So, I have returned from the last of Paella, fortresses, cathedrals, and art. The art is either about Jesus or sex, but not both together. The cathedrals are usually built inside of the fortresses. Spain has a long history of fighting with invaders, such as Roman and Arabs. If no one was invading then they seemed to be able to fight amongst themselves. City against city, region against region, fascist against communist. Even now that has not completely calmed down, but the place certainly did not feel threatening. The biggest rivals now seem to be Real Madrid vs. The Barcelona Futbal Club, and that is pretty intense.
http://tvnz.co.nz/football-news/barca-s-keita-questions-real-rivals-3439634
The wine is cheap, the Mediterranean Sea was tranquil, as we could see from the deck of our spa in the olive grove outside of Tarragonia. The old, old cities (200BC or so) were pretty exotic. So give it a try.
Also, Susi asked about Xanex, and although I do not pretend to be Dr. Phil, or Dr. Oz, or Dr. Laura or Dr. Joy Brown, I will answer. From my answer you will see why I would never succeed like any of them.
The answer to Susi's question is that Xanex really works, often, for most people. Yes, it does become addicting, but it can be very helpful. Also, it is easily misused and can become very harmful.
But the effect that Susi felt, of it calming her anxiety is pretty much what it was designed to do. I have other clients who take Propranolol, which is a beta-blocker, which slows down the racing heart and can keep you can be calm in situations that usually make you tense.
Is it better to learn to clam yourself down --probably, but it really isn't that easy, especially if you are constitutionally sensitive and responsive.
So, if it works, and you use it sparingly, and don't start popping them just to drive in traffic, or just to get zoned out, then why not.
But, it probably wouldn't have saved any of your marriages. That's just a guess. I don't know how hard you were to live with.
Tuesday, March 30, 2010
Sunday, March 14, 2010
Looking ahead
Here's the long and short of it.
Looking long-term, that's say two years. Things should be good for me and mine. That assumes that the rest of the world, including our government entitlement programs, the Capitalist money machines, the invading hordes of illegal aliens, the crazy Islamo-fascists, the crazy Tea-Party zealots, 5 members of the U.S. Supreme Court, and members of the local gentry don't finally push us all passed the tipping-point and over the edge.
My life is changing as I enter the age of government entitlements. Soon I will have the option of soaking out more from my government than I put in, but I don't think I will jump for that soon. Also, there are good signs that things in my family may be changing and, if all goes well, the cycle of life will continue. This is something I am wildly in favor of, despite what I have seen of human nature.
Closer in time, in another week we are leaving this continent temporarily, to experience other places, some we have never seen before. I am not one for high risk, body exerting, macho-proving trips. Nor do I care for highly uncomfortable, but proper eco-tourism, to see the exotic, while not disturbing anything, even the mosquitoes and snakes. No, we are going to Madrid and Barcelona, to drink wine, eat the paella, and watch the people who go to the beaches, parks and museums.
But, before I go I have 34 appointments. Business has been very busy this year, despite all the trashing of my profession that has gone on in the media. But the media trashes on everything now, so I guess no one listens. Of the 34 people or couples, I will be pleased to see 28, three are boring, and three are such a pain in the ass that they take up 75% of my extra effort. It only takes a couple of self-absorbed lunatics to muddy all the waters.
Last week I saw a woman I had not seen in 26 years. During that period I had seen her daughter, and two of that daughter's four children, who have all grown-up now, and seem to be doing better than I would have expected. The woman herself, who is 75 now, at first also seemed better than expected, but as she continued to explain her current situation, she brought up the secret cable that had been inserted in her brain and attached to her private parts, and they still use to get her stimulated. But, I couldn't help but admire the survival skills that helped her survive in this cruel and threatening world.
Looking long-term, that's say two years. Things should be good for me and mine. That assumes that the rest of the world, including our government entitlement programs, the Capitalist money machines, the invading hordes of illegal aliens, the crazy Islamo-fascists, the crazy Tea-Party zealots, 5 members of the U.S. Supreme Court, and members of the local gentry don't finally push us all passed the tipping-point and over the edge.
My life is changing as I enter the age of government entitlements. Soon I will have the option of soaking out more from my government than I put in, but I don't think I will jump for that soon. Also, there are good signs that things in my family may be changing and, if all goes well, the cycle of life will continue. This is something I am wildly in favor of, despite what I have seen of human nature.
Closer in time, in another week we are leaving this continent temporarily, to experience other places, some we have never seen before. I am not one for high risk, body exerting, macho-proving trips. Nor do I care for highly uncomfortable, but proper eco-tourism, to see the exotic, while not disturbing anything, even the mosquitoes and snakes. No, we are going to Madrid and Barcelona, to drink wine, eat the paella, and watch the people who go to the beaches, parks and museums.
But, before I go I have 34 appointments. Business has been very busy this year, despite all the trashing of my profession that has gone on in the media. But the media trashes on everything now, so I guess no one listens. Of the 34 people or couples, I will be pleased to see 28, three are boring, and three are such a pain in the ass that they take up 75% of my extra effort. It only takes a couple of self-absorbed lunatics to muddy all the waters.
Last week I saw a woman I had not seen in 26 years. During that period I had seen her daughter, and two of that daughter's four children, who have all grown-up now, and seem to be doing better than I would have expected. The woman herself, who is 75 now, at first also seemed better than expected, but as she continued to explain her current situation, she brought up the secret cable that had been inserted in her brain and attached to her private parts, and they still use to get her stimulated. But, I couldn't help but admire the survival skills that helped her survive in this cruel and threatening world.
Tuesday, March 09, 2010
2 men, surprise
I have been working with two couples since last summer. In both cases the women were depressed, angry and fed up with men who they saw as sullen, uncommunicative, and self-centered. One couple had been married for twenty-two years, one for twelve.
By November one of the men seemed easy to deal with, at least during the sessions. He expressed a willingness to change and he acknowledged that he had problems. He complained that his wife often had a temper and would get loud and challenging when she was unhappy and that pushed him away. She said that she was trying her best to "bite her tongue" and hoped he could relax and become more open with her.
The other guy, who I mentioned in a previous post, said he worked hard, he was not going to succumb to pressure, especially from some woman, and he went into the other room to watch wrestling.
Now, it's four months later. During that time the wife of the second man decided that if her husband was going to take a strong stand and not respond to her repeated pleas for a closer relationship then he could go fuck himself. After weeks of threatening, she moved out. A week after she was gone he began to fall apart. He was stunned. He didn't think she would or she could. But she did, and she seemed to like being on her own and not feeling that she was always wrong and deficient.
He begged and pleaded for a month. Flowers, candies, texts, poems, everything he had never done for twenty-two years. She finally relented and met him for coffee and a discussion of what she expects. Now, six weeks later, she has been back home for three weeks. He won't watch TV until she feels they have communicated enough. He takes her out once or twice a week. He comments on how she is dressed and remembers what she was talking about. He seems to like how it feels to get close to someone. He decided that he doesn't have to be like his father.
