Tuesday, December 30, 2008

Friend Poaching

Well, you know I like the window seat. That's New York City.

In the airport, waiting for the good people at American Airlines to call Group Six on a return to Chicago, I'm getting a little hot in my winter coat, even if it is the right coat for New York City on a bright sunny winter's day.

Only last night, at a wedding, I'm freezing. There's a tradition to marry outdoors, something about being just that much closer to everyone's Higher Power. And since it's too cold for that, the wedding planners brought the outdoors indoors, opened a literal door, welcomed in Higher and the 32 degree early evening chill.

I say to a friend, a daughter of a Holocaust survivor, "I hate being cold. I hate being hungry. I could never have made it in the camps (the concentration camps). I wouldn't have lasted a week. I'm not made of the right stuff."

She says, "Not many people did make it, dear."

Rrrright.

The Story:

We're all staying in the same hotel in Newark. The parents of the groom have arranged a group rate and transportation to the reception in New York, and a tall, elegant, African American gentleman picks us up in a rickety white bus that has seen better days.

I'm sitting next to my friend Mi. (The names I use here, well, they're any old names, generic, unidentifiable names).

Mi is sick with a virus, eyes all watery. She's wondering which drugs to take to dry herself up. She says, "I should be home in bed with a cup of hot tea."

I say, "Yeah, seriously. Why did you do this? Why did you come to this wedding? Are you crazy? You should be in bed with hot tea and a warm TV."

She nods. "Well, you know. It's Debbie. If it were anyone else, maybe, but it's Debbie. She's my best friend." Then she thinks about it. "She's everyone's best friend. You ask anyone on this bus, they'll tell you. 'Debbie's my best friend.' "

And I know it's true, of course. Because Debbie's my best friend.

We get to the party and there's a great shmorg. You can see our best friend's touches everywhere in this affair, the food, the flowers, the colors. I have a bite and see Debbie's mother-in-law, Regina, who happens to be a close friend of my mother-in-law, regally march into the room, lovely in her gown.

I rush over to greet her. She truly looks marvelous and she might even know it. When women in their eighties look marvelous, when they're breath-taking, radiating that very, very warm glow inside and out, for many of them do,* when they're happy they can glow in a way that's even richer than the glow you see emanating from ingenues.

When I see that glow, I just kvell**.

Regina and I hug and kiss, and when we get past how wonderful she looks and how terrible it is that I didn't insist that my mother-in-law come along for the wedding, I whisper in her ear. "You want to know a secret? You want to know something nice about your daughter-in-law? About Debbie?"

"Sure!"

"They all talk about her, you know."

"Nu? What do they say?!"

"All of her friends say the same thing. They all say, 'Debbie's my best friend.' Everyone says this. It blows my mind, such an incredible thing to have people say about you. And they say that about your Debbie. Everyone thinks she's their best friend."

She seems pleased.

It's a great party, everyone has a little of that glow thing.

At the end of the evening I'm thanking my hosts, saying goodbye to people. I see Debbie's mother, another one of my favorite people, along with Debbie's mother-in-law, lazing out at a table for ten by themselves. They're all smiles.

"We were just talking about you," says Debbie's mom.

"Me?!" I'm all excited. They're talking about me.

"Yes, you," Regina confirms. "I was just telling her what you told me earlier about Debbie."

"Hey," I object. "I'm just telling over what Mi told me. I'm just moving along information."

They smile. They're tired. And happy. It's been a beautiful wedding. We're all out of words. I sign off. "Okay, gotta' go, the bus driver is waiting. He's working pretty late."

And we're back on the bus, a long way from our hotel. And I'm power napping off and on, my head on FD's shoulder. Mi is a row in front of us, quietly catching up on the phone with her guy. He missed the wedding.

And she sneezes. Softly.

Everyone on this midnight bus is tired and quiet. Probably nobody heard.

therapydoc

* My mother-in-law has this beauty, as does my mother, and many other women I know.

**Kvell rhymes with Mel and means, in this case, melts, but really it means plotz, (rhymes with dots) which means, also, has to swoon there's so much good feeling.

Last Back 'Acha of 2008

I feel terrible for forgetting to do this. It's one of those things that hangs in the back of your head, like, Make your bed, or Bring up the laundry.

This feature links to bloggers who have linked to me, but it means that I've actually paid attention to statistics and have tracked you down, unless you were kind enough to send me a note, like they did over at On-line Education. At O-E, they basically put you in touch with online education, and since I happen to teach an on-line course, it feels right, somehow to start you off with a link to that website. Check it out. A list of 100 brain-bloggers.

Most of you are brainy bloggers, and there are some of us, who by virtue of the sedentary nature of our jobs, are tush bloggers. If there were a list of t-b's I'd be at the top, for sure.

Sometimes (often) I discover amazing blogs because I do this researching statistics ritual instead of doing things I should be doing. There are bloggers who have their GED, they'll tell you, despite ADD who live over at Maggie's Farm, which seems like a 2008 commune. But they eat meat, so they are obviously not as sixty-ish as they seem.

On the other hand, they're no longer seventeen. They also like the strip of Calvin and Hobbs they posted over there, which is informational, something out President Elect Obama and smoking. I still don't believe this. But if it's true, you heard it over at Maggie's and we're thinking they might be smokin' over there, (forgive me, say it ain't so), too. I particularly liked the rein deer. They linked to my 51 rule for marriage. I had totally forgot I wrote that post.

Ars Psychiatrica is a brainy place, brooding a bit about the DSM, but who isn't?

And BiPolar Lawyer Cook is cooking up a storm of therapy bloggers on her blog. Definitely a way to go.

Mother-in-Israel, speaking of hell on wheels (in a good way, in a good way, always worth the ride) has listed ALL of the WebBlog Awards for 2008. So if you're looking for a good blog, well, you can not go wrong here.

Okay, new idea. Since I didn't check the stats, I'm going to edit this and add any bloggers who feel they should be here. (email me at therapydoc@gmail.com) This is a great idea, I think, since you do the work, not me. Forgive me in advance, please, for missing you if I did, but let this be the cure before the malady.

This month was a real doozy of a month to be a therapy doc, and I had a couple of new grandchildren that my son and d-i-l added to the family on the first day of December, and we haven't even begun to talk about those two. But we will, when I land on my feet.

Happy 2009, it should be, it has to be, a better year for us all.

therapydoc

Here are some more:
Canadian Girl Post Doc in America
Mental Deviant
More Mindless Ramblings
http://blognut-moremindlessrambling.blogspot.com/2008/12/road-rage-or-winter-rant-from-blognut.html

LIFE IN THE SHORT LANE love her bio.

Retriever has a bunch of them. Try Fantasy Shrinks and Real Shrinks, or Trauma and Meaning, Requium or Imagination.

If you really want to imagine, check out Imagine If Child Protection Became Serious Business.

And, the links I forgot these, places I actually guest blog at, or will be in the future.

The Second Road, a recovery blog for people who have or who have to deal with other people's addictions.

My Gorgeous Somewhere, a writer/poets blog.

Thursday, December 25, 2008

Eat, Pray, and Love and Chanukah





Looks like we could melt that snowman with our candles. Totally unintentional.

This is the time of year my patients come in with holiday questions, and I happen to see a lot of Italian people. (Thank you, thank you, thank you Sopranos). A lovely Italian man who has been seeing me for a long time sweetly asks,
"So. Chanukah. This is the holiday when you light candles because the Romans tried to sack the Temple. But the Maccabees beat them off, right?"
He asks this before we begin to talk about real stuff, real problems, talk about self. It is pre-therapy chat, much like chit chat about the weather. I ordinarily don't usually let in questions about me, but this is a question about history. And who doesn't love history?

"Almost!" I exclaim, for it is hard to contain enthusiasm. "It was the Greeks who ransacked the Temple. They didn't hold by our doing things our way, like the way we want to rest on the Sabbath, check out from our ordinary lives, and they really didn't like that we prayed in a different language (Hebrew). This emperor's rules went like this: Be like us, be Greek, or die.

I am not making this up. And I love the Greeks, don't get me wrong, but this particular ruler, well. . .

So a bunch of Jewish rebels, both men and women, got together and decided to take back their turf. And they did."

"But the Romans did take over the Temple once, right?" he asks, confused.

"Uh, yes. Much later. They decimated it, leveled the whole beautiful city of Jerusalem, too, to make a point. Might makes right. It was important to do that, make that point. I don't know why."

"I feel ashamed to be Italian," he said.

"Hold on! We don't think of Italians in this way, or Greeks, either, although some people do have a little difficulty with the Germans and won't buy a Mercedes. But who can afford one anyway, these days? It is against the Jewish religion to hold grudges.

And anyway, since Eat, Pray, and Love, everyone wants to be Italian!"

And we move on.

