Saturday, April 20, 2013

Crazy, Scary, Sad

That was quite a week for those of us here around Boston.

Terrorism? Angry? Psychotic? Sad? Misguided?

I saw a patient on Tuesday who said he and his two kids had watched the end of the marathon and he was about fifty yards away from one bomb and forty yards from the other.  He said he knew immediately what was going on and he just picked up his kids and ran out of the way.

We have a fried who lives in Watertown, about four blocks from where the first brother was killed.  The police came to her home, in full riot gear, with automatic weapons drawn and walked through the house making sure she was safe and no one was hiding.

Two kids, two brothers, shut down the whole Boston area, about five million people shut in their homes.

Perhaps the one brother captured will be able to give some kind of an explanation for his actions, but it will never make sense.  What allows someone to feel that they need to blow-up random people to make a point is never quite clear.  Yes, there are political grievances, where one group feels unfairly dominated and exploited by another group, and they feel the only way they can he heard or to get their plight noticed is to kill a few children, but even in those cases, if people really want to find a solution, it could be done.  But there are enough powerful people who don't want the problem solved.

History shows that there are always many people, especially those who take leadership roles, are either have a fanatical devotion to the cause, or a fanatical devotion to their own importance, to allow for any compromise.

That is happening now in our government, in several places in the Middle East, and in many other countries around the world.

The main concern of most people is first for their own safety, then for their own well-being, and then for the well-being of their family and core group.  Yes, there are many people who truly care about the welfare of people they don't know, and who may be far away.  Many of them, including myself, will do things to be a point.... to the point where it sacrifices my own safety or well-being.  Sure, for a moment I have helped someone having a seizure, or I would pull a kid out of a lake, but probably not let them come live with me, or pay for them to go to college.

All of this still cannot explain what these boys did.  It must be more than just a psychological problem. On the reductionist end it is biological, down to the unfolding of proteins in the brain.  On the global scale it is related to the clash of cultures, ubiquitous saturation of violent images, and the well publicized examples of others who lose control.

The city, state and country must have spent millions of dollars and used thousands of people to track down and stop two young men. The forces of law and order did an excellent job -- perhaps using too many bullets.

All I can conclude from this that something like this will probably happen again within a few years. Again we will wonder why -- for the individual involved.  But the bigger causes, of people believing to strongly in things that really don't matter, will still be there.

Tuesday, April 09, 2013

Coping and Traveling

First, I want to thank the people, those whom I know and those whom I don't, who expressed support and concern for my wife.  Although she is still a bit stunned and a bit pissed off that she is afflicted with this, she is paying very close attention to doing what she should be doing, as she usually does, and there have been good results from doing this.  She does seem healthier and more stable.  There is more to do, but progress is being made.

A while before the diagnosis was made we had planned to take the trip we are on now.  We know that Spring comes late in New England so we came South, in part to visit friends who are down here, and then relax for a few days  here where it is warm, friendly and beautiful, even if the food  is too rich.

But what becomes clearer every day, from seeing my friends and hearing their stories as they relate to my wife, is that getting old kinda sucks. Right now I feel pretty good, and think of myself as fit and flexible. In my head I am the same as I was thirty years ago when I was playing basketball once or twice a week.  However, if I make the mistake of looking in a mirror, or trying to run and jump, it becomes very clear how different I am from how I was then. Also, one of my good friends can barely move his legs, another just had a second heart attack, a third cannot eat anything with fat. A fourth is having both knees replaced this summer.  We even have a couple of friends who clearly are not as mentally sharp as they were ten years ago.  On and on and on.

Psychologically, it isn't easy, and in some ways denial is the best strategy, except when there are measures that can, and need to be taken.  But within the pretty near future most of my friends and I will all be seventy years-old and then it will be tougher to still think of ourselves as just " middle age."

Thursday, April 04, 2013


I've written here before about how it is much more difficult for me, as a psychotherapist, to deal with the folks I see who are physically crumbling, hurting and in pain. I can deal with anxieties, depressions, wild ideas, bad judgment, bad behavior, as well as the lost and lonely, but the the suffering from illness, pain, especially when it is chronic and in a few cases, fatal, is the most draining for me.

Now, in my own home, my wife is dealing with a disease that is probably going to be chronic, is a long way from fatal, but is certainly life changing.  Although she has always been strong, healthy, active, alert, and for the most part living a much more correct and risk free life than I have, she has somehow contracted diabetes, in a form that seems to be a mixture of both Type 1 and Type 2.  Suddenly, from a life that was open and free flowing she has to take measurements, count carbs, and take a regimen of shots and pills that is still being calibrated.

I have no doubt that she will do all that she needs to do, and find a way to balance her life. Yet being hit with this, with really no warning or any way to anticipate that it would come, except for a sudden thirst and weight loss over a period of only a few weeks, is such a shocking smack of mortality that it has just washed me over with the sense of melancholy that comes with the realization that we are all so fragile and ephemeral.

As a husband, it is frustrating because I cannot reach in and turn her pancreas back on and drive away the virus, or toxin or whatever it is that has shut down that organ. I can only be here as best I can.

As a therapist, who works with so many other people who are suffering, and who has done so for so long a period, it seems to highlight how slow, inexact, and inefficient the process of psychotherapy is.

Since this has begun I have been more tired, and I have had to make an extra effort to be focused and attentive in my sessions.  What I see is that so many of the patients, who I have come to care so much for, really are more deeply troubled than I had wanted to see before.  Part of the way I work, which has been successful, is to regard all the people as basically able to function, and even if they are messed up I try to draw out their strengths and show them the expectation that they can improve their lives.  I am sure that this helps them reach for that too.

But when I really dig into their lives and minds I often see how difficult what they have to deal with is, and how their thinking  has been crushed by either/and emotions, family, illness, society or just bad luck.

And, as it is with my wife, all I can rally do is be there, reflect upon it, and talk to them about it.
These are not very powerful tools.