Tuesday, April 12, 2016

Snapshots: Spring Forward

(1) The Chinese Laundry 
It's Curtains

I kept looking at my draperies and thinking, just cut them. As in, I should cut them. They are ceiling to floor, and the window is only 56 inches high, so maybe a fresh look will do me good.

But not having a sewing machine, and suffering from poor hand-eye coordination, I ask FD to bring them down to our local laundress. She's generally good with repairs, so this should be something she'll manage fairly easily.

She calls me with an estimate, then assigns the job to someone else.

Within a few days, FD fetches the drapes. He brings home four hangers, two with draperies, two with the left over material.

"You're not going to like it," he says. "The guy who did the job ironed one curtain, then one of the scraps."

"Not gonna' fly," says I. "I'll bring it back tomorrow."

"Don't bother them," he advises. "They seem busy. I'll iron it."

Not wanting to put him out, I tell him I'll just hang the drapes and see.

So that's what happens, and frankly, one drape doesn't look much better than the other, and life gets in the way, so the draperies stay put, cover the window for about a week. Whenever I look at them, they annoy me.

Then yesterday, I notice a skirt in the trunk of the car. It was supposed to have been dropped off at the cleaners weeks ago. On my way home from work I make the stop, mention the drapes.

My laundress laughs and says, "I told him I would do it, iron the other one, but he says, no, you want them, like yesterday, not to worry about it. Just bring them in tomorrow, and of course I'll do it!"

"But both drapes need an iron, not just one."

She reassures me, "Just bring them to me."

And I'm quite sure that is the end of the story.

The lesson, in case you're wondering, is not If you want something done right, you should do it yourself.  Far from it.  The lesson is that when you're paying decent money for someone to do a job, and you don't like it, open your mouth. Maybe you'll get results, maybe not, but this one falls under. . .

Assertiveness training 101.

(2) Labeling Ourselves

The man is facing me for the first time, describing himself using DSM 5 language. The DSM is the American Psychiatric Association's diagnostic bible. Anyone can buy one, but the book is pricey. The DSM is a sliver, a subset of the ICD 10, the International Classification of Diseases, a much bigger volume that describes the global medical community's accepted medical disorders.

Everything psychological is also physical.

I ask the patient, "Did a doctor or a mental health professional tell you that you have . . .?"

"No, I looked it up."

This is common. The patient comes in with a diagnosis, and the diagnosis is the excuse, the reason for getting help. It is as if without one there is no real need for therapy. But with one, well, now we can get working on this thing that defines me.

But therapists know better, for so many people we see come for help because it is someone else who is making them sick, or made them sick. Maybe a parent or a spouse, a child, a colleague, employer, lover or peer.

Just yesterday, after dedicating a stone at the cemetery, a cousin and I sat at a table discussing our families of origin, and how they had contributed, massively, to our angst during adolescence. As we got closer to how our personalities had been affected, others at the gathering interrupted us to say goodbye. We shook our heads, smiled, and shrugged, knowing it would be impossible in this crowd to continue such an intimate discussion. We'll talk, our parting words.

It is therapeutic, at any age, to talk about these things. But diagnosing everyone? Is that necessary?

Well, diagnoses provide structure and a vague sense of stability, like a pole or a strap to hang onto when you're standing on a moving train. And now, in the information age, thanks to the pervasiveness of diagnostic criterion on the Internet, and the marketability of these topics on websites, television, and the news, people are coming to therapy, handing their therapists their diagnoses.

It is uncanny how often they are right!  They've diagnosed their parents, siblings, grandparents, everyone. They've caught onto genetic predispositions and heritability, even understand system dynamics, albeit roughly, and many are quite young.

And as much as I can go on and on (and will one day) about how thinking of ourselves and others as this one big thing, this diagnosis, boxing people in, as much as I rant that labeling, especially labeling for life, diminishes, limits, has the potential to stifle growth, it is an obsession, so we have to talk about it. And for good reason, the implications for the long-term, among them, and the treatment ramifications.

So it is good that we can talk about them, these buckets we're in. Good therapists applaud the help-seeking effort, especially young people for their  bravery. We lavish praise with the certainty that because they have caught the virus (young is even better), managing it will become easier. Change might become so habit forming over time, so much so that the once disabled, panic stricken, disorder-labeled self will stop to wonder: Did I even have it, this thing I took on as my identity?

It happens.



Kaasmuis said...

the diagnosis, the label (if there is one) helps to accept the ''problem''. It may feel like a set back at first, but in the end it helps with the acceptance of our uniqueness... maybe this isn't correct but it's how I experience it. I hate boxes and labels but they've helped me in accepting myself and life...

Kaasmuis said...

and with acceptance comes progress

therapydoc said...

I'm with you on all that, K. Especially the progress part which can be so so hard. But it is for everyone, which should have been my point, come to think of it. Nobody's perfect.

Steven Bruce said...

Really a interesting article having much needed tips and idea...

physical therapy

clairesmum said...

I wonder if it is easier to accept a diagnosis if you as the patient felt like an equal partner (or at least a valued participant) in the process. A diagnosis that is developed from a series of seemingly random and/or intrusive questions from a relative stranger can be quite hard to accept. Diagnosis can be a helpful framework in identifying what is not working well, but when without an equal assessment of and identification of a patient's strengths, a diagnosis can become a box with no hope of escape or change. Never take away hope. Like many tools, use of diagnosis can be used for help or harm. With electronic records, I do worry about how a diagnosis may be interpreted by others, who may or may not be capable of confidentiality and a nonjudgemental attitude.

therapydoc said...

So many good points on this one. I agree on everything. And the whole idea of putting a person's record in a cloud with their name and birthday, dx, really bothers me. i'll try to address the latter in a post coming up.

Better Things-- Seeing Ghosts