The other guy still works all day and comes home, watches TV and falls asleep. He still says that he is trying to change but his wife says that she sees no evidence of that at home. He seems petrified of getting close to anyone, even the kids. She is tired of holding back and after three months of waiting for him to come and participate, laid into him. He went out for a three hour ride. He came home and went to bed.
They have younger kids and she doesn't want to throw him out. They also would have a tough time financially, and she counts on him to watch the kids while she works. She is now trying to live with him, but not expect anything. He says he is "working on things," but I don't think he really knows what that means.
It's like a lot of things: You can only get what you want when you realize that you don't need it.
By November one of the men seemed easy to deal with, at least during the sessions. He expressed a willingness to change and he acknowledged that he had problems. He complained that his wife often had a temper and would get loud and challenging when she was unhappy and that pushed him away. She said that she was trying her best to "bite her tongue" and hoped he could relax and become more open with her.
The other guy, who I mentioned in a previous post, said he worked hard, he was not going to succumb to pressure, especially from some woman, and he went into the other room to watch wrestling.
Now, it's four months later. During that time the wife of the second man decided that if her husband was going to take a strong stand and not respond to her repeated pleas for a closer relationship then he could go fuck himself. After weeks of threatening, she moved out. A week after she was gone he began to fall apart. He was stunned. He didn't think she would or she could. But she did, and she seemed to like being on her own and not feeling that she was always wrong and deficient.
He begged and pleaded for a month. Flowers, candies, texts, poems, everything he had never done for twenty-two years. She finally relented and met him for coffee and a discussion of what she expects. Now, six weeks later, she has been back home for three weeks. He won't watch TV until she feels they have communicated enough. He takes her out once or twice a week. He comments on how she is dressed and remembers what she was talking about. He seems to like how it feels to get close to someone. He decided that he doesn't have to be like his father.
The other guy still works all day and comes home, watches TV and falls asleep. He still says that he is trying to change but his wife says that she sees no evidence of that at home. He seems petrified of getting close to anyone, even the kids. She is tired of holding back and after three months of waiting for him to come and participate, laid into him. He went out for a three hour ride. He came home and went to bed.
They have younger kids and she doesn't want to throw him out. They also would have a tough time financially, and she counts on him to watch the kids while she works. She is now trying to live with him, but not expect anything. He says he is "working on things," but I don't think he really knows what that means.
It's like a lot of things: You can only get what you want when you realize that you don't need it.
Friday, March 05, 2010
can't or won't? But...
I saw one of those Chantix ads on TV and it made me think of Gloria. Gloria took Chantix for over a week. She said it was working; it made her cigarettes taste like garbage. So, then she stopped taking it so she could smoke.
A few things about Gloria: she is in her late 30s, she weighs about 350, easily. She has beginning stages of everything you would expect and a bit more, as now she looses feelings in various parts of her body. She takes all kinds of pills to keep her from toppling over and dying. Sometimes she doesn't take the pills.
Once, with the help of other professions, we set up a diet and exercise program, based around carrots and short walks that would get longer. She took two walks. She stopped for a donut and coffee on the way back.
Here's the difference between Gloria and the Chantix commercial. In the commercial, if you listen closely, they always say that they couldn't have done it without Chantix AND a supporting family. Gloria doesn't have that. Her mother died when she was seventeen, her father is in Florida. He calls once a month to give her a list of his ailments. Her sister is somewhere in Chicago, she thinks.
She had a boyfriend, but he drifted away about eight years ago when she only weighed about 280.
Gloria is smart, funny, hip and knows a lot. She has friends who are also cool, but no one really special, and she is really special to no one. So who cares if she has that donut.
Yes, if she looses 180 pounds it might be easier for her to find someone special, maybe. But that would take two years of real discipline, and then what. Then, maybe.
Really, it's not about free will,it's not about psychiatric illness, it's almost always about relationships.
A few things about Gloria: she is in her late 30s, she weighs about 350, easily. She has beginning stages of everything you would expect and a bit more, as now she looses feelings in various parts of her body. She takes all kinds of pills to keep her from toppling over and dying. Sometimes she doesn't take the pills.
Once, with the help of other professions, we set up a diet and exercise program, based around carrots and short walks that would get longer. She took two walks. She stopped for a donut and coffee on the way back.
Here's the difference between Gloria and the Chantix commercial. In the commercial, if you listen closely, they always say that they couldn't have done it without Chantix AND a supporting family. Gloria doesn't have that. Her mother died when she was seventeen, her father is in Florida. He calls once a month to give her a list of his ailments. Her sister is somewhere in Chicago, she thinks.
She had a boyfriend, but he drifted away about eight years ago when she only weighed about 280.
Gloria is smart, funny, hip and knows a lot. She has friends who are also cool, but no one really special, and she is really special to no one. So who cares if she has that donut.
Yes, if she looses 180 pounds it might be easier for her to find someone special, maybe. But that would take two years of real discipline, and then what. Then, maybe.
Really, it's not about free will,it's not about psychiatric illness, it's almost always about relationships.
Tuesday, March 02, 2010
What I've learned in my absence
Yeah, yeah, I went away and left you unattended, my dear blog.. I have been sitting here waiting to get started, and then things just kept happening. Yes, we tried to get away from the constant cold of February for a few days, and we were fairly successful. We found a spot that was warm, not hot, but warm. That was good enough. We did our taxes, that was a pain in the ass; numbers up numbers down, not much left over, send that to the government.
People in this country don't trust their government. They fight wars to protect their freedom to elect the government, and then they hate the government they have elected. They find it difficult to pay $400 a month for an inefficient, confusing program run by the government. They would rather pay $700 a month for what is pretty much the same program run by people who get rich off the extra money, usually by denying services.
But that brings me to other things that kept me busy over the past month. Writing more checks. There was Haiti, that was bad, and the cancer people, the diabetes people and so many other diseases. Then the orphans, from Haiti, Africa, Romania, Afghanistan, etc. There are refugees In Africa, in Asia, in the Middle East. Yes, there is the Middle East, with war victims, terror victims, endless peace initiatives, and educational projects. That is true close to home too, with hospitals, wounded veterans, homeless shelters, battered women's homes, all in need. And our schools too. City schools need support, kids need scholarship money, money for sports, money for computers, money for lunch.
So this is what I've learned since I've been away:
The World Sucks --- send a check.
People in this country don't trust their government. They fight wars to protect their freedom to elect the government, and then they hate the government they have elected. They find it difficult to pay $400 a month for an inefficient, confusing program run by the government. They would rather pay $700 a month for what is pretty much the same program run by people who get rich off the extra money, usually by denying services.
