Tuesday, April 26, 2016

Trainwreck

I'm just a kid, maybe 18, working a clerical summer job at a bank, in a department that, unless you are a finance major, feels opaque, like one big secret. But my job is easy, attaching labels for certified mail, filing documents. This is the pre-computer age, everything is on paper. 

The entire department is female, except for the vice president, an older, sagging man in a pin-striped suit, long, white mustache. A skirt-chaser. He has a separate office, Mad Men style. The women are in desks lined close together, forming a grid, front of the room to the back. No cubicles. The lights are fluorescent, pens click, papers shuffle. 

The woman to my left is in her mid-forties, Greek. She takes a motherly role, shows me what to do, asks about my college plans, my boyfriend. 

"Oh, I don't have one, but yes, I'll go to college in September." 

She's surprised about the boyfriend part, and from here on in talks about the boyfriend I will have, and eventually marry, not too soon, not too late, and the children, and the house, and the job. She is, in retrospect, dead on.

The supervisor on the floor, our supervisor, is a stern woman, tall and sallow, pock-marked, but neatly put together and I can see that she is beautiful, in her way, as we all are, beneath her frown. On Monday mornings, before she comes in, always a half hour late, the entire room is buzzing, wondering what mood to expect, bracing for the worst. She will, undoubtedly, be hung over. 

It isn't something that I can see, as she makes her royal entrance, red scarf loose across her neck; short-handled, oblong ecru purse at her side. Her desk is in the corner of the back row, the rest of us face front. It is my first experience with an entire system openly managing the effects of alcohol, and I am fascinated.

To this day, with all I know. Anyway, I wrote that, for what it's worth.

Sometimes a patient walks into the office and I scent the lingering scent, see it in the eyes, in the face, in the color, a toxic look, and I nod, smile softly. "Talk to me." It is rarely about the alcohol, or the over-use, more likely about the social problems that this is inevitably causing, either with a child or a spouse, a co-worker. And we talk, once more, about the early years, before drinking became a  rote thing, and how these early, cliche experiences entered into the equation, and whether or not all of life, from there on in, must be determined from that, or do we have free will. Are we in charge of our destinies, in charge of anything, for that matter?

Some days it feels like yes, some no.

Sunday night ended two days of eating and attempts at drinking (on Passover we're supposed to drink four cups of wine over a five hour ceremonial meal; most of us dilute them by the second, massively.) The first days behind me, I check to see if the Cubs have won, and if there might be anything decent on TV. Amy Schumer's Trainwreck pops up on the menu guide as I check my phone.
Bill Hader- unlikely romeo

Cubs 9, Reds 0.. And yes, that is irrelevant, but when your baseball team is scoring touchdowns, you brag.

And of course, Trainwreck has me in the first scene, a parent sits his two daughters down on the hood of their car, one about seven, the other four, to tell them that he is getting a divorce, that marriage is obsolete. Why be stuck with only one doll, forever and ever, when there are so many, many, many other dolls to play with? He goes on and on until Amy and her sister Kim (Brie Larson) get the idea, but only one of the two thinks he's onto something.

Despite the nudity and the raunch (fast forward if that feels like the right thing to do) all else is charming. With a subplot lifted from The Devil Wears Prada, we're drawn in against our will to the versatile Bill Hader as Aaron, the saintly altruist, a Doctors without Borders hero and pro team physician.

Marissa Tomei makes a cameo appearance in a movie within the movie, reminding me, off topic here, of her argument with Joe Pesci in My Cousin Vinnie, a teaching moment if ever there was one, on productive couple conflict resolution, the argument about the faucet dripping in bathroom, if memory serves.

But back to Trainwreck.  Affable professional basketball players are the voices in the ears of relationship-hapless Aaron, and they play themselves, LeBron James and Amar'e Stoudemire. A lovable homeless guy supports Amy, knows she's alcoholic, like he is, and that she's a woman without borders, in her way.
Amy with the homeless guy
Here come the big spoilers, so stop reading if you haven't seen Trainwreck.
Amy Schumer with her father in Trainwrec

Gordon, Amy's father (Colin Quinn), is suffering in a nursing home from MS. Amy is warned, by a nurse, that he's hoarding his medication. He may be older, and male, but the father-daughter team share the same irascible world views. She's so like him, promiscuous, alcoholic, a person who fails others, as alcoholics do, when needed.

She doesn't act on the information that he's hoarding, and he completes the job. She's done nothing with the  tip-off, has not got it together to save her father. Life gets busy. Phones go off. Whatever.

We see, from this story, that behavior is reinforced, be it genetic or learned, when parents teach by example, that we have permission to be an alcoholic, permission to be the person who fails to come through, fails to help when needed, if our parents behaved in the same ways.

And certainly, alcohol enters into that equation, the choice to drink at the most inopportune moments, will bring us down.

No surprise to formula, Amy hits bottom, makes new choices.

Throughout, in every moment, Ms. Schumer is hilarious, her timing perfect, her deadpan delivery, so smart, that maybe it is worth the fast-forward, at least to some of us with more conservative, older sensibilities about what should be shown on screen. What Trainwreck illustrates is exactly how a good crash, a therapeutic, critical moment, comes about. "Bottom" is about loss, losing people you love, losing your livelihood, and most poignantly, losing your dignity and self-respect, to alcoholism.

My god how we try want to stop the ones we love from losing all of those things.

It is the kind of thing, we suggest to that patient, the one who is drinking with no intention of ever giving it up, who thinks he or she is in charge, that is likely to happen, the bad result. There's no such thing as a functioning alcoholic. Functioning is only functioning until it isn't. And it likely won't end, the recovery from loss, like it does in the movies.

therapydoc



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.

therapydoc