Hey, it's good to see you.
I'm glad you guys could come on down to the little summer place again. Seems like we get to see more people here than we do at home. Have a beer, that is, if you're still drinking.
So, what ya been doing? What ya been thinking? How about them Sox? Going to fold again, like they used to?
How about the world, Huh? Ya think we're going to make it, as a society? This new guy, he says he's a citizen of the world. The old guy, he still wants to go to war. Hates losing, thinks it's a footbal game, except lots of people die,
The new guy certainly can draw a crowd. The old guy is starting to sound kind of mean and bitter.
How come nobody wants the rights to off-shore wind?
How come Boston spent $20 billion, that right $20 billion to dig a hole under the city for a road, which gets clogged with gas guzzling cars, when they could have had the best mass-transit system in the world? And don't tell me I just thought of that because I said this ten years ago, maybe twelve.
Do you think we might have an American society that cares about each other, or should we stick with each of us trying to be millionaires and trying to sell each other crazy mortgages, big cars, fatty food, questionable drugs, insurance that doesn't pay for much, and reality TV. Lindsey? Brittany? Paris? Laura?
Do you want your daughterto be Hanna Montana?
"Wall Street got drunk" the guy said. I wonder how much he's still ben drinking. that's his only possible excuse for fucking up the world so badly.
So, how ya been? How are the kids? Any of them working? Max is 31 and still trying to be a video game tester. He plays "World Destruction" on his phone while he waits for his latte in the bus station. And you say Maggie's pregnant again. Great, you like the other two grand-kids, that you are raising. Maggie knows who the father is this time, that's cool.
As I said, how about them Sox?
Saturday, July 26, 2008
Tuesday, July 22, 2008
human brains, !
Our brains have evolved over hundred of thousands of years. This convoluted mass of protoplasm is one of the most amazing and complex structures that nature has produced.
Yet, in our present complex culture, some of the basic responses our brains have developed are no longer always adaptive. The process of deciding when to rely on the more intrinsic responses, and when to think about could be the best choice is a good deal about what therapy is about.
Example 1: Our brains have learned to size-up a situation quickly and choose a course of action. Is that shape a friend or a foe? Is it food that I can capture or a tiger that will eat me? The sooner you decide, and decide correctly, the better off you would be.
But, the world is more complex now. The person coming to meet you is a nice guy, but he wants something. There is now time to get more information. It can be harmful to take a position and stick to it as conditions change. You have to learn how to re-evaluate all the time.
Example 2: Brains have learned to take the short-term gain over the long-term. We act like we are rational and can plan, but under pressure we don't. There may be six antelope out in the field, but we will grab this one right here, even if it frightens the rest away.
So I said to him, "You're thirty-two years old and she is seventeen, how come you thought it was a good idea to have sex with her.?"
"Well, she was there, she made herself available, and it seemed like a good idea at the time."
AND it probably was a good idea --- at the time. But not ten minutes later. And now everything is a mess.
Yet, in our present complex culture, some of the basic responses our brains have developed are no longer always adaptive. The process of deciding when to rely on the more intrinsic responses, and when to think about could be the best choice is a good deal about what therapy is about.
Example 1: Our brains have learned to size-up a situation quickly and choose a course of action. Is that shape a friend or a foe? Is it food that I can capture or a tiger that will eat me? The sooner you decide, and decide correctly, the better off you would be.
But, the world is more complex now. The person coming to meet you is a nice guy, but he wants something. There is now time to get more information. It can be harmful to take a position and stick to it as conditions change. You have to learn how to re-evaluate all the time.
Example 2: Brains have learned to take the short-term gain over the long-term. We act like we are rational and can plan, but under pressure we don't. There may be six antelope out in the field, but we will grab this one right here, even if it frightens the rest away.
So I said to him, "You're thirty-two years old and she is seventeen, how come you thought it was a good idea to have sex with her.?"
"Well, she was there, she made herself available, and it seemed like a good idea at the time."
AND it probably was a good idea --- at the time. But not ten minutes later. And now everything is a mess.
Sunday, July 20, 2008
The Difference
This was an interesting week.
Last week I was away, lolling around, stretching, eating, making sure the tide ran on schedule.
This week I was back at work. It was interesting, and mostly predictable to see who had done what while I was away. Some people worked hard to make their lives better. They thought about the things we had talked about, they tried to make some changes. They are the ones who make this job worth it.
Some people worked hard, and thought about things, but are still stuck. Their attempts at changes, both internal and external/interpersonal/environmental, did not make much difference. I feel badly, because they are trying, and maybe I should be figuring out things better.
Of course, others did little. They came to see me again, and tell me the same stuff, with a few new excuses about why it was too difficult to take their finger out of their nose. "I know," I tell them, "life's tough, but, in the end, it's your life to do with what you will."
The differences between groups one and two is usually somewhat apparent. There could unmovable people in their lives, their may be physical impediments, or financial ones, or sometimes it is a real brain thing. But, there is a reason that I think I understand.
Why the folks in group three choose, and I use that word intentionally, to suffer, I don't know. Mostly, they don't see it as a choice. Usually, I do. Sometimes, I can see what the choice gives them. I try to change it, but I can't. Sometimes I really can't tell why they just continue to wallow in their own psychic mud.
The people in group three seem to love coming to therapy. But coming to therapy isn't going to make changes in their lives. They have to use what they get from therapy to make changes. Sometimes that's a tough sell.
Last week I was away, lolling around, stretching, eating, making sure the tide ran on schedule.
