She asked......

Ok, so that craziness and symbolic dance to please the powers that pay for it is over.  The National Parks are open, so that helps me, and others will get their food stamps, Head Start visits, cancer treatments, cosmic research, NSA surveillance, EPA protection, meat inspection, and paid for developing a big stealth jet that will never be finished.

I will be off to Yosemite soon, to visit a place I have always wanted to see.  I did not expect that it would be part of a political statement.  But, as I said in my Listserve post:  Nothing surprises me.  Nothing is too absurd, especially when it is exploitative, when those who have tell those who don't that they should suck it up.

Meanwhile I have been slowly responding to the hundred of questions I received last month.  people seem to care.  When I finally respond, most of them respond to my response, which is nice.  I now have a couple of hundred new email pals from all over the world.

Here is one example, here is only a part of what she wrote:

I am dating a man, actually engaged to him, who has "cheated" on me several times...cheated by engaging with women/old flames via social media twice in two years (suggestive texting)...and once he snuck off to go dancing, where he met a woman, and kept the flirtation going (no sex/only kissing) for a few weeks before he ended it.

All smoke and no flame, I guess you could say.  But I don't like it.  Not one bit.  

I responded:

Good question; sorry for the delay in responding.

My thoughts: (and read every disclaimer possible into these)
If he really, really is only doing these flirtations on-line, or by text, and he really wouldn't act on them if given the chance  (can anyone believe that? even him?)  But if that is true, then you have to remember that he is fifty, and I remember that as a dangerous age for men. It is really a time when we don't want to feel as if we are slipping into irrelevancy.  We are too slow for basketball and have to play "Senior" sports.  It's all about still being attractive.

But, if it really makes you uncomfortable, and you are worth it to him, he should be able to control it.  You can confront him gently.  Tell him how much he means to you and how much this makes you feel queasy and how you think less of him and his insecurities.  And also tell him that if it continues, you will not only leave him, but that your parting shot could make him unable to operate for a couple of months.

Give him that whole " hell hath no fury..." routine.

Forgive me for taking so long to reply, but I received hundreds of questions, and I still have my day job so it is taking me a while to get to them all.

All the Best!

Political, Slipping away

I have been very busy, and when I'm not busy being busy I have been busy answering the literally hundreds of questions I have received from around the world.  They mostly have been about how to get along with a significant other or how to find meaning in life.

I mean, good luck with those.  I will post my answers more often than I have been, I hope, if I'm not busy.

But right now I have to make a brief comment about the obvious: The U.S. government is fucked-up.  But I don't want to spread the blame equally, I think that 94% of it goes to the right-wing wing nuts who feel that spending money to keep middle class and poor people healthy and financially solvent is the worst thing that a government can do. But now they seem to have changed their mind about what they are upset about, and it seems to be that now they are upset because everyone can see they are a bunch of sore-loser blowhards who backed themselves in a corner and the President is pointing this out.

They thought they would be clever and hold the world up for ransom, and they still might.  But hopefully, this is another step in the beginning of the end of those who feel that the purpose of the United States is for white men to make as much money as they can, any way they can.  I know that five members of the  Supreme Court still believe that, so that will cause more trouble, but most of the country is turning away from that.

Obamacare is a huge social program, and it is the beginning of a slide toward government health care. That will prove to be widely accepted and greatly appreciated.  I do believe that everyone should be on Medicare, and then be allowed by buy their own supplemental plan, and that something like that is thirty years away, but maybe sooner.  For in twenty years most of the Tea Party will be in nursing homes trying to vote for Ronald Reagan again. By then the video game generation, who seem to be the kind of folks who care about each other collectively, if they are not blowing each other away and stealing each other's cars, will take for grantedthe benefits of universal health care, and not mind paying more taxes for it.

A clinical observation

Over the years of dealing with many people and hearing about thousands of relationships I have concluded, from the anecdotal evidence of my observations, that it becomes much more difficult to end a relationship, no matter how difficult, unrewarding, and troublesome it has become, after you have had sex with that person three or more times.

Seems to be the case...

The short answer

"A Mister Richard Fader from Fort Lee New Jersey writes:".......(most of you probably get that, right?)

