Self-denial and Fasting

Remember those days when I said that I wouldn't talk about my religion? And yet,

All over the world readers are asking,

How did you break your fast after Yom Kippur, TherapyDoc? Please tell us what you ate. We know how health conscious you are.

Ah, breaking the fast. We just completed a powerful day at the synagogue, a 25 hour fast, no food, no drink. All to atone for our sins and everybody else's (Meaning all Jews are in it together. It's one of our enmeshed things we do, atone as a people).

But it's still a lot of sins, no matter how you cut it. I hear, by the way, that the Catholic priests are sending letters home to members of their congregation to come back to confession. Is this because therapy's not working? Is it working for us ethnics? Ya' have to wonder.

Back to the fast. At first I thought I'd title tonight's post Self-Denial. But then I thought, no, you don't deny "self" when you don't eat or drink. If anything, it's all you've got.

Then I thought, perhaps Self-Deprivation. That made more sense. But I asked FD, just to be sure, and he said, "Well actually, it's about resting from food. We take a break from the physical stuff. Oh, and it's about afflicting the body by not eating/drinking." Those are the reasons the Torah gives us for the commandment to refrain from these things on the 10th day of the 7th month. (Don't ask me to explain our calendar).

Right.

So we give it a rest, always a good thing. And at the end of the day, we say, It was worth it. The fast is worth standing all day, praising the Old Mighty, hoping He'll look askance at who we really are. The fast makes us tired, but not so tired. We roll our eyes at one another and point to our watches, feeling pretty bad until it's about to end, then we perk up.

We think about life, and how it hasn't been easy for us. We figure it out that easy isn't what it's all about, probably. Probably people who think that life is about making it easy or just being happy needs to rethink the concept.

We're always waiting for the other shoe to drop. And it will for everyone. The other shoe drops eventually. It HAS to. It's suspended on a thread up there somewhere, getting heavier and heavier until. . .

Kabam!

But even though life's not about being happy, I still hold by the idea that Happy Is Better and that's what we have to shoot for. That's what I keep telling all of the depressed people in the blogosphere. Let that lighter part of the brain reign as often and intensely as possible.

But it's still a sometime thing, like all emotional states. We aim for it daily, but like that song, that Porgy and Bess song, A Woman is a Sometime Thing, Being Happy is a sometime thing.

Anyway, back to the fast and After the Fast and food. Self-deprivation (you can try to relabel it as rest, but come on, really, we're stretching here) self deprivation is good for the character. It's another one of those, What doesn't kill you makes you stronger things (another TherapyDoc world view under the condition that you get therapy to work out the what didn't kill you).

Self-deprivation is the way to feeling grateful. Take away what you've got, take away your usual physically pleasuring comfort-props like food, water, AND sex, and Wow, Are We Ever Grateful To Merely eat, drink, and you know.

But the fast of Yom Kippur is really about atonement, which you do better when you're resting. The fast helps us atone, become more self-reflective. We get a wider lens by fasting, ironically, we think about bigger pictures.

And we regret regrettable deeds of the past year, and self-adjure for incredible laziness and lack of ambition, for not doing the things we'd promised we'd do at this time the year before. The apologizing to others thing can be brutal. But yes, we have a built in Fifth Step into this religion. (12-steppers know what I'm talking about). If we hurt someone, we have to make amends before Yom Kippur. He doesn't forgive us if we haven't tried to get forgiveness from people who matter.

People matter.

Anyway, at the end of the fast the prayers at the synagogue are so loud, so powerful, so full of emotion and meaning, they probably put Gospel meetings to shame. But ours are only once a year.

And as my son said, "And everyone is actually happy those last few minutes of the holiday, looking forward to food."

Chammie turned to me in the middle of the fast and said, "I could go for nachos."

Not skipping a beat, I added, "With the sourcream, avacado, green onions and tomato, right? Maybe add a pinto bean dip?" (People wanted to shush us, but you could tell they also wanted to tell us what they wanted to eat).

She wasn't so sure about the onions and brought up yellow toffee. Anyway, I have no idea what Cham ate after the fast (see, we're not enmeshed, okay?), but FD made me pancakes and I squirted real whipped cream from a can on the rest of a banana cream pie, and am now feeling no pain.

What was that about self-deprivation again?

Moving right along, a quick update on Tante Fela.

