Friday, April 25, 2008

a Really Great (Great) Grandfather

T was talking about his father, which is something we often do in therapy.

His father was was in and out of his life for many years. T was most raised by his grand-parents. His grandfather was caring, but a bit too harsh.

Then T began to give more a a family perspective about what was expected of the men in his family. He said a lot began with his great-grandfather who was rich and owned a lot of land, and people usually did what he asked.

I guess that was true of the women too because, T went on to say, his great-grandfather had 42 children, with at least 17 different women.

That sets quite a standard for the men of the family.

Saturday, April 19, 2008

my old brain.

So, it is finally Spring here and everyone seems to be outside doing all kinds of rejuvenating stuff. How can you live in California without Spring?

I'm taking a walk around town, just checking everything out and I pass a window with the shade drawn. Before I realized it I was singing "All the shades were pulled and drawn, way down tight." Those words are from a song called "Silhouettes" which was very popular when I was probably in Jr. High school, and that was a while ago.

The words just flowed out. I must have remembered about 90% of them correctly.

Is this a good thing and I have access to a good memory, or am I getting like my father-in-law and I don't know what decade I'm living in? Hard to tell.

I know that music helps connect everything, so that with the tune, it is easier to remember the song as one until.

It is even more true that when there is emotion connected to something the memory remains stronger ( although not necessarily accurate). There certainly are a lot of emotions connected to Jr High love songs.

Anyway, I also remember that the song was sung by The Rays, and that about month later a group called The Silhouettes came out with a song that also hit #1 on the charts (Do they still have charts?) That was called "Get a Job" a refrain I still sing to several of my clients.

old brains

We often go and visit my wife's father. He's going to be 94 soon. Until last year he was doing pretty well, but last spring he contracted pneumonia and, although he recovered physically from that, it seems the stay in the hospital knocked out his mental equilibrium.

Now he often doesn't know what decade he is in. Often he is 16, back in the town where he was born, looking for his neighbors. Sometimes he is fifty and waiting to be picked up to play golf. There are lots of other disorienting things. It's sad that brains tend to shrink with age and then confusing things happen.

Would it have been better if he stayed more involved with others and had more interactions to keep him alert? He was never that naturally social. His wife did all the arranging. Once she died he slowly withdrew.

But, I don't know. He's 94. What can you expect?

At the doctor's recommendation we gave him Zoloft. We gave him one pill at a sub-therapeutic level to try it out. The next night he was up all night making phone calls, mostly to people who had been dead for twenty years. He called 911 because his wife was missing.

We didn't give him another pill.

Really, he should come and live with us, but we have too many stairs and we are not home enough. (I'm saying this just in case my kids read this.)

At 93 I'm buying a motorcycle. If I remember.

Monday, April 14, 2008


A couple of weeks ago I spent a day down at the Tech School where I got to see some terrific stuff they are trying to put together. They had robots with cool eyebrows, and big 3-D models of ho my opinions differed from everyone else.

The main speaker was Dan Ariel who wrote a new book about how people really don't make rational decisions, even about money.

So, I went up to him and I said "Duh."

And he said that economic theory is based on the belief that people are rational and will act in their best interest.

Like who they allow to beat them up when they're married I said.

He looked at me kind of strange and worried.

So then I said, like trading Credit Default Swaps.

Then he knew what I was talking about.

Dr. Phil tells people, rationally, with common sense, what they should do.

Nobody really listens to him either.

But he made $96,000,000

and he doesn't even have a license.

Wednesday, April 09, 2008

Here they come again

Here is the real problem. They call themselves "Health Care Companies" or health Management Companies" or some other misleading euphemism. But the truth is they are financial companies. So, when they come after me and tell me to fill out their Patient Outcome Management Forms, of their Patient Wellness Assessment Forms, or TOP Patient survey, I get upset.

They tell me that they are trying to help me make clearer diagnoses. Or they tell me they are trying to help their subscribers find the best clinical matches. It's all a lot of shit.

All they are trying to do is trying to find ways to justify their existence AND to pay us less.

Two of the major conditions necessary for successful psychotherapy are trust and understanding. I don't trust these companies, and I don't think they really have any understanding of what we do. I don't want their "suggestions" of how I should do treatment. If they know hoe to do it they should be out here doing it. Their suggestions don't come from any research that I respect. The symptoms they want me to treat are not symptoms that I really care about -- they are symptoms, not the problem.
They will go away when the issues are addressed.

But now it is fashionable for each company to begin to make their therapists accountable and monitor their effectiveness. Except they really don't know how to do that.

It's all about the money. They've collected it from the subscribers and they don't really want to give it away to us, the care-givers. An adversarial system of health care is never a good one.