another decade. Who really wanted to retire anyway? Some of these folks had real jobs and made real money. Some of them have retired. In some ways the great stock market crash represents huge changes in numbers, but no real change in the current lifestyle. But everyone knows that things a are different, and we will not be as plush as we had planned.

One friend, who does business in Europe said that the bad times have hit there hard now. The world blames the credit crazy U.S. for giving and then selling so many bad loans. But everybody bought them and tried to get rich. Now everyone is getting poor. Some much poorer than others.

For us older folks, there is some sense that we have been through some of this. We are not old enough to have been part of the depression of the 30s, but old enough to know that bubbles burst.

It just seems that the bubbles build and burst at a much faster rate now. People seem to be waiting around for the next one to begin. The idea of a slow, steady rise in the economy, based on real products and real work has not really taken hold yet.

Maybe new, "Green Energy" will sweep us up in a new wave of progress and everyone can ride that train back to wealth and consumption.

Or maybe not. Perhaps we will all be poor for a while, and stay home, have conversations and get to know each other.

But that's just an old man talking. Most of us will run around and keep in touch through text messages:
"Pizza?"
"2 late"
"OU812"

all fall down

I was away from blogging for almost a month. Why? Because there was too much else going on. Just one thing after another that needed to be taken care of. When I was done with all that my brain didn't have too many creative neurons firing. I went to bed.

I had to pay the bills for my practice, the bills for the house, and now the bills for my fading father-in-law. The car needed to be taken care of, so did my wife's car, not that I can do the work, but I had to drive it up and back. The house is being worked on and one day two guys were standing on the scaffold and staring right in on my desk.

Mr new doctor seems to question everything about my health. I have taken more tests than ever before, and I'm OK, just poorer. One wonders about why our health care is so expensive. "Just want to be sure." I wonder if it is my health, his pocket, or the lawyers he is really worried about.

I had to see my clients, see my kids and listen to my father-in-law not make sense and my wife get upset about it. I don't make much sense and she doesn't seem to care.

I took time to watch the leaves change color.

I did a bit to keep Obama moving in the right direction.

BUT, my life is a breeze compared to what I hear in my office, and usually my clients are not the ones who are the most lost, disorganized and overwhelmed, but they have to deal with people who are. A's mother is on cocaine and three months behind in her rent. B's brother is locked in a room and won't come out. C's sister came to live with her because her house has mold. Now she hasn't paid any rent, hasn't cleaned the room and disappears every weekend without any explanation. D's daughter has been suspened from school for fighting, three times.

This doesn't count all the illness that are impossible to deal with, Parkinson's Huntington's, ALS. These are the kinds of things tahat just suck life out of a whole family.

I hear about so many houses that haven't been cleaned in months, so many bills hat haven't been paid that people stop trying, so many lawns that haven't been mowed, so many roofs that haven't been fixed. Things are falling down.

It seems to me, and I've been doing this a while, that the pace of life, the price of life, and demands of keeping up have increased, partly because of technology, to the point where people can't keep up, and are dropping out.

Even without this financial mess, I think it's worse than it was, but maybe I'm just getting old.

Been so Long

Look at that. I just looked at the date of my last post and it was almost a month ago. I would have said maybe two weeks. It's amazing how life gets filled up with all kinds of stuff. I had even told myself that it would be good for my brain to keep writing often, but so much for my brain.

I have spent time having parts of my body poked and measured and scoped. Despite all their best efforts, and they really seem to be trying, they haven't found anything wrong with me yet. That's what you get for going to see a doctor.

I have also been doing what I said and trying to help the Obama campaign. The actual work I do has not been that meaningful. He has not yet called me to help do his mental health policy, although he should. I will lobby for that after I see that he wins.

I hope you noticed that the Mental Health Parity bill got stuck into the Huge Economic Recovery Package. It will be a slight help, although insurance companies will find ways around it. They didn't designate $770 million for mental health. They should have, as clearly everyone involved with this mess is nuts.

For me, the trouble mainly goes back to Reagan. It was he and his conservative crowd that decided that the purpose of America was to give everyone the opportunity to get rich. That was the only purpose. How anyone made money, how much it destroyed other people, other countries or the other values and fabric of our own society were not questions anyone even considered.

Also, those conservatives were the ones who began to target liberals as having useless tax and spend policies. While those criticisms were on target in some respects, what those people put in place were spend and spend policies. It has been the conservatives, and G W Bush more than anyone in history, who just spend money and build huge deficits. They created a climate of unregulated greed and here we are.

