Sunday, July 28, 2013
The $ factor.
I thought I had posted it here, but I only sent it out as a tweet:
"40% of my patients problems could be greatly improved, if not completely cured, by $35,000."
(I tweet @therapistmumble, but it's hardly worth following because I tweet about once a month).
On the front page of today's NYT "Review: section is an article by Moises Velasquez Manoff (that's a name for the new world) which gives a lot of research support to the concept that the poor suffer in many ways -- health, longevity, depression, etc, much more than people who are financially comfortable.
http://opinionator.blogs.nytimes.com/2013/07/27/status-and-stress/?_r=0
Now, to most of you this probably comes as a "Duh!"
But, unfortunately, too many people in this gold ol' U.S. of A. seem not only aware of that fact, but happy about it. We are getting back to where we were in 1964, of blaming the victim, and using the poor to make the rich feel better.
This is not a prescription for the long-term success of any society.
Friday, July 26, 2013
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.
Monday, July 15, 2013
Fishing
I ended my last post by saying that in today's climate it may not always be good to teach a man to fish.
But, really, I didn't get the analogy exactly right.
If you give a man a fish, you can feed him for a day, even if he doesn't know how, or doesn't have the resources to cook it, if the fish is fresh enough.
But if you teach him to fish:
He may get arrested for not having a license.
To get a license he may have to bribe people, or all the licenses may already be taken by corporate entities.
You may be introducing him to fierce territorial competition, for which he is unprepared.
There may not be enough fish due to over-fishing and lax regulation.
The fish that are left may be a health risk due to the polluted water they live in.
Did you also teach him to swim, or are you putting his life in danger?
And don't think farming is any better.
Nothing is that simple any more.
But, really, I didn't get the analogy exactly right.
If you give a man a fish, you can feed him for a day, even if he doesn't know how, or doesn't have the resources to cook it, if the fish is fresh enough.
But if you teach him to fish:
You can teach a man to fish, but are you going to buy him a boat, pay for the fuel, and then pay for the liability insurance?
He may get arrested for not having a license.
To get a license he may have to bribe people, or all the licenses may already be taken by corporate entities.
You may be introducing him to fierce territorial competition, for which he is unprepared.
There may not be enough fish due to over-fishing and lax regulation.
The fish that are left may be a health risk due to the polluted water they live in.
Did you also teach him to swim, or are you putting his life in danger?
And don't think farming is any better.
Nothing is that simple any more.
Sunday, July 14, 2013
Summer
Summer is certainly here. The Big 4th of July Weekend has passed and everyone is in full summer mode. Some are sitting on stoops, going to bar-b-ques, headed to the beach or the lake. The city is full of events to keep the residents home to spend their money locally, or to entertain the tourists. All the cities, large and small on the New England coast, from Newport, RI, to Bar Harbor ME are full and festive. The visitors from Topeka probably think it's like that all year long.
For me, still working, still doing at least three full days a week, the divide between work and play is huge. I feel so fortunate that my family, all three generations now, is happy, healthy, enthusiastic and even prosperous. It becomes even more difficult to turn the pages of the Sunday paper and read about what goes on in Egypt, Mali, Syria, China, Spain, and even Florida and Texas. It is even more painful to see what happens with our very own government, grinding to a halt in Washington, D.C, helping no one, solving nothing.
That is also what upsets me in my practice. So many of the patients i have to deal with have problems that are due as much to politics as they are emotions, neurological, genetic or family dynamics. I see a 58 year-old man who knows he will never be able to get a job that pays close to what he has had before. His unemployment support has ended. His wife is exhausted from dealing with his feelings of hopelessness.
I see a 25 year-old woman who is working as a waitress and wants to go back to nursing school but she already has $32K in student loans. Her father is dead and her mother makes $14 an hour. She would have to take all of her courses, do her clinical rotations, and also be working full-time to support herself,. A friend of hers from high school, whose grades were never as good as hers, has father who is buying her a condo near school and paying all of her expenses.
I have about a dozen more examples for this: cases in which $25K would be much more help than two years of therapy.
Give a man a fish and you feed him for a day. Teach him to fish and he will starve to death if there are no fish to catch.
For me, still working, still doing at least three full days a week, the divide between work and play is huge. I feel so fortunate that my family, all three generations now, is happy, healthy, enthusiastic and even prosperous. It becomes even more difficult to turn the pages of the Sunday paper and read about what goes on in Egypt, Mali, Syria, China, Spain, and even Florida and Texas. It is even more painful to see what happens with our very own government, grinding to a halt in Washington, D.C, helping no one, solving nothing.
That is also what upsets me in my practice. So many of the patients i have to deal with have problems that are due as much to politics as they are emotions, neurological, genetic or family dynamics. I see a 58 year-old man who knows he will never be able to get a job that pays close to what he has had before. His unemployment support has ended. His wife is exhausted from dealing with his feelings of hopelessness.
I see a 25 year-old woman who is working as a waitress and wants to go back to nursing school but she already has $32K in student loans. Her father is dead and her mother makes $14 an hour. She would have to take all of her courses, do her clinical rotations, and also be working full-time to support herself,. A friend of hers from high school, whose grades were never as good as hers, has father who is buying her a condo near school and paying all of her expenses.
