The Tricks of Sociopathy

There is a how-to. Genetics aren't everything.

Book burning, Nazi Germany, 1933

               I have to preface this by saying that I can only speak from then lens of my own culture, not teach (well) about anyone else’s. Although I would like to say that I could write from the perspective of someone who lived in Japan, or France, or Iraq, it would be warmed over, the experience of another.  So here’s what you get when you read from the perspective of a Jew.

               When some of us mention Hitler we add the words, y’mach sh’mo (sounds-like, rhymes-with y’locked-sh’go), meaning, His name should be obliterated from the face of the earth.  On Tuesday some of your Jewish friends or co-workers might have looked ashen and tired, fasting (yet going to work, which isn't encouraged but necessary sometimes) the fast of T’isha B’Av (sounds-like, rhymes-with mish-uh-b’-ah’v).  It is a long, grueling, 25-hour fast in the dead of summer, beginning at sundown on the eve of the ninth day of a lunar Jewish month, ending as the fires of Jerusalem had begun to wane, the next night. Three weeks before we began to show signs of mourning, the men stopped shaving. Then nine days prior observant Jews showered less, stopped wearing clean clothes (we drop them on the floor as a symbolic gesture). No meat, no music. Mourning.

               Mourning for what?  The loss of the Holy Temples, over two thousand years ago.  Not that's culture.  Every year, same thing.  Jews have other fasts, there are seven in all, but usually, if we get up before dawn and have a bite, they aren't as difficult, and none are as emotionally trying as T’isha B’Av. We had two of these holy places. The Babylonians, then the Romans, destroyed them both, built on the site that Abraham was asked to sacrifice his only son, where a mosque sits at this moment in Jerusalem.  The Jews, lost in battle for the city, were sent packing from Jerusalem, exiled.  Something like the Native-American experience for the likes of Tonto.  

               Now.  A proper fast, for an observant Jew, barring pregnancy or illness (which leaves out quite a few of us) means no water (zero, not even rain), and no food, not even a stick of gum.  No teeth brushing. Not a pretty day, Tisha B’av, between the dirty clothes, the bad breath, the sweat and a little starvation. The point of the fast, surely, to draw attention from the Old Mighty, She should notice we’re serious about redemption and hope for the universe.  No one should suffer, not even Her favorite scapegoat, the Jews.

               The other point, one more in line with therapy, is that we learn empathy. We are in the shoes of a Holocaust survivor, in the shoes of a Holocaust victim, in the shoes of a Ruwandan, an Indian, any indigent who suffers, starves, struggles daily.  One would think that this is empathy, but we learn, if we watch the documentary Imaginary Witness: Hollywood and the Holocaust   that our fast is a very weak approximation of the true horror, the true suffering of one who experienced the Holocaust. Nothing, nothing, nothing compares to this horror.

               Indeed, when Hollywood first took on the task of bringing the Holocaust into the homes of the international media-loving public, it was with trepidation.  The directors and producers of the time trembled at the thought of diluting the experience. Because, after all, to manipulate emotion, to capture our souls, a good film has an arc, and that arc is designed to be watchable, with a beginning, a middle, and an end, preferably a happy ending.

               Like dentistry or any surgery without anesthesia, there is no way to adequately convey the experience unless we have been through it.  And most who went through the Holocaust did not live to talk about it, and those who did were speechless for many years.  No words.

               The story, however, had to be told. So it began with brave attempts, The Mortal Storm, Charlie Chaplan’s The Little Dictator, Judgment at Nuremberg (the movie within the movie) and gradually culminated with War and Remembrance, very vivid, the Pawnbroker, Sophie's Choice, The Producers, Cabaret, and a first a television series, airing soon after Roots, The Holocaust.  That film-- four days in a row of nail-biting--captured one of every two Americans, had us glued to our television sets, a generation of teenagers, at once, newly aware of the Jewish experience in Germany. Then Schindler’s List, and ever since, more Holocaust films and documentaries than ever before, many so new that we can’t even get them on Netflix or Amazon-- each an amazing, sobering snap of life that none of us should miss, not if we wish to empathize with the most devastating experiences known to man.

               Therapists, certainly, need to be able to do this, empathize, if only to the degree that we can, having never been through such a thing.  

               Not to ruin your summer.  Here's a quick history lesson.* We learn empathy from history, too.  

Back in the thirteenth century, the French King, Louis IX, a religious zealot,made the Jews miserable if they didn’t convert. He would attend the baptisms of those who did this voluntarily.

When only 500 of the 3500 Jews in a town chose conversion over the alternative, death, an apostate, Nicholas Donin, came up with the idea that without their holy books, Jews were nothing.  Burn the books, destroy the culture. They will replace it.

Donin found an audience with Pope Gregory IX in Rome. He charged that the Talmud contained blasphemies against Christianity and God. The books were the power behind Jewish refusal to accept the true faith. The books needed to be confiscated, destroyed.

The Pope, convinced, ordered seizure of all copies of the Talmud and examined them. On June 12^th a stacked public debate sealed the fate. The rabbis defended the faith, but it was a foregone conclusion that 1200 plus copies of Talmud and related commentaries, all written by hand, some a thousand years old, would be lost forever.

The Jews, of course, were not.  That burning in 1242 included 24 cartloads of books. This didn't stop the people from writing about the event, or rewriting their books. All is recorded by eye-witnesses without iPhones.

By 1306, the French King Philip IV (the Fair) expelled the Jews from all of France, and in Germany, taxation, pogroms, blood libels, inspired them to leave for what was then Palestine, where they had originally been banished on Tisha B’Av, a millennium and a half before.   Rudolph I, not wishing to lose them, declared the Jews personal property and refused to let them leave. They were far too successful.

One doesn’t let a resource like this go so fast.

Then the Spanish Inquisition (Was Columbus Jewish?  Did he have to leave Spain?), the pogroms, and we didn't even talk about the previous Crusades. A people forever on the run.

Then in 1933, Hitler took note, burned classics, not just Jewish books, but any old classic that threatened the worship of Nazi ideology, books by:

 Henri Barbusse, Franz Boas, John Dos Passos, Albert Einstein, Lion Feuchtwanger, Friedrich Förster, Sigmund Freud, John Galsworthy, André Gide, Ernst Glaeser, Maxim Gorki, Werner Hegemann, Ernest Hemingway, Erich Kästner, Helen Keller, Alfred Kerr, Jack London, Emil Ludwig, Heinrich Mann, Thomas Mann, Karl Marx, Hugo Preuss, Marcel Proust, Erich Maria Remarque, Walther Rathenau, Margaret Sanger, Arthur Schnitzler, Upton Sinclair, Kurt Tucholsky, Jakob Wassermann, H.G. Wells, Theodor Wolff, EmiléZola, Arnold Zweig, and Stefan Zweig.. 

