Sunday, June 29, 2008

The Gloucester Girls

There has been a big to-do around these parts about several of the 17, sixteen year-old women of Gloucester, MA who got pregnant this spring. It seems that for several of them these pregnancies happened by design and not by the usual kind of lack of planning. The suspicion is that some of the women (girls?) discussed this and planned to have and raise their children together.

I don' know them or what they were thinking, but I do know that in my practice I see three families who have young women, 16, 17 and 18 who are pregnant and who are very intent of keeping their babies.

Now I am not going to enter into a debate about abortion. The point I want to make her is that these young women -- only one of whom has even briefly entered my office to talk about what is going on -- seem to have no real idea of what is going on.

None of them are in a real relationship. All of them have had sex with several different guys. None of the fathers of these pregnancies seem to be taking a real responsible role. One of them cares, one is trying to pull away, and the third father seems to be a mystery.

But, t think that these young women see getting pregnant as the only way they can have something productive to do after they leave high school. They are all from chaotic backgrounds. None of them have had a real or substitute father around for years.

From what I have seen or heard of the women, they could be smart enough to put another kind of life together, but they really either don't know how, don't have the confidence, or don't seem to want to go through the long struggle to get educated, employed, married, settled and give their children a stable home.

In their simplistic form of thinking they feel they can work it backwards. If they have a kid, someone will provide a home, an income, and maybe even a partner.

I don't know. They're not talking. I'm not even sure they are thinking. But I do think it is a refection of what it feels like to be on the losing end of a very competitive, winner-take-all society.

Friday, June 20, 2008

more than diet and exercise

To me, as a psychologist, when I talk to clients about changing their life-style, it means much more than diet and exercise. The most important thing to me is for people to find ways to find comfort and eliminate stress.

This means more than deep breathing.

From my biased point of view, the best thing anyone can do is surround themselves with good people. That means people who love them, support them, and respect them. It also means that those people have the same expectations of you as you have of them.

Freud, who I don't quote too much, said that to be healthy you have to be able to work and love. I agree with that. Now, working may mean that you take care of kids, or a house, or just simply have found a way to pay your bills and be independent. Loving means that you can maintain a long-term relationship that is mutually rewarding, enriching and beneficial.

If where you work and the people you have around you constantly cause stress, aggravation, conflict and tension, then you won't do too well. You will get worn down, and have symptoms.

I realize that we can't all have control of who our families are, who employs us, and whoever else rambles into our lives and causes havoc.

The world now is full of paperwork, emails, computer menus, late fees, pre-authorizations, user fees, war and salmonella. In addition, our relatives (everyone has them) are angry, depressed, jealous, resentful and/or incapable.

So, making a life-style change can be very difficult, especially since you can't go around shooting people any more.

Even for me, to cut down the hours I spend sitting so that my back gets better, has not been easy. It should be, but it isn't.

But, I will get up from the computer now and stretch.

Monday, June 16, 2008

wholistic conclusions.

Now that the pain is almost gone, just a few tingles left, I have again realized things that I have known, but have been under a great deal of pressure ignore.

That is that treating symptoms, which is what modern medicine is geared to do, even including psychotherapy, is more often than not, a circular waste of time.

My pain was terrible, although I know others suffer much worse, as plain old Aleve was somewhat effective. My first priority was to get rid of the pain. Nothing can be achieved when the pain is so distracting.

But, if I want the pain to stay away I have to make many changes. What happened to my back took twenty years, and if I don't want it to return, I will have to make life-style changes.

My pain was the result of a knee injury, that was treated only as a knee injury. It was made worse by how I continued to play, work, work-out, sit, drive, sit, walk and sleep.

Yes, I can take steroids, pain-killers or get surgery, and treat the symptoms, but if I do that the symptoms will reoccur sometime after the treatments are over. That's because the problem of my out of line muscles and ligaments won't really be fixed.

If I stretch, walk, work-out differently, don't sit nine ours in a row with only five or ten minute breaks, don't slump over a computer when I'm not sitting in therapy, I can change my body and make it healthy.

As a therapist I know this is true too. The symptoms I see, such as anxiety, depression, panic, lack of energy, lack enthusiasm, drug abuse, impulsiveness, temper tantrums, and alike are all symptoms of problems that usually, not always, but almost always, require life-style changes.

That takes a lot of work; a lot of consistent, sustained work.

Insurance companies don't like that. They want us to pick a symptom, treat the symptom, and go on to the next case. That is cheaper in the short run, but it only means that people will soon be back with new symptoms and the same situation which has become worse.

This is true of many, many conditions: obesity, diabetes, high blood pressure, irritable bowel syndrome,colitis, even many forms of heart disease and some cancers.

But medicine doesn't work that way. We are expert at treating symptoms. The problems often remain, the symptoms reappear. The treatments continue. Many drugs are designed to be taken for the rest of the patient's life. That way the symptoms are gone and some people make a lot of money.

We are even worse at prevention.

Wednesday, June 11, 2008

Pain 4

Well, it's finally breaking up. The pain is abating, some flexibility is returning, my outlook is improving and there is hope on the horizon.

What is disappointing is how difficult it was to get real help, and how, in the end, I had to find it and do it myself.

So many people my age have been through this sciatica thing. Everyone has their own cure. That's mostly because, most of the time, it goes away by itself. So whatever anyone was doing at the time was what they believe in.