This week I was back at work. It was interesting, and mostly predictable to see who had done what while I was away. Some people worked hard to make their lives better. They thought about the things we had talked about, they tried to make some changes. They are the ones who make this job worth it.
Some people worked hard, and thought about things, but are still stuck. Their attempts at changes, both internal and external/interpersonal/environmental, did not make much difference. I feel badly, because they are trying, and maybe I should be figuring out things better.
Of course, others did little. They came to see me again, and tell me the same stuff, with a few new excuses about why it was too difficult to take their finger out of their nose. "I know," I tell them, "life's tough, but, in the end, it's your life to do with what you will."
The differences between groups one and two is usually somewhat apparent. There could unmovable people in their lives, their may be physical impediments, or financial ones, or sometimes it is a real brain thing. But, there is a reason that I think I understand.
Why the folks in group three choose, and I use that word intentionally, to suffer, I don't know. Mostly, they don't see it as a choice. Usually, I do. Sometimes, I can see what the choice gives them. I try to change it, but I can't. Sometimes I really can't tell why they just continue to wallow in their own psychic mud.
The people in group three seem to love coming to therapy. But coming to therapy isn't going to make changes in their lives. They have to use what they get from therapy to make changes. Sometimes that's a tough sell.
Saturday, July 12, 2008
really doesn't matter
Went to the beach at night
the 5/8 moon showing itself thought the mist
one star visible
the sea was calm, the waves rolling slowly and rhythmically
one after another, one after another
we are specs in the universe
untiled by our insignificance
yet, we are all we have
and only have it briefly
take good care of yourself
I hope you mean a lot to you
the 5/8 moon showing itself thought the mist
one star visible
the sea was calm, the waves rolling slowly and rhythmically
one after another, one after another
we are specs in the universe
untiled by our insignificance
yet, we are all we have
and only have it briefly
take good care of yourself
I hope you mean a lot to you
Wednesday, July 09, 2008
$600 an hour?
A friend sent me information about an article in the NY Times bout some NY therapists who get $600 an hour. The article talks about how some of those therapists get sucked into pander a bit to these clients. I guess if someone is going to pay you $600 an hour it must be tough to say things that might drive them away.
As hourly workers go, $600 is right up there. I know there are lots of lawyers who charge more, but most of those charges are paid by big corporate entities. The people who get really rich these days are the ones who can leverage their money, either through many shares of stock, or selling thousands of copies of one thing, form diet books, to hula-hoops.
I truly doubt that these therapists who are getting about 6 times what I get are not saying anything more pithy or life-changing than what I say. As most of you realize by now, I am one of the most skilled and effective psychotherapist on the planet. I just have chose to market my services in some average mill city in New England. I guess that's my fault.
I still have not caved in to the American ideal that those who have more money are worth more as people. I ma not impressed, much to my wife's discontent.
Not that I am against money. If someone wants to send me a check for all of these words of wisdom I'd probably cash it. But, as you can see, I give it away for free -- which either makes me dumb or foolish,
or else makes these words priceless.
As hourly workers go, $600 is right up there. I know there are lots of lawyers who charge more, but most of those charges are paid by big corporate entities. The people who get really rich these days are the ones who can leverage their money, either through many shares of stock, or selling thousands of copies of one thing, form diet books, to hula-hoops.
I truly doubt that these therapists who are getting about 6 times what I get are not saying anything more pithy or life-changing than what I say. As most of you realize by now, I am one of the most skilled and effective psychotherapist on the planet. I just have chose to market my services in some average mill city in New England. I guess that's my fault.
I still have not caved in to the American ideal that those who have more money are worth more as people. I ma not impressed, much to my wife's discontent.
Not that I am against money. If someone wants to send me a check for all of these words of wisdom I'd probably cash it. But, as you can see, I give it away for free -- which either makes me dumb or foolish,
or else makes these words priceless.
Sunday, July 06, 2008
obviously
We are down here near the water for the 4th of July. We saw some fireworks, ate some burgers and dogs and even watch families run relay races carrying eggs on a spoon. It couldn't have been more All-American.
Yet, today, being on vacation I had time to read most of the Sunday paper. I read how Americans have been unwisely using up oil since 1973 when the price started to rise. I read that job security has almost totally vanished in this country for almost everyone. That came as a result of the capitalism that also gives a chance to everyone to become wildly wealthy.
I read how global warming is causing extreme weather, and that is leading to crop shortages, and that already has led to wars, which will get worse in the future. I also read about how our health care system is a mess, and the only real way out will be to get a single-payer national system.
These things are obvious, and they all have been for at least twenty years, most for forty years.
What is also obvious, is that we are still spending billions of dollars to send young men across the world to kill people they don't know, for reasons that are unclear.
But it's tough to change things here in America, as it is anywhere else in the world.
Despite all of our freedoms, which are many, and which should not be taken for granted. It is certainly true that living conditions are certainly better and more free than they were two-hundred years ago. But one thing has not changed: people with money and power will not give those things up easily, despite how unjust the conditions that their holding on to their means of acquiring that wealth might cause. Just look at how difficult it was to get rid of slavery.
As one soldier fighting in Afghanistan was quoted as saying: "It's been true for thousands of years: old, rich, powerful men talk tough -- young, poor, strong boys die."
Yet, today, being on vacation I had time to read most of the Sunday paper. I read how Americans have been unwisely using up oil since 1973 when the price started to rise. I read that job security has almost totally vanished in this country for almost everyone. That came as a result of the capitalism that also gives a chance to everyone to become wildly wealthy.
