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Friday, December 31, 2010

Sexting and Mental Health

The Brett Favre sexting case has been bothering me, mainly the thought that since he sexted, Mr. Favre has had nothing but bad luck.

It's probably a huge stretch, but I'm going to throw an idea out there anyway, wondering exactly how wrong I am. It's on my other blog, so here's the link.

Have a happy, healthy, thoughtful new year, everyone. See you in 2011.

therapydoc

Thursday, December 16, 2010

The Holidays and Business

Housekeeping:  There's another poll on the sidebar, take a minute.  And this post feels long to me, so grab a bite to eat and come back.  Settle in.

"Last year you weren't nearly this busy," FD corrects me.

I had told him that I'm beginning to feel the effects of nonstop holiday happiness.

"Who can remember last year?"

I remember blogging about this once, getting ridiculously busy in October, the drama, the sadness, the relentless desperation not letting up until after New years. I wrote that it had something to do with the stress of planning, how planning extended lengths of time socializing with family brings back memories, and they aren't usually the good ones. Heaven forbid we should remember the good ones. 

The thought of Uncle Al getting wasted, Cousin Ina slamming the door, swearing,  "Okay, that's it, we're getting a divorce!"  This type of family dysfunction-- boozing, screaming, slamming-- anger-- even passive-aggressive anger, "Good to see you, too," especially this-- tends to be a downer.

Add to that the happy family script: We're supposed to like getting together as a family.  You've seen the commercials, especially the one with the cousins getting away from their parents to a restaurant for dinner, just the cousins.  Delightful, but how often does this happen?  Great when it does.  I think it was Leo Tolstoy who said, 
"Happy families are all alike; every unhappy family is unhappy in its own way." 
Anna Karenina.  He was right, of course.

A prescription to manage the anticipatory anxiety:

a) plan as little as possible, wing it
b) label dysfunctional patterns, but don't argue; discuss
c) have an escape plan
c) expect little
e) accept a lot
f) and when the catastrophic expectations materialize, laugh about them.

Because after all, they were all predictable, the catastrophes.  We know our family members well enough to predict their nahrishkeit (rhymes with bar-ish-kite, means foolishness).

So clear the snow off the getaway car and check the availability at the local hotels.

But getting back to FD. He is right. This season has been the worst in years. Something in the air, something other than poverty, although poverty, and the anticipation of poverty, doesn't help; it is bringing people down.

The social scientist in me says it is entirely random, this year, and I'm different, too.  It is the luck of the draw, the draw of my particular patient mix, and really, mine is great, but this is work, not cocktails.  If you accept a lot of new patients, the complexity, the responsibility, will overwhelm. Never launch them, is the answer.  And take frequent vacations.

Maybe, however, there's a global confluence of variables at work, too. The unemployment, terrorism, the economic collapse of governments, the senseless murders and suicides hashed over repeatedly on the ten o'clock news. Kids voluntarily foregoing childhood, sexting.  War in Iraq, no pay raises for military families.  Riots.  Explosions in the Middle East.

Business as usual? Maybe yes, but these nagging toothaches add to what we already have, pain in our own ecosystems, in our own families, somewhere there is pain.

So avoiding the worst of times* is the prime objective.

We could start with ourselves, logically. Others might act out, Uncle Al, Cousin Ina, but we're affected, too.  Under the spell of what is supposed to be intimacy, I think the healthiest among us regresses. Where else can we be ourselves, the ones we used to be as kids, if not with family? 

We're a little different when we're with them, our siblings, parents, grandparents, aunts and uncles, cousins.  We slip into old patterns in the same context, eating and drinking with them, the same dinner table, hearing the same snarky jokes at somebody's expense.  The context triggers the synapses, old nerve pathways, thoughts and feelings of childhood come alive, like some ghost of holidays past.

Once we're there, we lose our more mature defenses-- intellectualization, rationalization -- the ones that make us think things through, forgive; and we regress to the childish ones, denial, projection.  The ones that blame.  The fun started with planning; being together finishes us off. 

You might think it isn't worth it, going home, but I think it is.  It's worth watching how this happens to us, and better even, it is worth labeling what is going on, appealing to the intellect of others in the family, the ones who might get it, who work programs or have had some therapy, or maybe caught on years ago, as children.  Also appeal to the heart of the family, the place in each of the first degrees, second degrees, thirds, that wants this to be a happy family.  Enjoy the best of everyone, and fight the regression to denial, projection.  Stay adult.