Eat, Pray and Love is a biographical novel by Elizabeth Gilbert. I mean, I would call it a biographical novel, but not being truly literary, meaning barely passing Rhetoric 101, I don't know for sure. But this little book is in the first person and reads like a novel and is in fine chick lit form and I love it. Liz breaks down after her divorce and takes a year to find herself. She chooses to divide her time between Italy, India, and Indonesia. She chooses Italy because she loves Italian.

This, of course, hooks me, because I didn't realize either, my love for Italian until mid-life, when it hit me that I loved opera- Italian operas. These two revelations changed my entire life and I bought disks to learn Italian, but failed miserably. You can not learn a new language after 40. Or let us say, I could not.

Anyway, if you haven't picked up all of your presents for the holidays and you know someone who likes stories about spiritual quests, this is a fabulous little book, for it does a lovely job of explaining meditation. Therapists are always recommending meditation (if you're a therapist and you don't, you really should reconsider.) Not that people have to run off and find a guru, but the quieting of the mind is a wonderful thing.

We do it in all kinds of ways, work to quiet the mind, for it takes work. Meditation is just one way.

I could write for hours about how much I love Elizabeth Gilbert's book, how funny she is, how well she describes depression and joy. How well she describes how hard it is to let relationships go, and how important it is to do that; how important it is to own your best friend, your most reliable companion, you. But we have bigger latkas* to fry today.

Holidays are therapeutic, right? But only, I think, when the family is happy together. When it isn't, we family therapy type docs use the inevitable, inescapable family reunions as opportunities for patients to try out new ways of relating to family, new behaviors. I tell people, "I'm on call, baby. If it doesn't work, and you're freaking out, just call me. If I don't answer, assume you're on your own. Of course, you have you, you know. And you are very cool."

I tell them if all else fails to go out and build a snowman, unless that's against their religion, building snowmen. Frozen images. In which case, doctors orders, but ask your rabbi, you might consider doing it anyway and leaving off the nose. Make it an imperfect frozen image.

All that, by way of introduction.

Chanucha.

It's hard to believe that the time has flown so quickly, that it is time for the annual Chanukah post. I think all I really want to do here is focus on spelling. Let's make a game out of it.

I'm going to try consistently to spell Chanukah the same way throughout the post. See if you can find the mistakes. Down a latka as you read. Your local deli probably has them. Down a virtual one if you have to, think of it as a very large, round french fry laced with onion. Dip it in apple sauce if you wish.

First of all, let's get the differences straight between Hannukkah and all the other December holidays. Leave out birthdays.

Like the others, I think, Chanucha is a happy holiday, and we have a pretty good time, all in all. Jewish children play with a cute little spinning top and we all light candles each night. The more careful among us buy electric menorahs (theme candelabras) to be sure there isn't a fire. But the more trusting among us light an additional flame each night with abandon, often with olive oil. As years go by we make less of a mess with the oil. It glows quite nicely even if there is a mess. The excess can always be used on the skin.

My brother-in-law tells me that you can't ever have too much olive oil in your life. He may be right.

Anyway, I feel that someone has to tell you that Channucha is not Xmas. It's not an imitation, has nothing remotely to do with that festival, except the timing sometimes, and we don't have a Santa, although I, personally, love the concept. My kids didn't even know there wasn't a tooth fairy until they were sixteen, so we can totally respect the concept of Santa, some of us, for sure.

This Festival of Lights (as some call Channucah) is a festival dedicated to differences. I'm surprised everyone doesn't celebrate it, honestly.

It's the original celebration of diversity.

You can read the whole story over at Judaism 101, but basically, here's the story:

Alexander the Great, a Greek emperor, went about conquering territory, and when he did, he allowed people to continue observing whatever they liked. He didn't make everyone worship Zeus or Athena or Dionysis or any of the Greek gods. And because he was so nice and the Greeks seemed to have so much fun and stayed so fit, under his rule many Jewish people adopted some of the Greek customs and their clothing, even language.

But more than a century later, a successor to Alex, Antiochus IV oppressed everyone who didn't go with his program. He prohibited the practice of the Jewish religion, particularly, and massacred the Jews, desecrated their Temple. He required the sacrifice of pigs (a non-kosher animal) on the altar, knowing it repugnant to us. The Hitler of his time.

Not a nice guy. The Jews teamed up as a nation and revolted, basically took back their holy site and rededicated the Temple by lighting the everlasting flame with a tiny bit of pure olive oil. The oil had been left over, untainted by the invaders, and should have lasted only one night. But it burned for eight. That's why we get eight nights of Chanucha, eight nights to light olive oil, and for most of us, eight nights to lubricate life with pizza and latkes, anything greasy will do. And we drink wine, some of us, each night. But we drink as Jews used to drink, meaning, not a lot, not to get drunk.

And THE WOMEN, because they were instrumental in this victory, ARE NOT ALLOWED TO WORK while the candles are glowing. We settle into a comfy chair with a book and let our minds wander to where ever they may go. Or we talk on the phone. Or catch up on our favorite blogs.

Merry Xmas, everyone, and Happy Chanucha, Happy Kwanzaa, Happy New Year. Don't drink too much, don't eat too much, and enjoy whatever there is to enjoy, for there has to be something, there has to be something to feel good about. And if you can't find anything, search for your best friend, that person inside who is always with you, always watching you, suffering right along with you. And talk a little Italian, if you can, with one another.

therapydoc.

*A latka is a seriously fried potato pancake, a traditional Chanucha delight. Some eat them with apple sauce.

P.S. If you happen to be looking for a present for an accountant, or anyone who likes history or the history of big firms, I just read (okay, skimmed it, bought it for my nephew) The Sex of a Hippopotamus: A Unique History of Taxes and Accounting by Jay Starkman. You can get it at Amazon or through Jay's website.

P.S.S. Thanks to http://www.judaism.com/search.asp?nt=bZdS&sctn=022&startPlace=9 for the pictures of the menorah, wicks and oil, and to clipart, for the snowman.

Saturday, December 20, 2008

Madoff


Usually if a Jewish person gets into trouble we try not to draw attention to it, we're so embarrassed. We call it a chilul HaShem, an abomination to G-d, and hope the news passes over quickly.

But a guy steals 50 billion dollars, well, it's hard to ignore. Our luck. He had to be Jewish, we say (as opposed to Italian, or Irish, Chinese or Sudanese, a Somalian pirate, a Brit, choose your nationality). People are going to talk about us. Slander us. This time of year, it's especially not so good. It's a real oy vey, something to geshrai (give a sudden shriek) about. Check out this journalist's Jewish Response to the Economic Crisis if you think I'm just a little paranoid about anti-Semitism.

My mother calls me on Friday. She says, "What do you make of this guy Bernard Madoff? Is he sick? I mean, what is he? Is he a sociopath? My friend Beverly says he's a sociopath. What's a sociopath?"

"I don't know if he's sick. I really don't. He might be. Or he might be considered a sociopath."

"Is it genetic?"

"Well, I'm not sure. It may not have anything to do with genetics, although believe me, we'd love to blame something like this on bi-polar or better, uni-polar disorder. Tell Beverly that you think Bernie Madoff had a uni-polar manic episode, a long one. You'll sound smart and it gets us off the hook."

"I can't even pronounce that. But if you're telling me it's probably not genetic, then are you telling me that his parents taught him to be a ganif like that? (Ganif is the Hebrew word for thief.) His parents probably came here on the boat with mine!"

"It's likely people would say that, that this cheating is learned behavior. I don't know. I get pretty tired of hearing parents getting the blame for everything. It's unlikely his parents gave him the green light to steal. It's culturally not what we do. It's frowned upon."

Mom sighs. "I know, I know. We take a kid to a psychiatrist for stealing a candy bar. What is a sociopath, anyway?" She's not into Googling things.

"People don't generally use the word correctly. It's a criminology word, I'm pretty sure. But mental health professionals also talk about sociopathy as related to personality, particularly Antisocial Personality Disorder. Sociopathy refers to having no guilt, to seeing the opportunity to hurt others and taking it. No fear of the consequences. No morality."

"I don't understand. How does a normal, nice looking man like him, turn into someone like that?"

"I don't know, Ma. In our crowd we would say, No Torah. But it's much more than that. Most people have some kind of respect law, for authority, some fear. And they have a super-ego, too, that little voice in the head that says, That's not nice. Don't do that. Seems that Madoff either hasn't got that voice or doesn't listen to it, or has no fear. Your guess is as good as mine, though. Crime isn't my specialty."

We get off the phone. But this bothers me, as it bothers everyone in my community, that this man has scammed so many people out of so much money. Not that their money is necessarily theirs. Some of us believe that if we have it, we have it so that we can redistribute it. But that's philosophy, theology. Some people really do wonder, however, "Is my money mine? Do I really own anything?"

