Wednesday, April 28, 2010

Me, Miners and Goldman Sachs

One of my clients mentioned today that a cousin of his was one of the 25 miners died in the mining accident in West Virginia. He was upset. He was understandably sad and angry.

The implied cause of the accident was that the mining company was a bit sloppy, had been sited for several safety violations, and was basically trying to save money by cutting corners. I also heard on the radio that mining companies try to save millions of dollars in medical expenses by fighting disability claims for black-lung disease and other chronic, degenerative diseases that minors often develop. This seems like a bad thing. Miner's die while other make money.

But who is it making money. Is it he mean, exploitive mining companies, that pay off judges, run the state legislature and extract profits for their shareholders. Yes, it's them. But it is also so many energy companies that use cheap coal to make electricity. Then it is so many other companies who use the cheaper energy in large quantities so they can make products people can afford. It is big-box stores that keep the lights on all the time and sell things cheaper because of cheaper energy. These companies also keep many workers employed, this feeds families and helps the whole economy.

These companies, as well as the energy companies and the mining companies are traded on the stock exchanges. When these companies make a profit, which they can do more easily by cutting costs, such as how much they pay miners, and how much they pay in disability payments, and how much they pay for energy, the shares go up.

Who makes money on the shares? Anyone who owns stock, such as pension funds, mutual funds, and any one who directly or indirectly is saving for retirement. When stocks go up many people have more money. They can spend more money, they can retire more easily and more comfortably (me). Some people can get very rich trading stocks, or derivatives based on stocks (Goldman-Sachs).

So next time you meet a woman who has taught for thirty-five years in Nebraska, and now she is retired and growing tomatoes, tell her to thank the miners who are sick and dying in West Virginia.

People love America because it gives them the opportunity to get very rich. If you are going to live in a society with very rich people, you are going to have to live with many more people who are very poor. How else are people going to get very rich, or even a little rich. It is very difficult to get that way just by going to work every day.

America has been this way since we allowed slavery in the Constitution.

Don't Tread on Me (but you can tread on my miner)

Saturday, April 24, 2010

That's the Point!

It is gratifying to see that the dozen or so readers of this blog can see right through the obfuscations and machinations of my often vague and convoluted thought processes. Hey, I am just a psychologist. I am not a "real" doctor.

But, what you have all, in your own way, figured out, the message in my lat post is that, in life, it is the process that counts, much more than the actual achievement.
Yes, it may be great to win the award, but then what. You fade away and there is a new champion next season. You become a has-been and you remember you best days as learning, working, practicing, struggling and improving. That is where life is -- in the struggle.

My patient in the last post, walked such a fine line with such precision, that he reached his goal and then was left without a direction. He was living without a purpose. That is not success. That's why so many people, who have made or acquired so much money, often end up in my office with cocaine problems.

Even this, this very this blog. It has no goal. It is all process. I am grateful for the ten to twelve of you who read it. I am thrilled that you sometimes comment. I write because I am attempting, for basically my own edification, to figure out how the world works and why it works that way. If you guys sometimes want to come along and help point the way, I appreciate that. I can sue some direction.

In truth, I may not reach my goal. Psychology, really isn't like physics; or at least I am not Sir Isaac Newton. Although I am looking, I really don't except that I wil find the four basic laws of human behavior. (Well, there is this Love, Money, Power, Sex thing, but I will get to that in a later post).

It is the search that is intrigUing. It is the process that is captivating, and as long as I have the enthusiasm for it, life is fulfilling.

I hope you find such a purpose in your life.

Also, you probably don't remember the old Ian and Sylvia song that had a line which said something like:

"I am a lonely mistral come and listen to my tale/ all my comrades are insane or else they are in jail...
I have no use for heroes. they are misfits like the rest..."

And so it is...who really, has it figured out.

I mean, besides Sarah Palin.

Wednesday, April 21, 2010

A cause?

Geez, times passes, especially when I do the same thing over and over, so I think that nothing, especially me, has changed.

