Friday, March 30, 2007


Ever have a panic attack? Doesn't seem like fun. Many of my clients have them. It's a big seller for me. I've done some training with one of the big researchers in the field so I have some treatment protocols mapped out. One of the universities that trains young and promising psychologists sends me their failures. It gives me a chance to add a few wrinkles and modify the treatment to meet specific needs. One of the good things about treating panic attacks is that the treatment works and people get better. That makes it more fun.

Jimmy came to me after he had seen another therapist. I like that; it gets my competitive juices going. I can strut my stuff; a couple of backhands, a few reverse jams, and he'll be all better.

He had taken a new job in September and was meeting his sales numbers. He also had just gotten married and was looking for a house. His mother had become sick. But he had always been very competent and always been an achiever so he could handle it all.
But then he got sick and nauseated. He was afraid he was going to miss work so he went to the doctor. The doctor gave him Compazine for the nausea, which wasn't a good choice.

Two days later he had an allergic reaction to the Compazine and all his muscles began to tighten up. By the time he got to the phone he could hardly move his jaw to talk to the emergency people. But the paramedics knew right away what it was and two days later he was fine.

It wasn't until two weeks after that when he thought he was getting sick again that he had his first panic attack. As is usually the case, he didn't know what it was and he thought he was going to explode or die. It's not fun to have your heart pumping and your mind racing and be breathing so quickly and be sweating and feeling so weird.

By the time he reached me he as still having them once in a while, but he was thinking about them with fear and trepidation almost all the time. That was in December. By early March we had reached the point that the only thing that bothered him was the idea that they would come back. He was not having any attacks, or much anxiety at all, and he was doing all of the usual things he liked to do.

I spread out the frequency of our meetings because I wanted him to start to think of himself as well. He did fine for a while, but then he called and said he woke up in the middle of one night in a panic. I talked him back to being OK, but he was very upset: his fear was realized and they returned.

He canceled his next appointment with me and told me he was going to try EMDR. I don't know if you know about EMDR, which is Eye Movement Desensitization and Reprocessing. To me, it's kind of sketchy, but you can look it up on Wikipedia and decide for yourself.

Anyway, a week later his wife calls me, and even though I can't really talk to her, she tells me that the EMDR lady isn't doing EMDR but has two new diagnoses for Jim and wants him on two more medications. Not good.

I will now have to undo someone else's work. You see, if your body feels that it has been traumatized, as he was when he couldn't move with the Compazine, it doesn't let you relax for a long time. Your defenses are trying to protect you from the danger you experienced, even if it isn't really there any more. but you remain vigilant. Even your thoughts are watching for danger. That was all that Jim had left. But he wanted to be ALL Better. He wanted to not even think about it.

But, you can't check to see if you are thinking about it or not, because then of course, you are thinking about it. Jim is going to have to slow down and learn to believe he is going to be better. He has to learn to not be afraid of his thoughts. You can't rush Mother Nature.

However, you can have a pizza and a beer and watch the Final Four and let it go at that.

Wednesday, March 28, 2007

just folks

Just writing this blog has made it even more apparent to me that the idea that people are anything close to being rational creatures is ridiculous..

Ask anyone to explain their behavior and what you really get are a bunch of excuses and a string of semi-coherent rationalizations.

We live mostly on instinct,hormones and emotion.

I was sitting in the third session with an interesting middle-aged man who came to me because of the constant anxiety he was feeling about losing his job. We discussed how difficult it could be for someone to be able to keep his mortgage payments going, and pay for college if his company was bought and moved far away.

He talked about long-standing feelings of anxiety. As we dug around in his past he remembered some incidents he had never spoken about to anyone. The times that his father would come in to his room and help him masturbate were some of his fondest memories of their father-son relationship. He was certainly not traumatized by this. Yes, it had an influence on his life, especially how it affected the things that turned him on sexually, and that was sometimes a problem now, as he seemed to really enjoy things that were not the kinds of things he wife enjoyed. But, now there is always the Internet to keep him happy.

He admitted that his sisters did not feel as warmly towards their father. He had come into their rooms also. The things he did with them, my client admitted, affected their lives, and their sexual adjustment also.

