It's summer again. You can tell because it is really hot. Is it that Global Warming thing, or is it just hot? You can also tell by the number of bugs that are flying around my computer screen and crawling across my keyboard. I can't squish them into the keys because the screen will turn colors and flip pages. I can only blow them away. But then they think I'm a wimp and take advantage of my lack of power.
When it is summer I go down to the beach, especially when it's hot, like it was today. Usually when I go to the local beach it is just full of vacationing families playing family games and splashing each other until the youngest kid begins to cry. If I go to the bigger beach a half hour away there is a much greater chance of being surrounded by vacationing NY psychiatrists.
But today there were a couple of NY therapists on my beach. I kind of knew one of them and he knew the others so we talked about our practices a bit and complained about insurance companies, and did some of the things that therapists do when they suddenly find themselves bunched together.
These guys are from NYC. They charge a lot more than I do, and I think they get more. They make their patients bill the insurance, and that way, since they don't sign contacts with insurance companies, they can charge what they want. I am not too thrilled with that, but I understand that they play in a different market and they serve a population that can pay. Rich people have problems too.
What does bother me is that they seem to see their clients two or three times a week, and they do so for months, and often for years. Even for years and years.
Now it is rare when you read here that I am in favor of anything that insurance companies do, but if I kept getting bills for three sessions a week, and it continued for year after year, I would be upset too.
The basis for my being upset comes from the word "therapy." If someone comes to me for "therapy: I take it to mean that I will treat them for something that is wrong, with the goal that it will get better, with the understanding that whatever is wrong, it can and will get better, or else there is no reason for treatment.
To me, endless treatment is not "therapy." It is hand-holding at a high price. It also encourages dependency, while therapy encourages independence.
I guess the competition in NYC is great enough that therapists have time to see people three times a week. I rarely see people twice a week, and when I do, it is to keep them out of the hospital, and I feel they are on the edge. If I saw someone three times a week, for more than two weeks, they would be in the hospital the next week.
I don't mind them having a different business model, but I do mind how it makes the whole profession look inefficient, and perhaps incompetent, AND at a very high price. I mean, if you're sixty-two years old, how many years can spend talking about your mother. You only lived with her for eighteen, and you've talked about her for forty. Let's get to the part where you grow-up and change your life!
Thursday, July 08, 2010
Monday, July 05, 2010
Recollections (revised) Part 1A
I don't talk about dreams much in therapy. I don't ask about them, nor do I think that they are the window into the unconscious. But sometimes they do trigger interesting discussions. In many ways they are kind of the neurological cleaning out of the flotsam left in the brain at the end of the day. For me, I know that I have to be more careful about what I read after I get into bed. I often fall asleep and then suffer with blurred visions of the Taliban or Sarah Palin running through my mind, disturbing my rest.
But I had a dream the other day which was clearer than most and the feelings that came with it stayed with me for a while, making me wonder what is going on in my own head. In the first part of the dream I was an MC of a big party, like a wedding or something. I was making all kinds of clever cracks, entertaining everyone. But that quickly morphed into a scene where someone, a good friend, was telling me how I had insulted his mother, and that she was very hurt by things that I said. The dream then quickly shifted to an image of me and this same kid, whose mother I had insulted, riding on a bus. He was saying to me something like, "isn't this great, we are finally growing up and going off to college." I sat there, on the bus, on one of those plastic seats of city buses. I was nodding in agreement, but I said, yes this really is great, but I feel as if I have done all this before."
When I awoke from the dream I was in a good mood. I remembered those parts of the dream very clearly and I loved the irony of the last line. I enjoyed how good I was at recognizing, as I rode of to college, that I had already done that, even though, in the dream, I was confused by what I was feeling.
All of this made be reflect upon what I was really like when I shuffled off to college. What I remember clearly, was that unlike in the dream, when I went to college the real time, I had little insight and even less perspective. I was really pretty clueless about how the world worked, and what I could do to make it work better. I was having a tough time figuring out where I fit into the whole scheme of things.
I already had developed a very quick and sarcastic wit, mostly because I needed something to protect me, as I was very skinny and did not project an image of physical power. But my wit was very unconventional and disarming. One of my high school teachers told me that I was really funny, even if most of what I said went right over the head of most of my classmates. He added that he hoped that the things I said would not get me killed some day, if per chance, someone did get the joke.
But even in high school my attitude about the world was becoming established. Because I was slighter than most of the boys, and this was because I was younger than most of the boys due to my mother sending me off to school early, Look, she said, he's smart enough and he's just wasting his time being a pain in the ass at home. So they started me at school two days after I turned five. I didn't have to wait for the next year. I was about ten months younger than most of the kids in my class, which, in fourth grade, is a lot.
I think I had to protect myself by paying closer attention to what other kids were doing and thinking. I got to be a pretty good at predicting what people were going to do. I could tell what songs were going to be "hits" the first time I heard them. I could tell which I my friends were going to be dumped by their girlfriends. This sense of observation developed to the degree that I began to be a ble to tell which of my teachers really didn't know what they were talking about. I had some really good teachers, and some who were real phonies. Some of them knew that I knew, and that wasn't helpful for me in school, but I knew that this kind of knowledge was what I really should be leaning.
The more I paid attention, and by my Junior year, it was a lot, I developed an awareness that most people were being played for suckers. They were being lured to put their efforts, beliefs and money into things that were either, illusionary, worthless, harmful or nuts. At the time it was things like big houses, constant new cars, and bomb shelters. I also was confused by all the fuss made about religion and patriotism. I didn't get it. For me it just didn't make sense to get all worked up because I happened to be born in a certain place. I mean, I am that different from the people who happened to be born over there?
I didn't get it . And no one did a very good job explaining it to me.
So I made a lot of sly, kind of sideways remarks. I knew enough not to say anything directly, especially about religion and patriotism. I could tell that could get me in real trouble. So I remained, just kind of confused. I had no solution. I had nothing else to offer in their place, so I kept a lot of it quiet. I didn't really know what to say.
I also realized, that few other kids that I knew even gave these things a thought. They did what was being done around them. They just kind of accepted that this was the way it was, and went on. Most of my friends were much more concerned with hitting a baseball and getting their hands up under a girl's sweater.
With that, we shared a common interest, so I was accepted and did Ok.
Because of my confusion I was voted the "most individualistic" kid out of about 700 in my class. That meant that people thought I was weird, but I guess I was clever enough to make it seem interesting.
And that's why I became a psychologist.
I thought, geez, if what I'm thinking about is so weird, what the hell is everyone else really thinking about?
For the past forty years, people have been coming in and telling me. So that part has worked out.
But I had a dream the other day which was clearer than most and the feelings that came with it stayed with me for a while, making me wonder what is going on in my own head. In the first part of the dream I was an MC of a big party, like a wedding or something. I was making all kinds of clever cracks, entertaining everyone. But that quickly morphed into a scene where someone, a good friend, was telling me how I had insulted his mother, and that she was very hurt by things that I said. The dream then quickly shifted to an image of me and this same kid, whose mother I had insulted, riding on a bus. He was saying to me something like, "isn't this great, we are finally growing up and going off to college." I sat there, on the bus, on one of those plastic seats of city buses. I was nodding in agreement, but I said, yes this really is great, but I feel as if I have done all this before."
When I awoke from the dream I was in a good mood. I remembered those parts of the dream very clearly and I loved the irony of the last line. I enjoyed how good I was at recognizing, as I rode of to college, that I had already done that, even though, in the dream, I was confused by what I was feeling.
All of this made be reflect upon what I was really like when I shuffled off to college. What I remember clearly, was that unlike in the dream, when I went to college the real time, I had little insight and even less perspective. I was really pretty clueless about how the world worked, and what I could do to make it work better. I was having a tough time figuring out where I fit into the whole scheme of things.
I already had developed a very quick and sarcastic wit, mostly because I needed something to protect me, as I was very skinny and did not project an image of physical power. But my wit was very unconventional and disarming. One of my high school teachers told me that I was really funny, even if most of what I said went right over the head of most of my classmates. He added that he hoped that the things I said would not get me killed some day, if per chance, someone did get the joke.
But even in high school my attitude about the world was becoming established. Because I was slighter than most of the boys, and this was because I was younger than most of the boys due to my mother sending me off to school early, Look, she said, he's smart enough and he's just wasting his time being a pain in the ass at home. So they started me at school two days after I turned five. I didn't have to wait for the next year. I was about ten months younger than most of the kids in my class, which, in fourth grade, is a lot.
I think I had to protect myself by paying closer attention to what other kids were doing and thinking. I got to be a pretty good at predicting what people were going to do. I could tell what songs were going to be "hits" the first time I heard them. I could tell which I my friends were going to be dumped by their girlfriends. This sense of observation developed to the degree that I began to be a ble to tell which of my teachers really didn't know what they were talking about. I had some really good teachers, and some who were real phonies. Some of them knew that I knew, and that wasn't helpful for me in school, but I knew that this kind of knowledge was what I really should be leaning.
The more I paid attention, and by my Junior year, it was a lot, I developed an awareness that most people were being played for suckers. They were being lured to put their efforts, beliefs and money into things that were either, illusionary, worthless, harmful or nuts. At the time it was things like big houses, constant new cars, and bomb shelters. I also was confused by all the fuss made about religion and patriotism. I didn't get it. For me it just didn't make sense to get all worked up because I happened to be born in a certain place. I mean, I am that different from the people who happened to be born over there?
I didn't get it . And no one did a very good job explaining it to me.
So I made a lot of sly, kind of sideways remarks. I knew enough not to say anything directly, especially about religion and patriotism. I could tell that could get me in real trouble. So I remained, just kind of confused. I had no solution. I had nothing else to offer in their place, so I kept a lot of it quiet. I didn't really know what to say.
I also realized, that few other kids that I knew even gave these things a thought. They did what was being done around them. They just kind of accepted that this was the way it was, and went on. Most of my friends were much more concerned with hitting a baseball and getting their hands up under a girl's sweater.
With that, we shared a common interest, so I was accepted and did Ok.
Because of my confusion I was voted the "most individualistic" kid out of about 700 in my class. That meant that people thought I was weird, but I guess I was clever enough to make it seem interesting.
