The Pennsylvania Amish, School Murder and Why

The recent murders of elementary children in Colorado and Pennsylvania have sickened the hearts of Americans. We can’t help but worry about our own children and consider the fact that if a one-room school house in rural Pennsylvania isn’t safe, perhaps our children aren't safe anywhere.

Why is this happening? What happens to men who turn a psychological corner and decide, for it’s a conscious decision, to go on killing rampages?

I’m sure many variables are going to be discussed by bloggers out there, primarily physical and sexual child abuse.

When I returned to graduate school in 1996 I wasn’t a kid and neither was one of my colleagues, Sylvia Margolin. I wanted to teach, become an academic, just be TherapyDoc on the side.

Sylvia wanted to study something called Peer Rejection.
I, of course, was interested in Internet Sex, chat room sex, and was laughed out of the water by a research chair at the University of Illinois. How ridiculous, hot chat. Who does that? No sour grapes here. All fences mended. Move on.

Anyway, I never forgot that Sylvia wanted to know what happens to kids who are rejected by other kids. A library search turned up her dissertation on "social support and activity involvement that reduces isolated youths' internalized difficulties," not exactly on the variables that make people kill kids. But there were 210 hits on peer rejection.

I did a little studying and wrote the story posted on this blog, Bullies, Guns, and a T.D. Bedtime Story. It's in the August archives.

Now’s a good time to quote from that post, just a little. The story is about a boy who was scape-goated. He was the one kid in the class that most of the others made fun of, teasing him mercilessly for everything and anything he did, anything he was. This went on for years and years.

At the age of seventeen the following happened:

. . .Thinking about his classmates, who happened to be good kids in the eyes of their parents and teachers, by the way, did have an effect upon him. It made him very angry, very, very angry. The more he thought about them, the more he wanted them to disappear.

The next day, when one of the kids called him clutz and all the other guys laughed, he shot back, “Maybe it would make me happy if I came to school with a gun and killed everyone of you—you, and you, and you.”

The boys were taken aback but then one of them said, “Sure, like you could even handle a gun, you weakling.”

But he kept repeating it every time they said something mean, which was often enough that day.

“Maybe it would make me happy if I came to school with a gun and killed everyone of you. It’s been done before. Hmm… now there’s an idea. Take you out, one by one, bullet by bullet.” Well. . .

See, I think that this fantasy, taking them out BULLET BY BULLET is exactly the fantasy that is seeded in peer rejection, and I’ll bet Sylvia’s dissertation bears me out. It’s a seed that takes root, probably between the ages of eight and ten and it grows, and grows, and grows.

Compound peer rejection with other forms of abuse, i.e., violent parenting, sexual molestation or rape, and voila', you have murder in Colorado, murder in Pennsylvania, murder. . .where else?

Should parents talk to their children about this? Well, yeah. They should ask their kids, WHO ARE THE LEAST POPULAR KIDS IN THE CLASS? WHO DON’T THE KIDS LIKE AND WHY NOT? ARE THERE ANY KIDS IN YOUR CLASS WHO ARE CRYING THEMSELVES TO SLEEP AT NIGHT? Shouldn’t we invite those kids to our home and get to know them?

Hard not to pontificate, hard not to preach. Social conscience? I'm thinking it better become the next new fad.

Copyright 2006, TherapyDoc

Yom Kippur

I know, I know, I said I wouldn't do this religion bit. But so much for promises. I have to tell this story.

The time between Rosh Ha Shana and Yom Kippur determine our fate, according to tradition. Yom Kippur, which was yesterday, sealed it with the fast.

Next week is Succos, a seven day holiday. So yeah, it might be hard to find me again at the office.

Anyway, I'm going to start this story with the Saturday BEFORE Yom Kippur, just a few days ago.

Theoretically, by the time we get to Yom Kippur we're supposed to have at least considered changing to become better people. The entire ten days, including Rosh HaShana and Yom Kippur is a pretty intense time. We're supposed to look back at our deeds and look forward to changing them.

That's always pretty intense if you ask me, looking back, looking forward.
It’s why therapists tell people to stay in the moment to be okay and manage their emotions. Usually that works. Not much is happening IN the moment.