But that brings me to other things that kept me busy over the past month. Writing more checks. There was Haiti, that was bad, and the cancer people, the diabetes people and so many other diseases. Then the orphans, from Haiti, Africa, Romania, Afghanistan, etc. There are refugees In Africa, in Asia, in the Middle East. Yes, there is the Middle East, with war victims, terror victims, endless peace initiatives, and educational projects. That is true close to home too, with hospitals, wounded veterans, homeless shelters, battered women's homes, all in need. And our schools too. City schools need support, kids need scholarship money, money for sports, money for computers, money for lunch.
So this is what I've learned since I've been away:
The World Sucks --- send a check.
Tuesday, February 09, 2010
freedom
I have written about this woman before, just over a year ago on January 28,2009. She is a fascinating mix of strengths and weaknesses. A mixture of psychological, neurological, traumatic, and also bureaucratic difficulties. She is very articulate, with a good sense of humor, but she gets disoriented very easily, is always anxious and in fear of harm, slightly paranoid, but from experience. She is also a hoarder, as bad as any of the cases you see on TV. (Boy, that is a sick, exploitive show, but that will be another post).
I received a call from a nurse who is part of her treatment team. They went to her house and realized that she is probably not taking her medication as prescribed because she can't find half the bottles that are lost in the mess. They also saw that she has three check-books she can't find, as well as several checks and money-orders that she has received. All lost in the piles.
They told me that they want to send in a visiting nurse, at least every other day to give her her meds, and also they would like to assign someone to be her payee who would manage her money, so her bills will get paid on time and her money will get put into a bank account.
This seemed reasonable, and probably helpful, so I brought it up to the woman at her next session. The idea made her very nervous, and she made me promise to tell them that she did not need, or want, those services.
As we discussed why, the reasons became clear, and reasonable. Although, in some ways she could see the benefit of them "helping" her that way, she really felt like they would be taking away her freedom to be who she is. They would clean up her place and make her throw away many things they viewed as trash, that she viewed as having useful potential, and/or things she was attached to. Yes, she attached to almost everything, but she felt strongly that everything had a purpose.
She felt the same about medication. She felt that if she took all the pills they gave her, she would be less anxious, but paradoxically, that would make her more anxious. She had a history of being abused by her mother, and then by a boyfriend, and finally by a husband who almost killed her --- see she does get very attached to things and people and can't let go. But from these experiences she feels that if she is not anxious she is much more vulnerable, She feels her anxiety protects her.
Also, she feels that on the medication, she would feel less anxious, but she would feel much less of everything, including, much less like being herself. And despite all of her flaws and hang-ups, she has come to enjoy being who she is. She feels hat she is a very nice person who happens to care too much about everything and everybody. She feels that the world would be better if more people were more like her. Instead there is a medical establishment that tries to make people, neat, clean, quiet and respectable. Zombies. She doesn't want that; she wants to stay alive.
So, I agreed to call them off.
I received a call from a nurse who is part of her treatment team. They went to her house and realized that she is probably not taking her medication as prescribed because she can't find half the bottles that are lost in the mess. They also saw that she has three check-books she can't find, as well as several checks and money-orders that she has received. All lost in the piles.
They told me that they want to send in a visiting nurse, at least every other day to give her her meds, and also they would like to assign someone to be her payee who would manage her money, so her bills will get paid on time and her money will get put into a bank account.
This seemed reasonable, and probably helpful, so I brought it up to the woman at her next session. The idea made her very nervous, and she made me promise to tell them that she did not need, or want, those services.
As we discussed why, the reasons became clear, and reasonable. Although, in some ways she could see the benefit of them "helping" her that way, she really felt like they would be taking away her freedom to be who she is. They would clean up her place and make her throw away many things they viewed as trash, that she viewed as having useful potential, and/or things she was attached to. Yes, she attached to almost everything, but she felt strongly that everything had a purpose.
She felt the same about medication. She felt that if she took all the pills they gave her, she would be less anxious, but paradoxically, that would make her more anxious. She had a history of being abused by her mother, and then by a boyfriend, and finally by a husband who almost killed her --- see she does get very attached to things and people and can't let go. But from these experiences she feels that if she is not anxious she is much more vulnerable, She feels her anxiety protects her.
Also, she feels that on the medication, she would feel less anxious, but she would feel much less of everything, including, much less like being herself. And despite all of her flaws and hang-ups, she has come to enjoy being who she is. She feels hat she is a very nice person who happens to care too much about everything and everybody. She feels that the world would be better if more people were more like her. Instead there is a medical establishment that tries to make people, neat, clean, quiet and respectable. Zombies. She doesn't want that; she wants to stay alive.
So, I agreed to call them off.
Wednesday, February 03, 2010
Newsweek again
I don't like to go over the same material lots of time -- although isn't that what most of life is anyway? But my wife still gets Newsweek -- she's been getting it since high school, and that was a while ago. And while she may be one of the two dozen people who actually subscribe to what at one time was a magazine that measured the pulse of the nation, it still has enough power to bother me.
The cover story is by Sharon Begely, the woman who trashed on psychotherapy a couple of months ago and got so many of us therapists all riled up. Well now she has taken her sensationalist approach to journalism and focused on anti-depressant medication. Again, as is her usual style, she reads a couple of articles and takes the most extreme view and turns it into the truth. This time she feels she has discovered The Placebo Effect, which is something that has been around for about forty years. She highlights the fact that most anti-depressant medications are slightly, if any, more effective than a placebo. This is stuff I think that even I, a derivative thinker, have written about on this very blog about two years ago. (if it wasn't so late I'd dig up the post).
The following article in the same magazine was written by a psychiatrist who took the opposite position and extolled the effectiveness and life-saving value of anti-depressants.
This kind of shit is exactly what our President Obama was talking about the other day. He said that discussion and debate are vanishing in this country and it is all point-counter point, with extreme positions and conflict.
The truth about anti-depressants is very complex. Their effectiveness varies greatly depending upon who is taking them, for what, for how long, and how sensitive their body is to chemicals and side-effects.
In many ways the reason these drugs are so wide-spread has more to do with drug company marketing and profits that their actual effectiveness as mind changing agents. It is also true that they can be addicting, and that they usually cause weight gain.
But, these drugs also have been very helpful to millions of people, for reasons that involve a complex interaction of factors.
Hardly anyone, not drug companies, the FDA, clinical researchers who want to get more funding, or the doctors who give out the pills has the time, the skills, the resources, or the money to really do an objective study to tease out all of the factors. We end up with Yes/No divisiveness and half truths.
It has always been this way; back to the time of when we blamed witches and demons.
The cover story is by Sharon Begely, the woman who trashed on psychotherapy a couple of months ago and got so many of us therapists all riled up. Well now she has taken her sensationalist approach to journalism and focused on anti-depressant medication. Again, as is her usual style, she reads a couple of articles and takes the most extreme view and turns it into the truth. This time she feels she has discovered The Placebo Effect, which is something that has been around for about forty years. She highlights the fact that most anti-depressant medications are slightly, if any, more effective than a placebo. This is stuff I think that even I, a derivative thinker, have written about on this very blog about two years ago. (if it wasn't so late I'd dig up the post).