You see, you can learn some of the tricks to sociopathy, it isn't all genetic.

Not to say that Hitler hadn’t an original thought in his head.

therapydoc

*The full story can be found on p. 360, commentary to Kinah 41, the Complete Tishah B’Av service, Artscroll Series. The kinot  are lamentations, sad poems sung in a sad, sing-songy drone)..:

Outsmarting Anger

First a Story

It doesn't help that between patients this morning, my mother tells me that she's still sick.  It started Saturday, a bug, nothing terribly serious. She looked gray yesterday with make-up.

In anticipation that she might be unable to eat today, before pedaling off to the office at 8:00 a.m. I stopped by her apartment to check her pulse and drop off breakfast, lemonade and jello. That's all any of us get in our family when we have symptoms of gastroenteritis, ala FD's expertise.  It's worked for us forever.

Mom is out cold when I get there early in the morning. After all, no place to go, except maybe the ER, and she doesn't appear to need that. Four various combinations of patient family members at the office later, it is time to check on her again.

Chicago Bike Path June 2013 Spring

How do we interpret the events so far?

I'm stressed, although keeping my cool, not hurrying or riding recklessly to get to the patient.  In my town, although it is considered a biker's town (read flat), if you don't ride cautiously you won't ride for long.

And it is a beautiful day, even at noon when it is ordinarily hot and humid in July. Miraculously, yesterday's humidity is gone and there is a lovely breeze coming from the lake.  I feel that superiority only people who ride bikes can feel-- it doesn't get any better. Runners and sailors feel it, too.

Then guilt sets in for enjoying myself, and I wonder whether or not I love my mother enough.  Shouldn't I  be worried about her falling in the bathroom?

How is it that we humans can feel two very different things simultaneously, worry and happy.  Worry, I posit, is the intellectual feeling of that particular moment. Happy is more sentient, the emotional or physical feeling at the time. We don't get that many great-weather-days in Chicago, so happy overrides worried.

Most of my ride is through parkland on paved paths. Mayor Daley, before Rahm Emanuel succeeded him, made sure bike riders, power walkers, buggy pushers, toddlers on Big Wheels, and he himself, a bicycling enthusiast, could traverse several miles without stopping at a traffic light. .

But once out of the park my last city mile is all traffic, and I have to be more careful, the Sunday drivers are out. Not that there aren't bike paths on the city streets, there are, so technically there should be no problem. Blocking a bike path warrants a steep hundred and fifty dollar fine. Even more, $500 and up, $2000, rumor has it, for those who (a) don't look before they open their car doors or (b) engage in the sport of picking off bike-riders this way. We are a sports town.

So imagine my surprise (not really) that the rules are violated. The first car that blocks my way sends me into traffic, but gets a pass. A few blocks later, a Chevy driver, his elbow hanging out of the driver's window, cell phone attached to his ear, hears me assert,

"You might get a big fine parking in the bike lane."

I'm not exactly a citizen-police type, and in more sane, less stressful moment would never have done this. Blogging about it, btw, one way of working it out. Ours is something like my exchange with the dog people in the park, the ones who used to let their dogs run loose. See that ecosystem post).  The Chevy driver, as I peak at him and ride off, isn't an elegant guy. His belly is hanging over his jeans and his tee-shirt is covered in sweat. Blurting to him is a mistake, we'll see.

He sneers at me as I pass,

"Shut up." A nasty guttural tone. 

I ride off, look back as he shouts the "B" word at me.

It's a beautiful day in the neighborhood, a beautiful day in the neighborhood, won't you be mine.

The crazy thing is that I even considered turning around to explain myself, wanted to tell him that this in his best interest, respecting the law.  But now I have to worry that he may vengefully come after me, veer into my space, knock off that little old lady on her way to take care of an even older little old lady.

I worried so much that I found myself looking back to the point of disorientation, danger, and at one point hopped onto the sidewalk, yes, a violation.

What you need to know:

Outsmarting Anger- Joseph Shrand, Leigh Devine

Occasionally we talk self-help here. It can't just all be about me.  Dr. Joseph Shrand and Leigh Devine, MS, authors of the lovely little book, Outsmarting Anger, might use the story as a teaching example. They would tactfully suggest that I sublimate anger, surely a character trait that will sabotage my sanguine nature in the end.  One day I will blow up for nothing, or displace my anger toward the wrong person, someone who did nothing wrong except maybe be in the wrong place at the wrong time.

Oh! That is what happened, although we might not call my suggestion to respect the bike lane a technical blow-up.

The doctors would be right, probably. But I'm too out of touch with my anger to say.

Anger, we learn from Outsmarting Anger, is the emotion that follows a threat. A threat is someone or something that might compromise our resources, residence, or relationships.  For this lesson alone, the book is on a Number One recommendation for anger management connoisseurs, and who isn't one.

The fellow in the dirty tee, by swearing, threatened my sense of safety, and my resources (the road). I feared for my life, too, my relationship with me.  As you know, fear, an arousal emotion, is a close relative of anger. Shrand and Levine explain how the two connect.  Unconsciously or consciously we fear a potential loss based upon our sensory perception. Then we recognize (cognate) the threat in the form of the other's anger. We respond to protect ourselves in the best way we know how, in kind, with anger.

What else do the Harvard researchers tell us about anger?

Those who can't control theirs have a somewhat immature prefrontal cortex. This makes sense to me, for I've always told my addict patients the same thing, those who can't resist the impulse to use substances, eat too much, gamble, or have lots and lots of sex, little else on the brain.  In those moments of caving to the urge we use a primitive part of the brain, the one that isn't thinking, that operates on auto. Like a dog to a piece of meat.

Stop and think, is the intervention. See yourself as a homo sapien before beginning another cocaine binge. It really, really wasn't fun coming off of it the last time.  But memory for addicts is like memory to women who want to get pregnant again. Not bad the last time, was it, that labor and delivery! A walk in the park.

If our problems with anger are all about an immature prefrontal cortex, how can we hasten its maturity? (This interpretation of scientific findings is rudimentary, but who can stop?!)

Think of another mantra around here, that adults who hate themselves but want to change, should take heart. Adults are quite capable of quick change, more capable than children who may not yet have the biological maturity to abstract, save and review. We have the physiology in place, only need to flex our muscles, establish lasting connections between the brain and the extremities.

Not so fast.

The subtitle of Outsmarting Anger, 7 Strategies for Defusing Our Most Dangerous Emotion refers to a deceptively simple but very useful 7-step treatment plan:

recognize rage, envision envy, sense suspicion, project peace, engage in empathy, and communicate clearly (I tried!).

