Thursday, November 30, 2006

missed lunch

I missed lunch today at the Four Seasons in NYC. Edgar Bronfman ws there, Nelson Peltz, Henry Kissinger, James Watson and a few others who can take the time away from their desks to rub elbows.

But it's Thursday and on Thursdays I see about ten hours of clients. I learned a few things, caught up on the adventures of what happened two weeks ago, since last Thursday was a holiday. I got to see that some people are really doing better. That helps the day go faster.

Here are a few highlights.

S has a job offer, didn't get drunk at all, and is letting the latest wrong man slip away by not returning his crazy phone messages.

Remember the couple I wrote about on 11/19 with the woman who panicked when she found the photos of her son. Well, the boy admitted he took them, and showed her how he did it. So, good; the father isn't a pedophile. But when she accused him he broke down and said that he had been on the computer, and that he is probably gay.

R was able to get her children to tell their father that they didn't want to go to Thanksgiving with the new woman in his life (they have been separated five months). How could she have ever loved and trusted such a scumbag. She cries.

The smack that went around this city over the weekend was bad. There were twenty-six overdoses and three deaths. D was cooking supper for her boyfriend and another couple when the boyfriend went to the bathroom. Five minutes later he didn't answer the knock. She popped the lock and found him blue on the floor. If she wasn't a nurse he would have been dead. He is still in the hospital. She thought he had been clean for over a year. How do you trust a junkie?

The same:
L called twice to say that there are stains on her coat and another hat is ruined because two of the stitches in the crown seem to have been cut. Why would someone break into her house just to do that. And where did they get a key, even after she had the locks changed?

Maybe tomorrow I will have tome for luch with Sandy Weill and Lou Dobbs.

Tuesday, November 28, 2006

It ain't all roses

This may come as a surprise to many of you out there, but in this job I do here in this cozy meeting room, I have to deal with some pretty weird people. I know, you thought that a job like this would be a good place to influence the powerful and mighty as they come in for their weekly or monthly chat, but that isn't always the case.

Oh, I have seen a few people whose names might perk your ears up, but without mentioning any names, they were drunks. I have seen some lesser lights and local stars, and some of them were pretty interesting, although many were tortured souls.

But, in the course of a day, I spend an hour with one or two folks who are just nuts. They have weird thoughts, they come to nutty conclusions, they don't make a lot of sense, and they tend to ramble on with great intensity, but no real point.

I have to dig deep into my clinical bag of tricks to devise the most effective response.

I often give a long, thoughtful look of deep reflection and then say "That's just crazy shit."

It's not usually too effective, but I feel it necessary to attempt to introduce some reality before the deluge of delusion.

Many of the other people I see are certainly not crazy, but they do seem to like to do weird stuff. but again, after years of clincal experience, nothing seems too weird any more, so what's the big deal.

As long as no one gets hurt -- including me.

I also see several people from very well-to-do families. But they are the losers of the family. Every family has one, some have several. Not all families can afford too many, but some can support two or three generations. Success does not always breed success.

So, here's hoping you are enjoying the holiday season, and for some of you, may the apple roll away from the tree.

Sunday, November 26, 2006

Non conforming, but not

There was the editorial in The Times today by Alan Ehrenhalt about conformity and non-conformity over the last 50 years here in America.

I lived through all that. I never conformed, but you'd never know that just by seeing my life. The sixties hit me about four years before everyone else. I was wandering The Village before I could drive, looking for what was cool, and what was going to change the world. Even then I knew it needed to be changed.

I was two blocks away from Dylan before anyone knew him. I probably passed him on the street. Maybe it would have been something. But since I didn't know what I was looking for I didn't see him. I went to college instead.

I was a writer in college, a maverick, iconoclast. I said sarcastic things that were clever. I was against things that needed to be opposed. But when I saw the line, the other side of which you got your head smashed hard with a billy club, I passed.

Last week, in The Times Book Review they highlighted those who crossed the line early and often. Hunter Thompston, Charles Bukowski, Allen Ginsberg, Courtney Love, and
Al Goldstein were up there, among others. They lived hard. They drank, they wrote, they screamed, they pissed their pants. They often died young.

Bipolar is what they would call them today, if they were unlucky enough to get near a psychiatrist.