I love the story, and forgive me if I've told it before, about the rabbi out taking a walk. A thief grabs his wallet and runs off. The rabbi runs after him shouting, "Take it, take it! Take the money! It's yours!" The rabbi assumes the guy needs the money more than he does. He's giving it to him so the thief doesn't have to suffer the sin.

So I'm thinking that this man, Mr. Madoff, just isn't thinking right. He doesn't understand his responsibility to the universe to redistribute wealth.

Or he has unipolar mania, a disorder that is rarely diagnosed, because it's generally perceived as hypo-mania, and everyone has one of those in the family, someone who tends to be incredibly gifted, whose gifts or thinking have the potential to get him into real trouble at some point or another, just about the time that his beautiful mind goes too far awry. No fear.

I went to shul this morning and the rabbi talked about Bernie Madoff and how everyone has a war story to tell because this guy took no prisoners.

Then he tells us the following story.

A few weeks ago a couple of young men finished their Friday night dinners and walked to the synagogue to learn together. They studied for many hours into the night, and when they closed the books and got ready to leave, noticed the pouring rain. Since it had been nice when they left their respective homes, neither had brought a coat.

They looked in the coatroom and saw two lone trench coats and various unclaimed items
.

Our synagogue happens to be a repository of men's coats and sweaters. We could open a store. Anyway.

The boys searched the shul to see if anyone was still there. Everyone had gone home.

They had to make a decision.

Should they borrow the coats? Surely if they did, they could return them early in the morning, first thing. Would it matter? Did they have the right to borrow the coats? Is it stealing to borrow something without permission? What is the law?

Rather than err on the side of stealing, the boys left the coats in the coat room and walked home in the rain.
(That will teach them to not listen to their mothers)

The rabbi's point, of course, is that had Mr. Madoff made decisions like these boys made decisions, had he worried, fretted about the consequences of his behavior, the ponzi scheme would never have taken place. He didn't worry, however, not enough. He's not into karma, and scoffs, apparently, at civil, federal, religion and international law, law of any kind. He has Bernie's law.

That or he's manic.

Below are a couple of diagnoses for you to chew on. Don't ask me to pick one because I haven't talked to him, and have no psycho-social-family history on the man. But I'd love to talk to him, I really would. And he does need a check up. He certainly needs some kind of excuse.

therapydoc

Criteria for Manic Episode:

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

1.inflated self-esteem or grandiosity

2.decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

3.more talkative than usual or pressure to keep talking

4.flight of ideas, or subjective experience that thoughts are racing

5.distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

6.increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

7.excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C. The symptoms do not meet the criteria for a Mixed Episode.

D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hypothyroidism).

Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.

Diagnostic Criteria for 301.7 Antisocial Personality Disorder

A. There is a pervasive pattern of disregard fro and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:

1.Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;

2.Deceitfulness, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;

3.Impulsivity or failure to plan ahead;

4.Irritability and aggressiveness, as indicated by repeated physical fights or assaults;

5.Reckless disregard for safety of self or others;

6.Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;

7.Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

B. The individual is at least age 18 years.

C. There is evidence of Conduct Disorder with onset before age 15 years.

D. The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode.

Sex differences: According to DSM-IV (in a 1994 publication by the APA), Antisocial Personality disorder is diagnosed in approximately three percent of all males and one percent of all females.


therapydoc

Tuesday, December 16, 2008

The Bus

That's the ski path I plowed in front of my house and the house next door.


It's snowing in Chicago. They say a picture is worth a thousand words.

I took off most of today because there's too much clutter in my life. At some point you tell yourself that your mental health deserves declutterization. My friends actually have another word that they use that we made up to describe this process of pitching things, not something I can repeat here.

And although it was great, throwing things away, I had to get to work to see my late afternoon patients. Meanwhile, the snow had been falling since eleven a.m. Driving in that stuff, parking, just the thought of snow on the windshield, makes me ill. And don't get me started about the way people drive. You can read more on that on someone else's blog.

I would have tried cross country skiing all the way here, but can't afford a fall, just can't. Sorry.

So I took the bus and am on time, but everyone else is late because of snow and traffic.

But I took the bus.

I think I've told you that I love it. Nobody likes waiting for buses, but once you're on one of these big green machines you feel instantly impenetrable. And as I'm walking to the bus I'm thinking, Hey, I could walk! But it's slippery on the sidewalks, something I learn soon after leaving the house, so why risk it.

The bus, meanwhile, is filled with happy people. Everyone is happy. Maybe it's because they're on the bus, not outside shoveling or slipping. But we're in high form here. The holidays are coming and it's so, so beautiful outside, it's not to be believed. Once I'm seated and feeling the love, I do what 90% of the world does on a bus, yank out my phone to take pictures. I think to myself, "Who will notice me taking pictures?"

I'm not aiming, just pointing my camera back, shooting random shots behind me. I see a couple of kids (above) popping up in all of them, and say to myself, "NG, no good, can't use these. What if someone recognizes them, someone they wouldn't want to recognize them. They're obviously in love."

So I raise the camera higher, and keep trying, but none of the shots are any good. And most of them have this young couple prominently, undeniably, displayed.
Then, in the last picture, I see it.

He's waving at me.

Busted.

I laugh and turn around. "I'm sorry. I just thought I'd get a couple of pics for my blog, but I keep getting you guys (I show them their pictures) and I figure that I can't expose you on a blog because someone might recognize you as a couple, and for all I know someone has forbidden your relationship, or one of you has a different, jealous partner.. . and. . .and. . "

The young woman is working on getting a word in edgewise as I struggle with words, so I finally shut up to hear her say, "It's okay, it's okay! We used to be in a relationship, but we broke up, and now. . ."

And since I'm not working, I interrupt her. "But his mother might object.. ."

This time he interrupts me, but he speaks softly and I don't hear what he says and I just roll right over him since his words aren't computing, "And your mother might object and she might get upset and you'll get into trouble.. ."

Then she interrupts, "But his mother is. . "

"What was that you had said before?" I ask him.

He smiles, his eyes are laughing, believe it or not, laughing at me. "My mother's been gone for a year now, so there's really no way she'll mind, and she wouldn't mind even if she were here. She passed away over a year ago."

Foot out of mouth, moving right along as if this is the most normal conversation I've had all day, I say,
"Uh, oh. So you've lost your mother and I'm ranting about her and how mad she will be seeing a picture of the two of you on the Internet, and now I've made you sad, and you're going to cry and I'm SO, SO, SORRY!!!!"
They both laugh at me. They think this is hysterical. Others are listening, too. Then our girl informs me with not a little authority, "And there's no way he'll cry; he doesn't cry."

He confirms. "She's right. Really. I don't cry. And you can use the picture, go ahead." And he's smiling and nodding encouragingly, and I just love him.

And she says, "Right, go ahead, it's fine. And really, don't worry. You didn't upset anyone. He never cries, he's fine, he really is"

And I love her, too, because she' maybe the nicest kid I have ever met in my life. And I say, "But he might, and he has good reason to cry, even should cry once in awhile, maybe. It's surely okay if he does and even if he doesn't, of course."

And I look into his eyes. "You're okay, really?" I ask him.

And he smiles and nods. "I'm okay really. And I won't cry if you're worried about that, about making me cry."

I shake my head in amazement. "This is amazing," I say. "This whole thing."

And they seem to agree.

Then, to be sure, I ask, "You're sure, you're a hundred percent positive that it's okay for me to post these pictures of you two on my blog, and to tell this story?"

"Sure, sure!" he smiles.

"Sure, sure!" she does, too.

Then, a lightning flash. "Where are we, anyway?" I ask.

"We're almost at _______" and she names my stop.

"Uh, oh! I have to run. I hardly ever take the bus, but I love it when I do, and I hope I see you again. Thanks so much!"

"Bye, bye," they say in unison, probably thinking I'm insane.

I walk from the bus stop back to my office thinking, What a wonderful winter we're going to have! Simply wonderful.

therapydoc

What If: The Movie

All right, all right. I get these things, these lovely notes from people in publicity jobs asking me to link to their product, movie, book, etc. Usually I'll try to review things I think might interest you.
But often I say, "I just haven't got the time."

So when they tagged me from What If: The Movie , when they sent me a note and suggested, Embed This! I thought, no time, no time, no time.

Except that the clips are only seconds long, and they really do point to some provocative ideas, the stuff of the future, and the stuff of imagination, and you know, you know, you know, that I tend to always be there when we're talking stretching your imagination.

I remember the first time I read Bernie Siegel's stuff about beating cancer using thought control. Marvelous. But don't stop the chemo. This is what we're talking about.

So here are a few clips, why not? Let's see if you have any opinions on this stuff.

First link, Bruce Lipton(these are to YouTube, by the way).

Here's the second with Joe Dispenza

And the third, Kevin Cavanaugh.

And the fourth, Virginia Ellen

for extra credit,
Dan Brule


and of course, Bernie Siegel.