Just don't referee.  That's what you spent money on the tune-up to avoid. 

Not everyone goes home, goes anywhere is the truth.  If we didn't have good holidays as children, if there were no presents under the tree, if there was no tree, if there was no dad, no mom, if nobody filled in, if there was no Santa Claus, if someone died,  then for sure, no matter if we have reinvented ourselves, now have a functional family, a home, it is still sad, remembering. And if we haven't reinvented ourselves, if we have successfully abandoned the dream of the happy family, then there is no reunion.  No matter, sad.

And if our parents didn't make it as a couple, if there was violence in the home, if there is violence in the home now, then LOSER is written all over us, we're sure.  Adult Children of Losers, ACOL's, and sadness. And the expectation that our spouse should have helped us correct this by now, by the holidays, for crying out loud, and didn't, then the blame game is in full swing, and it can be a very loud game.

Conflictual couples conflict the most before and during the holidays (probably associated with license to drink/use). It is wishful thinking, peace on earth.

My son asked me, "Why do you think this is, that people lean on their therapists more during the holidays? You would think they would be busy baking cookies. Eventually everyone needs cookies."

He is thirty-two, responding to my late office hours. I tell him that time's running out.  Fix it now, fix it now, people tell themselves.  Count down. . .Ten more days . . ., nine more days . . ., eight more days . . ., seven . . .

And the days are getting colder, and darker, and what we really want, all of us, is to snuggle up close with people we love, or one person, maybe by a fire, and sip something warm, maybe hum, turn on Johnny Mathis, sing.

That would be the goal, I suspect. And by the time we get to December 24, some people pull it off.

therapydoc

*Different author, Charles Dickens, A Tale of Two Cities.  Bring one of these, a good book, on vacation.

Thursday, December 09, 2010

Elizabeth Souter: The Editor

Oops! Housekeeping: I forgot to tell everyone to please check the sidebar and vote.  It was an impulse post, and once someone votes you can't edit it.  It should read:

__M-Th between 7-10 pm, CST
__Sunday 1-5 pm, CST
__M-F 9-12 am, CST
__No Thank you.

The lectures are about intimacy regulation, what else.

Onward.


A few months ago, a Harvard educator contacted me and asked if she could take a stab at editing a few posts on Everyone Needs Therapy for free. Of course I jumped.

Free? The only thing anyone has offered me for free is a set of screwdrivers from Home Depot. Which I declined. First accepted, then declined.

But this? A dream come true. We talked while I waited for the good people at 7-11 to make me a pot of decaf (between patients, don't think the phone ever stops), and I told her that I barely pulled a C in Rhetoric in college, probably because I didn't understand the meaning of the word, rhetoric. They assume you know what it means when you're in college, the name of the course.

Anyway, Elizabeth, tzideikat, (rhymes with lid-ay-not, means a female saint) took a red pen to my work. It got pretty crazy, reading the edits,


but she was nice enough to also show me how it looked edited, which is what you got.  After the second pass.

Plenty of bloggers are really writing for themselves, as they should, because as you know, writing can be therapeutic. But if you write for an audience, you're talking performance art, and everyone wants a good performance. Most of us need a good coach for that to happen.

A few months ago I watched my granddaughter's ballet class, and the patient coaching of Miss Vanessa, well, it was a thing of beauty watching her work with those kids.  Not that the raw performances weren't amazing, and let me tell you about my granddaughter. . .

That would be a digression.

So Elizabeth -- professor, writer, editor, and blogger at Motherhood is Not for Wimps – was kind enough to doctor a post or three, and the five-year old in me gazed up and said, Plie' away.


She teaches blogging at Harvard Extension School, so she's probably bleary-eyed at the end of the day, and I hated to overtax her. Still, she asked for it, and she took my scribble scrabble, delivered line-by-line feedback, evaluated how I write, the voice and constructions, my strengths and weaknesses. (Two of the edited posts are up, one will require a lot more emotional energy from me before you'll ever see it.)

Of course, it was like good therapy. Lots of encouragement and validation, things to think about, stuff to work on – enough to jump start the critical thinker in anybody, planted firmly, as you well know, by some previous mentor you surely merited along the way, probably by a first degree.