I didn't do that. I went to graduate school. I raised my kids.

I sent around nasty notes. I campaigned hard for losing causes. I still tried to offend people when I could, while still keeping the marriage together. I played a lot of basketball without dunking.

Maybe that's why I enjoy so many clients who take it to the edge. I like to help them lean over without falling into the abyss, or maybe I catch them on the way down. I think they know that I feel some hint of admiration for their exaggerated, futile attempts.

The skill it takes to try something real and fail is greater than what it takes to follow the yellow brick road to success.

Friday, November 24, 2006

Papa at Thanksgiving

Almost everyone came for Thanksgiving. The one who didn't make it wasn't really expected, but it was good that we offered. We know how much she struggles and we realize that she has to hold it together any way she can. For the rest of us, the importance was just in being there. We sat together, ate together, and were together at the time when families should be together.

In complicated, extended ways, everyone here was family. All of us are tied together by my daughter and son-in-law. In many ways we are the modern American family which has gone through a process of mitosis and has regenerated laterally as well as vertically. One of those present was there with his four parent, and they even brought a couple of parents of their own. It made for an interesting inter-generational interweaving of bloodlines and fault-lines. The fault-lines have long been sealed over, but the tremors have not been completely forgotten. Still, everyone was warm and friendly, and everyone wanted to be there.

After everyone left, the dishes were put away, the chairs were folded and the leftovers stored, my wife and I took a breath. My wife asked me four times if things went well, and then four times what I thought of it all. Then I went upstairs to listen to the rain.

I read about the neurological arousal systems in mammals, mostly rats.

I read how "an individual's cell firing properties can also change continuously as a result of the state of the sensory periphery, the animal's past perceptual experiences, its internal brain dynamics, whether it is actively or passively sampling its environment, and the animal's expectations for the future.*

The article went on to say that we humans do that to. I was doing that all during Thanksgiving. I was sitting there, sometimes actively, sometimes passively, trying to figure out how I fit into the world and how I should react to it. At the moment my survival did not seem to be at stake. There was no cat chasing me. I was certainly not facing starvation, I did not sense any dangers lurking in the dark as the terrorists and suicide bombers are far away.

I, probably more than anyone at the table was conscious of how much I am plagued by thinking about what I am thinking about (or is it a choice?). I think about my place in the family, and the family's place in the world, and the power structure of the world and its history and its future, and how much of a part we all play in it.

For further clarification and insight I moved next to my ninety-three year-old father-in-law who has had more past perceptual experiences than all of us. I wondered what thoughts were going through his head after having amassed the wisdom of all of those years. His reply, paraphrased, was that he was wondering how much he could eat and when he could go home and rest.

There is an unquestionable basic evolutionary truth in that.

Of course, there is the next question which is: Beyond survival, what?

From watching TV today the answer is apparent -- Shopping.

Wednesday, November 22, 2006


I am off now for the long holiday weekend.
I have seen 24 hours of people in two and half days. I could have seen 100 if I had the time and could keep my head on straight.

Families are such wonderful things. All of December will be packed because of the "holiday season."

Here are some of the things I got to talk about as Thanksgiving approached:

The first Thanksgiving without Mom.

The first Thanksgiving after the divorce

The last one of the marriage, since we are separating after the holidays.

Who do I invite to Thanksgiving since last year one of my sisters seduced my other sister's husband?

I am going to my in-laws, but I'm nervous because my mother-in-law told my husband that for his birthday last month she wanted to pay for a divorce. She always acts nice around me.

I am not going to say anything this year. I am just going to sit and watch my aunts and uncles get angrier and angrier as they rehash the same arguments they have been having for twenty years. I will wait to see who throws the cranberry sauce first.

I am going to stay sober. You'd better or you will end up out on your ass.

I convinced the judge to give me my daughter for the holiday becasue I know my wife and hr boyfriend will be having cocaine instead of turkey.

My recently "born again" mother won't let me in the house because I'm living with my boyfriend. The fact that she had me two years before she was married doesn't seem to matter now.

I'm not letting my kids go with my not yet ex-husband if he has his girlfriend over there.

I have to stay home for the day, otherwise "they" will break into my house and cut the stitching out of the tops of my new hats.