And that's why I became a psychologist.
I thought, geez, if what I'm thinking about is so weird, what the hell is everyone else really thinking about?
For the past forty years, people have been coming in and telling me. So that part has worked out.
Thursday, July 01, 2010
Not ready yet
I listened to the series that has been running on NPR the last few days about the use of fMRIs and PET scans for brain imaging. Many neuro-scientists have been studying the brains of various kinds of people and watching how their brains react in different situations. They would like to see if they can determine if different kinds of behaviors cam be predicted by different brain patterns. I have read about, and read some of the stuff of the two neurologists who were discussed on the show, Kent Kehl and Jim Fallon.
In the last report they discussed the case of a man in Tennessee who sliced up a neighbor into little pieces, and then went after his wife with a machete. In court, testifying for the defense, the neurologists showed that the man had a brain pattern and genetic pattern that is often associated with serial killers. He was physiologically pre-disposed to be more violent and explosive. This tendency was made manifest by the abuse he endured as a child.
Therefore, they argued, and the jury seemed to agree, this man was up against too many factors, and that he was much more destined than most people to lose control.
This is fascinating stuff, which is why I have read about it. Sometimes I feel that I would like to have a brain imaging machine in my office so I could tell the areas of the brain that were activated whn my clients were expressing certain emotions, or recalling specific events, such as today when a woman I have been seeing became enraged because the man who had abused her as a kid has appeared on a friend's page on Facebook.
But I think the use of brain images at this time can be very misleading, possibly very inaccurate and can be a very dangerous direction to go in. I don't think we are close to having demonstrated that we can think that pictures of our brains can mean more than self-reports or actual behaviors.
Yes, perhaps this man had more of a predisposition to lose control and he was "out of his mind" at the time he was slicing his neighbor into chunks. But, a case could be easily made that anyone who slices his neighbor into chunks is "out of his mind." Is this man more a victim of his genes and the other person just "bad?"
The slippery slope factor here is that, because of the current fascination and belief in new technologies, there is a tendency to believe the machine more than the person. So, if the brain scan shows a pattern that says you are depressed, then you are depressed, even if you don't feel that way. Or the opposite could be true, that you feel very anxious and panicked, but your brain pattern does not fit that of a panicked person so your insurance will deny payment for treatment. (I realize that that is not about to happen because the price of the scan is about the same as a year or so of treatment.) but the point is that I hope we don't get sucked into the use of great a technology long before it is ready, and it may never be ready for that exacting a purpose.
However, we already have doctors who can look at a brain scan, and then begin hawking their pills, brain exercises, or electronic brain-wave massaging machines that will cure your depression, ADD, or help with your math SAT scores.
Sometimes they get good, measurable results. But in my skeptical mind I would file those results in the placebo file.
I hope you all enjoy feeling free this weekend, if you are in the USA or not. Real freedom, the freedom to think and do what you wish, not just the freedom to let corporations make a lot of money.
In the last report they discussed the case of a man in Tennessee who sliced up a neighbor into little pieces, and then went after his wife with a machete. In court, testifying for the defense, the neurologists showed that the man had a brain pattern and genetic pattern that is often associated with serial killers. He was physiologically pre-disposed to be more violent and explosive. This tendency was made manifest by the abuse he endured as a child.
Therefore, they argued, and the jury seemed to agree, this man was up against too many factors, and that he was much more destined than most people to lose control.
This is fascinating stuff, which is why I have read about it. Sometimes I feel that I would like to have a brain imaging machine in my office so I could tell the areas of the brain that were activated whn my clients were expressing certain emotions, or recalling specific events, such as today when a woman I have been seeing became enraged because the man who had abused her as a kid has appeared on a friend's page on Facebook.
But I think the use of brain images at this time can be very misleading, possibly very inaccurate and can be a very dangerous direction to go in. I don't think we are close to having demonstrated that we can think that pictures of our brains can mean more than self-reports or actual behaviors.
Yes, perhaps this man had more of a predisposition to lose control and he was "out of his mind" at the time he was slicing his neighbor into chunks. But, a case could be easily made that anyone who slices his neighbor into chunks is "out of his mind." Is this man more a victim of his genes and the other person just "bad?"
The slippery slope factor here is that, because of the current fascination and belief in new technologies, there is a tendency to believe the machine more than the person. So, if the brain scan shows a pattern that says you are depressed, then you are depressed, even if you don't feel that way. Or the opposite could be true, that you feel very anxious and panicked, but your brain pattern does not fit that of a panicked person so your insurance will deny payment for treatment. (I realize that that is not about to happen because the price of the scan is about the same as a year or so of treatment.) but the point is that I hope we don't get sucked into the use of great a technology long before it is ready, and it may never be ready for that exacting a purpose.
However, we already have doctors who can look at a brain scan, and then begin hawking their pills, brain exercises, or electronic brain-wave massaging machines that will cure your depression, ADD, or help with your math SAT scores.
Sometimes they get good, measurable results. But in my skeptical mind I would file those results in the placebo file.
I hope you all enjoy feeling free this weekend, if you are in the USA or not. Real freedom, the freedom to think and do what you wish, not just the freedom to let corporations make a lot of money.
Monday, June 28, 2010
Another political rant of an aging Boomer
Summer is here, we are hanging out with friends down near the beach. Lots of eating and drinking and loose talk. The men, who are drunker than the women, begin to pontificate about the state of the world and what could have, should have been done. The women shrug us off like they did our children when they were five years-old and hungry.
Eventually someone asks me, as an aging therapist, about my view of human nature, and I reply somewhat cryptically that I realize that I have become just "one of the many here among us." Now, I do not expect many of you to immediately get that somewhat poetic allusion, although I'm sure that several of you who thought they should have been at Woodstock may pick up on it. There is a good chance my son will recognize what I'm talking about, and perhaps my daughter.
But it is true. After all these years of working with people, and all of these years of observing American politics, and the politics of the whole world, that was the best I could come up with.
I remember when I was not that way, when I believed that people shared an underlying sense of values, that most religions were similar, that science was really the search for the truth, that people recognized the folly of war, and that technology would spread knowledge and that knowledge would lead to enlightenment.
It was very helpful and comforting to believe that, although at times it became kind of confusing and a bit disheartening.
Now my views have been changed by my experiences of seeing close up not only what societies will do to their own people, but what husbands and wives do to each other, and worse, what they do to their children. I have also read lots of studies that show how totally irrational we are, such as the one done recently at MIT, that shows if you read someone's resume on a heavy clipboard, you will be more impressed with it than if you read it on a lighter weight clipboard.
Once you believe that, and I do. Then what can you say about human nature.
Therefore, I am now just one of the "many here among us who think that life is but a joke."
(B.Dylan, All Along the Watchtower)
If 250 years of democracy produces Sarah Palin as a viable political force, isn't that a good joke.
I'm not saying that this is a bad thing. Jokes are good. It is healthy to laugh. Studies have shown that too.
Eventually someone asks me, as an aging therapist, about my view of human nature, and I reply somewhat cryptically that I realize that I have become just "one of the many here among us." Now, I do not expect many of you to immediately get that somewhat poetic allusion, although I'm sure that several of you who thought they should have been at Woodstock may pick up on it. There is a good chance my son will recognize what I'm talking about, and perhaps my daughter.
But it is true. After all these years of working with people, and all of these years of observing American politics, and the politics of the whole world, that was the best I could come up with.
I remember when I was not that way, when I believed that people shared an underlying sense of values, that most religions were similar, that science was really the search for the truth, that people recognized the folly of war, and that technology would spread knowledge and that knowledge would lead to enlightenment.
It was very helpful and comforting to believe that, although at times it became kind of confusing and a bit disheartening.
Now my views have been changed by my experiences of seeing close up not only what societies will do to their own people, but what husbands and wives do to each other, and worse, what they do to their children. I have also read lots of studies that show how totally irrational we are, such as the one done recently at MIT, that shows if you read someone's resume on a heavy clipboard, you will be more impressed with it than if you read it on a lighter weight clipboard.
Once you believe that, and I do. Then what can you say about human nature.
Therefore, I am now just one of the "many here among us who think that life is but a joke."
(B.Dylan, All Along the Watchtower)
If 250 years of democracy produces Sarah Palin as a viable political force, isn't that a good joke.
I'm not saying that this is a bad thing. Jokes are good. It is healthy to laugh. Studies have shown that too.
Saturday, June 26, 2010
New Mac
I hope to be posting more now that I have my new MacBook. I can take it with me everywhere and all the time. I was not the only one in the store who didn't buy a new iPhone or an iPad, but I certainly was in the minority. Apple certainly seems to have tapped into whatever is the tempo of the time, or perhaps help create it.
I do not have a Facebook page, partly because I don't want to have to not "friend" clients, and mostly because I don't have any more time. I waste enough writing these rambling thoughts here, and sending them out to people I mostly don't know. If I had to be coherent and stay in-touch with the people who really were my "friends" then it would become a burden.
And who has time for Facebook? Probably many of you do. It's really a generational thing. For us olders, it takes time away from the time wasting habits we developed before all of this instant technology. I still get one weekly and three monthly magazines, and that does not include the professional journals. Those journals are soooo last century. By the time something is submitted, vetted, edited and published, it is either very arcane to begin with, or has been out on the Internet for months, if not years.
I am also on a couple of professional Lists, and they are full of Chicken Little Psychologists who alert me to every possible threat to the profession, possible ethics violation, acts of Congress that need to be responded to ( and I do), and money trends that rumble through the insurance world, none of which have ever been to our benefit. But the information is there, and I have to have it.
These lists also alert me to the exciting new developments that are revolutionizing our profession. Most of them turn out to be clever new words that describe a theory or concept that fell out of favor ten years ago when someone else coined a clever new word for something that had been popular ten years before that. But the information is there, and I have to have it.
I also get many more of my referrals or appointment changes through email, as well as updates from current and former clients -- which I think is helpful and informative, but it takes so much time. I'm not on my computer all day like so many people, because I have to actually sit and talk to people. So, at the end of the day, or when I get home, I have 150 emails, about ten of which are really informative. But it takes a lot of time. So who has time for Facebook?