I have about a dozen more examples for this: cases in which $25K would be much more help than two years of therapy.
Give a man a fish and you feed him for a day. Teach him to fish and he will starve to death if there are no fish to catch.
Saturday, June 22, 2013
Gettysburg to 2013 to 2163
We are rapidly approaching the 150th anniversary of the Battle of Gettysburg, one of the bloodiest few days in U.S, history. This will be a time of reenactments, strategic studies, and speeches about valour, honor, freedom defended and freedom lost.
There were fifty thousand casualties at Gettysburg. Most of them were young men who had holes shot through them from fairly close range. Most of them probably had little idea of exactly what the reason was for them to put their lives in danger. They were defending their land and their culture. They were brave, irrational and sucked in by peer pressure or fear of punishment for treason.
The underlying cause of that battle, and of the entire U.S. Civil War, had to do with the existence of slavery. Looking back on that, from a perspective of 150 years, there are few few people left, not even Paula Dean, who will defend the enslavement of other humans. It seems very generally accepted that it is inhumane, unjust, and that it should not be done.
But that does not mean that soldiers from the South, the slave owners, and all of the others who went to war, were callous, mean or inhuman. In truth that war, like many that have followed it, was due to changes in economic and energy policies. The Southern states depended upon slavery to keep it's economy profitable. If they had to pay people to built those beautiful houses in Charleston most of them would not have been built. If they had to pay a decent wage to plant and harvest cotton, the price would have been too high for the North, as well as the English and French to want to pay for it.
When almost any society is threatened with a complete loss of their comfortable lifestyle the most common reaction has been to go to war to save it. That's a good part of what caused the American Civil War.
Now, 150 years latter, there is another debate occurring about the U.S. energy policy. There is no threat of war because, at this time, there is no threat that anything is going to change that policy. There is a major threat ( it is already occurring) that if that policy does not change that we are radically altering the living conditions of the planet we live on. There is a large possibility that the number of casualties will be greater than the 800,000 of the Civil War. Due to the violent weather we have had just in the last five years, millions of people have been affected. Many have lost their homes, most of their possessions and their livelihood. Many across America have been injured and many have died in floods, tornadoes, hurricanes and fires or have been affected by some of the worst droughts in history.
Many across the world have been affected by floods and droughts that have ruined economies and resulted in starvation, refugees and wars.
In 150 years, in 2163, when people look back at what is happening today, I think that the lack of action on the energy policy that affects climate change will seem as unacceptable as slavery seems today. But people are defending it now for the same reasons they did then -- there are many people making a good living the way things are. Oil companies, car companies, electric companies, any company that uses a lot of power to do business does not want to pay for the changes that would be necessary if we began to eliminate fossil fuel. Most of us wouldn' t even be able to get to work.
It's very possible that some kind of new technology will save us from these catastrophes, but if that happens it won't be cheap.
But in 150 years, if many cities are under water, or billions of dollars are spend to prevent that from happening, if the weather patterns are consistently more violent than today and huge rains, long droughts and tornadoes become common, people then may be wondering that we were thinking.
We were thinking the same thing that the soldiers in Pickett's Charge were thinking: we are defending our way of life.
There were fifty thousand casualties at Gettysburg. Most of them were young men who had holes shot through them from fairly close range. Most of them probably had little idea of exactly what the reason was for them to put their lives in danger. They were defending their land and their culture. They were brave, irrational and sucked in by peer pressure or fear of punishment for treason.
The underlying cause of that battle, and of the entire U.S. Civil War, had to do with the existence of slavery. Looking back on that, from a perspective of 150 years, there are few few people left, not even Paula Dean, who will defend the enslavement of other humans. It seems very generally accepted that it is inhumane, unjust, and that it should not be done.
But that does not mean that soldiers from the South, the slave owners, and all of the others who went to war, were callous, mean or inhuman. In truth that war, like many that have followed it, was due to changes in economic and energy policies. The Southern states depended upon slavery to keep it's economy profitable. If they had to pay people to built those beautiful houses in Charleston most of them would not have been built. If they had to pay a decent wage to plant and harvest cotton, the price would have been too high for the North, as well as the English and French to want to pay for it.
When almost any society is threatened with a complete loss of their comfortable lifestyle the most common reaction has been to go to war to save it. That's a good part of what caused the American Civil War.
Now, 150 years latter, there is another debate occurring about the U.S. energy policy. There is no threat of war because, at this time, there is no threat that anything is going to change that policy. There is a major threat ( it is already occurring) that if that policy does not change that we are radically altering the living conditions of the planet we live on. There is a large possibility that the number of casualties will be greater than the 800,000 of the Civil War. Due to the violent weather we have had just in the last five years, millions of people have been affected. Many have lost their homes, most of their possessions and their livelihood. Many across America have been injured and many have died in floods, tornadoes, hurricanes and fires or have been affected by some of the worst droughts in history.
Many across the world have been affected by floods and droughts that have ruined economies and resulted in starvation, refugees and wars.