But, by now everyone's come to terms with it. The old man is dead. In his last years he admitted that maybe he had gone a bit too far, but he really meant no harm. He loved his family. They loved him, kind of. He was a good provider. Nobody's perfect.

The really sad thing about this case is that it didn't surprise me at all. So many times people will do what they feel like doing and explain it, mostly to themselves, later. I know what that feels like. I bet you do to.

We do it because it feels like we should, or just because we want to. Then we explain it. Hopefully we learn from it. There is a small part of everyone's brain that is rational. Sometimes it helps. Often it doesn't.

Tuesday, March 27, 2007

Pow, Biff, Bang, Pow!

Another attractive couple, both in their mid-thirties, three boys in their teens. They both had good jobs with big corporations. He came in with a smirk that indicated he was braced for what was to come. She already had tears in her eyes.

Fifty minutes later the smoke was thick from all the shots fired. Each was emotionally bleeding from the same wounds that had been opened over and over and never had a chance to heal.

It seems she had very strong reasons to believe that he cheated on her with a woman he had worked with. He admitted that he had been "over-involved" with this woman for several months, but that he had never done anything that he couldn't live with, and anyway, whatever it was ended in February of 06.

She was still thinking about it as if it were this afternoon. She brought out a copy of his cell-phone bill from December of 05.

He brought up long-standing issues of her sexual and emotional indifference. He make it clear that he has always been the more involved parent. She agreed that he was a good father, but she was saddled with the responsibilities of a sick mother and a dysfunctional sister.

I kept asking them what they expected me to do. I told them that if they wanted someone to tally up the hits, then that wasn't my job. If they came because they wanted to stay together, I could see that they both still, in some ways cared about each other. But, each had been hurt badly, and that we would have to find a way to build some trust.

She said she didn't think she could ever trust him. He said there was nothing more he could say that would change her mind.

I told them that if they needed to say that they came to therapy to give it one last try before they gave up, then I would right them each a note saying they tried.

I told them to call me if I could be a help in their staying together or breaking apart. I told them that if they came to see me two years ago maybe there would have been more flexibility. They both had come from complex backgrounds that had led them into this kind of a relationship, but it would take months to sort it all out, If they wanted wanted to go that route then they had to be willing to hang in there and show some patience and tolerance.

Again, I told them that I could never, and would never try to figure out who was right.

I don't expect a call.

I have one plant that has been with me in whatever office I've been in for over thirty years. It grows sideways on two big stalks. It's some kind of an ivy but I treat it like a bonsai. It has certainly heard a lot. I often wonder how it survives.

Sunday, March 25, 2007

not fast but . . .

The weekend is over and I am trying to get my head back in shape to go back to work. It is slightly more difficult because last week I was a little sick and had a slight fever. That was good because it seemed to make everything a little more intense. It was kind of fun, except for the feeling sick part.

But I'm better now, so I will have to use my regular brain. A little caffeine is all I can add, and I can't do too much of that or I have to go sprinting down the hall between sessions.

One thing you have to have if you are going to last in this business is patience (and patients too, ha ha). I have been seeing the same woman in my first hour of work each week now for just under two years. She is a great client; she works hard, she has a family history that crippled her early on ( hers was one of the mothers I highlighted).

Change comes slowly. It's true of all of us. Brains seem to get stuck. They seem to like to do the same thing over and over. I think there are parts of our brain that let us know that if we are not dead, or in great pain, then what we are doing must be working, so we keep doing it. It's difficult to stop.

I can see it in my own habits. I have about four or five patterns in my life that vary very slightly. Each time I move from one to the other I get the feeling that I have discovered something brilliant. Eventually I realize that I have discovered it two-hundred times before, but even a very slight changes seems drastic.

In two years this woman has done over fifty things she had never done in her life. She shops in new stores. She doesn't flirt with a man if she wants something, she asks for it, She treats herself to a new music CD each month. She is enjoying her life a bit more. She tells me that these changes have been the source of new feelings of hope and accomplishment.

Sometimes, doing therapy is like watching global warming.

Friday, March 23, 2007


This week I saw members of two different families in which the mother clearly traded in the father for the son as her primary support person. This is not a good thing for any and all concerned. It tends to create anger, stress, acting out and general weirdness.

