Friday, September 30, 2011

The Second One

My son, my second born, is in the hospital right now, sitting next to his beautiful wife, waiting for her to bring forth his first born. They are going through what seems to be the commonplace medical machinations in order to induce the kid to come see the world.  That is what my daughter went through ten months ago, and that is what happened twice to my wife, as both my kids were plucked out, rather than delivered.

So far, the first grandchild has been an overwhelming success.  She is happy, curious, expressive, and she loves her Grand-Pops.  Whenever she sees me coming she swerves around, looks at me and then gives me one of those wide, three-tooth smiles of welcome that make all the world worth surviving. I take those smiles very personally and I don't want to know if she treats anyone else as well. She looks at me, flaps her arms and raises her hands. My daughter was very similar and joyous at that age, although not as big.

So now a new one will enter our life-space very shortly.  I was very hyped- while my daughter was giving birth.  She was there with her husband and we all were trying to have Thanksgiving dinner.  My mind was waiting to see who it would be, and also very focused on how my daughter was doing.

This time it's similar and different.  I cannot know how my daughter felt, but I think I know exactly how my son is feeling, thinking and acting.  Everything is almost exactly the same, except for text messaging.  I can feel the excitement, confusion, anticipation, responsibility and joy that he is feeling. We have about a 57% overlap in personality, so I have a pretty clear idea.

I was 33 when I had him, and he is 32 now. the world is different but having a kid is very much the same.  Is this a good time to be bringing a kid into the world?  Who knows?  Right now it seems like it could be better, or it could be worse.  It is certainly better than being born in 1911, or 1930, or 1937.

I was born in 1945, and that turned out to be a pretty good stretch of time, but who could have predicted that.  My son was born in 1979, which is proving to be better than 1989, but a lot can still happen.

Having a kid, if you think about it, is always a leap of faith and a vote of confidence.  Of course, a lot of people don't think about it, and many of those kids end up in my office.

As a grandparent I see the sweep of time, the possibilites and the difficulties so much differently than I did as a parent.  Being a parent is day to day, often hour to hour, especially in the beginning.  As a grandparent it is the joy of a couple of hours, but also the awareness of the coming decades.  What can be, what needs to happen, and what are the few little nudges I can add along the way to make things easier, happier and turn out right ( the way I think they should).  These kidsare my legacy; things should not be left to chance.

But right now. the only concern is for the next two or three days and that he or she is healthy and robust.  If that comes to pass, then being brilliant, creative, beautiful, caring, intuitive, a good dancer and a skilled point guard will all happen in time.

Right now we just wait for the next text message.

Monday, September 26, 2011

A click away

Perhaps many of you saw the article in The Sunday NYT entitled "When your Therapist is Only a Click Away.

It described how the method of doing therapy over Sype is catching on, and that many people would have more access to therapy that way.

Of course most of the therapeutic community was not too thrilled with the idea, especially those of us who had to climb a fire-escape to peer through a window to watch Howdy Doody, before our family broke down (or saved up) to get our own TV.  Most therapist agree that it is important to have a person-to-person meeting in order to have the kind of person-to-person relationship that is necessary for therapy to work.

  I feel that being in the same room with patients is much more emotionally intense, much more revealing, and can lead to much faster changes.  Talking to a screen, is a little weird for people my age (old).  It makes me feel too much like my crazy aunt who had running conversations with the TV.

But it is certainly a generational thing.  People under 40, and certainly under 28, have spent much of their lives in front of screens.  That's how the world comes to them.  So many people have worked in cubicles, staring a screen all day, now they work from home, staring at screens.  But it must seem very natural to them to get and give information that way.

I just tried to download some puzzles to my phone. But this app wanted my personal info and my email, and then wanted me to post my results on Facebook and email them to seven friends.  I don't want my friends to know I'm doing puzzles on my phone.  But I guess lots of people do.  Maybe that's why no one is working.