The following article in the same magazine was written by a psychiatrist who took the opposite position and extolled the effectiveness and life-saving value of anti-depressants.
This kind of shit is exactly what our President Obama was talking about the other day. He said that discussion and debate are vanishing in this country and it is all point-counter point, with extreme positions and conflict.
The truth about anti-depressants is very complex. Their effectiveness varies greatly depending upon who is taking them, for what, for how long, and how sensitive their body is to chemicals and side-effects.
In many ways the reason these drugs are so wide-spread has more to do with drug company marketing and profits that their actual effectiveness as mind changing agents. It is also true that they can be addicting, and that they usually cause weight gain.
But, these drugs also have been very helpful to millions of people, for reasons that involve a complex interaction of factors.
Hardly anyone, not drug companies, the FDA, clinical researchers who want to get more funding, or the doctors who give out the pills has the time, the skills, the resources, or the money to really do an objective study to tease out all of the factors. We end up with Yes/No divisiveness and half truths.
It has always been this way; back to the time of when we blamed witches and demons.
Monday, February 01, 2010
Walk-in
These days about half of my new clients call me to make an appointment, the other, mostly younger half send an email. I don't usually get walk-ins. But I did today.
He was sitting in a chair in the waiting room. My scheduled client was already there, so I didn't think he was coming to see me, but I also knew that the other therapist who is usually in the office on Monday afternoon had left. He looked up quizzically as I came out to greet my expected client, so I returned the puzzled gaze. He then asked if I was who I am, and I replied that I was.
Then this gentlemen stood up and asked if I had an appointment available in the not too distant future. By the time he finished asking he was up to his full height of about 6' 4". He was a large, powerful looking gentleman, weighing about 280 pounds, with big shoulders showing through his leather jacket. His hair was slicked straight back and his eyes were dark and direct. There were black and red strands of the top of a tattoo reaching around his neck.
"I need some anger management." he said in a soft voice.
I gave him an appointment anyway.
He was sitting in a chair in the waiting room. My scheduled client was already there, so I didn't think he was coming to see me, but I also knew that the other therapist who is usually in the office on Monday afternoon had left. He looked up quizzically as I came out to greet my expected client, so I returned the puzzled gaze. He then asked if I was who I am, and I replied that I was.
Then this gentlemen stood up and asked if I had an appointment available in the not too distant future. By the time he finished asking he was up to his full height of about 6' 4". He was a large, powerful looking gentleman, weighing about 280 pounds, with big shoulders showing through his leather jacket. His hair was slicked straight back and his eyes were dark and direct. There were black and red strands of the top of a tattoo reaching around his neck.
"I need some anger management." he said in a soft voice.
I gave him an appointment anyway.
Saturday, January 30, 2010
another upbeat week
Let me repeat, as I may have said it before, and that in itself is part of the problem, I mean, me saying it before, and again. And what I'm saying is, that sometimes, part of it is, that growing old kind of sucks. And I'm not even that old, or even in bad shape or anything. But there are the things you don't know, and can't even think of when you're young(er). You can't know; and you don't think you will get like this, but you will, even with super-growth-hormones.
"Old man, take a look at my life, I'm a lot like you are." I remember that song from when Mr. Young and I were both 23. Now, we are getting to be (get that,only getting to be) the old man.
But that's OK. The getting old is OK. What makes it hard is that everything just comes around again. Just when you gather up enough hope to think it's better, it gets washed away. How many times? Many.
And I feel like a sucker each time, that's what hurts more. Each time I get riled up and think maybe I, we, they, have figured out a way, to make it better and to make it last. But then it gets washed away, like the castle in the tide, and now the hard sand on the beach is all flat again.
Does it matter? Not really, to me, directly in many ways. I'm still OK, my kids are OK. I am basically healthy (but slower) solvent, no real debt. The house is warm and dry. I have more 'stuff" than I know what to do with. The internet works fine. I could spend the rest of my left playing Soduku. Who would notice? My wife doesn't really know what I do up here anyway. I gave up porn years ago when I saw what could have been one of my clients in one of those movies. Really freaked me out.
I heard an early Dylan song also. He was running down the road because someone called him a Communist. They still chase you down the road even if the think you're a Socialist.
And who get hurt? As I said not me. Yes, people get hurt, many. The same ones. The ones in the cheap houses, with no credit to get the pipes fixed when they freeze. They live on the low-lands near the river and get flooded when the snow melts and the river rises. They lose their jobs when the factories move to China. Their kids have to drop out of college because they are smart enough to get a $10,000 scholarship, but college costs $47,000. So they go back to selling Toyotas, and now even they are busted.
Or they live in Gaza city.
And so many more people are getting on the State Insurance now, just like people were afraid of. State run stuff, can't be good. And you know what? That's true too. The state pays me less and they send out new, incomprehensible rules every day.
Private insurance companies are greedy. They lie, cheat and swindle. They take your money and throw you in the gutter. Public insurance is complicated, incompetent, and inefficient. They take you taxes, put you in a dirty bed, and leave you there.
The problem is that they are both run by people. THAT's the problem.
Can't blame people though, because that's who were are: cute, lovable, well-meaning, but flawed.
Can't just sit around either. That makes me feel as if I've given up, kind of useless, old. Don't want that.
So, I guess it''s back at it. Or at least it will be on Monday.
How's that for a happy ending.
"Old man, take a look at my life, I'm a lot like you are." I remember that song from when Mr. Young and I were both 23. Now, we are getting to be (get that,only getting to be) the old man.
But that's OK. The getting old is OK. What makes it hard is that everything just comes around again. Just when you gather up enough hope to think it's better, it gets washed away. How many times? Many.
And I feel like a sucker each time, that's what hurts more. Each time I get riled up and think maybe I, we, they, have figured out a way, to make it better and to make it last. But then it gets washed away, like the castle in the tide, and now the hard sand on the beach is all flat again.
Does it matter? Not really, to me, directly in many ways. I'm still OK, my kids are OK. I am basically healthy (but slower) solvent, no real debt. The house is warm and dry. I have more 'stuff" than I know what to do with. The internet works fine. I could spend the rest of my left playing Soduku. Who would notice? My wife doesn't really know what I do up here anyway. I gave up porn years ago when I saw what could have been one of my clients in one of those movies. Really freaked me out.
I heard an early Dylan song also. He was running down the road because someone called him a Communist. They still chase you down the road even if the think you're a Socialist.
And who get hurt? As I said not me. Yes, people get hurt, many. The same ones. The ones in the cheap houses, with no credit to get the pipes fixed when they freeze. They live on the low-lands near the river and get flooded when the snow melts and the river rises. They lose their jobs when the factories move to China. Their kids have to drop out of college because they are smart enough to get a $10,000 scholarship, but college costs $47,000. So they go back to selling Toyotas, and now even they are busted.