I get business because of Facebook. Those old high school sweet-hearts seem to pop up just when the marriage is getting very bumpy, and even if nothing actually happens, I hear the phrase "you were talking to HER" much more often in my office now than I ever had in the past.
I know that all of this new "instant" technology has had definite changes in how we think, respond, conceptualize and create. There is a lot of new research going on trying to determine how all of this "screen time" is affecting developing brains. And I'm sure it is.
Whether these changes in the brain will hurt the creativity of future generations, as I have already read somewhere, or does playing video games lead to violence or ADHD, the later of which is certainly possible. It doesn't matter.
From what I saw at the Apple store, being constantly hooked into technology is here to stay, or at least until it is replaced by something lighter, faster and even more omnipresent.
Sitting in silence, staring off into space once was the province of catatonic schizophrenics, but I bet now it will become a luxury, and people will pay $1000 a day to go to some spa in the woods and sit next to a tree, while a highly skilled staff member locks away your iPad for thirty-six hours.
Maybe by next summer I'll have one up and running right here on the Cape. Make your reservations now.
NB: The dog is my grand-dog. She is bigger now and better behaved. Very affectionate, very fast, but a bit skittish.
I do not have a Facebook page, partly because I don't want to have to not "friend" clients, and mostly because I don't have any more time. I waste enough writing these rambling thoughts here, and sending them out to people I mostly don't know. If I had to be coherent and stay in-touch with the people who really were my "friends" then it would become a burden.
And who has time for Facebook? Probably many of you do. It's really a generational thing. For us olders, it takes time away from the time wasting habits we developed before all of this instant technology. I still get one weekly and three monthly magazines, and that does not include the professional journals. Those journals are soooo last century. By the time something is submitted, vetted, edited and published, it is either very arcane to begin with, or has been out on the Internet for months, if not years.
I am also on a couple of professional Lists, and they are full of Chicken Little Psychologists who alert me to every possible threat to the profession, possible ethics violation, acts of Congress that need to be responded to ( and I do), and money trends that rumble through the insurance world, none of which have ever been to our benefit. But the information is there, and I have to have it.
These lists also alert me to the exciting new developments that are revolutionizing our profession. Most of them turn out to be clever new words that describe a theory or concept that fell out of favor ten years ago when someone else coined a clever new word for something that had been popular ten years before that. But the information is there, and I have to have it.
I also get many more of my referrals or appointment changes through email, as well as updates from current and former clients -- which I think is helpful and informative, but it takes so much time. I'm not on my computer all day like so many people, because I have to actually sit and talk to people. So, at the end of the day, or when I get home, I have 150 emails, about ten of which are really informative. But it takes a lot of time. So who has time for Facebook?
I get business because of Facebook. Those old high school sweet-hearts seem to pop up just when the marriage is getting very bumpy, and even if nothing actually happens, I hear the phrase "you were talking to HER" much more often in my office now than I ever had in the past.
I know that all of this new "instant" technology has had definite changes in how we think, respond, conceptualize and create. There is a lot of new research going on trying to determine how all of this "screen time" is affecting developing brains. And I'm sure it is.
Whether these changes in the brain will hurt the creativity of future generations, as I have already read somewhere, or does playing video games lead to violence or ADHD, the later of which is certainly possible. It doesn't matter.
From what I saw at the Apple store, being constantly hooked into technology is here to stay, or at least until it is replaced by something lighter, faster and even more omnipresent.
Sitting in silence, staring off into space once was the province of catatonic schizophrenics, but I bet now it will become a luxury, and people will pay $1000 a day to go to some spa in the woods and sit next to a tree, while a highly skilled staff member locks away your iPad for thirty-six hours.
Maybe by next summer I'll have one up and running right here on the Cape. Make your reservations now.
NB: The dog is my grand-dog. She is bigger now and better behaved. Very affectionate, very fast, but a bit skittish.
Saturday, June 19, 2010
Googlized
I received a big yellow envelop in the mail this week. It was from Google. They congratulated me that the listing of my practice on Google Maps Business was one of the most popular in my area. I am one of only 250,000 businesses in the whole country to receive this distinction. I also received a Favorite Place window sticker to display, with my own QR code right on it, so people can use their phones to go directly to my listing. So many people have clicked on to see my crinkled eye and somewhat smiling face. Several clicked further to look at my web-page.
I need to redesign my web-page. Being an early adapter I put it up in 1999 and have only revised it once when I removed my "Health Care Plan for America." But that is a different story.
Now, I don't know if this is a real honor or if this is a way for them to just generate more money by getting me to buy more services. But why always be so cynical? (Isn't it obvious why?)
Then as I reflected a bit more I became a bit sad: My psychotherapy practice is one of the most popular local business in my area? What does that say about my area? Shouldn't it be a cool restaurant or clothing store, or even a flower shop? Did I out-do Wal-Mart?
How terrible are things that so many people are out there looking for psychotherapists? I wish I could take my honor as a boost for me personally, instead I feel kind of bad for the social state of my community.
I would feel better if more people clicked on the Happy Times Dance Band and Social Club.
But nope, the world wants more therapy.
I need to redesign my web-page. Being an early adapter I put it up in 1999 and have only revised it once when I removed my "Health Care Plan for America." But that is a different story.
Now, I don't know if this is a real honor or if this is a way for them to just generate more money by getting me to buy more services. But why always be so cynical? (Isn't it obvious why?)
Then as I reflected a bit more I became a bit sad: My psychotherapy practice is one of the most popular local business in my area? What does that say about my area? Shouldn't it be a cool restaurant or clothing store, or even a flower shop? Did I out-do Wal-Mart?
How terrible are things that so many people are out there looking for psychotherapists? I wish I could take my honor as a boost for me personally, instead I feel kind of bad for the social state of my community.
I would feel better if more people clicked on the Happy Times Dance Band and Social Club.
But nope, the world wants more therapy.
Saturday, June 12, 2010
Happy Daze
Let's cheer up a bit. If you've been reading along here, you know that I often use this blog to let out my frustrations and exasperations that come with the role that I have chosen to take. But I want to add a bit of balance. It's not all that terrible. The folks I see, and the hours I spend do not make me feel that life is always tragic and cruel. I am not doing this for punishment, nor do I do it to gloat over other people's misery. Also, I can't say I do it for the money, as there are certainly easier ways to make lots more money, although none are more fascinating.
Really, doing this stuff is mostly rewarding, both mentally and emotionally. Being a part of the process of someone making difficult, positive changes in their lives is very exciting and fulfilling. Seeing people treat others better, insisting that they get treated better, and learning to take better care of themselves is exhilarating. It's like watching someone grow-up in time-lapse photography. They are shedding their old selves and grow new, more colorful, creative and successful new ones.
Yes, human life on earth is often unfair, capricious, and even absurd. So, nu? It can also be whimsical, warm and sexy.
Each case is a puzzle that I have to help put together.
A woman came to see me and she was depressed. The puzzle: why is she depressed and what can I do about it? How can we, she and I, rearrange the pieces of her life so that the depression will disperse. Or is it just brain chemistry?
I find out that her mother died when she was six, and two years later her father remarried. He paid more attention to his new wife than he did to her. To me, that is a big piece of the puzzle.
Then we have to see how that affects her now. How does she behave in other relationships? How does she react to loss, or prospect of loss? How much can she trust men? If her father didn't value her enough, how much value does she give herself? Many more.
Then what can we do to change how she feels, reacts and behaves so that things will change? That is the puzzle. I believe that if she changes how she acts and thinks, she will change how she feels. She will change her brain chemistry. I have done things like that. It works. It's rewarding and fun.
Some puzzles I can't solve. I can't get the pieces to fit. Or I think I can get the pieces to fit, but the client doesn't like the way they fit, so it doesn't work. Then I feel as if I didn't really find the right solution.
What do I do then?
I put it in my blog.
Really, doing this stuff is mostly rewarding, both mentally and emotionally. Being a part of the process of someone making difficult, positive changes in their lives is very exciting and fulfilling. Seeing people treat others better, insisting that they get treated better, and learning to take better care of themselves is exhilarating. It's like watching someone grow-up in time-lapse photography. They are shedding their old selves and grow new, more colorful, creative and successful new ones.
Yes, human life on earth is often unfair, capricious, and even absurd. So, nu? It can also be whimsical, warm and sexy.
Each case is a puzzle that I have to help put together.
A woman came to see me and she was depressed. The puzzle: why is she depressed and what can I do about it? How can we, she and I, rearrange the pieces of her life so that the depression will disperse. Or is it just brain chemistry?
I find out that her mother died when she was six, and two years later her father remarried. He paid more attention to his new wife than he did to her. To me, that is a big piece of the puzzle.
Then we have to see how that affects her now. How does she behave in other relationships? How does she react to loss, or prospect of loss? How much can she trust men? If her father didn't value her enough, how much value does she give herself? Many more.
Then what can we do to change how she feels, reacts and behaves so that things will change? That is the puzzle. I believe that if she changes how she acts and thinks, she will change how she feels. She will change her brain chemistry. I have done things like that. It works. It's rewarding and fun.
Some puzzles I can't solve. I can't get the pieces to fit. Or I think I can get the pieces to fit, but the client doesn't like the way they fit, so it doesn't work. Then I feel as if I didn't really find the right solution.
What do I do then?
I put it in my blog.
Thursday, June 10, 2010
Sometimes the Extremes are Real
I deal with a lot of shit that goes on in people's lives: illness, trauma, loss, loneliness, conflict, stress, and more things that don't really fall into categories, just the amazing things that people mange to do to each other. Most of that stuff gets worse over time, as it continually takes up more space in people's minds.
But sometimes awful things happen out side of their mind; just plain awful things that they then have to deal with. Most often it happens to people who already have had awful things happen to them.
This week's example is Marla, a woman I have been seeing for a long time. I began a few years a go with Marla because she had a terrible drinking problem. Her family, who helped create the problem by having a mother who would often promise her that she would amount to nothing, and a father who would occasionally get drunk and try to fondle her.
Marla found that when she drank she didn't feel so bad. Her parents, realizing she had a problem with alcohol, responding by going to court and taking custody of her son. They presented a huge, elaborately exaggerated case, mostly so they could get the child support checks that came for the boy. Marla was send out to find her own way to sobriety and self-reliance.
