It's Going to Get Worse Before It Gets Better

In my defense, I was tired. I had been up since four on Labor Day, although I napped, and to prepare for an upcoming Jewish holiday threw together a few chalahs (those breads Jews make for the Sabbath and holy days, shiny and twisted), one carrot cake, two blueberry, and four sheets of chocolate chip cookies.  For a change, it all turned out well, not a burnt morsel, nobody fell.

West Wing on Mourning

FD and I colluded to tackle a closet and made considerable progress. You know what that means. You label what should go back in, and most importantly, throw a great deal away.

At 8 pm, paralyzed, the TV beckoned, I succumbed, chose vegging and watching to reading the new DSM 5. Nothing appealed on the tube so I turned to The West Wing on Netflix.

To me, it is new, although a well-respected patient had recommended it years ago when there was no time, no inclination, for television.  My luck, I pick a Christmas episode (In Excelsis Deo) in which Leo McGarry, White House Chief of Staff, is about to be outed for having had a Valium addiction when he was Secretary of Labor.

"It is going to get worse before it gets better," Josh Lyman, his young deputy tells him.

And maybe it will. I'm still in the first season reruns.

Meanwhile, Mrs. Landingham, the President's secretary, tells Toby Ziegler, Communications Director, that she's sad because on Christmas she thinks of her two sons, killed in combat in Viet Nam in 1970. A minute later Toby takes a call from the police. A homeless man found dead in the park has Toby's business card in a jacket pocket.

"Is he a friend of yours?" the detective asks Toby.

"No, but he's wearing a jacket I donated to the Vets.  My card must have been in a pocket. Sorry I can't help you."

Cleaning out that closet, one of the things I found was a bag of clothes put aside to give to the Vets. Irene from Purple Heart calls me at least six times a year to see if there's anything to give away. There is always something to give away.

Toby doesn't recognize the body but feels he must do something for the dead man wearing his jacket. There is a bond. He searches out the man's relatives, finds a brother-- "a little slow" -- and determines to see that the deceased has a military funeral. He oversteps his authority and uses President Bartlet's name to make it happen, but when the president hears about it, he is unhappy.

"Do you realize," President Bartlet chides Toby, "that when this gets out, every homeless Vet is going to want a military funeral?"

"I hope so," Toby replies.

The President thinks about it, nods, and lays a grateful hand on the aide's shoulder. He gets it.

The music on the West Wing is sinfully good, and between the children's choir and the Xmas pa-rum-pa-pum-pum continuing throughout the snowy funeral, and Mrs. Landingham (Kathryn Joosten, Mrs. McCluskey of Desperate Housewives) telling Toby to wait up, she wants to go to the funeral, too, I'm in a million tears and hunt down FD to tell him that I have stupidly booked my whole day tomorrow, between babysitting and really working, and Wednesday, too, because distraction helps, but now I want to go to the cemetery to see how my mom in doing instead. She's been there a little over a week, after all. She is surely upset with me.

Although she knows the trip out there is going to kill my back.

I'm worried, that this could get worse before it gets better.  Best to watch less TV, maybe. No, watch more! When television is best, it inspires us to be better people. That episode of West Wing, several that I've seen so far, moralized without ever using the word. A bit like my mother.

So the next night I watched a Sopranos episode from the third season, wouldn't you know, the one where Tony's mother dies. "Why is this happening???" I shout to FD, but make it through the show anyway. No idea what happened there except Tony's sister insists people say things about their mother at their family/friend get-together after the funeral and no one can think of anything nice to say.

In the comments to the last post, one of you mentioned that as I work my own program, that grief therapy I've been shoving down your throats for years,that I should talk about it here (or did I dream this).  At first I balked, thinking, the new DSM will prove far more interesting, and I just read The Thirteenth Tale by Diane Setterfield (amazing), and The Good Wife is starting on television at the end of the month.

They're saying, you know, that blogging is dead. But someone told me the other day, "It will make a comeback, for sure.  You'll see."

We're in the seventh year of Everyone Needs Therapy. Seven years!  Maybe it is time that I write more about myself, my life, my mom and dad, my brothers, handsome and strong, one here, one there. Something tells me that you won't mind.

therapydoc

No Bother

In my family, real life consist of communication about What We’re Going to Do.

