Wednesday, May 23, 2012

Snapshots

 
That's the service elevator.

(1) Poor Communication

It is dangerous, telling people that you moved.  They think you moved out of the country and stop referring new patients, even if you've only moved a mile away.

What I didn't tell you is that I moved in with my mother-in-law. She makes a mean tomato bisque.

(2) It's Like a Dorm!


I like living in a big, bustling building that reminds me of a college residence hall.  Even my bedroom feels a little small, but larger than anything I slept in at University of Illinois (although maybe that's changed, it's been awhile). And that's okay. 


It's worth it to meet new people every day, mostly while waiting for elevators, especially since the median age in the building is near sixty-two, not nineteen.  I find I like the look of older people.  May, it seems, is National Older People's month.


FD relayed that news bite and asked, "Is that us?"

I look it up. It isn't an American thing, but a British initiative. The Full of Life campaign is a celebration of the opportunities, achievements, and aspirations of older people and their contribution to society and economy.

The flash banner reads: Full of Vitality, Full of Knowledge, Full of Wisdom, Full of Energy, Full of Talent.

Most people here are happy to say hello to a new person.  But today, waiting for the elevator, a woman about my age isn't looking up.  No biggie.  I'm in a hurry and press the Down button for the service elevator, increasing my odds that one or the other lift will come soon.   

The other comes, and as I step in, my new friend looks at me.  "Why did you press the button for the service elevator and then take this one?"  The tone is accusatory.

"This one came first."

"You're not supposed to do that, press for the service elevator unless you're going to take it."

That makes sense, but now I'm concerned.  For her, of course.  Because you have to wonder.  Is there a difference between people who admonish you about rules and people who don't? Everyone is different, and we all have our issues, but maybe admonishers worry more in general.  Maybe we'll discuss this one day, she and I.

(3) Something Close to the Original Score

I’m at a hospital, visiting my aunt, who is lying in a coma.  I learn that coma is a short word for non-responsive, and the doctors like the word non-responsive much more. The doctors admitted my aunt for pneumonia, maybe other infections, too, and she perked up with treatment.  Then, the next morning, she didn’t wake up.  But she didn’t pass away, either.

So we visited; my mother in her walker, gasping for breath every thirty feet through the long hospital hallways, refusing the wheelchair; and me, patiently beside her.  This is a very private family, so our visits with my cousins aren't interrupted with visits from their friends.  It is intimate, being a part of this small group.  None of us have shared this particular type of time together, coaxing a sleeping woman in her nineties to life, or  the alternative, waiting for her to move on.

My mother sings to her sister in Yiddish, songs of their youth, songs older than time. I ask her, "Did you sing these songs to us?" She has no idea, doesn't think so.  Her crowd only spoke Yiddish when they didn't want their children to understand what they said.  


Someone recognizes one of the melodies as the theme to Shindler’s List.  Here's the link to that, and below it, my mother singing.  It's only a video because I don't know how to upload audio.  I need an older person to teach me how.  But follow the link to Schindler first. 

http://www.youtube.com/watch?v=XLK5OWU2YGw

video


(4)  PTSD

Supposedly resolves after about a year, two at most.

We're leaving the hospital, pacing slowly to the garage.  Our habit has been to keep our visits short, my call, for better or worse.  My mother, who you would think has all the time in the world in her mid-eighties, is at her best in the afternoon, when I have to be at work.  It is me who must squeeze in these late morning visits, and they never feel long enough.

The day before my mother had mentioned that my sister-in-law spent two hours visiting, the implication, I think, that we're not doing our part.  I take it as a direct hit-- I'm not being a good enough niece, not a good enough daughter.

Surely in response to that, the next time we visit with my cousins and my aunt we stay a little over an hour.  Afterwards, on the way to the car my mother is clearly out of sorts.  She tells me she's upset, that she's been upset for the two weeks my aunt has been non-responsive.  She doesn't know if her sister is in pain; she has no idea how horrible it is for her beloved older sister, not really.  The two have had difficulty communicating this past year, a loss of hearing on both ends of the line having much to do with that.  It has bothered her.  Now this.

It can't be good, lying in a bed, barely breathing, on the way to something.  My mother tells me that she is hurting because she feels my aunt is hurting; her bad mood is all about that.  And here I had thought it was about the length of our visits.

In the dark hospital garage, hunched over her walker, looking at the grey cement floor, she tells me she has had a sadness all of her life.  She qualifies that: since my brother died she has had a sadness.  We're talking 42 years.  Sometimes it's more conscious than others, she tells me.  This is one of those times.


(5) You Can't Go Home Again

I visit a friend on a Saturday and we read from a book together, then we visit another friend.  On the shaded porch over iced tea, yet another friend tells us that she visited Poland last week.

She visited the cemeteries, the Jewish shrines, the concentration camps.  She found her father's home, where the Nazi's executed their entire family on the spot except for him.  The Nazis executed the family either outside the house, or in the woods near by.

The house that exists now is new; the family homestead, razed.