This sounds simple, but if any of this were simple then we wouldn't have to worry, would we, about people shouting expletives from car windows, wouldn't have to feel that anxiety, disruption, that lingering upset that is bundled with anger, and for some of us fear, for the rest of the day.

We don't have bumper stickers on bicycles, but if we did, life would be so much more fun.

therapydoc 

The "L" word, Sex

Those of you who read this blog regularly know that I rarely use the "S" word.

That John Lennon Song, Mind Games

And yet, here we are, associating it with the "L" word, Love. Is that even politically correct?

Sex in some relationships has been described as marital glue. It is what keeps many couples together when all else fails. Sometimes, it shouldn't, keep them together. Sometimes we're glad it did.

It sells.  Boy, does sex sell. It would seem that without it, nothing sells.

Twenty-five percent of divorced couples blame sex.

People like me are called upon to treat it, to treat problems with it, problems about it (cheating, sexual assault).  You would think everybody wants it, sex, but that's certainly not true at all.

Some merely want to express love in a physical way, and that it can be, an expression.

We've discussed how to use code to signal one's willingness for it, how that can be romantic.

"Honey, come into the bedroom, I have something I want you to look at."  

Or perhaps better,

"Kids, we're taking a nap.  Keep the fighting down."  

Other posts about it have suggested that problems with the mechanics, especially, are usually problems with communication. It is also difficult to communicate about because what we want feels so . . . private. To communicate about private things we have to feel safe, we have to trust. We all have numerous reasons not to do that, not to trust. Yet trust in a relationship that is sexual is everything.

Ironically, many singles assume sex to be a natural, safe part of their relationship. They trust too much and sometimes get burned, come to therapy to talk about it. That lovely piece of themselves, the part that trusted others in relationships erodes, changes. That is something to mourn.

But it is a coming of age thing, too. We really shouldn't trust just anyone. And trust, guess what-- has to be earned-- usually over time.  Lots of time.

A sex therapy is a type of relationship therapy. Meaning it is about both, trust and communication, that old faithful of any therapy, really.  If a couple can't communicate about how to load a dishwasher, then communicating about their most sensitive desires is going to be difficult, too.

"This way!"
"NO! This way!"

Not loving, not at all.

Oh, let me segue, it's my blog. 

I am always amazed at how the Old Mighty determined the male and female anatomy to be so different. (The Old Mighty is the way my grandfather referred to the Creator of the Universe). She worked it so that we have no intuitive knowledge about how the apparatus (fine, anatomy) of the opposite sex operates, even feels.*  Here we are, so alike, and yet in this difference, and those differences in our brains, we're only able to empathize with one another if we talk pointedly about ourselves. Leave the code at home.

My hunch is that we're made differently because where there is pleasure, cheap, clean, unadulterated pleasure, we are motivated to communicate to share it.

And the beat goes on.

I want to blame television, the movies.  In the media it seems to be all about intercourse, nothing else.  Someone doing someone. Even this language, seriously.  Doing? Think of the scenes you've seen on Madmen or another show. Doesn't the emphasis seem to be on penis-vagina sex, except for an occasional on-your-knees job, a sacrifice to make someone happy.

As a young trainee at Loyola University Medical School's Sexual Dysfunction Clinic in the 80's, I almost fell off my chair when Domeena Renshaw, a pioneer in the field, pronounced,

"Only one in five couples have successful intercourse." (Meaning both partners experience orgasm.)  "We just aren't made that way." (Meaning that we will both be satisfied during intercourse.)

Then she proceeded to show us slides that clearly indicate that the clitoris isn't in a physiological position to be especially excited by the penis. Location, location, location.  During intercourse the clitoris, the female center of arousal, isn't stimulated directly by the penis. The male's sex organ is sexy, certainly unto himself, but not to the clitoris.

Now of course you will argue this, because Mr. P is sexy, and beautiful, and can be involved in the pleasuring process as a willing, delightful participant. And the more compliments he gets, the happier he is, as is his wearer, who enjoys an improved body ego. And that's an important thing, I think, for both partners, loving their bodies and communicating admiration and love for what are probably the strangest parts.

That alone is a pick me up for Mr. P, encourages him to stand up and be counted. (Fine, I'll stop).

Mr. P's self-esteem (I couldn't stop, sorry) falls quickly if he feels the success of the party depends upon him, that the responsibility is all his. Ms. C. feels the same way when the circumstances are reversed.

So sex therapists will discuss this, the importance of relating lovingly, admiringly, giving as well as taking,  participating in a mutual process of pleasuring.  We suggest, too, that because of complementary anatomies, the way we are made, it is foreplay that matters most, not intercourse, no matter how it is demonstrated on television. The director of the show has no need to show the foreplay; the sponsors are waiting.

The largest organ of the body is the skin, and it needs attention in all kinds of places, not just those naughty bits that Monty Python used to tease about. Foreplay is all about that, the rest of the body.

But we can't assume that even this, touching other parts, other areas of skin, will be a good thing. We need permission, an invitation really, to touch someone, even if we're partners. It may be covert permission. We may already have it. After years, some of us merely know. Permission granted. Without permission, some people get very anxious at the very idea, being touched.

So let's say that permission is granted.  There are potential problems, however, permissions aside. In many cases Mr. P will be to blame for not cooperating. We'll talk about that case right now.

A young man, could be you, could be your brother, your son, your friend, calls a therapist for help.  Hopefully, he thinks, this is a sex therapist. The therapist, who has marketed herself with all the right Google key words, might hear that he wants sex therapy but might hedge her advice.

 If you are not in a committed relationship it is likely to be an evaluation, not sex therapy, not from me, anyway. 

Why? What's this?! It doesn't seem fair at all!  How is someone supposed to get into a committed relationship while being a failure at sex?

Excellent point, which is why we schedule the visit, not wanting to be unfair, and evaluate, maybe even suggest a treatment plan. But these recommendations are likely to have little or nothing to do with the mechanics of sex. They are relationship recommendations.

Our young man has never had real relationship problems, or problems with sex. He has had partners before his current relationship. He does not use drugs or drink. His parents are together and seem happy and he has never heard sex as a dirty word.  In his current relationship he is losing his erection because he is suddenly very anxious while putting on a condom.  He has an anxiety problem, he says, but only about performing in the sack and only in this relationship.

This is pretty common, losing an erection, or in the case of females, losing focus. Men often lose theirs in the process of putting on a condom. Getting back to the party feels like starting over.

So start over, we say. 

Whenever this happens, erections, arousal, drifting away, a couple is instructed to start over.

"And is she helping you at this point, when you both notice what you're labeling as a problem?" asks the therapist.

"What do you mean, helping?" He is lost.

"Well, either emotionally or physically. Either by loving you with words or actions.  Are you telling her what she could do to get you back into this?"