If you recall, last year she sat next to me for the High Holidays, a total stranger, a Holocaust survivor. We made friends, enjoyed being connected. I like meeting new people. And she had prayed, with fervor, Al tashichaini. Don't throw me away. (The root of that word, for those of you who are interested, is tashlich/to throw, the very same as in the ceremony some perform on Rosh Hashana, throwing symbolic sins into a river using bread crumbs or stones).

So this year (yes, she sat next to me, it was arranged) I listened to her and heard her emphasize, Al tashlichaini b'ais ziknah

Which means, Don't throw me away in my old age.

I turned to her and said, You? You're not old. She nodded and said, "I'm old, I'm old."

But both of us had kvetched about our backs hurting, so I said, Maybe not so old. And she smiled.

therapydoc

Here Today, Gone. . .

Abbey Brown of the Shreveport Times tells quotes the following:

"A clean slate," LaSalle Parish School Board member Billy Fowler said of why the tree was cut down in the past few weeks. "There's nothing positive about that old tree. It's all negative. And I'm serving on the new School Board, and we're wanting to start fresh on some things."

Read the post below.

See, I would have suggested, LEAVE IT UP. Remembering is the key, not forgetting. Fence it in. Put up a sign. Tell the world what happened there.

Say,

Never Again. No more KKK, No more nooses. No more intimidation.

I'd like to say, they were kids, they didn't mean it. They'll be ashamed when they're adults. But I'm not at all sure. So say, Never Again, and mean it. Start with education. It's a SCHOOL. This happened outside of a school.

From sundown Friday evening to sundown Saturday, according to my tradition, everyone and everything is judged. Tradition holds that that tree was judged last year on this day of the Jewish calendar.

May we all be judged favorably.

I was never one of those "peace on earth" people, but seriously, peace on earth,

TherapyDoc

The Jena 6, over a year later

The town barbershop still refuses to serve Black people in Jena, Louisiana.

After rotting my brain on Fried Green Tomatoes (no, I don't think it needs a review, do you?) I flipped my mostly eggwhite and lots of muenster cheese omelet (perfection) onto a bagel with home-grown sliced tomatoes and returned to a warm teev.

CNN showed thousands upon thousands of civil rights protesters descending upon Jena (pronouced Geena), Louisiana, all up in arms about the Jena 6. This, while you and I went to work. Al Sharpton and Jesse Jackson, according to news sources, said that the demonstration is about deteriorating race relations as much as justice gone wrong.

You know, if you live in an ivory tower, if you hang out with people who have had the privilege of a college education, it's entirely possible that you might fool yourself into thinking that indeed, because you actually love looking at the skin pigmentation of other people, that perhaps racism is on a decline.
But it's not in the good old South.

The fellow on CNN credited the blogosphere for the demonstration. Were it not for cybernet interest, there would be no interest, basically.

I went directly to the Internet, of course. Tom Leonard, reporting for the Telegraph in the UK, gives us the following:

The six teenagers were arrested after Justin Barker, 17, was beaten unconscious last December at school. The attack followed an incident at the school in which three nooses were hung from a tree in the school-yard.

The tree had traditionally been a gathering place for white students but, the day before the nooses appeared, some black classmates had met there.

Justin Barker, aged 17, was beaten unconscious. Significantly for the protesters, the local prosecutor decided not to charge the three white students who hung the nooses.
Five of the six were initially charged with attempted murder; the charges for the sixth were not disclosed as he was a juvenile.

Although the attempted murder charges were later reduced to battery, it did little to quell the anger among black Americans who came to yesterday's protest by the busload from all over the country.

That's today.

So I cut to the original story from June, 2006 at WhileSeated.org, complete with cool Utube video.

Here's a chunk from that historic post:

In September 2006, a group of African American high school students in Jena, Louisiana, asked the school for permission to sit beneath a "whites only" shade tree. There was an unwritten rule that blacks couldn't sit beneath the tree. The school said they didn't care where students sat. The next day, students arrived at school to see three nooses (in school colors) hanging from the tree. (Please note, the tree above is not the tree, but a tree at Jena High School.)

The boys who hung the nooses were suspended from school for a few days. The school administration chalked it up as a harmless prank, but Jena's black population didn't take it so lightly. Fights and unrest started breaking out at school. The District Attorney, Reed Walters, was called in to directly address black students at the school and told them all he could "end their life with a stroke of the pen."