But, I began to think about something I read this week in a chapter that was discussing, of all things, Hegel. The sentence was that "There is a profound difference between explanations based on causes and explanations based on reasons."

A long time ago, when I was entering into this field, it was philosophy that formed much of the basis for underlying interventions in therapy. The best therapy had to do with a quest for a "good life" and a quest for a "truth." I spend years talking about reasons. I wanted to know not just what made things happen, the cause, but why things happened -- the reason.

I do not feel that as strongly now. I have come to feel that reasons, if there are any, seem to be made-up post hoc. When you sit down to figure something out, it is more often you are just making it up. It could be anything, it could be nothing; it doesn't matter.

Yes, there is a cause. In these cases it will prove to be that something was missing in these women's lives, and they didn't get it from their husbands, or maybe they had gotten it too much from their husbands, but that may or may not matter now.

It is romantic and fulfilling to think, as many of my clients do, that "everything happens for a reason." But I have found that if that is so, then the reason is beyond my ken, and that my looking for it is just a work of fantasy. That level of reasoning won't help solve the problem.

A more mundane, hopefully more empirical, causal explanation sometimes will help.

Tuesday, March 20, 2007

Me and Max

First of all, I wasn't feeling that great. I had spent many hours this weekend helping my niece with her one-year old kid. The kid wasn't feeling too well. He was throwing-up and shitting all over me. But he was sweet and soft and he cuddled up to my shoulder and let me feel parental once again.

That's fine, but by Monday I was enduring some of the same symtoms, so by the time I saw Max was in no mood to be too understanding about stuff that is incomprehensable, and inaccurate.

He came right at me, saying I had upset him last time by telling him he had over-reacted to a woman he had met on-line. He felt that what she said to him would upset anyone. But I countered quickly by saying that in the scheme of his life, any conflict he ges into with someone he has never met shoud not take up sixteen seconds of his energy when he is faced with the huge task of getting every aspect of his shit togeher. I told him that, as his therapist, I am professionally disgraced by his lack of progress. I will not agree to collude with his crazy ideas.

This insulted him ( a blow to his narcissism) and he said that he was always proud that he never had crazy idea. He was in very good touch with reality. He knew what terrible shape he was in, and that was why he often thought about suicide. (Trying to pull out a trump card).

But I know this guy is too much in love with himself to every do himself any harm. So I agreed that he had an accurate perception of what was going on, but he had no idea of what he was going to do about it. If the bus is coming, and you see that the bus is coming, and you don't get out of the way, then you're not going to do very well.

So he cracked. He agreed that by next time he would have two short-term and one long-term goal listed on a piece of paper, and we would work, in a very structured way, about how to reach those goals.

BUT, he is not one to capitulate too easily. He called today to ""check" on when his next appointment was. He asked if maybe we could move it back because he already having trouble getting started. I told him he either came in with the list, or with a good understaning of why he couldn't do the list, or he didn't have to come back at all.

We shall see. He may punish me and not come, but I don't think he will give up so easily.

Sunday, March 18, 2007

Max's date with destiny

Tomorrow, in the middle of the afternoon, there is a good chance that I will fire one of my clients. Unless he agrees to work with me, and to do some work, I won't be able to see him anymore. The way things are now I will either have to scream at him, or punch him in the face.

It's not pretty when you get an old man angry.

The guy comes in almost every session, for five months, and then a break, and now for another three months, and tells me that I shouldn't lecture him because he knows what he did wrong. Then he gives he six or eight reasons, excuses really, why he couldn't do it right.

Do what right?

Get a job, keep a relationship, clean his apartments, not take money from his mother, not feel unfairly rejected by his friends, his relatives, his lawyer and his ex-boss.

His mother died when he was eleven and his father was more interested in his new girlfriend than he was in this son. That's too bad.

But now he is 53; it's time to get over it.

He got fired unfairly. That's probably true. The reasons they gave him were not good ones, but they probably couldn't stand having him around. So he got a lawyer and sued them. But the lawyer wasn't good, because the lawyer didn't call him back more than three times when he decided he was too depressed to state his case.