I’m going to drop this off at M.’s, then run over to the Jewel and pick up coffee, come home, take a shower, get ready for dinner.

I’m going to pick up Safta (grandmother) at the beauty parlor, drop her off, then run to the cleaners. When I get home I’ll baby sit so that you can go to your appointment.

Stuff like that.  

During the past three years, as my mother's health declined, she lived independently at a retirement center. She rarely asked for help, although she needed it. We could anticipate her needs, but she hated that we had to meet them, so independent for so long. "Go home," she would say, when I checked on her. "Go take care of your family."

If my brother or I wanted to go to a conference (our vacations are always conferences), we communicated well in advance. Someone had to be around in case our mother needed something, in case something happened to her. We always accommodated one another, only too happy to do it.

About a month ago we had a problem. We had a schedule conflict. 

The history:

FD and I rarely leave the country, hardly ever, unless someone in the immediate family is getting married.

But in February he tossed me a pamphlet for a tropical vacation, and a conference we could both attend in the fall. We talked about it as if it was a dream, probably something we couldn’t pull off, but surely an idea worthy of serious consideration, planning.  I offered to present a workshop there, too. Never did reach the right person for that.

As my mother became unsteady it seemed unlikely, this dream. And yet. . . anything’s possible. 

Flash forward: 

  

Only a few weeks ago, visiting my mother, she seemed tired, too tired. I called my brother and told him that I had to go to work, but that she didn’t look good to me, and if he could stop in to see her after hours, it would be good.  He did and popped her into his car and drove her to the hospital. I was minutes behind. 

In the ER I happened to mention the tropical vacation and my sister-in-law jumped in to say that they, too, had a trip scheduled for the fall, same week-- overseas-- and it couldn’t be changed, the tickets, already purchased.

Oh no. 

Admitted at Evanston Hospital, the hospitalists pumped my mother full of fluid IV and got her sodium up, discharged her in 18 hours, much to my dismay and outrage. Thanks, is what I told the doctor who insisted Mom couldn’t possibly stay longer for observation. Thanks, I repeated as the young professional left the room, finished with this case.  For nothing. .

Not something my mother would have said. 

We went through a nursing home stay, then an admission in another hospital, then a discharge, knowing recovery to be unlikely.  

My mother, always the people-pleaser, passed away last week, four weeks later.  

She probably didn’t want to be a burden.

therapydoc

Stumbling in the Man Box

I'm watching TV with my mother, who can't hear and has long stopped caring.

"Just put on Channel 7," she says.

I've learned to just put on Channel 7.  Nobody ever died of too much Wheel of Fortune.

What I find interesting is the way that disabled in so many physical capacities, she makes the best of each bad situation, even hopeless situations. So she can't hear, but she can watch.

Later on, in my home, I'm watching HBO's The Newsroom. Don Keefer (Thomas Sadoski), a news producer, is struggling with his office chair. He is on the floor in his office, has dissembled the legs, the wheels, and is changing them so that the chair will glide easier. He tells whoever it is that catches him at this that he is mechanically inclined. Later in the show we see him at his desk, seated very low. He looks like a child, too small for the man-size furniture. He leans back and the entire chair falls apart. He makes the best of a bad situation, but then, he could also have asked for help.

Different scenes, of course. My mom would ask for help, although she never liked it particularly, asking. But she always did when she needed it, and helping her, as children, developed character. (After all, we did nag for the dog, even if she was the one who asked for help walking him.)

If there was something anyone could do for my mother's hearing loss the other day, she would have asked for it, but at her stage of the game, it is the least of her problems.  Don, in The Newsroom, won't ask. It is a matter of pride. He'll stumble along and make the best of a bad situation, like my mother. His situation.

As a man, Don is stuck with certain, shall we say, man-isms.  A guy can fix his own anything.  A guy is capable, doesn't need to read the instructions, either.

One particle board kit and this myth about the necessity of instructions, bites the dust.  FD, who once stumbled in the man box, refusing to read instructions, put together a cupboard for me, a great deal, too, if a person doesn't mind hauling hundreds of pounds of particle board. Even with a good dolly, there is much muscle work here.

