Mothers Day is in May, Mental Health Awareness Month

The MIX featuring Mental Health Awareness Month

I don't know if it is intentional, or a Freudian thing, but the choice of the month of May for Mental Health Awareness Month is suspicious. May has always been for Mothers Day, and it always sneaks up on us. But it is chock full of emotion, for many, and can play with our mental health. So perhaps that had something to do with the choice.

For what it's worth, other months host mental health awareness days and weeks for different disorders. NAMI, the National Alliance on Mental Illness lists February as National Eating Disorders Week (Feb 23-March 1). March 30 is apparently World Bipolar Day. April is reserved for Alcohol Awareness.

May not only hosts Mothers Day and Memorial Day, but the month is divided into consecutive weeks:

Children's Mental Health Week, Anxiety and Depression Week, Older Americans Mental Health Week, and Schizophrenia Week

But Mothers Day gets all the attention. I caught a woman just a little younger than myself lingering at the flower display in the grocery store. I thought, She has one! And it made me sad. i realized this is my first Mother's Day without one. This past winter must have been good for flower growers because they are spectacular. A visual masterpiece.

Of course, even if you have one there's no saying this is going to be a fun or a stress-free experience, not the day, nor the gifting. There's stress built-in, especially if mom has always been difficult. The day's approach can be so depressing (or so I hear at work) that it is easier to carp about the commercial crassness of this otherwise benign Hallmark holiday.

But maybe it isn't so benign. It can be a comparison holiday for those who look around and see nothing but others with superior families, more functional families. They rank. Imagine seeing the day as a splendid opportunity to say, You matter. Let's do lunch, just the two of us. Or just family. Impossible.

Functional could look like this, how I did my brother's last birthday. He has one in early May. I popped by his office late on a Friday afternoon with a clunky box of documents that our mother and father had left behind, things that only my sister-in-law, a lawyer, knows how to decipher, cash out, or pitch. But I'm there with no birthday present. He sees me and is clearly happy to see me. But me, bearing no gift, first thing, before hello, guiltily blurt out,

 "I didn't get you a gift OR a card!" 

Thrilled, he flips back,

 "Great! Because I never have time to get you one either!" 

This can be loving, no gifts. I think if families dropped the gifts in general, they would have a lot more fun. But there would still be comparisons, who has fun, who doesn't.

Not having a mom, or having lost one, it doesn't matter how long ago, many of us are going to have difficulty on May 11, Mothers Day. And the reminders in the media won't let up until next week, when it is over. We will choose no brunch with Bloody Mary's (I just heard this, that people have pitchers of Bloody Mary's at brunch). Rather we'll opt out to go to a cemetery, have a discussion with relatives, some long gone, some new residents. Memorial Day is also in May. My thinking, one visit will do.

One of my kids sent me a link to a good podcast about Mental Health Awareness Month. A local radio station, THE MIX, WTMX (101.9 FM Chicago), features a social service agency, TURNING POINT. Susan Wiencek conducts the interview. I had wanted to write something substantive about mental health month, but didn't quite know where to begin.

Now I'm off the hook. You can listen to therapist Julie Rooney, and Ann Fisher Raney, CEO of Turning Point Behavioral Health Care Services, They do a better job. Turning Point, a social service organization in Skokie, Illinois, has been there for thousands of families over several decades. The agency hosts a new program called The Living Room, and it is literally a drop in center, an actual living room. People stop by and can talk to a professional, let go of some of their stress. Such a great idea, isn't it?

When asked,

"What can we do to become more aware of mental health issues?" 

either Julie or Ann, not sure  which panelist, replied, and I'm paraphrasing,

"Take a look inside yourself. You matter. Seriously consider your own mental health."

I loved that because we all do it, often, think about ourselves, look deep inside.  But this month we're supposed to consider ourselves important enough to deserve someone else to share in the process, too. Someone like a mom, in some ways. Or a sister or brother. Or not. No matter, no gifts are allowed.

So Turning Point, and surely hundreds of other creative social agencies have torpedoed the myth that mental health isn't affordable,  therapy is too expensive. Community mental health is alive and kicking. If you're lucky enough to have an agency with open doors, one like Turning Point, stop by.

My guess is that they serve cookies, too, and make a decent cup of coffee.  Just a guess.

Here's the link to the podcast.

therapydoc

A League of Our Own

The title of the film is really A League of Their Own. But watching it, many of us want to be a part of the sisterhood. It is my job to encourage aspiration and fantasy, feel-good processes.

But before we begin, to the Anonymous reader who commented on the Viagra post (that last one) about the reaction of a patient to a religious symbol, a cross he wore to work, sorry I missed that!  Just read it and replied in the comments section.

The Story:

Tom Hanks, Geena Davis in A League of Their Own

I thought I knew men. After all, 60% of my practice is men, and I have a brother, once had two. One father.  I married a male. Every dog we sheltered and loved was a male, counting three plus a relatively new male granddog, so make that four.

But what really had me assuming I understood men was my belief that as your everyday, nonthreatening, female therapist, males of all ages, not merely canine males, but humans, have shown me their soft side, the vulnerable side. It is exactly like ours, the female soft side, but men are a little more embarrassed to show it.  