But the future
of the Independent Practice of psychotherapy lies with those smart-phones.  I can see that within five to ten years many people will have a "Therapist App" which will be a direct "Facetime" link to their therapist.  Each of us in independent practice will have about ten to twenty clients, and we will be "on" all the time. Sixty ten minute conversations a day. "Get ready to talk to your boss" --Get back to work --- She looks cute to me, go talk to her -- How did that make you feel?  That was an interesting conversation with your mother. 

Real emotion, Real behavior; Real Time.

Heart rate, blood pressure, breathing rate, sweat glands, all kind of bio-feedback information will be measured instantly from the hand-held device.

All billed immediately through Pay-Pal.

It will not be the same as the therapy that we give now, sitting fairly close together, with pauses, silences and staring at the wall or the carpet.  Having your therapist in your pocket could create all kinds of over-dependencies, or it could keep you shaped-up, as those little lies, exaggerations and omissions that people tell their therapists will become more difficult to get away with.

Things will be different.  They already are.  There are always trade-offs.

Perhaps five years is too long.

Friday, September 23, 2011

Character (?)

I was reading last week's NYT Magazine.  It is all about how to educate the rich and poor.  The big article was about how something called "character" was as important in making headway in the struggle toward success as academic achievement. 

A group of several psychologists and educators had this discussion about character and they seemed to come up with two complimentary, but distinct dimensions.  One dimension had to do with what it really takes to succeed in this world, and the other had more to do with what it means to be a "good person."

The first one consisted of a bsic group of behavior traits. They labelled these as: grit, zest, curiosity, self-control, optimism, and  gratitude.  One more, emotional intelligence, I think includes many other traits. 

The other dimension included behaviors such as being understanding, helpful, empathetic, and caring. It was much more about being good to others and making the world better for everyone.

I think all of this is good stuff and is really what is important to both individuals and society.  I think it is sad that it falls to school to try and impart these kinds of thoughts and actions into people, when really this is what parenting is all about.  But i guess parenting and families are in tough shape for many people these days.  I see that a lot in my practice.

Not that it really ever been well done.  What we now think of as abuse and destruction had long been a staple of family life, and still is in many parts of the world.  But now we think that beatings, molestation, honor killings, degradation, silent scorn, rejection and expulsion are not usually the  best methods of building character.

When I think of the list of traits of the first dimension: grit zest etc, the first person who comes to my mind is that 10 month old girl I spent two days with last weekend.  She was certainly full of zest, curiosity and optimism.  She displayed enough emotional intelligence to know how to play her grandmother for all she was worth.   She was able to let us know what she wanted without flipping out, and was very gracious when she got what she asked for.  Her whole body would shake and flap for joy when she was given a small pile of Cheerios.

What is great is that her parents, through a loving process of allowing, encouraging, structuring, and caring have already begun to instill in her things she will need to not oly survive, but to flourish.  I think (boastfully) that I did a lot of that with my kids.  What is sad is that so many kids don't get that because their parents are too exhausted, too poor, to unstable, or too unavailable for all kinds of reasons.

But if a kid is neglected, frightened, intimidated, forgotten, or discouraged for the first two years of it's life it becomes very difficult for a school to get him or her to undo the skills he needed to survie and to then learn these new ones.  That's what I do in therapy, and it can take years.

I think it is worth trying.  I think these qualities are really important.  I do think that they are, and can be learned, to a great extent, although each child is born with a different temperament, which makes them more naturally energetic and/or sensitive.  But it's a very tough job to retrain somebody, especially when you have to send them back to the environment in which other skills, such as silence, defensiveness and secrecy are more adaptive.

Monday, September 19, 2011

crawling and giggling

It is a beautiful late summer day.  The sun is beginning to slant at a different angle.  It is fifteen degrees colder than it was last week.  More people are in the neighborhood, looking busier, walking faster.   Vacations are over, everyone is back from where they went, getting back to work.

Still, everyone I have been seeing is suffering from th economy in some way.  The problem is world-wide.  The necessary solutions are complex.  Battle lines are being drawn, no one wants to be the victim, so everyone loses.