Anyway, the Shabbas between R"H and Y"K is intense. Since it's the first Sabbath of the year we’re supposed to make it especially good, not speak badly about anyone else, work on our relationships, fool G-d into thinking we’re worth saving. (I could have it wrong, but that’s been my interpretation.) It's a little deeper than the usual eat, drink, and be merry, oh, and catch-up-on-a-week's-worth-of-sleep-if-you-can, Shabbas.

So I came to shul, the synagogue, a little earlier than usual last Saturday. Okay, very early, for me. I spotted someone new, a lady probably around 79-85 years old. She was sitting right in front of me. Let’s call her Tela.

She turned to me and asked me a question, maybe it was, Is this seat taken? I don’t know. I sort of wondered why she didn’t sit in the row with most of the other women her age who sit and pray, but also talk it up.

I said the seat had her name on it. That was the end of the conversation. She would occasionally kind of look back at me and smile and I did my best to smile, but it was one of those days when talking in shul was out of the question. Personally, I like those days.

Saturday passed, Sunday went by quickly, and soon we hit Yom Kippur.
On the High Holy Days we have assigned seats in shul. Different seats from our usual seats. I had requested to be in an area near my friends, most of whom have children or parents or in-laws sitting with them. I’m alone this year. They can put me anywhere.

I found my assigned seat, which was near my friends, but not next to any one of them. I was seated next Tela. She hadn’t been there on Rosh HaShana. Or maybe she was sitting someplace else and I hadn't noticed her.

Tela’s short and a little round. She wore a round black hat and a nice dark green silk suit. Her only jewelry consisted of a pretty gold watch and a thin gold bracelet on her left wrist, and the simple gold pendant with three small (but not too small) diamonds, that I’m sure her late husband gave her for an anniversary. She looked nice.

Tela coughed and sniffled and apologized for her allergies. (My nose had actually started up, too). No problem, I said, and introduced myself. What’s your name? She told me her name, which I couldn’t hear. Tela has a thick Yiddish accent and the congregation was a little loud with the singing at the time.

I asked: Are you new to this shul?

She said: Yes, mine husband passed five years ago. We leeved in Skokie and my son told me it would be good to sell the house, move into the condo not fah from he-ah. I could move by him in the suburbs but it’s too far a valk to his shul. So this is a short valk.

Me: His loss, our gain. Do you like it?

Tela (smiles): It’s okay.

We listen and sing along with the services for awhile. I’m listening to her because she is singing in her lovely, rounded, gutteral accent and I know how I sound. Her prayers sound more sincere.

Fela: Is your husband down dere?

The men are on a lower level, we women are in a balcony above them. We can see them. They can’t see us unless they look up. That’s the plan.

Me: No, he’s at the early minyan.(service). Have people been friendly here?

Tela (shy smile): Ferry nice.

Then, apologetically she says: I come from a different shul, you know. A traditional shul. You know what is a traditional shul?

Me: Sure. I grew up in Skokie. I went to Niles Township. I went to all the different shuls for Bar Mitzvahs.

Tela: Oh, they’re VERY conservative dere, right?

Me: Now they are I guess. (I smile. She smiles. Neither of us wants to say anything that would be remotely construed as negative.) I think it’s probably a fun shul, You know?

Tela: I tink so. This one here seems like a nice shul.

Me: We’re pretty laid back.

Tela: Not like (she names a different Orthodox shul in Skokie that maybe is more moneyed and the people show it).

Me: They’re nice too.

Tela: Of course.

We pray some more. She coughs and it’s kind of a bad cough, maybe not allergies. She turns to me and says, You know, it’s bad to be sick and old.

I nod.

It’s better to be old and rich.

We both smile at her punchline. Such Yiddish humor.

Now it’s time for people who still have living parents to leave the sanctuary. Those who have lost their parents will stay inside to say a special prayer, the Yizkor. I take off to talk to my friends.

First I stop to read Tela’s name off the seating chart outside the sanctuary. I see my friend Debbie.

Debbie (kind of laughing): So who’s your new friend?

Me: Tela _____. She’s very cute.

Debbie: Wait a minute. That name’s familiar. TANTE TELA?

Me: Maybe. How many Tela’s are there?

Debbie explains some connection with her family that I spaced out on and don't remember.

Me: We probably should take care of her. You know, socially, for awhile. She’s not too connected.

Other women join us and we're talking about the importance of getting babies to sleep at night. Eventually we go back into the sanctuary for the services. Before long it’s time for The Break. Most people take about an hour and a half to go home, nap, and quickly return for the last three hours of services. Most of Yom Kippur is spent standing in prayer. It’s exhausting.