If you take a large sample of any group, any population of, let's say males, and look at the very center of the bell curve, the mean, forget the better differentiated ten to twenty percent in the tails, the outliers, but look at everything to the immediate left and right of center, you will find what is considered normal for the sample of whatever it is you are measuring.

My hypothesis, and many would agree, is that if we look at men and male bonding, communing within the male biological sex, we will probably find: Men bond best when bonding over . . .

baseball.

Not only baseball, of course, but whatever sport is seasonal. Hockey, football, basketball, soccer, golf. Any sport will do, either to play or spectator or speculate about. Any sport is safe for males to discuss together, mull over, grieve, gamble, theorize, philosophize, or celebrate.

Whereas women seem to prefer to bond over what is bothering them: their emotions, how to handle their paranoid aging father, a jealous colleague, loneliness, the condition of their oldest child returning from a party.

Not that some men don't bond this way, even lunch, too. Some of us are finding in our practices that male patients do talk about their troubles with other men, not just their therapists. But my hypothesis is that 80-90% are more likely to bond at the water cooler at the office about a catch, a throw, a kick or a putt.

And brothers will call each other or text about sports, whereas they will not do that about anything else, and the conversation will go something like this: Did you see that tackle! Do you believe that! I know!  End of conversation. Hang up.

Not that this is bad! Being fanatical about sports beats getting all excited over drag racing or bullying or dog-fighting. Nevertheless, for years, mea culpa, I mistakenly believed female bonding to be deeper, more intimate, better. Superior. Because it strengthens our understanding of one another, ties relationship knots tighter. Emotional intimacy trumped recreational intimacy! Or so I thought. Not that recreational intimacy isn't wonderful, it surely is. Indeed, in relationship therapy we shoot to increase every type of intimacy.

But that’s not the point here. The point is that for most of my professional life, and that's a lot of years, and certainly for years prior to that, I held a bias about men and sports, considered the entire phenomenon, being glued to the screen especially, bizarre. So much emotion, so much money, so much time and effort on a game. And most of the time those invested aren't even playing the game, they are merely admiring amazing athleticism. But doesn't it get old? Apparently not, no more so than Dancing with the Stars or the Olympics gets old.

Women like me watch a game every once in a while, suffer through every Cubs season, whether we truly follow or not, as do most die-hard  northside Chicago Cubs fans. (This is our year, by the way). Maybe that's why some of us can't relate to bonding over sports. Cub fans generally just sigh, won't talk about the game. Not that sighing together isn't intimate.

That said, relating to sports obsessions is still hard for me, the idea that men connect socially primarily over sports. My usual empathy goes AWOL on this topic, or it did until I finally saw A League of Their Own.

Warning, SPOILERS coming right up, if you haven't seen it.

The film is a decidedly women's film, full of relationship pathos, so women love it. But because women play amazing baseball, men love it, too. Jimmy Dugan (Tom Hanks at his best) manages a team in the AAGPBL All Girls Professional Baseball League, one of several to replace men's baseball during World War II. Soom after the men returned from battle, the AAGPBL died a natural death. The players went their separate ways.

Some thirty years later, a Hall of Fame is dedicated to the All American Girls Professional Baseball League. (The biographies have to be good reading). Jimmy Dugan's team meets at the opening. So happy to see one another after so many years, the bond of female friendship and admiration is palpable, the expression of affection and intimacy, heart-warming. These women know one another and feel free, because they are women, to merely let it go, express the happiness, the love. Playing together, working together, their lovers and fiance's overseas, they had something very special, a temporary group commune of sorts, with a common goal.

Maybe male athletes do it too, behave bonded, share the love at reunions. Maybe they even keep up with one another years after having retired their numbers, hanging their uniforms in plastic. Maybe they have lunch or go for drinks, reminisce about younger days.I'll have to watch more baseball movies to find out. All I know is that we see genuine emotional intimacy at its finest in this film, as the women who played ball in their young adulthood come together as almost seniors to celebrate their past trials and tribulations.

Perhaps this happens at your average high school reunion, too. That's the idea, isn't it? Such would be another example of how one type of intimacy, recreational or academic/work intimacy contributes to and enhances another, emotional intimacy.

The film brought me back to my years as a pre-teen, a child playing baseball at the park after school, and made me wish the games had never ended, that sports for girls hadn't somehow become uncool. The denouement, the ending, that reunion at the museum, simply capped the loss, the missed nostalgia. We could have had that, had we simply dropped the mystique of being female and Played Ball!

No, we took up tennis.

Thank G-d, it is finally warm enough to take out my mitt from that bottom drawer, grab a grandchild, see if he wants to play the oldest game ever. Catch.

therapydoc

Just one more observation with therapeutic import, maybe. We'll throw in that Jimmy Dugan is influenced by his female team members to give up the sauce.

Most of the time I fall asleep watching TV. It's one way to wind down, for those of us who have trouble turning off our thoughts, our fears. Worries come naturally before bed. So if you are me, you watch movies on television in pajamas, on a small screen on a dresser only a foot away from the bed. It isn't all that comfortable. You have to crick your neck a bit to see, but in twenty minutes your eyelids droop, retinas burn. Before long you have lost the plot, are asleep no matter how good the film, the Modern Family or Madmen. An old Sopranos is better than Ambien.

