Snapshots

Let's just catch up with one another, run with good old stream of consciousness. Because everyone likes Freud.

(1) Stream of consciousness reminds me of water, we can start with this. Mine was pretty dirty when I returned from a ten-day work-vacation, lots of brown algae covered the glass. The water hue had changed, but it wasn't  something that just called to me.  Mostly people called me.  Inspired by dialysis on Desperate Housewives,  I finally got to siphoning a couple of very pathetic aquariums after weeks of neglect.  When you get behind on the maintenance, when you don't siphon your water, you have no idea the guilt.  Hard to look your friends in the eye.

I'm so glad they're alive, seriously.

Meanwhile, at the office. . . listening to someone spill some serious issues . .  it occurs to me that there's a dead fish in the tank. (What did you think, there wouldn't be a tank at the office?).  Something on the floor of the aquarium looks dead. And the tail count of swimmers seems to be down by one.

It's hard to focus on my patient's problems, but I do, I get through the session, a little worried, but focused, more alive than ever with guilt.

Caption balloon over my head:

They starved while I was away  
One of them became the other's dinner.
I poisoned them, left the water unattended for too long!

The 45 minute visit ends and I rush to the tank to see--  Is he really dead? No!  Clown II is very much alive, treading water behind a rock. The lifeless matter on the aquarium floor is a piece of orange coral.

Between patients I change a fifth of the water, really fast, scrape some algae off the sides, dry up the evidence. Feed the goof-balls a few vitamin-enhanced flakes.  Take a deep breath.

(2) But down to more important things.

If you're a Chicagoan, the best news in months is not Rahm Emanuel running for mayor, it is the Bears making the play-offs. They compete against old rivals, the Green Bay Packers, and the city is stoned, has caught a fairly nice buzz at the very thought of Sunday's game. There's no way to describe what it means to Chicagoans to have a winning team.  Our serotonin levels skyrocket; people come to therapy and it's all about the Bears and how much better this is, winning.

What about those Bears! Can you believe it!   

Just a giddy bunch of urban bleacher bums. Makes no sense, but who cares?  Anything to make a city happy.

You know they lost, right?

But the loss, too, is thrilling, and most people appreciate the game, even me, a person not particularly into sports unless I can play.  I'm just happy that millions of sports fans can vent and bet and get their bad karma out of their system while watching men or women in pajamas and hats play their guts out. It's a fine use of displacement, one of our fairly primitive but surprisingly accessible defenses, give it over, whatever it is, to someone else, and how anger should be expressed. Shout it out about a play. 

Sublime.

Except for the domestic violence that follows after the game when people have had too much beer.  Other than that, spectating  is a brilliant coping strategy.

Even better is when watching the game with friends and family is like being a part of a support group.  People who would never go to therapy do this.  The best example I've ever heard comes from someone who tells me that his family is so serious about their team that they won't even watch a game with someone who is not a fan. They just can't stand the thought of the enemy so close.

I can totally admire this. This makes sense. Get together, bond over guacamole and a game that will be yesterday's news tomorrow.  Purge all the hatred and anger, the sadness out of your system-- as a group!   It is enlightened, and don't think they don't know it.  That's why you can't get in.

Even in defeat a group like this is empowered.

The Bear loss, unfortunately, means that the feeling is gone, the serotonin awash, even though Chicagoans know how to take defeat, we're used to it by now, builds character.  And do we have the Bulls, let's talk, and the Blackhawks.

What really blows me away about the Bears game, to belabor the subject just a little more,  is life imitating art. The night before the game FD and I had watched On Any Given Sunday, an Oliver Stone soap about a third string quarter-back, a nobody who saves the season. The top two quarterbacks are field carrion, massacred by other teams, and the third-string do-nothing is all the home team has left. He takes the ball and we see that long, long pass in slow-motion, the pigskin gracefully propelling across the field into the arms of the receiver.  Over and over again. We see this axis shot about five thousand times, but it's worth it because these are happy moments and he's the hero of the day! We need heroes is the truth.