Tela was a little late returning to services. She took a look in my prayer book for the place. She had a different prayer book, the one they used in her Traditional shul in Skokie. We both say a part of the service that lists a LOT of sins. She mumbles something under her breath in English (We pray in Hebrew).

Me: What did you say?

Tela: I said. Sins. We made a lot of sins. So many sins.

Me: Uh, huh.

Tela: And you know? Others. They make even more sins.

Me: Uh, huh.

Tela: You know dere vas a var in Israel on Yom Kippur.

Me: Der vas. (It’s hard not to slip into Yiddish accents with elderly people. G.D. tells me that when we get old we’ll all be speaking in Yiddish accents. It’s natural.)

Tela: I tink it was 1983.

Me: Maybe so. But we won. Even fasting, the Israeli’s won.

Tela: But we lost some.

Me: Ah.

Tela: I lost mine cousin.

Me: I’m so sorry. (pause). I’m so sorry. (pause.) I’m so sorry.

I don’t know why I said it three times.

Tela: You know I’m a concentration camp survivor. A Holocaust survivor. (She looks me deeply in the eyes.)

Me: I didn’t know. Which camp?

She said the name, I didn’t hear it, and didn’t want to interrupt her flow, so I nodded.

Tela: I lost mine parents, and mine sister(s). I don't know vhy I'm here. I don't know... vhy...I'm here.

I am unspeakably moved and tear up. I nod, gulp. We pray some more. I hear her say, Al tashlichaini. She repeats it. I close my eyes tight. It is a quote from Tehillim 51, Psalms, and in context with the rest of the verse means,

Don't cast me away from your presence, don't take your holy spirit from me.

We get to the end of the service and everyone is happy. The fast is over. We can go home and eat and drink. We’re all singing, Next Year in Jerusalem. I introduce Tela to my friend Chani, they exchange pleasantries. Chani seemed a little pensive throughout the service. I was sure she was thinking of her mom who had passed away just last year.

I turn to Tela and say, It should be a healthy year.

She says, Yes, a healthy year. And there should be peace in Israel.

Amen.

Debbie turns to Tela and offers her a ride home. Tela declines. She looks sad behind her glasses. She has that look of low expectations, the look she gave me when I said, Had people been nice to her in the shul? I want to say it’s a survivor look, maturity mixed with age, mixed with independence. But I know better than to generalize about survivors. They’re not all like her.

You’ll tell me more, Tela, okay?

She didn’t answer. Maybe she didn't hear me.

I hope she stays with this shul. I truly hope we’re worthy.

Copyright 2006, Therapy Doc
(see the last and only religious post I said I would write Lessons From a Family Therapist September if you’re interested in Rosh HaShana)

Getting Out of Abusive Relationships, Teri Hatcher and People Pleasing

This piece is not just about Teri Hatcher, it's about all kinds of controlling, exploiting, difficult relationships that make people want out.

Those of you who read Vanity Fair's spread on the actress having confronted the man who sexually molested her in childhood probably sighed a variant of the Yiddish sigh, chaval.

Chaval means. . . well, it's hard to explain. "What a shame" hardly cuts it, but comes close. "OMG" also comes close. But chaval really has to be said with pathos and a tad of disgust, and that's what's sad about saying it. You almost have to say, "Oy. . .(pause, smirk, sigh). . .chaval."

For those of us, and there are many, who learned about our body from someone who had no permission to touch it, Ms. Hatcher's story packs a punch. She came forward to the police with her story when she heard about another young woman the perpetrator had molested.

That young woman killed herself. He had other "lovers," too, apparently. Teri wanted him put away.

Children who have been sexually abused can be bullied into not saying anything and usually are intimidated in that way. There are tomes on what happens psychologically to them, how their future relationships are doomed or frought with problems, how their sexuality becomes the center of their psychology.

When I went to graduate school, we were taught that if you had a sexual abuse case it was a BIG DEAL. The patient (victim) would be on the couch for years. Now the incidence is so high that the profession's rife with good family therapy interventions, confrontation one of them, but only at the right time.

Incest and sexual abuse are still a big deal. The police and the courts are more savvy now, however. The child only needs to tell the truth and the healing begins. There are advocates and therapists all over the place. Just get the job started.