I read how global warming is causing extreme weather, and that is leading to crop shortages, and that already has led to wars, which will get worse in the future. I also read about how our health care system is a mess, and the only real way out will be to get a single-payer national system.
These things are obvious, and they all have been for at least twenty years, most for forty years.
What is also obvious, is that we are still spending billions of dollars to send young men across the world to kill people they don't know, for reasons that are unclear.
But it's tough to change things here in America, as it is anywhere else in the world.
Despite all of our freedoms, which are many, and which should not be taken for granted. It is certainly true that living conditions are certainly better and more free than they were two-hundred years ago. But one thing has not changed: people with money and power will not give those things up easily, despite how unjust the conditions that their holding on to their means of acquiring that wealth might cause. Just look at how difficult it was to get rid of slavery.
As one soldier fighting in Afghanistan was quoted as saying: "It's been true for thousands of years: old, rich, powerful men talk tough -- young, poor, strong boys die."
Sunday, June 29, 2008
The Gloucester Girls
There has been a big to-do around these parts about several of the 17, sixteen year-old women of Gloucester, MA who got pregnant this spring. It seems that for several of them these pregnancies happened by design and not by the usual kind of lack of planning. The suspicion is that some of the women (girls?) discussed this and planned to have and raise their children together.
I don' know them or what they were thinking, but I do know that in my practice I see three families who have young women, 16, 17 and 18 who are pregnant and who are very intent of keeping their babies.
Now I am not going to enter into a debate about abortion. The point I want to make her is that these young women -- only one of whom has even briefly entered my office to talk about what is going on -- seem to have no real idea of what is going on.
None of them are in a real relationship. All of them have had sex with several different guys. None of the fathers of these pregnancies seem to be taking a real responsible role. One of them cares, one is trying to pull away, and the third father seems to be a mystery.
But, t think that these young women see getting pregnant as the only way they can have something productive to do after they leave high school. They are all from chaotic backgrounds. None of them have had a real or substitute father around for years.
From what I have seen or heard of the women, they could be smart enough to put another kind of life together, but they really either don't know how, don't have the confidence, or don't seem to want to go through the long struggle to get educated, employed, married, settled and give their children a stable home.
In their simplistic form of thinking they feel they can work it backwards. If they have a kid, someone will provide a home, an income, and maybe even a partner.
I don't know. They're not talking. I'm not even sure they are thinking. But I do think it is a refection of what it feels like to be on the losing end of a very competitive, winner-take-all society.
I don' know them or what they were thinking, but I do know that in my practice I see three families who have young women, 16, 17 and 18 who are pregnant and who are very intent of keeping their babies.
Now I am not going to enter into a debate about abortion. The point I want to make her is that these young women -- only one of whom has even briefly entered my office to talk about what is going on -- seem to have no real idea of what is going on.
None of them are in a real relationship. All of them have had sex with several different guys. None of the fathers of these pregnancies seem to be taking a real responsible role. One of them cares, one is trying to pull away, and the third father seems to be a mystery.
But, t think that these young women see getting pregnant as the only way they can have something productive to do after they leave high school. They are all from chaotic backgrounds. None of them have had a real or substitute father around for years.
From what I have seen or heard of the women, they could be smart enough to put another kind of life together, but they really either don't know how, don't have the confidence, or don't seem to want to go through the long struggle to get educated, employed, married, settled and give their children a stable home.
In their simplistic form of thinking they feel they can work it backwards. If they have a kid, someone will provide a home, an income, and maybe even a partner.
I don't know. They're not talking. I'm not even sure they are thinking. But I do think it is a refection of what it feels like to be on the losing end of a very competitive, winner-take-all society.
Friday, June 20, 2008
more than diet and exercise
To me, as a psychologist, when I talk to clients about changing their life-style, it means much more than diet and exercise. The most important thing to me is for people to find ways to find comfort and eliminate stress.
This means more than deep breathing.
From my biased point of view, the best thing anyone can do is surround themselves with good people. That means people who love them, support them, and respect them. It also means that those people have the same expectations of you as you have of them.
Freud, who I don't quote too much, said that to be healthy you have to be able to work and love. I agree with that. Now, working may mean that you take care of kids, or a house, or just simply have found a way to pay your bills and be independent. Loving means that you can maintain a long-term relationship that is mutually rewarding, enriching and beneficial.
If where you work and the people you have around you constantly cause stress, aggravation, conflict and tension, then you won't do too well. You will get worn down, and have symptoms.
I realize that we can't all have control of who our families are, who employs us, and whoever else rambles into our lives and causes havoc.
The world now is full of paperwork, emails, computer menus, late fees, pre-authorizations, user fees, war and salmonella. In addition, our relatives (everyone has them) are angry, depressed, jealous, resentful and/or incapable.
So, making a life-style change can be very difficult, especially since you can't go around shooting people any more.
Even for me, to cut down the hours I spend sitting so that my back gets better, has not been easy. It should be, but it isn't.
But, I will get up from the computer now and stretch.
This means more than deep breathing.
From my biased point of view, the best thing anyone can do is surround themselves with good people. That means people who love them, support them, and respect them. It also means that those people have the same expectations of you as you have of them.
Freud, who I don't quote too much, said that to be healthy you have to be able to work and love. I agree with that. Now, working may mean that you take care of kids, or a house, or just simply have found a way to pay your bills and be independent. Loving means that you can maintain a long-term relationship that is mutually rewarding, enriching and beneficial.