Personally, I call it the power of hope, politics aside.

therapydoc

Monday, December 15, 2008

One for the Road

I think winter makes me hungry. The food themes keep on coming.

A quick story.

Tonight I had a few errands to run after work. There's snow on the streets in Chicago, and the streets are slick, meaning no one knows how to drive, and I'm getting a little frustrated. They should make people learn to drive in the winter, make us take our drivers tests in weather, seriously. Then set us loose.

This is the last errand, a trip to a modest grocery store. There must be hundreds of them in the city, but I go to this one because there's usually parking in front. And they keep late hours.

The shopkeeper is a quiet guy, an average sort of guy, deep middle-age, thin blondish hair that will never go gray. He's never said two words to me except maybe, Aisle Three to the left.

Not that he has to talk or smile, for sure not. People need the benefit of the doubt. Nobody has to be smiley any time of day. Nowhere is it written. And there's plenty to feel grumpy about, actually, no matter who you are. We all have stress. Remarkable levels of stress.

So he's generally not very communicative, not with me, and I am used to it, have come to expect it and even hope for some sort of dismal exchange. It's nice to be able to predict a few things along the road. I imagine my counter guy has to say, Aisle Three on your left too many times in a day.

As I pull up my cart he's counting up the coupons, organizing his drawer a little. He finishes what he's doing and without looking up, starts to ring up my items.

At some point I see him toss something into a white plastic bag and hear him mutter something under his breath. Peanut butter. I hear it clear as day.

I bought this off brand kind of peanut butter, all he's got on the shelf. I ask, "Is it any good, this peanut butter?"

He concentrates on bagging but raises his eyebrows. "I don't know."

So I ask, "So what did you say before you said peanut butter, anyway? I heard you say peanut butter, but didn't catch what you said before peanut butter."

He looks up at me for the first time in his life and says, "Grape jelly. I said, Grape jelly and peanut butter are my favorite. And that's what you have here. Grape jelly and peanut butter. Mmmmm Mmmmmm. I love grape jelly with peanut butter. It's my favorite thing on earth."

And he smiles.

"Mine too!" I lie. The truth is that I prefer orange marmalade to grape jelly, but grape takes a second, if a distant second. But you need grape jelly in the house in case you're in the mood sometime, and we've been out of it for too long. So I bought it, a big jar of Smucker's grape jelly.

He's obviously not impressed with the marshmallow fluff in my cart, hasn't commented on that. But it's good, too, if you haven't tried it, with peanut butter, if a little decadent nutrition-wise.

He's clearly happy now. "Yup! Grape jelly is the only way to eat a peanut butter sandwich!"

Excited, he engages me in this discussion and I couldn't be more pleased. Truthfully, there aren't very many people who care all that much here. He continues to say, "Did you ever try that Smuckers jelly-peanut butter combination? It comes in one jar, a mixture; peanut butter and jelly."

"No," I admit, thinking this is not for me, the peanut butter/jelly combo in a jar, that it's probaby too sweet. "But if you say it's good, I'll try it." And I'm thinking, well, maybe one day. He is convincing.

"It's amazing," he assures me, nodding furiously.

"Great, thanks for the tip."

"Any time," he says, friendly as can be, all smiles as I walk out the door.

The social lesson here, obviously, is that there's a way in to everyone. Right?

therapydoc

Wednesday, December 10, 2008

What's in a Name


No matter the family dysfunction, if you have children you have an opportunity to change direction. And it does seem, that if you come from a family that was functional, you can change that, too, with the right match.

But for now, let's stick to the former idea, the hopeful one, that no matter the family dysfunction, we can change direction somehow. Let's stick with this thesis that we can direct fate, for everyone likes thinking they can. We don't have to be slaves to circumstance.

Those of us with anxiety disorders especially like this world view.

As are those in The Business. They know that we go to the movies to see how others fumble at controlling their lives, and how other people, ordinary people, make it all work out somehow. Satisfactorily.

The people in the business know that some of us really need happy endings. We need to see change that will make it all functional, and we're so grateful for this art, for the places we can go to see that things really do work out for the best. Our favorite drug, seriously.

Therapists like me try to model our personalities, actually, off of therapists in the movies. We assume that they get paid better, so why wouldn't we? I admire them, but can't really bring myself to behave like them.

Like the therapist in the movie Ordinary People (played by Judd Hirsch, a natural therapydoc) leaves his office and chases down his patient, a fifteen year old kid. He goes where ever the kid's pathology takes him.

The little guy, poignantly played by Timothy Hutton, has watched his brother drown in a boating accident and has significant post-traumatic stress. Timothy is not going to go to therapy voluntarily. His mom, Mary Tyler Moore, isn't a touchy-feely Mom. She apparently isn't chasing him. So Judd chases him.

When the doc catches up with him, the conversation goes something like this:

The kid says, "I needs control."

Judd says, "We therapists aren't real into control."*

And it is true! I clap loudly, of course, when I hear this and get dirty looks from people all around me in the theater, but I can't help it. Who could? It's true. You want to control your life, but life basically takes over, does whatever the __ it wants.

We have a Yiddish expression, and I always get it wrong, so forgive, me, correct me, put me in idiom jail, Mann tracht und Gott lacht. Man is busy making things happen, plotting the details, and God laughs. I'm sure He/She has a serious knee-slapper or seventeen million of them every single day.

Anyway, one way of doing this, controlling your life, plotting the course of destiny, is to name a child after someone you respect. I'm pretty sure that several cultures do this.

For example, a guy named James might name his son after himself, making his son James II. James II names his son James III, and so on. This pattern continues generationally. Pretty soon you have many, many respectable guys named James in the family tree.

This makes it a lot easier to be a family therapist plotting names and dysfunction in the family forest. We don't have to ask, "So what was your great-great grandfather's name?" We're pretty sure that it is James and a Roman numeral.

On my husband's side, there's a David in every family. At least one David. I had no idea how important the tradition of naming the first son David could be until I failed to name either of my first born male twins, David. In my family's tradition, if a living uncle or an aunt is named David, you wouldn't name your kid David. It's just not done. So we didn't.

And we're paying to this day.

Relatives from far away will visit and gaze at photographs that I have elegantly stapled to a wall in the hallway to the kitchen, giving up on picture frames (they break) long ago. I dedicated the entire wall to pictures and when I get depressed I go there and visit everybody.

So visiting relatives will look at the pictures, too, and say, "So which one is David?"

I'll point to my fourth child.

"Wait a minute. He's not the b'chor (first son)." I tell over the Explanation.

Ice.

Nah, I'm just kidding. They smile as if to say, "Well, you figured that one out." That's how it is in most families with strong traditions about names. Keep it functional, they're saying, or we'll show you the door. And we want to please them, too, and keep the wheels of history well-oiled.

It's about wanting control. Well, some of it is.

We really do want to change history, change tomorrow if we can. That's what therapy is all about. It's why we go to see therapists. And if the therapist is a behaviorist, we begin to play around with the future. This is exactly what we do in therapy, some of us. We play around with the future.

For example, a patient will mourn seeing the next day, dread going to work: "Tomorrow I'm going to go to work and the boss is going to beat on me something fierce." Therapists hear this at least once a week.

And we'll say, "Ha! You're not going to work! Are you crazy?"

Forgive me. Forget that line Are you crazy.

We say, "You're not going for three weeks! Maybe more. You have to get better." And we all bless Bill Clinton and FMLA, the Family and Medical Leave Act.

Or we discuss other ways of handling situations and teach assertiveness. If you're not really sick, and face it, you're probably not, we work with the system, and sure, teach assertiveness. We teach this even if you are sick, but we wait until you're well enough to absorb it.

You'll say to your boss, at some point, "Boss. I have two hands only."**

We can control quite a bit when we open our mouths, sometimes.

Therapy is hard, however, so the simplest way to control destiny really is to have a child or adopt a child and to name the little peanut after someone you totally admire and respect, someone who probably wasn't always saintly, but grew into the role.

If we're smart about this, we'll look into the family tree or perhaps our communities, or even to history, and will find someone born with an easy disposition, someone thoughtful who doesn't automatically get riled up just because everyone else is riled up. We'll name a child for a person who thinks before speaking, responds rather than reacts, has a ready smile and if at all possible, an aptitude for music, even song, for song is music; someone who assumes the best in people, rather than automatically suspecting the worst.

Then the little miracle, robed in this fabulous name of a fabulous person tells people, "I'm named for So and So. Let me tell you about So and So."

And So and So lives on.

Talk about controlling destiny.

therapydoc

P.S. You can read about imagination, control, and addiction at The Second Road. I post over there once a week.

*Thanks Paramount. For sure. The best line in movie history. Whatever it was.

**And thanks, Helen, for the two-hands-only line.

Monday, December 01, 2008

Lunch

Now that Thanksgiving is behind us, let's talk about lunch. The brown bag kind.