Before this new stage of life, the one in which instructions become valuable, deep middle age, he wouldn't do that, referred to the paper and print. The challenge is in figuring out the kit without instruction, without help. But now FD reads first, during, and last. That said, he won't be buying another this large and this heavy again. We humans of both sexes  are educable.

For Whom Would You Like to Make the World A Safer Place

We learn all kinds of things, and unlearn them, sometimes.

For example, we could say that not reading instructions, not asking for help, is learned behavior. The role models of boys in their Wonder Years, the heroes, the mentors, inadvertently or sometimes consciously buy into machismo (a word on Wheel of Fortune yesterday). They learned machismo when they identified with role models, other men, usually fathers but sometimes uncles, grandfathers, or foster parents.

Therapists often hear explanations about why people parent the way they do.

"I do what my parents did.  We didn't have books.  I parent like my father parented me, and I turned out okay."

Like ducks who follow the first thing they see after they hatch from an egg, we follow our parents and early guardians, at least until adolescence, and even after that, much is cemented into those neuro-pathways. What we do, what we believe, doesn't just die with childhood.

Assume, then, that children with role-models who freely display rage, who vent to children, break walls, for example, slap, crack the chandelier with their decibels all for a bad report card, model violence.  The role model might say that it is all for the cause, the edification of the child-- grades are important--they mean so much--but it is what it is.

So I went to a conference about stopping violence, always relevant.  I go to as many workshops like this as I can because some of the presenters are so incredibly talented and I always learn something. This one was presented by Up2USQSI.  You can find them on Facebook. Strangely enough, while visiting my mother in the hospital a few weeks ago, a rabbi stepped into her room. I thought  saw her there.

Rabbi Eileen introduced herself and began to discuss my mom, kind enough to include mom in the conversation, not talking around her. I recognized Eileen immediately as the woman who spoke up the most at the Up2Us workshop. She answered those thoughtful questions at circle time. She owned it, that she was there, in this other role, social worker, and effusively Liked the workshop, asked me if I learned anything that Thursday morning.  I said, "Why yes, of course.  The Man Box."

At the workshop, as a group, participants threw out adjectives about what it means to be a man.  Below is our Man Box. Woe to be in a box like this.  Not so good, being a guy.  I've always been thankful to be a woman, except when lifting something heavy.

The presenters, school teachers interested in changing the world, one workshop at a time, do it by teaching kids to shout out when others demean women, usually with verbal violence. They also teach professionals like me, people like us. Men don't have to identify with all the wrong things. They need not be joking at the expense of women, at the expense of anyone, and when someone else does, it can be labeled for what it is, not cool.

Not my job

I had to think, what does NMJ mean? (from the funnel), because I didn't pay enough attention at the workshop.  Not My Job, right?

But it is.

therapydoc

Making It Our Job

When She Leaves You and You're Sad

A young  man in his thirties, the foreman of a construction crew, sits across from me crying.  The woman he wanted to marry has left him for another man. Tears are streaming down his well-shaven face, his beautiful blue eyes, red.* A woman leaving him is the ultimate abandonment, but he is learning this tall tidbit about himself for the very first time.

We've been talking about his issues for a few months, his history, mainly, the many things he has done that he wishes he had not. We can blame his father for being a poor example, or his mother for assuming he was fine without much help from her. I see this in a lot of men. Mothers assume it isn't necessary to talk to them about private matters, that a nonjudgmental discussion of the real boy and his identity is an invasion of privacy.

We look for diagnoses, as if these will help, but all we find is an emptiness, and a loneliness that had never been discussed with either parent.  None of the people in his life ever discussed life, really, and how to be a real person, the one that people remember for the good, the special. There is a place in our heads that should shout out about what is right, what is good, what will live on when we are gone. That place, that sense of self is reason to care for the self, to nurture that very special being that we refer to as "I". It can't be empty.

My mother gave us a false alarm this past month. I say false, knowing she isn't out of the woods, but she was so sick that she asked that we write her eulogy because she wanted to edit it before she died.  She didn't like how my father's funeral went, I'm pretty sure. We roasted my dad.

So what do you do when you are in that position?  If you are a writer, you begin to write, although if you are me, you do it in your head. The words never hit the keyboard. They don't have to, either, because you're picturing yourself speaking and it is way too much work to add the pregnant pauses that are compulsory at a funeral.  Adding a pause to an essay feels so contrived, like writing a screenplay. So much about my mother gives me pause.