In 150 years, in 2163, when people look back at what is happening today, I think that the lack of action on the energy policy that affects climate change will seem as unacceptable as slavery seems today. But people are defending it now for the same reasons they did then -- there are many people making a good living the way things are. Oil companies, car companies, electric companies, any company that uses a lot of power to do business does not want to pay for the changes that would be necessary if we began to eliminate fossil fuel. Most of us wouldn' t even be able to get to work.
It's very possible that some kind of new technology will save us from these catastrophes, but if that happens it won't be cheap.
But in 150 years, if many cities are under water, or billions of dollars are spend to prevent that from happening, if the weather patterns are consistently more violent than today and huge rains, long droughts and tornadoes become common, people then may be wondering that we were thinking.
We were thinking the same thing that the soldiers in Pickett's Charge were thinking: we are defending our way of life.
Wednesday, May 22, 2013
A brief criticism of everything
Today, one of my colleagues posted the following link to an article
http://www.medicalnewstoday.com/articles/259854.php
Nose jokes aside, and moving further and further away from Freud, I find this study to be very exciting and I hope it is an indication of the direction that mental health will be taking.
Many of us feel that the new DSM V is a bit of an embarrassment to the field. It is not scientific, it is based on symptoms and not causes, and in many ways is much more of a political document than a medical one.
Real research that tries to find the causes of problems will eventually lead to better treatment. Catch-all terms that change over time and are merely descritive of behaviors that are currently out of favor are not very helpful.
This article is a very small first step. The authors state that: The results showed that nose neurons from the schizophrenia patients had much higher levels of one particular microRNA (called miR-382) than those taken from the unaffected controls, as Shomron explains: .......After some more research, the team found that this particular microRNA molecule regulates the expression of genes that are involved in the creation of neurons.
This is just a marker, it is not a cause. But it takes us way beyond the early theories of only environmental causes. It shows that true schizophrenics have a different brain chemistry, as the result of a mutation in the expression of a gene.
BUT, i also want to make it clear that I believe that biological explanations will only rarely be sufficient. That's why DSM VI will also be a failure, as they are basing their future on finding more bio-markers.
However, if Psychology is going to remain relevant to anything but advertising, we will have to interact and collaborate with other sciences to develop a better understanding of what shapes human behavior, both adaptive and maladaptive. I think these sciences need to include both the more basic ones --biology, chemistry, genetics, as well as the more general ones, such as sociology, anthropology, and even climatology.
We can't be stuck doing the things we did forty years ago and calling them different names.
So, up your nose to your brain!
DJB
Sunday, May 12, 2013
interconnecting parts
The world we live in now has become increasingly complex. We are all so much more interconnected that the things we do and the things we use have effects on other people's lives, usually without any intention, or even awareness on our part.
There are large things we do that effect other peoples physical and psychological health. We make choices about how we behave politically that make a difference. The things we choose to buy, the places we go, the people we choose to interact with all effect those people. Many of these are intentional choices we make about how to use our time, resources and energy.
How we treat the people we interact with makes big difference in the kind of world we live in. If we are friendly, positive and up-beat, most of the people around us will respond to us that way. This is not universally true, but it does make a difference.
The reverse is also more true than not: if we treat others with anger, scorn, disdain or indifference, we will find that the world we live in is not pleasant.
The world was not designed to give us up-lifting, meaningful or fun and rewarding times. Quite the contrary, our species has survived because it has (mostly ) learned to adapt the the local conditions. Our species has survived and become dominant because we have learned to be social and to work together. However, we have also learned to divide into small groups and fight for resources. This behavior may no longer be adaptive, but it has not yet been extinguished.
The problems most of my patients bring into my office are usually the result of some behavior that is basically necessary for survival but is now being misapplied. Anxiety is an example of being too fearful, and of trying to control things that cannot be controlled. Paranoia is from a loss of trust. Addictions are usually a perversion of what was pleasurable. Depression is often, to a large degree, from feelings of incompetence and worthlessness.
So be aware of how you feel, and how you express yourself to those around you. How you act does change the world you live in, and that world, in turn, will change you. It is a constant, interactive process.
There are large things we do that effect other peoples physical and psychological health. We make choices about how we behave politically that make a difference. The things we choose to buy, the places we go, the people we choose to interact with all effect those people. Many of these are intentional choices we make about how to use our time, resources and energy.
How we treat the people we interact with makes big difference in the kind of world we live in. If we are friendly, positive and up-beat, most of the people around us will respond to us that way. This is not universally true, but it does make a difference.
The reverse is also more true than not: if we treat others with anger, scorn, disdain or indifference, we will find that the world we live in is not pleasant.
The world was not designed to give us up-lifting, meaningful or fun and rewarding times. Quite the contrary, our species has survived because it has (mostly ) learned to adapt the the local conditions. Our species has survived and become dominant because we have learned to be social and to work together. However, we have also learned to divide into small groups and fight for resources. This behavior may no longer be adaptive, but it has not yet been extinguished.