Little One* sees me packing his and says, "Oh, by the way. Don't put pickles in my lunch. Like. . .ever again."

"But honey. You like pickles. And with tunafish you need one. Everyone needs a pickle with tunafish."

"Well, remember what happened that time. . ."

"Don't be ridiculous. That was a long time ago. Yesterday the juice didn't leak through the bag, did it? I used the special snacksize ziplock bag and it worked, right?"

He has frustration in his eyes, his voice a nervous edge. "But what if it hadn't? What if it had leaked. We were lucky this time, but what if we aren't the next?"

I'm patient. "It didn't leak. The pickle didn't leak. Correct me if I'm wrong. The pickle leaked only that one time, but yesterday, no plastic wrap, just the zip-lock, the pickle juice did not get all over your notebooks. Right? A new paradigm."

"I know. But what if it does? Why take the chance?" He's waving his hands passionately, they tell it all.

"I'll tell you why it's worth it to take the chance, but only if you really want to know."

He looks at me skeptically. "Hit me."

"Because one day you'll be married and maybe she'll be packing you a lunch with a pickle and you'll see her doing it and you'll stop her, irrationally. She'll look at you with confusion and say, 'But you LOVE pickles,' and you'll say, 'But not in my lunch.' Then you'll tell her the story about what happened to you when you were nineteen and she'll blame me."

I go on. "You have to get over this for the sake of your marriage and for the sake of my relationship with my future daughter-in-law. I'm at risk here, risk of conflict, abandoment. All of it."

He sighs. "Does it always have to come to this? My future relationships?"

"Yes."

"Don't you think you're exaggerating a little?"

"Uh, uh. This is important. And there's more to it, of course. The only way you'll get over the trauma is to grab a pickle by the bumps, double wrap it if you have to, but pack it and eat it with your sandwich at school."

"You're not going to blog on this, are you?"

Poor guy.

therapydoc

*Not so little. Almost twenty years old, he towers over me.

Tuesday, November 25, 2008

Help Desk Closed

That last post was awfully long. I apologize. No time to edit, it's busy season. And I wanted my little friend to get a good grade. (smiley emoticon here)

Everyone have a great Thanksgiving. I'm sure there's something to be happy about, something to be thankful for, if you think on it.

One of the things I'm thankful for is all of you.

All the best,

therapydoc

A Chandlers is Safer

There's more to this concept about blogging being therapeutic. Before words in previous posts are taken too far out of context, maybe it's a good idea for us to take a closer look; get out the x-ray vision, see what's lurking beneath what apears on the surface, at least, to be a marvelously good time.

Not that we need x-ray vision. If you've blogged awhile you might have come to realize that almost everyone is a little vulnerable, almost everyone is socially sensitive, at least to a degree.

Kids are particularly at risk for harm in social contexts. We think of them as more sensitive than adults. We professionals think of kids as a vulnerable population, in fact.*
And they blog, too, a very social activity with potential risk.

So this post is for them.

A high school student writes to me from North Kingstown High School in Rhode Island, asking if I would mind participating in an interview about blogging and its relationship to therapy.

Not willing to out myself with a phone number, I ask her to send me the questions. For sure I'll answer by email or write a post about it. She can copy, paste, interpret, disagree, then cite me as a reference for her paper.

Citing where you get your information is the kosher thing to do, both on or off the web.

Cyber-safety, you'll see, is the important variable to consider if you're answering the research question, Is Blogging Therapeutic? It's the confounding variable, for those of you who understand what that means.

If you put yourself in danger emotionally when you blog, the experience is not going to be very therapeutic.

Okay. Here we go.

1. How long have you been blogging?
Two and a half years. I can't believe it myself. All I wanted to do was teach. Now you know the color of my . . .

jacket.

2. Do you feel that blogging can have the same therapeutic benefits as keeping a journal?
This has everything to do with who is reading the blog, who is reading the journal.

Let's take a look at a journal, first. It is hard copy, pen and paper, or maybe an electronic file on a computer, a CD, or a flashdrive.

You might leave a paper/pen journal in a drawer, or inadvertantly make an electronic file accessible to others who stalk around the house.

That leaves your mother, father, sister, brother, grandmother, house-keeper, or friend an opportunity to find it, read it, make a copy, blackmail you, send it half-way around the world, for all you know. Or perhaps have a heart attack (that would be your mother or father).

So in some ways, blogging knowingly for all to see on the Internet might seem safer. You can make a blog totally private, theoretically, so it is accessible only to those special people you invite. Of course, if you invite them and they don't read your blog, that might hurt.

You can get hurt you with the teeniest bit of criticism, too, open yourself up to all kinds of bruises to the ego as a blogger.

Bloggers can wait for weeks and nobody stops by, which hurts because the expectation, the hope, is that someone will comment eventually. Whereas journals aren't set up for comments. (Although some teachers have students write personal journals as writing exercises. And they might comment; I don't know.)

As far as blogging goes, however, even if it's by invitation only, any guest can copy and paste and show others what you wrote.

But let's just say, you're tough.

You want to blog, even if it leaves you vulnerable to mean comments, blackmail, expulsion from school, that sort of thing. Assuming you know how to clear your browser of cookies and don't allow comments to go to your email, assuming that you blog anonymously and no one knows who you are, then there is a slim hope that your confidences on a blog might be safe from exploitation.

Confiding, expressing deep thoughts, is a variable that makes blogging therapeutic. The writing process, however, is another.

Expressing yourself and getting things off of your chest with a journal OR a blog can be a huge relief, very much like talking can be a huge relief in therapy. On the other hand, if people read what you write and identify you, show your story to all of their friends, well, consider your life public record.

Not everyone wants to be an Ashley Dupre, not even Ashley Dupre.**

Let me make up a fun example to illustrate how blogging, in particular, can backfire.

Journaling can backfire when someone you don't want to read your journal finds it and reads it. The same thing happens to some bloggers who think, who hope, they're anonymous. This example speaks to the kind of stuff I see at work. You'll see that kids, in particular, don't always get the therapy they think they're getting when they blog. But they might wind up in therapy.

A couple comes to therapy and tells me that they have found their daughter's blog and read it regularly. She is a good writer, they have learned, and from reading her blog, they realize that she is very much into it, feels her blog is a fantastic place to just let it all out, all the junk inside.

The kid has netted a host of new friends, too, in the process. She has no idea that her parents are reading her blog.

She freely posts about her sex life and her many relationships. The comments on her blog also reveal that she has quite a bit of experience with older boys who praise her body.

She is thirteen.
You might think this is a good thing, perhaps, that her parents have learned about her promiscuity. You might even wonder if her whole reason for blogging, perhaps, was to out herself, to get caught, get help.

Maybe. But maybe not. You can't count on every parent to leap to therapy for the family. And not everyone parent is going to be able to resist losing it, reading that sort of stuff. There is such a thing as child abuse.

So it's about who is reading it.

3. Do you feel that blogging acts as a type of group therapy?
Sure. But let's first look at the active agents in real group therapy, face to face group therapy, the type you see in Bob Newhart's office on television, or whoever the latest TV group therapist is these days.

The active agents are all about feeling accepted, even loved, supported, and understood. A therapy group is a place of trust and safety. You can be yourself. Other group members might call you on your weaknesses, your faults, but there's a therapist there to keep it safe.

It's encouraged, too, that group members lift one another up, say positive things. You can learn social skill, including how to take criticism in real face to face group therapy. Then you're better prepared to face the great outdoors.

The one with a real sky. Sunny? Cloudy? Stormy? You can cope.

If you're blogging to get the same benefits, it's likely you are trying to establish yourself as a member of a small virtual community. And you can be one, too, if you visit other blogs. People comment, lend support, express love on one another's blogs. Even if only a few bloggers comment, but comment nicely, it feels good and feeling good is therapeutic. So it can feel very much like group therapy.

There really is potential to establish good relationships here in cyberspace as a blogger. Just don't get in denial about the downside.

4. Is there a specific age group/or personality that you feel would benefit most from blogging?
It's not as much about age, as it is the ability, the maturity to edit. And editing curbs your self-expression, as such potentially robs the process of that therapeutic agent. If you aren't careful, at any age, your secrets are open access.

And unfortunately, anonymity, as cool as it sounds, might really be impossible. (Here's that downside). You want your friends at school to know what's going on in your head, and you want certain people to read your blog. But those secrets of yours, on a blog are potentially out to anyone who stumbles upon it. At any age. Forever, really. Even if you try to keep the blog by invitation only. Life is full of betrayal.

In my humble opinion, it may not be possible to have that community and friendship and stay anonymous. There are people who might betray you, but you might out yourself in a weak moment. The temptation to tell people you blog is HUGE. It's overpowering. And if you don't watch what you write, self-exposure leaves you vulnerable to embarrassing not only yourself, but your family, your friends, or anyone you even remotely refer to in a story.