Not surprisingly, although there are things to say that are interesting and certainly descriptive, what popped to the forefront of the "eulogy" were superlatives!  Sure, my mother isn't perfect, but it is mostly herself she makes suffer. There is so much wonderful in her fairly old soul that it all surrounded me like flowers in the spring at an indoor arboretum. They burst out everywhere.

And I realized, listening to my hungry friend, the one who feels so empty because he has been abandoned, that this is what happens to me as I work as a therapist. The patient sits in his death-defying all but comatose situation, and all I can see is wonderful, or potential for that, and I nod and validate what he sees.

Meanwhile, I'm waiting for the moment that he can walk into his own arboretum.

therapydoc

*Most blue collar workers shower and change into fresh clothes before therapy. Kids without jobs, no. They could be in pajamas.  Not that that's bad, but it does say something.

The Origins of Abandonment Anxiety

He's in there somewhere, being four years old.

The blanket is the original Hide and Seek tool, and everyone loves Hide and Seek, which is surely all about working out abandonment issues.

My daughter and her partner took a work vacation to a far away land, and FD and I volunteered to babysit for a several days.  That meant I was a single mother for the first time in a long time.

FD entertained the three boys by day, when he could, but the life of a family practitioner is defined by paperwork and long nights at the office, figuring out what in the world Medicare wants from him. Our lives have always been this way. Bring it on Affordable Health Care Act.

Parenting, of course, is like riding a bike.  So the ways I had with my own children carried over, bridged a twenty-five year gap.  Prone to giving children as much space and as much intimacy as they oddly indicate they need works best for me, communicates respect and understanding. We had no problems, during these past ten days, with the exception of dangerous open drawers and cabinets, as well as an occasional toilet that needed attention.

One night I'm putting the littlest-on- legs to sleep, following the routine, one that mirrors the routine I had with his mother. Either young parents have some type of subliminal unconscious memory, or people in their thirties really do remember the original bedtime drill. Ours works like this:

dinner,
bath,
pajamas,
books in bed, a story,
a prayer,
eyes closed.

The dim light from the hallway makes it hard to read, but is a soporific. The little guy tires early, but that doesn't mean he wants to sleep.

I stay.  Meaning, just because the routine ends doesn't mean it is time to go. I read my own book or nap, play Scrabble on my phone, check Facebook.  I use this time in the dark to plan the next  day, too, or obsess about my problems, stretch, do leg lifts at the end of his bed.  He trusts that I will stay with him. He wants me to stay with him. He has won this war, the Stay With Me War.  We even have a song, one sung a hundred years ago, passed on to future generations.

Stay with me.
Don't go away.
Stay with me.
HaShem (God) Please stay!
Stay with me.
Don't go away.
Stay with me. Please stay.

Fairly simple, and children of all ages seem to get it. The tune is from Damn Yankees, pretty sure. Can't remember which original song.

Quite contrary to the Ferber method, isn't it, this way to get kids to sleep. It is at odds, even, to the ghost method discussed elsewhere in this blog.  Ferber (and I haven't read the best seller, wish I wrote it, having used it so many years ago) upon hearsay seems to recommend that at a certain age perhaps whenever a baby has object constancy,* you let the kid "cry it out" in a crib.

They don't usually head-bang, babies, and if they do, need rescuing. Crying it out merely express consternation at being alone. Adults do it, too. And when they realize there is no one coming to save the day, we all give up and go to sleep. We can flex our muscles very young, however, given that chance, as babies who have to deal with being alone, abandoned, and probably, because they are pre-verbal, mostly, in that first year, somehow forget the ordeal. Their little bodies, minds, remember however, and bedtime gets easier with every passing test.

This is great when they are captive, in cribs. When they appear in the family room and interrupt your show, their legs many inches longer, some of us feel they can be treated as ghosts. One partner says to the other,

 "I hear a ghost."

 And the other partner declares,

 "Well, if we ignore ghosts they go back to bed. If we pay attention to them then they won't go to bed. They will stay up and annoy us. So let's pay NO attention to this ghost. Pretend he's not there."  