But I stayed up for Geena Davis, Lori Petty, Megan Cavanagh, Rosie O'Donnell, Madonna and the rest of the team. Why?

Probably because No crying in baseball had me in tears, naturally. 

Team manager Jimmy Dugan is a little rough on his right fielder (Evelyn Gardner, played by Bitty Schram), after Evelyn throws wild to home, when she should have thrown to the shortstop. Dugan screams at Evelyn at the top of his lungs, glares at her bug-eyed. He probably reeks of liquor. She cries. He's incredulous. You're crying?  No crying in baseball!  he shouts.

She cries even more, and from this incredible scene that exemplifies the most obvious difference between the sexes (and genders), we learn the now famous mantra: No crying in baseball!  There is no crying in baseball! 

Geena Davis, playing Dottie Hinson, the star of the league, Dugan's most talented player, chastises him, both about his delivery (Why don't you give her a break, Jimmy) and that he drinks too much. Smitten by the tall, wry, reserved, mysterious catcher, Dugan works on all of it.

And later in the film, Hanks has us in hysterics again. Tested once more by a terrible throw to what was supposed to be shortstop, as soon as the side is retired Dugan confronts his right fielder. But this time he desperately tries to control his anger. He literally stutters and shakes with rage, but holds it in. He's calm compared to the last time, even if he is physically trembling with emotion to contain his rage and what comes out of his mouth. He tells Evelyn to keep working on that throw to the infield.

That's all. Just the facts, assertive.

Brilliant, classic anger management, so brilliant that now I have to buy A League of Their Own (unless one of my kids wants to give it to me for Mother's Day), so that I can show it at the office, thus deducting whatever equipment is necessary to do that.

Oh! Just checked the scores. It seems the Cubs beat the Cardinals 3-0 yesterday. Yes!

Snapshots: Viagra, Melanoma, and those Pre-Passover Blues

No, the two have nothing to do with one another.
Or they could, I suppose, if anyone thought Passover a sexy holiday, which would make for an interesting discussion that we will never have. 

Let's start with this.

(1) "Harmless" erectile dysfunction treatment associated with melanoma

No more Viagra for you son. And Laura Berman, a famous sex therapist who has at least one clinic to treat women with sexual intimacy problems, will have to put her prescriptions on hold, rewrite one of her books, too. The results of a new study indicate that penile enhancement medication, also used for female sexual arousal, is linked to one of our worst cancers ever, melanoma.

When I was young there was a song, Nature's Way. Spirit, sings the soulful, ominous warning.

It's nature's way of telling you dying trees,
It's nature's way of telling you soon we'll freeze.

We froze east of the Mason-Dixon line, and to the west, too, last winter. Or shvitzed.

Hearing the association between ED drugs and melanoma  I'm humming the song again, seemingly out of nowhere (that's how the brain works, people). We could look at our bodies, and our psychology, as one of nature's finest, most exquisite creations, capable of incredibly creative ideas, achievements. And we think nothing of messing with them.

A chunk of my patient demographic, people in their thirties and forties, barely middle age (forties are the new thirties, thirties the new twenties), impatient with therapy (or in denial) ask their primary care doctors for Viagra, Cialis, and Levitra, etc., penile enhancement drugs. Before this new study the docs couldn't say with certainty: The drugs are bad for you. Work on your relationships. As long as blood pressure and heart rate were relatively strong, they caved. So now they can say that. The drugs are bad.

Erectile dysfunction (ED) is nature's way of telling you something's wrong, probably with a relationship or an understanding of sexual relationships. Or the mechanics of sex. The most common cause of ED is anxiety, not only performance anxiety, but any kind of anxiety, and often, guilt. And anger.

Melanoma tells us something's wrong with the pharma treatment, too. The problem, if it is not vascular, is psychological or educational. ED drugs treat a symptom. They are a bad idea, the wrong way to treat the problem, if it even is one.

We can discuss the right way another time. I've got to get ready for next week's holiday.

(2) The Holiday Blues
Everyone knows that during the holidays, especially the first ones after the loss of a loved one, we're more vulnerable to depression. Just when we're supposed to be happy, a brick falls on our heads. There's no denying it. We remember faces sitting around the table, singing songs, smiling. These are good memories, and when we think about it, surely a blessing, a good opportunity to add to the positive memories, the legacy, of  people who made such a difference in our lives.

Of course, if I believed that, it would be a sign I'm not a therapist.

In fact, the stress of the holidays, the togetherness, brings on bad memories often, and the worst in people, especially if more alcohol is consumed than usual. The legacy memories, for many of us, aren't always good.

But for some of us they are.

Good or bad, the mental deluge, the stimulation of anniversaries, always has an effect. Great stuff to talk about at parties. (See video link below).