When I told him that wasn't the lawyer's job he got furious with me.

If he really was depressed, I could deal with it. But he just comes in and whines, and then tells me that I am not allowed to tell him he is whining.

Well, that's not therapy. Tomorrow he either agrees to set goals, take responsibility, and work towards those goals, or he can find another box of tissues.

As Dorothy Parker said when she was asked what she knew about horticulture:

"You can lead a whore to culture, but you can't make her think."

Friday, March 16, 2007


I must admit that Eve is an attractive woman. I also know it's a bad sign when I notice that a woman is attractive because it usually means that the woman doesn't know how to turn it off.

I mean, I see many attractive women (and that makes it more fun) but their appearance very quickly fades as part of what is going on in therapy. I almost always focus on what is going on psychologically. I couldn't work unless I could do that. The times when I get distracted, I know that the woman continues, almost always unconsciously, to be somewhat provocative.

Anyway, Eve was seeing me after coming out of detox. She went in because she and her sometime boyfriend had spent the last two weeks partying, and she couldn't take it anymore. When she came out she told him, Bob, that they she couldn't see him if they were drinking. He agreed.

But they went out again, and they got drunk for the whole weekend. Eve came home and went next door to an older man, Carl. He took her in, put her in his spare room, gave her some Atavan and she recovered.

The next weekend, in order to stay away from Bob, she went out with Dan, who was rich, and didn't drink much. She did OK, but was bored.

A week later Bob came back and swore that he loved her. She knew she loved him. Five days later she was back in detox.

She came out, convincing the doctors that she finally knew better. She was home one day when Bob showed up. He promised he wouldn't drink again and to show he loved her he gave her a two thousand dollar ring. He said if they were still together in a month he would buy her a real ring. She ran to Carl's house, crying. Carl took a four thousand dollar ring out of a box and told her he had always loved her.

Eve went home, stunned. She answered the phone. Dan was calling from Chicago. He said he had been thinking about her for weeks. He was flying home and going to bring her the ring he bought. He would save her from all her troubles.

Eve sat in my office and told he all this yesterday. I couldn't have made this up. The details are even more ridiculous.

After she showed me the two rings, nice big rocks, she kept saying, "Come on Dr. T. this isn't funny."

But, it was.

Wednesday, March 14, 2007

Why is Lisa like this?

Today, Lisa talked some more of how and why she has always felt different, different from everyone, even those in her own family. She was the third of four children and she remembers that as early as when she was three years-old she could see that her brothers and sister could have fun. They would laugh and tease each other, but she was always sad. If someone teased her she never said anything in return, and then would cry all night.

She cried when she first went to school. She sat by herself most of the time and wouldn't make eye contact with the teacher. She could only have one friend at a time, and by the time she reached high school, that was too many.

She spent her days in high school walking through the halls with her head down so she she didn't have to look at anyone. It was then that she learned that when there are too many people around and the anxiety kept rising, she could count to 100, and by the time she finished she would probably be safe.

She decided that in order to avoid attention in high school she would do her work perfectly so that the teachers would not have to check on her. She was often up until three in the morning doing homework. She checked it and rechecked it six or seven times. She got all As and never said a word.

To take a break, after school she would get on a city bus and ride it to the end of the line. Then she would get out and walk home, from wherever she was. It was usually a three to five hour walk. If someone was walking towards her she would cross the street.

She went to the local college but the pressure to stay perfect kept building. Being in college she learned to drink. She found the drinking relieved her anxiety. She was mostly drunk for the next two years. Being drunk allowed her to let herself do things she had only read about. That's how she got pregnant.

She dropped out and moved home. Her mother again took very close control of her life. Now, because of coming to therapy, she has stayed sober and moved out with her son. She gets money from disability (SSDI) to pay the rent. That is supplemented by some money she gets from her lover, who is married, but comes a couple of times a week. That is the perfect relationship for her at this time.

Clearly, explaining what is wrong with Lisa begins with assuming that she is constitutionally, physiologically, different from most people. Somewhere in her there is a heightened sensitivity, and much stronger vigilance than in almost everyone you know. Yes, it was exacerbated by her chaotic family, her alcoholic father, her controlling mother, her attacking, sometimes violent brothers. But there is something in Lisa that really is different, and that he needs to learn to control.

