Thursday, May 26, 2016

1001 Ways to Live Wild

So you could have written that last post, maybe. It didn't take long. But neither of us, asked to pad the list of Eight Reasons We Overbook to 1001 Reasons We Overbook, could have made it happen. 

Who writes a list of 1001 items?

Barbara Ann Kipfer. She has a few books of lists, like 14,000 Things to Be Happy About, and 4000 Questions for Getting to Know Anyone and Everyone. She sent me the lovely little hard-covered work,  1001 Ways to Live Wild  via her publicist, published by National Geographic, which is where the truly wild things are, within those pages.

Otherwise Barbara's suggestions might have turned out to be a bit too soppy, sweet, a just do it book, rather than something truly imaginative. The book is full of tiny risk-taking strategies (although few are terribly risky) to take us out of our comfort zones, and it's good to get out of there once in awhile. We call it good stress.
Barbara Ann Kipfer quotes
Barbara Ann Kipfer quotes
Barbara Ann Kipfer quotes


I'd have to think twice, however, about recommending this list to certain patients, people who have zero get up and go, no emotional/physical energy. We would have to wait for the recovery stage, otherwise the disorder would sabotage the therapy. Therapy should sabotage a disorder, but it can work the other way around if you recommend an intervention at the wrong time. And you look inexperienced, naive.

It is not for the agoraphobic, either, until there's a possibility of getting out to a museum, or taking a walk. Without some initial help, maybe a lot, most people who can't leave the house aren't likely to hop a plane and go to Scotland. 

This is my coffee table, the place for the best books.
Therapydoc's coffee table

The list nicely satiates the topic, if you're a qualitative research person, loving that kind of thing, and reflects the author's interest in nature, geography, art, music, travel, meditation, and karma.

It is filled with joy and adventure, and if you can get some serotonin going, it can't hurt to work a few of the behavioral strategies. Take them with a good attitude and they're likely to feel pretty good. But some of them are costly, and it is presumptive to think that just anyone can travel.

Dr. Kipfer has a PhD's in linguistics, archaeology, and Buddhist studies, and reminds us that being wild can feel good, and some of our wildest moments are at our fingertips. We don't have to go to Tibet.

But consider
No. 326. Plan a trip to see as much as possible of the Colorado Trail's eight mountain ranges, six national forests, and six wilderness areas.
And if that is impossible, let me add, watch River Monsters, on Animal Planet, maybe How to Catch a Halibut. You might win a free fishing lesson, too, if you go to the website. That should wake you up.

therapydoc

Wednesday, May 25, 2016

8 Reasons We Overbook

I don't mean double book. Just packing too much in one day.

The day after promising to post daily for a week or more, my schedule is ridiculous and I think, How will I fit this in?

How does this happen? Why?

You take on new patients, that's how. And if it is a marital therapy, you probably want to see them twice that first week, not once. Maybe three times. That's how some of us do it. How one of us does it.

But it isn't only therapists who can't resist adding more to an already full workload.

Let's take a look at the reasons we over-schedule, take on more than we probably should.
Feel free to add thoughts. This is a short-list.

Why We Overdo It 

1. We can't say No.

So many reasons we can't say no.

fear of rejection,
fear someone will be angry with us,
fear we won't be included next time, will be left out,
wanting to be the go-to person
for starts.
Some see it as a weakness, call it co-dependent, others admire such strong emotional attachment.
Where would we be without people who can't say no?

2. There's an ethnic, and quintessential American world view, that it is good to get things done, to accomplish a lot.  The idle mind is the devil's playground, you know.

The thinking is that this is what being alive is all about, doing things, helping other people, providing for ourselves and our families, even having fun, or not having fun, but contributing to a community.

We burn out sometimes, we get grumpy, but it is back to it the next day, dysfunctional though it might be when the stress is too much and the spouse or kids get the brunt of it. That's a sign, you know, that the world view needs to change.

3. We LIKE being busy

There's a certain energy level that some people just have, and it has to go somewhere. We can work on subduing that, or we can go jogging, fly a kite, compulsively do dishes or clean the baseboards, whatever those are.

4. We need the money.

There's not much money in doing nothing, so most of us try to work, and get the most for the effort. Adding an extra shift, an extra patient, a second, third, or fourth part-time job, makes financial sense most of the time, pays down the credit card. It isn't greed. It is necessity.

But it can be greed. Either way, workaholics seem to think they need it.

5. We can avoid intimacy 

Too busy, too tired, both valid, great excuses. (Workaholics are often accused of this, but it isn't just people who work all of the time that we're talking about, but those of us who always have something to do, anything but take the proverbial "nap."