For me, being busy before a holiday also implies cooking and baking, happy busy which is productive, too. In this creative process, inordinate amounts of time are spent trying to remember the things my mother cooked and baked, reading over her recipes, tattered, but written in her beautiful cursive script, soon to be extinct, oil and batter stained (not her fault). I experiment like she did, write it all down. On a computer, obviously. Who has a index cards? I envy those of you who do.

Passover, one of the biggies when it comes to stress, is upon us. The office is closed for 8 days. You will see us at the zoo and the museums, sprung from the drudgery of everyday life.

But if you want to know what this holiday is really all about, you eat matzah. (These we buy at the store, hardly anyone makes them anymore, the rules of baking proper Passover matzah are too complicated.). No matter how ad agencies might make it sound, the stuff is nearly indigestible without lots of butter.

Matzah is the Passover food because it is difficult to digest, unleavened, no yeast allowed, the quintessential symbolic food of modesty. This is a low food, a symbol that reduces us to tears (let's not go that far) by the end of the week. The idea is to get the leaven out of our hearts, recognize it really isn't all about us, and that we're not the ones to thank for our successes, can quit patting ourselves on the back. After all, only a few thousand years ago we were slaves in Egypt, enslaved for a long time, over 400 years. We couldn't have got out on our own. Passover celebrates freedom from slavery and the Creator who made it happen in spectacular fashion. (The story is mind-blowing, as Cecil B. DeMille rightly tells it in  The Ten Commandments.

All that to link over to an irreverent video that made me smile. Sean Altman sent this pitch:

Therapydoc,
I follow your blog. Please enjoy my REAL story of Passover — JEWMONGOUS' new music video "They Tried To Kill Us (We Survived, Let's Eat)" http://youtu.be/TPAcf1RF2ps

Yours, Sean Altman

www.jewmongous.com

212-995-0273

JEWMONGOUS

Ex-Rockapella star Sean Altman's comedy song concert JEWMONGOUS is "tuneful and sharply witty" (Los Angeles Times), "relentlessly clever" (Chicago Tribune) and "bawdy with a wicked modern streak" (Washington Post), combining "the tunefulness of the Beatles and the spot-on wit of Tom Lehrer" (Boston Globe). Altman, who "writes hilarious and irreverent acoustic rock songs about his awakening Jewish awareness" (Jerusalem Post), is "part of a new breed of Jewish hipster comedy that includes Jon Stewart, Sacha Baron Cohen, Sarah Silverman and Heeb Magazine" (Philadelphia Daily News). He is a former, founding member of Rockapella and led that pioneering vocal group through its heyday years on the Emmy-winning PBS-TV series, Where In The World Is Carmen Sandiego?, for which Altman co-wrote the famous theme song.  His classic Passover song "They Tried To Kill Us (We Survived, Let's Eat)" has been featured on NPR's Fresh Air with Terry Gross. Altman has twice performed at the White House Chanukah party for the President, he has shared the stage with Billy Joel, Joey Ramone, Jay Leno, Whoopi Goldberg, Spike Lee, Jonathan Winters and They Might Be Giants, recorded with XTC and Richie Havens, and he performs vocal standards at the bedside of hospital patients as a volunteer with Musicians On Call.  Altman has performed JEWMONGOUS throughout the USA, Europe, Israel and once in China.  www.jewmongous.com

There you go. Not how it happens in most homes, but funny.

Oh, and the Passover Brownie recipe.

Pesach (Passover) Brownies, Gebrukst (for non-gebrukst add potato starch, not cake meal)

1 cup Mothers unsalted margarine melted (yes, the brand matters, use Mothers with proper Passover certification)

Melt into the margarine with 3/4 package chocolate chips

Let cool 5 -10 min

In the mixer beat 

2 eggs

1.5 cups sugar

Add margarine/chocolate

Add 1 pkgs ground walnuts (6 oz) and 1/4 cup cake meal* 

Bake in a 9 x 12 pan at 350 for 30 min. Test with a toothpick.

When they are dry, let them cool down then freeze for 30 min before cutting. Or just eat them.

Happy Holidays, friends.

therapydoc

*Cake meal is very finely ground matzah, a truly humbling baking substitute for the fine flour we use all year round. 

Ivan Lopez: Could this have been prevented?

Ivan Lopez screenshot Facebook http://tinyurl.com/lfx3w9c

Ivan Lopez shot 19 people yesterday, killing three at Fort Hood, Killeen, Texas. Five years ago, same army base, Nidal Hasan, an army physician, killed 13, wounded 33. Hasan has been sentenced to death.

Lopez served 4 months in Iraq in 2011 driving a truck, served in the Sinai Peninsula, too, and the National Guard. He's not been injured, officially, in combat. In fact the army claims he didn't serve in combat.

He either requested or was ordered a mental health evaluation, hence the transfer to Fort Hood from another base, according to one report.. His mother died of a heart attack in November last year, and the army gave him a hard time about going to Puerto Rico for the funeral. Granted a one day leave, he complained, was granted two. (Not much of a grief allowance, but typical in the military). The psychiatrist considered him nonviolent, prescribed Ambien for sleep. Follow-up in a month.

Perhaps Lopez forgot to tell the doctor. Somebody is going to pay for this. I need to be with my family.