Black students were assaulted at white parties. A white man drew a loaded rifle on three black teens at a local convenience store. (They wrestled it from him and ran away.) Someone tried to burn down the school, and on December 4th, a fight broke out that led to six black students being charged with attempted murder. To his word, the D.A. pushed for maximum charges, which carry sentences of eighty years. Four of the six are being tried as adults (ages 17 & 18) and two are juveniles.

Yesterday, I was in Jena for the first day of the trial for Mychal Bell, one of the Jena 6. The D.A., perhaps in response to public pressure, tried to get Bell to cop a plea. Bell refused, and today, jury selection began. After today, we'll know whether or not the case will be tried in front of an all-white jury. Jena's 85-percent white, and it remains to be seen whether or not the six can get a fair trial.

Both off-the-record and on, Jena residents told me racism is alive and well in Louisiana, and this is a case where it rose above the levee, so to speak.

Seems to me, that energy of my generation is making a reappearance. So long a wait.

I wanna' be there next time.

Oh, and by the way. You know that you really should fry green tomatoes with a little olive oil, garlic, basil, s & p, right? Not just a dish from the South, you know.

therapydoc

Owen Wilson's Suicide Attempt

You know that on occasion I get the skinny on Hollywood gossip, right? But keep in mind that my mother-in-law says that her mother used to say, Believe half of what you hear.

So believe half of this.

On Sunday the National Enquirer ran a story that Owen Wilson had cut his wrist and was hospitalized, cocaine in his system.

Then on Monday, Dafne Merkin wrote a piece in the New York Times Magazine (Darkness Invisible) and asked rhetorically:

In a culture that encourages outing everything from incest to pedophilia, is depression the last stigma, the one remaining subject that dares not gossip its name? Does a disclosure about depression, especially from someone who seems to have it all, violate an unspoken code of silence — or, at the least, make us radically uncomfortable with its suggestion of a blithe public face masking a troubled inner life?

She asks that question because the word on the street in Hollywood is that Mr. Wilson really didn't try to kill himself. We are to believe that he is a heroin addict who accidentally overdosed.

And it is his family that wants us to believe this. Rather than expose him as suffering from depression his whole life, the family told the press to spread the word about his "addiction."

Remember, I'm just spreading gossip here, but if it's true, and let's just say for the sake of argument that it is, then the poor guy isn't even granted the right to communicate cogently about his preferred final communication.

NOW THERE'S A POWERFUL FAMILY SYSTEM.

If it's true.

And I believe it's half true, the powerful family system part for sure.

Ms. Merkin's piece is written from experience, and is a poignant reminder that although we romanticize depression, it is far from sexy, and our culture respects, perhaps even admires the risky, self-destructive abuse of illicit drugs. Hurting one's self to get high is sexy, exciting.

Battling negative emotions is not.

As FD says, It is still considered a weakness to be depressed, especially for a macho guy like Owen Wilson who plays cowboy roles. It's bad for the career to be weak, as in paralyzed with sadness.

Apparently depression is stigmatic, but heroin addiction is IN. We're still not bored with celebrity rehab. The thought of Paris Hilton, Lindsay Lohan, Owen Wilsons (!?!#) getting stoned out of their gourds still turns us on.

Addiction's hot. Depression's well . . depressing.

Now, as a therapy doc, I have to tell you that indeed, addiction is not sexy. It is life threatening, no question and most people who have substance dependencies do not want them. The dual-diagnosed, those who suffer from both depression AND drug or alcohol dependency, aren't whistling Dixie, either.

I'm a little worried, frankly, that Hollywood makes out that it is cool to be a drug addict. The message to kids who are already looking to self-medicate for depression is, Get illegal drugs. You'll feel better and you'll be Cool.

Anti-depressants are for losers.*

Mr. Wilson? If you're out there? I hope you get well. Keep at it, for the sake of your talent. You make us happy when you're on screen.

And when you're well, tell the world exactly how hard it is to beat depression, but tell them that it's worth the fight. It is harder to beat depression and much more macho, than it is to use heroin. The fight against depression is positively heroic.

Be our hero, Owen. Take it on. You're in good company.

*FYI, I just read something (WSJ, not a real science journal) about current higher suicide rates for teenage girls associated with lower pharmaceutical prescriptions in that age group for antidepressants.

No kidding.

Shaking my head with confusion,

therapydoc

Paranoia

You pot smokers out there know what I'm talking about.