If where you work and the people you have around you constantly cause stress, aggravation, conflict and tension, then you won't do too well. You will get worn down, and have symptoms.
I realize that we can't all have control of who our families are, who employs us, and whoever else rambles into our lives and causes havoc.
The world now is full of paperwork, emails, computer menus, late fees, pre-authorizations, user fees, war and salmonella. In addition, our relatives (everyone has them) are angry, depressed, jealous, resentful and/or incapable.
So, making a life-style change can be very difficult, especially since you can't go around shooting people any more.
Even for me, to cut down the hours I spend sitting so that my back gets better, has not been easy. It should be, but it isn't.
But, I will get up from the computer now and stretch.
Monday, June 16, 2008
wholistic conclusions.
Now that the pain is almost gone, just a few tingles left, I have again realized things that I have known, but have been under a great deal of pressure ignore.
That is that treating symptoms, which is what modern medicine is geared to do, even including psychotherapy, is more often than not, a circular waste of time.
My pain was terrible, although I know others suffer much worse, as plain old Aleve was somewhat effective. My first priority was to get rid of the pain. Nothing can be achieved when the pain is so distracting.
But, if I want the pain to stay away I have to make many changes. What happened to my back took twenty years, and if I don't want it to return, I will have to make life-style changes.
My pain was the result of a knee injury, that was treated only as a knee injury. It was made worse by how I continued to play, work, work-out, sit, drive, sit, walk and sleep.
Yes, I can take steroids, pain-killers or get surgery, and treat the symptoms, but if I do that the symptoms will reoccur sometime after the treatments are over. That's because the problem of my out of line muscles and ligaments won't really be fixed.
If I stretch, walk, work-out differently, don't sit nine ours in a row with only five or ten minute breaks, don't slump over a computer when I'm not sitting in therapy, I can change my body and make it healthy.
As a therapist I know this is true too. The symptoms I see, such as anxiety, depression, panic, lack of energy, lack enthusiasm, drug abuse, impulsiveness, temper tantrums, and alike are all symptoms of problems that usually, not always, but almost always, require life-style changes.
That takes a lot of work; a lot of consistent, sustained work.
Insurance companies don't like that. They want us to pick a symptom, treat the symptom, and go on to the next case. That is cheaper in the short run, but it only means that people will soon be back with new symptoms and the same situation which has become worse.
This is true of many, many conditions: obesity, diabetes, high blood pressure, irritable bowel syndrome,colitis, even many forms of heart disease and some cancers.
But medicine doesn't work that way. We are expert at treating symptoms. The problems often remain, the symptoms reappear. The treatments continue. Many drugs are designed to be taken for the rest of the patient's life. That way the symptoms are gone and some people make a lot of money.
We are even worse at prevention.
That is that treating symptoms, which is what modern medicine is geared to do, even including psychotherapy, is more often than not, a circular waste of time.
My pain was terrible, although I know others suffer much worse, as plain old Aleve was somewhat effective. My first priority was to get rid of the pain. Nothing can be achieved when the pain is so distracting.
But, if I want the pain to stay away I have to make many changes. What happened to my back took twenty years, and if I don't want it to return, I will have to make life-style changes.
My pain was the result of a knee injury, that was treated only as a knee injury. It was made worse by how I continued to play, work, work-out, sit, drive, sit, walk and sleep.
Yes, I can take steroids, pain-killers or get surgery, and treat the symptoms, but if I do that the symptoms will reoccur sometime after the treatments are over. That's because the problem of my out of line muscles and ligaments won't really be fixed.
If I stretch, walk, work-out differently, don't sit nine ours in a row with only five or ten minute breaks, don't slump over a computer when I'm not sitting in therapy, I can change my body and make it healthy.
As a therapist I know this is true too. The symptoms I see, such as anxiety, depression, panic, lack of energy, lack enthusiasm, drug abuse, impulsiveness, temper tantrums, and alike are all symptoms of problems that usually, not always, but almost always, require life-style changes.
That takes a lot of work; a lot of consistent, sustained work.
Insurance companies don't like that. They want us to pick a symptom, treat the symptom, and go on to the next case. That is cheaper in the short run, but it only means that people will soon be back with new symptoms and the same situation which has become worse.
This is true of many, many conditions: obesity, diabetes, high blood pressure, irritable bowel syndrome,colitis, even many forms of heart disease and some cancers.
But medicine doesn't work that way. We are expert at treating symptoms. The problems often remain, the symptoms reappear. The treatments continue. Many drugs are designed to be taken for the rest of the patient's life. That way the symptoms are gone and some people make a lot of money.
We are even worse at prevention.
Wednesday, June 11, 2008
Pain 4
Well, it's finally breaking up. The pain is abating, some flexibility is returning, my outlook is improving and there is hope on the horizon.
What is disappointing is how difficult it was to get real help, and how, in the end, I had to find it and do it myself.
So many people my age have been through this sciatica thing. Everyone has their own cure. That's mostly because, most of the time, it goes away by itself. So whatever anyone was doing at the time was what they believe in.
Because I always worked so hard to keep in shape, I really set myself up to be locked out of shape once my body shifted. I actually have spent about 20 years setting this up.
But getting help was not helpful. No one really looked at the whole picture of who I was,and what my muscles, ligaments and bones were doing. What I did for work (sit a lot), and how I worked out.