One news bureau suggests that not only Ambien, but a variety of other psychotropic prescriptions were prescribed as well. Nothing unusual about that, to be expected, even, but one of those drugs could have been an SSRI, from a family of drugs that has saved millions, but is associated with suicide and bad decision-making.

Though Lopez was taking Ambien and other prescription drugs for a variety of psychiatric woes, he walked out of the Killeen, Tex., shop with his gun, authorities said.

Quick story:  About a month ago a new patient, referred by a physician, called me very depressed. In his fifties, I saw him the next day, and as is usually the case, he had a pocket list of the medications he's taking. One, an SSRI. Short list of those:

fluvoxamine maleate(Luvox),
paroxetine hydrochloride (Paxil), 
citalopram (Celexa)
escitalopram (Lexapro),
fluoxetine (Prozac)
and Sertraline hydrochloride (Zoloft). 

Hearing his suicidal thoughts, I scheduled him for the next day, and then again the day after that. That or refer the patient directly to an emergency room for evaluation and hospitalization. My new patient wasn't ready for that but it is always Plan A.

Not being a medical doctor, when he told me about the SSRI, I thought nothing of it, assumed that perhaps he just needed more. I was going to call the referring physician, when FD popped into the room (a family doctor, happens to live with me). I picked his brain first, described a man in his fifties, suicidal thoughts, an SSRI. Could we up it?

He quickly replied, "Not the best choice, that family of drugs, for someone with suicidal thoughts. Can make suicidal people disinhibited."

What does that mean, disinhibited? I understand what it means in other contexts, but how does disinhibited manifest under prescription meds?

"Oh, they'll do things they might not ordinarily do. A person with suicidal or homicidal thoughts might be more inclined to act upon them on those drugs. That's why we keep them away, generally, from suicidal teenagers. They're already unpredictable."

Which leads me to an entirely different explanation, why Ivan Lopez gunned down innocent people at Fort Hood. His neighbors describe an amiable, friendly man, married to a friendly woman. Armed, as soldiers usually are, he acts upon impulses that seem out of character for friendly people. He is disinhibited, and this is what disinhibited people sometimes do.

The only other real consideration is his self-diagnosed traumatic brain injury. Brain trauma can change character, too, turns loving personalities into angry, violent people. But they are always angry and irritable and Lopez wasn't.

We can blame the meds, perhaps, but perhaps not. He had a Facebook page, an alias Ivan Slipknot. On that page he wrote in Spanish:

“The people shouldn’t fear the government — the government should fear the people.”

So perhaps it wasn't out of character, after all.

We might be wonder why the psychiatrist didn't make a followup for Lopez sooner. He had a month between visits.

I would venture to say that the facilities at Fort Hood are mobbed with psychiatric patients coming home from Iraq and that professionals are working night and day treating post traumatic stress. Suicide in the military is at an all-time high. It is likely that Spc. Lopez didn't express violent thoughts or plans, his dirty little secret. His knew what he was doing. But he felt lousy, so he asked for legitimate help, medication for sleep.

It has been five years since the last massacre on an army base, one that had the makings of a terrorist attack. We worry incessantly over those. Time to worry about our soldiers. Vet them a little more carefully in those evaluations.

therapydoc

Retire from blogging?

Blogher, via Neil Kramer, aka Citizen of the Month, either launched or is about to launch a discussion of the end of an era, something on the order of this: Has blogging gone the wayside? 

Did blogging die because FaceBook, YouTube, and other stimulating, current media, are far more exciting than reading the soap-boxes of deep thoughts we bloggers can't help but share with THE WHOLE WORLD.

Ray William Johnson of Equals Three

I don't know if it is true, if blogging is dead or not, but Ray William Johnson, of Equals Three, a YouTube enterprise, is retiring as the host of his experiment with YouTube social media. People do move on, try new things. It can get old, anything, day after day.

We'll get to Ray in a minute.

Microsoft, you might have heard, is generously offering rebates of $100 to those who still have Windows XP on their computers (an enticement to upgrade, just spend $699 to be eligible). Bring in the old machine and swap it for a high-powered new one, guaranteed to be virus-free. Those of us who don't want to spend that much, who prefer to buy a functional, yet cheaper machine, might do that. We'll be recycling the old one ourselves.

In Chicago tossing electronics in the alley is a huge No No and warrants a citation and a fine. It isn't the most tedious thing in the world, cannibalizing a fax machine to isolate the hard drive. (Once a utility company convinced me to fax copies of my passport, bills, all kinds of things, and idiot me, I complied). Deconstructing a fax machine isn't as easy as snatching a hard drive off a desktop; it can take some hammering. Best Buy will take it all, cannibalized or not, all of those old electronics, virtually slobbered over an HP printer that should have worked! but did not, finally driving me to banishing it to the back room. Banished to the backroom is certain death for anything.

Progress, not perfection, an old 12 Step saying, when it comes to change.

When my mother passed away, she left an old Compaq Presario desktop, barely used, that still worked. She would have used it more, typed her synagogue newsletter for many years on the "dinosaur" before her disease didn't let, her fingers wouldn't cooperate. My father only used the machine to trade jokes (the worst jokes) with his friends and play the stock market. (This is a bad idea in your late eighties. Discourage your parents, take away their passwords, declare their browsers full of viruses; do whatever you have to do.)