But the results of those critical introjects!  You have to thank the coaches, the moms, the dads, the teachers, the sibs, the neighborhood folks, that guy at Little League.

Thanks Elizabeth.


therapydoc

P.S. If you want to work on your blogging, strengthen your voice and the quality of your work, Elizabeth Souter tells me that she is not too wiped out too take on another client. (She writes, too, is a published author). Check her out at Motherhood is Not for Wimps, but for an editing appointment, check out her personal website.

Wednesday, December 08, 2010

In Treatment Versus 30 Rock Chain Reaction

Having only watched the 45-second HBO web clips of  In Treatment, I don't have a right to judge.  But these are fairly delicious.

Dr. Paul Weston (Gabriel Byrne), a dark, Jewish Dr. House-ish parental child with abandonment issues and at least three seasons worth of conflict, explores his feelings openly with a therapist, hits on his therapist, is hit on by his patients. What could be more compelling than this?


How does it happen that in over thirty years of doing therapy, no one has hit on me? I must be doing something wrong.

In Treatment surely grabs us where we want to be grabbed-- emotionally, of course-- fully engages our empathy sensors. Someone told me the show feels voyeuristic, as if we're watching true stories, the scripts seem so real.  I took a look at the Wikipedia recaps and no surprise, the stories really do match the kinds of narratives we hear off screen in therapy. 

As time passes for a therapist, stories like these lose their edges, blend in with one another.  Patients I haven't heard from in ten years will call and ask, Remember me? I do and I don't.  But I remember them as soon as they plug in their key words: drug dealer, death of a family member, affair, domestic violence, rape, cancer, cut-off.

So much is universal.  Sometimes telling over bits and pieces of case studies here on the blog, changing the names, gender, race, location, etc., feels like overkill.   So much trouble just so that nobody can exclaim, Hey, you told my story!   Just not that special, is the truth, our stories.  At some point your story, like my story, is just like the story of somebody else.  There's a Jewish expression, Ain chadash tachat hashemesh.  There's nothing new under the sun.  Ecclesiastes, I think. 

Arguable, no doubt.  The way things present, the way the stories play out, the infinite variations of a theme, the content, the details, these are new.  The variations of narratives, like jazz, keep people like me in the game.  They are why people like you like to hear about therapy, talk about it, share the compelling, heart-tugging details of your lives. Every story really is special.

But back to teev.  The TV docs do have fabulous offices, don't they? At first I thought Paul Weston had an amazing office, but then I learned that his patients come to his apartment for therapy.  Dr. Jennifer Melfi, (Lorraine Bracco) Tony Soprano's doctor, he's not.

Still, he's compassionate, handsome, engaging. And although he really needs to get an office, just to be sure he doesn't get too comfortable with his patients, something tells me the show will have a very, very, nice run.

Chain Reaction: Mental Anguish, a 30 Rock episode is completely different. (Spoilers coming up) It's a comedy, for one thing. Liz Lemon (Tina Fey) can no longer deny needing therapy but has no time. So sunny Kenneth -- God gave us two ears and only one mouth because listening is more important than talking-- fills in at work.

Liz lies down on the couch to talk it all out- the betrayal, the lies (Santa)- and Kenneth grabs a pencil and a legal pad to take it all down. A therapist really only needs an ample supply of legal pads, fine tip pens, and a good sofa to go to work, much more important than tea or coffee service. These tend to distract. What, no latte machine?

Listening to Liz brings up unresolved history for Kenneth, which starts the chain reaction. Liz, having told her story, feels better, but Kenneth, the listener, feels sick. So Jack Donaghy, their boss, (Alec Baldwin) steps up to play therapist for Kenneth, and of course, he's next in the chain reaction.
Jack's the one in the suit.

Everyone helps everyone else is the idea. Any one of us can be a pretty decent therapist, given the opportunity (interface be damned). It is why so many of us do dinner with our friends, leave our families behind so that someone else can listen. We may not lie down, but there's something about the process.

The lay therapists on 30 Rock are really funny, of course, at least everyone in my family room laughed out loud. But I couldn't (well, not so much), not because their timing was off, not because the lines weren't funny or didn't fit. They did. But there were too many of them, words. Certainly for a first visit.