Once away from her family however, Marla has begun to do quite well. She has been sober for two years and she is now back in college, doing well. Fighting to maintain her low self-esteem she tells me that she knows she is not smart, but she has this quirky thing she does: If she reads the books and goes to class, she does very well on tests. She can't explain it.
Having grown up learning to distrust the people whom you should be able to trust the most, it is not surprising that she has few friends and generally stays away from people. But, over time she met a guy at her all night job, and they became involved. This relationship was in-place when I met her, and it had been going on for years. He seemed to be genuinely caring and committed to her, despite his being married to someone else, and the father to children whom he also cared about. But when Marla was upset he would call me to alert me, or he would bring her to my office when he felt she was in danger of becoming too depressed and isolated.
After years of this, this man, whom we shall call Harvey, began to have an increasing amount of trouble in his own family. His affair with Marla had been known and tolerated, but as his kids grew-up the tensions with them and the rest of the family, and probably others, all seemed to mount. Harvey had once called me but we agreed that since I was Marla's therapist it would be better if he had his own. So I never knew the real details of the stress he was under.
Two weeks ago Marla came to my office, and after talking about her visits with her son she became even more silent then usual. When pushed, she said she had heard from Harvey and he had said that it seemed a good time for them to not see each other for a while. She said that when she questioned him, he then said he was just having a bad day, and things would be fine. But she had not heard from him for four days now and didn't know if she should call him. She knew he was stressed out and she didn't want to bother him, and make his life even more difficult.
Yesterday Marla showed up, a day before he scheduled appointment. The appointment I was waiting for was late so Marla came in, sat down and stared at the floor. "You're not going to believe this."she said.
"Harvey is dead. He was dead last week, that's why he never called. He was dead three hours after I spoke to him."
"How did he die?"
No one is saying. My son is the one who found it in the paper. The obituary only said that he died suddenly.
That can mean all kinds of things. It certainly makes one wonder, but I don't actually know.
Marla said that she knew his father had died early of a heart attack. Maybe that was it.
Maybe.
Marla left the office. She said she was going for a long walk. She has been known to walk twenty- seven miles to deal with her depression.
She called in today to say she was OK. Going to walk in the other direction.
But sometimes awful things happen out side of their mind; just plain awful things that they then have to deal with. Most often it happens to people who already have had awful things happen to them.
This week's example is Marla, a woman I have been seeing for a long time. I began a few years a go with Marla because she had a terrible drinking problem. Her family, who helped create the problem by having a mother who would often promise her that she would amount to nothing, and a father who would occasionally get drunk and try to fondle her.
Marla found that when she drank she didn't feel so bad. Her parents, realizing she had a problem with alcohol, responding by going to court and taking custody of her son. They presented a huge, elaborately exaggerated case, mostly so they could get the child support checks that came for the boy. Marla was send out to find her own way to sobriety and self-reliance.
Once away from her family however, Marla has begun to do quite well. She has been sober for two years and she is now back in college, doing well. Fighting to maintain her low self-esteem she tells me that she knows she is not smart, but she has this quirky thing she does: If she reads the books and goes to class, she does very well on tests. She can't explain it.
Having grown up learning to distrust the people whom you should be able to trust the most, it is not surprising that she has few friends and generally stays away from people. But, over time she met a guy at her all night job, and they became involved. This relationship was in-place when I met her, and it had been going on for years. He seemed to be genuinely caring and committed to her, despite his being married to someone else, and the father to children whom he also cared about. But when Marla was upset he would call me to alert me, or he would bring her to my office when he felt she was in danger of becoming too depressed and isolated.
After years of this, this man, whom we shall call Harvey, began to have an increasing amount of trouble in his own family. His affair with Marla had been known and tolerated, but as his kids grew-up the tensions with them and the rest of the family, and probably others, all seemed to mount. Harvey had once called me but we agreed that since I was Marla's therapist it would be better if he had his own. So I never knew the real details of the stress he was under.
Two weeks ago Marla came to my office, and after talking about her visits with her son she became even more silent then usual. When pushed, she said she had heard from Harvey and he had said that it seemed a good time for them to not see each other for a while. She said that when she questioned him, he then said he was just having a bad day, and things would be fine. But she had not heard from him for four days now and didn't know if she should call him. She knew he was stressed out and she didn't want to bother him, and make his life even more difficult.
Yesterday Marla showed up, a day before he scheduled appointment. The appointment I was waiting for was late so Marla came in, sat down and stared at the floor. "You're not going to believe this."she said.
"Harvey is dead. He was dead last week, that's why he never called. He was dead three hours after I spoke to him."
"How did he die?"
No one is saying. My son is the one who found it in the paper. The obituary only said that he died suddenly.
That can mean all kinds of things. It certainly makes one wonder, but I don't actually know.
Marla said that she knew his father had died early of a heart attack. Maybe that was it.
Maybe.
Marla left the office. She said she was going for a long walk. She has been known to walk twenty- seven miles to deal with her depression.
She called in today to say she was OK. Going to walk in the other direction.
Friday, June 04, 2010
May has ended
May is tougher than you think. It always is. People naturally think that the Christmas holidays are psychologically rough times, and they are, but May is worse.
Why? I am never sure.
My best theory is that, like trees, the sap rises into people's brains and they get all kinds of ideas. In May it gets warm and people begin to act on things they have been thinking about all winter. I live in a climate where we have a real winter. The people here have not all moved down to where the beaches will be covered with oil.
I get more almost suicides in May. More couples break-up for ridiculous reasons, after being stuck together all winter. More bosses screw their secretaries, especially now that Xmas parties are more restrained. More housewives screw the plumbers. (I have two plumbers as clients). More money is spent foolishly. More people who remained sober since Christmas, break-out in May, usually with disastrous consequences.
I'm happy that it is now June. The ledges on the high bridges are empty again. Bring out the BBQ, spend time with the family. Fill up the above ground pool, mow the lawn. Chill out, enjoy the summer.
the "May-nia" is over.
Why? I am never sure.
My best theory is that, like trees, the sap rises into people's brains and they get all kinds of ideas. In May it gets warm and people begin to act on things they have been thinking about all winter. I live in a climate where we have a real winter. The people here have not all moved down to where the beaches will be covered with oil.
I get more almost suicides in May. More couples break-up for ridiculous reasons, after being stuck together all winter. More bosses screw their secretaries, especially now that Xmas parties are more restrained. More housewives screw the plumbers. (I have two plumbers as clients). More money is spent foolishly. More people who remained sober since Christmas, break-out in May, usually with disastrous consequences.
I'm happy that it is now June. The ledges on the high bridges are empty again. Bring out the BBQ, spend time with the family. Fill up the above ground pool, mow the lawn. Chill out, enjoy the summer.
the "May-nia" is over.
Sunday, May 30, 2010
Treatment Failures (?)
I was pleased to see the brief discussion about trying to treat an addict who lies. This is common. Many addicts lie. They lie to themselves, so it is easy for them to lie to others.
In my last post I was not saying that I was angry at this patient for lying to me, nor was I totally surprised. I was disappointed, both in him, for promising to try to to be honest, and with myself, for allowing it to happen again.
It is not very difficult to determine why he lied. He needed letters for his probation officer. He didn't know if I would cover for him, and he probably didn't want to put me in that position.
I probably would not have told his probation officer, at least not before making several other attempts at getting him to change. Then what? I can't be sure. Drinking alcohol, even getting wildly, obnoxiously drunk, is not against the law. But if it is a condition of your probation that you can't drink, then it becomes against the law for you.
We all joined in the cover-up, especially over the last month. Everyone kind of likes this guy. The people who run the alcohol monitoring program liked him, and were also probably sick of him. So was probation. He didn't break any other rules: he showed up to every appointment, he did his community service, he paid his fines, he stayed out of trouble. I think everyone involved (except his wife) decided not to push too much and let it go.
Now he is out of the system. He doesn't need me for letters, nad probation doesn't need me to cover their ass.
Now the qustions are completely different. Does he need treatment? Who determines that? Does he want treatment? That's up to him. Can he benefit from treatment? That depends upon why he thinks he would be coming. Am I the best one to treat him? How can I believe anything he says? How much does that matter?
We still have an appointment set up from before his wife called and told me what she has been living with. If she shows-up for that appointment we will try to answer all of those questions before proceeding.
I'd like to be able to believe his answers. But then, Obama thought he could believe BP.
In my last post I was not saying that I was angry at this patient for lying to me, nor was I totally surprised. I was disappointed, both in him, for promising to try to to be honest, and with myself, for allowing it to happen again.
It is not very difficult to determine why he lied. He needed letters for his probation officer. He didn't know if I would cover for him, and he probably didn't want to put me in that position.
I probably would not have told his probation officer, at least not before making several other attempts at getting him to change. Then what? I can't be sure. Drinking alcohol, even getting wildly, obnoxiously drunk, is not against the law. But if it is a condition of your probation that you can't drink, then it becomes against the law for you.
We all joined in the cover-up, especially over the last month. Everyone kind of likes this guy. The people who run the alcohol monitoring program liked him, and were also probably sick of him. So was probation. He didn't break any other rules: he showed up to every appointment, he did his community service, he paid his fines, he stayed out of trouble. I think everyone involved (except his wife) decided not to push too much and let it go.
Now he is out of the system. He doesn't need me for letters, nad probation doesn't need me to cover their ass.
Now the qustions are completely different. Does he need treatment? Who determines that? Does he want treatment? That's up to him. Can he benefit from treatment? That depends upon why he thinks he would be coming. Am I the best one to treat him? How can I believe anything he says? How much does that matter?
We still have an appointment set up from before his wife called and told me what she has been living with. If she shows-up for that appointment we will try to answer all of those questions before proceeding.
I'd like to be able to believe his answers. But then, Obama thought he could believe BP.
Tuesday, May 25, 2010
Again!!
Over a year ago I posted about a guy I had been seeing for almost two years who got drunk six weeks before he was about to get off probation, scuffled with a cop and ended up in jail for a month or so.