The question is, What keeps adults who have been abused from doing what Teri did, from speaking up? And why did she wait so long? Why do people who are being exploited in relationships not extricate themselves from the situation immediately? What keeps them from GETTING OUT?

I think the same dynamics, the reasons for not shouting out, operate in all relationships that are characterized by domination, abuse and/or control.

Let's digress from sexual abuse and take a look at less obviously violent relationships, those in which anger is always just below the surface, those in which speaking up or confronting a spouse, perhaps, or a parent, feels like it risks a put down or a sarcastic remark.

Or perhaps emotional neglect, when a person's need for validation and approval isn't met or when that individual is denied the power to make basic decisions.

In the case of sarcasm or verbal sniping, the receiver hears he/she's "responsible" for the anger. In the case of emotional neglect, they're "responsible" for their own lack of power, too incompetent to make decisions.

A person (let's use the female gender) begins to doubt herself and her worthiness over time. She thinks perhaps she doesn't really doesn't need the things she thinks she needs, after all. She only needs what he says she needs. She is under the influence. His influence.

It may translate into that famous of all couple therapy bug-a-boos, control. He has control issues.

Sometimes it gets pretty ugly. He controls the movies they see. He controls their vacations (his family can go with them, perhaps, maybe ALL the time). He controls the money, won't let her spend money she herself has earned. He can do that because he's convinced her that it's a selfish thing to do, they need to save.

Once he's convinced her that she's selfish for having material needs, he controls whether or not they buy a second car. He controls whether or not they go out and have drinks with friends. He controls whether or not they go out at all and with whom.

He controls whether or not they have sex. He controls whether or not they buy TIDE over the store brand. If she argues, he convinces her that she's selfish. He's the one with the common sense in the family. He's the one who can make good decisions.

She loses the part of her that went into the relationship with self-esteem. It gets buried, EVEN IF SHE HAD IT BEFORE THEIR RELATIONSHIP BEGAN.

This becomes another example of what you don't use, you lose in relationships. If you don't use decision making skill, you're not validated for making good decisions, you doubt you know how to make them.

How can you leave a relationship under those circumstances? Do you see where I'm going? It's hypnosis, basically. She's too unsure of herself to make a move.

At home, and on the job, out in the world, to get that part back, to be validated for the person she remembers she is, she works harder than anyone else and does more than anyone else, but she's still insecure.

This can be the essence of people pleasing. Living to please; living for praise from others. Sometimes people like this work so hard that they falls into a very well-defined category of depressed people that I am compelled to advise, Okay I think I want you to take some family leave time off work, people who have crashed and burned from overcompensating on the job.

These people NEVER WANT TO TAKE FAMILY LEAVE! They're my favorite people. You guys are my favorite people and I die for you to get out from under the influence, to break the spell.

Sometimes getting out from under the influence is simply taking back one's life, saying no, doing what you want. Most controllers can't fight it when their passive spouses assert themselves. They're too weak themselves at the end of the day.

IF THEY'RE PHYSICALLY ABUSIVE, however, these men are dangerous and their wives know that they had best not rock the boat.

BUT IF THEY'RE EMOTIONALLY or VERBALLY ABUSIVE then the women who are married to them have already lost the shred of self-esteem that might enable them to bark back.

That barking back won't happen without intense professional coaching and scripting. I've talked to hundreds of women who found it almost impossible to say:

"When you talk to me that way I don't love you. When you talk like this you're unlovable. I want to love you but you're unlovable when you behave this way. I want to love you. Please stop. You know you don't mean it. Inside, you love me."

How HARD, (expletive it) is that? It's pretty darn hard to get words out when you've been convinced that he's going to turn it back on you, no matter what you say, make you feel worse.

AND IN THE CASE OF SEXUAL ABUSE?
To come forward, to assert, to stop the violence is to risk hearing that you're a slut, that you didn't object, that you LIKED it, that you encouraged it.

It draws attention to times that you would like to forget. It makes you feel like damaged goods and worse, THAT OTHERS THINK YOU'RE DAMAGED, SCREWED UP, SOMEHOW NOT WHOLE ANYMORE.

Chaval. It should never happen. No one should have to go through abuse or exploitation. If you recognize it happening YES, YOU NEED THERAPY, YOUR RELATIONSHIP NEEDS THERAPY, HE NEEDS THERAPY (check all three).

And if it's not workable and you know it? Just need to get the blank out. You can pick up the pieces later.