Anyway, more than one of the questions I received was from far away and it asked, simply, if I thought that there would ever be a time when the people of the world would get along better, and that greedy, power-hungry people would no longer have such a strong influence.

I replied:

I do think that, overall, the world has become more civilized and there is really less torture, fewer huge wars,     and more are  people getting along better. I don't know if you have a chance to read Steven Pinker's 

"Angles of Our Better Nature" but he makes a good case for that.

Yet, it is obvious we are not close to the great wave of human harmony.  I think the global climate change has 

put pressures on countries to fight for basic resources that are becoming more scarce.  
That is a lot of what underlies the problems in the Middle East and northern Africa today. 

I also think that technology has made life so much more efficient that it is becoming more difficult 
for people to find meaningful work, if they can find work at all.

Until those problems are solved in a manner that gives everyone a chance to survive and have a 

decent, but not decadent lifestyle, there will be fighting and trouble.

Take good care of yourself.

social anxiety

I am slowly reading through the comments and questions I have received from my Listserve post ten days ago.  I am going through them when I can, but I also have have my day-job, the three grand-kids, a wedding I attended, a bit of time with the wife and friends, and then the Sox clinched the pennant and the patriots caught the ball and won another game.

But a few of the questions were about how to deal with social anxiety.  As one woman put it:

I'm in a field that requires a lot of 
networking, but I have a lot of social anxiety when I spend time with these 
people outside a professional setting. I don't feel like I belong, that I have 
any right to be there. I get seized by dread. Any advice?

These feeling on not belonging, not being worthy, feeling conspicuous, and constantly

lacking, are very common, much more than anyone who has them realizes, mostly because 

no one talks about them.  But they can be very powerful, and they put a great strain on a

person's life, and a strain on the lives of others who depend upon them.

I have treated many, many people who have many different shades of anxiety disorders, and most of them make a great deal of progress and function much better.  Only a few are ever  completely free of  those feelings and are never bothered again.

It is because of this I am fairly certain there is some genetic component to this.  Some          people are designed to be more sensitive and more reactive.  There are good parts to that, 

to being more aware of how other people feel, and what is going on around you, but it can 

get way overdone and make a person so uncomfortable and be such a strain that it greatly   limits their lives.

That isn't to say that the cause is totally genetic; that is never the case.  But when someone who is prone to anxiety is put through circumstances of great stress, ambiguity, or is with  people or in circumstances that they cannot control, they are vulnerable to panic attacks     and strong feelings of anxiety, doom and dread.  

Given all that, this was my reply to the people who asked about social anxiety:

Social anxiety really sucks.

 some tips:

 1.  When you go into an social setting don't expect to be fine; that will only disappoint you and make it seem worse.  Expect the anxiety and sit with it. See if you can let it pas through you.







 2.  Of course you belong -- we are all united by our real insignificance -- even if you don't feel it.  if you are surrounded by people and feel tense, just sit and observe.  Don't pressure yourself to talk until you want to.  Try to pay attention to the conversation more than your internal feelings.  If you can show people you are actually listening to them they will be very flattered and they will think you're a great person.







So, that was my "Internet Advice," It's worth about as much as she paid for it.  I hope it was helpful.  Anxiety increases when people try to control things that are not within their power to control.  Your mind churns and churns trying to find a solution.  Then you feel that your mind is out of control and you must be crazy.  That's when things get worse.




Anyway, I hope that none of you feel like that today.  



Enjoy the beautiful Autumn weather. ( and forgive me for the disjointed formatting, I'm not sure where it came from.)

the task ahead

I am almost finished telling everyone who sent a request that I will get to their question some time in the next -- who knows when --- but I will.

In my message to the Listserve I said I would answer questions and of the 260 responses, a bit more than half seem to be legitimate questions.  In the piece I wrote I stated that nothing that people do surprises me anymore. After reading the comments, I find I am not surprised, I am a bit saddened that there are so many people out there who are not only struggling with so much, but are also searching for a way to find help.