This worked for me and FD and none of our offspring ever actually feared ghosts, so it kills two birds with one stone.

Makes sense, assuming no china is broken. At that age, Stay With Me is over, is counter-indicated, assuming a parent has done an emotional check in during those hours before the kids go to sleep, has heard a recap of the day, attended the child, really listened, did fake it, allotted Special Time, somehow banning other children, interruptions, from the airspace.

Ghost is another game of Hide and Seek, really, except the seeker won't play. But between, say, 9 months and 4 years, it is all about staying with the little tykes in their beds, or in the same room, and it can be for a long time, up to 90 minutes, crazy as that seems, two 90834's as we think of time in the therapy biz, quite a commitment. It probably only works for a therapist if she doesn't mind a longer day, or merely likes to relax in the dark, doze off to the sound of a pre-schooler complaining, chattering.  I've always liked this time, took no calls. And stayed.

Have the cup of water ready.

So here I am, in deep Routine with my grandson, only four years old, a sliver of my age, not statistically significant, waiting to see who falls asleep first.

Then, one night, while stretching to leave, the bed creaks too loudly. He opens his eyes, recognizes me, knows full well what is going on. He waves at me, dismissing me with his little hand, then closes his eyes again, as if to say,

 "You can go now."  

But I stayed.

therapydoc

* object constancy-- knowing someone, something, exists even if it isn't visible.  The Piaget test is a ball rolling under the sofa, whether or not the infant attempts to retrieve it.

Breasts and Other "Things"

Sorry, no pictures today.

(1)  Breasts first, naturally

I'm waiting outside for my ride one beautiful morning, and a woman dressed in black exits the building.  I catch a glimpse of her prominent chest as she passes by, and can't help but wonder if she wears black often to avoid attention to her more obvious features.

Men, I'm told, fantasize about breasts, revere them, and women do, too. Some also stare, jeer, and comment unnecessarily.

Some less-than-proud breast owners wish to reduce them, hot and inconvenient as they are, a source of back pain, the subject of much conversation, jest. Who can blame a woman for wanting to reduce?

It isn't the type of thing that dominates my thoughts, and even as a pre-teen, as other girls began to "blossom" and I lagged behind, it didn't bother me. My body image wasn't wonderful (most of us haven't a wonderful body image at any age) but it wasn't bad, that young bod, and got me where I needed to go. People seemed to like me, and when that is the case, most other things don't matter so much, depending upon the degree of most other things. So I don't remember dwelling on these diminutive aspects of myself.

But girls who develop fast and furiously do think about them, initially, perhaps, with pride in what they are given, the design, the substance. Later, however, they might become mortified and annoyed, especially if anyone paws at them, especially if they suffered childhood sexual abuse, not that large-breasted adolescents are more or less at risk.

There's a song by Argent that might help us here, Hold your Head Up. (It is embedded in a second post because I couldn't figure out how to add it to this one.)

Hold your head up, hold your head up, hold your head high. 

Doing that, holding our heads up, we thrust back our shoulders. And when we thrust back our shoulders, we thrust forward those parts in front that for some shall not be mentioned, and for others merit alternative names.

And yet not liking one's breasts, a disrespect of a kind, is a not just a minor body ego sabotage, but an extreme ego sabotage. Because if we can't hold our heads up, fearful of negative attention, our self-esteem is compromised, we are hiding, and hiding implies shame. We aren't helping how we appear to others, either, don't seem proud or confident. Not if we don't hold our heads up. So breast reduction can be essential to healthy living.

I was introduced to breast enhancement, the opposite pole on the redesign-your-body-part continuum, as a therapeutic issue, when a patient (others have followed) considered the procedure and thought the decision important enough to talk about with a mental health professional.

Before making that fateful, painful choice, as part of a decision-making therapy we go over the whys and the why-nots.

I'm finding that a woman who walks in thinking she wants bigger or shapelier breasts will walk out convinced it is a good idea, even more so if she is sure it is someone else who wants them. Women are quite sure that this will make them more attractive (someone has done a good job at this sale, often an older sister or mother) and heaven knows, nothing is more important at the moment.  As a therapeutic issue, it is rich, worthy of three visits minimum prior to making a decision to add hard plastic to an otherwise soft, malleable body part.

