Wednesday, January 28, 2009

slightly baffled

Sometimes things are so fascinating, so complex that even I, 50,000 hours later am still amazed.

I've seen this woman three times now. She is in her mid-forties. She is very articulate, very in touch with her often scary, often overwhelming feelings, and can describe things in glowing, flowing detail. She says she has skills in reading, writing, synthesizing ideas, and creating images.

Yet, she she says her house is a total disgrace. She has piles and piles of stuff and she is afraid to put things away because she doesn't know where they go. Also, she has no sense of spacial relationships. I have never seen anything like it. She has trouble finding her way from the parking lot into my office. I can see her hesitate in the waiting room, trying to figure out which door leads to my office. She told me that if I had a pile of pens and told her to put the red ones in one pile, the green in another and the blue in a third, she could do that. But if I said, organize those pens, she would stare at them for hours and not know where to start.

The causes of this could be anywhere and everywhere and I am certain it is both. It is psychological, neurological, genetic, and the result of familial deprivation. She has had a terrible life, having been in an orphanage until three and then adopted by a caring but crazy mother. That lead to terrible, abusive relationships.

But those are over. Now she is just a total mound of exhaustion and anxiety. And yet she is charming, outgoing, friendly and very caring to her friends and the world at large.

I would love to run about $100,000 of neurological and physiological tests on her. I doubt that they would find anything definitive.

Wednesday, January 21, 2009

Still cold

Now, the guy has been President for almost thirty-six hours and it's still cold. I guess he's not going to live up to expectations. But then, few people do.

I have that problem with clients. I see all the potential. Hey, if they weren't so screwed-up there is no end to what they could be doing. Sometimes I get all excited when I think of the possibilities. This one could be an artist, this one could be a teacher, that one could be governor with a little bit of energy-- it certainly doesn't take too much to be governor in lots of states.

But, then I have to back off. It scars them to feel expectations. Mostly they just want the fear to subside or the depression to lift. If they could sit and watch TV without having a panic attack or thinking about how miserable they feel, that would be enough.

But it's not. The only way you really get better is to get active. Get up, move, get your blood going, think about what you need to do, do some planning, plan to be good to someone else.

Aim high.
It's the process
Success really doesn't matter

Then you can watch TV

Thursday, January 15, 2009


So you think that this job is all about sitting here, nodding and saying "how do you feel about that?" Sure it is. That's why we get paid the $4.50 an hour by UBH, but only if we get our forms in on time, with all the correct boxes checked.

But here are a few other things I had to squeeze in today.

I have a literally poor client, on SSI, Medicare/Medicaid,who received a letter saying that since she turned 65, and since she got a cost of living raise on her SSI check from $996 to $1026, she is no longer eligible for Medicaid as her supplemental insurance. To keep her policy she will have to spend $465 a MONTH for a deductible. So, she came in crying and we ended up calling the State Senator. We have to wait to see what he can do.

Another client who suffers panic attacks was pulled over by the police for something minor. She had a panic attack and couldn't talk or make sense. The cop thought she was on drugs and wanted to put her in his cruiser and arrest her. That really freaked her out. I had to talk to the cops and a lawyer for her. That one got resolved.

I have a guy who lost his job working for the state because of what was going on at work. They have stopped paying him and he is waiting for a hearing. He has been waiting for two years and is about to lose his house. The State knows he has a good case that is probably relevant to several other people so they don't want to settle it, or something. He is becoming desperate, depressed and kind of crazy. I had to try to make sense out of what his lawyer was, or wasn't telling him. No real progress has been made on that.

I have been working with another woman with panic attacks for months. Part of her problem, which is common, is that she is afraid to take a pill, as the pill might do something to her mind that she didn't expect and that would make her panic. But now she is ready to take the pill. I had spoken to her PCP three months ago to explain to him why the medication would be helpful. He was very agreeable. Today she went to him to get the prescription. He had nothing in his notes. I had to call him. He was at lunch, he was at the hospital, he was cutting his finger nails. Finally, I think that one got resolved.

I still have an hour left to sit and say "how do you feel about that." I am afraid to pick up any more messages.

Saturday, January 10, 2009

The older old man

I was trying on my new glasses to show my daughter. They are gray on top, silver on the sides, slightly curved with no bottom. They are current. My daughter, who had closed her eyes so that showing could be more dramatic, open them and announced, "You look old."

She quickly added that I did look cooler, and more with it, and that I should not go back to my old frames, but that fact is, I look old. At least older than the people she has become accustomed to looking at, who are mostly twenty-five to thirty-five, and now bring along with them a new generation, who are mostly two months to two years. They look young, with rosely cheeks, dewy skin and sparkling eyes.

But, it was later, when we went to the nursing home to visit the older old man, that my daughter could no longer keep the tears from running down her cheeks, although nothing was really happening except age.

The older old man is 95, and after 03 years of holding together he is now afflicted with what is now considered the disease of deterioration, dementia and dying. The older old man was pleasant, and even seemed to kind of figure out who my daughter was, or at least he was able to fake his way through it, relying on his well established social skills, much the same way years ago when this very daughter had mastered the skill of appearing to read by learning all the words to "Fred and Ted."

But his presentation of holding it together had too many flaws as he asked, about every thirty seconds about his wife, who has been dead for nine years. He also, in a friendly, personable way, turned to my wife, his daughter, and asked her how her parents were.

And that was it. He was tired. He tried valiantly, and succeeded to get himself up out of his chair, and staggered in small, very quick steps traversing the three feet from the chair to his bed, grabbing my wife's arm so that he would not pitch himself full force into a frontal forced landing. But we got him safely into bed, clicked on an alarm gizmo, which is designed to call an aid if he tries to get himself up.

We put on our coats, and before we were out of the room he was asleep. He will spend the last of his days more asleep than awake before he slips over into eternal rest. It is very difficult to watch, as much for him as it is for ourselves. Especially those of us who will put on a new pair of current style glasses than make us look kool, but old.

Saturday, January 03, 2009

It Begins again

I am here, still away from work, watching the new year begin.

It has been cold here. We were with friends and ate blueberries. We were safe and warm.

The next day the stock market went up as a sign of hope.

Today Israel marched into Gaza as a sign that nothing has changed there for sixty years, really for three thousand years.

From this distance it is difficult to tell what exactly keeps those people so entrenched in their "My Way or Death" positions. The Israelis have treated the Palestinians terribly. The Palestinians have never accepted Israel. The large majority of both populations are caught in the middle, until hostilities break out and then they cling to their side. They fight for power and pride, fostered by some kind of religious justification.

For someone in my profession, who labors for hours to help one person relieve their anxiety, it is difficult to watch hundreds of people be blown out of existence during a ten minute air-raid. But this kind of thing is not new to the world. That is what becomes so discouraging as we age,

Never give an eighteen year-old a weapon and visions of glory for using it. But every culture does. So it goes on.

The issues were too complex for President Bush, who believed in right or wrong. Perhaps a new administration, with more ideas, can bring the pressure of the whole world to bear on this conflict.

If the world can truly be different, the changes have to begin right there. Perhaps that is why it is happening now, just to show where the bleeding starts.