That's when it's about avoiding intimacy.

Part of being busy, if busy is to be functional, is fitting in time to have our needs for intimacy met, and the needs of our partners, regardless of our schedules.

There's are other posts on this blog about intimacy avoidance, check them out.  But it could be as simple as an aquarium emergency. You can't let your fish die, you know.

6. We're just getting started in this world, learning how to live

Doing is becoming, growing, adding to who we are. I'm a person who . . .
We're who we were yesterday, and today we're that person (unless we don't want to be) who identifies with a new skill, a new activity. This builds identity.

As young people we're not all encouraged to garden, or even pull weeds in the yard, for example, or to learn instruments, or learn any other hobby, thing that calls to us, makes us want to get off our duffs and do.  But then, as adults some of us get a defining moment, and suddenly, the thought of playing piano, or taking singing lessons, even going back to school or working part-time is inspiring, irresistible.

Because at any age, if we look at it right, we're just getting started.

7. There's less focus in aging

As we age, some of us find our minds wandering, wanting to do more, not less. Maybe it is because we realize we don't have that much time left, but the brain is certainly on the move. The body wants to slow down, but the mind says No. (We're ruling out a manic episode, but it feels that way.)

Work that once satisfied isn't enough, it is boring but it pays the bills, so presented with an option, for example, of saying yes to becoming, say, a member of the board, or taking on a speaking engagement, or even coaching T-ball, we say YES.
Even if, at the end of the day, we would rather eat and watch TV.

8. Multi-tasking can become addictive, especially for feel-good tasks

Some of us are gifted with the ability to multi-task, need to multitask, will plan another task even as we're busy doing something else. Some of us can do two to three things at once.

We can be at a Little League game and listen to a MLB (Major League Baseball) on our phones, and we see nothing weird about this at all. Or go to a meeting and surreptitiously check the scores. It is the pleasure principal. We do what feels good.

Take that thought, or any of the others above, add your own, and before long, you're over-booked.

Not that you don't like it that way.

So yeah, adding too many patients to the day could be due to anything. But some of us, if we commit to something, will probably get it done, manage to get everything done,  too, if not perfectly.

It is why they say:
If you want something done, give it to a busy person.
And the crazy thing is, these people don't even pat themselves on the back.

Now. Why is it that some people don't overdo it, or don't even try to accomplish very much?

It isn't, despite what your momma and papa told you, about being lazy.

therapydoc

Tuesday, May 24, 2016

The 10th Anniversary

Unbelievable that this blog has stayed alive 10 years. I've had fish that haven't lasted that long. But in all fairness, marine fish are a little on the vulnerable side. They do best when they've listened to Brene Brown's  TED Talk, The Power of Vulnerability.

Not that I haven't always encouraged them to express themselves, to be authentic, above all.
Watchman Gobi, a little nervous

The blog, for all its longevity, suffers from Attention Deficit Disorder. I've tested it, and it is obvious that it rarely stays on one topic for longer than a day. We jump all over the place in this spot, from birth to death, order to disorder, to food, hobbies, conferences air travel, anywhere this anonymous blogger has traveled to lately, and always, always, we discuss relationships of all kinds.

It can be a chore though.  So why not experiment for a week, maybe two, assuming the experimenter can go that long. We're going to try to beat the ADD.

A snapshot a day for two weeks, not counting Saturday and Sunday. You can use those days to catch watch some baseball.

If you subscribe to this blog by email, your mailbox will be glutted, so feel free, delete right away. You know how to find this place.

But don't unsubscribe. Because the chances are excellent that I'll quit and go back to writing once or twice a month. ,

Anyway, this is the lineup for the next few hopefully short posts:

Insanity in High School, (because it used to be college, see, now it is high school)
1000 Ways to Live Wild, (it's a book)
a peak at psychologist-starring television shows like IN TREATMENT and The Bob Newhart Show,
Chuck Lorre's Vanity Cards,
and Transgenerational Addiction, brought to life by the television show MOM.

Can this be done?

Probably not.

Talk to you tomorrow.

therapydoc






Sunday, May 08, 2016

Snapshots: Mothers Day

Is it, Mothers Day, or Mother's Day?

(1) Gold-Cross

Anyone who has ever been to therapy, or who is psychologically astute, understands that emotional states can be triggered by holidays, by birthdays, and anniversaries.

It is because we're encouraged to remember these days, and the very mention of the date on the calendar, signals brain retrieval, all that is associated with that date, whatever is within reach. So on your brother's birthday, if you forgot it before, you'll remember it when you write a check with that date. The anniversary of your first marriage will give you pause.
Heinrich Bavarian Gold-Cross crystal, right, 

And marketing is ubiquitous. The approach of Mother's Day is a harbinger to remember Mom. Buy her something. What if it were just a day of remembrance, the living and those who are gone, no buying anyone anything, or even, having to remember to give cards?