Well, he came out of jail, entered rehab, and went back on probation. In the beginning of his new probationary period he was put into a program that met almost every day, and monitored him closely. He had to stay sober for ninety consecutive days to get out of the program. He failed three times, lasting between fifty and eighty days. After those failures they told him he had to stay in the program until his probation is up, which will be Friday. And it will be Friday.
He has still been seeing me almost every week, and for a while he had been honest with me, telling me when he had been drinking and getting away with it. But over the last five months he had been telling me all the time how much he has learned, how much better his life is, how humble he had become, and how well he was doing with his new AA friends. He told me he was sorry that he had wasted so much of his life; but now he was sober.
I know that he needs me to write monthly letters to his probation officer. So I guess he couldn't risk telling me the truth. We had been talking a lot, especially this last month, about my concern that once he is off probation, and no one is watching, that his urge to drink will become very powerful.
He was very insightful and reassuring. He told me his strategies and back-up plans. He also told me that his wife has been watching him closely, and that she would probably cut him free if he began to drink again.
Bullshit.
Yesterday, I got a call from his wife asking me if it was true that on Friday, the day his probation ends, that I promised him I would get him into rehab.
What?
Didn't I know that he has been drinking about three days a week for the last two months, and that he has somehow managed to stay clear of getting tested.
Oh.
I guess the probation department is sick of him. I can't imagine that a substance abuse program that has someone checking on him one to three times a week really couldn't figure this out --- even if I didn't. They run tests, breath and urine.
I guess they figure that if he isn't in real trouble then his drinking is his problem, and his wife's.
Well, I am not going to turn him in. His wife told me not to call him because her life would be hell, and she doesn't want him to go to jail.
I don't either. And I will try to get him into rehab as soon as his probation ends. And when he gets out, I doubt that I will take him back as a client. I have a tendency, as I have mentioned, to try and bring out the best in people, I have higher expectations for them then they have themselves, and I think that sometimes it frightens them.
Drinking is not against the law. If he gets loud and belligerent and obnoxious, he runs the risk of getting in trouble. He also runs the risk of losing his wife. But he has lost a wife before this one.
Addictions are very powerful. They, whatever substance one chooses, can make you feel better, for a while, then anything else in the world.
That makes the rest of the world so disappointing, and so much more difficult to be a part of.
Well, he came out of jail, entered rehab, and went back on probation. In the beginning of his new probationary period he was put into a program that met almost every day, and monitored him closely. He had to stay sober for ninety consecutive days to get out of the program. He failed three times, lasting between fifty and eighty days. After those failures they told him he had to stay in the program until his probation is up, which will be Friday. And it will be Friday.
He has still been seeing me almost every week, and for a while he had been honest with me, telling me when he had been drinking and getting away with it. But over the last five months he had been telling me all the time how much he has learned, how much better his life is, how humble he had become, and how well he was doing with his new AA friends. He told me he was sorry that he had wasted so much of his life; but now he was sober.
I know that he needs me to write monthly letters to his probation officer. So I guess he couldn't risk telling me the truth. We had been talking a lot, especially this last month, about my concern that once he is off probation, and no one is watching, that his urge to drink will become very powerful.
He was very insightful and reassuring. He told me his strategies and back-up plans. He also told me that his wife has been watching him closely, and that she would probably cut him free if he began to drink again.
Bullshit.
Yesterday, I got a call from his wife asking me if it was true that on Friday, the day his probation ends, that I promised him I would get him into rehab.
What?
Didn't I know that he has been drinking about three days a week for the last two months, and that he has somehow managed to stay clear of getting tested.
Oh.
I guess the probation department is sick of him. I can't imagine that a substance abuse program that has someone checking on him one to three times a week really couldn't figure this out --- even if I didn't. They run tests, breath and urine.
I guess they figure that if he isn't in real trouble then his drinking is his problem, and his wife's.
Well, I am not going to turn him in. His wife told me not to call him because her life would be hell, and she doesn't want him to go to jail.
I don't either. And I will try to get him into rehab as soon as his probation ends. And when he gets out, I doubt that I will take him back as a client. I have a tendency, as I have mentioned, to try and bring out the best in people, I have higher expectations for them then they have themselves, and I think that sometimes it frightens them.
Drinking is not against the law. If he gets loud and belligerent and obnoxious, he runs the risk of getting in trouble. He also runs the risk of losing his wife. But he has lost a wife before this one.
Addictions are very powerful. They, whatever substance one chooses, can make you feel better, for a while, then anything else in the world.
That makes the rest of the world so disappointing, and so much more difficult to be a part of.
Tuesday, May 18, 2010
I let it go on blog day
Today is "blog for mental health day" in case you were uninformed. I expect by now that you have already read countless mental health bloggers. If you want more you can find them today at www.yourmindyourbody.org.
But I don't think they would be thrilled with my post today. You see today I let one slide.
I had just finished a session with Al, who got so depressed because his girl won't talk to him even though he has sent her eleven text messages telling her that he has realized how wrong he has been. he was just a lump of hapless rejection. Of course he has a tough history of parental rejection and oppression going back to when he was three, so this hurt hit him badly.
Then I got a call from Ben. He said left a message saying he just got out of jail, but he wasn't a criminal. He went to jail for illegal gun possession. He had a gun because he wanted to blow his brains out. Then, in jail, he said they put him on the wrong medication and it really messed up his mind. He was looking for help, for the right drugs and for therapy.
Was this true? Is this really what he was seeking? Quite possibly.
But today. I really didn't feel I could offer all that to him. I referred him to the full-service clinic at the other end of my building. They have people who do therapy, give drugs, do home visits, and take his insurance.
Nothing personal, but today I didn't want to do all that.
But I don't think they would be thrilled with my post today. You see today I let one slide.
I had just finished a session with Al, who got so depressed because his girl won't talk to him even though he has sent her eleven text messages telling her that he has realized how wrong he has been. he was just a lump of hapless rejection. Of course he has a tough history of parental rejection and oppression going back to when he was three, so this hurt hit him badly.
Then I got a call from Ben. He said left a message saying he just got out of jail, but he wasn't a criminal. He went to jail for illegal gun possession. He had a gun because he wanted to blow his brains out. Then, in jail, he said they put him on the wrong medication and it really messed up his mind. He was looking for help, for the right drugs and for therapy.
Was this true? Is this really what he was seeking? Quite possibly.
But today. I really didn't feel I could offer all that to him. I referred him to the full-service clinic at the other end of my building. They have people who do therapy, give drugs, do home visits, and take his insurance.
Nothing personal, but today I didn't want to do all that.
Tuesday, May 11, 2010
Falling Down
I continue to be amazed at the growing number of people out there who just can't cut it. It seems that the skills that it takes to keep functioning, productive and effective in our society are increasing month by month. More and more people seem to be getting confused, discouraged, or just plain overwhelmed.
Yes, the people who come to see me have difficulties. That is a given. But at least they are trying to deal with them. But they all bring with them stories of family members and friends who are worse off than they are, and who have become burdens to the families and friends who already have difficult lives.
Much of it is economic, as it is now very difficult to survive with a low-end job. Many, many jobs pay from $8 to $20 an hour. Almost all the service, retail and food related jobs. No one can really survive on that. Maybe if you're 24, and share an apartment, but you can't make a life. Yet, it is difficult work, with only a very narrow path to improvement.
But also the amount of drugs, alcohol, confusion, ineptitude, racial and sex discrimination, that is out there just adds to it all. Every day I get calls from people hoping to find a way to get on SSDI. The demands of a job, a family, and making a life become too much. They just don't want to do it any more. And once you fall behind it is so difficult to catch up. The welfare rules are complex and humiliating. The banks and credit system will screw you once you step into it too deeply, the computer-run bureaucracy, both the public and corporate ones, are impenetrable. People get angry. There seems to be anger everywhere. Changes come too quickly, no one seems to know what's next, or how to prepare for it.
There is a very strong feeling out there that things are not fair, that the rules are different for different people, the deck is stacked, and that there are no longer any standards of morals and justice. That seems to be the feelings of people on both the political right and left, but they each see different enemies.
What I see going on is this: AND I'm the one who KNOWS!
1. America has become much too much about the money. It always has been, but now it is worse and obvious. There is a lot of publicity about people who do not work hard yet acquire unspeakable amounts of money. Some people are just clever, some are heavily leveraged, and many just made money with the money they were born with. But now it is clearer that many people have become rich by bending the rules, a lot. And they get rewarded for it. No one really stops them.
2. People who see this expect that they too should be granted and easy, party, fun-filled life, without working too hard. They resent that they have to work hard every day. They feel exploited and angry. And now, with all of the new technology, everyone expects to be a star. We all have something to say, no matter how trite, trivial or meaningless. We all Tweet, Facebook, blog and YouTube. (Here I am, ranting on!)
But I have so many clients who have kids, brothers or close friends who spend hours and hours on-line, never see the light of day, and can't earn a living. Between Facebook, Pogo, and porn, their lives are complete. But they have no real skills.
Fifty, sixty years ago, it seems to me through the heavy fog of distorted memory, my father went to work eight to ten hours a day, six days a week. He was happy to be making money and have a warm home and a couple of annoying kids. He had come from Eastern Europe as a kid, and he was happy to be safe, and be able to keep what he worked for. He didn't expect life to be easy, He didn't want to be a star. He knew the world wasn't fair, as many of his relatives had been arbitrarily murdered by the Nazis. But he was willing to work, and he took satisfaction from it.
Much of that seem hard to find today. The Mexican, Chinese and Vietnamese are doing our dirty work. So many Americans seem to want to stay home and play video war games. The threat to our country certainly does not come sneaking across the border. It is right here in front of the 54 inch screen.
Yes, the people who come to see me have difficulties. That is a given. But at least they are trying to deal with them. But they all bring with them stories of family members and friends who are worse off than they are, and who have become burdens to the families and friends who already have difficult lives.
Much of it is economic, as it is now very difficult to survive with a low-end job. Many, many jobs pay from $8 to $20 an hour. Almost all the service, retail and food related jobs. No one can really survive on that. Maybe if you're 24, and share an apartment, but you can't make a life. Yet, it is difficult work, with only a very narrow path to improvement.