I first saw this guy almost twenty years ago. He was about 30 then, He was lost and depressed. He was a smart kid, in a good job. His brother had just killed himself, which wasn't helpful, and his father had been very depressed also. So this kid was understandably worried.

I saw him regularly for a couple of years then. He got most things straightened out. Moved on to a better job, and carefully planned out his life. He would come back every two years or so, just to stay on course. I would see him four or five times. His course was very planned and very straight. Understandably, he didn't want to take too many chances, and he like steady reassurance.

He found a good woman. She had a few issues too, who doesn't. But they have stayed together. They never had children, I think because they both felt a bit too fragile. His brother was in the army, and now is "born again." If they talk it is only about Jesus. His sister wandered off into the Arizona desert, smokes pot and strings beads. His parents died about nine and five years ago.

Now he is about fifty. He has lived his life according to plan. He is well situated with a nice home in the city and a nice place in the mountains. He has cut back at work because he has plenty of money, well invested and his work has become very routine. He is good at what he does, but it is very business/business and not very intrinsically, interpersonally rewarding.

So, now what? He is again, kind of lost. He can walk and bike and ski. He can volunteer and teach reading and computer skills, but that attracts a few kids who hardly care. He would like to run kind of a non-profit thing, but they are over-staffed and under funded these days, and he has no experience fund-raising, or grant writing. He is smart enough to learn that, but it doesn't seem like fun.

Now he stays in shape, he's not sure for what. He goes to a lot of fund raisers because people invite him. As I said a few weeks ago: "Life sucks, send a check."
He has not yet found the cause he wants to set-up a web-site for.

"Lost, middle-age, well-off white guys" doesn't seem to have that kind of a pull on the heart-strings.

Thursday, April 15, 2010

polishing a gem.

Sometimes I see people who are depressed, and they are depressing. Blah, blah, blah, the world sucks, people were mean to me, blah blah. Why can't I do things right? My mother...blah, blah, blah.... It can get so bad that a friend of mine, who was a talented therapist and specialized in cognitive therapy for depressed people, left his clinical practice for software development.

But sometimes I get to see a person who should be depressed, but they are absolutely delightful. Perhaps a bit screwed-up, but still, they seem to have overcome a great deal. I saw one yesterday, let's call he Cheryl. I have been seeing her for about two months, and even though her life gets worse, her attitude, her behavior, and her sense of herself (and her sense of humor) get better and better.

She began life with three strikes against her. Her mother was eighteen, tried to raise her for three months and gave her to her sister to raise. Her sister didn't last a month before she left her with her best friend. This woman has mostly raised her, or tired to. But that woman has been through three long-term relationships; one with a drunk, one with a sleaze and one guy just disappeared. Two of them left children behind. During some of the darkest days Cheryl went to live with her biological grandmother, but that woman became very ill and Cheryl was put in foster care. Her real mother got her out and gave her back to the friend who had been raising her.

Not surprisingly Cheryl was not the easiest adolescent to deal with. Beginning at 14 she was drinking and cutting school. Right before she was going to be thrown out she would go back to school and got As. Then she would drop out the next year. At seventeen she got her GED, a boyfriend and an apartment. The boyfriend left so she went back home and began college. She did well in college but was drinking too much so she dropped out, got a job, a new boyfriend and moved out. She threw the boyfriend out because he wouldn't work, and went back home and back to college. She was doing well but still drinking too much so she came to see me. The weekend after our first visit she drank too much, blacked out and woke up in jail.

But now she is in therapy, and she seems to really like it. She said she needed to stop drinking, and she has. Without a license she had to stop going to college again, so she stayed home and began cleaning the house, which her "mother" made her do, and she began to read. Then, when her next boyfriend lost his job, she increased her hours at her job and she makes him drive her to work every day.

In treatment she is delightful, insightful and really funny. At twenty-three she has been through all of this and she has really learned how the world works. She has figured out who she can trust ( not many), how to push back, how to make deals, and how to take care of herself. She rejected three lawyers before she got the right one, got him to take what she could pay, and made a pretty good deal with the court.