This healthy but very outdated computer accompanied me home after we had sorted out all of Mom's valuables, the paintings, the chotchkes (rhymes roughly with latch-keys) she salvaged after my father passed away. That which no one else wanted found a home in my basement, the last stop before the back room. 

One day it made sense to turn it on, and since it had no sound, I turned to Amazon for an external sound card, the first of two. Since the machine did have XP, I installed Windows 7 (had to buy it). Soon it became obvious that although the 13 inch monitor had worked just fine for my parents, newer programs, like the ones that edit websites, don’t work on short monitors. So that had to go, too. I added a few gig of memory, sorely needed, and a receiver to get Internet (the TP-Link seems to be working quite well, but the green blinking light could cause seizures in a more vulnerable individual).

There wasn't much physical space for this setup, so I took it into the bedroom thinking it would stream video nicely, and it does. But you know how it gets. When there is a critical mass of electronics in a room the colorful diodes speak to you in the middle of the night. You can’t sleep, frantically arrange books or other strange objects (a coaster) to cover the glare..

But one night a few weeks ago, to see what is relevant and current and cool, I turned on the computer and clicked onto YouTube. Now that I have a decent-sized monitor , it is a pleasure. My television, also near my bed could fit in your glove compartment.

There is Ray William Johnson saying goodbye. Who is Ray William Johnson? I had no idea, but he has a YouTube show with a few million subscribers tuning in to watch what is popular on the Internet, those vids that go viral. Ray is a nice looking, funny, fast talking young man, an actor who deadpans. (It's all in the delivery). Retiring from the hit show, he is telling viewers about the drudgery of repetition, if I remember correctly, tells us he's looking to be replaced. YOU could replace him, or so he says. 

Most things probably get to be tiring if you stay with them long enough. I'm always amazed that my work as a therapist never does. Sure, it isn't always what I want to do, go to the office, sit and connect with people, ostensibly help them. But it is never boring. If I made some kind of change, it would have to really sing to me, and the odds of that happening are slim.

I thought about this great thought and wondered why blogging, which should be repetitious by now, still feels fresh. It isn’t a drag. We’re going on eight years! Maybe because there’s no pressure, no rush to post anything, and it is a hobby, not a job, after all. The way I see it, if it is fun for me, if I get a laugh out of it, or a cry, for that matter, then you will too. And there isn't a formula, you know that. I don't get caught up in should's and musts and have-to's.

My hunch is that for Ray, it isn't that his show needs to change, or that he has to invent a new wheel, but that he let it get routinized. That and the pressure must be overwhelming. The stakes are high when a million plus are watching, after all.

That's never going to happen to most of us ordinary bloggers, an audience of millions!

So in answer to the BlogHer question, the medium is far from dead. 

therapydoc

   

The Salinity of Tears

My son, a doctor of physics, came over last night with his wife (they needed wood glue; I made smoothies*). I wanted to ask him a question, but forgot: If you're swimming backstroke and you start to cry, will the tears change the salinity of the pool?

Silly question, for sure not. You only squirt out a few, but any tears feel disturbing. Still, you say to yourself, that it is nice being in the pool, no one can tell these are tears; it's all water. And although everyone knows that squirting them out, during mourning is a good thing, they make people uncomfortable, even when the raison d'etre is understood.

It has been six months since my mom passed away, unbelievable, and I'm able to say to anyone who asks, How's it going? that I'm doing good.

By good that means less sadness, fewer tears, fewer negative thoughts and self-recriminations, although these still pop up. The legacy we try to keep alive in our heads is already fading, although new memories surprisingly replace the old.

My greatest fear is that I'll lose the sound of her voice. In so many years of doing therapy, I can't remember anyone bringing this up in a good way, the sound of her voice in my head. People remember being yelled at, criticized. It was my good fortune, certainly, that the voice I hear is a nice sound, although there was some of that, criticism. In the idealization process, the criticism completely faded.

Friday night, after a delicious, substantial meal with a couple of friends, I had a dream. In the dream I'm asking my father, who passed away three years ago, if he thinks I should buy a new car.

I show him the shiny, black sedan at the used car lot. In his good natured way he shrugs and tells me it seems as good a car as any. Usually when you dream of dead people they don't talk, they just make an appearance, so this is an exciting dream. Real memories of my father had faded, all that looking after my mother coming first. My father made a few dream appearances these past few years, none of them talking roles. So it was nice to say hello.I'll have to ask my hostess about those ingredients.**

Not that I'm so deep, or even dark (as one awesome website suggests). But one of the things that happens to you as a therapist is that you look for meaning in little things. Or maybe therapists are just this way, which is why they become therapists. It is an occupational hazard, and family therapists, especially, look for metaphors, the one big thing wrong, or perhaps right, in families. But it is also nice to look for the big universal picture, if there is one, and how we fit into that.

So here's a story.