And, of course three people who have no place to go and no one to be with. I know that two of them will get drunk.

I hope things are better where you are. Fourteen people will be squeezing into the little box I live in. I think I know most of them. I hope they feel welcome.

Sunday, November 19, 2006


When I was younger, over twenty years ago now, my office was in a different building with many other kinds of professional offices. As I would come and go I would often notice a woman who was considerably younger than I was even then. I would notice her because she was, well, noticeable. She was the kind of woman who had an abundance of physical attributes as well as a warm and friendly smile, and she carried herself well.

As it happened she worked in an office of a friend of mine and she would answer the phone and we would chat and then we would say hello more often as we passed along the way.

After a couple of years I moved out of that building, and, as is often the case with older men and beautiful young women who turn our heads, I forgot about her completely.

About five years after that she called me, and asked to see me professionally. This of course, ruined all of my forgotten fantasies because once someone is in the "client" category all that training comes into play and there are all sorts of boundaries and taboos that click into my brain.

This woman was having some conflict in her life. She was recently married and she had realized that some of her husband's habits that she had expected to be left with his bachelorhood were still present. The one that bothered her was his too frequent attention to pornography. (Why someone who had this woman for a wife needed pictures was a question that may or may not be clinically relevant.

At that time, over ten years ago, it had to do with magazines and the telephone. He came with her for some sessions and things seemed to be gotten under control. He was pretty open. He had some issues from his passed that he recognized. He had a history of some slightly unusual interests, but certainly nothing I had not heard of from other clients, and he was motivated to keep his wife happy.


All went well for another six or seven years. Then came the Internet and of course the access was too easy. Pictures, moves, some chat-rooms, some dirty-talk, stuff that goes on quite a bit through the use of our amazing technology.

What made things bit worse was that they now had some young children and his doing this in the house kind of freaked her out.

Yes, they were having some difficulties as a couple, the kids had limited their intimate moments, but when doesn't this happen, and money was more of a problem, and he said he just found a way to escape. He assured her that he had never met any real people, and didn't intend to.

Before they had come back to me they had been through several rounds of his promising to stop, but the lure of naked ladies two clicks away was too easy. But now that the kids were beginning to use the computer she couldn't tolerate it.

After being off-line for a couple of months, and being in therapy again they seemed to begin to build trust. He seemed to be under control, and they went away again.

Two years passed until yesterday. I received a phone call from the woman who is screaming and crying. She is going to kill him, throw him in jail, never see him again, get a restraining order. She had found pictures in their digital camera of what appeared to be their eleven year-old son. She was pretty sure it was his naked torso, his back, and then a blurry picture of his behind.

She immediately thinks that her husband has gone way over the line. That the sex stuff has driven him crazy and that she never should have trusted him or believed any of his attempts to make her comfortable. She is furious at herslef for leaving her kids in danger.

This is serious stuff.

Right away I'm thinking that I'm a mandated reporter, I have to tell about child abuse. I have to make sure that the kids are safe. I have to make sure that she is safe.

I ask her if she has talked to her husband or the children and she said no. Her husband is at his office -- he is now a lawyer. The kids are playing with their cousins. She picked up the camera to use it herself and saw the pictures in the memory.

I realize that if we call the cops this man's career could be over no matter what the truth is. So I told her to call him. Tell him to stay away from the house until she calms down and has more information.

I am going over the man in my brain. Did I believe him? Do I trust my clients too much in order to help them feel that someone understands? How could I have missed this? What clues were there? What did I really think? I also wonder why he would have left them in the camera.

She calls him, tells him to stay away. He, of course denies everything, but they all do.

She talks to the kids. Her son looks scared, her daughter clearly really doesn't know anything. She calls her sister. She calls her mother. They attempt to clam her down.

Her husband calls back crying, telling her to try and find the truth. She doesn't know if she can ever trust him again.

Two hours later. When she s going over the pictures, her son seems to be hanging around nervously. He tells her that he took the pictures of himself. He shows her how he did it, and that he didn't know how to erase them. She can see from the angle of the shots that they certainly look like they were done by a 12 year-old, who was holding the camera on himself and thought that a picture of his ass would be funny.

But, what does she do about her trust of her husband? Is there any way she can feel close and relaxed and trusting, or is it all too smashed to pieces?