Things from boxes, put them in the dishwasher right away
I don’t remember last year, or the year before, but Mother’s Day crept up on me last week, and it hasn’t really let go. This will be the third since mine passed away, and everything reminds me of her, as if it were the first year. 

In the first year following her death, no matter what anyone said, no matter what I saw on TV, or what was in the news, or what anyone told me at work or anywhere else, it reminded me of her. 

This year, in April, with a little time off, I ventured into the basement and opened boxes, wondered where I should put those things inside, who should get what, who would appreciate the possessions she chose to buy, that she held in her hands. Who would use them? 

It didn't even occur to me, in those moments, that in a few weeks television ads would glut our personal space with reminders that we should buy presents, or give presents to other moms, maybe a daughter-in-law, an aunt, a daughter, a friend. It was as much as I could do, open boxes, and all of it, unconscious.

She had Bavarian gold-cross china, with a simple black and gold-cross rim pattern, elegant, not ungapatched (sounds like oohn, gah, patcht, Yiddish, means busy, cluttered, overly ornate, not her). 

A woman grows up, as she would say, poor as a church mouse, works with her husband in their family retail china, silverware, and crystal business, surrounded with beautiful things every day on the job. She can get anything she wants wholesale or at cost, and chooses not Wedgewood, not Royal Doulton, not Lenox or Oxford, but a simple, elegant German pattern. 

In the hospital she mentions it, Who will get my china when I die, my good china, the gold-cross? A nurse hears her and says, If no one else wants it, I'll take it.  

Yeah, right.

(2) Being Angry on Mother's Day

I hosted a little family luncheon on Saturday, and my grandchildren seemed more interested in the adult chatter than usual. When you host you are a few degrees of separation apart from the conversation, so you watch more than listen, and it surprised me, as it always does, how tall my mother's great-grandsons had grown. My father would have been proud of their looks, and certainly their height, but my mother would have loved their solicitousness, the way they tend to hover around older people, not to help, truth be told, but to see what we have to offer.  It isn't only the cookies in the cookie jar my grandsons are into, but advice on things, mostly hobbies. I have an indoor garden. FD likes to fish. I have a marine aquarium. Kids are fascinated about such things.

They would have loved their great-grandmother, my mom, I tell them, both of my parents. Their memories of them have surely faded by now, mostly visits in a stroller to the senior residence, finding processed chocolate pudding in the refrigerator, making a mess, as pre-kindergarteners will do, Mom telling me, It's fine, don't worry about it, I'll clean up later. This, my obsessive compulsive mother.

Thinking about their loss, and hers, my eyes narrow with anger that she isn't with us, isn't at the table.

Returning to the group from the kitchen, I sit down, remark, thinking no one hears me, I wish there were no Mother's Day. I wish nobody had invented it.

Surprise, almost everyone does hear it.

And they ask, a little shocked, Why?

And I say, It just makes me so angry that she missed all of this, missed your successes and frustrations (she would have listened), missed seeing two of of her grandchildren marry beautiful people, missed watching the great-grandchildren grow out of babydom

Then my daughter says, If I ever have a girl, I'll name her ____. (My mother's name).

And a son: Oh, man. I miss her, too.

Then somehow we launch into the topic of meat, and how she had a way with food, never over or under-cooking it, and I tell them that when she and my father would come home from work late, 6-6:30, I was the one who had cooked for them, and I couldn't have been older than fourteen, which sounded right to me, until I looked at my almost fourteen year-old grandson and pictured him manning the broiler.

And the anger passed, for awhile.

But you know what it's like.

Happy Mother's Day, friends.

therapydoc

Waterford-crystal: perhaps not so simple 





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


Thursday, March 24, 2016

High Functioning Autism, Ethnic Jokes, and Purim

Ordinarily I wouldn't get started on this, knowing that it is likely to upset at least one reader. But because some of you will propose theses for doctorates and masters degrees, it feels like the right thing to do, open up a topic for further study. Also, this is Purim Torah. And despite what's going on in the world, I'm in a better mood.

Purim isn't the topic for further study, not unless you're Jewish and like studying up on stories from days of old. But the story is about genocide, which is related to racism, and racism affects our mental health because (a) it hurts and provides people with excuses (bad ones) to kill, and (b) racists sometimes tell bad jokes.

Purim is one of those, the joke's on you, holidays. The story is a tale of monumental reversal, salvation, victory, fasting, love, sexual exploitation, and plots inside the kingdom. We're talking Persia, 369 BCE.