You're chilling on the deck, your neighbor steps out to toss out the trash, gives you a funny look and you think, Busted.

I've had patients tell me they had to stop smoking pot because the paranoia got so bad. A cop pulls up at a stoplight, turns his head and looks at you. You freak, come down fast, and you're not the same for the rest of the day. Aw.

The rest of us might say, If you weren't stoned you wouldn't have to deal with that, would you? You'd have nothing to be worried about.

Yes and no. Well, yes, probably, if you're a habitual stoner.

Those of you who are dealing with elderly parents, however, have quite another kettle of fish boiling. As FD says, if the brain doesn't get enough oxygen, if circulation is poor, if the heart's not pumping like it should, if a person's on one too many medications and needs all of them, if sleep is wanting, well, there's an accident waiting to happen.

And I read a study associating hearing loss and paranoia. OF COURSE HEARING LOSS WOULD BE ASSOCIATED WITH PARANOIA IN THE ELDERLY--THEY DON'T HEAR THINGS CORRECTLY. Sorry for shouting.

And as my geriatric psychiatric consultant in California is wont to say, Those mini-strokes the elderly suffer are virtually undetected until the patient suffers from a delusion. Then the docs suspect stroke. And a little anti-psychotic can go a long way.

Great, more meds. And go tell someone suffering from a delusion that he's suffering from a delusion. He'll say, YOU'RE the one who's delusional. When the mind plays tricks on you, and it's YOUR mind, you basically are going to trust your mind, not someone else's.

Such a Catch 22.

Well let's get clinical. It's what you pay me for. If you learn about paranoia in graduate school, what you'll learn is that there are at least two types: There's the type associated with the intense anxiety of Paranoid Schizophrenia (Axis I), and there's the type associated with a personality disorder, Paranoid Personality Disorder (Axis II).

Like Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder, they're difficult to differentiate sometimes. But unlike OCD versus OCPD, in which one makes the symptom bearer sick and the other makes everyone else sick, when the featured symptom is paranoia, everyone feels sick.

Let's take a quick look at the personality disorder. We do not diagnose this, of course, if a person is justifiably paranoid, as is often the case with immigrants who do not understand language or cues, minorities who suffer discrimination, and political or economic refugees who have been on the run.

The diagnostic criteria for 301.0 Paranoid Personality Disorder include:

A. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by 4 or more of the following:

(1) suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her

(2) is preoccupied with unjustified doubts about the loyalty or trust-worthiness of friends or associates

(3) is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her

(4) reads hidden demeaning or threatening meanins into benign remarks or events

(5) persistently bears grudges, is unforgiving of insults, injuries, or slights

(6) perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack

(7) has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition.

If a person had the personality disorder before the onset of schizophrenia, it's considered premorbid. In other words, a person diagnosed with schizophrenia can also have this disorder, but we add the suffix, "Premorbid".

Oy, it's not a good thing. And of course, the spouses of these individuals are often accused of having affairs, their friends and children of stealing, business associates deliberately try to cheat them. People look at them the wrong way, people wrong them. People think they're stupid.

These are angry people.

There is a strong association with child abuse, and you can see why. If you can't trust your own parents to take care of you and protect you, who can you trust?

You learn to trust only yourself. You get VERY strong, VERY tough, impenetrable. You're FINE all on your own.

I'm fine all on my own trickles into all kinds of relationships, doesn't it? It's one of the reasons people avoid intimacy, and it's why I would say it represents a fear of intimacy. How can you let yourself be vulnerable, how can you tell people your true feelings, your fears, your sadness, if you think you'll be punished for divulging that information?

Having feelings makes you a weakling, don't you know?

I'm not going to go into treatment right now, and I'm not going to list the features of paranoid schizophrenia for you. They're on this blog somewhere, probably in the Cho posts.

But I will say that I think when you notice these features in a person at any age, if you're intimately involved with this person or perhaps you are a blood relative, it might be worth it to gently confront it, to bring it up as a disorder. A tricky disorder. Because at some point you'll have to address it yourself, probably. You'll be the object of suspicion.

Or better yet, somehow, somehow, somehow, get that person to join you in therapy for a problem of your own so that he/she has a relationship with a mental health professional.

Trust me. You're going to need it.

therapydoc

One Year Later, Tante Fela

I called her Tante Tela when I wrote about her last year in the Yom Kippor post, worried that someone would actually recognize her if I used her real name, Fela, which means miracle, you should know.