Not long ago all of my children had left Chicago for school, careers, or marriage. Now three are back in town, complete with families, and one of the other two rumbles about a return. My daughter had the hardest choice, moving here from Los Angeles, no small miracle. People don't move from Los Angeles to Chicago. Career, not family, their deciding factor. We don't care why.

So they are working. And when your kids are lucky enough to have jobs, and they can effectively juggle life with children, partners, and pets, well, you are happy and don't care if you don't talk much.You can be in the same town and barely get off more than a text.

Today 11:05 AM
Daughter: Game times today: 3:30 in Skokie, 5:00 JCC.

Today: 1:35 PM
Me: Cool.

In a million years you don't complain at how little verbal communication you have, you're so happy that when you get together, even for a kids basketball game, that you haven't had to fly across the country. And you  drive your grandchildren to school five days a week, and to the orthodontist. There are donuts in everyone's future.

No matter, on a typical Saturday I tend to feel badly. Memories of my mother come out of nowhere, usually in services at the synagogue. And I probably look sad, and people might even notice tearfulness. I hate this but am powerless. And there's that dictum that it is good to cry, you won't forever, you'll miss not missing her one day.

So there I am, totally trancing out, picturing my mother's face when I would walk through her door, enter her home. She is still living with my father, and I let myself in with my key, for they are either eating a meal, sitting in the den watching television, or puttering around. They notice and are so happy to see me, so glad for the company. Or Mom is living independently in her apartment in a residential center after he has died, and I walk into the cafeteria, surprise her at lunch and she lights up, that enormous smile shatters the cosmos. And I remember how, when I leave, she always walks me out, not just to the door, but all the way down the hall, almost to the elevator but not quite. Leaving the house, she is outside on the front porch, watching until I drive off,  fade away.

So there I am on a Saturday, standing against a wall in the synagogue because the rabbi is talking and I can't handle sitting anymore, and someone taps me on the shoulder. I turn around and it is my kid and she throws her arms around me, she just knows, and gives me a tremendous hug. Right there in front of everybody.

If I ever complain about anything again, just hit me.

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*Our lives have changed since I bought a Ninja last summer. All the left-over fruit goes in the freezer, especially bananas. Add a little mango juice, water, and a little vanilla ice cream, and life is beautiful.

**If you want to remember dreams the trick is to hesitate before completely waking up in the morning. Lie there a minute, eyes closed, and they'll come back.

What a Drag it Isn't Getting Old: the 86th Academy Awards

Judi Dench in Philomena

The mid-western weather is depressing. How depressing? People are calling for permission to blow off therapy. That's how depressing.

I'm home unusually early one night last week and the TV is singing to me. With the flick of a button there's Andy Griffith as the Mayberry sheriff in a rerun in black and white (1960).  The sheriff looks handsome, smiley and helpful in his khaki uniform, helping Aunt Bee break into a pharmacy.

They have to use the "hidden" key on the door-ledge because it seems the old pharmacist isn't feeling well. The older man's niece will fill in for him. A stranger in this small town, she has all the right credentials and she is going to run a tight ship.

Another townsperson, also elderly like Aunt Bee, a known quantity, bursts through the door in a panic. As Andy proposes to help her get her pills, the new pharmacist puts her foot down. No you don't. Not without a prescription. Nothing doing.

http://www.tvland.com/shows/andy-griffith-show/photo-galleries/the-andy-griffith-show

"But my pills! My pills!" the clearly pain-racked, tottering old person demands dramatically. "You wouldn't deny an old woman her pills!" Then she describes her many aches and pains, and how now she will certainly die without them.

Andy turns on all of his charm, and by the end of the show the new pharmacist relents, visits the older woman at her home with a pot of soup and her pills. Andy asks about the change of heart and the younger woman confides, "They're placebos. They were sugar pills, Sheriff."  Her uncle hadn't been plying this customer with opiates after all. He knew what he was doing.

Oh, if only it always worked out this neatly. We baby boomers are just beginning to notice our aches and pains, our arthritis, weak knees, necks, shoulders, and hips, parts of the body we didn't even know existed before. We're popping Advil and Tylenol, comparing which analgesic works best.

Therapists who have been sitting for years (it's a living) suffer lower back pain, an occupational hazard. Years ago a mentor of mine, sitting on a pillow shaped like a doughnut, warned me that sitting is the most dangerous part of this job. She was right, ___ her. But most of us with an ounce of sense won't be asking our doctors for anything stronger than ibuprofen, and we'll try not to even have to take that. We'll dutifully carry on with our yoga, those swims, physical therapy.

But I digress. The morning after the Andy Griffith Show, a song pops into my head, Mother's Little Helper. Rolling Stones, circa 1966,Aftermath. (Remember that album?!) The lyrics, if memory serves, include these verses:

Things are different today, I hear every mother say that she needs something today to calm her down. And though she's not really ill. There's a little yellow pill.
She goes running to the shelter of her mother's little helper.
And it helps her on her way. Gets her through her busy day.

Refrain: Doctor please, some more of these, outside the door, oh a few more.

What a drag it is getting old.

There are a few more verses before the close:

And if you take more of those, you will get an overdose.
No more running to the shelter of your mother's little helper.

Yet heroin is on the upswing, almost fifty years later.  