So, I am holding on to hope for the next couple of weeks. There are about 35% of the people would vote for the Republicans even if Sarah Palin herself were running. It does seem that for now, the independents and the often undecided voters have had enough of war, bad health care, a crappy economy, and watching this country fall into chaos and decline.

Even my most moribund clients are taking notice in this election. Only the ones who are chronically bitter and angry seem to be for McCain.

Great Theater

Wow!
All of this is better, and more unexpected and unpredictable than any TV show. Unfortunately, so many people seem to view this election as if it was "American Idol."

You have to have some kind of admiration for John McCain. You never know what he will do next, and you never quite know what he is thinking. While this may be great for a self proclaimed "maverick," it is really terrifying to think of a President acting that way. A little stability in a time of crisis could be helpful.

He "suspended" his campaign to run to Washington, as if anyone could suspend a Presidential campaign five weeks before the election. Did he mean that no one should pay attention to what he was doing? I don't think that was what he meant. I think what he meant was: watch me act like I'm concerned, but I rally don't quite know what I'm doing. He also may have been trying to find a way to eliminate the vice-presidential debate, before Sarah tells the world that she knows all about foreign policy because Putin flies over her house.

A good thing is that even many of my clients, many of whom don't pay much attention to who is running their country, are paying attention now. I also think that as Obama continues to be on TV all the time, in ads, in debates, inginterviews, people will begin to see him as Obama, the Liberal Democrat, but much less as Obama, the Black guy. He is just becoming familiar, and that is a good thing for this county.

Unfortunately, Palin is not doing the same for women. She is fulfilling the stereotype of the not too swift beauty-pageant lady, who wants to bring peace to the world but whose talent is baton twirling.

Obama survived the debate about foreign policy, which is supposed to be McCain's strength. It is impressive that McCain has been to all these countries and knows all these people, but his stace seems to be ready to go to war with them all. He doesn't seem to see that going to war hasn't been too successful over the last fifty years.

Obama's lead is building, but who knows, one explosion, a TV appearance by Satan on David Letterman, or Tina Fey coming out in support of McCain, and everything could swing the other way very quickly.

More Obama stuff

So, as I said, I am doing work for Obama. Today, since I live in a very blue state, I was called people in battleground states to see if they could do some work in theri neighborhood. I leaned a few things.
First, most people don't answer their phones, even if they have cell-phones. I think my wife is the last person who believes that if the phone rings you are supposed to answer it.
Second, i seems that so many people in America are moving and struggling. So many phones are disconnected, and so many people who signed up only two months ago are already someplace else.

There was some genuine enthusiasm, so it seems some people are paying attention.

I can't remember an election that has gotten this slimy this early. It seems that McCain will say anything he feels will be effective, but without any attention to truth. I guess he feels that Bush did it to him, so he can do it to Obama. "The Straight-Talk Express" seems to be completely derailed as he and Sarah have no contact with the press. They don't want to be accountable to anyone. Even the ladies on "The View" called him a liar, and he had nothing really to say.

It's sad, because there is so much at stake. For him to suddenly become a fiscal watch-dog, when he himself was censured by Congress during the last banking crisis is as ridiculous as it gets.

But that's they way things are going.

Also, That web-site that was posted as a response to my last post was interesting and worth checking out.

Should have seen it coming

About three years ago, looking back from what we know now, I should have known that the financial world was about to implode. At that time I was seeing the usual sixty different people in a month. What I realized even then was that about ten of the people I saw, who had been not doing too well professionally, were suddenly taking exams to become mortgage brokers. Even those who couldn't pass the exams were sell mortgages for their sleazy brother-in-law or cousin. The cousin was often the guy who sold mortgages, and to add to his profit margin, sold cocaine.

I had one woman who had a few relationship problems, but she was selling both real-estate and mortgages, and she was making many, many dollars. She worked constantly, looked stylish, networked with everyone, and knew everyone. Everyone thought they could be just like her.

Well, they couldn't.

But they all sold mortgages to their aunts and uncles and ner'-do-well brothers. They all seemed to have some sense that these people couldn't afford the payments. Many of the people taking the mortgages were taking money out of the houses they had owned for years, believing that the equity in the house would just continue to rise at 20% a year. Often they used the money to pay off the credit card debt they had gotten by buying SUVs, and the trips that came with them.

The banks were encouraging people to use the credit cards, and would sent new ones to people as soon as the old one was max-ed out. The mortgage companies were selling on the basis of low-rates that the Fed had dropped to get the economy going after the stock market bubble burst, without regard to creating a bubble in housing.