The doctor (MD) used "evidence based medicine" and recommended for me to follow the course of what most people would need. Unfortunately this course would be very slow, very expensive, involve a dozen different people, and then end up right where I am now-- stretching.
The chiropractor said rest, ice heat, which was fine in the beginning. He couldn't move my bones though, because the muscles were too tight.
The message people were great, but I can't get a message every day. They found the problem, but really didn't offer a solution.
I found all the stretches on Rebuild Your Back.com. I am doing 7 stretches 5 or 6 times a day and it works.
So, I am getting my life back. I have cut my schedule of clients 10 to 20%. I am trying not to get back to the 115% level that got me into this in the first place.
But people keep calling.
I guess they think I have something to say. Or else I just listen really good.
What is disappointing is how difficult it was to get real help, and how, in the end, I had to find it and do it myself.
So many people my age have been through this sciatica thing. Everyone has their own cure. That's mostly because, most of the time, it goes away by itself. So whatever anyone was doing at the time was what they believe in.
Because I always worked so hard to keep in shape, I really set myself up to be locked out of shape once my body shifted. I actually have spent about 20 years setting this up.
But getting help was not helpful. No one really looked at the whole picture of who I was,and what my muscles, ligaments and bones were doing. What I did for work (sit a lot), and how I worked out.
The doctor (MD) used "evidence based medicine" and recommended for me to follow the course of what most people would need. Unfortunately this course would be very slow, very expensive, involve a dozen different people, and then end up right where I am now-- stretching.
The chiropractor said rest, ice heat, which was fine in the beginning. He couldn't move my bones though, because the muscles were too tight.
The message people were great, but I can't get a message every day. They found the problem, but really didn't offer a solution.
I found all the stretches on Rebuild Your Back.com. I am doing 7 stretches 5 or 6 times a day and it works.
So, I am getting my life back. I have cut my schedule of clients 10 to 20%. I am trying not to get back to the 115% level that got me into this in the first place.
But people keep calling.
I guess they think I have something to say. Or else I just listen really good.
Friday, June 06, 2008
pain 3, the doctor
So, after suffering too long and trying alternative solutions I went to the medical doctor today. I haven't been to a regular doctor, except for my eyes, in years, so this was a new guy in a big medical complex.
He was easy to approach, thoughtful, and reasonable. He did a few pokes and squeezes and twists and agreed that yes, I had sciatica. He said it has lasted a bit more than normal so that isn't a good sign. Then he wrote orders for tests.
I left some blood there at the lab, so they can see if I have cancer, and then I'm supposed to get an MRI. I buy my own insurance and have a $2000 deductible, so this will probably eat all of it up, especially if I get the MRI, which they said is about $1200. In Taiwan an MRI costs $125. I will have to pay for his insight, for the lab, for, and later for the guy to read the MRI, then the new people at the back clinic, and then the Physical Tx people. by then it will be over $2K so I will only pay 20% or something, who knows.
But the medical alternatives seem to be drugs and/or surgery, and I'm not keen on either. He offered my a few drugs to control the pain. that was friendly, but they are not the kind that will dampen the inflammation and heal the problem. They are more the kind that many of my clients try to buy on the street.
He also offered me anti-inflammatory meds, but said it would be cheaper to just triple my doses of Advil.
So, I'm taking more Advil, I will give the acupressure guy and the chiropractor another week to work magic or else I get the MRI and enter the medical world, but I am very reluctant to do so. I guess, as a psychotherapist I remain an "alternative" kind of guy.
For now, I am back to my favorite weekend medication, which is Jamison. It doesn't do much for the future, but it makes the present brighter.
Everything in moderation!
He was easy to approach, thoughtful, and reasonable. He did a few pokes and squeezes and twists and agreed that yes, I had sciatica. He said it has lasted a bit more than normal so that isn't a good sign. Then he wrote orders for tests.
I left some blood there at the lab, so they can see if I have cancer, and then I'm supposed to get an MRI. I buy my own insurance and have a $2000 deductible, so this will probably eat all of it up, especially if I get the MRI, which they said is about $1200. In Taiwan an MRI costs $125. I will have to pay for his insight, for the lab, for, and later for the guy to read the MRI, then the new people at the back clinic, and then the Physical Tx people. by then it will be over $2K so I will only pay 20% or something, who knows.
But the medical alternatives seem to be drugs and/or surgery, and I'm not keen on either. He offered my a few drugs to control the pain. that was friendly, but they are not the kind that will dampen the inflammation and heal the problem. They are more the kind that many of my clients try to buy on the street.
He also offered me anti-inflammatory meds, but said it would be cheaper to just triple my doses of Advil.
So, I'm taking more Advil, I will give the acupressure guy and the chiropractor another week to work magic or else I get the MRI and enter the medical world, but I am very reluctant to do so. I guess, as a psychotherapist I remain an "alternative" kind of guy.
For now, I am back to my favorite weekend medication, which is Jamison. It doesn't do much for the future, but it makes the present brighter.
Everything in moderation!
Wednesday, June 04, 2008
pain 2 -- loss of arrogance
I didn't really realize it before, and I'm kind of startled by it, but now that I am going through this pain thing, it's become clear.
Part of what I've learned is how, as a therapist, I've been carrying around an underlying arrogance, and I don't think that's a good thing.
But somehow, even though I have even posted here about how aware I am that one slight random event can completely change your life, I guess I never really thought that would be me. Yes, I was grateful that nothing really terrible had happened to me, but like most people, I attributed it to my own abilities, foresight and planning.