Good job, Teri.

Copyright 2006, Therapy Doc

The Comisky Wound

I haven’t been to the South Side to see a Chicago White Sox baseball game in a long time. When I was a kid the White Sox didn’t play at U.S. Cellular. The South Siders play Comisky Field. Same place, different name.

As a North-Sider and a Chicago Cubs fan, the White Sox, didn’t matter to me. Too far away. We just didn’t go down to the South Side to watch the Sox. The South Side was not only out of bounds, too far, but could have been too “dangerous.” After all, white flight flew north, not south in Chicago, to the northern suburbs. I lived in the most Jewish of them all, Skokie.

A little shuttle train to the city enabled my brothers, friends and me to take the Howard Street L, an elevated train, directly to Addison Street, a North Side stop. We got off at Addison and there was Wrigley Field, tall and proud, home of the Chicago Cubs. Five bucks and we’re in the gate.

It was that or stay at home and watch the game in black and white on WGN, Channel 9. I could quote batting averages of greats like Ernie Banks, Billy Williams, and Ron Santo back in the sixties, and sure, collected baseball cards.

Almost twenty years ago, married with children, I determine it’s time to reward Bobby, one of my four boys, for something or another, probably for reaching 20 points on the ever-present behavior modification "point system" on the refrigerator.

So I buy some tickets to the White Sox/Blue Jays game, not so much for the Sox, but for the Jays. I don't know why, but Bobbie loved the Blue Jays, not the Cubs, not the Sox, neither Chicago team. He probably liked the bird.

We leave Bobby's twin brother Ricky to baby sit our youngest, Sammy, who is about 4 at the time. I think my instructions to Ricky went like this:

1) pick up Sammy at camp
2) take him the park to play
3) take him home
4) eat the dinner that I left you
5) don't burn down the house.

These were the usual instructions.

We take off for the game in the car (you can take the train, but it’s a long ride from where we live in the city), but I’m worried. Ricky is only 11 and Sammy is my baby. It wasn't that I didn't trust Ricky to baby sit a four-year old. It was just that as a working woman I'd had a literal army of babysitters. My experience leaving the kids with kids hadn't been the greatest. They tended to leave me with no vodka at all.

And Ricky was still a kid. But I had told myself and my spouse, FD, that this would be okay. I could deal with a baseball game. Bobby deserved it. Ricky could handle Sammy. We'd be home before too long. The neighbors knew to check in, and FD wasn’t in China, he worked only five miles away.

So the two of us are off to Comisky Field and we get there in one piece, park and find our seats. I’m unimpressed and already regret going to the game. The Sox are not my team. I simply don’t care about baseball, not really, not anymore. I have no interest in drinking beer, like most people, to assuage the boredom. There are no big TV screens, no electronic banners, no bells and whistles. And Bobby doesn’t seem so Tom Terrifically interested.

These are not cell phone days, by the way. Nothing to play with. I wait until Ricky and Sammy should have been home from camp and the park, maybe it’s the third inning, and leave Bobby to find a pay phone to call home. The public phone, since we’re so high in the bleachers, is near our seats.

The phone rings, rings, rings.

It rings and rings.. They aren't home.

Or they were home and have been slaughtered by the home invader. (I have a repeating home invader dream about once a year, never know when it’s coming on, am convinced now, that this is why).

Being a rational-cognitive therapist (among my many beings) I know I must counter these thoughts if I am to survive my anxiety. But I can’t convince myself that the possibility of home invasion is remote. Maybe there was a home-invader. Without proof, who knows?

I call a neighbor and she checks the house, returns to the her telephone to say, "They're not answering. It doesn't look like anyone's home."

"Did you see any home invaders perhaps?"

"Uh, no."

I return to my seat and say to Bobby, “They're not home."

"Oh, I'm sure they're probably over at the Levitt's."

The Levitts! They live near the park! I call the Levitts. No, they aren't there.
I call home. No answer. The phone rings and rings and rings.

Forget countering negative thoughts. The boys have been kid-napped, obviously. I have the worst panic attack in years, have forgotten what a panic attack is like it has been so many years, but even now I can feel this one in my chest remembering it.

My thinking on this, just so you should know, is that if you don't have true panic disorder, but you do suffer occasional panic attacks, with a little searching you can remember them all. I remember them all. I ask myself is these are like the snapshot memories that some prostitutes have, the ones I’ve treated who say they remember every trick.