Then the bubble popped. Surprise!

It was completely unregulated. What made it worse was the brilliant investment bankers who devised "credit default swaps" and were leveraging derivatives on those at 30- 1.

Then the families who wanted it all now, and was encouraged to put it all on credit, was faced with the reality that they owned much more than they had in assets, and that they now had negative equity in their houses. It was over for everyone.

Now, John McCain wants to tell you he will reform all this, by stopping the greed of the "Fat Cats." Well those "Fat Cats" are the are Republicans he is counting on to finance is campaign. He forgets to tell you that. That's why he wants to keep the Bush tax cuts. That way they get to keep their money.

That's called getting tough.

It's OK (almost)

Well football is on. And football and HD TV were made for each other. We are here in America, watching football, drinking a beer, and everything is just fine.

It's easy to forget that we are fighting two wars, one for no reason, and one we are losing. It's easy not to think how today we had to pay taxes and so much of that money is going to to bombs and corruption.

It's easy to forget that houses are being foreclosed at a record rate, that unemployment is rising rapidly, that we are being fleeced by oil companies. It is these same companies that will make more money when we "drill, drill drill" and it won't make the price of gas cheaper.

It's easy to forget that the Justice Department is corrupt and run out of a religious/political office. It's easy not to look at the department of the interior that takes bribes and has sex with people from these same oil companies.

Mr. McCain says he wants to go to Washington and make changes. He doesn't say that he will change any of this. He won't stop the war that spends a couple of billion of my money each month. He won't change the people in these corrupt departments because they are all the same Republicans that are paying for his campaign. He won't change health care and make it affordable or efficient. He will go to Washington and change the face of the man in the White House. Everything else will be the same.

But, hey, football is on. My team is winning so everything must be right with America. Let's not bother with politics. That way we can act stupid, be happy and poor, and probably lose more of our sons and daughters in wars for the oil companies.
But that's a small price to pay for HDTV.

more discussion

It seems that, among others, we have a "Right-Wing-Radio-Republican" in our midst. There are hordes of people who have been out there for over twenty years now who have decided that the best way to enter into a political discussion is to scream, slander, debase, and just throw all kinds of hyperbolic charges at the opposition. It's the "all Democrats are dangerous," and "Liberalism is a disease" type of argument that only leads to greater divisions in the country. Everyone says they are against it untle they realize that it takes only 270 electoral votes to win.

But, as we can see from the last two Presidential elections, it works. Perhaps a lie is still a lie no matter how many times you say it, but then how many people still believe that Saddam Hussein had anything to do with 911?

Now we have McCain leading the cheers for Ms. Palin, as if she has become the next American Idol. Her qualifications seem about the same, cute, popular, and can give a good scripted come-back. Ms. Palin may be strong enough to be Vice-President, but she seems to be a kept hot-house flower who is not allowed to speak for herself without a card to read.

Once again, it's great theater. How many times can we run the 9/11 movie?

Obama must be amazed that McCain can flip from being the "experience" guy to being the "new change guy" just because he says so. Who has time to really see if it means anything when you really are worrying about making the next mortgage payment?

Oh, and on health-care. That's the field I work in. Everyday I see how intrusive, wasteful, inefficient, insensitive and expensive our "free-market" system is. It is designed to make people money (even me) much more than to keep people healthy.

discussion?

Well, we are beginning to get some reactions here. I can't quite call it a discussion when some of the folks seem pretty much off the wall. That often seems to be the way political discussions go these days. I don't know where the raping and killing part comes in. Are people really still that afraid of Black people?

Amanda -- please register and vote, even if it means using a couple of stamps. If I knew where you were I'd forward some to you.

One thing the Republicans are very skilled at is creating symbols. They have been running on the same issues for decades, but they really don't talk about issues. They get people to feel for patriotism, safety and loyalty -- and even when what they actually do is really harmful to the nation they still are able to get people to feel that it is more American somehow, to be that way.

McCain is now running ads that trash his own policies and his own party, and then he blames it on Obama. If McCain wins the only thing that is going to change is the face of the man in the White House, but he poses as St. Patrick, and about to drive all the snakes away.

I really do think that Obama wants to create more of a caring society atmosphere in this country than anything we have seen since FDR. McCain is a true believer in American Individualism -- which ends up beong every person for himself, which then results in those who have more power and influence taking advantage of that and depriving others of their opportunities. Something like good health care really takes the kind of cooperation that this country has not been good at.