She has been on all kinds of medications. Most of them slow down her scary thoughts, but they slow her down too. She gains weight and she gets very tired.

It is it just in her genes? Or how the DNA was expressed through RNA given her living conditions? That seems more like it. It is always an interaction between who someone is physically,biologically and genetically, with what perceptions, sensations and interpersonal connections happen to them. But sometimes, much more rarely than the drug companies want you to believe, the balance is way over on one side.

From much of my reading I would say it may have something to do with the formation and development of her amygdala. There are many people doing a lot of exploration into what this area of the brain does, and how it does it. But it going to be a long time before I would let anyone mess with my amygdala.

Still, with insight, support and practice, change will take place. But for Lisa, the sensitivity will never go away. Probably, Emily Dickinson was that way too.

Tuesday, March 13, 2007

Watch you step

Now that everyone has met each other, it's good to know that this virtual life has so many layers of benefits to everyone. It's been interesting to me, just to watch where my mind goes, and then to be able to read what everyone else is experiencing. It adds so much to the sense of how complex and varied our species is. New careers, new jobs, old friends, childhood memories, histories, alcohol, bad boyfriends,drawing, pictures, poems, the whole spectrum.

And I don't have to take care of you.

But I have learned many things, just in the two days I've been back at work this week. I'll stick with one message today, as I've been told that this is a blog, and the average attention span given to any one blog is about two to three minutes. Which is fine, because that' probably true for me too.

So today's lesson is this: Don't fall behind. Don't make too many(and sometimes one is too many), major mistakes. Because here in this country, at this time, with these attitudes, once you're a step behind, you're fucked.

I see guys in their fifties who have lost their job, partly because they were just in the wrong place, partly because they were a step too slow, partly because they made a bad decision, and that's it for them. They'll never get another good job like that. Their savings will be shot, their lives will be completely altered.

Don't put yourself into debt. Don't get sick. Don't go crazy. Don't let your divorce ruin your career. Don't let your career ruin your marriage. Don't let your addictions ruin your marriage and/or your career. Don't get a DUI. Don't get a felony charge, or even hang around with people who do. Don't look like a terrorist.

Once you get way behind the eight-ball, even your therapist is going to have difficulty getting you back in shape.

This country doesn't care. It seems to feast on the weak and the poor. The decks are stacked in favor of the banks, the bureaucracies, the institutions and the insurance companies. Usually, the only thing you can fall back on is inherited money. If you don't have a trust fund, get used to riding the bus.

Most of the people I see in this category are good, hard working, caring, well-meaning people. But this society is very unkind to the slightly inept. There is no safety net, there is no compassion, there is no real generosity. And it isn't that people are mean, it's just that everyone is frightened to take the time to care, because that may just make them break stride, and next thing they know they have fallen step behind themselves. The pressure is always looking over your shoulder.

The only real solution is to do two things: Plan for contingencies, and don't get too caught up in the American race to nowhere. Both of these can relieve stress, free-up time, and allow you to do what is important in life:

Have fun. -- in a nice, jovial, environmentally friendly, socially constructive, inter-personally supportive, clever, inventive, creative, expressive kind of a way.

If you can run your own life and ignore the pressure, then you will have time and space in your head to care about those around you, and then you will be a blessing to the world. (But you won't be compensated in American dollars)

Saturday, March 10, 2007

New Bedford

I do't usually get too political on this blog, except for a couple of shots at the government, which is currently of very poor quality. There are thousands of blogs that are doing a good job of pointing out how terrible the Bush administration is, and the wide-spread consequences of its actions.

But, something has happened fairly close to where I work that must be mentioned. I am drawing attention to it as a psychologist, and to show the deep and harmful impact of a stupid act of "justice."

This week over three hundred federal agents marched into New Bedford MA and raided a factory in which many of the people working there were undocumented as to their immigration status. They arrested 350 people, almost all of them women, put them in handcuffs and shackles, stuffed them into buses, took them to an old army base, and from there flew most of them to detention camps in Texas and New Mexico. Left behind were hundreds of children, most taken into custody by DSS. Most of these children were born here, and hence are American citizens.