An even more intriguing phenomenon, one that goes in the why not basket, is that men have brought this up in therapy, too, men who are taken with particular women, but don't like the enhanced breasts, who don't think harder is better, don't appreciate a less natural form of female breast. They are disappointed when they realize this is what they will have to have and to hold for many years to come--  enhanced, but not exactly better, breasts.

And we can tell, I am told, that once we are onto this, even when a woman is dressed, for she undergoes the pain and suffering to look good in clothes, ironically enough, just as one can see when someone has had a "nose job".

FD, our resident physician tells me that when he sees two breasts, he sees two potential lawsuits.

(2) Anthony Weiner and Sexting

The National Organization of Women wants Anthony Weiner to withdraw from the gubernatorial race.  After all, he promised he would stop sexting and it has come to our attention that he has not.

One need not be a feminist to feel disappointment and even outrage following a leader's exposure as one who is caught sexting, literally with his pants down. Political hopeful Weiner continued to send erotic messages by phone, and they weren't to Mrs. Weiner, rather to better endowed women (it is likely) who saw him as a source of fulfillment of their own exploitative objectives, a source of jobs, likely, and desperate (we see them in this light) to engage in job interviews in this fashion.

Mr. and Mrs. Weiner were supposedly having marital problems at the time. He sexted under the name Carlos Danger, a handle that is fast becoming a hugely popular Facebook alias. (Thanks S.A., or Carlos, for that tip).

Mrs. Weiner is telling the press that she is standing by him. Conan jokes that this means standing over the computer as he "works".

David Letterman advises that before a public figure sexts,  he should ask himself ten questions, the most important:

"What could possibly go wrong?"

What's up with sexting, anyway?

Is it a reflection of a fabulous body ego, pride in a particular part, whichever the part may be, a type of narcissism that begs flattery? It would seem so!  A good body ego, not bad. Not looking for a reduction or an enhancement, just showing off. I enhance this all on my own. Look at me!

And yet, when we're asking for attention, Look at me! it is a sign that we need attention, not that we are psychologically strong and independent, mature, evolved, capable of seeing, focusing upon others. We're not finding our sense of self-satisfaction from within, we still need others to validate us.

Not that we ever won't need validation, but there are degrees of need. The whole point of praising, complimenting intentionally, at times to an extreme, especially while parenting, albeit modified to reflect reality, is that so many of us desperately need it, didn't get enough growing up. One who is sexting is communicating this:

  Ah, so this is one thing that I excel at-- I have a very nice whachamacallit. Let me show you. Is this not fine?

Oy vey.

The sociological impetus for the behavior, the cultural context, is that we are an age of anything goes. There is an old Cole Porter song, Anything Goes, about the roaring twenties that plays in my head on occasion.

In olden days a glimpse of stocking was looked on as something shocking now heaven knows, anything goes. 

How I love that song. Anything goes means that truly, nobody cares what we do. And if they are judging, if they do care, there are enough of us who don't to balance the judgement. Having the freedom to do what we want, to make our own determination of what is right for us, real freedom, independence, is a wonderful feeling, and we have the right to the degree that the law allows, no small detail.

Expressing ourselves, living our own values, is what makes us the most interesting of all creations. It is hugely empowering, being human.

Not that we aren't judged by someone, and that won't feel good. Here I worry that I am judged at this moment for even writing about breasts, penises. We live in a country, most of us live in countries, with puritanical roots, a reason that people are outraged, why they care when their political representatives show the more savage sides of themselves.  Yet, the moral majority may not even be a majority anymore, and sex therapies thrive, meaning interest in sex thrives, better sex, more sex.

Does sexting enhance a sexual relationship? Someone will have to study it.  As instant porn, not love, and it enhances something.

The feminist perspective is that porn objectifies, takes away what makes us three dimensional, with thoughts, feelings, accomplishments, strips is of human, dignity. Arousal via objectification is not love; there is no heart, no allegiance in the act. It is all in the body. Much like seeing, wanting, then eating the perfect pizza. The pizza disappears when it is over.

Maybe we just don't want to know that our leaders gorge on anything, whether or not that is fair.Too much information.

therapydoc

Argent - Hold Your Head Up