Yes,I am a good, caring and understanding therapist, but I also always somewhat, put on a very subtle display as having a good life. I was in shape, I was financially sound, I have a long-term marriage,and my kids are grown and doing pretty well. I was not yet rich and famous, but perhaps that would come too. I guess, in some ways, I felt I was a good model. But it was also a kind of arrogance. Kind of "see, I can do it, you should do it too -- maybe not just like me, but like you want it.
Now, I've been in pain for six weeks. This is the kind of thing that is common, and happens to everyone, but it still isn't really over, and it has been very limiting and debilitating. Now, I can show that I can stand the pain and the adversity. I have many clients who have much worse and more chronic conditions, but I am still in the midst of mine.
And I don't like it. it sucks, I'm sick of it.I'm getting treatment and improving, but it's slow. I get worried that it won't end, I get tired and irritable.
The severity of what I am going through is also partly my fault because I don't ask for help. That's part of the arrogance. I had always worked these things out myself. A few pills, ice, stretching. So, I just kind of denied, or hid the problem. That was part of the arrogance too. I caoul handle my problems myself.
So, now I'm finished with that. I'm going for help wherever I can find it.
Anyone who can push the magic button will get a big kiss.
They say it will take time. That's what I say to all my clients.
But this is America -- I want to be better now.
Part of what I've learned is how, as a therapist, I've been carrying around an underlying arrogance, and I don't think that's a good thing.
But somehow, even though I have even posted here about how aware I am that one slight random event can completely change your life, I guess I never really thought that would be me. Yes, I was grateful that nothing really terrible had happened to me, but like most people, I attributed it to my own abilities, foresight and planning.
Yes,I am a good, caring and understanding therapist, but I also always somewhat, put on a very subtle display as having a good life. I was in shape, I was financially sound, I have a long-term marriage,and my kids are grown and doing pretty well. I was not yet rich and famous, but perhaps that would come too. I guess, in some ways, I felt I was a good model. But it was also a kind of arrogance. Kind of "see, I can do it, you should do it too -- maybe not just like me, but like you want it.
Now, I've been in pain for six weeks. This is the kind of thing that is common, and happens to everyone, but it still isn't really over, and it has been very limiting and debilitating. Now, I can show that I can stand the pain and the adversity. I have many clients who have much worse and more chronic conditions, but I am still in the midst of mine.
And I don't like it. it sucks, I'm sick of it.I'm getting treatment and improving, but it's slow. I get worried that it won't end, I get tired and irritable.
The severity of what I am going through is also partly my fault because I don't ask for help. That's part of the arrogance. I had always worked these things out myself. A few pills, ice, stretching. So, I just kind of denied, or hid the problem. That was part of the arrogance too. I caoul handle my problems myself.
So, now I'm finished with that. I'm going for help wherever I can find it.
Anyone who can push the magic button will get a big kiss.
They say it will take time. That's what I say to all my clients.
But this is America -- I want to be better now.
Sunday, June 01, 2008
pain 1
Wow, it's been a month. That's quite a while, even for a fading blogger like me.
Well, there was a reason, pain. I have this sciatica thing, pain, running right down my leg. It's mostly better, but it's still there. It makes it difficult to sit in a chair and type at a computer unless I sit exactly right.
I have learned a lot during this month, about myself, growing old, living with pain, and how I react.
I don't like it, this pain thing. I don't recommend it as a learning experience. But it seems now that I will survive.
It has given me insight into some of my clients, and into how no one can really tell how much pain you feel. So many people I see in my practice are sent to me because many doctors feel these people are in pain, but not THAT much pain. It's very difficult to tell.
Some people want drugs, some people want attention, some people want excuses. But many are just in pain, and it kind of sucks.
I will have a lot more to say about this. I've got to stand up now.
Well, there was a reason, pain. I have this sciatica thing, pain, running right down my leg. It's mostly better, but it's still there. It makes it difficult to sit in a chair and type at a computer unless I sit exactly right.
I have learned a lot during this month, about myself, growing old, living with pain, and how I react.
I don't like it, this pain thing. I don't recommend it as a learning experience. But it seems now that I will survive.
It has given me insight into some of my clients, and into how no one can really tell how much pain you feel. So many people I see in my practice are sent to me because many doctors feel these people are in pain, but not THAT much pain. It's very difficult to tell.
Some people want drugs, some people want attention, some people want excuses. But many are just in pain, and it kind of sucks.
I will have a lot more to say about this. I've got to stand up now.
Friday, May 02, 2008
The way we are going
They are making artificial blood, but it still kills too many people.
There is an artificial heart, that works for a while.
Artificial skin can be used in some circumstances.
There are many examples of artificial limbs that work well.
Lots if artificial hair.
Silicone breasts
redone noses, faces, lips, chins,
artificial hips, knees, shoulders.
Brains?, well not yet,
BUT
in Switzerland there is a company that has linked over 2000 IBM microchips that can handle 22.8 trillion operations per second. Each is supposed to represent a neuron and the hope is that this will mimic brain functioning, and with enough electricity swarming through it they hope it can generate a mind.
I hope it has good parents.
There is an artificial heart, that works for a while.
Artificial skin can be used in some circumstances.
There are many examples of artificial limbs that work well.
Lots if artificial hair.
Silicone breasts
redone noses, faces, lips, chins,
artificial hips, knees, shoulders.