And it surely takes some of the fun out of the whole thing, editing.

But therapy, to tell you the truth, isn't always fun.

On the other hand, you can get the benefits of a community, without getting so personal. You can do that by writing only what you don't mind the whole world reading, and by visiting other bloggers and commenting appropriately on their blogs. They'll return to visit you, to say hello. Maybe often.

5. Are there negative aspects to blogging? If so, what are they?
Well, we've mentioned a few. Aside from the potential disclosure of unbelievably personal experiences to millions (potentially) of strangers, one of the negative aspects of blogging is possible trauma to the blogger, to the degree that it can become post-traumatic stress.

Toxic comments can do this to you.

Most bloggers enable comments. Unless you keep a blog private or don't allow comments (ask your techie friends how) you open yourself up to input from heartless individuals who say some very cruel, insensitive, derogatory, even vulgar things.

Some people can manage or delete comments like these and shrug them off. A kid, on the other hand, might have trouble forgetting the mental images that racist, homophobic, misogynistic predators leave behind.

In other words, you might need therapy from this process of trying to get therapy from blogging. It can be really ugly.

The cool thing about blogging, obviously, is that it brings people together. The downside, unfortunately, is that it opens you up to spammers and cyber-abuse, your average insecure, vitriolic human with nothing better to do. Blogging is not for the feint-hearted. Trust me.

6. Do you feel that it is beneficial to use a blog as an online diary?
I know people do it and I think it could be a really good thing as long as they don't publish it. Using blog space as free cyberspace is a great way to establish a diary, and it is secure. Save your diary as a draft. Don't publish it. It's still a diary, a record of your thoughts and feelings at a certain time of life.

You can write whatever you want, and if you're the only one who knows your password, no one else will read what you leave in cyberspace, assuming you leave it up there as a draft. When you want to read your diary, you can open the draft up, read it, and save it again until you're fifty and nostalgic.

No one else need know. And it's still on-line. Safe from the house-keeper.

therapydoc
*Researchers worry about the effects of their studies on vulnerable subjects, or populations.

**Ashley Dupre, a.k.a. Kristin, is the name of the nemisis of Eliot Spitzer, former governor of New York, who hired her for her "escort" services. He didn't know who she was and she, according to her interview, had no idea who he was.

Wednesday, November 19, 2008

With Feeling

See the yellow fish? He doesn't look too good.

We were talking about truth in blogging, and I felt conflicted that I have to be in this position of reminding you that when I make up an anecdote, that I'm making up an anecdote.

Ordinarily bloggers are honest. But a therapist never wants to reveal case material publicly, for fear of breaching the privilege of patient-doctor confidentiality. To avoid that, I patch together random interactions, invent stories, create personalities.

But when it's about fish, I can tell you, the stories are true.

Sometimes I wonder if fish can be empathetic. I know that dogs are, and cats, maybe. Probably those elephants we talked about have some empathy. I'm not a pet psychologist, so I'm clueless here. Feel free to help me out.

Therapists are empathetic, or they're supposed to be. But even an empathetic therapist can and should be able to detach. If a therapist doesn't intellectualize, doesn't lead with the head and not the heart, then everyone in the room is going to be an emotional wreck. People don't go to therapy for that, to increase their perception that life is basically chaos.

So I can detach when I work, detach with my friends, detach even, from my family.

But as a hopeful therapist, a person who sees improvement in just about every thing, every one (although it can take some time), and every type of situation, the thing that still throws me is death. Not leading with the heart here isn't an option.*

The Story:

FD tells me that my fish jump to attention when I walk by the tank. They swim a little faster, breathe a little harder. Of course they have eyes, you know, so it is not out of the realm of possibility that they recognize me, associate me with frozen krill and brine shrimp, Formula One and Formula Two. Who wouldn't jump, just thinking about yummy stuff like that. Mmmmmmm.

So I can relate, I guess, to fish developing relationships, in their way, with people. We just talked about elephants a few days ago, and I imagine that elephant keepers (keepers?) commune with their pachyderms, whereas if someone like me spent a week with an elephant, it's unlikely we'd have much of a relationship. The beast would sense my fear, my disrespect when it came to his bodily functions.

But pretty tropical fish that swim around in water, well, we attach emotionally to them, and it would be nice to think that they care, somehow, too. When I come home from work I go straight to the tank to say hello, to see how they're doing. When I get up in the morning I'm quiet, so as not to wake them. In exchange for this, they swim around and look pretty, try not to die.

I had Blue, just Blue (don't panic, he's fine), for over a year because having one healthy fish was fine to my liking. But as you might remember, he got a little too big for the tank, so I asked FD and Number 3 Son to move him into larger quarters. A little construction, no small task, actually, and Blue had the ocean to himself.

Such a large tank all to himself did seem silly, or so they all told me. So with the help of my son-in-law (a real fish nut, you should see his tanks), we created a community for Blue. He did pretty well, too, once he established his territory (the conch) and seemed to enjoy the company. I was really worried since Blue is a fish with really sharp teeth, and fish like that, should their appetites kick up. . . well, you just never know. But he never gnashed at the new fish.

One night about a week ago, I got home, hung up my coat, and took a hard look at the tank. The yellow tang, a little guy (you usually see humongous ones in the stores) looked sick. He had a brown spot where one would guess his heart should be, and he was leaning against a rock on the floor of the sea.

I tried to hand feed him, but he didn't look interested. He didn't even sniff at the food. I called my son and reported the symptoms. "Brown spot?" he replied with a sigh. "You may as well fish him out and put him in a plastic bag and freeze him, Mom."

Why the freezer, I don't know. But I couldn't do it. I had just watched a Boston Legal episode on euthanasia* and it made me consider the whole business of assisted suicide, even when it comes to fish. So writing this I let Little Tang gasp for life, holding onto a thread, and felt more than a little sick, myself.

When he passed on, he would go the way fish are supposed to go, downstream, I thought. And it would take me awhile to get over him.

Soon Little Tang gasped his last breath. When I discovered him he had wedged himself under the rock, making it difficult for me to fish him out with a net. I stuck an algae scraper into the water, a long stick. Usually Blue runs from it, hides. But this time, when I tried to poke the tang out from under the rock with the stick, his protexia went nuts. Blue bit at the stick, swimming around frenetically, as if to say:

Haven't you done enough damage for one day?

I felt blamed. Yet it did seem that Blue cared about his little buddy. And he wasn't going to let me show any disrespect for the dead, or as someone insensitively suggested, steal his midnight snack.

I gave it a rest, came back and fished out the dead fish. Again Blue objected. But he was powerless.

I knew it would be hard for me to sleep. FD came home and I told him the story and shared that the other fish might be at risk. When one fish goes. . .He said, "Maybe you need to syphon some of the water. Aren't you supposed to change some of the water every couple of weeks?"

When the kids lived at home, it did seem that they made a huge mess syphoning water relatively frequently. But since it's been just me and Blue for so long, we had it so that once a month was just fine. And miraculously, it never got messy.

So I got a little defensive, but FD put the bug in me. Although it was late, after midnight, I started a water change, just 10 gallons, but enough to keep everybody safe. And the next morning, no question, the three remaining fish seemed healthier.

So.

(a) I was right to feel guilty,
(b) taking responsibility made everyone feel better,
and
(c) whether or not fish have feelings is still anyone's guess.

therapydoc

**You can argue that every type of loss feel a like a death, and you would be right.

**The Boston Legal episode I'm talking about has the best treatment of parents cutting off an addicted child I've ever seen. Episode listed on the ION station as WCPX 13, it's about Shirley Schmidt being best man at her ex-husband's sixth wedding, assisted suicide, and an amazing treatment of addiction in family relationships.

I think it's the episode responsible for hooking me on this show, which, by the way, is awfully preachy this year. And for Republicans, insulting. I posted on the cut-off in families with addictions, if you're interested in this at The Second Road.

Tuesday, November 18, 2008

SADS is back

From thisTo thisin only a week.

I can't believe it. It seems like I just terminated with my SADS patients for the spring and summer, and already the calls are coming in. The days are short, the nights are cold. And the bloggers, like Master of Irony, are worried.

But come on, Chicagoans! The sun peeks out every so often, and although it might be cold, the wind doesn't always whip up, it's not supposed to tomorrow, and we live for tomorrow in our neck of the woods.

Get out and jump in some leaves. Put on a heavy sweatshirt, get a pair of warm, fuzzy, boots at Target. Black ice in Indiana? Who cares! (Well, those of you who commute to or live in Indiana do, I suppose, sorry about that).

So a quick check list on battling November thru March seasonal depression:
A brisk walk every day (or if you're me, a bike ride when there's no precip or wind chill). Just do it. Bundle up and do it. Don't worry what you look like.

Turn on the lights when you get home in the evening, all of them. Pay the electricity, but spare the depression. Ditto about the heat in the house, if only for an hour or two, get warm.