As I have said in the past, I am not a fan of psychiatric diagnoses.  I feel that these labels only mark people as "sick" when they are really just dealing with the shit the world has handed them, often from the moment they meet their parents.

The causes of upset and strife are similar all over the world: stress, loss, loneliness, illness, trauma, and inadequate resources.  These are the factors I usually look at when I try to define a problem and then set about looking for a solution; something that is always a joint process with the patient.

The sad part to me is that there are so many terrible situations that people are reporting, and I hope to be answering them really soon.  The other side of the picture is that only one percent of the readers of the List felt the need to respond, so the other 99% either thought what I said was OK or useless, but they are moving on well enough without me.

In some ways that's comforting.

A comment about the comments

The comments in question are not the comments on this blog, which are mostly Forsythia's welcome and supportive comments.  But I have been reading the emails that I have been receiving from the post on the Listserve on Friday.  There are over 200 of them, and most took me up on the offer to ask me any kind of question about relationships.

The questions have come from all over the world,literally: China, Portugal, Brazil, UK, Australia, Italy, South Africa, India, and at least twenty U.S. states.  I believe I have heard from every continent that is not covered in ice.  Some of the questions are very specific and about the relationship the questioner is in.  Some are very general and ask for the kind of general guidance that I am reluctant to give. And others are from people who are dealing with emotional difficulties, the kind that I deal with in my office.  In fact, I hope to make a few referrals if i get more specific information of where the questioner is located.

Many people state in their email that they have not  sought help, and have not asked their question before.  Several have said that they feel more comfortable asking someone who they don't really know, who is hundreds of miles away.

Again, it shows how much confidentiality, and the fear of being judged plays such an important role in establishing a therapeutic relationship; any relationship really.

I hope that over the next few weeks I will have time and permission to post some of the questions, and my marvelously wise answers here.  But now I have to go and change my grandson's diaper.

Be patient kid, you're acting like you're two weeks old.  Oh, right.......

The Listserve

A year or two ago, someone in NYC began an Internet project called The Listserve.  He or she got about 24,000 people to sign up to get an email a day from a randomly selected person who had subscribed.  I have been reading these emails fro about a year.

A two days ago I was randomly selected.  What I posted is written below.  But before you read that I want you to notice that at the end of the post I invited people to ask me any question they wanted, since you already know how impressed I am with my own knowledge.

Well, so far, less than two days later, I have received over 200 comments and questions.  In the coming days I will post some of the question I received, and my very clever answers.  That will be easier than thinking up things on my own.

Here is what I posted:

Hello Listserve:

            I am considerably older than most of those who have already posted 
their messages on this site, and thus I have lost most of my armor of idealism .  
Much of this is due to the experiences I have had working as a Psychologist in 
Massachusetts mill cities for almost forty years.  I feel I have seen almost 
everything humanity can offer.  I no longer question whether something is good 
or bad; I just see it as fascinating.

            There is nothing anyone can do that would surprise me any more.  
Anything my wildest imagination can produce someone out there is doing it, and 
they are doing it thinking it will bring them happiness or satisfaction.  Most 
of the time it doesn’t.

            I would give you all advice, because I know, better than Dr. Phil, 
what you should do with your life, but more than that I know that you wouldn’t 
listen. That's not how people change.  Change has to come through emotional 
experience.  Perhaps in three years you might think back and say, “maybe that 
guy was on to something.”

            I am a big believer in the saying “When the student is ready, the 
teacher appears.”

            Humans are a work in progress, an intriguing but flawed species.  If 
you haven’t realized by now, please take notice: the world is almost always run 
by character-disordered people.  Kings, Queens, generals, presidents, tyrants, 
business leaders, billionaires, market movers, and celebrates are usually 
greedy, power-hungry narcissists, or else they have that missionary zeal and are 
self-righteous.  That’s not always true, only about 90% of the time.

            Most people are basically kind and caring. They want to get along, 
have a few satisfying relationships – which is difficult enough-- contribute 
something to the good of the world and then relax and enjoy their family and 
friends.  But then someone comes along who wants to grab power and take control  
of everyone and everything.  He (it almost always is a he) identifies some small 
difference as a huge threat, then gathers a group of devoted followers to save 
his people from it, and everything goes downhill from there.   Just look at 
history, and look at what’s going on now.