Reactions to the Republicans

The Republicans are meeting now and I am watching it on TV.

I have two immediate reactions. NOTE: I am very biased.

1. The Republicans seem to glorify war. The short movie about the Navy Seal who died was moving, and really tragic. This really gallant young man died in a war that didn't need to be fought. He saved his comrades while fighting people who really offered no threat to this county. No one mentions that. The Republican honor soldiers as if they are fighting for the Republican Party, which, sadly, in some ways they were.

2. The Republican convention is always full of white people. This time they can't even find a few Black faces to put the cameras on. This time the convention is not only all white people, it is all old white people, probably all rich old white people. anyone from outside the country who looks in must feel that the USA is a homogeneous nation of war loving white people.

A large part of it is.

And, as Joe Lieberman says, John McCain is not your average Republican. That is true. He is much more often irrational, impulsive, and a man more comfortable in the world of forty years ago.

Just my thoughts. Feel free to react.

Juno in Juneaux?

I'm sure I'm not the first to make that bad pun, but I guess it has to be said. Of course, the daughter of the VP nominee is keeping her child, not looking for a more adult home like the kid in the movie. That's fine with me. I can certainly respect that decision.

What I am having a great deal of difficulty accepting is John McCain's decision. I think that Mrs. Palin and her entire family seem like a fine, likable, fun bunch of people. They read the Bible and they like to hunt, fish, drink and screw. There is nothing at all wrong with that.

BUT, it doesn't qualify her to be Vice-President of the United States! I have many friends who like to hunt, fish, drink and screw. I like them a lot and we have some really good times, but I'm not voting for them.

She basically may be very smart and a quick-study, but she has NO real experience running things. She has just taken an interest in foreign police in 2007 when her kid went off to war. Comparing her lack of experience to Obama's is like comparing someone in their first month of Single A ball to the Major League Rookie of the Year. They are several leagues apart.

Being a devout Christian does not count as a qualification, especially when you really have not managed to stick closely to those beliefs. Yes, we are all fallen, especially me, but that doesn't qualify me to be a heart-beat away from taking over if the oldest candidate ever skips three heart-beats in a row.

I don't blame her at all. She is probably a great woman, but I think it certainly shows how impulsive and manipulative John McCain can be, and I can't trust someone like that to run the country.

But, he doesn't want to fix health care, or make mortgage companies accountable, or relieve the middle class tax burden, and he does want to spend billions more on wars, and on looking for oil -- and she wants to keep drilling for oil everywhere too, that's one things she knows about. If that's your idea of change, then it's clear why they need to bring God into the picture.

Love,
Tx

What is important

Well you guys are correct. The goodness of life lies in the details, especially in the friends and family.

But, there is also the importance of pushing for your beliefs and causes, and that is what I will be doing over the next few weeks.
I feel that this country is at a very crucial, historic and vital crossroads. This election could be more important that any election since 1860. The two candidates hold very different views of how our government should work, what our country's role in the world should be, and what the basic values of this country will be.

While I do not feel that Mr. Obama is the great savior, I do feel that his message and the direction he wants to lead us in is so much more positive and helpful that Mr. McCain.

I know there are thousands of political blogs, and I will be writing about politics more than usual, but I will also be visiting many of the other blogs out there and hoping to draw people into a discussion about what kind of country they want to live in.

I am doing this for my own mental health, for my children's future, in order to help my clients find easier ways to have health care, get an education and stay out of debt.

This is important. Maybe we can all work together to get it done.

Sarah Palin

Although I am neither a woman nor and African American I sent the following letter off to The Globe today.

When Thurgood Marshall died and left the vacancy on the Supreme
Court President G. H. W. Bush must have felt the pressure to fill the
chair with an African American. He did so by finding a man who was
certainly an African American but not one who would bring the
perspective of that segment of our society on to the court. Quite the
opposite, he has shown himself to be opposed to many of positions of
most African Americans on many significant issues. But, even at his
nomination hearings Judge Thomas felt he was being attacked because he
was Black.

Now, John McCain has selected a woman as his running mate. And
yes, she is undeniably a true woman, and she certainly does represent a
portion of the population of women. But her views do not represent
those who have fought for decades for women's rights, for equality, for
power, and respect. She is a conservative Christian who is
anti-abortion, anti-gay, and whose major qualification to be
vice=president is that, as a woman, she can somewhat look like Hillary.
This seems to be a cynical and manipulative choice., and an attack on
feminist women the way Clarence Thomas has been an anathema to African
Americans.

