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Monday, August 30, 2010

The Garage Sale



Technically it's a front yard sale.

My son stops by to see what's going on, exclaims, "For sure you're going to blog about this!"


After the smoke clears and I have a little distance, weigh all the risks, the benefits, because who can move without doing that, it seems like a good idea. 
 Once I had a patient who worked for the stock exchange.  Or was it the commodities exchange.  In the pit.  Everything about it, he said, wreaked mania.  The sheer energy, the excitement, the thrill of buy-sell.   Of course, that was when the millennium was new, the economy flourishing.  Now we all feel a little older, slower.

I never knew it, but garage sales are the real American stock market.  It never grabbed me, however, the old furniture, old light fixtures, what people called OPJ, other people's junk.  Not that the show, The Antique Road Show  couldn't keep my attention, it did.  But it wasn't like browsing thrift stores turned me on, and I only bought a few things second hand -- winter jackets for the grandsons.  One was for girls, apparently, so that was a huge faux pas.  Some of us need more direction than others.

Like many immigrants who come to this country, my father, after serving in a world war, had to decide what to do with his life if he expected to buy property, support a family, that sort of thing. He started setting up windows in a jewelry shop and thought, How hard is this?  I should own the shop.

And without the Internet to guide him, without a degree in business administration, he and his brother set up a business or three.  They hired someone to fix watches and Dad watched carefully.  The modest idea morphed into a buying and selling obsession.

It is an obsession, I'm learning, one that is not in the DSM, yet millions of people have it.  Most are on Ebay.  They have stores and monikers and merchandise and self-esteem, pride themselves on their packaging, their advertisements, the text of the sale, the pitch.  For now, sales are primarily online. 

Selling online, as even my father could see, is replacing the store.    My father wanted to get into it, selling online, but his illness overcame him.  That and age.  At some point you really do stop retaining new information, even old sober sharpies like my dad. 

So when he passed on he left us a lot of stuff.  Things like china, stoneware.  Random gift plates and jewelry, ID bracelets, new, in cases worth at most, $18 bucks a pop.  Clock radios.  Wallets and lighters.  Cigaret lighters!  Most of the jewelry was neither hisht nor haihr (Yiddish for neither here nor there).  Meaning not very valuable, but it might be. You never know.

Perfect garage sale stock.  Your average buyer at such an event will embrace the prospect and think about the problem for as long as you keep the tables up, as long as you attend to them.
"Do I buy it or not?"  they're asking themselves.
Real pressure.  I had no idea that putting a few things out to make a couple of bucks for my mom would be so intense!  Each sale so meaningful, so important.  It's like me at the grocery store.  Do I try the generic?  I want to, I really do, but will it give me a rash?  Is it worth the rash to save a couple of bucks?  Probably not.  But it might be.  (Certainly the generic Pantene is fine.  At least for me.)

The heat at the garage sale, palpable.  Do I buy it or not?  Can I get it for less?  Why won't she come down.  And everyone calling my name, because I'm the one who sat down with my mother for days, went over the stock with the glass, weighed it, loved it.  All this work to set a fair price.

So it's the closest thing to a family manic episode, or to being at the stock exchange on cocaine (for it's quite common, or used to be synonymous, market and cocaine) or to working in a gift shop the week before Xmas.  And obviously, it is grief work. 

It was hot.  Being there was being in the hotbed of America.  The wonderful people of Chicago would have felt it anyway, the heat, 90 degrees in the shade.  This is an annual neighborhood gig, the neighborhood yard sale, and there are twenty-six other yards to pick over.  Why everyone seems to come back to mine is still a big mystery.

Of course there's much more story here, but it can wait.  Suffice it to say there was jewelry, and the thing that seemed to draw shoppers to the yard was the jewelry.  And Israeli coins.  Why, when we're in a recession that has affected every one of us in one crazy way or another is jewelry the hot ticket item at a garage sale, well, you tell me.  My hunch is that it is beautiful, and garage sales are synonymous with deals, and beautiful and deal, go together. At least that's one of the things I learned as a child.

Anyway, this event took some preparation, and you could say it was highly anticipated, we were all pretty pumped, looked forward to hanging out in the hood on a Sunday and divesting of the junk that had moved from my mom's basement to mine.  Had to get a city permit and everything.  This just felt important.

