Transition, But First, Going Away

I am pretty sure that I am finished being a hands-on, face to face psychotherapist.  I cleaned out my desk.  The office is being rented to someone else.  I have kissed all of my patients good-bye. 

It was difficult, kind of earth-shattering in a very personal way, but now it’s done.

I did this gradually, over a two year period, so I think it went as well as possible.  It also gave me time to transition to the next phase.  I have worked with so many people who needed to navigate through difficult transitions,  They had many different reasons: job loss, death of loved ones, illness, accidents, divorce, recovery, new job, new move, new partner. I tried to help them develop new skills. Now it’s my turn.

What I seem to be doing, just by having the time now to do so, is to step back and look around. I had been focused on so many individuals who each had to deal with unique situations. Now I want to look up at the sky.  I want to try to put everything in some kind of perspective, to see how everything ties together. The world is changing very rapidly.  It is creating a great deal of excitement and hope, but also disruption and fear.  You can se e that in the politics that are in such turmoil.

I also see so many educated, dedicated, creative, caring people who are doing exciting, transformative, world changing things in so many areas, such as genetics, brains science, communications, space exploration, immunology, business management, sustainable energy, product development, medicine, food science ….. on and on in almost every field, even psychology.

I guess what I’d like to do is help everyone take a moment to step back and see how all of these changes interact with each other, and what kind of a new world we are creating. How do electric cars relate to genetic editing, to transgender marriages, to sustainable energy, to drone warfare, to on-line education, to a mars landing, to guided meditation?

Is all of this taking us where we want to go or is it just keeping everyone busy and making some people very rich?

I have become very aware that everyone’s lives will be very different in just twenty five years.  I have also become very aware that, if I’m here, I will be 96 in twenty five years.(WTF?)

Therefore, before I ask the two hundred basic questions I have been thinking about, and try to generate a discussion about how we should all participate in designing our future, I will be going away.  Far away, to the other side of the world.  Got to do this while we can, ya know.

When I return we will begin the next phase, unless I decide that it’s enough to just play Shoots and Ladders, Pony, trains and ball.

See you in month or so.

Enjoy the summer.

Set Free!

Yes, I promised my few dozen followers that in this new year I would have the time and the intention to set the record straight, and do so with regular blogging at this site.

So, I didn't.  Not yet.

No one has expressed too much disappointment, so I don't feel to guilty.  Especially since I believe that most of my followers are bots.

But I have been set free!  Set free by rejection.
If you remember, I think I wrote about how I presented some of my ideas at our the State Psychological  Conference.  I received such a mixed reaction to that, at the urging of my Division's program co-chairperson, I submitted a more extensive version for the national conference.

I guess she urged others also, because I was informed there were many, many submissions and mine was not chosen as one that the members would most want to attend.

Of course not!  That's why I submitted it.  They need to hear what is really going on.  They need to stop being so insulated and praiseworthy of group-think.

But now I'm free.  I no longer have to alter my thinking to be acceptable.  I no longer have to submit to any committees and try to follow the rules and submit the forms.

Now, when I get around to it, I start telling you all how it is.  A Psychological Memoir --Past, Present and Future.

But right now, we have left the not so cold weather of New England and tomorrow I am going to the beach.

Like always, the truth will have to wait.

Take care of yourselves until then.

Or, if you're a bot, unplug and then plug back in a minute later.

It Must Be Me

It's still summer.  Beautiful down here, as I said last time.  Friends, family, people, food, drinks, sun, sea, surf, stars.  Lots of stuff to do.

My wife and I played golf yesterday. We are not good golfers.  I have almost gotten to be mediocre, but I don't play enough.  I began to play because it is one of the few sports my wife will do.  She gets bored after nine holes.

We played on a hot afternoon at one of the local courses.  Since it's summer and busy we were paired up with a couple of guys who are about my age who were golfers.  The were buddies, and they said  they play about three or four times a week. They were were nice people and friendly to us.  They were very good at golf. At least a stroke a hole better than me, more on harder holes. But they didn't seem bothered by us whacking the ball around.  They were mildly competitive with each other. A lot of kidding back and forth.  They seemed to repeat things they had said to each other for years.

Often, when we are paired up with another couple, we get to know a bit about them: where they live down here, where they lived before, what they did, how many kids, grandkids, where they like to eat. just general stuff.  When we get paired up with men, they are polite but no information gets exchanged. These guys talked to each other about fishing, about grilling, and about watching golf on TV.  I don't know if they had wives and families.  They could even have been married to each other, although that seemed unlikely.  Although, really, they were. They seemed like guys who had worked at a job for many years, and now they were happy to be finsihed with it.  They were free now to do what they wanted.  They had earned that.