Briefly: The Persians beat the Babylonians, and Jews exiled from Jerusalem by the Babylonians wound up there. The king, Achashverosh, has done away with his wife Vashti because she wouldn't dance naked for his friends at a feast. These feasts go on for days and days, and people get wildly drunk They expect to be entertained.

Having banished Vashti from the kingdom, Achashverosh orders that all the beautiful virgins in the country come to the palace to interview for the job, queen.

Esther, a Jewish orphan, adopted and raised by her older cousin Mordechai, becomes the king's top pick. The king loves Esther dearly. He has no idea she is Jewish.

An officer of his court, Haman, is a huge anti-Semite. Haman is narcissistically injured (angry) at Mordechai who refuses to bow down to him at the palace gate. (Jews only bow to God, or sometimes to marshal arts teachers to be polite). Haman has made it in politics, has influence with the king. He requests the annihilation of the Jews, ostensibly because they follow a different set of rules. Achashverosh, a simple guy who just wants to feast, can't see why not. Differences between people are threatening. He signs off to the execution of the Jewish people.

Mordechai gets word to Esther that she has to stop the edict, must intervene somehow. She's not so quick to accept the mission. The king will put to death anyone who visits him without an invitation, and she has not been invited in 30 days. Mordechai tells Esther that if she does not take the initiative, then salvation for the Jewish people will come from somewhere else. She steps up.

An aside to therapists: When working with patients who feel hopeless about their lives, who cannot see a way out, not a single possibility, yet have some faith in God, you can use the following line from the story, even tell an abridged version of the story. Try to say it in Hebrew, because it makes an impression, lends authenticity. The transliteration is in the picture to the right:

The (salvation) solution will come from someplace else, is beyond what you might expect or are looking for.

Solutions come in two dresses, either creative thinking, or seemingly random events.
it isn't our call

But back to the story: The Jews pray and fast for three days, hoping to curry God's favor. Esther gets her audience with the king, liquors him up and outs Haman as a bad man with murderous intentions. The king is outraged and reverses the decree. He hangs Haman and his sons, and permits the Jews to kill their enemies within his kingdom (it is a huge kingdom). They take no spoils, but declare another holiday, a good reason to knock off work early.

It is an eating and drinking holiday, but before any feasting, there is running around town with gifts of food and charity. Kids dress up as kings and queens, and the story is read from a scroll. A younger adult generation entertains with a video, kids who should have gone into film making, not medicine or law, roasting the rabbi and almost everyone else.

Why bring up Purim? It is a lesson that with the stroke of a pen, kings and potentates can order the end of life. It starts with advisers, meetings, influence, maybe someone whose ego couldn't take a hit. Such attitudes are passed down in families and communities, but mostly, families. We trust our parents.

There is a connection to high functioning autism.

Once I saw a man with high functioning autism (or I made him up for this post). We called it Apsergers Disorder until the DSM did away with Aspergers in 2013. The man, like his father, put people into racial and ethnic categories. The Blacks. The Mexicans. The Polacks, The Asians, The Obese. Everyone had a box, and the man, like his father, couldn't describe anything that a person might do or say without first putting the person into the box.

He's a nice doctor for a Jewish guy.

Why does he have to take seconds. Look at him!

At first I thought it a racist thing, then realized he had indeed learned it from his father. But more than that, he honestly didn't see anything wrong with it. He thought it was great that he could do this, organize people, understand them by labeling them. He didn't see the labels as gross generalizations, ridiculous simplifications, or that 99% of our DNA is the same.

(Once I went to China and said something about the Chinese, thinking my experience mattered. FD said, "You really can't generalize about 1.5 billion people.")

When I got to know the patient better, I realized that for him, everything had to go into a box. He had to organize somehow. Having high functioning autism, unable to empathize, he also didn't know he had the disorder. As often happens with such patients, he came to therapy for his wife, who had issues with him and his social/marital insensitivity.

He and his father had made an ethnic or physical trait category into a social cue. Labeling people appealed to his obsessive compulsiveness, helped him gain some control in a world of humans who otherwise mystified him.

Moral of the story: When you have a patient who sees nothing wrong with telling ethnic or racist or very insensitive joke, it is a sign that he might have a disorder, such as high functioning autism. He may not mean any harm. You'll know if he is completely confused by your efforts at correction.

Now, Haman? A total racist, calling for the annihilation of a people he didn't respect, hated for their differences, their values. Today he might be put in jail for conspiracy to commit a genocidal (terrorist) act, duping an innocent king on the sauce. And he would see a therapist, undoubtedly, to work on his narcissism  and sociopathy.

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