The problems most of my patients bring into my office are usually the result of some behavior that is basically necessary for survival but is now being misapplied. Anxiety is an example of being too fearful, and of trying to control things that cannot be controlled. Paranoia is from a loss of trust. Addictions are usually a perversion of what was pleasurable. Depression is often, to a large degree, from feelings of incompetence and worthlessness.
So be aware of how you feel, and how you express yourself to those around you. How you act does change the world you live in, and that world, in turn, will change you. It is a constant, interactive process.
Thursday, May 02, 2013
Old White Man
For various reasons I had a sessions this week with two brothers and a sister. They were in their late forties and they compared their impressions about what it was like growing up in their family.
But now their father, who was a distant father but a very successful businessman, is eighty-eight. He has been a widower for a long time, and now he is home, by himself, and moves with great difficulty. His children, mostly his daughter, come to see him four or five times a week to bring him food and cook for him.
He is not very sociable, because is usually tired, and they often find him asleep in his chair.
His daughter explained that this is true because every night he sits up in the chair, facing the door, trying to stay awake. He holds a 35 caliber pistol on his lap and waits for "them" to come and try to take away his.........well, that's not quite clear.
One of his son's says that the gun doesn't have a bullet in the chamber and the old man doesn't have the strength in his hands to pull the lever and get his weapon ready. But it's the thought that counts.
But now their father, who was a distant father but a very successful businessman, is eighty-eight. He has been a widower for a long time, and now he is home, by himself, and moves with great difficulty. His children, mostly his daughter, come to see him four or five times a week to bring him food and cook for him.
He is not very sociable, because is usually tired, and they often find him asleep in his chair.
His daughter explained that this is true because every night he sits up in the chair, facing the door, trying to stay awake. He holds a 35 caliber pistol on his lap and waits for "them" to come and try to take away his.........well, that's not quite clear.
One of his son's says that the gun doesn't have a bullet in the chamber and the old man doesn't have the strength in his hands to pull the lever and get his weapon ready. But it's the thought that counts.
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 helpful......to 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.
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 helpful......to 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."
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
struggles
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.
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.
Sunday, March 31, 2013
Turning the Corner.
In
the month since I have last posted something here many things have changed. But what I feel most is
that if I have not yet turned the corner, I can certainly see around it. The
future may be full of fears and fantasies, but there is now a pathway through
the fog, and for the most part, at least right now, it is exciting.
The
downside is that there is a large negative influence that has exploded upon the
scene. This is not just the
constant addition of obstacles and impediments to the practice of my
profession. No, this is very
personal and it is the diagnosis of a chronic illness of my wife. It is something that can be managed,
and it may not turn out to be as destructive as it possibly could, but it does
change the way she views herself and how she will need to operate in the
world. The extent of the necessary
vigilance is not yet known, but the impact of mortality, and of the randomness
of fate, is now always present.
This
will mean more pressure from my wife, and from inside of me, to live our lives a
bit more deliberately and bit more meaningfully – as if I haven’t been doing
that. She doesn’t like feeling that things are beyond her control.
She is hurt and angry, so I get to be the victim of mini-slights and
corrections, as if it is me who is out of control. But I realize that those slights are temporary.
But
before the diagnosis hit, and about a week after my last note here, I turned
on this computer and sat in for the opening week of my on-line course on
biology and genetics. It is being
given free ot any and all who are interested. But it is not a consumer friendly version of anything. It is the course given by Eric Lander,
the leader of the Human Genome Project, last semester at MIT.
The
only difficulty is that the course, to do it well, requires lots of time. Because like any real
college course about the Community College level, the tests require much more
than answering questions about what was taught. They require taking what was taught and using it to solve a
problem. The problem involves
terms and concepts that may have been briefly mentioned in a lecture, but which take time to review, organize and understand. For example, the course gives the list of amino acids, but
never really clarified the differences, or how they bond, or how they interact
with other proteins – or for that matter what proteins are and how they are
formed. But the questions make you
go and find these things out, which is possible, interesting, but very time consuming.
But
the main thing for me is that the course is about what is being learned
now. It is about things that were
discovered ten or five or two years ago, and how they are being put to use, may possibly be in the future, Also, it is about a basic feature of
who we are as people and how we got that way and how things inside of us work,
or don’t work.
I
find this such a refreshing change from the vagaries and speculation of
psychology and psychotherapy. The
genetic/biochemistry interactions that create many features, traits, and
illnesses that we have are extremely complex, and most are not at all clear
yet, but they are emerging, and ways to explore them are also emerging. It is such a long way from the personal
speculation about hypothetical constructs and pompous “interpretations” of
slight bits of behavior that have been true in psychotherapy for decades. These “interpretations” often reflect
much more about what goes on in the therapist’s mind than in the patient’s.