No, of course not.  She is expecting him to get it up.   After all, this is his job. Her pleasure is supposedly within his agency.

It is so backward, I feel. We used to have this expression, not popular, apparently today, not in the age of Fifty Shades of Gray, that you have to be responsible for your own orgasm.

Taking responsibility for one's own climax means many things, among them wanting to feel in the mood when we know our partner is in the mood or certainly will be, preparing mentally and physically for time together. But it is also telling a partner what we want, exactly, when we're actually making love (there's that word). We're the only ones who know the answer to that, to what makes us feel good. It is a nice process, too, a learning experience when we don't know what makes us feel good, when there are two eager learners, working with trial and error.**

The dysfunctional cycle or homeostatic feedback loop of the case:

Two partners, A and B are involved in the love making process, except that only A feels responsible for the success of a "date".  Suddenly:

A has trouble with his erection while putting on a condom, or at any other time.

B waits for A who is having trouble with Mr. P., who seems to be taking a nap.

A begins to get anxious, fiddling with the condom or worrying that this will never happen. Mr. P isn't waking up.  Wake up, damn it!  Mr. P doesn't cooperate under pressure.

B is becoming impatient, is considering what is on television.

A worries that B is going to abandon him, drop him. The two aren't committed after all. Meanwhile, Mr. P is not looking his best, is nowhere to be found, has disappeared altogether.

B looks at A, accusingly. Well?  When are we going to get back to it? (Note, not What can I do to help?)

A's anxiety rises with every passing second. Mr. P is hardly breathing.

B to A:  Call me when you've fixed this problem.

A's fears are realized. Our young man has learned that he had better fix this or he'll never have a normal relationship. He calls a sex therapist.

What do you mean, Is she helping me with this?  No! Why would she?  

The Beatles liked to sing in the song Mind Games, which I'm pretty sure is about sex, but in code,

Love is the answer.  

Work on that, we say. The rest is commentary.

therapydoc

*Our DNA is approximately 95%  alike, yet we still use the language, the opposite sex..  I think that is because that five percent weigh in when we interact in this way, in a potentially procreative, sexual way.

**This is why some of us recommend sex in the format of a committed relationship. If you assume you have until you are a hundred years old, give or take a few years, to figure it out, there is less stress. Trial and error, lots of words and audible breathing, and this falls into place rather quickly. Oh, and deserved trust, lets not forget.

P. S. John Lennon died December 8, 1980. A fan killed him, I think.  We could comment on that all day long, I suppose.

The Black Hawks Win, and the Gay Pride Parade

They don't seem to have a thing in common, at first glance.

O'Doul's- the non-alcoholic beer

But for an addict, they have everything in common.

(1) The Hawks

I feel pretty lame, and in some ways traitorous, but as a Chicagoan for over half a century, I should have been posting on Facebook like all of my young friends.

Haaaawwwwwkkkkkkkssssss!!!!!!

OMG!  ANOTHER WIN!!!!

THEY DID IT AGAIN!!

And I should have been to a game, and I should have been at the rally, a huge Mardi Gras that many are still talking about. The pictures in the paper make me feel that as a blogger I missed a tremendous photo op. Foiled again.

The Hawks won the Stanley Cup in 2010, too, and the revelry in the city made the angels in Heaven look down and wonder if perhaps they should attend. Nothing could be better.

And indeed, if you looked closely at the celebrations, you would have thought we found Osama bin Laden. No, really, the two don't compare. The only thing that compares with the feeling are other titles, the World Series, the NBA championship. Entire cities can't get out of bed the next day.

Players, fans alike, sodden in beer, the Mayor declared last Friday a Ferris Bueller's Day Off. No self-respecting lawyer worked. Chicagoans, proud of the accomplishment of their team, partied like it was  . . . .2010.

Those of us in my business hear about it up close and personal just a little differently. The desire for social inclusion is very strong. And drinking, as any fool knows, makes socializing much easier. The shy among us develop a personality they never had, sober. Drinking is a lubricant, a way to find that brave, intelligent, funny person inside. Who wouldn't want to do that?

It is also a way to alcohol dependency. What is fascinating is that over-indulging is encouraged in the cooler companies, at least once a month, a perk! Employees are invited to go out on one Friday, a "no-work" day, on the company tab. Drink until you see double, or perhaps aspirate on your pretzels and peanuts.

Sounds like fun. But if you are an alcoholic in recovery, and new on the job especially, wanting to fit in, it isn't fun. It is torture. You go and sip your O'doul's, your non-alcoholic beverage, and you remember how you used to celebrate with your friends merely that it was Friday, because after all, you had worked a full week and that, for many, is a cause for celebration. You are angry-- livid-- that you are the only one out with your colleagues-- not getting high.

Perhaps you remember celebrating the Stanley Cup win by the Hawks in 2010. You don't remember it well, but you do remember the revelry, the communal high. Being cool. Among friends.

If you are in AA, maybe, at that one-Friday-a-month work bash at the trendiest bar, you text your sponsor who writes back, GET OUT OF THERE AND GO TO A MEETING. But you don't want to go to a meeting, don't want to be with those people. You want to be with these people, the ones who are having so much fun. You want to be a part of this party, to be the funny woman, the funny man, that person who is laughing it up.  You don't want to be mature, emotionally excluded, out of the loop, detached, and boring.

If you make it through the afternoon unscathed, you tell your therapist the next week how angry you are that you have to be an addict, that you can't drink, that forevermore you can't party, can't be a part of this wonderful abandon.

The therapist tells you it is good to be angry, good to grieve that loss, because being like this, drinking to abandon, is an attraction to you, even though you know it is very much like being a child, perhaps three-years-old, plus or minus a few. The selfishness, the need for attention, the desire for undivided attention, special attention, is roaring. It was great being three, it was great being a child, but adulthood, finally, has set in.

Welcome to your bar mitzvah, I like to say. We Jews have big (sober, used to be) parties to celebrate becoming a man, a woman. It is a different world, by far, adulthood. A better one, really. You get to drive, not just a car, but your life. Now you are responsible, have to quit blaming everyone else.

Go Hawks.

(2) Gay Pride

I love the gay pride parade, let's get that straight. But like the Stanley Cup celebration, for addicts, it has its downside.

Not to cast aspersions, but some people come to therapy for sex addictions. Not that the percentages of sex addictions (obsessed!) are higher for the sexual minorities, my guess, they are not, but sex addicts, like all others with dependencies, have triggers. One of them is being among others who are, what in my day we would have called, promiscuous.I don't think the word exists anymore.