            As I said, I am old, I am wise, and I know everything about human 
relationships.  If you want an answer just send me the question.  I won’t expect 
you to take my advice.

Diagnostic discussion

Given all of the talk about how helpful, accurate or scientific psychiatric diagnoses are, and how embarrassing DSM V is, there is an attempt o bring some hope to psychiatry in an article in the Sunday NYT Review section.  In that piece, Dr. Eric Kandel, a Noble Prize winner in physiology, tries to make the case that we are well on the way to having better diagnostics through brain research.

In his explanation he gives a very positive nod to the use of psychotherapy as an effective treatment for mental disorders.  Along the way he re-labels psychotherapy as a brain-treatment, and takes a slap at therapists lack of scientific rigor, but his view of therapy is general very positive.

He makes a case, that is much more hopeful than real, that further study of neuroscience, genetics, and bio-chemistry will eventually, in years to come, reveal the underlying causes of mental disorders, and greatly improve diagnosis and treatment.

I certainly agree with Dr. Kandel that these sciences are of great importance to the understanding of some of the contributing causes of emotional and behavioral irregularities but, given who he is and where he comes from, he is trapped in a very reductionist, medical model.  If psychotherapy is a “biological brain-treatment” as he states, so is a family, a sub-culture, and a romantic relationship.  These things also have a major impact on how a person feels and behaves, and they cause many major changes in the brain.  Until we learn how to integrate all of these factors into our attempts at understanding what causes what,  we will be still fumbling around with inaccurate half-truths.

At present, diagnoses are often as much a political act as they are a science.  They are descriptions of what is considered, at the time, unacceptable behaviors.  What is unacceptable changes with the culture, and the soical values of the times.  There are many, many examples, from hysteria to homosexuality, that were illnesses then, but are seen as acceptable now.  I am sure what is now called bi-polar disorder in ten years will have four different names.

Yes, our mind is a product of our brain, but our brain reacts to what is happening in the world around it as much as what is happening inside our skulls.

That’s my view, even without a Nobel prize.

August -- gone

There is just over an hour left in August of 2013.

Quite a month.  It is so precious here in new England, and it goes by like a breath of salt air off the ocean.  Gone.

What happened this month, beside the world almost having everyone go to war again because a few crazy people can't share power?

I didn't work almost all of August.  More than ever I really enjoyed not going to the office.  The patients are all important and worth the effort, but the system has become even more complex and burdensome, and the big insurance companies continue to find ways to pay us less, and then blame it on Obama.

I did spend a lot of time with some crazy people, but they were not my patients, so I could just let them be interesting and let them prattle on about their views of the world, themselves and whatever it was they found so meaningful. Noy my problem.

Today was my daughter's birthday and, as it happens, my daughter-in-law's birthday, which makes things a bit hectic.  But now, to add to the confusion, my newest grandchild, and first grandson, was born yesterday.  He is a big, healthy boy, with two tired, proud parents and an almost two year-old sister who is still trying to figure out why her life is suddenly so different.

So the world reamins it's complex, unfiar, unaring, often cruel place, but my immediate, tightly knit, cloesely guarded spot in it remains remarkably, happy, prosperous, and almost all very healthy.

But now August is gone.  It is  that sweet, melancholy time when the light becomes sharper and golden, when things start up again and become more serious.  We put away the hammock and the kayak, and wonder where the time went.  We didn't get to take that five mile walk to the end of land to the lighthouse for the fifth year of planning to do so. I did paddle across Pleasant Bay.  I did take the girls to the beach and run in and out of the water, and in and out of the water, and in and out of the water.

Hopefully we will do it all again next year, with the boy sitting in the sand, and we try to stop him from eating it.

Quick Fix

I am away from my office for a few weeks, wandering around near the water, doing a pretty good job of not thinking about those I left behind.

Down here I get to talk to friends, and friends of friends, and just see what they do and hear about what they think.  I don't have to do anything about it, which makes life much easier.