But also the amount of drugs, alcohol, confusion, ineptitude, racial and sex discrimination, that is out there just adds to it all. Every day I get calls from people hoping to find a way to get on SSDI. The demands of a job, a family, and making a life become too much. They just don't want to do it any more. And once you fall behind it is so difficult to catch up. The welfare rules are complex and humiliating. The banks and credit system will screw you once you step into it too deeply, the computer-run bureaucracy, both the public and corporate ones, are impenetrable. People get angry. There seems to be anger everywhere. Changes come too quickly, no one seems to know what's next, or how to prepare for it.
There is a very strong feeling out there that things are not fair, that the rules are different for different people, the deck is stacked, and that there are no longer any standards of morals and justice. That seems to be the feelings of people on both the political right and left, but they each see different enemies.
What I see going on is this: AND I'm the one who KNOWS!
1. America has become much too much about the money. It always has been, but now it is worse and obvious. There is a lot of publicity about people who do not work hard yet acquire unspeakable amounts of money. Some people are just clever, some are heavily leveraged, and many just made money with the money they were born with. But now it is clearer that many people have become rich by bending the rules, a lot. And they get rewarded for it. No one really stops them.
2. People who see this expect that they too should be granted and easy, party, fun-filled life, without working too hard. They resent that they have to work hard every day. They feel exploited and angry. And now, with all of the new technology, everyone expects to be a star. We all have something to say, no matter how trite, trivial or meaningless. We all Tweet, Facebook, blog and YouTube. (Here I am, ranting on!)
But I have so many clients who have kids, brothers or close friends who spend hours and hours on-line, never see the light of day, and can't earn a living. Between Facebook, Pogo, and porn, their lives are complete. But they have no real skills.
Fifty, sixty years ago, it seems to me through the heavy fog of distorted memory, my father went to work eight to ten hours a day, six days a week. He was happy to be making money and have a warm home and a couple of annoying kids. He had come from Eastern Europe as a kid, and he was happy to be safe, and be able to keep what he worked for. He didn't expect life to be easy, He didn't want to be a star. He knew the world wasn't fair, as many of his relatives had been arbitrarily murdered by the Nazis. But he was willing to work, and he took satisfaction from it.
Much of that seem hard to find today. The Mexican, Chinese and Vietnamese are doing our dirty work. So many Americans seem to want to stay home and play video war games. The threat to our country certainly does not come sneaking across the border. It is right here in front of the 54 inch screen.
Thursday, May 06, 2010
The week of the oil spill
Sometimes it is difficult to even know where to start. It's like getting hit with a rogue wave, knocked down, rolled over, washed out, pushed back and left dazed and confused on a beach six miles away. "What the fuck just happen?"
This week was like that. Maybe because it's May. May is always a volatile month. The sap rises, gets in the brain, thinking goes haywire.
There were so many stunning incidents that it would take pages and pages to describe them all in the complex context that wold give them justice.
Couple #1. After waiting ten ears for him to clean up his act so they could be together. They unite as a loving ecstatic couple,spend three years building a life, learning to trust, and then she cheats on him with a high-powered business colleague. Comes home, cries, asks for forgiveness.
Couple #2. Six months ago, when they were, again, both very drunk, her got into a jealous rage and beat her badly. He went to jail. She got sober and started her new life. She realized he was a liar, a manipulator, and an addict. Without him she was relaxed, competent and sober. I knew what had happened (as I am sure you have also) when she missed her appointment last week. Today her friend called to see if I could get her committed because she was back with him, getting drunk and beaten.
Couple #3. Last year she came to see me to deal with the grief over her son who had killed himself. This year her brother, who had been a nasty drunk for years came to live with her for three months while he went through the dying process. He died last month. Today she called to tell me that the tests on her husband showed that he has lung cancer and it is also in his liver.
Couple #4. They are getting divorced, for many very valid reasons. But he still misses her. He is basically a hapless, inept kind of shelp, but he wasn't going to be passive this time. So he got drunk and tried to come and see her. When the door didn't open he pushed out the air-conditioner and jumped into the living room. But it was the wrong apartment so now he's in jail.
Alice, on crutches, has a spasm, fell down and smashed her good knee and now can't walk at all.
Bruce, just getting somewhat free of panic attacks, took a walk to get outside on the beautiful spring day, see the sun and be happy. He took a deep breath, filled up with pollen, couldn't breathe, vomited, almost fainted, had a panic attack, won't leave the house again.
Carla, who is nuts, just plain nuts, in many different annoying ways, and has been for years, is in trouble with the court for being stupid and annoying. She wants to get a psychological evaluation to prove that she is not nuts. I won't do that for her because: 1. I am her therapist (for the little good does that does for either of us). 2. because I don't want to show her that she is nuts, and 3. I don't do evaluations. So she has been calling every psychologist in the county and explaining, her own unique way, what she wants them to do. Then she leaves them my phone # to arrange the appointment as if I am running a concierge service. I have already received six very confused calls.
Of course there is more, but that is the general flavor of how the week has gone. The question is not Why is this happening? I actually can give very reasoned, precise explanations for all of this. The question is not even, What should I do about this? There are several things I can see I need to do in order to begin to repair the damage.
But really, it's just like the oil spill. It comes from not having a safety valve. It gets into everything. It is so hard to clean up, the effects will linger for years.
It can take 125 years for 500 artisans and craftsman to build a cathedral.
One person can blow it up in thirty seconds.
1.
This week was like that. Maybe because it's May. May is always a volatile month. The sap rises, gets in the brain, thinking goes haywire.
There were so many stunning incidents that it would take pages and pages to describe them all in the complex context that wold give them justice.
Couple #1. After waiting ten ears for him to clean up his act so they could be together. They unite as a loving ecstatic couple,spend three years building a life, learning to trust, and then she cheats on him with a high-powered business colleague. Comes home, cries, asks for forgiveness.
Couple #2. Six months ago, when they were, again, both very drunk, her got into a jealous rage and beat her badly. He went to jail. She got sober and started her new life. She realized he was a liar, a manipulator, and an addict. Without him she was relaxed, competent and sober. I knew what had happened (as I am sure you have also) when she missed her appointment last week. Today her friend called to see if I could get her committed because she was back with him, getting drunk and beaten.
Couple #3. Last year she came to see me to deal with the grief over her son who had killed himself. This year her brother, who had been a nasty drunk for years came to live with her for three months while he went through the dying process. He died last month. Today she called to tell me that the tests on her husband showed that he has lung cancer and it is also in his liver.
Couple #4. They are getting divorced, for many very valid reasons. But he still misses her. He is basically a hapless, inept kind of shelp, but he wasn't going to be passive this time. So he got drunk and tried to come and see her. When the door didn't open he pushed out the air-conditioner and jumped into the living room. But it was the wrong apartment so now he's in jail.
Alice, on crutches, has a spasm, fell down and smashed her good knee and now can't walk at all.
Bruce, just getting somewhat free of panic attacks, took a walk to get outside on the beautiful spring day, see the sun and be happy. He took a deep breath, filled up with pollen, couldn't breathe, vomited, almost fainted, had a panic attack, won't leave the house again.
Carla, who is nuts, just plain nuts, in many different annoying ways, and has been for years, is in trouble with the court for being stupid and annoying. She wants to get a psychological evaluation to prove that she is not nuts. I won't do that for her because: 1. I am her therapist (for the little good does that does for either of us). 2. because I don't want to show her that she is nuts, and 3. I don't do evaluations. So she has been calling every psychologist in the county and explaining, her own unique way, what she wants them to do. Then she leaves them my phone # to arrange the appointment as if I am running a concierge service. I have already received six very confused calls.
Of course there is more, but that is the general flavor of how the week has gone. The question is not Why is this happening? I actually can give very reasoned, precise explanations for all of this. The question is not even, What should I do about this? There are several things I can see I need to do in order to begin to repair the damage.
But really, it's just like the oil spill. It comes from not having a safety valve. It gets into everything. It is so hard to clean up, the effects will linger for years.
It can take 125 years for 500 artisans and craftsman to build a cathedral.
One person can blow it up in thirty seconds.
1.
Wednesday, April 28, 2010
Me, Miners and Goldman Sachs
One of my clients mentioned today that a cousin of his was one of the 25 miners died in the mining accident in West Virginia. He was upset. He was understandably sad and angry.
The implied cause of the accident was that the mining company was a bit sloppy, had been sited for several safety violations, and was basically trying to save money by cutting corners. I also heard on the radio that mining companies try to save millions of dollars in medical expenses by fighting disability claims for black-lung disease and other chronic, degenerative diseases that minors often develop. This seems like a bad thing. Miner's die while other make money.
But who is it making money. Is it he mean, exploitive mining companies, that pay off judges, run the state legislature and extract profits for their shareholders. Yes, it's them. But it is also so many energy companies that use cheap coal to make electricity. Then it is so many other companies who use the cheaper energy in large quantities so they can make products people can afford. It is big-box stores that keep the lights on all the time and sell things cheaper because of cheaper energy. These companies also keep many workers employed, this feeds families and helps the whole economy.
These companies, as well as the energy companies and the mining companies are traded on the stock exchanges. When these companies make a profit, which they can do more easily by cutting costs, such as how much they pay miners, and how much they pay in disability payments, and how much they pay for energy, the shares go up.
Who makes money on the shares? Anyone who owns stock, such as pension funds, mutual funds, and any one who directly or indirectly is saving for retirement. When stocks go up many people have more money. They can spend more money, they can retire more easily and more comfortably (me). Some people can get very rich trading stocks, or derivatives based on stocks (Goldman-Sachs).
So next time you meet a woman who has taught for thirty-five years in Nebraska, and now she is retired and growing tomatoes, tell her to thank the miners who are sick and dying in West Virginia.
People love America because it gives them the opportunity to get very rich. If you are going to live in a society with very rich people, you are going to have to live with many more people who are very poor. How else are people going to get very rich, or even a little rich. It is very difficult to get that way just by going to work every day.
America has been this way since we allowed slavery in the Constitution.
