Monday, October 31, 2011

Nature's tricks

Tis All Hallows Night, the evening to celebrate the dead and dying.  Most of the snow is gone from around here, and my neighbors all have their power on, although that can't be said for many of those fifteen miles away.  That's just one of Nature's tricks.

As the sun began to slip away I pulled on my black sweats, pulled my too-big black hoodie over up head, pulling the strings on the hood so it comes down over my eyes, then I set out to walk the neighborhood as the Emperor from Star Wars, one of the best known movie villains.   I didn't bother to get one of those white plastic scream masks, the craggy lines and furrows in my face from more than thirty years of listening to misery are enough to frighten any six year-old.

Now I have returned and I wait for them to come to me, the princesses, witches, many various animals and super heroes. I don't know if it will be a busy year.  There were lots of parties scheduled for Saturday but the storm blew them all away.

I appreciated being able to take a brisk walk, emperor or not.  The most difficult patients for me to deal with are the ones who are sent to me  to help find a away to keep them going and hopeful, even when movement is very difficult and hope is draining away fast.   I am seeing several people who are in tough physical shape.  Cancers, which may or may not be treatable, degenerative bone diseases, MS, Parkinson's, crushed vertebrae, or missing limbs.  I also have a couple of parents of children who have complex medical problems.

I talk to them; I listen to them.  We try to find other things to think about, ways to lessen some of the tension, to avoid some of the pain.

What makes the task more complex is that so often the treatments for many of these problems are often the causes of other problems, and the treatments for the secondary problems can also create new problems.

I don't want to blame doctors or medicine because many of the new treatments are truly amazing, and many people are alive today, and healthy, who would have suffered and died ten years ago.

But the medicines are often so strong, and almost everyone reacts differently.  People get dizzy and fall down, and break things.  People become terribly allergic and break out in painful rashes, or hives.  People can't digest food while taking certain medications and they lose weight or throw-up and then they find that they can never eat certain foods again.  People get scars from radiation. People gain weight from many pills, others develop neuropathy, or other auto-immune diseases. What is worse is that it seems that once people develop sensitivities they become increasingly sensitive to almost anything and everything.

Seems like one of those tricks of Nature. 

So I just keep walking.  Walking and whistling in the dark.

Monday, October 24, 2011

N.B. +

Nota bene:  I have been blogging here, not too feverishly, for about three years.  After about six months I got a flurry of questions about the ethics and  confidentiality of what I was doing.  I think many of them came from pastoral counseling students.  I think I reassured them, as I will try to do again, that I am very aware of the importance of confidentiality as a part of therapy.  I believe that any patient must feel that anything they say to me will not be revealed to anyone.  I inform them of the very few exceptions, such as imminent danger to themselves or others.

I don't think any of my clients could point to anything I write and say "that's me."  Although I hope they could say, "that could be about me."  I write her to attempt to sort out themes. The theme for me in the last post was partly about how sad it is when someone feels so battered that they choose to retreat from the world. But the other part was about the limits of my influence as a psychotherapist.  I can only influence anyone so much.  I have come to believe that people cannot, and should not try to do what they are not ready to do. And, they may never get ready, because what I may see as possibilities for them may be something that they will never be interested in doing.

I know that one of my faults as a therapist is to set goals for people that are often different from anything they ever envisioned themselves doing.  For many of my clients I have some idea that, if they have not already done so, they should go to college, open their own business, and be in enriching, mutually beneficial relationships. Now realize, I never verbalize that, and I often can see that those are not things that many people expect, or want to do.

The point is that I feel no one should be limited by anxiety, worry. loss, depression, self-doubt, rotten parenting, or any other emotional difficulty. --- There was even that story on the front page of Sunday's NYT that told of a schizophrenic woman who built her own business to keep her psychic demons in check.

Not everyone feels that they can, or want to pull themselves together to the degree that I would like to see.  I have to honor that. 

And I won't name any names.