For
me, now, this is exciting. It is new, it is evolving, it is fascinating and it
could and should be useful. Will I
ever be able to use the knowledge I gain if I continue to pursue things of the
same of similar nature. That is my
goal. I don’t expect to ge a Ph.D.
in genetics or microbiology. I
don’t expect it will be me who make any startling discovery, or theoretical
break-though. But I would like to
find a way to show how so many things are tightly integrated, and highly
interactive, both inside and outside of people. How a change in diet, fatigue, air pollution, architecture,
sunlight, muscle tone, or repetitive noises can influence someone. This can interact with family
relationships, work performance, a personal slight, a sexual flirtation, a
political point of view. These
things can affect family, friends, neighbors or a whole subculture. Those
things have political ramifications that can affect diet and air-pollution that
can affect how glucose can form the proper bonds with other amino acids, which
can help or hinder a gene from performing its function properly.
It
is vastly complex, and I understand that no one can really have a real grasp on
the details. But it is exciting,
fascinating. And mostly, it is
real.
And
anyway, I’m not that good at details.
Monday, February 18, 2013
Still wondering
Looking back on almost thirty years of trying to facilitate changes in the lives of people who are suffering with psychological, emotional and behavioral problems I am still impressed with how complex we humans are. There are so many factors that influence how we think and what we do, most of which we are unaware of.
There are the major things such as who your parents are, what is your families ability to provide stability, how healthy you are, and where you live, that determine so much of how you view the world and how you act. But those can be broken down, and broken down to the details, and which details matter, and when they matter still seem so variable.
Why is my patient, Max, so anxious while his brother is so uncaring? Same house, same parents, same community, most of the same genes. But two very different people. It's true in every family.
Of the five therapists in my office, four of us are Pisces. In fact, the four of us have birthdays within three days of each other? Does that really mean anything?
Some of the patients I see, who come to me after years of being anxious and depressed, work with me for six months and skip happily out of the office. Other take five years and still stare blankly at me during our sessions. Others leave after three or four meetings and I never hear from them again.
What's the difference? Me?
Obama wants to begin spending millions of dollars to study the brain, to see what goes on, what makes it function, or function better? Fascinating.
He compares it to how successful the Human Genome Project was. Which it was. But what do we rally know that is useful from the HGP? We do know somethings, and we seem to be on the verge of learning others. But, mostly what we have learned is that it is all much more complex than we imagined.
Despite the crazy pressures that may be crushing the way that I practice, these are the things that I still want to find out. It will be interesting. I may even be able to be helpful.
I will probably have to spend more time out of my office finding ways to search and research. But that's OK now.
There are the major things such as who your parents are, what is your families ability to provide stability, how healthy you are, and where you live, that determine so much of how you view the world and how you act. But those can be broken down, and broken down to the details, and which details matter, and when they matter still seem so variable.
Why is my patient, Max, so anxious while his brother is so uncaring? Same house, same parents, same community, most of the same genes. But two very different people. It's true in every family.
Of the five therapists in my office, four of us are Pisces. In fact, the four of us have birthdays within three days of each other? Does that really mean anything?
Some of the patients I see, who come to me after years of being anxious and depressed, work with me for six months and skip happily out of the office. Other take five years and still stare blankly at me during our sessions. Others leave after three or four meetings and I never hear from them again.
What's the difference? Me?
Obama wants to begin spending millions of dollars to study the brain, to see what goes on, what makes it function, or function better? Fascinating.
He compares it to how successful the Human Genome Project was. Which it was. But what do we rally know that is useful from the HGP? We do know somethings, and we seem to be on the verge of learning others. But, mostly what we have learned is that it is all much more complex than we imagined.
Despite the crazy pressures that may be crushing the way that I practice, these are the things that I still want to find out. It will be interesting. I may even be able to be helpful.
I will probably have to spend more time out of my office finding ways to search and research. But that's OK now.
Monday, February 11, 2013
Turn, Turn, Turn
I went away for a while where everything was warm and relaxed. At the end of a good time I realized that it was one of the very few times that I didn't want to go back to work. This year, 2013, has been different. I knew things were changing but it really feels as if the roof is falling in. When I came home I tried to write it all down and after about six pages of telling myself what was going on I realized that there have been several changes piled on top of each other which reate more confusion, more work and less money. So, I condensed it all into this:
Last November I took a trip to Italy and reflected upon how our profession was changing. Change was coming, but I thought it would be manageable, and that I had a few years to continue to ease toward retirement.
But 2013 hit, and with it the S**t hit the fan. It all comes down to letters and numbers. The first one is something I have been writing to my Senators about at thee to five month intervals, but the issue and the threat of drastic cuts never goes away.
The other four are either hitting us now or are on the horizon, coming rapidly to shore.
EMR
90834
DSM V
PQRS
What all these letters and numbers seem to mean is that an individual independent psychologist, working in his/her own ideal office, who wishes to be able to see the entire range of people who seek services, and that means those people who need to use their insurance to cover the cost, will have a great deal of difficulty to find the time, and to meet the cost of adapting to those changes.
In some ways we created our own difficulties by marketing our services so well. I remember, a long time ago, when I first opened my practice one of the biggest concerns we had was that people were reluctant to come and see us because of the stigma of needing help. Now it seems, everyone comes for help, for almost everything that affects them: stress, relationship problems, work problems,bad judgement, bad behavior, excessive behavior, passive behavior........
Now the problem has become: Who is going to pay for all of this?