Brains?, well not yet,
BUT
in Switzerland there is a company that has linked over 2000 IBM microchips that can handle 22.8 trillion operations per second. Each is supposed to represent a neuron and the hope is that this will mimic brain functioning, and with enough electricity swarming through it they hope it can generate a mind.
I hope it has good parents.
Friday, April 25, 2008
a Really Great (Great) Grandfather
T was talking about his father, which is something we often do in therapy.
His father was was in and out of his life for many years. T was most raised by his grand-parents. His grandfather was caring, but a bit too harsh.
Then T began to give more a a family perspective about what was expected of the men in his family. He said a lot began with his great-grandfather who was rich and owned a lot of land, and people usually did what he asked.
I guess that was true of the women too because, T went on to say, his great-grandfather had 42 children, with at least 17 different women.
That sets quite a standard for the men of the family.
His father was was in and out of his life for many years. T was most raised by his grand-parents. His grandfather was caring, but a bit too harsh.
Then T began to give more a a family perspective about what was expected of the men in his family. He said a lot began with his great-grandfather who was rich and owned a lot of land, and people usually did what he asked.
I guess that was true of the women too because, T went on to say, his great-grandfather had 42 children, with at least 17 different women.
That sets quite a standard for the men of the family.
Saturday, April 19, 2008
my old brain.
So, it is finally Spring here and everyone seems to be outside doing all kinds of rejuvenating stuff. How can you live in California without Spring?
I'm taking a walk around town, just checking everything out and I pass a window with the shade drawn. Before I realized it I was singing "All the shades were pulled and drawn, way down tight." Those words are from a song called "Silhouettes" which was very popular when I was probably in Jr. High school, and that was a while ago.
The words just flowed out. I must have remembered about 90% of them correctly.
Is this a good thing and I have access to a good memory, or am I getting like my father-in-law and I don't know what decade I'm living in? Hard to tell.
I know that music helps connect everything, so that with the tune, it is easier to remember the song as one until.
It is even more true that when there is emotion connected to something the memory remains stronger ( although not necessarily accurate). There certainly are a lot of emotions connected to Jr High love songs.
Anyway, I also remember that the song was sung by The Rays, and that about month later a group called The Silhouettes came out with a song that also hit #1 on the charts (Do they still have charts?) That was called "Get a Job" a refrain I still sing to several of my clients.
I'm taking a walk around town, just checking everything out and I pass a window with the shade drawn. Before I realized it I was singing "All the shades were pulled and drawn, way down tight." Those words are from a song called "Silhouettes" which was very popular when I was probably in Jr. High school, and that was a while ago.
The words just flowed out. I must have remembered about 90% of them correctly.
Is this a good thing and I have access to a good memory, or am I getting like my father-in-law and I don't know what decade I'm living in? Hard to tell.
I know that music helps connect everything, so that with the tune, it is easier to remember the song as one until.
It is even more true that when there is emotion connected to something the memory remains stronger ( although not necessarily accurate). There certainly are a lot of emotions connected to Jr High love songs.
Anyway, I also remember that the song was sung by The Rays, and that about month later a group called The Silhouettes came out with a song that also hit #1 on the charts (Do they still have charts?) That was called "Get a Job" a refrain I still sing to several of my clients.
old brains
We often go and visit my wife's father. He's going to be 94 soon. Until last year he was doing pretty well, but last spring he contracted pneumonia and, although he recovered physically from that, it seems the stay in the hospital knocked out his mental equilibrium.
Now he often doesn't know what decade he is in. Often he is 16, back in the town where he was born, looking for his neighbors. Sometimes he is fifty and waiting to be picked up to play golf. There are lots of other disorienting things. It's sad that brains tend to shrink with age and then confusing things happen.
Would it have been better if he stayed more involved with others and had more interactions to keep him alert? He was never that naturally social. His wife did all the arranging. Once she died he slowly withdrew.
But, I don't know. He's 94. What can you expect?
At the doctor's recommendation we gave him Zoloft. We gave him one pill at a sub-therapeutic level to try it out. The next night he was up all night making phone calls, mostly to people who had been dead for twenty years. He called 911 because his wife was missing.
We didn't give him another pill.
Really, he should come and live with us, but we have too many stairs and we are not home enough. (I'm saying this just in case my kids read this.)
At 93 I'm buying a motorcycle. If I remember.
Now he often doesn't know what decade he is in. Often he is 16, back in the town where he was born, looking for his neighbors. Sometimes he is fifty and waiting to be picked up to play golf. There are lots of other disorienting things. It's sad that brains tend to shrink with age and then confusing things happen.
Would it have been better if he stayed more involved with others and had more interactions to keep him alert? He was never that naturally social. His wife did all the arranging. Once she died he slowly withdrew.
But, I don't know. He's 94. What can you expect?
At the doctor's recommendation we gave him Zoloft. We gave him one pill at a sub-therapeutic level to try it out. The next night he was up all night making phone calls, mostly to people who had been dead for twenty years. He called 911 because his wife was missing.
We didn't give him another pill.
Really, he should come and live with us, but we have too many stairs and we are not home enough. (I'm saying this just in case my kids read this.)
At 93 I'm buying a motorcycle. If I remember.
Monday, April 14, 2008
Irrationality
A couple of weeks ago I spent a day down at the Tech School where I got to see some terrific stuff they are trying to put together. They had robots with cool eyebrows, and big 3-D models of ho my opinions differed from everyone else.
The main speaker was Dan Ariel who wrote a new book about how people really don't make rational decisions, even about money.
So, I went up to him and I said "Duh."