This panic attack is terrible. My heart is pounding, I can’t breathe. I’m weak in the knees and feel like I’ll pass out. I’m was sick with anxiety, and try to protect Bobby from catching it. Knowing that it’s just anxiety doesn’t help, either.

I jockey between the pay phone and reporting back to Bobby, trying desperately not to panic him. He notices that I’m upset and he is upset, which upsets me more. .

At some point I say, "We're going home."

No argument there. But before we go, obsessively I say, “Let's make one last call for the road.”

Ricky picks up the receiver. These are land phones we’re talking about.

"Where in the world have you been? Are you okay? Is Sammy okay?"

"Huh, yeah. We're okay. We're eating."

"Why didn't you answer the phone? How long have you been home? I was sick with worry about you guys! Where were you?!?"

"We were over at Gershon's house, the Russian kid. We were playing video games in his basement. We lost track of the time."

"Oh. You're sure you're okay?"

"We're fine."

"Why didn't you go home?"

"I thought we'd just stay for a couple of minutes, play a few games and go. I lost track of the time. Sorry."

Never mind that he broke the rule on video games. We didn’t do video games, even then, no Nintendo especially. Not in our house, shunned television, even, and our kids admitted, years later as young adults, that their grades were better, probably because of that. Outside the house, we surrendered.

Never mind that Gershon wasn't on the list of things to do.

They were safe.

"We can stay if you want," I tell Bobby. "We can finish out the game."
But the game is ruined; he wants to go home.

All in all? Not a good memory. Not a feel-good night for the fam, and I stayed away from Comiskey Field, now US Cellular, for many, many years, too traumatized to go back. And anyway, if I’m going to watch two teams play baseball. One of them is going to be the Cubs.

therapydoc

Critical events, risk, and the Chicago White Sox

Critical events are happenings that instantaneously wrest our psychological development from the doldrums, jolt us into growth and differentiation, or potentially retard it, slow us down.

When critical things happen we know we have to talk to someone, a mental health professional, or that eventually we’ll have to work it out. Like we flunk out of school. Or we hear someone has died. The sheer jolt is confusing and the brain just can't do it alone. A critical event can be traumatic, the stuff of posttraumatic stress, recurring memories, intrusive thoughts, and nightmares.

But it doesn’t have to be. A critical event can be benign, too.

You might remember the letter that says you got into college, or the one with your ACT or SAT scores, having a baby, getting your first raise. The jolt applies to finding a new best friend, running the 50 yard dash in under 6 seconds, smoking your first joint, drinking your first drink (alcoholics can tell you the date, time and place), getting your first pet.

All the firsts. . .

First funeral, first car wreck, first prom, first day in prison, first apartment, first day away from home, first bunk at summer camp, first boyfriend, girlfriend, first time having sex, first marriage, first guitar, first time on Letterman.

Psychologists call them snapshot memories. I think of an enormous pop of the light bulb those professionals photographers used before digital became so powerful.

Maybe not all firsts are critical events, and certainly most people don't go to therapy for firsts. They do shape us, however, and serve to divide up our memories, block out the timelines of our lives.

I think of my mother blocking out a sweater, deliberately shaping the heavy wool. Not everyone takes things to the dry cleaners. Some people use Woolight and coax a heavy sweater into shape on a thick towel so that the shoulders don't look funny like they would on a hangar. No, there's no real connection, sorry.

So firsts are good, and they're part of the reason therapy docs are always encouraging us to take small risks, to live a little, push ourselves to do things that are probably good for us, even though we’re scared out of our trees.

New experience is expansive. Action builds self and confidence.

THE STORY

I personally can't stand crowds. The thought of going to Comisky Field, (it's hard to remember that now it's U.S. Cellular ) to see the Chicago White Sox terrifies me. And it's easy to avoid. You just don’t go, save a lot of money.

Last summer FD asked me to please come with him to a Sox game. I hadn't been to one in about fifteen years, had a bad experience that time.

But he begged. Please, honey. I have great tickets. It's our anniversary. Barry and Alex are going (his brother and our nephew, St. Louisans, Cardinals fans). When do you even get to see them? What're you going to do, stay home and watch TV? (Well, yeah).

So I caved.