Don't Tread on Me (but you can tread on my miner)
The implied cause of the accident was that the mining company was a bit sloppy, had been sited for several safety violations, and was basically trying to save money by cutting corners. I also heard on the radio that mining companies try to save millions of dollars in medical expenses by fighting disability claims for black-lung disease and other chronic, degenerative diseases that minors often develop. This seems like a bad thing. Miner's die while other make money.
But who is it making money. Is it he mean, exploitive mining companies, that pay off judges, run the state legislature and extract profits for their shareholders. Yes, it's them. But it is also so many energy companies that use cheap coal to make electricity. Then it is so many other companies who use the cheaper energy in large quantities so they can make products people can afford. It is big-box stores that keep the lights on all the time and sell things cheaper because of cheaper energy. These companies also keep many workers employed, this feeds families and helps the whole economy.
These companies, as well as the energy companies and the mining companies are traded on the stock exchanges. When these companies make a profit, which they can do more easily by cutting costs, such as how much they pay miners, and how much they pay in disability payments, and how much they pay for energy, the shares go up.
Who makes money on the shares? Anyone who owns stock, such as pension funds, mutual funds, and any one who directly or indirectly is saving for retirement. When stocks go up many people have more money. They can spend more money, they can retire more easily and more comfortably (me). Some people can get very rich trading stocks, or derivatives based on stocks (Goldman-Sachs).
So next time you meet a woman who has taught for thirty-five years in Nebraska, and now she is retired and growing tomatoes, tell her to thank the miners who are sick and dying in West Virginia.
People love America because it gives them the opportunity to get very rich. If you are going to live in a society with very rich people, you are going to have to live with many more people who are very poor. How else are people going to get very rich, or even a little rich. It is very difficult to get that way just by going to work every day.
America has been this way since we allowed slavery in the Constitution.
Don't Tread on Me (but you can tread on my miner)
Saturday, April 24, 2010
That's the Point!
It is gratifying to see that the dozen or so readers of this blog can see right through the obfuscations and machinations of my often vague and convoluted thought processes. Hey, I am just a psychologist. I am not a "real" doctor.
But, what you have all, in your own way, figured out, the message in my lat post is that, in life, it is the process that counts, much more than the actual achievement.
Yes, it may be great to win the award, but then what. You fade away and there is a new champion next season. You become a has-been and you remember you best days as learning, working, practicing, struggling and improving. That is where life is -- in the struggle.
My patient in the last post, walked such a fine line with such precision, that he reached his goal and then was left without a direction. He was living without a purpose. That is not success. That's why so many people, who have made or acquired so much money, often end up in my office with cocaine problems.
Even this, this very this blog. It has no goal. It is all process. I am grateful for the ten to twelve of you who read it. I am thrilled that you sometimes comment. I write because I am attempting, for basically my own edification, to figure out how the world works and why it works that way. If you guys sometimes want to come along and help point the way, I appreciate that. I can sue some direction.
In truth, I may not reach my goal. Psychology, really isn't like physics; or at least I am not Sir Isaac Newton. Although I am looking, I really don't except that I wil find the four basic laws of human behavior. (Well, there is this Love, Money, Power, Sex thing, but I will get to that in a later post).
It is the search that is intrigUing. It is the process that is captivating, and as long as I have the enthusiasm for it, life is fulfilling.
I hope you find such a purpose in your life.
Also, you probably don't remember the old Ian and Sylvia song that had a line which said something like:
"I am a lonely mistral come and listen to my tale/ all my comrades are insane or else they are in jail...
I have no use for heroes. they are misfits like the rest..."
And so it is...who really, has it figured out.
I mean, besides Sarah Palin.
But, what you have all, in your own way, figured out, the message in my lat post is that, in life, it is the process that counts, much more than the actual achievement.
Yes, it may be great to win the award, but then what. You fade away and there is a new champion next season. You become a has-been and you remember you best days as learning, working, practicing, struggling and improving. That is where life is -- in the struggle.
My patient in the last post, walked such a fine line with such precision, that he reached his goal and then was left without a direction. He was living without a purpose. That is not success. That's why so many people, who have made or acquired so much money, often end up in my office with cocaine problems.
Even this, this very this blog. It has no goal. It is all process. I am grateful for the ten to twelve of you who read it. I am thrilled that you sometimes comment. I write because I am attempting, for basically my own edification, to figure out how the world works and why it works that way. If you guys sometimes want to come along and help point the way, I appreciate that. I can sue some direction.
In truth, I may not reach my goal. Psychology, really isn't like physics; or at least I am not Sir Isaac Newton. Although I am looking, I really don't except that I wil find the four basic laws of human behavior. (Well, there is this Love, Money, Power, Sex thing, but I will get to that in a later post).
It is the search that is intrigUing. It is the process that is captivating, and as long as I have the enthusiasm for it, life is fulfilling.
I hope you find such a purpose in your life.
Also, you probably don't remember the old Ian and Sylvia song that had a line which said something like:
"I am a lonely mistral come and listen to my tale/ all my comrades are insane or else they are in jail...
I have no use for heroes. they are misfits like the rest..."
And so it is...who really, has it figured out.
I mean, besides Sarah Palin.
Wednesday, April 21, 2010
A cause?
Geez, times passes, especially when I do the same thing over and over, so I think that nothing, especially me, has changed.
I first saw this guy almost twenty years ago. He was about 30 then, He was lost and depressed. He was a smart kid, in a good job. His brother had just killed himself, which wasn't helpful, and his father had been very depressed also. So this kid was understandably worried.
I saw him regularly for a couple of years then. He got most things straightened out. Moved on to a better job, and carefully planned out his life. He would come back every two years or so, just to stay on course. I would see him four or five times. His course was very planned and very straight. Understandably, he didn't want to take too many chances, and he like steady reassurance.
He found a good woman. She had a few issues too, who doesn't. But they have stayed together. They never had children, I think because they both felt a bit too fragile. His brother was in the army, and now is "born again." If they talk it is only about Jesus. His sister wandered off into the Arizona desert, smokes pot and strings beads. His parents died about nine and five years ago.
Now he is about fifty. He has lived his life according to plan. He is well situated with a nice home in the city and a nice place in the mountains. He has cut back at work because he has plenty of money, well invested and his work has become very routine. He is good at what he does, but it is very business/business and not very intrinsically, interpersonally rewarding.
So, now what? He is again, kind of lost. He can walk and bike and ski. He can volunteer and teach reading and computer skills, but that attracts a few kids who hardly care. He would like to run kind of a non-profit thing, but they are over-staffed and under funded these days, and he has no experience fund-raising, or grant writing. He is smart enough to learn that, but it doesn't seem like fun.
Now he stays in shape, he's not sure for what. He goes to a lot of fund raisers because people invite him. As I said a few weeks ago: "Life sucks, send a check."
He has not yet found the cause he wants to set-up a web-site for.
"Lost, middle-age, well-off white guys" doesn't seem to have that kind of a pull on the heart-strings.
I first saw this guy almost twenty years ago. He was about 30 then, He was lost and depressed. He was a smart kid, in a good job. His brother had just killed himself, which wasn't helpful, and his father had been very depressed also. So this kid was understandably worried.
I saw him regularly for a couple of years then. He got most things straightened out. Moved on to a better job, and carefully planned out his life. He would come back every two years or so, just to stay on course. I would see him four or five times. His course was very planned and very straight. Understandably, he didn't want to take too many chances, and he like steady reassurance.
He found a good woman. She had a few issues too, who doesn't. But they have stayed together. They never had children, I think because they both felt a bit too fragile. His brother was in the army, and now is "born again." If they talk it is only about Jesus. His sister wandered off into the Arizona desert, smokes pot and strings beads. His parents died about nine and five years ago.
Now he is about fifty. He has lived his life according to plan. He is well situated with a nice home in the city and a nice place in the mountains. He has cut back at work because he has plenty of money, well invested and his work has become very routine. He is good at what he does, but it is very business/business and not very intrinsically, interpersonally rewarding.
So, now what? He is again, kind of lost. He can walk and bike and ski. He can volunteer and teach reading and computer skills, but that attracts a few kids who hardly care. He would like to run kind of a non-profit thing, but they are over-staffed and under funded these days, and he has no experience fund-raising, or grant writing. He is smart enough to learn that, but it doesn't seem like fun.
Now he stays in shape, he's not sure for what. He goes to a lot of fund raisers because people invite him. As I said a few weeks ago: "Life sucks, send a check."
He has not yet found the cause he wants to set-up a web-site for.
"Lost, middle-age, well-off white guys" doesn't seem to have that kind of a pull on the heart-strings.
Thursday, April 15, 2010
polishing a gem.
Sometimes I see people who are depressed, and they are depressing. Blah, blah, blah, the world sucks, people were mean to me, blah blah. Why can't I do things right? My mother...blah, blah, blah.... It can get so bad that a friend of mine, who was a talented therapist and specialized in cognitive therapy for depressed people, left his clinical practice for software development.
But sometimes I get to see a person who should be depressed, but they are absolutely delightful. Perhaps a bit screwed-up, but still, they seem to have overcome a great deal. I saw one yesterday, let's call he Cheryl. I have been seeing her for about two months, and even though her life gets worse, her attitude, her behavior, and her sense of herself (and her sense of humor) get better and better.
She began life with three strikes against her. Her mother was eighteen, tried to raise her for three months and gave her to her sister to raise. Her sister didn't last a month before she left her with her best friend. This woman has mostly raised her, or tired to. But that woman has been through three long-term relationships; one with a drunk, one with a sleaze and one guy just disappeared. Two of them left children behind. During some of the darkest days Cheryl went to live with her biological grandmother, but that woman became very ill and Cheryl was put in foster care. Her real mother got her out and gave her back to the friend who had been raising her.
Not surprisingly Cheryl was not the easiest adolescent to deal with. Beginning at 14 she was drinking and cutting school. Right before she was going to be thrown out she would go back to school and got As. Then she would drop out the next year. At seventeen she got her GED, a boyfriend and an apartment. The boyfriend left so she went back home and began college. She did well in college but was drinking too much so she dropped out, got a job, a new boyfriend and moved out. She threw the boyfriend out because he wouldn't work, and went back home and back to college. She was doing well but still drinking too much so she came to see me. The weekend after our first visit she drank too much, blacked out and woke up in jail.