But what I hear can be pretty distressing, and that is, even more than before, people are going for the quick fix.  Psychotherapy seems to have lost some of its panache; it takes too long, it costs too much,  and it can be painful to think about the bad things, or to confront difficult problems.  These days it is much easier to find a life coach, a motivational speaker, a spiritual healing, an body-mind energy consultant, a brain-ionizer, a vitiman dispenser, or just a guru to show you the path.

Now, the quick fix has always had allure, for centuries.  But many years ago the fix seemed to be more through suffering, sacrifice and prayer.  Today it seems to be through self-indulgence, self-appreciation, fulfillment and money.  And who can say no to that.

The trouble is, of course, that the quick fix rarely works.  What these kinds of fixers seem to miss is that they are fighting against all of a person's biological history, genetics, family history, interpersonal history, cultural and sub-cultural patterns, and financial resources.

Usually the effects of a weekend pep-talk and a few exercises feels really good, and lasts for anywhere from three hours to three weeks, sometimes a couple of months.  But almost always, those entrenched thought and behavioral patterns creep back in and take over.

However, the bigger problem is, that psychotherapy also, often takes a great deal of time, and still isn't that effective.  That process too has to fight against all of a person's biological history, genetics, family history, interpersonal history, cultural and sub-cultural patterns, and financial resources. Some of these we can confront and work through, others, such as genetics, social class, finances and sub-culture, are often cannot be influenced by verbal interactions that happen in an office for an hour 9 now 45 minutes according to most insurance companies), a week.

There are things that I would strongly recommend that a coach can be necessary;

-- Sports

-- Financial planning

But, with both of those, be careful, find someone with a successful history, the longer the better, and make sure that what they said they did really happpened.

The $ factor.

I thought I had posted it here, but I only sent it out as a tweet:
"40% of my patients problems could be greatly improved, if not completely cured, by $35,000."

(I tweet @therapistmumble, but it's hardly worth following because I tweet about once a month).

On the front page of today's NYT "Review: section is an article by Moises Velasquez Manoff (that's a name for the new world) which gives a lot of research support to the concept that the poor suffer in many ways -- health, longevity, depression, etc, much more than people who are financially comfortable.

http://opinionator.blogs.nytimes.com/2013/07/27/status-and-stress/?_r=0

Now, to most of you this probably comes as a "Duh!"

But, unfortunately, too many people in this gold ol' U.S. of A. seem not only aware of that fact, but happy about it. We are getting back to where we were in 1964, of blaming the victim, and using the poor to make the rich feel better.

This is not a prescription for the long-term success of any society.

Not enough

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

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

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

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

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

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

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

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

         

Fishing

I ended my last post by saying that in today's climate it may not always be good to teach a man to fish.

But, really, I didn't get the analogy exactly right.

If you give a man a fish, you can feed him for a day, even if he doesn't know how, or doesn't have the resources to cook it, if the fish is fresh enough.

But if you teach him to fish:

You can teach a man to fish, but are you going to buy him a boat, pay for the fuel, and then pay for the liability insurance?

He may get arrested for not having a license.

To get a license he may have to bribe people, or all the licenses may already be taken by corporate entities.

You may be introducing him to fierce territorial competition, for which he is unprepared.

There may not be enough fish due to over-fishing and lax regulation.

The fish that are left may be a health risk due to the polluted water they live in.

Did you also teach him to swim, or are you putting his life in danger?

And don't think farming is any better.

Nothing is that simple any more.

Summer

Summer is certainly here.  The Big 4th of July Weekend has passed and everyone is in full summer mode.  Some are sitting on stoops, going to bar-b-ques, headed to the beach or the lake.  The city is full of events to keep the residents home to spend their money locally, or to entertain the tourists.  All the cities, large and small on the New England coast, from Newport, RI, to Bar Harbor ME are full and festive.  The visitors from Topeka probably think it's like that all year long.

For me, still working, still doing at least three full days a week, the divide between work and play is huge.  I feel so fortunate that my family, all three generations now, is happy, healthy, enthusiastic and even prosperous.  It becomes even more difficult to turn the pages of the Sunday paper and read about what goes on in Egypt, Mali, Syria, China, Spain, and even Florida and Texas.  It is even more painful to see what happens with our very own government, grinding to a halt in Washington, D.C, helping no one, solving nothing.