Or they live in Gaza city.
And so many more people are getting on the State Insurance now, just like people were afraid of. State run stuff, can't be good. And you know what? That's true too. The state pays me less and they send out new, incomprehensible rules every day.
Private insurance companies are greedy. They lie, cheat and swindle. They take your money and throw you in the gutter. Public insurance is complicated, incompetent, and inefficient. They take you taxes, put you in a dirty bed, and leave you there.
The problem is that they are both run by people. THAT's the problem.
Can't blame people though, because that's who were are: cute, lovable, well-meaning, but flawed.
Can't just sit around either. That makes me feel as if I've given up, kind of useless, old. Don't want that.
So, I guess it''s back at it. Or at least it will be on Monday.
How's that for a happy ending.
Saturday, January 23, 2010
my brain made me do it
And speaking of political turns of events, those of us here in the over-educated belt are kind of shocked to see that a good-looking "regular-guy" defeated an older, not overly charismatic, but very articulate and intelligent woman. There were lots of factors that led to his victory, and one of the major ones was his "No new Taxes" pledge -- the pledge of every conservative since Reagan. The pledge that has led to huge deficits, and then, under Bush W, to huge differences between the sinking middle-class and the fewer and fewer who have more and more.
But brains do that -- us humans are somewhat programmed to take the short-term over the longer term. We always seem to have a sense that there may not be a long-term so lets take what we can right now. That is part (again, only part) of the reason people have affairs. When the heat gets turned up, it is very easy to convince yourself to enjoy what the moment has to offer. Your mind can jump to the idea that it won't matter, you won't get caught, or simply that you will deal with it later, but right now is RIGHT NOW!
This is certainly the thinking (and lack of logic) that goes with addictions. When something is what you want, what you crave, the future consequences seem to diminish, if not disappear entirely.
So it isn't surprising that people who feel that they have less money in their wallet, will vote to keep it there, and try to avoid thinking that we are all turning into California, where even their great university system, which is part of why Silicone Valley was so successful, is crumbling, and they still don't want to pay.
Long-term planning takes maturity. Even Freud defined part of being mentally healthy as being able to delay gratification. But, we can always do that later.
But brains do that -- us humans are somewhat programmed to take the short-term over the longer term. We always seem to have a sense that there may not be a long-term so lets take what we can right now. That is part (again, only part) of the reason people have affairs. When the heat gets turned up, it is very easy to convince yourself to enjoy what the moment has to offer. Your mind can jump to the idea that it won't matter, you won't get caught, or simply that you will deal with it later, but right now is RIGHT NOW!
This is certainly the thinking (and lack of logic) that goes with addictions. When something is what you want, what you crave, the future consequences seem to diminish, if not disappear entirely.
So it isn't surprising that people who feel that they have less money in their wallet, will vote to keep it there, and try to avoid thinking that we are all turning into California, where even their great university system, which is part of why Silicone Valley was so successful, is crumbling, and they still don't want to pay.
Long-term planning takes maturity. Even Freud defined part of being mentally healthy as being able to delay gratification. But, we can always do that later.
Friday, January 22, 2010
The Supremes
The new boys have spoken. It seems that Mr. Roberts couldn't get there fast enough to do his big corporate buddies a favor and turn the apparatus of government over to them. And where was Clarence!!
Let's be clear about this. For those of you Socialists who ran around thinking that Freedom here in Amerika means that Individuals have rights to their own thoughts, speech and actions, and to elect their own representatives -- well no wonder you guys can't even run Cuba.
Freedom means that American Corporations are free to make as much money as possible. That is what is in their charter. It is also clear that if anything as repulsive as an elected government should do anything to limit that freedom, well corporations have the god-given right to spend whatever it takes to change that government. Government should do nothing to obstruct that freedom.
It is the duty, right and privilege of every American citizen to buy whatever it is the corporation is selling, whether it is a bad mortgage, highly sedating drugs, an expensive insurance policy that may not pay the benefit, a credit card with a 33% interest rate, an SUV that gets 14 mpg, a crib that could chop your child's head off, a Big Mac, a Whooper, or an entrepreneurial woman in Las Vegas.
America is about the money. The freedom of those who have it to get keep getting more of it. Anything that gets in the way of that goal is Socialism. And that is BAD. As bad as a Clemson loss in a bowl game.
Buy stock in United Health Care. They will own at least five Senators.
Let's be clear about this. For those of you Socialists who ran around thinking that Freedom here in Amerika means that Individuals have rights to their own thoughts, speech and actions, and to elect their own representatives -- well no wonder you guys can't even run Cuba.
Freedom means that American Corporations are free to make as much money as possible. That is what is in their charter. It is also clear that if anything as repulsive as an elected government should do anything to limit that freedom, well corporations have the god-given right to spend whatever it takes to change that government. Government should do nothing to obstruct that freedom.
It is the duty, right and privilege of every American citizen to buy whatever it is the corporation is selling, whether it is a bad mortgage, highly sedating drugs, an expensive insurance policy that may not pay the benefit, a credit card with a 33% interest rate, an SUV that gets 14 mpg, a crib that could chop your child's head off, a Big Mac, a Whooper, or an entrepreneurial woman in Las Vegas.
America is about the money. The freedom of those who have it to get keep getting more of it. Anything that gets in the way of that goal is Socialism. And that is BAD. As bad as a Clemson loss in a bowl game.
Buy stock in United Health Care. They will own at least five Senators.
Saturday, January 16, 2010
Martha
If I didn't know better I would be really surprised at what is happening right here in my progressive, liberal, sometimes caring state. But I do know people and I understand. I see them every day and often spend hours listening to crazy logic, based on half-truths and lack of information.
It isn't the lack of information so much that is the problem. It is the lack of desire to go and find out; the information is there. It is the pervasive willingness to settle for a simplistic sound-bite, a winning smile, and a sprinkling of fear.
I mean really, we had Rudy Giuliani here yesterday talking about how fighting terrorism is our #1 priority.
Yes, and no. And who are the terrorists here, and there? === Not to minimize that there are crazy people in other places that really do hate us.
Anyway, there seems to be a real chance that some guy who is running as the male version of Sarah Palin could get elected here in one of the bluest of the blue.
If he wins, the real reason will be because he is a big, handsome, physical guy who is running against a smart, articulate woman. America, and probably the rest of the world, rarely looks to smart, articulate women to protect them and solve their problems.
We find it easier to go to war to keep the peace.
It isn't the lack of information so much that is the problem. It is the lack of desire to go and find out; the information is there. It is the pervasive willingness to settle for a simplistic sound-bite, a winning smile, and a sprinkling of fear.
I mean really, we had Rudy Giuliani here yesterday talking about how fighting terrorism is our #1 priority.