But now she is in therapy, and she seems to really like it. She said she needed to stop drinking, and she has. Without a license she had to stop going to college again, so she stayed home and began cleaning the house, which her "mother" made her do, and she began to read. Then, when her next boyfriend lost his job, she increased her hours at her job and she makes him drive her to work every day.
In treatment she is delightful, insightful and really funny. At twenty-three she has been through all of this and she has really learned how the world works. She has figured out who she can trust ( not many), how to push back, how to make deals, and how to take care of herself. She rejected three lawyers before she got the right one, got him to take what she could pay, and made a pretty good deal with the court.
My problem is that often, with people like this, I begin to expect too much. You know, I expect her to be in law school when she finishes therapy. I think she should be Mayor. She is wondering if she can handle getting an LPN.
I have to be careful I don't frighten her away. I have to go slow. That way she can make her own decisions about what she wants to do, and I get to hear more of how she describes the world.
I'll let you know when she wins the election.
But sometimes I get to see a person who should be depressed, but they are absolutely delightful. Perhaps a bit screwed-up, but still, they seem to have overcome a great deal. I saw one yesterday, let's call he Cheryl. I have been seeing her for about two months, and even though her life gets worse, her attitude, her behavior, and her sense of herself (and her sense of humor) get better and better.
She began life with three strikes against her. Her mother was eighteen, tried to raise her for three months and gave her to her sister to raise. Her sister didn't last a month before she left her with her best friend. This woman has mostly raised her, or tired to. But that woman has been through three long-term relationships; one with a drunk, one with a sleaze and one guy just disappeared. Two of them left children behind. During some of the darkest days Cheryl went to live with her biological grandmother, but that woman became very ill and Cheryl was put in foster care. Her real mother got her out and gave her back to the friend who had been raising her.
Not surprisingly Cheryl was not the easiest adolescent to deal with. Beginning at 14 she was drinking and cutting school. Right before she was going to be thrown out she would go back to school and got As. Then she would drop out the next year. At seventeen she got her GED, a boyfriend and an apartment. The boyfriend left so she went back home and began college. She did well in college but was drinking too much so she dropped out, got a job, a new boyfriend and moved out. She threw the boyfriend out because he wouldn't work, and went back home and back to college. She was doing well but still drinking too much so she came to see me. The weekend after our first visit she drank too much, blacked out and woke up in jail.
But now she is in therapy, and she seems to really like it. She said she needed to stop drinking, and she has. Without a license she had to stop going to college again, so she stayed home and began cleaning the house, which her "mother" made her do, and she began to read. Then, when her next boyfriend lost his job, she increased her hours at her job and she makes him drive her to work every day.
In treatment she is delightful, insightful and really funny. At twenty-three she has been through all of this and she has really learned how the world works. She has figured out who she can trust ( not many), how to push back, how to make deals, and how to take care of herself. She rejected three lawyers before she got the right one, got him to take what she could pay, and made a pretty good deal with the court.
My problem is that often, with people like this, I begin to expect too much. You know, I expect her to be in law school when she finishes therapy. I think she should be Mayor. She is wondering if she can handle getting an LPN.
I have to be careful I don't frighten her away. I have to go slow. That way she can make her own decisions about what she wants to do, and I get to hear more of how she describes the world.
I'll let you know when she wins the election.
Monday, April 12, 2010
He and She
He came to see me, partly because She sent him, saying that if he didn't get help then the end of their relationship was near.
He is about 40 and has had about twenty relationships, not counting hundreds of one-night stands. But you can't believe everything he says, even He doesn't believe it. He is trying to be honest and build trust. He is sincere about that, even though he has never done it and never really experienced it. His father was basically, in clinical terms, an irresponsible drunk. His mother was chronically depressed and helpless.
According to Him, She is the model of psychological health. Yes, she left her husband of many years to be with Him, so what does that tell you? She is showing him how to be honest and attentive. (Her own mother stole her SSN and ruined her credit) She seems to want his total attention and devotion. She alerts him every time his attention wanders from her. She had decided that he has ADD, because he cannot focus on her as much as she needs.
He is trying his best to stay with her. He takes all the blame. He is in recovery from several addictions. He has learned to take the blame.
She has been in therapy. She has been a therapist. She does not blame, but She has a talent for pointing out causes and giving explanations. Her explanation is that He is the cause.
They are trying hard to make their relationship work -- or are they just trying to score points. I do not count points. I just want them to care and trust and enjoy themselves -- and then get out of my office so that I can rest.
He is about 40 and has had about twenty relationships, not counting hundreds of one-night stands. But you can't believe everything he says, even He doesn't believe it. He is trying to be honest and build trust. He is sincere about that, even though he has never done it and never really experienced it. His father was basically, in clinical terms, an irresponsible drunk. His mother was chronically depressed and helpless.
According to Him, She is the model of psychological health. Yes, she left her husband of many years to be with Him, so what does that tell you? She is showing him how to be honest and attentive. (Her own mother stole her SSN and ruined her credit) She seems to want his total attention and devotion. She alerts him every time his attention wanders from her. She had decided that he has ADD, because he cannot focus on her as much as she needs.
He is trying his best to stay with her. He takes all the blame. He is in recovery from several addictions. He has learned to take the blame.
She has been in therapy. She has been a therapist. She does not blame, but She has a talent for pointing out causes and giving explanations. Her explanation is that He is the cause.
They are trying hard to make their relationship work -- or are they just trying to score points. I do not count points. I just want them to care and trust and enjoy themselves -- and then get out of my office so that I can rest.
Tuesday, April 06, 2010
Neuropsychologists
This is what has bothered me a lot this week. You may not care, but this is my blog so I am going to rant on a bit.
I have a more than the usually weird client whom I have mentioned here before. She seems to have some kind of physical symptoms to go along with her spacial disorientation and hoarding behavior. She sees me, and also attends a day program a couple of times a week. She had been improving in fits and starts and stops since I have been seeing her for a year. The day program thought it would be a good idea to get a neuropsych evaluation done. I agreed. Perhaps they could find something more specific, or at least give some insight.
Over the last decade there has been a huge increase in people who label themselves as "Neuro-psychologists". They are supposed to be skilled at using specialized tests to determine the presence and extent of things such as leaning disabilities, ADHD, dementia, brain damage, and other more physiological causes of psychological distress.
I have only gotten about six reports from such people, and I can't say I've been impressed. First, many of the tests they use are the same ones, or perhaps revised versions of the ones I learned when I was in graduate school in the dark ages. Several are now scored by a computer, but that doesn't really make them more sophisticated.
Of the six reports, two told me nothing new, one was helpful, one was very revealing and two seemed to offer wild guesses at things that turned out to be wrong.
The report on this woman was different. It was insightful and accurate and it offered not only new information but support of things I was not sure of.
Now, that would be good except it was written in a way that just condemned the patient. Some of the scores on some of the tests indicated that she exaggerated or even manufactured some of her symptoms -- which is true. But they wrote the report and called her "malingering" which strongly implies that she is devious and manipulative. Their recommendations were that she be given a few sessions of DBT and sent back into the world. She should not be given other services, they said, because she is a waste of time.
Whoa, this is not a helpful presentation. Here is a woman who clearly has issues. Yes, she is confused and she exaggerates and she makes things very dramatic, but her life rally sucks and she doesn't seem to be getting much pleasure out of all of this.
The report offered no explanation as to why she would do this, or what was in it for her, or how she got this way. They could have said that this was a woman who has more strengths than she uses. They could have said many things that would have been helpful to the treatment. But instead they only wrote about the data. They got their conclusions from the numbers. They didn't think about treatment. AND they gave the report directly to her! That set everything back about six months.
So I wrote to the people who wrote the report and told them that I thought they could have been much more helpful. I tried to be nice about it. I don't know if they will respond.
Psychology has enough trouble being a science; it doesn't have to be mean about it to prove that we know stuff. Not helpful.
I will let you know how, or if, they respond.
I have a more than the usually weird client whom I have mentioned here before. She seems to have some kind of physical symptoms to go along with her spacial disorientation and hoarding behavior. She sees me, and also attends a day program a couple of times a week. She had been improving in fits and starts and stops since I have been seeing her for a year. The day program thought it would be a good idea to get a neuropsych evaluation done. I agreed. Perhaps they could find something more specific, or at least give some insight.
Over the last decade there has been a huge increase in people who label themselves as "Neuro-psychologists". They are supposed to be skilled at using specialized tests to determine the presence and extent of things such as leaning disabilities, ADHD, dementia, brain damage, and other more physiological causes of psychological distress.
I have only gotten about six reports from such people, and I can't say I've been impressed. First, many of the tests they use are the same ones, or perhaps revised versions of the ones I learned when I was in graduate school in the dark ages. Several are now scored by a computer, but that doesn't really make them more sophisticated.
Of the six reports, two told me nothing new, one was helpful, one was very revealing and two seemed to offer wild guesses at things that turned out to be wrong.
The report on this woman was different. It was insightful and accurate and it offered not only new information but support of things I was not sure of.
Now, that would be good except it was written in a way that just condemned the patient. Some of the scores on some of the tests indicated that she exaggerated or even manufactured some of her symptoms -- which is true. But they wrote the report and called her "malingering" which strongly implies that she is devious and manipulative. Their recommendations were that she be given a few sessions of DBT and sent back into the world. She should not be given other services, they said, because she is a waste of time.
Whoa, this is not a helpful presentation. Here is a woman who clearly has issues. Yes, she is confused and she exaggerates and she makes things very dramatic, but her life rally sucks and she doesn't seem to be getting much pleasure out of all of this.
The report offered no explanation as to why she would do this, or what was in it for her, or how she got this way. They could have said that this was a woman who has more strengths than she uses. They could have said many things that would have been helpful to the treatment. But instead they only wrote about the data. They got their conclusions from the numbers. They didn't think about treatment. AND they gave the report directly to her! That set everything back about six months.
So I wrote to the people who wrote the report and told them that I thought they could have been much more helpful. I tried to be nice about it. I don't know if they will respond.
Psychology has enough trouble being a science; it doesn't have to be mean about it to prove that we know stuff. Not helpful.
I will let you know how, or if, they respond.
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