It does seem as if, except in upper middle class, well educated neighborhoods, the model of sitting face to face with one patient in your comfortable office and talking about the ripple effects of their parents' interactions is sooooo 20th Century.
I am not saying that what is coming will be better or worse, but it is coming.
I just may not be a part of it. I'm not sure I can afford it.
Tuesday, January 22, 2013
Misguided Angel
I don't often give alive, mostly because it never works. But I will offer this up anyway, just because there are some things I have learned.
If you are a parent, grandparent, close friend, teacher, or other important person in the life of a young woman between 12 and 19, and you see that she is becoming overly attached to "bad boys," then do whatever you can to get her away from him, and then find out why she does this to herself.
Now, this won't be easy. There is no more unquestioned, loyal, unexplained ridiculous love that that of a fifteen year old girl-- remember the original Juliet? And fifteen year old girls never listen to their mother, especially mothers who have done the same thing.
Yet, you will save this woman, and everyone in her family many years of aggravation and heartache if you can pry her away.
Tell her if she wantss to be a savior and a social worker she will be underpaid enough.
If you are a parent, grandparent, close friend, teacher, or other important person in the life of a young woman between 12 and 19, and you see that she is becoming overly attached to "bad boys," then do whatever you can to get her away from him, and then find out why she does this to herself.
Now, this won't be easy. There is no more unquestioned, loyal, unexplained ridiculous love that that of a fifteen year old girl-- remember the original Juliet? And fifteen year old girls never listen to their mother, especially mothers who have done the same thing.
Yet, you will save this woman, and everyone in her family many years of aggravation and heartache if you can pry her away.
Tell her if she wantss to be a savior and a social worker she will be underpaid enough.
Sunday, January 13, 2013
Yes, Hope for the New Year!
It is a new year. We are about half way through the first month. It's been OK so, far; good for me. I have just completed a weekend of hosting a young woman who is fifteen months old, and then all of us went to visit another who is a very mature twenty-five month old little girl. They seem to like each other. They also like to run, chase, dance, jump and be silly. Now that I have finally recovered from my cold and ensuing cough I can fully enjoy their company.
While my practice is very busy the foundation upon which it is based is crumbling. It's going to be a bad year for many psychotherapists. Despite all the attention that is being suddenly paid to mental health problem, due to the rash of irrational killings, the attention is not tied to any resources, just rhetoric. For reasons that remain obscure, this year we are now supposed to limit, and monitor, the number of minutes we spend in a psychotherapy session. Suddenly we are supposed to average 45 minutes instead of 50 to 60. I guess we can do what we want, but we will get paid less.
To me, it hardly matters, as I am not going to put in the time to fight the American Medical Association, United Health Care, Blue Cross and Blue Shield and the other corporate deciders who have never actually attempted to deal with a person who is stressed, depressed, or in the middle of a panic attack -- not to mention attempt to smooth out the life of someone who has been raped, molested by their step-father, grew-up with a schizophrenic or drag addicted mother, or lost three of the five members of their family in a fire when they were eight.
It gets a bit discouraging to be expected to work hard, confront vast, complex individual and societal problems, and be told that we shouldn't really expect to get a living wage for that, and that in order to get what they will give us we have to keep better records, become more efficient, justify how we work, and document that we are following protocols that may or may not be relevant, and accept less money. So, if your therapist seems a bit stress, cut him/her some slack.
The prevailing American culture still makes it clear that money is still more important than actual people. I doubt that many of those decision makers spent the weekend playing run, chase, dance, jump and being silly. They were worried about the cost.
Too bad for them.
While my practice is very busy the foundation upon which it is based is crumbling. It's going to be a bad year for many psychotherapists. Despite all the attention that is being suddenly paid to mental health problem, due to the rash of irrational killings, the attention is not tied to any resources, just rhetoric. For reasons that remain obscure, this year we are now supposed to limit, and monitor, the number of minutes we spend in a psychotherapy session. Suddenly we are supposed to average 45 minutes instead of 50 to 60. I guess we can do what we want, but we will get paid less.
To me, it hardly matters, as I am not going to put in the time to fight the American Medical Association, United Health Care, Blue Cross and Blue Shield and the other corporate deciders who have never actually attempted to deal with a person who is stressed, depressed, or in the middle of a panic attack -- not to mention attempt to smooth out the life of someone who has been raped, molested by their step-father, grew-up with a schizophrenic or drag addicted mother, or lost three of the five members of their family in a fire when they were eight.
It gets a bit discouraging to be expected to work hard, confront vast, complex individual and societal problems, and be told that we shouldn't really expect to get a living wage for that, and that in order to get what they will give us we have to keep better records, become more efficient, justify how we work, and document that we are following protocols that may or may not be relevant, and accept less money. So, if your therapist seems a bit stress, cut him/her some slack.
The prevailing American culture still makes it clear that money is still more important than actual people. I doubt that many of those decision makers spent the weekend playing run, chase, dance, jump and being silly. They were worried about the cost.
Too bad for them.
Sunday, December 30, 2012
A Post about Posting
In some ways it was gratifying to see that my last post struck a nerve and was passed around a bit. It wasn't quite "viral" but it was read by many more people than usually view my occasional thoughts.