Friday, October 21, 2011

not my choice

I have written about GR here a while ago.  She had lost her long-time boyfriend, who was married to another woman, when he died under suspicious circumstances.  That was over a year ago.

GR is a very intelligent woman who has had emotional difficulties since childhood.  It was not that she was born with deficits or neurological problems, she was just born into the wrong family.  Her mother was a religious fanatic, a hoarder, and used her kids to clean and cook. Her father drank too much, and tried to put his hands in the wrong places.  GR and her sister went off in opposite directions at adolescence.  Her older sister was out-going, thrill seeking and friendly.  By the time she was seventeen she had been having sex with two different men a week. Now, fifteen years later, she probably still does.

GR, in contrast, has had two lovers in her life.  One got her pregnant.  When her son was about five, and GR was home alone and drinking, her mother called protective services and had the boy taken away.  The mother took custody mostly so she could collect a check from the state.  It took GR about seven years, and all kinds of treatment letters and programs to prove to enough people that she was competent, and she was able to get the boy back.

At one time, in high school, just to see if she could, GR decided to study.  She got all"A"s that year and was ranked fourth in her class.  No one at home noticed or cared, so she gave it up, as not worth the effort.  Twelve years later, while she was seeing me, as part of the process of regaining custody of her son, she went back to college.  Again, she did very well for one semester.  But then her boyfriend died, and she gave it up.

Now she has given almost everything up.  Her son is with her and he is doing OK, not great, in high school.  She is on disability because of her chronic depression and OCD.  She gets some support for her housing and food stamps.  She knows how to scrape by with very little money. She encourages her son to do well in school, make friends, and participate.  He seems to be doing that.

She isn't.  She leaves the house once a week to shop, and one time every-other week to see me.  Otherwise she doesn't want to have anything to do with anyone.  She is on an Internet chat list for mothers of adolescents.  She plays games on Facebook, but doesn't correspond with anyone.  She reads a lot and works out on the floor to videos.  She has no idea how long this self-imposed isolation will last.

She tells me that she is not as depressed as she has often been.  She gets up everyday and takes care of herself and her son.  She sees her current lifestyle as a choice, not a symptom. She knows there is the possibility of a richer, more active, more interesting life, but she really feels there is a greater possibility of more losses, rejection, emotional pain, and of being exploited.

It's not worth the effort, she says.  It's not worth the risk.

It's her choice, not mine, but for now I have to honor it.

Monday, October 17, 2011

More examples

The economic conditions have caused a lot of stress, anxiety, depression, feelings of helplessness, worthlessness, inadequacy and anger.  These things are pretty obvious, but they are very detrimental to individuals and families. 

As I said yesterday, my practice in this industrial city, is an indication of what is going on in the country.  Five years ago I had several cases of couples coming in big SUVs, they were having alcohol and recreational drug problems, and sneaking off with their friends' husbands and wives.  Several of the women were even flaunting their newer, bigger breasts.  It was all with money they took got from remortgaging their homes.

Now, several of them are back, having lost the home, and at least one of the jobs.  The crash has been devastating.  They feel cheated, as they were only doing what the world was telling them to do, which was to pump up the economy.

Of the couples who have come back, most of them have figured out a way to stop blaming each other and pull together.  That is good to see.  It can really be a step-up, away from the foolishness and craziness.  People are finally learning that having credit is not the same as having money. If the pain and suffering last a year or two I am sure the lesson will really sink in.  If they manage to get a new job within about six months they may think they are brilliant and can get away with anything.  Very few people really learn to plan,  I think we are still short-term hunters and have to eat as much meat as we can before it rots.

There are many other ways that this economy is making people suffer, especially people in their early twenties, who have student loans and $12 jobs.  They are lost and know they can't afford a marriage and a family.  They drink beer and watch movies at home.

It seems as if the answer will have to come from local communities.  People will have to learn to think small, not look to big government or big corporations who will not hire.  They will have to find ways to trade with each other, build a community that keeps services and money flowing amongst themselves.