My problem is that often, with people like this, I begin to expect too much. You know, I expect her to be in law school when she finishes therapy. I think she should be Mayor. She is wondering if she can handle getting an LPN.

I have to be careful I don't frighten her away. I have to go slow. That way she can make her own decisions about what she wants to do, and I get to hear more of how she describes the world.

I'll let you know when she wins the election.

Monday, April 12, 2010

He and She

He came to see me, partly because She sent him, saying that if he didn't get help then the end of their relationship was near.

He is about 40 and has had about twenty relationships, not counting hundreds of one-night stands. But you can't believe everything he says, even He doesn't believe it. He is trying to be honest and build trust. He is sincere about that, even though he has never done it and never really experienced it. His father was basically, in clinical terms, an irresponsible drunk. His mother was chronically depressed and helpless.

According to Him, She is the model of psychological health. Yes, she left her husband of many years to be with Him, so what does that tell you? She is showing him how to be honest and attentive. (Her own mother stole her SSN and ruined her credit) She seems to want his total attention and devotion. She alerts him every time his attention wanders from her. She had decided that he has ADD, because he cannot focus on her as much as she needs.

He is trying his best to stay with her. He takes all the blame. He is in recovery from several addictions. He has learned to take the blame.

She has been in therapy. She has been a therapist. She does not blame, but She has a talent for pointing out causes and giving explanations. Her explanation is that He is the cause.

They are trying hard to make their relationship work -- or are they just trying to score points. I do not count points. I just want them to care and trust and enjoy themselves -- and then get out of my office so that I can rest.

Tuesday, April 06, 2010


This is what has bothered me a lot this week. You may not care, but this is my blog so I am going to rant on a bit.

I have a more than the usually weird client whom I have mentioned here before. She seems to have some kind of physical symptoms to go along with her spacial disorientation and hoarding behavior. She sees me, and also attends a day program a couple of times a week. She had been improving in fits and starts and stops since I have been seeing her for a year. The day program thought it would be a good idea to get a neuropsych evaluation done. I agreed. Perhaps they could find something more specific, or at least give some insight.

Over the last decade there has been a huge increase in people who label themselves as "Neuro-psychologists". They are supposed to be skilled at using specialized tests to determine the presence and extent of things such as leaning disabilities, ADHD, dementia, brain damage, and other more physiological causes of psychological distress.

I have only gotten about six reports from such people, and I can't say I've been impressed. First, many of the tests they use are the same ones, or perhaps revised versions of the ones I learned when I was in graduate school in the dark ages. Several are now scored by a computer, but that doesn't really make them more sophisticated.

Of the six reports, two told me nothing new, one was helpful, one was very revealing and two seemed to offer wild guesses at things that turned out to be wrong.

The report on this woman was different. It was insightful and accurate and it offered not only new information but support of things I was not sure of.

Now, that would be good except it was written in a way that just condemned the patient. Some of the scores on some of the tests indicated that she exaggerated or even manufactured some of her symptoms -- which is true. But they wrote the report and called her "malingering" which strongly implies that she is devious and manipulative. Their recommendations were that she be given a few sessions of DBT and sent back into the world. She should not be given other services, they said, because she is a waste of time.

Whoa, this is not a helpful presentation. Here is a woman who clearly has issues. Yes, she is confused and she exaggerates and she makes things very dramatic, but her life rally sucks and she doesn't seem to be getting much pleasure out of all of this.

The report offered no explanation as to why she would do this, or what was in it for her, or how she got this way. They could have said that this was a woman who has more strengths than she uses. They could have said many things that would have been helpful to the treatment. But instead they only wrote about the data. They got their conclusions from the numbers. They didn't think about treatment. AND they gave the report directly to her! That set everything back about six months.

So I wrote to the people who wrote the report and told them that I thought they could have been much more helpful. I tried to be nice about it. I don't know if they will respond.

Psychology has enough trouble being a science; it doesn't have to be mean about it to prove that we know stuff. Not helpful.

I will let you know how, or if, they respond.