If ever there was gong to be a critical moment in my life as a blogger that could have been it. I should have followed up immediately with clever, insightful posting on each of the next five days, with the hope that my mumblings would become the "go to" place for psychological insight into the evolving and/or decaying state of our wired, digital, always on, always expressive society.
But I didn't. I had a cold. I still have a cough. It is the holiday week so I only have to work one day of eleven. Due to my coughing, and everyone else's illness also, we canceled our trip to the Big City, and I stayed home and read old books, old and new magazines, blogs and weird web sites. I watched things on YouTube, I listened to things on SoundCloud, I almost caught up on my email, I watched really meaningless football and I spend some time with the grandgirls, who had been sick also.
After all of this I have come away thinking that before I say anything else; before I rush to post my brilliant insights out here in the great and ever expanding world of cyberspace, I really ought to have something unique and interesting to say. Even then I have to make sure that I am putting it out there because I want people to read and comment on it, more than I want to become known for saying it.
Russ Douthat, one of the NYT's more conservative columnists wrote today that people should take the time to read opinions that don't agree with theirs. They should try to understand that the opposition, no matter which side, may not be just a bunch of brainwashed nutjobs. While I think that idea has a lot of merit, for me, at this time, I am recommending that I stop reading almost everyone. The political noise has become deafening. Everyone has an opinion, many people put them out there, and then even more people write mean, trite comments, dismissing what was said.
There is a constant flow of opinion, information, music, art, good and bad science, family pictures, famous people, naked celebrities, half truths, the other half of truths, ways to be creative, ways to be creative differently, ways to make money, creative ways to make money, ways to spend money, ways to stay healthy, things to eat, how to cook them, how to grow them, where to buy them. Individually, people post about the parties they are at, the restaurants they go to, the drinks they make, the people they don't like, the pills they take, the things they buy, pictures of their kids, their plants, their private parts, on and on and on and on........
My friends and colleagues are making "apps" as I predicted they should. One is even making the exact app that I had designed one day last summer.
Everything is in the marketing. My app, which I never actually finished, is no better or worse than her app, but if she can get it our there first and fastest, then maybe, perhaps.....
The good thing about having a cold is that I didn't feel like doing much of anything. I just let myself stare out the window at the early setting sun and just let my mind wander, without the pressure of doing anything worthwhile, and without trying to keep up with what is going on.
What I seemed to learn from this was that things will keep going on, and on, but that they really don't seem to be going anywhere particularly quickly, except "over the fiscal cliff" which could happen because no one can make anything happen.
So, my job now is to make sure I move back a little, for a while. I will just sit here, or walk somewhere, or play with one and two year-olds, and give my own mind a chance to clear.
I will finish Moby Dick, (only 1/3 left), listen to some Bach, and I will watch the sunset, and sometimes watch the sun rise.
Perhaps, if I gain some brilliant insight, I will write about it here. But I don't expect brilliance, and that's OK. It's enough to be alive and getting healthy.
Happy New Year to all!
I hope all of you stay healthy, find some peace, some prosperity, find some fulfilling activities, and enjoy being with a few people who are important to you.
If ever there was gong to be a critical moment in my life as a blogger that could have been it. I should have followed up immediately with clever, insightful posting on each of the next five days, with the hope that my mumblings would become the "go to" place for psychological insight into the evolving and/or decaying state of our wired, digital, always on, always expressive society.
But I didn't. I had a cold. I still have a cough. It is the holiday week so I only have to work one day of eleven. Due to my coughing, and everyone else's illness also, we canceled our trip to the Big City, and I stayed home and read old books, old and new magazines, blogs and weird web sites. I watched things on YouTube, I listened to things on SoundCloud, I almost caught up on my email, I watched really meaningless football and I spend some time with the grandgirls, who had been sick also.
After all of this I have come away thinking that before I say anything else; before I rush to post my brilliant insights out here in the great and ever expanding world of cyberspace, I really ought to have something unique and interesting to say. Even then I have to make sure that I am putting it out there because I want people to read and comment on it, more than I want to become known for saying it.
Russ Douthat, one of the NYT's more conservative columnists wrote today that people should take the time to read opinions that don't agree with theirs. They should try to understand that the opposition, no matter which side, may not be just a bunch of brainwashed nutjobs. While I think that idea has a lot of merit, for me, at this time, I am recommending that I stop reading almost everyone. The political noise has become deafening. Everyone has an opinion, many people put them out there, and then even more people write mean, trite comments, dismissing what was said.
There is a constant flow of opinion, information, music, art, good and bad science, family pictures, famous people, naked celebrities, half truths, the other half of truths, ways to be creative, ways to be creative differently, ways to make money, creative ways to make money, ways to spend money, ways to stay healthy, things to eat, how to cook them, how to grow them, where to buy them. Individually, people post about the parties they are at, the restaurants they go to, the drinks they make, the people they don't like, the pills they take, the things they buy, pictures of their kids, their plants, their private parts, on and on and on and on........
My friends and colleagues are making "apps" as I predicted they should. One is even making the exact app that I had designed one day last summer.