Make soup. Big pots of thick, wonderful soup.

Don't think about the weather. Think about anything but the weather.

Make it your business to get out and visit someone who is shut in.

See how much it might cost to buy some used skis, or snowshoes, a sled or a tray. If you can afford it, consider an exercise club membership. There should be some deals coming up.

Take hot showers.

Get creative, not drunk. Make your holiday cards if you can, and make them meaningful.

Don't even think about spending a lot on presents this year. Everybody gets it that times are hard.

Sing.

Learn to whistle.

Call a friend. Play a game. Write a book. Move the furniture.
This isn't a comprehensive list. I know there's another one on the blog somewhere. I just thought you should know, it's not your imagination. The weather does affect mood, probably because we're simply receiving less by way of sensory stimulation. If we choose to stay in we make matters worse. It's a challenge.

What's this I hear about Wii, anyway? Should I go see someone who has it? I've always wanted to play drums.

therapydoc

Sunday, November 16, 2008

Wild Things and Translocation


We pushed away momentarily from an informal dinner on paper, talked out. I suggested a little television while we digest a bit and flipped through the cable guide, found Wild Things. Knowing FD likes to learn anything about anything, I pushed the "Okay" button on the remote.

Rhinos. Have you seen it? The story made news in February.

Pretty interesting TV viewing, for awhile there. But I am eating, digesting. And the large animals are rubbing parasites off of their hides, lolling around in mud. I came in late, so am not sure why the animal authorities in South Africa have trans-located rhinos and elephants, but it has something to do with preservation.

They show an auction for zoos, another way to preserve them. I'm surprised that kids aren't afraid to go to zoos. After all, if we can put large mammals and pachyderms behind bars, how hard would it be to contain Little Joey?

I felt pretty sick before long and excused myself from the table, but wandered back as my stomach settled down. (Cookies help here.) Anyway, there on the tube, a young elephant is bullying a small rhino. The narrator explains that if the rhino doesn't get free, the elephant will pin him down with his knee and gouge him to death with his tusk. This is a common thing in Africa, a little like certain school yards in America.*

Interestingly, the reason for this unusual aggression, and, apparently, excessive unusual sexual behavior of the elephants, too, has to do with their age at translocation. These elephants are teenagers.

We all know that this is not a good time to move kids. Teenagers need some stability in friendship. Separating friends at this most emotional time of life can be a terrible thing, psychologically, a terrible loss. Loss makes us angry.

The scientists returned to the native territory of the aggressive young pachyderms and sought out a few elderly elephants, grandfatherly elephants, to translocate them, too. The teenagers settled down as soon as they had a little supervision. Having grandparents around stopped the aggression and the hyper-sexuality.

Now. Seems to me that this is a call to grandparents everywhere, not to go to Africa, but to get more involved with their teenage grandchildren.

You might say it's a call to the wild.

therapydoc

*An exaggeration, for those of you who are not living in America. It's true that it can be dangerous in certain places, like alleys in the wee hours of the morning, certainly at night, but this depends upon many things, primarily your zipcode.

Saturday, November 15, 2008

The Babushka

We had a scholar in residence at our synagogue this weekend, a very distinguished Jewish historian. I recommend his books highly, if you really want to know what we've been through as a people.*

Berel Wein is also an esteemed rabbi and a lawyer, although he gave up law for the higher calling.

FD and I used to listen to his Jewish history lectures on cassettes, audiotapes, ages ago. He's funny, bright, insightful, and old. I don't mean that he's old physically, but he's got an old Jewish soul. He's old enough, he'll tell you, to tell you what he thinks and not care at all what you think about what he thinks.

So you can see why I like him.

Anyway, we had some guests on Friday night, and as we wound down the meal, had to make the decision, Do we go to the lecture? Or do we go to our respective comfort zones and read and doze, read and doze, break things up with another cup of tea?

Either my allergies are kicking up or I've got a virus. So I'm thinking I shouldn't go out. But Berel Wein! I excuse myself, get ready, and join the party. What's the worst thing that can happen? I fall asleep?

We get there just in time for the speaker. The rabbi starts with a joke. This is how Jewish people are (maybe everyone is). We start with jokes.

But you would think he's addressing that post on falling asleep in shul, honestly, conceived at the pleasure of the presence of a different scholar in residence. Here's Rabbi Wein's joke:

A minister knows that one of his parishioners always falls asleep as soon as he starts to talk. He can't stand it. So one day he thinks, "I'll get even with him."

Everyone's in church, and he starts his sermon softly, in a drone. The fellow dozes off. When the minister is sure the guy is sound asleep, he rouses the rest of the congregation shouting, "Everyone who wants to go to Heaven, please stand up!" The congregation rises. The sleeping congregant snores.

Everyone sits down. The minister talks awhile longer, then he starts in again, shouting only the last half of the message at the top of his lungs,

"Everyone who wants to go to Hell. . .Please stand up!"

The sleeper is finally roused by the phrase, please stand up and he jumps to his feet, confused. Everyone snickers. He turns to the minister and says, "Reverend, I don't know what the cause, or what you're asking us to contribute, but you and me are the only ones in the room standing."

Well, I liked it. And with that he tells over his lecture about the relationship Jews have with money. He recounts the history of trade and virtual money, the arrangements merchants worked out so that they didn't have to load bushels of coins onto donkeys, risking life to robbers and thieves, in order to buy things and make a living.

If Yankel in London has a cousin Shloimie in Iran, then England will always have salt, is the basic idea.

I stayed awake for over half of the rabbi's talk and wanted, you have to believe me, to stay awake for all of it. But on a Friday night, if I close my eyes, even for ten seconds, it's all over.

I woke up to hear Rabbi Wein talking about his grandfather, not a rich man. But the rabbi's grandfather had a $10,000 life insurance policy, his only savings, and he cashed it in to give all of it to an organization in Europe to save Jews from the Holocaust. The relief fund saved over a hundred thousand lives.

This is the real relationship we have to money, Rabbi Wein tells us with pride. His Zaideh, his grandfather gave it away.

The rabbi continued, "A man's worth is as good as the respect of his children, his grandchildren. If they love and respect him, he is a successful man."

Jews are always judging successful living in this way, vis-a-vis our relationships. We assume G-d has standards, too, and that He/She loves people who are loved by others.**

Well, I knew I was in for it walking home. FD kicks up a few leaves, turns to me and asks, "What part of his speech got to you the most?"

"The part about his grandfather," I reply. "Of course."

"Right. A man who is respected by his grandchildren. Mine won't even know me, won't know what I'm all about, what I believe in."

It is very much like FD to get upset about the kids living in another city on an ordinary day. I try not to think about it, and since we communicate often in so many different ways with the children, I can fool myself into thinking that I really do have a relationship. But FD is the realist between the two of us, I think. Or am I?

I'm speechless, allow him his sadness. There's time to beat what I feel is exaggeration, if not illogical thinking out of him, to strategize with him about even better ways to stay in touch with the little ones, like making Skype more visually interesting, perhaps. Throw in a magic trick.

What FD didn't know was that Rabbi Wein got me thinking about my own grandparents and my relationship to them. They escaped Europe well before the Second World War to come to America, having suffered enough losses during WWI.

Blessed with both sets of grandparents. I was closer, strangely enough, with the grandparents that didn't live nearby. My father's parents were only a few blocks away, but we had to drive to my mother's parents, and we didn't have a second car for several years. You've heard bits and pieces about my Zaidee on this blog, but nothing about my Bubbie.

She was the kind of grandmother you could hold onto and she made cookies, but wasn't fat. When you're poor there's less of a chance for eating disorders, being too fat or too thin. You eat when your children have finished eating, and you're glad that there's food left over. My Bubbie and Zaidee, immigrants, had six children, considered six million during the depression.

They hailed from Austria. When FD met Bubbie he couldn't believe how she and my aunts enjoyed sweets. Nothing made them happier than dessert.

I remember her with long dark brown hair pulled back in a bun; she colored it until the day she died. I see that twinkle in her eye when we walked through the door to visit. She would pull out a cigar box of buttons, thimbles, and string for us to play with.

Sometimes my daughter-in-law marvels at my games, the ways I think up to play with her daughter. She says, "You pull entertainment out of everything ordinary, every day stuff."

I get it honest.

It is the unconscious learning when you're a child, that's so powerful.

When you apply yourself and learn things with effort or by rote, you might forget them or not. But those other things that you learn without knowing you've learned them, like playing with string, can come in handy years down the line, too. The things we learn without even knowing we've learned them, some of them really good things, might serve as links to our past.

This is the reason I tell patients, when they're ranting about their traumatic histories, Try to be more generous with your parents, if at all possible. You may not remember the good things you learned through osmosis. One day maybe you will. (I know. It can be hard to be charitable sometimes.)