Yes, and no. And who are the terrorists here, and there? === Not to minimize that there are crazy people in other places that really do hate us.
Anyway, there seems to be a real chance that some guy who is running as the male version of Sarah Palin could get elected here in one of the bluest of the blue.
If he wins, the real reason will be because he is a big, handsome, physical guy who is running against a smart, articulate woman. America, and probably the rest of the world, rarely looks to smart, articulate women to protect them and solve their problems.
We find it easier to go to war to keep the peace.
Saturday, January 09, 2010
Who is brave?
Let's think about three appointments I had in a row last week. Let's call them 10, 11, and 12.
10 is a woman in her early thirties who has been seeing me for several months because she had a series of bad panic attacks. She doesn't have too many full-blown attacks any more but she is constantly afraid that she will. This makes her afraid that she has lost control of her mind and that she is about to go completely crazy. She won't, but she thinks about it much too much, and with too much intensity.
She had been telling her husband about her fears, but after a few months of trying to reassure her, he just tells her to get over it.
I want her to take some medication. I think it would really help. But she is afraid that once she swallows the pill she has no control of what it will do to her mind, and that the pill will push her over the edge. She is a brave, tough young woman and she fights her fears all the time. You would never know that she is constantly fighting off thought of a mind explosion.
11 is a man I have also been seeing for a while. He is finally beginning to make progress battling a terrible depression. He has spent months in his house, mostly lying in bed trying to find the energy, and in his mind, a reason to get up. He has a lovely wife and a beautiful daughter and he stares at them, knowing he should do more to take care of them. He has been taking many pills, and they have helped a little.
He lost his job months ago. He is behind on his bills. He feels like a failure and is just beginning to get passed hating himself for it. There are some very complicated and involved reasons why this all descended upon him, but no one can see those. People look at him and wonder why he can't just go back to being what he was two years ago.
He is making progress. The thoughts of suicide are less frequent. He is bravely fighting through the dark clouds that have filled up every room of his life.
12 drags herself in on crutches. One leg is worse than useless to her, as it also causes her almost constant pain. Her ankle is not only busted, it is deteriorating, as are several of the bones in her spine. This deterioration has put pressure on her spinal chord and caused seizures. The seizures have caused her to fall and re-injure her ankle, as well has her knee and her wrist.
The pills she takes, and the devices she has implanted in her serve to somewhat diminish her pain. She can take more pills, but then she will sleep all day and all night and not be able to finish a sentence. She does that some times.
There are things she can have done to her that could help. There is a list of three more surgeries. They could relieve most of the pain, or they could paralyze her, or even make her heart stop.
She has one hand and arm that works without pain. She uses it to bravely kill hordes of zombies that attack her through a video game.
10 is a woman in her early thirties who has been seeing me for several months because she had a series of bad panic attacks. She doesn't have too many full-blown attacks any more but she is constantly afraid that she will. This makes her afraid that she has lost control of her mind and that she is about to go completely crazy. She won't, but she thinks about it much too much, and with too much intensity.
She had been telling her husband about her fears, but after a few months of trying to reassure her, he just tells her to get over it.
I want her to take some medication. I think it would really help. But she is afraid that once she swallows the pill she has no control of what it will do to her mind, and that the pill will push her over the edge. She is a brave, tough young woman and she fights her fears all the time. You would never know that she is constantly fighting off thought of a mind explosion.
11 is a man I have also been seeing for a while. He is finally beginning to make progress battling a terrible depression. He has spent months in his house, mostly lying in bed trying to find the energy, and in his mind, a reason to get up. He has a lovely wife and a beautiful daughter and he stares at them, knowing he should do more to take care of them. He has been taking many pills, and they have helped a little.
He lost his job months ago. He is behind on his bills. He feels like a failure and is just beginning to get passed hating himself for it. There are some very complicated and involved reasons why this all descended upon him, but no one can see those. People look at him and wonder why he can't just go back to being what he was two years ago.
He is making progress. The thoughts of suicide are less frequent. He is bravely fighting through the dark clouds that have filled up every room of his life.
12 drags herself in on crutches. One leg is worse than useless to her, as it also causes her almost constant pain. Her ankle is not only busted, it is deteriorating, as are several of the bones in her spine. This deterioration has put pressure on her spinal chord and caused seizures. The seizures have caused her to fall and re-injure her ankle, as well has her knee and her wrist.
The pills she takes, and the devices she has implanted in her serve to somewhat diminish her pain. She can take more pills, but then she will sleep all day and all night and not be able to finish a sentence. She does that some times.
There are things she can have done to her that could help. There is a list of three more surgeries. They could relieve most of the pain, or they could paralyze her, or even make her heart stop.
She has one hand and arm that works without pain. She uses it to bravely kill hordes of zombies that attack her through a video game.
Tuesday, January 05, 2010
The future has arrived
I got a good glimpse of the future today as a big package arrived from one of the managed care companies I try to avoid dealing with. They informed me that they have taken over two of the state's biggest contracts -- the ones that are sure to get bigger as more people turn to The Commonwealth Connector to get the insurance they are mandated to have. There was a nice letter congratulating me for being invited in to the select group of providers. I can now accept patients from two of the state sponsored plans that previously only could go to semi-private under-funded full-service clinics staffed by pre-licensed social workers and non-English speaking psychiatrists. Now, it is my privilege to see these multi-problem families at a low rate of pay, with a high co-payment, thus insuring that many will drop out of treatment when they realize what it will really cost them.
Since I have already adopted the attitude that going to my office almost qualifies on my tax forms as a hobby, I will probably sign the contract, and in that way I will be able to see all of my old patients who had gotten laid-off and lost their good insurance.
The truth is I really would not mind working this way, as long as I could be sure that the people who run this managed care company were getting the same hourly rate that that I am. Probably not the case.
Since I have already adopted the attitude that going to my office almost qualifies on my tax forms as a hobby, I will probably sign the contract, and in that way I will be able to see all of my old patients who had gotten laid-off and lost their good insurance.
The truth is I really would not mind working this way, as long as I could be sure that the people who run this managed care company were getting the same hourly rate that that I am. Probably not the case.
Monday, December 28, 2009
Hope and reality for '10
Getting ready for the new year. Full of hope and vim and vigor. High expectations for that championship season, that break-through discovery, the new romance, new job,new child, maybe even a warm day.
Just remember, and this is nothing personal, incompetence is everywhere. It isn't malicious, it doesn't have to be devious, it's just lots of mistakes, poor performance, distracted workers, bad software, misinformed, badly trained, or just plain sloppy.
That's why electronic records will cause as many problems as they solve, the air-conditioning only breaks when it's hot, the roof only leaks when it rains,luggage gets lost, and Saab is going out of business.