OR, stated more simply:

Clarence Thomas is to Thurgood Marshall
as
Sarah Polin is to Hillary Clinton

Re-emerging

Now the summer is beginning to fade. I have been away from everything for a while. We have been wandering around down here,taking time off. It was something I needed to do more than I realized. The last few months, with the back pain, with other vague but unrealized health worries, had put the focus on me much more than ever before.

With that comes the awareness that at my age sickness can lead to crumbling, can lead to being wiped off this planet. Isaac Hayes was just slightly older than me. Gene Upshaw was my age, so were abut twenty per-cent of the people on the obituary pages. It all kind of spooked me out. Me who is supposed to be so full of perspective and so calming.

I spent so much time thinking about thinking that it all kind of got to be a bit too much. I couldn't think about it any more. Who I was, what I was doing, what I want to be, how I want to spend the rest of my time, what is really important to me, all these things kept swirling through my head burning a deep hole but leaving no answers.

So we came down here, as we do every year. I thought I could use the time to get away, and maybe I could figure things out. Maybe something clear would emerge.

So far I've spent time hanging out with friends and doing things that take up time. Even golf. It's been very beautiful. The weather, the sea, the rolling green, the blue sky, the golden sun. The time has been easy, fun and even sociable.

Yet, there remains the vague feeling of something not yet accomplished. I have not yet mastered the art of just taking care of myself. Making deals and keeping myself entertained somehow just never seems to be enough. I'm not sure why.

Must be something my mother did or said. Maybe it was my father.

Still, I'm not sure what it is that I am expecting.

So today, after almost two weeks away, I am beginning to schedule appointments for next week. For the first time is six weeks I don't feel afraid of it. I am even just beginning to look forward to seeing everyone -- well almost everyone -- again.

Yet, I have decided that I need to re-allocate my time, find out what is missing, and what it is I expect to do, not just return to what has always been done and keep the ball rolling down the same familiar hill.

As I have said here many times, change is difficult. Even for me. Hopefully, this blog will help hold me accountable.

Welcome friend

Hey, it's good to see you.
I'm glad you guys could come on down to the little summer place again. Seems like we get to see more people here than we do at home. Have a beer, that is, if you're still drinking.

So, what ya been doing? What ya been thinking? How about them Sox? Going to fold again, like they used to?
How about the world, Huh? Ya think we're going to make it, as a society? This new guy, he says he's a citizen of the world. The old guy, he still wants to go to war. Hates losing, thinks it's a footbal game, except lots of people die,

The new guy certainly can draw a crowd. The old guy is starting to sound kind of mean and bitter.

How come nobody wants the rights to off-shore wind?

How come Boston spent $20 billion, that right $20 billion to dig a hole under the city for a road, which gets clogged with gas guzzling cars, when they could have had the best mass-transit system in the world? And don't tell me I just thought of that because I said this ten years ago, maybe twelve.

Do you think we might have an American society that cares about each other, or should we stick with each of us trying to be millionaires and trying to sell each other crazy mortgages, big cars, fatty food, questionable drugs, insurance that doesn't pay for much, and reality TV. Lindsey? Brittany? Paris? Laura?

Do you want your daughterto be Hanna Montana?

"Wall Street got drunk" the guy said. I wonder how much he's still ben drinking. that's his only possible excuse for fucking up the world so badly.

So, how ya been? How are the kids? Any of them working? Max is 31 and still trying to be a video game tester. He plays "World Destruction" on his phone while he waits for his latte in the bus station. And you say Maggie's pregnant again. Great, you like the other two grand-kids, that you are raising. Maggie knows who the father is this time, that's cool.

As I said, how about them Sox?

human brains, !

Our brains have evolved over hundred of thousands of years. This convoluted mass of protoplasm is one of the most amazing and complex structures that nature has produced.

Yet, in our present complex culture, some of the basic responses our brains have developed are no longer always adaptive. The process of deciding when to rely on the more intrinsic responses, and when to think about could be the best choice is a good deal about what therapy is about.

Example 1: Our brains have learned to size-up a situation quickly and choose a course of action. Is that shape a friend or a foe? Is it food that I can capture or a tiger that will eat me? The sooner you decide, and decide correctly, the better off you would be.

But, the world is more complex now. The person coming to meet you is a nice guy, but he wants something. There is now time to get more information. It can be harmful to take a position and stick to it as conditions change. You have to learn how to re-evaluate all the time.