That is also what upsets me in my practice.  So many of the patients i have to deal with have problems that are due as much to politics as they are emotions, neurological, genetic or family dynamics.  I see a 58 year-old man who knows he will never be able to get a job that pays close to what he has had before. His unemployment support has ended.  His wife is exhausted from dealing with his feelings of hopelessness.

I see a 25 year-old woman who is working as a waitress and wants to go back to nursing school but she already has $32K in student loans.  Her father is dead and her mother makes $14 an hour.  She would have to take all of her courses, do her clinical rotations, and also be working full-time to support herself,. A friend of hers from high school, whose grades were never as good as hers, has father who is buying her a condo near school and paying all of her expenses.

I have about a dozen more examples for this: cases in which $25K would be much more help than two years of therapy.

Give a man a fish and you feed him for a day.  Teach him to fish and he will starve to death if there are no fish to catch.

Gettysburg to 2013 to 2163

We are rapidly approaching the 150th anniversary of the Battle of Gettysburg, one of the bloodiest few days in U.S, history.  This will be a time of reenactments, strategic studies, and speeches about valour, honor, freedom defended and freedom lost.

There were fifty thousand casualties at Gettysburg.  Most of them were young men who had holes shot through them from fairly close range.  Most of them probably had little idea of exactly what the reason was for them to put their lives in danger.  They were defending their land and their culture.  They were brave, irrational and sucked in by peer pressure or fear of punishment for treason.

The underlying cause of that battle, and of the entire U.S. Civil War, had to do with the existence of slavery. Looking back on that, from a perspective of 150 years, there are few few people left, not even Paula Dean, who will defend the enslavement of other humans.  It seems very generally accepted that it is inhumane, unjust, and that it should not be done.

But that does not mean that soldiers from the South, the slave owners, and all of the others who went to war, were callous, mean or inhuman.  In truth that war, like many that have followed it, was due to changes in economic and energy policies.  The Southern states depended upon slavery to keep it's economy profitable. If they had to pay people to built those beautiful houses in Charleston most of them would not have been built.  If they had to pay a decent wage to plant and harvest cotton, the price would have been too high for the North, as well as the English and French to want to pay for it.

When almost any society is threatened with a complete loss of their comfortable lifestyle the most common reaction has been to go to war to save it.  That's a good part of what caused the American Civil War.

Now, 150 years latter, there is another debate occurring about the U.S. energy policy.  There is no threat of war because, at this time, there is no threat that anything is going to change that policy.  There is a major threat ( it is already occurring) that if that policy does not change that we are radically altering the living conditions of the planet we live on.  There is a large possibility that the number of casualties will be greater than the 800,000 of the Civil War.  Due to the violent weather we have had just in the last five years, millions of people have been affected.  Many have lost their homes, most of their possessions and their livelihood.  Many across America have been injured and many have died in floods, tornadoes, hurricanes and fires or have been affected by some of the worst droughts in history.

Many across the world have been affected by floods and droughts that have ruined economies and resulted in starvation, refugees and wars.

In 150 years, in 2163, when people look back at what is happening today, I think that the lack of action on the energy policy that affects climate change will seem as unacceptable as slavery seems today. But people are defending it now for the same reasons they did then -- there are many people making a good living the way things are.  Oil companies, car companies, electric companies, any company that uses a lot of power to do business does not want to pay for the changes that would be necessary if we began to eliminate fossil fuel.  Most of us wouldn' t even be able to get to work.

It's very possible that some kind of new technology will save us from these catastrophes, but if that happens it won't be cheap.

But in 150 years, if many cities are under water, or billions of dollars are spend to prevent that from happening, if the weather patterns are consistently more violent than today and huge rains, long droughts and tornadoes become common, people then may be wondering that we were thinking.

We were thinking the same thing that the soldiers in Pickett's Charge were thinking: we are defending our way of life.

A brief criticism of everything

Today, one of my colleagues posted the following link to an article

http://www.medicalnewstoday.com/articles/259854.php

Nose jokes aside, and moving further and further away from Freud, I find this study to be very exciting and I hope it is an indication of the direction that mental health will be taking.