I see some signs of it among people who have lost jobs more than a year ago and realize they have to figure something out for themselves, something different. They now have cleaning businesses, repair businesses, cooking businesses, very basic stuff.

The older workers, from their mid-fifties up, make these kinds of transitions with a lot more difficulty. They do not welcome the challenge of starting over.  They feel they have already deal with enough challenges.

But this is America in the New Millennium.  We have been trained not to care.

Sunday, October 16, 2011

More on tough times

It is often said these days that we are going through the worst economic times in seventy years.  The world is suffering from the bursting of bubbles, greed, high stakes foolishness and the fall out from chasing false values.

Seventy years ago there was a brand new field of psychotherapy.  Freud was still leading the charge, very few people got to experience any kind of treatment besides being locked away in insane asylums, and the treatment anyone received was either totally ineffectual or harmful.

When I was training as a therapist I was made aware that the incidence of "mental illness" among those with less money and fewer resources was much greater than for those who were better off.  There was always a great discussion over which was cause and which was effect.  I still was trained, and for the most part was able to focus my practice, in dealing with problems that could primarily be described by a psychiatric diagnosis.  I have discussed in here how inaccurate and often misleading those diagnoses can be, but the point I want to make is that I felt that I was treating psychological and emotional problems.  Many of these problems, I always felt, were the result of conflicts in a person's close interpersonal relationships. Anger, loss, rejection, neglect, shame, scorn and loneliness were many of the themes that often came up in therapy.

I still deal with mostly with those same issues, along with addictions, chronic anxiety, hopeless and powerlessness, real and perceived.  But these days I feel that a lot of these feelings are secondary problems.  The underlying causes are economic. 

There were no private practices of psychotherapy in the 1930s.  Today I feel we have to differentiate between what is a normal reaction to not being able to find a job, or any reliable source of income, and dealing with all the consequences that brings.  Anger, helplessness, shame, stress, family strife, disappointment, embarrassment, feelings of self-depreciation are common, but they are not pathological.  We need to find ways to treat and change these feelings, but the best treatment would be a job.

My office is in an industrial city that is a bellweather for the economy.  In the 1990s there were business in this city that had to hire buses to bring workers in from a city twelve miles away.  Now those bus drivers are out of work along with a long line of others.

I will give more specific examples of what this does to people, the community and everyone's outlook on the world next time.

Monday, October 10, 2011

Sucked in to the Internet

Friday was our day to take care of the oldest granddaughter, The Bird, ten months old.  She is a city girl and accustomed to watching the sights, sounds, sirens, and special people who traverse the city streets,  as she rolls in her stroller from her neighborhood to downtown.

Since I am already sure that the iconoclastic blood of her grandfather runs through her veins I took her down to partake of the folks who were putting on the demonstration, the folks of "Occupy Boston." We read the signs, nodded in appreciation as the folks played the drums, and sought out indications of agreement form passers-by.  In general I felt sympathetic.

After we returned The Bird to her parents and went home I began to poke around on the Internet to see what kind of attention the demonstrators were receiving and what who was reacting in what ways.  I read articles on about four sites, and read the comments, which always seem to bring out the worst in people.  That was my downfall.

The comments on the Fox News site were confusing to me.  I knew somehow those folks would be against the demonstrators, but I couldn't see how they would frame it since in many ways it seemed like the same issues that the Tea Party people were also trying to highlight.  But somehow the Tea Party people were Patriots, while the Occupy people were hippie-Communists, trying to destroy America.

That where I made my mistake and decided to put in a post in support of the Occupy people and asking for some kind of clarification of their anger.  Pretty rapidly I received four responses from people who seemed to be right there, waiting to respond.  Two of the responses were just quick and nasty.  I was called dirty, immature, and a Mamma's boy who expected to have everything handed to him.  One was positive, thanking me for being supportive.  The last one was a long message telling me that if I ever had real experience in the world, and not just from what my college professor told me, then I would know that America is only for those who help themselves.  There is not a right to expect that corporations or the government should do anything for you expect to allow you to do whatever you want, unless you hurt somebody.