Here is one of my favorite examples. I have been getting rejection notices for a claim to an insurance company for which I am not a provider, and never was. This rejection is for people I have never seen, and for a procedure I don't do, and I am not qualified to do, and therefore have never billed for. But, the best part, is that I have been receiving this rejection notice once a week, every week, for twelve years! Yes fans, you read that right, twelve years.
Every two or three years I have made an attempt to stop it, just to save the mailman, and save a tree. But it is impossible to stop. Once, someone told me I could get them to stop if I repay the money that I was never given, about $94.
I decided not to do that.
So these notices will continue to come, once a week, long after I have retired, long after I have died, long after the insurance company has gone out of business. The paper will be put in recycling bins and be recycled to come out as rejection notices for a procedure I didn't do on people I never saw, at a place I have never been.
Enjoy the new year, but don't count on getting that much accomplished.
Just remember, and this is nothing personal, incompetence is everywhere. It isn't malicious, it doesn't have to be devious, it's just lots of mistakes, poor performance, distracted workers, bad software, misinformed, badly trained, or just plain sloppy.
That's why electronic records will cause as many problems as they solve, the air-conditioning only breaks when it's hot, the roof only leaks when it rains,luggage gets lost, and Saab is going out of business.
Here is one of my favorite examples. I have been getting rejection notices for a claim to an insurance company for which I am not a provider, and never was. This rejection is for people I have never seen, and for a procedure I don't do, and I am not qualified to do, and therefore have never billed for. But, the best part, is that I have been receiving this rejection notice once a week, every week, for twelve years! Yes fans, you read that right, twelve years.
Every two or three years I have made an attempt to stop it, just to save the mailman, and save a tree. But it is impossible to stop. Once, someone told me I could get them to stop if I repay the money that I was never given, about $94.
I decided not to do that.
So these notices will continue to come, once a week, long after I have retired, long after I have died, long after the insurance company has gone out of business. The paper will be put in recycling bins and be recycled to come out as rejection notices for a procedure I didn't do on people I never saw, at a place I have never been.
Enjoy the new year, but don't count on getting that much accomplished.
Thursday, December 24, 2009
very quiet night
It's dark out now, and very, very quiet.
Very little light reflects off of the snow
Only a slight wind rustles the dry leaves and bare branches
Is that really all that is out there?
Santa,
This year give me more of what I want and less of what I deserve.
Wishing you all:
Merry Christmas,
Happy Hannukah
Joyous Solstice
A Wonderous Winter
and most of all
A Happy, healthy, prosperous, peaceful, creative and fun new year.
"Let's hope it's a good one, withour any fear.
Very little light reflects off of the snow
Only a slight wind rustles the dry leaves and bare branches
Is that really all that is out there?
Santa,
This year give me more of what I want and less of what I deserve.
Wishing you all:
Merry Christmas,
Happy Hannukah
Joyous Solstice
A Wonderous Winter
and most of all
A Happy, healthy, prosperous, peaceful, creative and fun new year.
"Let's hope it's a good one, withour any fear.
Friday, December 18, 2009
Health care -swept away
It is becoming increasingly apparent that Mr. Obama had too much trust in his own abilities and the political process. He had hoped that by letting everyone participate, and trying to give everyone a voice, including Republicans, insurance companies, pharmaceutical companies, all the interests that opposed the Clintons, that he could reach a compromise and a consensus. He didn't realize until recently that many people would oppose him no matter what he said, and that others were never going to move from a totally self-interested position.
Many had no reason to compromise, for they felt with enough time and enough money, and a few hysterical distortions, they could get what they wanted. Others feel that their corporate livelihood is at stake, and they could not see passed that for any greater good. It is difficult to ever see a bigger picture than your entire wealth and position.
This is not a surprise. Anyone who has been working in health care has been able to see the the big players, such as United Health Care, Humana, The Blue
Shields, and the other major companies, were really no more threatened than the banks were last year -- even less because they did not screw-up their own incomes. I have known things were going to be bad since my heart-throb, Sarah Palin began talking about 'death panels."
The health care companies have been spending an average of $1,500,000 a day lobbying Congress. I mailed in $50 once.
I try to explain this to my clients when they feel overwhelmed by how unfair life is. They are correct; they are getting screwed; hardly anyone beyond a few friends and family and me, cares.
But that's what makes it interesting. The best course of action is to keep on fighting against the tide. It is an invigorating, and noble endeavor -- even if it is, perhaps, useless. If that becomes tiresome, then find a a way to build a wall, or construct a shelter, fend off the evil-doers, enjoy your family and friends, put on some good music, and dance.
Many had no reason to compromise, for they felt with enough time and enough money, and a few hysterical distortions, they could get what they wanted. Others feel that their corporate livelihood is at stake, and they could not see passed that for any greater good. It is difficult to ever see a bigger picture than your entire wealth and position.
This is not a surprise. Anyone who has been working in health care has been able to see the the big players, such as United Health Care, Humana, The Blue
Shields, and the other major companies, were really no more threatened than the banks were last year -- even less because they did not screw-up their own incomes. I have known things were going to be bad since my heart-throb, Sarah Palin began talking about 'death panels."
The health care companies have been spending an average of $1,500,000 a day lobbying Congress. I mailed in $50 once.
I try to explain this to my clients when they feel overwhelmed by how unfair life is. They are correct; they are getting screwed; hardly anyone beyond a few friends and family and me, cares.
But that's what makes it interesting. The best course of action is to keep on fighting against the tide. It is an invigorating, and noble endeavor -- even if it is, perhaps, useless. If that becomes tiresome, then find a a way to build a wall, or construct a shelter, fend off the evil-doers, enjoy your family and friends, put on some good music, and dance.
Tuesday, December 15, 2009
genetics too, and parents too
There is a good article in The Atlantic of all places by a science writer, David Dobbs. He writes about research done by Marian Bakermans-Kranenburg who worked with children who were way over on the sensitive/reactive/irritable end of the spectrum.
Then he goes on to review other research to link these kids, in part, to a specific gene allele that was linked to the processing of serotonin. This is linked to a vulnerability to depression
What the article was mostly about was that some kids are genetically more reactive than others. It discusses how if these kids have a stressful childhood they often go on to have difficulties with anger, ADHD and impulse control in the rest of their lives. But the more surprising part seemed to be that if these kids were more nurtured and protected they often went on to not only do OK, they went on to be more crative, spontaneous and successful than others in many areas.
It is no surprise to me that people are made differently and that some of those difference can be helpful and exciting, but also, under different circumstances, the same qualities can get someone messed up.
What is new is that with new technologies we are finding ways to see more of what is interacting with what. We can watch the blood flows in the brain as the brain reacts to different situations and we can see gene patterns that emerge and are partly linked to personalities.
The implication is often that this can lead to new levels of treatment interventions that can be more specifically designed. However, at present, this is also very dangerous. Because what we are really seeing is that the mind/body/brain/environmental interactions are even more complex that we had conceived. These interactions are going on constantly, and thus the conditions are constantly changing and making new conditions. When you mess with two factors out of a thousand, you can't be sure of what you're going to get.