Many of us feel that the new DSM V is a bit of an embarrassment to the field.  It is not scientific, it is based on symptoms and not causes, and in many ways is much more of a political document than a medical one. 

Real research that tries to find the causes of problems will eventually lead to better treatment. Catch-all terms that change over time and are merely descritive of behaviors that are currently out of favor are not very helpful.

This article is a very small first step.  The authors state that: The results showed that nose neurons from the schizophrenia patients had much higher levels of one particular microRNA (called miR-382) than those taken from the unaffected controls, as Shomron explains: .......After some more research, the team found that this particular microRNA molecule regulates the expression of genes that are involved in the creation of neurons.

This is just a marker, it is not a cause.  But it takes us way beyond the early theories of only environmental causes. It shows that true schizophrenics have a different brain chemistry, as the result of a mutation in the expression of a gene.

BUT, i also want to make it clear that I believe that biological explanations will only rarely be sufficient.  That's why DSM VI will also be a failure, as they are basing their future on finding more bio-markers.

However, if Psychology is going to remain relevant to anything but advertising, we will have to interact and collaborate with other sciences to develop a better understanding of what shapes human behavior, both adaptive and maladaptive.  I think these sciences need to include both the more basic ones --biology, chemistry, genetics, as well as the more general ones, such as sociology, anthropology, and even climatology.  

We can't be stuck doing the things we did forty years ago and calling them different names.

So, up your nose to your brain!

DJB

interconnecting parts

The world we live in now has become increasingly complex.  We are all so much more interconnected that the things we do and the things we use have effects on other people's lives, usually without any intention, or even awareness on our part.

There are large things we do that effect other peoples physical and psychological health. We make choices about how we behave politically that make a difference.  The things we choose to buy, the places we go, the people we choose to interact with all effect those people.  Many of these are intentional choices we make about how to use our time, resources and energy.

How we treat the people we interact with makes  big difference in the kind of world we live in.  If we are friendly, positive and up-beat, most of the people around us will respond to us that way.  This is not universally true, but it does make a difference.

The reverse is also more true than not: if we treat others with anger, scorn, disdain or indifference, we will find that the world we live in is not pleasant.

The world was not designed to give us up-lifting, meaningful or fun and rewarding times.  Quite the contrary, our species has survived because it has (mostly ) learned to adapt the the local conditions. Our species has survived and become dominant because we have learned to be social and to work together.  However, we have also learned to divide into small groups and fight for resources.  This behavior may no longer be adaptive, but it has not yet been extinguished.

The problems most of my patients bring into my office are usually the result of some behavior that is basically necessary for survival but is now being misapplied.  Anxiety is an example of being too fearful, and of trying to control things that cannot be controlled.  Paranoia is from a loss of trust. Addictions are usually a perversion of what was pleasurable. Depression is often, to a large degree, from feelings of incompetence and worthlessness.

So be aware of how you feel, and how you express yourself to those around you.  How you act does change the world you live in, and that world, in turn, will change you.  It is a constant, interactive process.

Old White Man

For various reasons I had a sessions this week with two brothers and a sister.  They were in their late forties and they compared their impressions about what it was like growing up in their family.

But now their father, who was a distant father but a very successful businessman, is eighty-eight. He has been a widower for a long time, and now he is home, by himself, and moves with great difficulty.  His children, mostly his daughter, come to see him four or five times a week to bring him food and cook for him.

He is not very sociable, because is usually tired, and they often find him asleep in his chair.

His daughter explained that this is true because every night he sits up in the chair, facing the door, trying to stay awake.  He holds a 35 caliber pistol on his lap and waits for "them" to come and try to take away his.........well, that's not quite clear.

One of his son's says that the gun doesn't have a bullet in the chamber and the old man doesn't have the strength in his hands to pull the lever and get his weapon ready.  But it's the thought that counts.

Crazy, Scary, Sad

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

Terrorism? Angry? Psychotic? Sad? Misguided?

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

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

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

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

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

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

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

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

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

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