I think now, pretty clearly, that it was the kid. That answer makes a lot of sense. It also makes everyone feel good, and that can be dangerous.

The consequences of being wrong, either way, are terrible.

Wednesday, November 15, 2006


We, as humans, certainly don't have it worked out yet.

Continuing on this theme of trying to figure out how much we have control over our own lives, one thing that has to be considered is how our hormonal drives make us crazy.

My speculative conclusion, based on repeated anecdotal evidence from my own practice,as well as from observing the people in the rest of my life, is that I see too many examples of the excesses of an evolutionary adaptive behavior.

One of, if not the most basic function we have driving us is to reproduce and to attempt to populate the world with our own progeny. Therefore it is important for the males to attempt to maximize the chances of their babies survival, even at the cost of other men's babies. Perhaps that explains much of the crazy primitive behaviors that seem so irrational and so out of control.

So many men go wild with jealousy once they have become sexually involved with a woman. They become controlling, restrictive, dominating,intimidating, paranoid and often violent. And too often, for too long a time, the women will come to me and say something like "Yes, he broke my jaw, but I still love him."

What the hell does that mean?

The men too, if they come to talk to me at all, will say, "I really didn't mean to hit her, but she wasn't listening." Which means she wasn't obeying his wishes that she give up everything in her life and tend to his needs and insecurities.

This is not just a lower class thing, it happens so often, and to so many couples, especially during those fertile years. Uber-Alpha males protecting their territory, and women being attracted to the scent of the Alpha.

Then, more often than not, when the marriage does end. The men become terrible parents, if they bother to stay around at all. Many of them, not the majority but many, just disappear and go on and get other women pregnant.

I guess the hormonal drive is directed at quantity rather than quality.

It certainly makes for another generation of business for me.

Saturday, November 11, 2006

Gift of Today

Today, up here in the amazing Northeast, was one of those gift days
that you can't expect but you have to take hold of when they appear.
Maybe it's just one of the results of global warming and it is a
harbinger of the end of civilization as we know it, but for today it
was warm and comforting.

We may not get a day this warm until
next April. But it was better than that because the sky had that extra
clarity that only comes with the tilt of the earth that brings autumn
to New England. I wandered down passed the newMcMansion they are
building that is reaching higher than it's neighbors to catch a view of
the water. It is a house that does not belong, should not be built, and
holds no real value except to curse whoever lives there with a life of
tacky egoism.

But once passed that blemish I was on the path of
the scrub-pines that led to the dunes. Up over the little rise and the
water burst visible. The dune-grass is a bright green and yellow, the
sky was perfect and the sea was almost flat. The waves came in
mesmerizing and methodically every nine seconds. They broke from each
end sending an arrow of shooting white curl to a roiling mid-point. The
white gulls sat on the hard packed brown sand where the water hadreceded
and waited for tide to bring in their next meal. One two-masted sloop
boobed halfway to the horizon with two bleached white sails. The sound
of the breaking waves rippled over the smooth stones.

All I could do was watch and nod and smile. It was clear that the earth will
survive all of us and everything we do to it. There will be other
creatures that will thrive on the pollution we leave behind.

Since I am not in Mumbai,Lagos, Darfur or Baghdad I could lull myself into allowing the feeling that allis right with the world. My wife, at this moment is happy, my children are healthy, beautiful and now self-sufficient.

I can survey the
length of the beach and can see no terrorists. That round woman with
the big black dog is kind of frightening, but I am not scared. For a
moment in time, at this spot, the world is good

Friday, November 10, 2006


It's right there on page 98 of "Freedom Evolves" by D. Dennet. He tries, and actually does a pretty good job, of explaining that we, as humans, have free will, but yet, also, our choices are determined by who we are, biologically, and by what we have experienced. The only alternative to that is completely random behavior, and that really isn't possible.

If you are going to be a psychotherapist, or if you are going to be in therapy, then you have to believe this. A large part of the job of being a therapist is to figure out why people are doing what they are doing, even when they say, as my clients did last Thursday, that they didn't mean to behave that way.

Take any confident, healthy 40 to 55 year-old man who has been married for a long time, dangle in front of him an attractive, eager, willing, smitten woman, and he is going to have trouble saying no (right, Bill?). It's partly biological.