The story continues.  On this tour, a holy woman from Israel sprinkles holy soil in places like this homestead to properly bury fathers, mothers, grandfathers, grandmothers, brothers, sisters, aunts and uncles.  Wrongly buried people are everywhere in Poland.

It reminds me, I tell my literate friends, of that Jonathan Safron Foer book.

(5) Catching Things


Used to be I caught planes, remember?  That's my grandson catching a butterfly.

FD says to me, "Let's go to ____ (a city in the south).  There's a kindergarten graduation I promised to attend!  Those are the only ones worth going to!"

Ordinarily I jump at such a suggestion, but the price of oil is high and the airfares reflect this and I don't like enabling the industry.

"But it's her graduation," he whines.

"And ten years from now, even five years from now, when you ask her what she remembers about her kindergarten graduation, it won't be that her grandparents spent $500.00 to fly there."

"She might.  And you won't feel that pinch.  Not in ten years."

"No.  But that house we just left?  It needed a new roof, if you recall."

I tell him that there's one graduation I wouldn't miss for the world, and that's my daughter-in-law's.  She's getting a doctorate, and those take years of hard work, change your brain, your life forever. Not to take away from our kindergarten graduate.  It is a big deal, if mostly for rather little people.  We'll see.

(6) Being Closer to Reality

It's a beautiful day, a little chilly, but I finished work early and approach my new building from the back. The bike rack is in the basement and to get to the storage room I have to take the service elevator.

Still outside, however, I can hear shouting from a window not all that high up above, a woman's voice, "Stop it. (Pause) Stop it. (Pause)"

Then louder, "Stop it." And louder still, "STOP IT!!"

I wait a moment because it is so familiar, this whole gestalt, being in an apartment building, not a house, hearing a desperate voice. Over thirty years ago, on the holiest day of the year, I'm living in a third floor walk up, ready to go off to the synagogue and I hear, "Stop it. HELP! Someone help!! He's killing me, he's killing me!"

The voice doesn't stop.  I call 911.   Moments later the police arrive.

That's the whole story.

I'm pretty sure that this time, Stop it was about a toddler making noise.

Happy to be here?  My friends keep asking that.  You bet I am.

therapydoc

Friday, May 11, 2012

When Rules Are A Challenge

Thoughts from readers on this one would be appreciated.

Live alone, no arguments. Live social, arguments, or if you prefer, disagreements.

We can escape conflict about the thermostat and almost everything else, living alone. But it can get boring and lonely. So we try to partner up, and most of us like to go for drinks, lunch or dinner, just to be with people.  We can't all succeed at this, even when we want to.

It can be hard for some of us, socializing, because we live in a world with social expectations and rules.  To have friends we want to follow those rules to fit in, but they are often subject to change and not everyone has the innate ability to comprehend the wisdom behind them.

There are overt rules, the spoken ones, the ones written on the black board: Ask for a pass before leaving the classroom. You'll find them in the employee handbook, too: No sexual joking around with employees. 

The covert rules are assumed; you won't find them posted anywhere. Once they may have been spoken, but they are now so much a part of our social fabric that we no longer over think them, they just make sense in context. Before leaving the house, make sure to wear clothes. What sociologists call traditional roles are characterized by dozens of covert rules, rules like this one: Of course I'll make dinner while you read the paper or check your email. I'm a woman.

We like making rules, all kinds, and as soon as we're in a position to do so (think parenting, managing, teaching), we'll oblige, take full advantage, probably because we like predictability even more than we like power.  Predictability makes us less anxious.


Curfew at 11:00 for the kids.  
Morning coffee ready at 6:00 a.m. 
I’ll throw in a load of laundry if you mow the lawn. 


Must we discuss this? 

Rules take out the mystery out of life, and everyone gets to where they want to go on time.

No rules, no set objectives, less consensus no end to conflict about the way things should be. Add one extra person to a decision making process, spend hours in committee. (There is an old saying: three Jews, five opinions.)

So we work hard to make life systematic, predictable and organized. Some may grumble about it and do their own thing, and they will find like-minded others (with whom they will ultimately argue about other things, assuming their relationships are healthy). We strive, however, for a social contract full of the promises that make life sweet, a little easier to handle.  More predictable.

Or  choose to live alone.  No arguments. It is pretty hard to live life all by yourself, but you can see why people do.

It isn’t the overt rules that really get to us, so much as the covert ones, those unspoken social expectations. When we can't read people's needs it seems we're lacking in manners. But even when we do know the covert rules, meeting the expectations of others can be difficult, if not impossible.  For example we might know that at a cocktail party we should socialize, converse. If we don't, people think we're snobby.  But that's very hard for some of us.

The social lubricant of alcohol helps grease those wheels. Alcohol is even referred to as liquid courage, and is on the menu to ensure everyone is more likely to be socially lubed up. This is ironic because some of us, finally disinhibited with the help of drink, are likely to make socially unacceptable, insensitive remarks, even behave offensively, perhaps remove clothing that should stay on, or consider boxing a social sport.