Most sex addicts are on the internet, not the streets, buying porn, passing it to their friends, or selling it, or they have sunk to other levels. This aside to lend perspective to the idea that being gay and openly looking for love-as-a-one-night-stand is a mere sub-category of sex-addiction. Ministers come to therapists to ask what to tell their straight porn-loving parishioners, or their spouses. So we're not throwing stones on anyone's parade here. An obsession with sex is not a gay thing.

That said, the Gay Pride Parade in Chicago, if you haven't been to one, is a love fest and a must see. The colors, the joy, that feeling, pride, makes all of us happy, and it is so hard to find pride and happiness like this on an average day.

We're Americans, born to a culture with Puritan roots, so being proud of ourselves for merely having a sexual self at all, is hard. Ninety percent of us pray, or used to, according to a Life Magazine poll, not that we can believe that number. But it even if it is fifty percent it is significant. And the gods, last we heard from them, those of us from the Big Three religions, aren't saying that being gay is a good thing.

Gay pride parades in Heaven?  Unlikely. But maybe!

So I ask my gay patients, Are you going to the parade this week?  The newly out of the Ikea armoire are excited. Yes!  Looking forward to being with my people, seeing people who understand. I'm looking forward to openly being proud!

The sex addicted, the ones who handle their feelings by impulsively running off to pick up someone to take someplace to have sex, give a resounding NO!

 Do you know what people do at the parade? They look for someone like me to grope, to follow around, to hook up with. Do you know what that feels like to someone who actually wants to be groped, be followed, be loved?  It is irresistible. So no.  

Proof positive that it isn't necessary to follow the crowd, to be where everyone else seems to want to be. Better, my alcoholics tell me, to figure out who we are, watch it all on television, all the revelry, the parades, and do a little soul searching, maybe, just maybe, think back on some of those memories, the ones that ultimately drive us to therapy.

The memories are the generic form or Antabuse* for every addiction.

therapydoc

*Antabuse is a drug that if you take it before drinking reacts violently with alcohol, makes you physically ill. Some take it when they think they are vulnerable so that they won't drink. Nobody wants to get sick like that and you won't drink if you're very sure that you will.

Paula Deen: What She Did Wrong

I’d link to a pic about Ms. Deen, but at this point just can't look at her anymore. 

Check out  Carlo Allegri / AssociatedPress / January 17, 2012 in the LA Times Daily Dish.

Ms. Deen used to host a beloved cooking show. Now perhaps she's back to the restaurant, among friends, maybe hostessing. What happened there?

...  a leaked deposition quoted her as admitting to using the N-word and wanting to plan a"plantation party" that would have had black men dressed as Civil War-era servants. The deposition was part of a harassment suit brought by LisaT.  Jackson, a white former employee who claims that pornography, racism and anti-Semitism were prevalent at Uncle Bubba’s Oyster House in Savannah,Ga., where she worked. Uncle Bubba's is one of two restaurants operated by Deen and her family.

In case you’re unfamiliar, harassment/discrimination suits would tag any one of six protected classes:

 race, color, religion, sex, and national origin. This according to Title VII of the 1964 United States Civil Rights Act  [U. S. C. §2000e–2(a)]

Paula's status as owner of the restaurant makes her culpable, possibly, of three of the five:

(1) pornography: showing pornography or links to it in the workplace when others are offended by it constitutes unwelcome sexual conduct,

(2) racism, and 

(3) anti-Semitism -- a national-origin ping.

We have a new interpretation of that law, as of June 25, 2013, vis-a-vis retaliation and the "but for" clause of tort law. Not being a lawyer, I can't tell you if it will help Ms. Deen, but it is fascinating reading. The short version is a little less wordy, lacks the individual justice opinions. 

 But quickly, employers are not to discriminate against the protected classes. Amendments to the Civil Rights Act since added age, veteran status, pregnancy, and disability, maybe others. Sexual orientation is subsumed under "sex, " tested originally when Joseph Oncale quit his job on an oil rig because he couldn't stand harassment from his crew, men threatening daily to rape him. The Supreme Court ruled it a form of harassment based upon sex.

The story about Ms. Deen caught me because as a therapist, I know that cultural discrimination and sexual harassment, certainly all of the hate "isms" hurt people.  There is an entire industry, thankfully, of designer workshops to stop relationship violence. Some workshop professionals load them heavily with empathy training. The goal is to teach it, what it feels like to be on the receiving end of harassment, abuse. That's the objective. 

Crossing the line isn't always conscious. Paula Deen will say as much. A hostile environment isn't usually recognized as hostile. Harassment often makes other people laugh, ironically, obsessed with inclusion they are afraid to speak up, join instead. This is the group think we've discussed on this blog before.

Worse, many still find jokes about the isms funny. Oy vey.

Every workplace, every public figure, everyone over the age of three, really, should have empathy training. We therapists would have less work to do, but that's good.

So thank you, Ms. Deen, for bringing this world-wide attention.

We will hear that Paula loves black people. And Jews, too.

Jackie Mason, a famous Jewish comedian (I went to see him live, expected to laugh but couldn't), is caught on tape in 2009, calling newly elected Barack Obama a shvartze.

If you Google the word shvartze you’ll find it means black in Yiddish, a derogatory expression, one our grandparents, if they immigrated in the twenties, might have used. The children of those immigrants, now in their sixties, like Paula Deen, used the word, too, people like my parents who knew it was derogatory.

 The schvartes are going to riot downtown because that man assassinated Martin Luther King.

And people did riot. People broke into businesses, expressed their rage, tired of oppression, low wages, discrimination. 

My generation doesn't use it, never did. But people like my parents, who had been oppressed in Europe, who worked hard for what the owned (easier being white, no question) did not particularly admire this behavior, the destruction of property, theft, retaliation. The riots surely reinforced their fears of people who were different from themselves. Jews of that generation, fresh from the Holocaust, feared everyone, really. That experience in Germany, their experience historically with outsiders, tended to be negative, replete with collective memories of the rapes and exterminations of entire villages, courtesy of the Nazi's, but also Cossack pogroms, and the Crusaders, more rape and murder in the name of holy something.  Let’s not forget the Spanish Inquisition. Good times.

So yes, a fear of others surely is laced into their DNA, and let’s not excuse it, but there were no workshops desensitizing the old Jews in the sixties. They needed empathy, and as whites, didn't get it.

But what about Paula Deen?  Her case smacks of wanna’ be White Supremacy, of all things! Although she is sorry, has expressed her remorse sincerely, and we believe her, maybe, she seems a paragon of racist southern white, complete with drawl and sweet tea. And appearances mean something in this world. She will have a hard time bouncing back. Martha Stewart could do it, Tiger Woods, too. But Paula Deen may not. Why?

Because discrimination is different than white collar crime and sex addiction. Racism is different. The mere suggestion of a plantation party with black slaves as wait-staff should have made her cringe. An invitation like this should make all of us cringe:

Come to our DJANGO UNCHAINED Ball!  