The next day, I took my time before getting ready to go to shul (Saturday morning services), eventually got dressed. In Chicago you can feel the cold before you get outside; you just know it's cold in November, don't need to consult with a weatherman. So I wore a really warm sweater, one of Empath Daught's old ones, the hot pink one I sent to the cleaners to get rid of the little fuzz balls. And it felt very good, very cozy.

But I thought, I could really use something more on my head, you know? Like a hat, or better, a hood. But I don't have a coat with a hood, except for my raincoat. I stared into the closet and noticed a scarf on the shelf, a paisley wool scarf that I'd purchased at a Chinese linen store on Lawrence Avenue about thirty years ago. I bought it in three colors, different prints.

So I took the scarf and I wrapped it around my head. I remember my Bubbie wearing one like that, a scarf tied under her chin. All Bubbies wear babushkas. In the city I see them everywhere on Lincoln Avenue, women in babbushkas. It's never been my style, gotta' admit.

But before leaving the house I checked the bathroom mirror, thinking I'd take it off more than likely, that it would look soo old, but surprised myself.

Not half bad. How crazy is that?

therapydoc

*Berel Wein wrote these books, and dozens of essays, too:

Echoes of Glory: The story of the Jews in the Classical Era, 350 BCE-750 CE

Herald of Destiny: The story of the Jews in the Medieval Era, 750-1650

Triumph of Survival: The story of the Jews in the Modern Era, 1650-1995

Faith and Fate: The story of the Jewish people in the twentieth century

Fabulous coffee table books, great reading.

**Somewhere in a mishna some call The Ethics of the Fathers, Pirke Avot, always worth reading and rereading, memorizing, actually, no matter what your religious preference.

I use these teachings all the time at work, like when I'm teaching parents to teach their little kids how to control their tempers.
Who is a strong person? One who can control his passion.
It's easier, I tell them, to throw a punch than it is to stop, think, and respond assertively. It takes strength of character to do that, stop the punch. Any whimp can hit someone.

Wednesday, November 12, 2008

Pillow Talk



FD hates it when I do this, tell you what we talk about horizontal.

But it's usually not very interesting, and rare that I share. What we talk about, often, when it's just the two of us, is incompetency in the hospital (that can be the answering service) and very occasionally, the last patient the service had to call us about, woke us up about.

Here's a sample of the kind of ranting I get to hear early in the morning.*
FD will groan. Do you believe that guy? He tells them at ICU, No more, no thank you, I'm out of here. Then he stops the transfusion, gets dressed and checks himself out of the hospital! For this I've spent three hours talking to residents in the middle of the night, so he should walk out on a procedure that will buy him a few more months in the Land of the Living. You couldn't have slept through that.
Well, uh, no. I heard it all.

And continue to hear about it. Could have been an ER episode.
And that's okay, that he complains, lets off a little steam. It's healthy. And I'm a paid consultant. He gives me some of his stress, leaves it in the bedroom (not always the most romantic idea). He never uses names or identifiers, and since it's ER call, it could be virtually anyone, and is. If it's someone I might know, someone I'd actually want to hear about, he won't say a word, won't rant, but he might slam a drawer.

I tell him, throw shoes, pies, muffins. Save the furniture. When we recycled at the recycling center, we threw bottles. Now that was great.

It's nice if you have that capacity to complain, nicer still if you hold others captive to listen. (We'll get to nagging another day). As his consultant, had this been a real case, I would have told him that his patient probably came in looking for opiates and left the hospital looking for opiates.

So this morning I get up and don't even bother looking at the clock. I know it's somewhere between 4 and 5 and I'm telling my brain, Just go back to sleep, when FD murmurs, "Time to get up. It's 5:05." He's really telling himself to get up, not me.

"5:03."

I am up, so I excuse myself for a minute, but come back to bed. He's happy. Usually I don't come back to bed. "Why are you coming back to bed?" he asks joyfully.

"To be with you," I say. "I know you think our relationship is all about companionship, so I'm being a companion."

Immediately he launches into a complaint. "I can't get over that guy walking out of ICU the other day. If I ever see him again. . ."

I want to say, Get over it, it's not about you. But that's not therapeutic, you know. So I don't say anything, close my eyes.

Out of nowhere, total non-sequitor, I ask, "What percentage of your waiting room is composed of black people?"

I don't use the PC term, African American, because it's just we two and color, not ethnic origin, matters at this moment to my visual brain. Healthy skin is nice in any color.

"Some days it's mostly black."

"You're a magnet for people with soul."

"Must be. Or could it be the neighborhood?"

And then I tell him how happy I am that Barack Obama is going to be President, even though I was truly on the fence, and no, I won't tell you who I voted for. But I love the feeling of patriotism in America right now, love seeing Hope visit Washington, the White House, the national cemetary. I love that so many people came out to vote, that people, so many Americans, now feel that they are a part of the political process. It's been a long time.

"It wasn't only black people who elected the President," he says.

Right, right. But you know how it is. The Irish, when they weigh those choices for judge, vote for Irish first. The Italians vote for Italians. The Poles vote for Poles. The Jews vote for Jews. People do vote ethnic, I'm pretty sure, and when their candidate wins, it's a good feeling.

We had some company on Friday night, and in the haze of serving and clearing, picking at my tofu and stir-fry, here and there I caught some of the conversation. Someone mentioned this feeling, a ground-swell within the African American community. He thought it comparable to the wonderment within the Jewish community after the Six Day War, when the Israelis trounced the surrounding Arab nations. All of them.**

Triumphant, proud. People didn't like it, those who didn't understand, didn't mind so much the victory, as the pride.

Some of us are scared of people who get happy like that, people who strut, shout, celebrate a victory. It feels too much like power, face it. People are afraid of exhilaration when it's ethnic.

And yet we love those songs. Hold your head up, hold your head up, hold your head high.

Did anyone see Boston Legal the other night? Roe, 11/10/2008. If you didn't and you still plan on it, SPOILER ALERT. But I'll only spoil one plot, if that helps you any.

Jerry Espenson, (Christian Clemenson, simply brilliant) the attorney with Asperger's Disorder, is buying muffins and coffee with his dear colleague, Katie Lloyd (Tara Summers, I like her very much, too).

A smart-talking mortgage broker thinks the two lawyers are listening in on his cell phone conversation in line. The broker taunts them, calls them Mr. and Mrs. Snoopy. He makes fun of Katie's South African dialect and Jerry's tics. Jerry keeps cool, but he's getting visibly upset.

They finish their order, turn to leave, and Jerry accidentally bumps into the broker who subsequently escalates his insults, calling Mr. Espenson Dimento.

Katie takes her friend by the elbow to get him out of there, but Jerry has a moment of clarity. He glares at his nemesis, takes a muffin in hand, aims like a marksman (all in slow motion, just terrific work here) and deliberately pitches the pastry overhand, fastball, hard.

And whack! The muffin's on target, clips the guy's profile, smack dab on the cheek.

It gets wild, of course, and wonderful, and Jerry ultimately chooses to defend himself in court. He tells the jury that having had emotional issues and Asperger's since childhood, he has suffered abuse and bullying for forty years. He simply reached his max in that coffee shop, his passion, years of anger simmering inside, got the better of him.

He had to react, couldn't take another insult. He isn't sorry for what he's done, although he is sorry for celebrating with that little dance that he does.

There's more, and this is a great episode. I won't even tell you about the abortion subplot, which is almost as good. In fact, it's better.

The rise in pride in this country, surely muted by our economic woes, is not something we should associate with the rising frustration that drives someone like a Jerry Espenson to throw a muffin, although you could argue the similarity. These are very different tides. The political process is a constructive process.

Back to our pillow talk.

FD says, "You know, we're pretty much out of food."

"Yeah, I haven't been in the shopping mood so much."

"But just because you're not hungry. . . Okay, I'll go to the store after shul."

"No, don't. We have blueberries. That's really all we need right now."

This is a cue for me to make muffins. For some crazy reason, my goofy home recipe makes only 10 muffins. The pan with the first six went into the oven first, and I heard the timer, took it out in time. Perfect. Soft. Yum.

But the second pan, the one that went in later, I forgot about. And as I luxuriated in the shower, they burned, my first decimation of muffins since we got the new stove in April. It seemed a real waste and I felt badly, but the last four were hard as rocks. so I tossed them into the garbage.

FD thought they were salvageable, but you know.

These things can be dangerous.

therapydoc

*Anecdotes about patients on this blog, medical or psychological, are always sheer fiction.

** Wikipedia says, 1967 Arab-Israeli War, the Third Arab-Israeli War, Six Days' War, an‑Naksah (The Setback), or the June War, was fought between Israel and Arab neighbors Egypt, Jordan, and Syria. The nations of Iraq, Saudi Arabia, Sudan, Tunisia, Morocco and Algeria also contributed troops and arms to the Arab forces.