Monday, February 22, 2010

Bereavement

I’m up and it’s only 2:30 a.m., happen to catch a glimpse of myself in the mirror. In a shiva house the mirrors are covered, for the most part, for that first week of mourning following the passing of a first degree relative. There are all kinds of superstitious reasons, frankly I’m not interested in them. All I know is that one of the towels fell off the bathroom mirror and there I am, looking at me, and it isn’t pretty.

Has it aged me, losing my father? Or should we say, wizened me. Both right. It is a new experience, not at all like I thought it would be. It feels as if I’ve been hit in the back of the head with a baseball bat, still, over a week later, and that I’m in some kind of daze. It is surreal, detached.

We call it Bereavement, a V code, V62.82. Thankfully I have very few of the symptoms that distinguish bereavement from Major Depressive Episode. I haven’t got the guilt over what I didn’t do, no morbid preoccupation with death, no marked psychomotor retardation (although driving has been a little scary, haven't quite got the coordination back). No hallucinations, although my dreams, really scary.

And sure, it’s hard to sleep, and it is very early in the morning. I throw on a heavy FBI sweatshirt, one that my youngest son bought on his senior trip to Washington, DC, take a tour downstairs to the kitchen. I haven’t been home in a few days, have stayed overnight with my mom. It is traditional to choose a site for visitation, so my brother and I, without ever discussing it, have been at her home for the week, receiving visitors.

It is the flip of being a therapist, ideally. Being a therapist is all listening, or 80% listening, 20% feedback. Being a mourner, in my tradition, is talking or sitting quietly, but the mourner is the initiator. You don't impose your stuff on a mourner. Visitors come to sit with you for seven days, keep you company. It's about consolation, paying condolences.

You talk about whatever you want to talk about, so if you don’t want to discuss your father you don’t have to. But this is your chance, so to speak, to honor his memory, to publicize his goodness, his life experience.

We learn about life from the obituaries, at a certain age, and the eulogies.

I'm sitting near the toy box, see toys on top, not inside, remember putting them there, picking them up from the living room. My daughter and son came in for the funeral of their grandfather, one with an almost toddler, and after they left I didn’t want to put it all away. I look at the toys and it feels as if the visit was years ago.

I make a stab at reading from a novel, American Wife, by Curtis Sittenfeld, a wonderful treatment of Laura and George Bush, but can’t concentrate. There are a few newspapers on the table, but the words don’t penetrate. Something about winter Olympics and bobsleds. And of course, Tiger Woods. I think, I should blog about Tiger. Then I think, I should blog about my father.

He buried my brother 40 years ago to the day of his death. Isn't that amazing? Someone says to FD, Sometimes you get a glimpse of how things are actually run. It's not all random.

Here are some of the things I said at the funeral:
My father was such a complicated man that I can’t tell you if he would want me to make you cry, or not. I think not, because he was such a social guy. He would be happy to see such a nice crowd.

He simply had this magnanimous warmth, he greeted everyone as if he’d been waiting all week for you to stop by. Always someone knocking at the front door window, the telephone always ringing. Almost always for my Dad.

Last Wednesday morning, we're in the ER. He's in terrible pain. They put a gown on him, hook him up to an IV, his clothes are in a plastic bag. He’s on oxygen.

“You never saw me like this,” he says to me, for the hundredth time since he’s been so ill. This has been his mantra for months, now, “You never saw me like this.”

Every day it surprises him, embarrasses him that he’s weak, short of breath, and he’s embarrassed about it. Like many men of his generation who did not experience the hunger of the concentration camps, being physically weak is unfathomable. It isn’t who we are, he would say, for he encouraged us to take good care of ourselves, always. You eat right, lots of garlic, you sleep right. Your body cooperates. He has to remind me; this isn’t him.

And I tell him that it’s okay. I know who he is.

A story: Kovel, Poland: the end of the Russio-Poland War, 1920. Bands of marauding Cossacks, White Russians; they're raiding towns everywhere, especially the ones with Jews. They pillage and rape and kill babies with their bayonets, toss them into the air.