That one kind of intrigued me, so when I sat down again, about seven hours later, and really just to see what button I would push, I responded by telling the person that I have run a successful business for thirty years and I have learned that  what is necessary for success is strong and dependable infrastructure provided by a good government, and that no business, and no person really, can survive in this complex society on his own, cooperation and interdependence is necessary for success, especially on a large scale, for a whole society.

In less than five minutes I received a long rambling answer telling me that it is written the Constitution that government should not do much of anything, and that people who expected more were trying to undermine the Exceptionalism of America and bring the greatest country on earth to its knees.  He ended with this : 
"Nothing you have said changes those impressions one bit.  Just because you have run a business doesn't mean you aren't an anti-American leftist.  It just means you have no appreciation for the gift of being an American and therefore don't deserve our consideration of your ludicrous, ill-conceived opinions."

I am posting this here not to show that there are great divides and a total lack of communication across them, as much as to show that there are many, many people, mostly older, angry men, who are on their computers twenty hours a day, defending their world from the likes of me.

Just as I am sure that my granddaughter will absorb many of my values without realizing that it is a choice, I am sure that this person comes from a very different place, literally and figuratively than I do.  The sub-culture he hangs around in, whether real or virtual, is very supportive of his beliefs, and it is only due to these advances in technology that we have the opportunity to irritate each other.

I think, in the long run, that may prove helpful to our society.  If it doesn't cause another Civil War, it could be preventing one.

Friday, October 07, 2011

Greatness has no time for football

If almost everyone was as driven and creative as Steve Jobs no one would make much money.

If everyone THOUGHT they were as creative as Steve Jobs no one would make any money.

It takes drive, passion and focus to be someone like the late Steve Jobs.  Most creative people have great generativity:  they have many, many ideas, some of them are brilliant and many of them are a waste of time.  But what makes those people different than others is that they just keep on going.

I have had patients like that -- if they are not successful, if their ideas don't work, or even if the ideas are good but they can't find a way to get them developed or publicized, then they are diagnosed as bipolar- just someone whose mind is racing.  If one of their ideas work then they become a success; if two hit it then they are geniuses. Steve Jobs had more than two.

I believe (almost) anyone  can do (almost) anything they want if they put their mind, body, time, energy, passion and soul into it.

But they probably won't be able to do much else. I somehow don't think Mr. Jobs went to a lot of Sunday bar-b-ques with is buddies and watched a lot of football.  Everything comes with trade-offs.

or maybe he was a Jets fan.

Monday, October 03, 2011

The new one

Things went OK!
She (it's a she) is home now.
The mother was banged up a bit, but I hear childbrith can get nasty.  But that was two days ago and now everyone is home.

All kinds of family clustered around to hold the pink bundle of warmth.  The kid seemed to take it in stride, as long as she got feed every two or three hours.  She is good tempered, very nicely shaped, and will keep getting better and better.

I am very appreciative that both of my granddaughters live within twenty minutes of where my wife and I have settled.  I will see them often and stick my nose into their business.  However, what I really would like would be to buy one of those big Victorian houses that fill up the next town, and put each family in on a different floor.  I would give everyone their privacy, but I would have access to making sure that everything went along as I wish.

I am not a controlling person, that is certainly not my style, and I know that it doesn't work.  I couldn't be in the profession I am in if I ever beleived that people would listen and do what they are told. But I like to have influence.  There are ways to be a factor in what needs to happen and to apply a few gentle taps and make sure it goes that way.

Yes, you may say, but your children are parents now, and they will raise these kids in the way that is best for their famiies and their times. And yes, ther is some merit to that.  My parents always stayed at some distance except for periodic visits, and my wife's parents vanished into the sunshine. 

But I am now the patriarch of the family, and I will steer this ship, and I have a good idea what the course should be.  Age and wisdom should be honored and respected.

So, when can we start playing Candy Land, or do we have do that with an App?