And we were mobbed.  All day long, the same people kept coming back.  I felt we were old friends by noon.

You'd have thought it was the California gold rush. They're squinting at things, peering through loops.  If I had sold nothing but jewelry loops, mom would have walked away a rich woman.  They're weighing little trinkets from one hand to the next. 

"Is it 14K?" Everyone wants to know. "14K? 10K? Any 18K? Can't you go inside and look for more? You know you have more! This couldn't be everything from the store!"

How do you tell people, Listen, my grandkids took all the good stuff back with them when they were here for the summer. They might be young, but they're not stupid. 

"What we have here," my standard reply, "you have to buy it at your own risk. This isn't what I do for a living."

Oy vey! Wrong answer. So what do you do?

Well, when you're caught off-guard and you're me, you're honest, and let's just say, . . . we're off.

But let's not talk about me. What's really interesting is that there is a garage sale culture, the ecosystem that has passed many of us by.  We can't do everything, can't have our hands in everything.  We have to miss, on occasion, an awesome ecosystem or two.

Sometimes people come to therapy and they haven't got hobbies, haven't got a social niche or a social system they're comfortable in, or haven't  things to do during their discretionary time.  Many people, these days have a lot more of that than they wish they had, discretionary time.  Discovering how to develop an interest in everything, maybe even old things, collectibles, or free things, like the exoskeletons of the cicada (see previous post) is the cure. It's called personal growth, learning who you are, what you like, doing it, and convincing others, this is good to do, this is good to have.

Who knew I would have liked the stock exchange?  Never in a million years would have thought such a thing.

therapydoc

Sunday, August 22, 2010

Externalizing

Triangling gets a bad wrap, and blame certainly does, too, in couples therapy. But sometimes externalizing the blame works nicely and can keep people together. If it's about either one of you it's going to go south pretty quick.

This is a lot like scapegoating, which also gets a bad rap, but shouldn't always. If you can scapegoat a nebulous, vague object, if you can blame it, or them, or they, then you can get your anger out and nobody gets hurt. Externalize the problem. Get it out of the marriage, the bedroom.

Let's take a made-up example, but there are so many real ones that are similar, you'll relate.

Say you're at the airport waiting for your partner to pick you up.  You call and call and the line is busy, or he's just not picking up.  You're getting angrier and angrier.  Your plane landed early.  You want to go home.

He finally arrives and you go off on him.  "Why did you tie up the phone?  Why didn't you check your text messages?  I couldn't reach you?!!" 

No, "Hello, honey.  So glad to see you.  I missed you."
No hugs and kisses.
Neither of you feels the love.

Much better to blame the phone company, or technology in general, or how dependent we are on technology. Much better to say, "Honey I'm so glad I'm home, but I HATE the phone company. Obviously you didn't get my texts or my voice messages. I'm switching to . . .I just HATE them!"

This feels really good, to hate them sometimes. The company we all love to hate. You have effectively triangled out the phone company. And it's about time someone did.

therapydoc

Snapshots: Information Overload and West Point Ring Cycle

Not my mother-in-law's car, but it could have been.  Did you know there are several websites with photos of automobile crashes?  You can search by make. What a comment that makes, online ambulance chasing.

1. My mother-in-law calls us from her cell phone.  Her voice is a little harried, she's working on control.  She tells us she’s been in a car accident, that she’s fine, but can we meet her in Skokie? She’s been shopping at Old Orchard, and on the return seems to have collided with a Model T.

“I was too complacent,” she tells us. “Things were going too well. I was too complacent.”  As if you can always be in control.

Days later she’s decided she will not drive anymore. This is her wake-up call.
She is in her mid-eighties and can dance circles around anyone at a wedding. We see her as the new poster child for knowing when enough is enough, for letting people help her, having trust that it will be okay.

2.  That's Robert's Fish Store below.  Robert is on the left, Arturo on his right.




 I call her on a Friday morning. “I’m going to the fish store on Devon. Do you want to join me?”
Devon is a famous avenue in Chicago, known for the ethnic stamp of the markets, the bakeries, places of worship..  

“Sure,” she says.