Today, I went out by myself in my kayak.  Paddled down the river and out into the Sound.  I paddled through the little waves out to the mound of rocks.  Looked at the land, sea and sky, and wondered again who I was and what I was thinking about.  I think about thinking too much.

My wife was busy all day so I stopped for some clams and a beer. I was going to sit at the outdoor bar and chat with the folks who were enjoying themselves, but as I passed I heard they were talking about drinking, and drinks.  The talk was a bit loud and a bit sloppy.  They obviously knew what they were talking about and had been at it for a while.

I just  moved on to a table.

I'm a  fun guy, but not in the ways that most people have fun.  I like to drink, but not that much.  I like to play golf, but the score doesn't matter. The only movies I like are strange and have been seen by about three dozen people.  I get bored by most novels.  I don't believe in happy endings. I love to talk to people, especially now that I don't have to help solve their problems, but I make jokes they don't understand, and references to things they never heard of. I think a lot of things are funny. Many of them are the things other people take seriously.  I think I'm funny.  I'm really good at entertaining myself.  I get all my jokes.

But I can't just relax and enjoy everything day after day.  I can't just take care of myself and let the rest of the world go off and do it's thing.  I know when it does things often turn out badly.  I worry about my kids and my grandkids.  I worry a lot about my profession.  Psychology, and the treatment of mental health issues are not evolving fast enough.  They are not keeping up with the rest of the sciences and with the way the world operates. Not effecient or effective.

But I've been at this for almost fifty years now.  It's time to put it down and let someone else pick it up.  I'm very fortunate to be as healthy and happy as I am.  Let it be.

But I can't.  Things should be better. It bothers me.  Some things have improved, but not enough.  People should care.  Most don't.  They are better than I am at just having a good time.  I'm almost jealous.
But I'd be bored.

I see it with my patients all the time.  Long-term habits are hard to break.

Not enough

         In between session of running in and out of the water and jumping over tiny waves with my almost two year-old granddaughter, I was able to read parts of the NY Times on Sunday. As usually, there were many descriptions to some awful things that are going on around the world, which show the varied ways in which people can be horrible to each other.

         I read a few more positive things also, but one piece that I felt was the most relevant to me as a Psychologist was on the back page of the Review section, written by Nickolas A. Christakis, a sociologist and professor at Yale.

http://www.nytimes.com/2013/07/21/opinion/sunday/lets-shake-up-the-social-sciences.html?hpw&_r=0

         I thought it was important because what he presents is very much like I have been saying for at least the last three years to the seven people who listen to me, and that is that our discipline, the science of Psychology and with it the practice of psychotherapy, have become too narrowly focused on the same specific areas we have already studied, and on variations of the same ways in which we have been practicing for seventy years.

         Clearly the practice of Psychology has resulted in many improvements in treatment, especially in how we deal with specific problems, such as PTSD, panic attacks, and even borderline personality.  But we have not taken any dramatic leap forward in conceptualization, and especially in the combining and utilization of knowledge from other branches of science.

         There are so many exciting things going on the fields of genetics, microbiology, and biochemistry that seem to be relevant to how we think and what we do.  It has also become clear to me, after over thirty years in practice, that the core of what we do is based upon a model devised by overly intellectual white Europeans early in the last century.  We can now see that there are so many other factors to consider, such as health, wealth, culture, sub-culture, information availability, and use of technology.

         All of these genetic, biochemical, sociological, and certainly political factors are constantly interacting  with each other in very complex ways and I feel strongly that if we are going to improve our understanding of the causes and influences of what makes people think, feel and act the way that they do, and therefore improve our treatment of those who suffer from it, we have to greatly expand our foundation of study. We have to be much more aggressive in our efforts to learn from, to interact with, and collaborate with others in other disciplines.

         As the market has been showing, unless we change, we will become more out of date and irrelevant.

         

Another Blow to the Profession

DSM V.

It's a joke, and everyone knows it.

It isn't enough that we, Ph.D. Psychologists have to battle it out with "coaches," gurus, Internet experts and mystics, now the entire field of psychiatry has disgraced itself.  Since 2/3rds of Americans really don't know the difference between Psychology and Psychiatry we get lumped in with this blatant attempt to bolster revenue by a profession that is even worse shape than ours.

Psychiatry has become a profession in which 96% of its practitioners have become nothing but pill pushers.  I don't think they get more than ten hours of training in psychotherapy.  So now, to help them out and to aid their fellow travelers in Big Pharma, the list of thoughts and behaviors that can now be considered "pathological" has been increased to include almost anything except brushing your teeth and going to bed early.

The worst part is that they did this despite a lot of pressure, even from their own members.And because of all of the disagreements, they skipped the part about getting anything close to scientific data to back up their ideas that a three year-old who screams and cries because you take your iPhone back, is having an out-of-control event that may require medicating.