If you go to dinner with friends for therapy, you know, to make it work, you really do have to pencil in as many hours as there are eaters. And choose your friends carefully, make sure they know how it goes, the rule not to monopolize. And no need to punctuate, not really.

Leave that for the guys on TV.

I could stop right here, but did read some research on therapy in the media, and learned is that it is variable. Sometimes what we see is spot on, sometimes not. But one thing's for sure. If most of it is like what I've seen lately, it is narrow.

They all seem to do the same thing! It's all a talk therapy, so 1930's, so forties. Whatever happened to the fun therapies of the fifties, sixties and seventies? And what about now, now that we have the Internet? Do you think I don't log on with a patient at least once a week? Look at somebody's facebook page? A single's profile?

There are probably as many different styles of treatment, as many therapy "aps" as there are therapydocs. The personality of the doc is a force of nature, and as hard as some try to be blank slates (the better to read your transference, my dear), it's just not fun, isn't always effective, and it takes forever.

Much more powerful to listen as a kid reads his poetry, or recites a rap, snapping his fingers. Nothing better than this. Or let a patient put someone in an empty chair, describe this imagined larger than life influence, often a parent or a boss, and scream away, express feelings in a safe venue. Or assert, learn to say it nice. The old Gestalt techniques of Fritz Perls are still powerful.

So is Joseph Moreno's psychodrama, literally playing out domestic scenes with family members, real dramatizations of power and control, conflict.

Virginia Satir, a mother of family therapy, had parents standing on chairs, pointing down at their kids, berating them. Virginia made parents feel ridiculous, acting as dictators.

We could go on, and on. Just wanted you to know. TV therapy? Enjoy. But it doesn't compare to the real thing.

therapydoc

Thursday, December 02, 2010

Sexual Harassment and Some Older Guys

My father, a very macho man, but one who considered himself enlightened, still liked the differences between men and women.

Age 89, we're in the car on the way to dialysis, he has difficulty breathing, walking.  Just living, really, is difficult.  Not much daily desire to flirt with anyone.

As a Navy guy he likes nothing better than a good joke, any type of joke, has no idea that the 'blue' jokes can be a form of sexual harassment in the wrong company.  In years past he and his friends swapped these on the Internet, printed them out to read while playing cards. You can't trust your memory at some point.

I tell him a joke about being old and losing your memory.  These, to my dad, are hysterical, even if you're in a ridiculous amount of pain.  Then I share with him about a new business, working with a lawyer and a few other professionals to teach sexual harassment prevention, relationship safety, make the world a safer place, safer for women and men. It's an empathy thing, relationship safety.

He gets it right away that men, too, can be sexually harassed. As a businessman, a guy with his own store, he never liked it when anyone harassed a minority, any kind of minority. People are people. No one gets that better than storekeepers. You meet all kinds of people minding the store.

He's excited about the new venture (not so new), and very curious.

"I used to tell the women how pretty they were-- at work, anywhere-- I complimented women all the time." He stops and takes a breath. "Was that sexual harassment?"

Maybe. Knowing you, Dad, probably. Even if you didn't mean it, if they didn't like it, you might not have been able to tell, so you would continue doing it.

"But it made them feel good! I was just making people feel good! There never was any doubt about me wanting anything other than that. And your mother worked in the store.  I told her she looked good.  I told you that you looked good."

You flirted with other women right in front of her.

"So is that bad? She knew I wasn't doing anything."

Words are everything, poor guy has to hear from his daughter, at his age.  They matter, especially from the boss. If a woman tells you to stop flirting and you don't, then you're harassing her.  You can be breaking the law.  It's harassment before she tells you to stop, but all the more so after she tells you to stop. It's not about you, not about what you think, it's about her, how she takes it, how she feels.

"I just thought . . . She smiles.  It's a compliment.  She knows me, there's nothing wrong with that."

We're telling guys, and women, too, I tell him, not to comment on new clothes, not to say anything about how an article of clothing fits someone, or how their make-up looks. Stay away from anything that might make a person think you're coming onto them, or you find them sexy.

"I'm glad I retired in time," he tells me. "I couldn't have changed."

He's on his way to dialysis, and there are women who are going to be prodding and poking, helping him in and out of the chair.   They like my father.  We both know that they've probably heard worse.

therapydoc