My grandfather is running an errand, probably buying something for the farm. My grandmother is in bed nursing my infant father. A gang of these animals bursts in on her. They see my grandmother, a beautiful woman, probably all of twenty, nursing. One says something, probably in Russian, to the others. They argue, banter back and forth. They stare at her, they look at my father, they look at one another. The toughest one says something. They shrug. And they leave.

My grandfather returns from the store, he hears what has happened, and he packs a few things, takes this little family to the forest at the outskirts of town for as long as it takes until the hooligans move on to another.

But you know, a small town family, they’re always waiting for another gang of Cossacks.

Probably in response to my grandmother’s fears, and being the oldest son, my father takes the protector role in life when he can, which is how I see him as a kid, watchful. Bigger than life, really. I’m a naturally fearful person, irrationally afraid of home invaders, as you know. But if he's home, I'm not afraid.
There are too many stories, a blog is just a blog. Okay, just a little more.
Things not everyone knows:

He was charitable, he couldn’t say no, especially not if people asked him for something directly. A total softy, if you looked my father in the eye, respected him for who he was, he would give you the universe if he could find a way. And honestly, he believed he owned that, too, that the world was created for him.

Which is how we’re supposed to think.

He would teach that it’s what’s inside that counts, not what you have. It’s not acquiring things, it’s living that counts, living fully. This in the heart of of the suburbs, a very material world.
The world is not going to be the same, not for a lot of people, without my father.

therapydoc

Friday, February 12, 2010

Mr P and Vitamin V

I wanted to move on, to talk about failure, but then I get this comment on the last post. It's about failure, but not exactly the failure I had in mind, and not being a failure, but fearing failure. You're not exactly a representative sample, not if you read me, but still. What do you think?

The comment is in response to my hard stand about taking Viagra for anxiety that's situational: a young woman expects a good sexual performance very early into a relationship, maybe even the first date. And a young man wants to rise to the occasion. PRESSURE.

Mr.P and Vitamin V said...

Doc,

1st of all, I'm a huge fan!!!

Let me represent Mr. P and Vitamin V for a moment..

I can tell you that very often by the 3rd date, if the man hasn't made some sort of sexual "move", the woman gets insecure and feels that something is wrong with her..And trust me, talking about how wonderful she is and saying that I like to take things a little slower does not work at all..

She wants something to happen!! Granted, I'm not complaining about that, but if something is going to happen, I like to insure that it actually happens..Without Viagra early in the dating process, my anxieties often take control and make things not work properly..

And oh my goodness, if it doesn't work, she either feels that she's not attractive OR she thinks something is wrong with me...It's not necessarily about her achieving an orgasm, it's more about showing her that I like her and I'm attracted to her. It doesn't have to be spectacular the 1st, 2nd or 3rd time, etc..It just has to happen...As things progress and I feel more comfortable, I don't need the V..

And your description of the healthy relationship is what I would love to achieve..I guess what I'm trying to say is that early in a relationship, words don't seem to have as much of an impact..They're not believed as much as they should be...Later on, words mean more..And one more thing, Doc!! I don't see 2 women for every man out there.

February 11, 2010 10:59 AM

Saturday, February 06, 2010

Satisfying the Girl

When things come in threes, I write about them. I think, this can't be an isolated issue, maybe it isn't random, not if it's coming in threes.

A guy tells me that he has found a solution to dating anxiety. I'm interested in the solution, I really am. But first, of course, want to know
Why should a guy have dating anxiety?
After all, there are two single women for every single man, probably three. A man can have six eyes and he'll still be a hot property in certain circles.

Hold constant (control for) any predisposition toward anxiety, anxiety disorders in the past, anxiety disorders in the family, post-traumatic stress disorder, child abuse, obsessive-compulsive disorder; hold all that in abeyance, and there's still a likelihood, or so I'm hearing, that dating is scary as hell.

I don't mean to be glib. I understand why people are anxious about dating. It's the rejection that's terrifying. Rejection hurts, and the chances of being rejected after a first date are rather high, actually. This we understand.