Interfering with this flow of events is really what I do. But I have to do it indirectly, by talking to someone. As I said a couple of posts ago, I can't get directly to the brain or the mind. But some some people are going to think that they can, and this will either be a great break-through or a real disaster.
I can imagine a time when knowing someone's genetic make-up could be helpful in designing a psychotherapeutic treatment plan. Some people are naturally more quiet and reflective. Others learn better from behavioral experiences. Do you think we will ever be able to tell who is which, just by looking through a microscope at a slide of someone's spit?
Then he goes on to review other research to link these kids, in part, to a specific gene allele that was linked to the processing of serotonin. This is linked to a vulnerability to depression
What the article was mostly about was that some kids are genetically more reactive than others. It discusses how if these kids have a stressful childhood they often go on to have difficulties with anger, ADHD and impulse control in the rest of their lives. But the more surprising part seemed to be that if these kids were more nurtured and protected they often went on to not only do OK, they went on to be more crative, spontaneous and successful than others in many areas.
It is no surprise to me that people are made differently and that some of those difference can be helpful and exciting, but also, under different circumstances, the same qualities can get someone messed up.
What is new is that with new technologies we are finding ways to see more of what is interacting with what. We can watch the blood flows in the brain as the brain reacts to different situations and we can see gene patterns that emerge and are partly linked to personalities.
The implication is often that this can lead to new levels of treatment interventions that can be more specifically designed. However, at present, this is also very dangerous. Because what we are really seeing is that the mind/body/brain/environmental interactions are even more complex that we had conceived. These interactions are going on constantly, and thus the conditions are constantly changing and making new conditions. When you mess with two factors out of a thousand, you can't be sure of what you're going to get.
Interfering with this flow of events is really what I do. But I have to do it indirectly, by talking to someone. As I said a couple of posts ago, I can't get directly to the brain or the mind. But some some people are going to think that they can, and this will either be a great break-through or a real disaster.
I can imagine a time when knowing someone's genetic make-up could be helpful in designing a psychotherapeutic treatment plan. Some people are naturally more quiet and reflective. Others learn better from behavioral experiences. Do you think we will ever be able to tell who is which, just by looking through a microscope at a slide of someone's spit?
Thursday, December 10, 2009
changes
I sat with Bob and we talked about how he has not sent his resume out. It has been six weeks. He almost did it. He is waiting for his girlfriend to review it. He knows he needs a better job. He's been stuck in this one for five years, going nowhere. He could probably get a better one pretty quickly too. He's good at what he does.
Alice should move out of Frank's apartment. They were roommates for a couple of years. Then they were kind of more than than. Then Frank met Betsy and she moved right into his room. Now Alice and Frank are kind of friends and everything is awkward. If she moved out she could see more of Paul, who was once Frank's friend, but isn't any more. But Paul likes Alice, so they meet at the coffee shop. If she wanted to she could move in with her sister....but she doesn't.
Me?? I've been doing the same thing for almost thirty years. Things are getting more diffiuclt, with all of the forms and regulations, and diminished reimbursemnts. Sometimes this almost feels like just a hobby.
I've been thinking I ought to do something else, or at least learn about something else. I've been thinking that for about eight years.
This week I signed up for a six week course. In six weeks my whole life could be changed.
In six weeks I may be a gastroenterologist.
No, that's not the title of the course. I'd better check-- but whatever it is, it's new and different.
Alice should move out of Frank's apartment. They were roommates for a couple of years. Then they were kind of more than than. Then Frank met Betsy and she moved right into his room. Now Alice and Frank are kind of friends and everything is awkward. If she moved out she could see more of Paul, who was once Frank's friend, but isn't any more. But Paul likes Alice, so they meet at the coffee shop. If she wanted to she could move in with her sister....but she doesn't.
Me?? I've been doing the same thing for almost thirty years. Things are getting more diffiuclt, with all of the forms and regulations, and diminished reimbursemnts. Sometimes this almost feels like just a hobby.
I've been thinking I ought to do something else, or at least learn about something else. I've been thinking that for about eight years.
This week I signed up for a six week course. In six weeks my whole life could be changed.
In six weeks I may be a gastroenterologist.
No, that's not the title of the course. I'd better check-- but whatever it is, it's new and different.
Wednesday, December 02, 2009
new look
I had last seen her about three months ago. She had come in with her husband to give it one last try. They had come to see me over ten years ago to work out what was missing from their marriage. At that time the kids were young and she was struggling to hold it all together.
They came back last year with the same complaint, She said she knew he loved the family but he had never figured out a way to show it. She had raised the kids while he worked at his job and on the house. She had gone to work and made friends while he had gone to work and worked on the house. She had invited him out to do things but he worked on the house and watched war movies and The History Channel. She had gotten depressed, took several medications and went to bed and he worked on the house and watched war movies and The History Channel. Two years ago she went on the computer and found a Christian chat room. She began to talk to people who listened to her problems and encouraged her to work on her marriage. He worked on the house and watched war movies and The History Channel.
When they came back to therapy she had told him many things she hoped they could do together, including having sex. He said he loved her but didn't know if he could change and didn't like to be told what to do.
I didn't see either of them for three months.
She came to see me yesterday. She was at least twenty pounds thinner, had her hair done, put on some make-up and was colorfully, but appropriately dressed. She said she had been to a lawyer last week and was moving out after Christmas. She had lost weight because once she made the decision she felt elated, went off her anti-depressants and walked three miles a day. Without him she didn't need any medication to cope.
She was looking forward to her new life. It is clear that she won't have trouble finding it --- although trouble may be what she is looking for.
When you're done, you're done, and often a new look comes with it.
They came back last year with the same complaint, She said she knew he loved the family but he had never figured out a way to show it. She had raised the kids while he worked at his job and on the house. She had gone to work and made friends while he had gone to work and worked on the house. She had invited him out to do things but he worked on the house and watched war movies and The History Channel. She had gotten depressed, took several medications and went to bed and he worked on the house and watched war movies and The History Channel. Two years ago she went on the computer and found a Christian chat room. She began to talk to people who listened to her problems and encouraged her to work on her marriage. He worked on the house and watched war movies and The History Channel.
When they came back to therapy she had told him many things she hoped they could do together, including having sex. He said he loved her but didn't know if he could change and didn't like to be told what to do.
I didn't see either of them for three months.
She came to see me yesterday. She was at least twenty pounds thinner, had her hair done, put on some make-up and was colorfully, but appropriately dressed. She said she had been to a lawyer last week and was moving out after Christmas. She had lost weight because once she made the decision she felt elated, went off her anti-depressants and walked three miles a day. Without him she didn't need any medication to cope.
She was looking forward to her new life. It is clear that she won't have trouble finding it --- although trouble may be what she is looking for.
When you're done, you're done, and often a new look comes with it.
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