I wrtoe last time about how some mothers do not live up to the ideal that we think of, and that can have grave psychological consequences. But when a government, my government, decides to tear families apart, to take mothers away from their young children, it is the government that is creating long-lasting problems of abandonment, distrust, childhood anxiety, PTSD, powerlessnes and an anger that will lead to future behavioral problems.

And this was done, why? To protect us? From seamstresses? From women who had been exploited by the factory owner? Yes, the factory owner was arrested, but he is out on bail. That option was not give to the "illegal aliens."

It is a disgrace that this current administration again chooses to sweep down on the poorest and most defenseless among us. They do this again to create the sense that their is an enemy in our midst and that we constantly be on the defensive. They did this to win their elections. They scare us away from looking at what is happening.

Of course, they haven't caught the real enemy, and they haven't even told us why we are at war in Iraq. But now, in Massachusetts, they are crushing Hispanic seamstresses and ripping families apart, just like slave-masters 200 years ago.

The least we can do is be an outspoken witness to this act. Let you government know that this is not the America we are supposed to send our troops to die for.

Friday, March 09, 2007

Thrusday's mothers

I was going to write about Bill, but he can wait.
I came home last night really struck by the current state of motherhood, or at least how the previous generation conceived of the role -- or even the way they continue to carry it out.

I saw many people yesterday, and with almost all of them some interactions with their mother came up, either something recent, or in the past. Of course I do that a lot in psychotherapy because it is your parents who play a large role in how you begin to think of yourself, and in how you first think the world works.

I have taken just five of the mother's discussed to illustrate what I mean:

Mother #5
This mother was working part-time as an office manager for her daughter. The daughter was running around a lot trying to sell stuff. She had had a lull in the business but then had a good month and made sales. But she needed a couple of new machines in the office to make it run better. Being a little short on cash she used a credit card that she holds jointly with her mother. She charged up about $2500 and figured she would pay it back when the money from the new sales came in, about six weeks to two months.

The bill came to the mother, which was a surprise to my client. Two days later the police came to the business and arrested her for fraud. She didn't know what they were talking about. Her mother, when confronted, said that her daughter had not properly informed her of the transaction.

Mother # 4
This also happened last week. One of my clients is recently engaged for the second time. Her parents came up from Florida and her new future husband wanted to impress them by taking them out to a nice dinner. After a couple of drinks my client's mother turned to her next future son-in-law and said. "You know, Sally's last husband left her because she cheated on him. I hope she doesn't do that to you. You seem like such a nice guy."

Mother #3
My client has been sober for three months now. He is still living back at home since his divorce. He has found a good job in a bank and has been there over a month. He came home late Wednesday night after a meeting. As he walked into the house he was greeted by his mother. She offered this for support:
"Now you think you're mister fancy-pants because you have a dress-up job. Well, you're still a drunk to me, just like your father."

My client was cool, and responded, "I'm glad you don't drink Ma It would probably kill you after six or seven Oxyies.

My client was remembering coming home from Jr. High. He had moved to a new school and was having trouble making friends and with some of the work. His mother had been a very smart woman who had helped him with his homework in the early grades. But now when he came home she was usually walking around the house with a hammer trying to find where the voices were coming from and to kill them. He said she smashed half a dozen TVs.

And Mother #5
My client still has panic attacks. She ran into her mother who still tells her just to get over them. The mother told her that she has been telling her that since she was a eight years old and would spend hours being scared and crying. The mother pointed out that their was nothing to be afraid of, and that my client was alive and healthy and had wasted all that time being anxious.

My client pointed out that what scared her was being left alone all weekend when she was nine, and having to cook and take care of her younger sister and brother while her mother when off with different men.

Her mother answered that she had always asked her if she wanted to come, but she never did.

I can list many fathers who are no better.

Wednesday, March 07, 2007

and Work

It was Freud, someone who is rarely quoted these days, and with good reason -- mainly because he was a bit of an egotist and a pervert -- who said that the definition of a healthy person is one who can work and love. I agree with him on that.

I have spent many posts on this blog giving examples of how people seem to screw up their lives looking for love in all the wrong places, but recently I have noticed a strong trend in my practice of how the stress of work is shattering people's lives.