So I originally worried someone would tell her about that Yom Kippor post, which is why I changed her name, I didn't want it to somehow get back to her before I told her about it. Maybe it would upset her. But of course, one of my best friends actually told Tante Fela's nephew about the post and he thought it was a good thing and he showed it to her, and she did read it and thought it was a good thing, too.

So maybe it was a good thing.

But you want the upshot, right? A year later?

Well, it's not good.

I got to the synagogue bright and early on Thursday, New Years Day, Rosh Hashana and took a look at the seating chart. I already had a feeling that Tanta Fela wasn't going to be sitting next to me. We have assigned seating for the High Holidays and she's relatively new in the shul. Last year some of the regulars weren't there so she had a seat right next to me.

But this year the regulars were back and she was ousted from that seat. I looked for her but couldn't find her. She must have come a little late, because when I looked again, there she was, about six rows in front of me. I noticed her looking back once or twice, confused.

After services I ran over to her, kissed her and wished her a happy new year.

"WHAT HAPPENED?" she cried. "Why did they move my seat?" She was really upset.

I tried to explain it to her, but she kept shaking her head. She couldn't believe it.

When I told F.D. the story he reminded me of the original post (which I guess you have to read for this to make any sense whatsoever).

Al Tashlichaini, he said.

OMG. That's what she had said.

So I asked around, and guess what? At least one other person in my row won't be there for Yom Kippor this year. So we'll do some shuffling around and Tante Fela will get her seat back, please G-d. I'm calling her first thing tomorrow.

The sign on and sign off this week, the week before Yom Kippor (the day all judgement is sealed), is

Gmar tov (the end should be good). But we have to make it that way, I think.

therapydoc

All Substances Postponed til October

I apologize to all of you who were counting on the Carnival of All Substances* to be posted on the 10th of September. Traditionally (is 4 a tradition?) I get it up on the 10th

But this week's a bear, honestly, and I just can't do it. Last week I moved my office (no stress there) and had out of town guests. I'm squeezing a week's worth of patients into a very short week for the third week in a row, and still have grocery shopping to do for the holiday.

And then. . .the cooking. There's (a) the chicken soup and knaidles, (b) the chalah, (c) the tzimmis, (d) the fish heads . . .

Fish heads?

Oh, you don't know. So we greet the first holiday, Rosh HaShana (the New Year) with all kinds of symbolic foods, especially sweet ones, like apples dipped in honey. But some of us have to have fish heads on the table, too.

I think fish heads gross EVERYONE out, honestly, except maybe people who actually cook a LAMB'S head and put it on a platter for the table. Anyway, these heads represent the bracha (the blessing)

You should be like the head and not the tail.

So let's try to keep at least a step ahead this year. Why not?

And on that note, I hope it really is a good year for all of us.

Shana Tova Umt'ookah ( have a good and sweet new year). I'm hoping to see Tanta Fela.

TherapyDoc

P.S. I'll get that carnival up, the Old Mighty willing, on October 10 instead.

Mr. Satuday Night

I want to teach you a simple family therapy technique. It is the whole of family therapy, really. Not that you can't learn from it if you're not a therapy doc. Maybe you can.

Deep breath.

We use big words like process, meta-message, homeostasis, triangulation, and the like. But the most complicated lessons are more intelligible without all that jargon. Process is one of them.

Do you remember the movie, Mr. Saturday Night?

I haven't seen it in years and can't remember the entire plot. I keep meaning to take it out and watch it again. But I usually remember the key messages in films, the ones that family therapists take out and mull over to eventually tell over when the time is right.

It's about a comedian, Buddy Young, Jr. (Billy Crystal) and his brother Stan (David Payner). Buddy has all the ego; he's a performer and he's brilliant, but he emotionally and verbally abuses Stan, his accountant for many years. We watch them age, Stan more gracefully than Buddy.

One of the things Buddy does well, for all his faults, is teach Stan process. After he tells a joke, or better yet, enacts the joke, performs a sight gag, Buddy says to his brother, See what I did there?

That's process. What he does, is process, not usually what he says. If you can see what Buddy does to make his audience laugh, you get process. It's much more than telling a joke. Families do this, too. Everyone in a family behaves in ways that make everyone else respond. Except usually, if they're in family therapy, they're not getting laughs.

Forget Mr. Saturday Night for now. Let's use a typical family therapy example that a student presented to me in supervision. He tells it over like this.