We do a little independent shopping and meet at the fish store. Waiting at the counter is a Jewish woman with two lovely little kids, a boy and a girl.

I pay Arturo and turn to leave, but Mom can't stand it.  She has to approach the little girl.

“How old are you?” she asks exuberantly.

“Five,” the child asserts with pride.

Quietly I pipe in, “Have I got a boy for you!” thinking of my five-year old grandson.

The adults all laugh but as we walk to the car I think, How heterocentric was that? Even if I think I’m minority sensitive, I’m obviously not sensitive enough.  No, nobody else gave it a second thought, but that really is the point..

3. On Saturday morning I meet my young adult son at a senior retirement home for religious services. My kid has an important part in the service, and when he is guest reader, I like to hear him do his thing. I also like the way they run the service, how one resident calls out the pages, and the others giggle until they all agree. Being in their company feels right, being with people who have experienced life in full, great things, maybe, and much sorrow.

I take a seat near the end of the aisle so I can get up to look down from our level to the front entrance, the common room. The whole building is very beautiful and the high ceilings temper my usual institutional claustrophobia. The chapel doubles as a movie theater. Not many people under seventy here, only those who assist or bustle to get lunch on.

Three-quarters of the way through the service, a woman in her eighties in a perkie summer suit and straw hat asks if she can take the seat next to me. I'm in the row designed for walkers, and now I worry that I hogged a seat meant for someone else.

"No, please," I whisper, "Sit down."

First she apologizes that she doesn't use a prayer book. "I can't see, so there's no point. But I listen, and I enjoy the feel, the spirituality, just being here."

"You can be the ears of half the people here, and they can be your eyes."

"Exactly," she nods.

I tell her my mother is probably going to be moving here in a few months, and ask if she likes it. In Yiddish she answers, If you can't be at home, it's the next best thing. But she misses her home.

It turns out she has still not sold her suburban condo, like my mother hasn't sold her house. I don't ask if she's just lost her husband, or why she's here. To me it's fairly obvious that this "solution" is highly functional for people in her age group. It beats falling at home, and people check on you if you're not at dinner.

She asks me my mother's name and I tell her. She gets that look of recognition people get, but it's noncommittal. Maybe she knows my family and doesn't like them, I worry. I've learned to worry first, ask later. It's the Jewish neurosis.

"Seems to ring a bell for you," I observe.

"That's your father's last name, right?"

"Right."

"Did they live on the West Side?"

Sure did. Everyone did. Most of the Jewish Chicago immigrants moved to the west side of the city when they immigrated in the thirties, preceding the Holocaust.

"I think I lived in their building," she continues. "My family occupied three of the six units.  That would be your grandparents.  Are they still alive?"

"No, they've passed on.  But that's so coincidental, isn't it?" I exclaim in a whisper.  "You knew them.  What do you remember?"

She's embarrassed. I'm not sure if what she remembers is good or bad, or she just can't remember.

"I didn't see them as our landlords, they were just people. We were all just people." Before the services break, she tells me the name of the street.  She is spot on.

I tell the story to my son as we walk home and he laughs, says, "How random is that?"

It's not random at all if you have a critical mass of Jews. Happens everywhere in Israel, no matter who you talk to, and apparently, if you move into a retirement center, it will happen there, too.  I'm sure it happens wherever there are concentrations of the same tribe.

4. Peggy Noonan of the Wall Street Journal writes about how our lives are controlled by technology, as an electronically informed culture, we're guided by what we read.  And this is something philosophers have noted hundreds of years ago, as well.. (Information Overload is Nothing New).

Ms. Noonan mourns our obsession with our electronic gadgets to the degree that we don't make eye contact anymore, we're busy with our virtual communication. A patient has just complained to me that it used to be, when you went away on vacation, you got away. No more. We commiserated about the constant barrage of communication, how our lives have to be stressed as a consequence, despite the tickling of the pleasure centers in the brain, the social connectivity.

Worse than the disturbance is the volunteered slavery, the phenomena that we are led by the nose by what is new.  We're no longer free thinkers. No longer is research under the purview of the PhD's.  Everyone has new information to post.  So we're always checking, checking, checking to see what others are saying before we make a move.