Where: Anywhere, but it will feel like the Deep South
Why: Because we love that movie, Django, it brings us back to the way things used to be.
Your Hostess: Not sure, but Paula Deen, America Cooks Deep South, is catering!
What to wear: Big hair, heavy make-up, beautiful gowns, gloves, tails
How to speak: Practice that Southern drawl
Meeting you at the door:  Black slaves in their very best. You’ll finally get that respect, the Suh and Ma’am you deserve!

Not funny, right? The Washington Post:

. . .  her scandal reinforces stereotypes — simplistic ones, to be sure — of Southern culture. She already personified perceptions so often used to mock the South: the deep-fried cooking and the big hair, heavy makeup and even heavier drawl. For those people who, consciously or not, already paint all Southerners as prejudiced people, the Deen lawsuit deposition fits squarely into the mold.

She’s lost her show, her sponsors, and honestly, many of us are very tired of looking at her face. Gazing at us in each photograph we see a person lacking empathy, clueless as to how it might feel to have dark skin, forced to serve white people.*

Picture the ball:  A sea of white faces, dotted only with black ones dressed in black and white serving the white faces their dainty hors d'oeuvres on those little round trays. 

Oh, Paula! How could you even think like this?! Get a workshop.  Don't put it off. You need the intensive version, we're thinking.

therapydoc

*This reminds me of why people choose other service jobs (for the money), like waiting tables at Hooters. The women who wear skimpy clothing to serve men in restaurants, bars, do it to get paid. But they don't always like it.

Extremes, Exaggeration, Cut-offs, Boundaries and Homeostasis

Or: How Failing to Establish Boundaries, thus Needing to Cut Someone Off, an Exaggerated and Extreme but Sometimes Necessary Measure, Can Be Avoided 

(1) Extremes and Exaggerations

There was a Jewish sage, the Rambam, I think, Maimonides, who lived in the twelfth century. A doctor, (they didn't specialize then) he recommended that if you want to change something about yourself, your life, then err on side of extreme. If you are shy, exaggerate working the room. Act social.  Make yourself talk until people are bored listening to you. (All this my interpretation of a distant memory, probably wrong.)

If you are angry, become the Dalai Lama.

If you are late, strive to make every appointment really, really early.

Pushed too far it is ridiculous. If you are old, work at being young. If you are sick, make yourself well. Exaggerating doesn't work for everything, and surely the Rambam knew that.

The chachma (Soft "ch" not like the "ch" in "chuck", but sounds like "chuck", roughly; means wisdom in Hebrew or Yiddish or both), the chachma is that if you try to exaggerate a behavioral trait, if you over-shoot, aim for much more or much less, you are likely to fail, to miss that faraway objective. But the arrow will fall center, and you will be in a better place than before you tried.

I'd add, keep those expectations low (he may have said that, too). We all lose weight, then gain weight, then lose weight, then gain it back, hundreds of thousands of times in a lifetime, and the goals are usually unrealistic. Expect less, try for just a little success, and be grateful that on occasion you still enjoy eating.

Over-shooting works in that we improve, if only temporarily. Systems are homeostatic, especially behavioral systems, depressingly predictable. And yet: if we can handle failure, adopt a benign pick yourself up, brush yourself off, start all over again mentality, then at least we won't completely go to seed. We'll succeed some of the time. The job is to keep those times coming with practice.

Rambam's cognitive-behavioral therapy is useful in that way. The problem, of course, is that someone who is too shy to walk into a room isn't able to work one, not right away, not even for a day. So most behaviorists suggest baby steps. We'll get to those.

But first, what about the hocus pocus of The Secret, that book I never read but heard about from at least a dozen patients when it made the rounds and spotted right away as a great visual cognitive therapy.

The idea, seemingly, is that we all want to be different, better, but before we shoot off our new great idea, or buy new clothes, or invest in a weight-loss pill, maybe even get therapy or a lottery ticket, before doing anything to improve, best to imagine the change.

Start with a vision, a picture of more of a good quality, a picture of less of an undesirable one. If we mentally focus on the new me (rich!) and do it often, spend significant amounts of time imagining what change looks like, we are likely to wear it. In that Iphone video in your head, you are the star:

 No thanks, I'll pass on the cake.  

First you see yourself saying that. There you are, passing on the cake.

As opposed to everyone's favorite lyric, a send-off on a maudlin, yet wonderful Les Mis song, A little drop of rain can hardly hurt me now, that spawned my family's concessionary joke

A little piece of cake can hardly hurt me now.It's here, that's all I need to knowwww.

Better: See me. See the cake. See me taking the classic pass on the cake.

No thanks, I'll pass on the cake.

Too extreme for some people, and too time consuming, all that imagining, if it is going to be effective. And there may be something about depending upon the spirit world and who knows how that will go? Thus many of us recommend moderation.

I'll have just a little piece of cake. Please.

Moderation is the go-to strategy, most likely, of every great philosopher. (All of us don't make it through Philosophy 101, so I really don't know.  But probably even the Rambam loves moderation in another chapter of the same book, or a different book. Ask a scholar.)

So that's good. But as I said, I like Baby Steps, made famous in some movie or another. A toe in the water, then the entire foot, ankle. Take it slow. No need to do everything in a week, no need to accomplish everything in a month, think the year. The New Year's resolution but break that puppy down. Don't swim every day, not at first. Don't jog every day. Don't eat well every day, you won't anyway; why beat yourself up about it. Plan only your next step. Even with religion, slow it down. Baby steps.

Get used to the water.

It's all good, any attempt at change is good, but the extremes get us into trouble if we go there directly. The problem with extremes, even wanting to go there, is that they are so extreme. Never eat chocolate. Never get angry. Can we battle homeostasis, a law of nature? Hardly. The consequence of never get angry is blowing up out of context, scaring the daylights out of everyone.

And as long as we're rambling and losing focus something else happens when we deny our anger. We lose self. Nobody knows who we are. We lose such a huge piece of ourselves, our passion, we become unidentifiable, blend in with the sofa.

We have to manage anger, obviously, but losing it altogether is like losing salt and pepper. The food is missing something and we're not interested. We're not even going to discuss chocolate.

(2) Cut-offs and Boundaries

A social cut-off is extreme. Doing it feels extreme, and being cut-off is sometimes a call to panic. No one there to tell you, No need to freak out. Homeostasis.

Years ago a friend told me that her father-in-law was such an impossibly insensitive man, he said so many insensitive things, that she couldn't be around him, had an averse response to just being with him. Panic attacks at family dinners. Her therapist suggested she cut him off. She called the dad-in-law "borderline."