Because I always worked so hard to keep in shape, I really set myself up to be locked out of shape once my body shifted. I actually have spent about 20 years setting this up.

But getting help was not helpful. No one really looked at the whole picture of who I was,and what my muscles, ligaments and bones were doing. What I did for work (sit a lot), and how I worked out.

The doctor (MD) used "evidence based medicine" and recommended for me to follow the course of what most people would need. Unfortunately this course would be very slow, very expensive, involve a dozen different people, and then end up right where I am now-- stretching.

The chiropractor said rest, ice heat, which was fine in the beginning. He couldn't move my bones though, because the muscles were too tight.

The message people were great, but I can't get a message every day. They found the problem, but really didn't offer a solution.

I found all the stretches on Rebuild Your I am doing 7 stretches 5 or 6 times a day and it works.

So, I am getting my life back. I have cut my schedule of clients 10 to 20%. I am trying not to get back to the 115% level that got me into this in the first place.

But people keep calling.

I guess they think I have something to say. Or else I just listen really good.

Friday, June 06, 2008

pain 3, the doctor

So, after suffering too long and trying alternative solutions I went to the medical doctor today. I haven't been to a regular doctor, except for my eyes, in years, so this was a new guy in a big medical complex.

He was easy to approach, thoughtful, and reasonable. He did a few pokes and squeezes and twists and agreed that yes, I had sciatica. He said it has lasted a bit more than normal so that isn't a good sign. Then he wrote orders for tests.

I left some blood there at the lab, so they can see if I have cancer, and then I'm supposed to get an MRI. I buy my own insurance and have a $2000 deductible, so this will probably eat all of it up, especially if I get the MRI, which they said is about $1200. In Taiwan an MRI costs $125. I will have to pay for his insight, for the lab, for, and later for the guy to read the MRI, then the new people at the back clinic, and then the Physical Tx people. by then it will be over $2K so I will only pay 20% or something, who knows.

But the medical alternatives seem to be drugs and/or surgery, and I'm not keen on either. He offered my a few drugs to control the pain. that was friendly, but they are not the kind that will dampen the inflammation and heal the problem. They are more the kind that many of my clients try to buy on the street.

He also offered me anti-inflammatory meds, but said it would be cheaper to just triple my doses of Advil.

So, I'm taking more Advil, I will give the acupressure guy and the chiropractor another week to work magic or else I get the MRI and enter the medical world, but I am very reluctant to do so. I guess, as a psychotherapist I remain an "alternative" kind of guy.

For now, I am back to my favorite weekend medication, which is Jamison. It doesn't do much for the future, but it makes the present brighter.

Everything in moderation!

Wednesday, June 04, 2008

pain 2 -- loss of arrogance

I didn't really realize it before, and I'm kind of startled by it, but now that I am going through this pain thing, it's become clear.

Part of what I've learned is how, as a therapist, I've been carrying around an underlying arrogance, and I don't think that's a good thing.

But somehow, even though I have even posted here about how aware I am that one slight random event can completely change your life, I guess I never really thought that would be me. Yes, I was grateful that nothing really terrible had happened to me, but like most people, I attributed it to my own abilities, foresight and planning.

Yes,I am a good, caring and understanding therapist, but I also always somewhat, put on a very subtle display as having a good life. I was in shape, I was financially sound, I have a long-term marriage,and my kids are grown and doing pretty well. I was not yet rich and famous, but perhaps that would come too. I guess, in some ways, I felt I was a good model. But it was also a kind of arrogance. Kind of "see, I can do it, you should do it too -- maybe not just like me, but like you want it.

Now, I've been in pain for six weeks. This is the kind of thing that is common, and happens to everyone, but it still isn't really over, and it has been very limiting and debilitating. Now, I can show that I can stand the pain and the adversity. I have many clients who have much worse and more chronic conditions, but I am still in the midst of mine.

And I don't like it. it sucks, I'm sick of it.I'm getting treatment and improving, but it's slow. I get worried that it won't end, I get tired and irritable.

The severity of what I am going through is also partly my fault because I don't ask for help. That's part of the arrogance. I had always worked these things out myself. A few pills, ice, stretching. So, I just kind of denied, or hid the problem. That was part of the arrogance too. I caoul handle my problems myself.

So, now I'm finished with that. I'm going for help wherever I can find it.

Anyone who can push the magic button will get a big kiss.

They say it will take time. That's what I say to all my clients.

But this is America -- I want to be better now.

Sunday, June 01, 2008

pain 1

Wow, it's been a month. That's quite a while, even for a fading blogger like me.

Well, there was a reason, pain. I have this sciatica thing, pain, running right down my leg. It's mostly better, but it's still there. It makes it difficult to sit in a chair and type at a computer unless I sit exactly right.

I have learned a lot during this month, about myself, growing old, living with pain, and how I react.

I don't like it, this pain thing. I don't recommend it as a learning experience. But it seems now that I will survive.

It has given me insight into some of my clients, and into how no one can really tell how much pain you feel. So many people I see in my practice are sent to me because many doctors feel these people are in pain, but not THAT much pain. It's very difficult to tell.

Some people want drugs, some people want attention, some people want excuses. But many are just in pain, and it kind of sucks.

I will have a lot more to say about this. I've got to stand up now.