Today I was sitting with Jake, who is twenty-eight. He is a good looking former basketball player for a small school. He is from a family of divorced parents who both worked hard and still love him, but they couldn't pay for all of the ridiculous costs of higher education and so he has several thousand dollars in loans to repay. He has been living with Shelia for over a year and she wants to get married.

He is very uncertain about marrying her at this time. One reason is that their sex life has greatly diminished. She says that is happening because she hardly sees him, and when she does finally see him all wants to do is grab her, and she doesn't want to be treated that way.

Jake says he understands how she feels. But he doesn't see her because he is working fifty or even sixty hours a week. He feels he has to do that if he wants to keep his job, and that he has to keep his job if he wants to get married. What worries him the most is that even when he works fifty-five hours a week and then pays rent, his car loan, car insurance, student loan, cell-phone bill, internet bill, laundry, one pizza, and five cups of coffee he is already $200 short. He would like to take Shelia out for dinner, but he doesn't have the time or the money.

Shelia only works forty to fifty hours a week. She doesn't make as much as Jake, and she is looking to him to make it all happen, while still paying attention to her, and then get married, buy a house and have a baby. Shelia says that and then goes to get her nails done, puts it on the charge card and owes $8000.

Both Jake and Shelia feel they have been sold an empty box called the American Dream. They feel they are doing their part, but getting screwed for it. Shelia has already had the experience of getting laid-off from a job with a big company. That company doesn't exist any more because it was bought by a bigger company for $8.7 billion. Many people got rich on that deal. Shelia doesn't know any of them. She and the twenty people in her department got laid off.

The stress is a lot for those kids. They are in a stage of their live that should be pretty care-free and a lot of fun, but all they can think about is money, and how they don't have it.

I saw Jake at noon. He came over on his lunch break and had to get back to work before anyone missed him. Usually he has lunch at sales meetings. At one o'clock I saw Bill, who is fifty-two and more frightened than Jake. I'll tell you about him next time.

Monday, March 05, 2007


Today I was sitting with Martin. I had seen Martin's wife a couple of times and she complained that he seemed preoccupied. He hadn't been paying as much attention to her and the children as he usually did. He was staying out late more often and she was worried.

Martin came in and told me that she shouldn't worry. He was very attached to his wife and family. It would help, he said, if she wouldn't worry, and if she didn't ask too many questions.

Martin is a good looking man with flashing dark eyes. He is thin but strong looking. He is very direct and very engaging when he talks. As our conversation continued it became clear that Martin was very involved in finding was to support his family financially. However, due to his background, educational opportunities, and employment history, Martin's career path has not been the kind that I would have designed for my son. While my son is now working for a small start-up company, and that involves some career and financial risks, with the hope of career and financial rewards, Martin is reaping some financial rewards, with the risk of ending up in jail.

But this was not the first time I had seen Martin. He seemed to like talking to me because no one had ever really discussed options with him. Because of family circumstances he had become very independent at a very early age, and he had learned to figure things our for himself. He had learned how the world works.

One thing was very clear, Martin was smart.

Now, what does that mean? When a psychologist says that someone is smart it means something because the field of useful, clinical psychology came into being during WWII by helping he Army determine who was smart and who wasn't. That determined who would give orders, and who would get shot. Psychologist are the ones who invented, refined and then widely distributed the idea of intelligence through-out the land.

Now there are lots of test of I.Q. and most of them are designed to show how people's relative abilities fall into the pattern of a bell-shaped curve. I.Q. is measured by asking questions and giving such tasks as puzzles, analogies, math, vocabulary, and social sequencing. The idea is that if you can do well at these tasks you can do well in school, or in life.

After years and years as a psychologist, I don't believe much of that.

First, I don't really believe in the bell-curve idea. From my (completely unscientific) experience, I feel that 97.5% of the people start with about the same native abilities. Some people may have some special talents, like better physical coordination, or a quicker mind for math or spelling, and certainly people have different temperaments. But, basically, with structure and discipline and practice, people can learn to be just about anything they want. Anyone.

Two per-cent have bad brains and can't do it. Half a per-cent have some amazing talent and are off the charts at the top.