Example 2: Brains have learned to take the short-term gain over the long-term. We act like we are rational and can plan, but under pressure we don't. There may be six antelope out in the field, but we will grab this one right here, even if it frightens the rest away.
So I said to him, "You're thirty-two years old and she is seventeen, how come you thought it was a good idea to have sex with her.?"
"Well, she was there, she made herself available, and it seemed like a good idea at the time."
AND it probably was a good idea --- at the time. But not ten minutes later. And now everything is a mess.

The Difference

This was an interesting week.
Last week I was away, lolling around, stretching, eating, making sure the tide ran on schedule.

This week I was back at work. It was interesting, and mostly predictable to see who had done what while I was away. Some people worked hard to make their lives better. They thought about the things we had talked about, they tried to make some changes. They are the ones who make this job worth it.

Some people worked hard, and thought about things, but are still stuck. Their attempts at changes, both internal and external/interpersonal/environmental, did not make much difference. I feel badly, because they are trying, and maybe I should be figuring out things better.

Of course, others did little. They came to see me again, and tell me the same stuff, with a few new excuses about why it was too difficult to take their finger out of their nose. "I know," I tell them, "life's tough, but, in the end, it's your life to do with what you will."

The differences between groups one and two is usually somewhat apparent. There could unmovable people in their lives, their may be physical impediments, or financial ones, or sometimes it is a real brain thing. But, there is a reason that I think I understand.

Why the folks in group three choose, and I use that word intentionally, to suffer, I don't know. Mostly, they don't see it as a choice. Usually, I do. Sometimes, I can see what the choice gives them. I try to change it, but I can't. Sometimes I really can't tell why they just continue to wallow in their own psychic mud.

The people in group three seem to love coming to therapy. But coming to therapy isn't going to make changes in their lives. They have to use what they get from therapy to make changes. Sometimes that's a tough sell.

really doesn't matter

Went to the beach at night
the 5/8 moon showing itself thought the mist
one star visible
the sea was calm, the waves rolling slowly and rhythmically
one after another, one after another
we are specs in the universe
untiled by our insignificance
yet, we are all we have
and only have it briefly

take good care of yourself

I hope you mean a lot to you

$600 an hour?

A friend sent me information about an article in the NY Times bout some NY therapists who get $600 an hour. The article talks about how some of those therapists get sucked into pander a bit to these clients. I guess if someone is going to pay you $600 an hour it must be tough to say things that might drive them away.

As hourly workers go, $600 is right up there. I know there are lots of lawyers who charge more, but most of those charges are paid by big corporate entities. The people who get really rich these days are the ones who can leverage their money, either through many shares of stock, or selling thousands of copies of one thing, form diet books, to hula-hoops.

I truly doubt that these therapists who are getting about 6 times what I get are not saying anything more pithy or life-changing than what I say. As most of you realize by now, I am one of the most skilled and effective psychotherapist on the planet. I just have chose to market my services in some average mill city in New England. I guess that's my fault.

I still have not caved in to the American ideal that those who have more money are worth more as people. I ma not impressed, much to my wife's discontent.

Not that I am against money. If someone wants to send me a check for all of these words of wisdom I'd probably cash it. But, as you can see, I give it away for free -- which either makes me dumb or foolish,

or else makes these words priceless.

obviously

We are down here near the water for the 4th of July. We saw some fireworks, ate some burgers and dogs and even watch families run relay races carrying eggs on a spoon. It couldn't have been more All-American.

Yet, today, being on vacation I had time to read most of the Sunday paper. I read how Americans have been unwisely using up oil since 1973 when the price started to rise. I read that job security has almost totally vanished in this country for almost everyone. That came as a result of the capitalism that also gives a chance to everyone to become wildly wealthy.

I read how global warming is causing extreme weather, and that is leading to crop shortages, and that already has led to wars, which will get worse in the future. I also read about how our health care system is a mess, and the only real way out will be to get a single-payer national system.

These things are obvious, and they all have been for at least twenty years, most for forty years.

What is also obvious, is that we are still spending billions of dollars to send young men across the world to kill people they don't know, for reasons that are unclear.

But it's tough to change things here in America, as it is anywhere else in the world.

Despite all of our freedoms, which are many, and which should not be taken for granted. It is certainly true that living conditions are certainly better and more free than they were two-hundred years ago. But one thing has not changed: people with money and power will not give those things up easily, despite how unjust the conditions that their holding on to their means of acquiring that wealth might cause. Just look at how difficult it was to get rid of slavery.

As one soldier fighting in Afghanistan was quoted as saying: "It's been true for thousands of years: old, rich, powerful men talk tough -- young, poor, strong boys die."