It was great. We were sitting in your office and Don (15) completely ignored his mother's request to stop playing with his cell phone. But he put the phone away when his father asked him to. So I asked the father, "Why do you think Don listens to you and not to her?"

"Because she never makes him do anything," Dad replied.

My student was very proud of his question and how the father got involved, how dad thought about it and proffered the interpretation about the content. But it's times like these that I press an imaginary buzzer and say bzzzzzzzzzz to indicate wrong and I say as much. Wrong.

"What's wrong?" asks the student.

Give me your best shot.

"I thought that went well, actually. We were making the point that mom has to get tougher to get respect."

And who made the point?

"Well, Dad did."

So this is a chidish, him beating on her in front of the children? (a chidish is Hebrish, a combination of Yiddish and Hebrew, meaning something new).

"I suppose not."

Well, we really showed her.

"I guess it didn't accomplish anything."

It didn't accomplish anything because the student got sucked right into the family system, played into their family hand, joined the family discussion about "safe" content. The problem isn't really about the kid listening to one parent over the other. That's "safe" content that allows Mom and Dad to disagree, probably to avoid intimacy, which as we've already established, scares almost everybody.

Most functional couples will disagree about parenting but they find ways to do it together without egregiously annoying one another. They talk about differences and find resolutions without putting one another down, especially in public.

This couple had a fight in my office so that someone, theoretically the therapist, would stop them from fighting destructively. What my student witnessed was a family enactment of their biggest problem.

After they hurt one another, couples will retreat to their own respective little corners and won't come out for awhile. Kids are very uncomfortable with this. They want their parents out of the ring altogether. They want their parents to be happy. So a kid will lure his parents to my door by becoming the "identified patient." You have to misbehave to do that.

Kids are very smart, so they do that.

I told my student that one of the things he might consider doing with families is commenting on process. You try to make the family aware of what they're doing. You ask, DID YOU SEE WHAT HE (anyone in the family who does just about anything) JUST DID THERE?

Or

(to the group) DID YOU SEE WHAT JUST HAPPENED HERE?

Someone might say, Well, so and so insulted so and so. Or So and so isn't listening.

Then you can say, Why don't you guys talk about that.

Even if they look clueless and say nothing and act as if they didn't see anything, you don't interpret for them. You don't fall into that same old trap of being the smart, wise old doc with all the answers. You say, Why don't you (anyone) talk to him (anyone else) about either (anything) or (anything else).

You get 'em talking. If they hurt one another you stop them. Wait, I'll cry. You can't do that here. Now talk about . . .And do it nicely.

And as soon as it makes sense, you dismiss the young sacrifice, ask it to wait in your waiting room while you talk awhile to its parents, keeping in mind that the goal is for them to talk to each other, to love each other and express that. Take that risk.

Leave your office happy.

Junior is superfluous, really. Once you have the 'rents alone you can cut right to TherapyDoc's favorite list of questions (Q) and directives (D) that a therapist could care less about but which are far more interesting any day of the week than talking about how to punish Junior.

(Q) So how did you two meet?

(D) Talk to each other about how it feels to be in this predicament at this stage of your relationship

(D) Talk to each other about what you could have, should have done differently over the years. . .

If you feel resistance you can start a little more softly with,

(Q) What was he like as a baby?

(D) Tell her (him) when you first noticed that Junior stopped looking you in the eye?

(D) Tell her (him) how it was for you when Junior left for nursery school.

(Q) Did you two argue when he was a baby?

Then crescendo with a vengeance to

(Q) Did you two argue when you were engaged?

(Q!) Why do you think that was?

(D) Tell him (her) how you felt about (pick content)

(Q) Did you think it wouldn't last, this marriage of yours? DO you think it will last?

(Q) What's it need, really, your marriage?

And that's just the short list. Your objective is to track back to better times. Everyone likes you when you get them to talk about happy times. And the goal, of course, is that they like you so there's a chance of trusting you and coming back to see you so you can help them get out of their corners, get out of the ring, and into the sack.

And you definitely want to do some individual work with ALL of them. Early as possible. Especially with Junior. It hasn't been easy being Junior.

But the family will do best if you teach process. Without process they'll never stop playing Who's the Better Parent? Or Who's the Worst Kid?

And they'll NEVER get under the covers together that way.