As if this is a reason to cut someone off. Understandable, but extreme. There are books about difficult people, understanding why a person is difficult. I prefer the word, complicated.

But it happens quite often, therapists recommending cut-offs, usually when someone won't respect boundaries. Figuring that out, how to set a boundary, and keep it set, is an objective of many therapies. Loosening boundaries to open up to more intimacy, is another.

Not going to lie, it is healing to cut off  contact for awhile with particular people, maybe for months, even longer. But it should be discussed. Anyone with the chutzpa to blast through personal boundaries can handle our labeling their behavior. And it shouldn't be forever, the cut-off.

It is easy to cut people off by moving away. Too busy to call anyone back, hoping the needier, more dependent, or difficult individuals will lose our scent, it is a lovely, expensive way to emotional relief.

Inconvenient and cowardly. Better to assert, label the hurt, the criticism, the panic attacks at the sound of criticism, the negativity dripping from that someone's mouth, even when it is negativity about others, not us, when the negativity is about the universe, or one of the protected classes, those gays, those whatever.

All of it, label it all. Make a splash in a calm, assertive, no need to get emotional fashion.

I disagree, why bring yourself up by putting other people down? 

Not that this will necessarily work. But we script it in therapy. Nothing to lose. Nothing. (We're not talking about physically abusive relationships).

Those who are cut off seek help, too.They are sad, don't like that they chase and lose. They are often seeking intimacy, ironically.

That's why it is so admirable when a person doesn't want to be the bad guy, when we want to say, in so many words, Don't call me anymore, don't visit, and I'm de-friending you on FaceBook, when we want to do this, say it, but don't. We just can't bring ourselves to it. To survive, we make an occasional process comment like the one above about putting people down, or we're straight about why we don't spend so much time with the other person.

I'm a conflict avoider, and you're really negative, a lot.

Such strength to say those words. Feels impossible. It isn't.

People who don't cut off difficult others (again, a disclaimer, not talking about sociopaths or even almost sociopaths) have learned that when there is a reunion, a party, when backed into a corner, our boundaries about to be seriously compromised, we need an exit strategy or a magazine, a puzzle, a game, something to rip out and use to disappear.

You know that cutting someone off is shooting them in the heart.

How do we mend that particular broken heart when it is our heart and we have been cut off?

Best to assume that the one who cut us off is self-protecting, setting a boundary. Most of us, if we rationally examine our behavior, can see our own faults. If we can't, we should ask someone who knows us well. We may not think our words or actions are hurtful, but if someone isn't talking to us, then they may have been hurt. Apologies upon that epiphany, what we did wrong, sometimes work, but are no magic bullet. And if someone doesn't take our apology, at least we tried.

And if rapproachment, or detente, never happen? If the relationship stays disengaged, cut off, a seeming non-relationship (as if there ever could be a non-relationship) wait.

Have it in mind, always, to wait. In the interim, both of you grow, become infinitely more interesting, funnier, smarter, wiser, less-judgmental. Deeper. Not always, but often.  When people change, there's nothing quite like it. We want to be their friend. They want to be ours. We have to respect those boundaries until that happens, even after we have grown.

Those who cut off, who set what feels like an impermeable boundary, can only hope that the ones shut out will still want to be with them by then.

therapydoc

Snapshots: When Your Kid Gets Married

You work long enough at this job, and it feels as if all of the people you see are relatives, kids. Just a few random snaps from the past few weeks.

The New Bride in the Family

Liza Minnelli

(1) Guilt by Association

First Snap:  Maybe This Time

I'm talking to a patient I've known for years. He knows I blog and has always wanted me to blog about him, but I just can't. Shelly is not his real name. I tell him:

"One day, Shelly, one day there will be a way to bring your story in front of the camera and not identify you, embarrass you."

We're there.

Shelly could really be a woman in her sixties, for all you know, but for our purposes we've designated him male, about forty. He has had no luck in relationships, picks the wrong women to love. They find him solid, the perfect catch for marriage because he's kind, loving, works steadily, and can dance. He's also generous, likes to cook, goes to church, and doesn't drink. And he could have been cast for Graceland. He is everything they want a man to be.

The first wife cheated on him, as did the second. His third engagement never made it to the altar because she cheated, too. Now, having fallen deeply in love for the fourth time, he's singing ala Liza Minnelli, straight out of Cabaret, or do you prefer Glee-- Maybe This Time 

Glee Maybe This Time

He's in love again and so, so worried, after four months of dating, that she's interested in someone else, too.

But she isn't. I know she isn't from what he tells me, and we bring her in to talk about Shelly's past, so that she can forgive his paranoid accusations, his insecurities, and they can work on these as a couple.

He has had a bad history with intimate partners, but hearing about his childhood and the women in his family of origin, his adult relationships don't compare. The house?  A crack house. Role models brought home multiple partners. And not only were they not terribly private, they saw nothing wrong with this.

The only true survivor of an unpredictable zoo, Shelly is the stalwart of the family now, the one everyone comes to for advice, for money, too, naturally. He never could be, never wanted to be anything like them.

But he thinks he is, that everyone knows, that he is tainted. You can read the dysfunction on him, or so he believes, can see it in his words, his smile. So goes the irrational way we see ourselves, sometimes, imprinted at a young age by identity.

Some of us are destined to define ourselves by the people who raised us, our flesh and blood, our families. No matter how different, the shame is so deep that it feels as if it shows, we feel guilty for being a part of all that. Logical? Not at all. But that feeling-- shame, unworthiness, dirty--irrational, ridiculous because he's nothing like anyone in his family, is wonderful in every way, comes from association. Guilt by association.

Second Snap:  Country Boy

Aaron Lewis Country Boy

Andrew (again, all of the details are entirely made up) has a PhD in economics from a top school. He married a girl he met in college, and has two adopted children, one foster child, and one biological child. He adores all of them. He's been working in a university for years, but still doesn't have tenure. He keeps getting knocked around, and publishing, for some reason, eludes him.

He's a country boy.

He doesn't look like a country boy, and he certainly doesn't have Aaron Lewis' self-acceptance, the self-esteem of a real country boy. But Andrew's parents moved him at critical moments in his life, and his haircuts didn't match the haircuts of his peers, his accent stuck out. His clothes were too gray, and he had a last name that predicted he would be the brunt of many jokes for as long as he lived.

Tall, handsome, built, he still sees himself as gawky, awkward, with features that are too large and a voice that sounds, to him, tinny, whiny. It isn't. He could broadcast the news. Hard as he tries, he sees himself as a geek, an outsider. His parents are both shy, socially introverted, and they didn't introduce much panache. Depressed, he calls them.  His diagnosis? Dysthymic Disorder, 300.4. He's suffered that low-grade depressive fever his whole life.