The only thing they seemed to have left out is the "Delusional Grandiose Marketing Strategy" diagnosis that should be given to the entire  crew that put this thing together.

Let's just all start over with the big masks, and shake those coconuts with seeds in them.  That will drive the evil spirits away.

Recollections (revised) Part 1A

I don't talk about dreams much in therapy.  I don't ask about them, nor do I think that they are the window into the unconscious. But sometimes they do trigger interesting discussions.  In many ways they are kind of the neurological cleaning out of the flotsam left in the brain at the end of the day. For me, I know that I have to be more careful about what I read after I get into bed.  I often fall asleep and then suffer with blurred visions of the Taliban or Sarah Palin running through my mind, disturbing my rest.

But I had a dream the other day which was clearer than most and the feelings that came with it stayed with me for a while, making me wonder what is going on in my own head.  In the first part of the dream I was an MC of a big party, like a wedding or something.  I was making all kinds of clever cracks, entertaining everyone.  But that quickly morphed into a scene where someone, a good friend, was telling me how I had insulted his mother, and that she was very hurt by things that I said.  The dream then quickly shifted to an image of me and this same kid, whose mother I had insulted, riding on a bus.  He was saying to me something like, "isn't this great, we are finally growing up and going off to college."  I sat there, on the bus, on one of those plastic seats of city buses.  I was nodding in agreement, but I said, yes this really is great, but I feel as if I have done all this before."

When I awoke from the dream I was in a good mood.  I remembered those parts of the dream very clearly and I loved the irony of the last line.  I enjoyed how good I was at recognizing, as I rode of to college, that I had already done that, even though, in the dream, I was confused by what I was feeling.

All of this made be reflect upon what I was really like when I shuffled off to college. What I remember clearly, was that unlike in the dream,  when I went to college the real time, I had little insight and even less  perspective.  I was really pretty clueless about how the world worked, and what I could do to make it work better.  I was having a tough time figuring out where I fit into the whole scheme of things.

I already had developed a very quick and sarcastic wit, mostly because I needed something to protect me, as I was very skinny and did not project an image of physical power.  But my wit was very unconventional and disarming.  One of my high school teachers told me that I was really funny, even if most of what I said went right over the head of most of my classmates.  He added that he hoped that the things I said would not get me killed some day, if per chance, someone did get the joke.

But even in high school my attitude about the world was becoming established. Because I was slighter than most of the boys, and this was because I was younger than most of the boys due to my mother sending me off to school early,  Look, she said, he's smart enough and he's just wasting his time being a pain in the ass at home.  So they started me at school two days after I turned five.  I didn't have to wait for the next year.  I was about ten months younger than most of the kids in my class, which, in fourth grade, is a lot.

I think I had to protect myself by paying closer attention to what other kids were doing and thinking.  I got to be a pretty good at predicting what people were going to do.  I could tell what songs were going to be "hits" the first time I heard them.  I could tell which I my friends were going to be dumped by their girlfriends.  This sense of observation developed to the degree that I began to be a ble to tell which of my teachers really didn't know what they were talking about. I had some really good teachers, and some who were real phonies. Some of them knew that I knew, and that wasn't helpful for me in school, but I knew that this kind of knowledge was what I really should be leaning.

The more I paid attention, and by my Junior year, it was a lot, I developed an awareness that most people were being played for suckers.  They were being lured to put their efforts, beliefs and money into things that were either, illusionary, worthless, harmful or nuts.  At the time it was things like big houses, constant new cars, and bomb shelters.  I also was confused by all the fuss made about religion and patriotism.  I didn't get it.  For me it just didn't make sense to get all worked up because I happened to be born in a certain place.  I mean, I am that different from the people who happened to be born over there?

I didn't get it .  And no one did a very good job explaining it to me.

So I made a lot of sly, kind of sideways remarks. I knew enough not to say anything directly, especially about religion and patriotism.  I could tell that could get me in real trouble.  So I remained, just kind of confused. I had no solution.  I had nothing else to offer in their place, so I kept a lot of it quiet. I didn't really know what to say.

I also realized, that few other kids that I knew even gave these things a thought. They did what was being done around them.  They just kind of accepted that this was the way it was, and went on.  Most of my friends were much more concerned with hitting a baseball and getting their hands up under a girl's sweater.
With that, we shared a common interest, so I was accepted and did Ok.

Because of my confusion I was voted the "most individualistic" kid out of about 700 in my class.  That meant that people thought I was weird, but I guess I was clever enough to make it seem interesting.

And that's why I became a psychologist. 

I thought, geez, if what I'm thinking about is so weird, what the hell is everyone else really thinking about?

For the past forty years, people have been coming in and telling me.  So that part has worked out.