Those on the autism-Asperger’s spectrum have difficulty with social cues, don't interpret body language well, nor twists of vernacular. Shipwrecked in public, no idea what to say, unable to read people, not knowing why people do what they do, they must learn to respond appropriately, to validate, repeat back what is said to them to stay on topic.

But even when they do, they still suffer a seemingly irreparable empathy deficit. Even when coached by therapists (Ask questions! Don’t talk about yourself!) they are likely to act and to feel stiff and awkward, or talk too much.

Whether (1) suffering from a disorder on the spectrum; (2) gifted with empathy but socially phobic;  or (3) embarrassed or impaired by any number of the mental/behavioral disorders, some prefer to hide in a proverbial shell, if not an unoccupied bedroom or bathroom. Understanding that the social ideal is to be schmoozing (Yiddish, rhymes with losing, means gabbing away) this can feel beyond challenging.

As a society, we're beginning to recognize that the social skill we value is not within everyone's reach.  Reading about the lives of people who survived their social issues, i.e, Look Me in the Eye by John Elder Robison, and Quiet: the Power of Introverts by Susan Cain (I haven't read that one, but it sounds marvelous) is helping. The psycho-educated are more prone to compassion, less judgmental, even those of us who like rules, who live by them.

The idea is to give the socially less smooth the benefit of the doubt. Most people need tolerance, love and friendship, and it is good for the rest of us, if we can, to provide.

The good kids, the ones who play with the kids who aren’t fitting in? They should get prizes.

The trend-- that we become aware of our differences, and forgiving, for we are so similar-- is going to continue. The ecosystem, the big one we call society, will somehow collectively worry less about conforming and raising SAT scores, more about raising psychological and emotional IQ’s, the understanding of those  differences, the importance of making fewer negative assumptions about others.

We might consider this kind of education, which is everywhere, in books, on television, on the Internet, if not so much in schools, the therapy of an entire society. The object of change--everyone.  

The dream systems intervention.

therapydoc

Thursday, May 03, 2012

Independent to a Fault

I wrote this on Sunday, July 2, 2006. But I don't think I ever posted it, and on the reread think that it is probably a good pre-Mother's Day post. None of the concepts are new, old time readers have heard them all before. But maybe not the therapeutic suggestion at the end. I'm pretty sure that's new.

A person grows up in a home with sick parents, people who couldn’t attend to his emotional or physical needs. Or a family in which a sibling is sick and needs constant attention. The “healthy” child takes care of himself, makes his own lunch, does laundry—helps out his family the best he knows how. It can go the other way, of course, he might act out to get attention, cut school to go out for donuts.

But if he doesn’t, if he merely tries to make do, keeps hope alive, he might find that he tends not to ask for help. He is used to taking care of himself. Asking for help feels presumptuous, an imposition. He is capable, others are not. Asking for help has been beaten out of him. The answer, clearly, is no. And even if it were yes, it feels selfish to ask.

An independent-to-a-fault child might have watched as one of his two parents nurtured that less-than-healthy child or spouse. Someone else is nurtured, not him. Nurturing is modeled, so reluctance to nurture feels wrong. This wonderful person feels guilty saying to anyone, “No, I don’t really have time to . . . “ Some would surely label him co-dependent, an interesting label for someone who has worked to be independent all his life.

In other families, children are free of responsibility, their parents tend to their needs, quiz them on spelling tests. Children ask parents for help and hear, “Be right there!” and the parent materializes. A certain envy ensues, but acceptance, too. This will never be my life.

For our hero, asking for help is adding to the burden of an already over-taxed family system. He learns the opposite lesson, Take care of yourself; don’t ask for help; you can do this. A cognitive-behavioral therapist, seeking a core belief, might find that deep down this now adult child feels unlovable, believes the only reason people love him is that he is useful, a big help to have around.

His world view, a family world view, is that it is best to be a helper in life. Everyone likes someone who helps out, who seeks nothing in return. The cooperative, socially functional world view, a social contract that implies trust, I’ll scratch your back, you scratch mine, is anathema. He doesn’t really feel worth it, asking for a back scratch, stealing another person’s time. There are others more worthy, needier than he.

Independent to a fault, someone will love him, who wouldn't? But he will be difficult to love. He doesn’t understand that the gift is in the giving, and others need to give just as much as he. He won’t accept help, isn’t fond of gifts. Partners, children, find this annoying in a spouse, a parent. They want to give, too, and he denies them the pleasure. It feels good, making other people happy.

Treatment is behavioral, naturally. We suggest tennis*.

therapydoc

*If you don't play tennis, here's how the game goes. Usually, if you play on public tennis courts, there are several courts side by side. If you aren't the best tennis player, or even if you are, you will naturally hit the ball in a such a way that it lands on another court. You have to wait until the players on that court err in play and stop play for a moment. Then you ask, "A little help please?" This is universal tennis language and people who play tennis don't resent chasing down your ball and throwing it back to you. Or they shouldn't.