We approached U. S. Cellular and the traffic got congested. We weren't exactly sure where to get off the expressway . Being late, being lost, this particular anxiety doesn't really throw me, I like exploring. Of course the parking lot was full and the officious-looking traffic people pointed us to a line of cars that edged forward six inches every half hour, going nowhere.

FD somehow made the perfect right hand turn to get us back to State Street where there was parking at the Illinois Institute for Technology. I love architecture so I this was a good thing for me, getting a bird's eye view of a new neighborhood, a new college campus. All my life I assiduously avoided the South Side, being a Cubs fan, and all. The Chicago Cubs are a North Side ball club.

Boy, there were a lot of smiley people going to the Sox game, mostly young, confident people familiar with this world. Or so it seemed to me. Only I was out of my element. But okay, I was cool.

We got inside Cellular and because we had these great seats (thanks to a friend with season tickets-- thanks Stewie) we didn't have to push our way through any crowds. Barry and Alex were already there and my son, I was told, had already stopped by. He vends.

This is the real reason I went to the game, is the truth. I wanted to see him in action before he left home for the year in September. Lemon freeze. Get your lemon freeze.
I took a picture of him and put it up in our front hallway. He’s in his vending jersey. It was a real snapshot memory, with a real snapshot.

Being at the game was unbelievable. They pumped me full of beer (one beer is full of beer, okay, it was 16 ounces). The Sox must have scored 14 runs, and each time, a dream come true for a child at heart, they do fireworks at Cellular!

And the visuals! They have these enormous television monitors broadcasting the game, and moving electronic banners that light up the lower and upper decks. The crowd is insane, their exhilaration palpable. Who doesn't love exhilaration?

And the Sox beat the Cardinals! The Cards are mortal enemies of the North Siders, arch enemies. They always cream our Cubs. But FD and Barry, and Alex, all from St. Louis, are routing for the Cards, and although I don’t like the White Sox, particularly, although hold nothing against them, they beat the Cardinals and that’s good enough for me.

I didn't even have to stay for nine innings because my guys couldn't stand watching their team get whooped. They had had quite enough by the 8th inning. Oh, and yes, I was ready to get out of there by then. Quite enough exhilaration for one night.

The next day I could tell everyone who would appreciate it that I'd been to a Sox game! Those who got it nodded appreciatively.

Honestly don't think I'll ever forget it and am a much bigger person now. I have more to talk about, can join into a conversation about baseball, and I can almost relate to the sport enthusiast thing. Well, not really, but almost

The Sunny Side of Therapy :) :) : ) :) Positive Psychology

This is an FYO on a popular news item in today's Wall Street Journal.

There's a feature story called, "The Sunny Side of Therapy." It's about focusing only on the positive, a person's true resources, strengths, etc. I was surprised the article didn't refer to "blessings."

Now you know I'm a pretty positive person, but I just have to tell you.
This is bunk with a capital B.

It's all well and good to try to stay there, to try to stay happy and to think pleasant thoughts. I heartily recommend it and in family therapy whack bubble bursters over the head with a newspaper (WSJ?).

But when a person is suffering from depression or any of the disorders in the DSM-IV, for that matter, it's going to take a lot more than positive psychology to get well.

Positive psychology is nothing new. Therapy docs have been relabeling problems for years, ever since family therapists (plug, here) found that symptoms were functional for people. People like their symptoms. They not only get attention for them, but they communicate with them.

Even support for "everything's relative" has been around for decades. Broke your ankle? At least you didn't break both. (thanks Y.)

It's actually good to pick yourself up, brush yourself off, and start all over again. Once you can.

Real therapy, good therapy gets in there and resets the bones, cleans out the infection. It requires a little more than applying a Band-Aid.

Those snake oil salesmen made it all up to advertise in the Journal.

There. I've said it. Have a happy day!

Copyright 2006, TherapyDoc

First steps to treating rape-and a therapy story

I wrote this one to show you how badly I can blow a case, and to make suggestions to increase the odds it won't happen to you.


You people know me as therapydoc, but I do research and have a faculty appointment, too. One day I took a call, expecting it to be a client, but it was the dean asking me if I would please take on a funded project. There is this small problem, she tells me, of acquaintance rape.

Ultimately a new agency to treat college rape survivors off campus gets off the ground because of the project, and I get a paper out of it, present it to the annual meeting for the Council on Social Work Education.  It's about how social workers should be treating rape.