Let's get to the Oscars.

(1) In early January I had the pleasure of viewing Philomena, a film about an elderly woman seeking her lost child. As an unmarried pregnant teen, her father warehoused her in a Catholic orphanage. There, at the hands of brutal, poorly trained midwives, she has a baby boy. She is allowed to watch nuns, nurses, cuddle with her baby, and as he grows she observes as he plays with other children and they interact as mother and child. He knows she is his mother.

She is in his life for an hour a day until, at age three or four, he is lost to adoptive parents, no goodbyes. Left is a tearful young woman who will always have an empty place, a hole in her heart that no one, nothing but he can fill.

Judi Dench, nominated for best actress, didn't win the Oscar last night, but she will be remembered as Philomena, a light-hearted (if sad at times) woman, hopeful and religious, screaming youth and positivity that at her age isn't supposed to exist. But it does.

The real Philomena Lee attended the Academy Awards ceremony. Ms. Dench is working. She couldn't get off.

(2) The drug-overdose and death of Philip Seymour Hoffman made me angry.Why did this happen? Who gave him drugs? Why didn't someone who cared stop him from killing himself? Cocaine, heroin, methamphetamines. You will tell me, and I will tell you, that drug-seekers will find their drugs. It is the secrecy, however, that boggles the mind. The secret is so special that no one blurts. Because, after all, nobody dies of this stuff.

Philip Seymour Hoffman http://tinyurl.com/ltomb6b

A British street artist, hoping to draw attention to the issue, erects an eight-foot sculpture on Hollywood Blvd., Oscar injecting heroin. The words inscribed on the shunned piece of art: "Hollywood's best kept secret." 

Oscar shooting heroin http://tinyurl.com/lm7uwby

Only a few blocks away at the awards ceremony, a memorial is going on, featuring those in the industry who made their mark but passed away. Some timely, others not. It is an annual awards retrospective.

At the end, the fade, the camera lingers on photos of Philip Seymour Hoffman. Other memorials fly by so fast that they are hard to read, but this one hovers on stage just a little longer than the rest. Hollywood's best kept secret.

Earlier in the evening Bill Murray had addressed the academy, slipped in a reference to his deceased friend, Harold Ramis. The crowd is surprised, but uncomfortable, we're not there yet, not remembering, and Mr. Murray moves on quickly to the movies at hand.*

Harold Ramis, we miss him already

June Squibb at the Oscars

(3) If you haven't seen Bruce Dern in the film Nebraska, as grumpy old Woody Grant, an elderly alcoholic who thinks he has won a magazine sweepstakes, his portrayal is trumped only by June Squibb as Kate, his aging wife. She is aging better than he is and has plenty of attitude. She laughs at him, berating his stupidity while protectively telling him not to leave, as he heads off to claim his prize in Omaha.

Marvelously irreverent, Kate sarcastically rips into Woody. She roasts everyone she has ever known and isn't particularly nice to her son, either. In an interview with Bob Nelson, the screen writer (WSJ), I read that the people behind Woody and Kate are Mr. Nelson's parents, very much the same in real life. Nebraska is nothing, imho, without June Squibb, hilarious in this role, and many of us were rooting for her for the Oscar.

She didn't get it, either. But more important, perhaps, she scored attention to aging well,as Judi Dench does for Philomena. Ellen Degeneres (simply brilliant, ordering pizza for the audience, three large ought to be enough, taking tips when it arrives) jokes poker-faced with Ms. Squbb, roasts her early in the opening monologue. Assumed by the hostess to be hard of hearing because of her age, the actress is charmed, if perhaps a tad insulted at the very idea.

(4) Death, unless we're ready to hear about it, and even then, is a drag.

Hard-rocker Pink incongruously sings Somewhere Over the Rainbow halfway through the Oscars ceremonies in a tribute to Judy Garland. This before the retrospective and that Philip Seymour Hoffman punch, just before Bette Midler comes on to sing Wind Beneath My Wings. Talk about milking it. But Judy did die young, and she spent years abusing alcohol and prescription meds. Her children, in third row seats, surely had a hard time watching, listening.

As Pink makes us cry, we eat up the set, a delicious montage of a young Judy in the Wizard of Oz, ruby slippers and all. We are reminded that there was a time, way back when, that we stayed glued to our television sets on Thanksgiving for our annual Wizard of Oz fix, anticipating that blast of color at the end of the black and white film, assuming an aunt had a color set.

Pink does a nice job, singing a quiet song; her family must be proud. And Bette Midler, like Pink, doesn't belt it out either. This show had to be sad, mellow, and it is all the better for it.

Probably some people thought about it, during that emotional television event, about those mother's little helpers, the pills that people like Judy Garland used to get through the day.

They aren't just Hollywood secrets.

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* Mr. Ramis died of complications from an auto-immune inflammatory vasculitis, a relatively rare disorder. Chicagoans loved his improv at Second City, and everyone remembers his films:  Caddyshack, Ghostbusters, Stripes and Groundhog Day. Cut down in his prime, like Mr. Hoffman, but this one makes me sad.

Aftermath, Rolling Stones about Valium


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