What's confusing is not the anxiety, but what men are doing now to resolve it. To resolve dating anxiety, men are taking Viagra. Young guys. We're not talking just the Medicare set.

Apparently they're sure that women expect a really good performance in bed. Nobody's watching Oprah or Dr. Phil, or Dr. Laura or Dr. Ruth, not as much as we once thought. If they did they would know that a good sexual relationship does not depend upon a good performance by anyone.

On television, thankfully, and even in most of the books in the self-help section at the book store, we learn that a woman is supposed to be responsible for her own sexual satisfaction. If she's interested in this, sexual satisfaction, and she should be, since this is great marital glue (don't get me started, I don't know if it works as glue if you're not married)

(a) she should try to connect with her partner while she's alert, not about to fall asleep,

(b) both of them should focus on their sensuality, wake up the brain, stimulate all five senses,

(c) she, especially she, since he's had his sexuality in his hand since he learned how to urinate, but she should get to know her body, understand what makes her happy (I know, I know this is an unpopular suggestion, especially for some people who have religious concerns, one day we'll give it more time) and

(d) if she wants him to feel he's doing something, then she has to tell him what to do to pleasure her.

True story.
Guy calls me for marital sex therapy. He says,

“She’s too small. Maybe we need a pelvic floor therapist, or maybe you. The doctor thinks we probably need a sex therapist like you, but I think a pelvic floor therapist.”

I haven't a clue what this is, a pelvic floor therapist, am hoping this is a sex therapist. This young man has called me many times before, but we've never met. He's never satisfied with my telephone assessment of the situation, yet I still hear from him every six months or so, feel we're old friends. (He could be a she, or maybe an avatar, we're not outing anyone here).

I reply,

“There’s no too big or too small. You need a relationship therapist, one who understands sex therapy, or a sex therapist who understands relationships.”

“No, she’s too small.”

End of conversation. No too big, no too small. At least one of us is clear on this.

That had to be said, that there's no too big, no too small. A couple has to manage with what they have and can, should, try to enjoy the process, try to figure it out. Somehow.

So if size doesn't matter, then what does?
You guessed it:
(1) communication,
(2) discussion of mechanics and myths about sex,
(3) practice at home, and
(4) resolution of emotional interference.


Why would anyone think that you can have all that, and what you don't have can be resolved, all on a first date? Surely it takes a long time to get any one of the four right, let alone all four. Most couples who come to a sex therapist have been working at it a long time and have given up. They've already spent a few years getting to know one another, getting to know one another's likes and dislikes, exploring and talking day after day, year after year, and even then, it just isn't working. They know there's baggage, too, that is in the way, even secondary trauma. We'll never get it right! There's something really, really wrong here!

This isn't second nature, really, a sexual relationship, or any other kind of relationship, to tell the truth. But we'd best focus.

Sexual behavior as a couple is learned, and it is learned in process, from one another, since there are two of you. And you both have baggage, attitudes, histories. It can years to learn to communicate in certain areas, about certain things, without fear, embarrassment, or anxiety, for some of us. And people get so angry at one another! When we communicate anger, intimidation, power, or dominance it can be a huge turn off (I know, I know, the exceptions).

And there are many of us who are depressed, and nothing kills libido like depression, nothing; and past traumas, too, like incest, or other sexual abuse, abortions, not sexy. Really not.

Then there are the mechanics of sex, the how-to's, and these are, perhaps should be, trial and error, too, and there's a lot of room for error, so it can take years, without direct communication, without straight talk, honesty, to develop a mutually satisfying sexual relationship. The joy is in the process, really.

Then there's that whole trust thing. Sex and trust go together. How are you supposed to have that on a first date? A second date? Surely you fool yourself, you say, Oh, this person's had that vasectomy, and then, surprise, he was kidding. Or she says, You're the only one, and she's checking her phone. You get hurt and your trust issues get worse, not better.