But this weekend I spent taking care of the ten-month old bundle of energy and amazement.  She crawls, climbs, giggles and laughs out loud at everything that pleases her.  What pleases her includes plastic bottles that spin, doors that have two sides, pulling herself up on a coffee table and taking everything off of it.  Keys and cell=phones seem to be the biggest prizes, and gravity is something worth demonstrating over and over.  However, making a ball go up in the air, against gravity, produces gales of laughter.

It will be years before this new, round, mostly pink person has any idea how skeptical her grandfather is about human judgement, and interpersonal interactions.  The economy is good where she is.  Her parents are very good to her.  They keep her healthy and safe and encourage her to grow.  She also has about fifteen other relatives and friends who smile back at her every time she smiles, which is most of the time.

Obviously, there will be another generation to keep this all going.  There will be another member of our family from our other child, coming with two weeks.   Despite all that is wrong with the world it is always thrilling and encouraging to spend time with a healthy, happy baby. It seems to bring out instinctual hope.

I realize that a lot of children are not a fortunate as this one.  But the most imprtant factor is that any child feels safe, welcome and nurtured.  I will do the best I can to help this one and the next one to explore, learn and be amazed. If they can enjoy doing that, and enjoy begin here, it will help everyone. everywhere.

All politics are local.  As local as the kitchen floor.

Wednesday, September 14, 2011

I've been away for a week and they changed the whole blogging format.  I'm disoriented.  I don't know if I can make sense in this box that hardly has borders. Perhaps my mind will slip outside the borders and rush away, out of control, down corridors of my building, bothering the people in the insurance agency, or the other doctors, or the bank investigators who are rarely seen, and when they do show up they wheel in those metal cases.  What do they really know?  Could they have prevented much of this if they really investigated?  My mind wants to know.

She, that woman who seriously thinks she is running for President of the USA, actually said that getting a vaccine to prevent cancer will cause mental retardation? She believes in a non-influential government, but she doesn't believe in science, or health.

What does this say about the education system of America that people don't come up and demand that she go back to fourth grade.  How does anyone take anything seriously if this is condoned?

When did Congress pass the law that rich people are right and poor people are wrong?  That seems to be the law of the land now.  I know several rich people who believe that. I have spoken to them, and I am not impressed with their ideas -- or their values.

I have patients who are poor and their lives are very difficult.  I have patients who are rich and their lives are very stressful.  I don't have happy patients; that's not my job.

But why be cynical on this beautiful day, which could be one of the last beautiful warm days of summer?

Because if you're not cynical they take your money, they tell lies, they get away with cheating, and they change the rules. 

They are the corporations, the government, the churches, the elites, the rabble, the immigrants, the prejudiced.

They are everyone but me and you.

Tuesday, September 06, 2011

too many like him

I have been back at work a while.

A mother called and told me her son wanted to see me.  He said he was ready to talk and wanted to change.  The young man was 23.  he was good looking, strong, and had a job that expected regular attendance, strong physical effort, and  good customer relations,  He was more than able to do that, and he said his company thought he was excellent.

The only trouble was that he was still living at home and was spending most of his money on Oxys and Perc 30s.  He said he felt better when he was high.  His job was boring; his life was boring and getting high made everything easier to take.  Except that he was broke.

He also realized that he was blowing out his brain cells.

But he really could come up with no alternative.  He a quit the pills a couple times, but got bored and a bit depressed and had gone back to them.  He said he hung out with six or ten other guys just like him, except half of them didn't have jobs any more.

He didn't like school.  He hadn't put the effort in and didn't think he could now.  He had been in a couple of relationships but the women didn't really think his being high so often was that attractive.  He understood that.  He didn't see any way that he could really get a good enough job in this economy that would allow him to really live independently.  His father had worked hard for thirty years or so, had a haeart attack and now was disabled and couldn't do much of anything.  His mother was still working but she thought she was about to be laid-off.

Why bother?

I offered him a way to figure out the answer to that question.  Although he was certainly a polite kid, and seemed to have real insight into his condition, he declined.  He did say he would consider taking Suboxone, if that would help him cut down on the pills.  I think he was hoping that his insurance would pay for the Suboxone.

America's future is it's youth!