I read it and worry that I have guided people, not so well sometimes, here on the blog.

But then again, it wasn't long ago that I told you to throw your cell phones in the back seat when you drive, before Oprah did her show on it.  And haven't ranted about it for a long time because frankly, it feels that this is the wave of the future. Nobody looks out the window anymore.
Thanks, Ms. Noonan.

Below: President Dwight D. Eisenhower, West Point Class of 1915, with a 1960 graduate, admiring a ring.



5. On the opinion page of WSJ,  Margaret Lough, a recent West Point graduate, waxes on nostalgically (My Place in the West Point Ring Cycle) about the meaning of the class ring, how each class determines what theirs will say. Ordinarily the motto rhymes.  Class of 2008, No Mission Too Great. This year the class has chosen, For Freedom We Fight.

It's a beautiful piece of journalism foreshadowing young people, idealistic, risking their lives to defend the lives of other Americans, our constitutional rights, our right to freedom.

I was in tears.

therapydoc

Wednesday, August 18, 2010

Spam

I just have to tell someone.

It's driving me crazy. The spam is driving me crazy. I screen my comments, meaning they come to me from Blogger as email. It gives me the chance to read comments before posting them.

This used to be a simple thing to do, took very little time. But now it seems that for every genuine comment, there are five that qualify as pure comment spam.

Comment spam is generally machine generated from an Anonymous individual. This entrepreneur wants me to direct you to links, places you probably don't want to go. They're not the kind of places you would find on my sidebar. Do you really want to visit websites for shady pharmaceuticals, diet drugs, and porn? Doubt it.

The content of the comment can be so disgusting it literally makes me sick just scanning it to screen it.

My experience is probably akin to what one of my kids experienced at the tender age of nine. He opened an email with a naked little girl captioned, Got milk? Disturbing to some of us.

So I'm becoming loathe to open comments from people who go by the name, Anonymous. Especially since they're anything but anonymous.

Thus:

If you can. Try to work with the other options for signing comments so they're less likely to be deleted due to my not irrational aversion, my allergy to comment spam.

Instead of choosing Anonymous, pick the option: Name/URL. Choose a name for yourself, and and fill in the box with your new moniker. We all need to reinvent ourselves once in awhile, and everyone needs an alias. This is your chance.

You don't have to put down a URL. There are too many in the universe already.

Then tell me everything. Or whatever it was you wanted to say.

Much obliged,

therapydoc

Friday, August 06, 2010

The Dishwasher, Marriage, and Obsessive Compulsive Disorder

Caveat:

Before we begin, please do not consider the following post an exhaustive treatment on how to treat Obsessive Compulsive Disorder. The intervention I discuss is only one strategy, and treating OCD can be quite long-term, begs different methods. It is never a simple behavioral therapy. I'm only suggesting that without a behavioral approach, the therapy is remiss.

Nor am I making fun of people who have the disorder or dismissing them as silly. That's the farthest thing in my mind. It's a very serious, painful disorder.


The Post

Many couples argue about the right and the wrong way to stack a dishwasher. There is, apparently, a right and a wrong way, depending upon the direction of the jets. You knew about the jets, right? So couples argue about this one quite a bit, and it's not an Obsessive-Compulsive Disorder thing, not even a control thing, so much as an
Are the dishes getting clean?
thing.

So we could talk about that, for sure, but let's talk about me.

I’ve become one of those people who washes the dishes 100% before stacking them in the dishwasher. I never thought it would happen. There's no need to do this. This particular Whirlpool sounds like an airplane, but the dishes come out clean when the war is over.

So FD comes home and eats breakfast, wants to stack his plate of crusted bagel crumbs and butter in the dishwasher. He sees the clean dishes and asks me, “Are these clean? I just emptied this thing.” His tone is upset, confused.

“Yes, they’re clean. I’m using the rack to let them air dry.”

“Well, how am I supposed to know what’s clean and what isn’t?”

He has a point.

You're all thinking, I know you are, this is so obsessive-compulsive, washing before a wash. But the difference is that there is no second wash.