I also think that intelligence, I. Q, come down to only one thing: The ability to anticipate what is coming next. The better you can do that, the better you will do in life. If you can get out of the street before the bus comes around the corner, it's better for you. If you can figure out where the fish will be biting, that's an advantage. If you can tell where your enemy will attack, you have a better chance of surviving. If you learn which seeds are more likely to produce a good crop, you will not be hungry. If you can tell what will make your customer happy, then you will make many sales.

Anticipate. That's what smart people do. See what's coming, prepare for it, make it work for you and your family.

That's what Martin is able to do and it keeps him out of jail. He can tell who to trust. He knows how far is too far, and how much is too much and he stops before he reaches those points. Because of things that have happened to him, and also things that he has seen that have happened to others, he has learned what the odds are of what will happen next.

I have, in my almost upper-middle-class way, tried to persuade Martin that he is smart enough to do well at other endeavors, ones where the risks are not as great. He laughs at me and asks if he should apply for a job at the bank.

He would be very good at determining where to invest money. But what about that tattoo?

Sunday, March 04, 2007


The lead article in today's NY Times Magazine is another one about religion. Religion in this country is still a big thing as so many people not only want to be part of something, they want to be part of the RIGHT thing.

But this article, by Robin M. Henig,who writes about neurology, takes that view that a human brain is more comfortable when it feels it has answers, even if they may be the wrong answers. And there is a great deal of truth to that.

But, what I want to say, briefly, is that religion. like so many other human endeavors, is full of contradictions. It offers the promise of a better life, of a life lived through moral reasoning, of loving and caring for each other, of a brotherhood for all people, and a feeling of being a part of something that is greater and more meaningful than each of us alone, as mere selfish individuals.

And, on the other side, it divides us into angry camps of distrusting tribes, with each camp willing to kill each other over issues such as how to end prayers, who needs a Pope, cartoon characterizations of a deity, and especially which God left which lands to which people. Religions seem to be very adept at handing down strict rules to follow (I guess that's why they have followers), with the threat of very dire consequences if the rules are not followed in the manner that some hallucinatory lunatic decrees.

In that way religion is a great, long lasting example of all things human. It is full of potential that is hardly realized. To be done right it takes thought, reason and discipline. But most people, and this has been true to centuries if not millennia, seem to go quickly for the easy answer, and remain pretty sloppy thinkers. It's not that they really lack in "native intelligence." It's more often the case that most people have never been really taught how to think, especially how to value long-term gains over short-term pleasures. There are reasons for that too, evolutionary ones.

But, one thing that I have learned as a therapist: It is easier to believe than to think. Just as L, who strongly believes that "some nut broke into her house and cut the stitching out of the inside of the sleeves of four of her new sweaters." And she is totally convinced that the same person, or group of people put that tiny hole in her boot to allow the water in.

It would help if she would think about it.

Friday, March 02, 2007

Brief interview

Interviewer: So, Therapist, how do you feel?

Therapist: I'm fine. My knees are aging, but I'm OK.

I: No, I mean how do you feel when the woman is sobbing because her lover died, or because she had another miscarriage, or when your client gets fired, or when their kid gets arrested, when another relationship ends in tatters and ashes.

Th: Bad, sometimes. Sometimes, if I can see the person really tried to make something better and it fell apart, I feel badly. But, I'm not good at sympathy. If someone screws up again and stares at me, feeling like they just need someone to understand how the world is unfair, when with a little judgment or a little effort they could have made things better, then I want to punch them in the face. (I usually don't).

I: How to you keep from being overwhelmed with everyone's problems?

Th: Some of that you get from good training. I have learned to realize that these are someone else's problems and not mine. It makes me feel like that's a good thing.

I: Do all of these skills carry over to the rest of your life? Is it hard to stop caring for people?

Th: No, I'm not a nice person. Out of the office, when someone screws up I tend to think they are fools or idiots and I love to tell them so.

I: Does the work you do color they way you view the world? Do you view the world as as evil or malicious?

Th: The world just is. It is not good or bad. Is it bad when an eagle eats a mouse or a lion eats a lamb? That's just the way it is. It will all disappear.