This is why people like me don't even feel it should be happening without commitment, sex. Crazy, I know, and so unpopular, so unreasonable, that this is likely not going to catch on. But it's too important, sex, too integral to what makes a healthy couple healthy, content, establishing a good relationship while naked. The reality of sex is that it exposes us. Who wouldn't be terrified, seriously?

Let's draw a parallel to aggression to explain this phenomena, the pressure to satisfy the girl, the pressure to have sex in general, no matter the status of your relationship.

It's compelling that the Saw movies are in their seventh year. Every year there is another one of these very, very violent, horrible, graphic movies. People go to them, we think, to master their fear of violence. If you see the film often, or you see a new one every year, eventually it doesn't upset you, the thought of cutting off your own leg, and well, you're tough. You're strong. You've desensitized to your fear.

Some of us would disagree, however, that this is what makes a person strong. If this is what makes a person tough, seeing violence and not feeling anything, not being affected, then that person's definition of strong is perverted.

The corollary is sex. We can regard this fascination with sex, this insistence upon it, because it is supposed to be a loving act,
the flip side of violence. And we can see the obsession with it in the same way. Have it often, have many partners, do it perfectly, and at some point you will be immune to the anxiety, the embarrassment of taking off your clothes, of someone seeing you for who you really are.

That's pretty sad, isn't it? In a good relationship, one that is trusting, loving, caring, and kind-- taking off your clothes might still be embarrassing, but it's a good kind of embarrassing, a shy kind of embarrassing, even, an intimate one.

You might say, for example, "I've gained five pounds this winter," and your spouse will say, "Don't ever lose them! I love them! I love these pounds!" For he knows that you are responsible for your own weight, too, and he doesn't want to work your program, he just wants to make love. And he loves you.

And in a good relationship, one that is committed, you are staying the night, so staying the night isn't even a question, it happens all the time, it's not a big deal. So theoretically, if you have that, commitment, you can roll over when you're both a little tired of sex play, and say, Goodnight, even if everyone's not completely satisfied, and it's okay.

But not anymore. Oh, no. Committed or not committed,

NO! YOU (I) MUST BE SATISFIED OR FORGET IT! WE CAN'T POSSIBLY CONSIDER GOING TO SLEEP YET!

Where are people learning this?

This dysfunctional pressure to reach orgasm is perhaps a reaction to what could have been the rule, perhaps even as recently as forty years ago, a covert rule that men didn't need to concern themselves with female satisfaction. Nice girls didn't like sex. So slam-bam, thank you ma'am, theoretically ruled. But perhaps that whole thing was a myth, that men who loved their women ever even did the slam-bam, thank you ma'am thing. Yet the reaction formation for sure is alive and well.

Now, men have to perform, their needs are important, but hers are, too, and she's demanding a performance, or so some of the guys feel. The guys are thinking they have to be studs again. THEY have the secrets to female satisfaction, and if they don't, well, no second date. So of course they're anxious, because in their minds, and apparently in hers, too, what makes it great, sex, is that erection.

Zachen v'aitzen Columbus. (Yiddish for, What in the world is wrong with this picture? Don't ask me for a direct translation. Find my mother, ask her.)

This is fantastic news for the makers of Viagra and Cialis. Forget that only one woman in five has orgasm during intercourse, anyway, with or without these drugs. Forget that without an intimate understanding of a partner's arousal, physiology, and how much he or she had to eat, meaning how extended, distended, in other ways one might be, that there's no way one partner can help the other achieve orgasm. Forget that foreplay should take a half an hour, intercourse maybe five minutes, maybe ten, or it's going to hurt, certainly will irritate her. None of this matters. It's all about Mr. P.

It shouldn't baffle us that the importance of sex has taken on such magnitude that a man will take a medication that could be dangerous, just to be sure to please a date. This is horrible and is indicative of a related issue, that we have grown accustomed to instant relationship gratification (hand me my phone, please, I need to read my email NOW). She wants it now. Or so he think. Why waste time?

Nobody's taking the time to nurture the relationship.

And the joke is that people think they can nurture their erection, their arousal, without it.

therapydoc