And he said that economic theory is based on the belief that people are rational and will act in their best interest.
Like who they allow to beat them up when they're married I said.
He looked at me kind of strange and worried.
So then I said, like trading Credit Default Swaps.
Then he knew what I was talking about.
Dr. Phil tells people, rationally, with common sense, what they should do.
Nobody really listens to him either.
But he made $96,000,000
and he doesn't even have a license.
The main speaker was Dan Ariel who wrote a new book about how people really don't make rational decisions, even about money.
So, I went up to him and I said "Duh."
And he said that economic theory is based on the belief that people are rational and will act in their best interest.
Like who they allow to beat them up when they're married I said.
He looked at me kind of strange and worried.
So then I said, like trading Credit Default Swaps.
Then he knew what I was talking about.
Dr. Phil tells people, rationally, with common sense, what they should do.
Nobody really listens to him either.
But he made $96,000,000
and he doesn't even have a license.
Wednesday, April 09, 2008
Here they come again
Here is the real problem. They call themselves "Health Care Companies" or health Management Companies" or some other misleading euphemism. But the truth is they are financial companies. So, when they come after me and tell me to fill out their Patient Outcome Management Forms, of their Patient Wellness Assessment Forms, or TOP Patient survey, I get upset.
They tell me that they are trying to help me make clearer diagnoses. Or they tell me they are trying to help their subscribers find the best clinical matches. It's all a lot of shit.
All they are trying to do is trying to find ways to justify their existence AND to pay us less.
Two of the major conditions necessary for successful psychotherapy are trust and understanding. I don't trust these companies, and I don't think they really have any understanding of what we do. I don't want their "suggestions" of how I should do treatment. If they know hoe to do it they should be out here doing it. Their suggestions don't come from any research that I respect. The symptoms they want me to treat are not symptoms that I really care about -- they are symptoms, not the problem.
They will go away when the issues are addressed.
But now it is fashionable for each company to begin to make their therapists accountable and monitor their effectiveness. Except they really don't know how to do that.
It's all about the money. They've collected it from the subscribers and they don't really want to give it away to us, the care-givers. An adversarial system of health care is never a good one.
They tell me that they are trying to help me make clearer diagnoses. Or they tell me they are trying to help their subscribers find the best clinical matches. It's all a lot of shit.
All they are trying to do is trying to find ways to justify their existence AND to pay us less.
Two of the major conditions necessary for successful psychotherapy are trust and understanding. I don't trust these companies, and I don't think they really have any understanding of what we do. I don't want their "suggestions" of how I should do treatment. If they know hoe to do it they should be out here doing it. Their suggestions don't come from any research that I respect. The symptoms they want me to treat are not symptoms that I really care about -- they are symptoms, not the problem.
They will go away when the issues are addressed.
But now it is fashionable for each company to begin to make their therapists accountable and monitor their effectiveness. Except they really don't know how to do that.
It's all about the money. They've collected it from the subscribers and they don't really want to give it away to us, the care-givers. An adversarial system of health care is never a good one.
Monday, March 31, 2008
worse than it is
Today is Monday, and somehow on Monday I see some of the most difficult, most chronic people that I have to deal with.
I have been practicing in this city for twenty-seven years. I began here the month after John Lennon was killed, so it's easy to remember.
In a practice like this each year I see between 150 or 175 different clients. Usually, about 50 to 60 get carried over to the next year. After 27 years I have learned that the average length of time that anyone spends in treatment with me is bi-modal. It is either six months or eighteen months.
But every year I get one or two people whose lives, or whose minds, are a mess. They stick around for a while. After a while they begin to accumulate.
Today it seemed like everyone I saw was someone I had seen forever, and that I would see until the day I died. But that isn't true.
I checked my records and found that of the 66 people I have seen this year 17 of them I have seen for five years or longer. That is 1/4 of all the folks I see. By the end of the year I will have about 100 people will have finished therapy. But not these folks.
I checked further and noticed that five of those 17 people account for 58% of the phone calls I get.
They are troubled, in constant crisis, some are more than a bit narcissistic, need guidance, reassurance, attention, and seem to have some sense that having a therapist means having a super-mother with a huge breast.
It is these people that have driven some of my colleagues out of business.
I try to set limits. They now know that just because the leave four messages doesn't mean they will get a return call. Life goes on.
I have been practicing in this city for twenty-seven years. I began here the month after John Lennon was killed, so it's easy to remember.
In a practice like this each year I see between 150 or 175 different clients. Usually, about 50 to 60 get carried over to the next year. After 27 years I have learned that the average length of time that anyone spends in treatment with me is bi-modal. It is either six months or eighteen months.
But every year I get one or two people whose lives, or whose minds, are a mess. They stick around for a while. After a while they begin to accumulate.
Today it seemed like everyone I saw was someone I had seen forever, and that I would see until the day I died. But that isn't true.
I checked my records and found that of the 66 people I have seen this year 17 of them I have seen for five years or longer. That is 1/4 of all the folks I see. By the end of the year I will have about 100 people will have finished therapy. But not these folks.
I checked further and noticed that five of those 17 people account for 58% of the phone calls I get.
They are troubled, in constant crisis, some are more than a bit narcissistic, need guidance, reassurance, attention, and seem to have some sense that having a therapist means having a super-mother with a huge breast.
It is these people that have driven some of my colleagues out of business.
I try to set limits. They now know that just because the leave four messages doesn't mean they will get a return call. Life goes on.
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