Interpreting, chatting with the patients, holding court, this is what therapists who haven't been trained in family therapy do when they think they're doing family therapy. These are psychodynamic, individual therapy techniques. And they're great for individual work.

But you have the family in your office. MAKE 'EM TALK TO EACH OTHER.

This way they don't have to depend upon a professional for the rest of their lives. It's not about learning one lesson. Face it, nobody remembers anything for more than a week. (See The Five Minute University on U-Tube.)

Okay. Back to Mr. Saturday Night. If you haven't seen the video and plan to see it, don't read any farther.

At the end of the movie Buddy, always the star, is seeing pretty hard times and Stan, always in the proverbial shadow, is retired but happy. The men are old, well into their 80's and they're reminiscing.

Stan says something to the effect that he wasted years of his life working with Buddy. Buddy defends himself. I didn't take your life, Stan. I gave you one.

Then Stan tells over the line I've repeated a thousand times in therapy, and now you probably will, too, at least once, to someone.

Yeah, but you could'a been nicer.

I just love that line.

Did you see what I just did there?

Copyright 2007, therapydoc

My Two Scents

Or an alternative title might be, If He Smells Good. . .

It's easy to think that a therapist like me who has an obvious bias (family therapy) might judge other kinds of therapists. But in fact, that's not true.

Like I've said before, a dodo bird is a dodo bird is a dodo bird.

All kinds of therapy docs have been found effective with all kinds of problems. Even though cognitive behavioral therapy is the darling of the National Institute of Mental Health (in combination with psycho-pharmacology for depression) if you have a doc who can speak in full sentences and knows when to shut his or her mouth, you're probably doing okay.

That's the verdict on psychotherapy. If you get someone with a good bedside manner who doesn't come on to you, the process will probably help. Won't cure you of anything, necessarily, but you'll feel better if all you have to do is spill your guts to someone.

And then, there are the obvious quacks.

I have a great story about how I got into aroma therapy, something I'd consider quackery if I hadn't experienced it myself, but have to save it. Suffice it to say that now I do recommend scents, basically as an adjunct intervention (not to replace therapy), something to help raise the senses. To get you outside of your head.

Anyway, today I was standing in shul (synagogue, if you're new here), not thinking about anything in particular, listening to the cantor's repetition of prayers the congregation had already said to themselves. Probably one of the primary reasons people like to go to shul or church or whatever is to space out while someone else is doing the real work for us. It's sublime to sit back, absorb the atmosphere, pretend to listen. Even to pray. Chill, as the kids say.

So I was emptying my brain, feeling a little bored. Face it, everyone does. And it occurred to me that my perfume wasn't very interesting anymore. (Onella, okay?) I have two basic scents and it's an autonomic thing, shpritzing one on before I go out on Saturday to the synagogue.

There I am thinking that I'm bored with Onella and should have put on the Sensi (Georio Armani) since I've noticed this before, not being sure I even LIKE Onella anymore, when I remembered a case from years and years and years ago that you'd like to hear about, for sure.

A great looking guy wore a wonderful aftershave, and he wore it really strong. It was even a little strong for my taste, and I can take a lot of good aftershave, but I got used to it. Anyway, I knew he had a problem with alcohol and I asked FD about it and FD said, Well for sure he covers the scent of alcohol with the cologne.

Thought so. And yet, the patient was a very sensuous guy, and one of the things he complained about was his wife's lack of sensuous sensitivity, blah, blah, and I wanted to believe that the guy really just liked to smell good. But at some point he admitted he really did have something of a problem with alcohol, but it wasn't a very BIG problem, and he only got drunk when he was depressed. So could we work on that?

It's your nickel, friend. Not what I'd recommend, but let's see how far we go.

Not far. He dropped out of therapy, missed his next appointment, but came back a few months later to tell me how he had had a critical moment, a life changing event, what we might call a "hit bottom" story. Everything, everything, everything went wrong one day and he wound up in a hospital. He realized he had to quit drinking, and he did.

It was then that I noticed that the room didn't reek of his cologne. And ironic part of it was, of course, that I knew how much I'd miss it. When people get better you know you're going to miss them. But usually it isn't their scent.

And the kicker? I couldn't even say, "So tell me. . . what was it you used to wear? What was the brand of that aftershave?"

There would have been absolutely nothing therapeutic about that question and it could have even sent him back a ways.

Sometimes it's hard being ethical, seriously.

ethically yours,
therapydoc