But the following story happened years before, when all I had to go on was my fairly extensive knowledge of cognitive behavioral and exposure therapies for anxiety and post traumatic stress.  I had used these tools for all kinds of abuse and assault, even for rapes that had happened in the past.

So I'm thinking I'm good talking to a rape victim, someone freshly violated .  Dispassionately, quietly, she tells me, "I was raped over the weekend."

Tell me everything.

"It was right outside your office, across the street at the park on Saturday night. I had parked my car on the street and left a party around mid-night. I saw a man in the car parked behind mine. Before I got into my car and knew what was going on, he grabbed me and pulled me into the park and . . ."

How awful. Did you report it?

"No. I was very embarrassed and I guess, shocked. I was a virgin. I just wanted my mother. I went home. We wanted to keep this private so we came to you for help. The insurance company said you could help me. You know this."

Uh, huh. I know a little. Do you mind telling me the story again? Try to remember everything.

She tells the story again. I am treating this like other trauma or crisis, going over the story, not because I care about the grisly details, but for the healing and warmth, the retelling in a safe place.  I think she'll suffer, this will haunt her, she will have nightmares, and want to warn her of this, begin the exposure therapy immediately, rather than get to know her as a person.  So I objectify her, too, treat her from the book.  I haven't even heard of Rape Trauma Syndrome, something unique, needing something different.  It's not in the DSM.

Assuming that there is meaning in the madness, the mandatory telling and retelling of the narrative, there is theory behind exposure therapy.  Flood the brain with details and it will tire of them.  People who haven't been raped retell silly stories to their friends about things that upset them, then tell them again to others, then retell them to friends-- and the stories are infinitely less traumatic. Somehow there's mastery in the retelling. We feel more control over the situation

I not only tell people to retell stories, but if they are traumatic, we'll do the retelling under very controlled circumstances, bit by bit, over many sessions, for cognitive exposure.  The cognitive in this type of intervention is a way of saying imagined, or visualized, in the brain. That's how therapy is, sometimes, very purposeful, behavioral.  And this helps quite a bit, structured technique.  Add a little EMDR, and you're golden.

Like I said, I'd done all kinds of cognitive behavioral therapy for trauma victims, and there's more than retelling.  We might do a rewrite of a trauma, for example, then repeat the rewrite over and over again in sessions. Sometimes the victim of an assault will bring in a friend or trusted relative and we'll talk about revisiting the scene of the crime, repeatedly, to allow the brain to integrate the idea that in fact, the perpetrator is no longer hanging around.  This type of therapy is useful for any type of assault.  It's useful for kids, too, who have been beat up, bullied.

But rape.  Treating rape.

Wrapping your head around so much stuff, you can't rush it, and sometimes all of that work does nothing to counter the idea that the perpetrator will come around again, eventually.


Rape can be devastating. It can affect a person's emotional and physical health (and will). Reproductive problems or pregnancy, sexually transmitted disease, broken arms, bruises, tears, concussions, even death happen. Emotional symptoms include depression, anxiety, sleeplessness, intense fear, flashbacks, nightmares, suspicion, hyper-vigilance, isolation, irritability, lack of concentration. Socially things can go crazy—victims hide from everyone, stop going to school, lose jobs. 

All of the above and more are consequences of rape.

This is not a short-term therapy.

I have to admit, when this young woman came to see me, I didn't know enough because I knew nothing about Rape Victim Advocacy.

If I had referred this young woman to a victim advocate program or had worked closely with one at the time, she might have continued her treatment, perhaps joined a support group, worked to become a survivor, to help other victims become survivors. 

Who knew?

Rape victim advocate agencies are state funded (in Illinois, relatively well funded at this first writing in 2006) and employ individuals who have often experienced rape themselves, who may have had therapy, surely had support and advocacy, and are now able to work with victims to empower and transform them into survivors.

Advocates call their clients frequently after the first contact, worry about them when they don't show up for appointments, ensure legal advocacy and medical intervention. In other words, they go the extra, extra mile.

Sure rape victims can use therapy and will need to recover from the physical-emotional onslaught they experienced. But I have to say, seriously, based upon my own knowledge and my experience treating that young woman four years ago, that this trauma calls for more than therapy. My client didn't return after the second visit.

Rape victim advocates are the best first step. All kinds of docs need to know this, not only therapists and psychiatrists, but primary care physicians, Ob-gynes, everyone. Get the word out.

therapydoc