Another example of mythological OCD:

My mother, 84.5, lives independently but won’t cook for herself anymore. Or bake. She is a fabulous cook, a wonderful baker, and although I’ve tried to fill in, I’m too impatient for real baking; you know what I mean. She won’t cook because it’s too messy. Does she have Obsessive Compulsive Disorder?

She might, is the truth, but in this case, her behavior isn’t a function of her OCD; it’s a vestige of self-esteem. Why should she have to clean up for herself at her age? She's done enough of that, cleaning up for herself, for others. It's time to call it quits.

So we don’t have to treat Mom. But when should we treat compulsions? (Obsessions are the thoughts, compulsions the behavior). And when should we leave symptomatic behavior alone?

We might suggest that if a younger person refuses to cook for herself because a splat of omelet on the range causes her too much distress, then that might be something to treat, depending upon a host of other variables.

And how would we do that, treat it?

It’s not necessary to talk about toilet training as a child, although a therapist could make decent money off this approach. And it’s fun to talk about early childhood, for we do establish much of our irrational tendencies as children just coping with life stress. Life, if you're a kid, has inherent stressors, mainly having to do with weird rules and the behaviors of large people.

But far more elegant than talking about childhood is a behavioral approach. You start (I do) with something that’s upsetting to the patient, like a spill. A therapist like me might pour grape juice into a pitcher and leave it close to the edge of my desk for an entire visit to see how long it takes for the patient to say,
“Could you please move it? It’s going to fall.”
Ridiculous, right? It’s not going to fall. It is a full pitcher. It isn't going anywhere. I move it an inch away from the edge.
“Good enough?”
Of course not.
“Does this make sense?” I ask.
Well yes, it does. We could have an earthquake. Anything could happen. We talk about the concept of stressing the mental set, making the brain grapple with the thought that it could fall, all kind of bad things can happen. But it won't. I won't let it. The thought is irrational and dysfunctional.

Dysfunctional because while under the influence of an obsessive thought, or a compulsive behavior, whatever else is going on in our lives, whatever else is important, is taking a second to something as small as a pitcher of grape juice. And we make other people miserable, waiting for us.

Sure, caution is a good thing, and most of us avoid precarious situations like spills, but when the caution is obligatory, rigid, symbolic for everything, somehow, then we have to tickle many sources, not only a difficult childhood. Pick a trigger, any cause for anxiety, then another, and play with it, talk about it, test it.

Try syrup, working with a spill phobe. No one with this set of compulsions (the cleaning set) is comfortable with spilled syrup.

Hold a spoonful of syrup over the floor, make like you’re going to spill it, but don’t. Get very close to spilling it, but definitely don't. This requires some coordination, but repeat the near accident over and over, each time measuring the length of time the patient is holding his or her breath. (Not literally, just look for any change in expression).

A little anxiety is what we’re shooting for, not too much, and a gradual magnification of the stimulus. This teaches the patient to manage his or her anxiety some other way, and hopefully you're familiar with relaxation techniques and have passed them on, or cognitive strategies, like the rational thinking we discussed above.

The technique of gradually increasing the stress of a feared stimulus is called desensitization. Gradual is key. No need to give anyone a heart attack with spilled grape juice of syrup. Not until you're sure that spilling won't cause a heart attack.

The therapy really can take years. There's always another trigger to desensitize the patient who has this disorder. Medication is helpful, and surely a couple's therapy is always in order, psycho-education for the spouse, and coaching, even shadowing.

So what about me and FD? With the dishwasher. We could dedicate one side of the dishwasher to clean dishes, another to dirty. But I feel this contaminates the clean ones that are minding their own business, just resting across from the dirty ones.

Maybe someone can think of a better idea. I’m not sure I want to quit washing the dishes 100%. It feels good, hot soapy water on skin (I never thought of it this way until a friend mentioned it to me). And it seems like something that should become a permanent bit of the home’s personality, saving counter space, like we're heading in a new direction.

And FD could actually look at a dish to see if the dish is clean. Would that be so bad?

therapydoc
Dear Readers,

I took down the last post because I'm conflict avoidant, basically, and the heat of those comments could have fried an onion.  The replacement post is probably going to be provocative, too, in a not-so-serious way.  I hope. I needed a tension cutter, and universal problems, like arguing about how to stack a dishwasher, promises to be one.

therapydoc