But what about free will? Is the poor guy responsible for his behavior?

Of course he is. That's because we, as humans, have the capacity for thought and reflection. We can think about what we are doing AND, what we are going to do. Thinking is an experience. It adds to the long time of other experiences you have had that influence your behavior.

Therapy, to a large degree, is thinking. You think about how you feel and what makes you feel that way. You learn, hopefully, to think more before you act. You learn to make connections between actions and feelings. You learn to anticipate -- which is really what intelligence is all about. So, if you come to therapy you get smarter.

That is why our lives are determined by everything we are and everything that has happened to us, BUT it is still compatible with our having free will, and the responsibility for our actions and decisions.

If you want your life to improve, think about what you are doing. It's that simple.

But, of course, that isn't simple a all.

Tuesday, November 07, 2006

The Answer

Did you vote?

How did you decide? Was it determined by what you knew, what you thought, what happened in Iraq or who your parents were?

In some ways it we all of those. All the experiences of your life, interacting with all of your unique biological physiology, for all the years you have been alive, created that moment in time. Your decision.

Yet, you decided. It was your own decision. Or at least it felt like that.

If I get to know you better, which of course I hope I do, then it probably wouldn't be difficult for me to predict how you voted. Once I know how old you are, where you live, what you do to support yourself and how much money you have, I could take a pretty good guess. These factors matter. That's why some of you received many phone calls and some of you didn't.

If you have read much of this blog, you can certainly make a good guess about me.

So, we are not unique, we are programmed. Our behaviors are set.

Yet, as a therapist I have to believe that people can change. And I do believe that part of the process of therapy is to help people take control of their lives. But how can they do that if everything is lined-up in advance. There is so much that has already gone into you that you can't just turn it all around.

Even if you rebel against that statement, it's because you are the kind of person who tends to do that.

But you can.

Next time I will begin to tell you how.

Right now I will leave you with one word. This is a word I got from Daniel Dennet, who is still one of my favorite neuro-philosophers (although he kind of got too wound-up about religion).

The word is "compatiblist."

Sunday, November 05, 2006


So, I was thinking, why should I just jump up and explain all of human
behavior to the six of you out there reading all of this. Instead, I
will make it a big morechallenging and interesting. I will give you the answer, but you will have to choose the right one, or ones, from the following choices:

1. Their brains made them do it.

2. They are lazy, impulsive and immature

They have no real control of their behavior because they are really
part of a virtual reality that is controlled by computer chips placed
in the back of their necks.

4. Bipolar

5. Even though their behavior is determined by their genetics and their experience,
they can make choices and have responsibility for their actions.

6. Tom Brady

7. You can have free will if you want it; but if bad things happen it's because of circumstance, emotional difficulties, and abuse. Then
it is time to declare that you are an alcoholic and go into rehab.

8. Parts of some of the above.

Friday, November 03, 2006


Yesterday, Thursday, was a busy day for me.. Many people came to visit me in my office and tell me stuff.

One person told me that knew they should stop drinking. So, I said, "Good idea, stop drinking. Ten beers and two shots of Jack every night for thrity-six years is probably not making you fun to be around, and it isn't good for your future health."

A woman told me she thought she should get out of her marriage. The man she loves constantly scrams at her, gets in her face, breaks her dishes, swears at her, threatens her and even brandished a knife. After a lengthy discussion I explained to her how to call the cops and what to expect.

Later, a couple sat before me; the woman was outaged, the man was tearful and full of remorse. "I didn't mean to do it," he said It just happened."

"It just happened!?!" she screamed back at him. "You just happened to be naked on top of a naked woman sticking yourself inside of her? That just happened? You didn't mean it? "

We, all of us, are people. People are supposed to be the most rational of creatures, and maybe we are. But if we are it doesn't seem to be something we take advantage of much of the time.

If we have free will, and we can do what we want, why doens't that first client just stop drinking? When will the second one decide it's time to leave? Why didn't that loving husband realize the consequences of his actions, and act accordingly?

Or, do we really have more in common with ants and homing pidgins and just roll out the behaviors that have been designed by our genetic material?

Where did I get the blogger gene?

I will answer all of these questions soon, meantime, talk among yourselves.