Everything is in the marketing. My app, which I never actually finished, is no better or worse than her app, but if she can get it our there first and fastest, then maybe, perhaps.....
The good thing about having a cold is that I didn't feel like doing much of anything. I just let myself stare out the window at the early setting sun and just let my mind wander, without the pressure of doing anything worthwhile, and without trying to keep up with what is going on.
What I seemed to learn from this was that things will keep going on, and on, but that they really don't seem to be going anywhere particularly quickly, except "over the fiscal cliff" which could happen because no one can make anything happen.
So, my job now is to make sure I move back a little, for a while. I will just sit here, or walk somewhere, or play with one and two year-olds, and give my own mind a chance to clear.
I will finish Moby Dick, (only 1/3 left), listen to some Bach, and I will watch the sunset, and sometimes watch the sun rise.
Perhaps, if I gain some brilliant insight, I will write about it here. But I don't expect brilliance, and that's OK. It's enough to be alive and getting healthy.
Happy New Year to all!
I hope all of you stay healthy, find some peace, some prosperity, find some fulfilling activities, and enjoy being with a few people who are important to you.
Friday, December 21, 2012
What the NRA mean
I think i am paraphrasing here, but this is the jist of what the NRA said today:
The nice old guy
in the blue uniform
with the gun in his holster
making $8 an hour
in the school entry way
will be honored as a hero
after the first bullets from the high-velocity automatic weapon
pass through him.
And then we will have the funerals for the rest of the children.
The nice old guy
in the blue uniform
with the gun in his holster
making $8 an hour
in the school entry way
will be honored as a hero
after the first bullets from the high-velocity automatic weapon
pass through him.
And then we will have the funerals for the rest of the children.
Monday, December 17, 2012
Terrible, terrible, terrible
Anyone who knows or ever knew a six-year old has to be totally stunned and heart-broken at what happened on Friday. It is one of the scariest and most meaningless kind of acts that anyone can commit.
The U.S. is faced with another awful, expensive dilemma, as another part of our infrastructure is found to be neglected, underfunded, and ignored, and that again, it is revealed what happens when a problem is left to grow instead of being solved.
The first problem, and one I admit I have an interest in, is the huge amount of mental and emotional difficulties that are not dealt with. There is a growing number of kids who are on the autism spectrum and/or have really difficult behavior problems. These kids either don't get help and end up in jail, or they bounce from school to agencies, to probation to special schools, and if they are getting the treatment they need, and some do, it is very expensive.
Could this kid have been found and his behavior averted if there were more services available? Perhaps. That is very difficult to know. It is certainly worth the effort. I think some of my patients could have gone that way, perhaps, but they got at least some attention.
And the other part is guns, especially automatic weapons, that can shoot dozens of rounds very quickly. I have asked on some of the web sites I visit on which there are some gun advocates, for an explanation of why American citizens need to be armed. I have not yet received an answer that I really understand. I do not expect it to be rational, as perhaps my abhorrence of the availability to such weapons may not be rational, but I would like to understand the thinking, or the feeling.
Yes, gang member have guns, and drug dealers have guns, and so do legitimate hunters and backwoods men. But we don't live in the 1820s any more. We live in a time when all of our lives are greatly intertwined. There are many more restrictions we have to live under if we are to have a society that functions.
But I really believe that there are many people out there who believe that the Muslim in the White House is about to declare Sharia Law, and that if we are not armed out women will be taken away. I guess tehy feel that if it can happen in Egypt, it can happen here.
The U.S. is faced with another awful, expensive dilemma, as another part of our infrastructure is found to be neglected, underfunded, and ignored, and that again, it is revealed what happens when a problem is left to grow instead of being solved.
The first problem, and one I admit I have an interest in, is the huge amount of mental and emotional difficulties that are not dealt with. There is a growing number of kids who are on the autism spectrum and/or have really difficult behavior problems. These kids either don't get help and end up in jail, or they bounce from school to agencies, to probation to special schools, and if they are getting the treatment they need, and some do, it is very expensive.
Could this kid have been found and his behavior averted if there were more services available? Perhaps. That is very difficult to know. It is certainly worth the effort. I think some of my patients could have gone that way, perhaps, but they got at least some attention.
And the other part is guns, especially automatic weapons, that can shoot dozens of rounds very quickly. I have asked on some of the web sites I visit on which there are some gun advocates, for an explanation of why American citizens need to be armed. I have not yet received an answer that I really understand. I do not expect it to be rational, as perhaps my abhorrence of the availability to such weapons may not be rational, but I would like to understand the thinking, or the feeling.
Yes, gang member have guns, and drug dealers have guns, and so do legitimate hunters and backwoods men. But we don't live in the 1820s any more. We live in a time when all of our lives are greatly intertwined. There are many more restrictions we have to live under if we are to have a society that functions.
But I really believe that there are many people out there who believe that the Muslim in the White House is about to declare Sharia Law, and that if we are not armed out women will be taken away. I guess tehy feel that if it can happen in Egypt, it can happen here.
Monday, December 10, 2012
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.
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.
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