Too much teasing. Too much bullying for being the boy he had to be, coming from the family he didn't choose. He lived in areas of the south that didn't take kindly to all kinds of people, certainly not intellectuals. And although he lived on a farm until he was fifteen, and can milk cows and hunt pheasant, he is an intellectual and always will be. No chicken feed for him.

Guilt by association.

Is there any hope for people who suffer this enduring condition that is bound to sabotage, bite us in some way or another?

Well, of course there is. Begin by not judging so much, not judging anyone, not ever (this is the only way to true empathy and understanding, even of ourselves). Begin by assuming that we all come from someone, and if others don't like where we come from, or who we come from, their bad for assuming themselves better.

Begin changing by tempering the effort to differentiate. No matter how we leave our roots behind, whether or not it is by dressing better (or worse), getting better haircuts, trimming our beards, studying Emily Post or shamelessly social climbing, our history is us. And it makes us so much more interesting than a two-dimensional magazine photo.

Aspiring to being better than the people who raised us works and we should, but to tackle self-esteem, we have to start with what we have, seeing ourselves objectively, as children of the universe, saddled with a past that should be something we can talk about, let go. It is only some of us, not all.

Change on the outside (not that we can't or shouldn't) is so much work.

No wonder the diagnosis for guilt by association, very often, is one form of depression or another.

(2) Marrying off my son
Sure, you deserve pictures, and I stole the one at the top of the post from a friend, and this one below, from her daughter's wedding, with permission, naturally. It was beautiful, and exhausting, no big affair. And I didn't crash, truly, until this week. Between the mental and physical exhaustion and the cottonwood allergy, I thought I needed an annual physical. Married to a doctor, you get one of these every twenty years.

Third Snap:

Girls in White Dresses

The wedding was in New Jersey, and we're from Chicago. But we have people there, and finding things isn't that hard, now that we all have more than a compass. One of the things I took on was hospitality in the hotel. I wanted to be sure people felt cared for, had a few snacks, (good snacks) in the hotel in case they were too tired from traveling to want to go out.

So I rushed around the day before the wedding and took care of people. But there were guests, I soon learned, from the other side, that weren't on my list. I had some extras, but not enough.

A man from the tribe (we identify with those skull caps, you know what I mean), approached the desk in the lobby while I was talking to a clerk about delivering the hospitality bags.

"Are you here for my son's wedding, by any chance?" I ask, smiling.

"Oh, how nice!" he replies. "A wedding. Are you inviting me? I'll come!" (Oy vey.)

"Uh, sure. Maybe. What are you here for?"

"It is Memorial Day and my daughter arranged a memorial service." He's still smiling. (It gets better)

"For who?" I ask, carefully.

"For my wife." (and better, even).

"And when did your wife die?" I squeak out.

"Two weeks ago."  (And still smiling. The power, the sheer power of a positive personality).

"I'm so sorry."

"It was so nice, just being greeted here, invited to your son's wedding" he says, winking. "I'm from Pasadena."

And we launch into a discussion of Pasadena.

(3) Crazy dreams

My youngest, the one who got married, asks me what the band should play when my daughter walks down the aisle with her spouse and their three young sons. They moved back to Chicago last year after ten years in California.  Considering winter past, and this ridiculously cold spring, California Dreaming, obviously.

Which brings us to our last story

Fourth Snap:  About a month ago, having trouble sleeping, up and down all night, I woke up for the fifth time at five a.m. and started the coffee. No big deal.

I told myself, that this is how it is when you're older. You merely don't sleep much. Gradually you need less and less. It is like you want to live every day, every minute, don't want to waste any of those demarcations of time. You're looking at that Facebook timeline of life and the future is coming up short.

My father, in those years before his death, deep into his eighties, hardly slept at all.

But I know that on Friday night I'll catch up, regardless, because I drink a little wine with my meal, and am often down for the count by ten, book open. It will be an eight to ten hour night, no question, and the rest, the sleep, is healing.

Not that I'm recommending anyone drink wine for sleep. It is counter-indicated. Sleep problem? Talk to your primary care doc. He'll probably send you to the likes of me.

Anyway, that night happened to be a Friday night and the system didn't work. The rich food, the glass of wine, no magic bullet. I was up late reading, which is fine, but woke up very early, as usual. On a Saturday! That surprised me, as did my headache. One crummy glass of wine.

Two Tylenol, a cup of half-caff later, I'm in bed again, reading, and asleep in fifteen. This time I REM.

REM is Rapid Eye Movement, the stuff of dream sleep, and there is nothing like it, we all know. Refreshes a body's soul. My dreams are transparent, too, no need to work to understand them.

In this one, FD runs off without me in a strange place, some convention in a suburb not that far away. The subtext is that I am looking for him, but am also looking for my daughter, who has moved away. I can't find anyone to tell me how to get to my car, or where the parking lot is located. I'm in a hotel which is also home to a/synagogue with a hundred people I vaguely know but cannot name. At a convention booth is a news crew shooting footage of someone, maybe a news anchor, speaking into a microphone, looking directly at the camera. Someone points to me and tells the anchor (I think it's Jane Pauley), that she should interview me, that I know a lot about the subject. I say sure, and am waved to a chair, handed a microphone, and answer all of the questions well, loving it. All of my anxiety in the dream dissipates as I pontificate on some random topic that I don't remember upon waking. At the end of the interview I realize I have left my purse somewhere, with my phone, but even this doesn't bother me. I am in the moment, living it, and all is well.

I wake up and In Sickness As In Health, Helping Couples Cope with the Complexities of Illness is open to page 139.Barbara also blogs. Always lovely to stop by to see her.

Outsmarting Anger

Barbara Kivolwitz and Roanne Weisman have pieced together a lovely little how to and I recommend it highly.

How to Outsmart Anger is barely dented, and I don't understand this, and keep apologizing to the publicist, who wants a review. But the truth is that when I get like this I prefer chick lit. I did like it, and am going to read it and discuss it in more depth when something anger-specific comes to mind. But for now, check out the review by Jamie Ducharme on how to outsmart anger, and if it fits, check out the book. And if you have questions, the author, Dr. Shrand, promises to answer them for us. He'll even grant me an interview. Comment and let's take advantage!

 Anger is stupider than it looks. Recommend a rager near and dear, or one you wonder if you love.

Soon after the wedding the spell broke. As you certainly suspect, the sleeplessness had to do in part with aging, but more likely, is that fear of abandonment we've talked about so many times, and definitely a little performance anxiety, stage fright related to an upcoming workshop.

I'll be that person, the one who is supposedly able to work without notes, the one who will be in the moment, entertain, and teach. #readslikeaTedTalk.

And face it. We're all afraid of losing our phones.

therapydoc