Then at the playoffs, the very next day, Coach Lovey Smith is forced to play his third-string quarterback, Caleb Hanie, for the Bears. His two other quarterbacks are hurt. Hanie throws two quick touchdown passes in succession, almost saves the day.

Anyone who can save the day, however this happens, whenever, deserves our blessing. And all I can think is . . . until now . . . I didn't know there was such a thing . . .  as a third string quarterback.

I could learn to love football, not sure. So many underdogs.

The joke is that I thought I ordered what I thought was On Any Given Sunday, a DVD, because FD told me that I had to know more about football before presenting wellness workshops to football players. He tells me this and all I hear is Buy movie.  Tax deductible. On Any Sunday, or something like that.

Turns out On Any Sunday is about motorcyclists.  But that's what I got.

Which is why we have On Demand, only $2.99. Although I do sort of want to see the Steve McQueen movie at some point, can already hear the movie in my head, VvvvvRrrrrrMmm, can't you? 

A few inspirational quotes before we go, from the sage fictional football coach. We all need one of these in our lives, a sage coach.

On any given Sunday you're gonna win or you're gonna lose. The point is - can you win or lose like a man?

When a man looks back on his life, he should be proud of all of it, not just the time he spends in pads and cleats.

The game has got to be about more than winning. (Are we sure about this?  What am I missing?)

(3)

Before this whole football thing, before taking off for my work-vacation, Chicagoland felt pretty bleak.  Most people don't take advantage of the snow, don't get out on cross-country skis, traipse through the alleys and parks while talking to psych nurses on their bluetooths, marveling at powder.  Everyone seems depressed, cold,  broke, worried about  black ice.  Nothing to look forward to, holidays over, it's not good.  And because people are scrambling to figure out their insurance in early January, and the incredible emotionality of December has died down, I try to take off.

Without telling anybody.  I've learned that the best way not to abandon people is just not to abandon them.  Nobody needs to know much about what we do between visits, and we have this thing, it's called cellular communication.

And if you invested in your family, if you have managed not to alienate any of your kids, not so much, then where ever you go, you have people.  You have to see your people whenever you can, where ever they are.

(4)   So let's get to these.

In Atlanta the major attraction, for it is cold here, too, is the Fernbank Museum of Natural History.  There are some seriously large dinosaurs at the Fernbank.  You can imagine what goes on when the doors close.  Some don't eat meat, I understand.  Should we trust them because of this?  Would you not think, Hey, perhaps that fellow, that herbivore behind the little fence, you can hardly even call it a fence, wouldn't mind feeding somebody to a carnivore, sort of make a trade?  Were they nice dinosaurs, the vegetarians?  And the ones that ate meat, were they mean? And if they were, was it because they ate meat?  Has anyone studied this?

Of course, if you watch StarWars, or if your father watched StarWars maybe two hundred and fifty-nine times and counting, then you probably just look at creatures in a museum and think: George Lucas must have liked these.

We made some cookies using a StarWars cookie mold and they were very tasty, not just good-looking.  There are no calories in the parts that you cut away.  Everyone knows this.

(5)

Stinking Georgia flu.  That's as close as I get to cussing.
You know what they say, "If you have your health, you have it all."

Georgia's great, except that along with New York and Florida, it is host to this winter's flu epidemic. Whereas everywhere else in the country people suffered from:

ILI

What's ILI?

Influenza Like Illness.  See, they don't want us to know that they gave us the wrong flu vaccine.  So they're telling us:

Hey, it's not flu! It's a lot like flu, but you're way off if you think that it is flu, way off.

What I took from Georgia, carried along with me to Los Angeles, was not flu, not really.


(6)

"You did it. You gave me the flu. I hate you. Or I will, when the truth comes out.  Thanks for the memories."

So instead of catching the La Brea Tar Pits in L.A., moving as little as possible seemed like the right thing to do. 

But let's consider this.  What's worse?  Being sick?  Or feeling guilty about maybe infecting others? No matter how much Purell you use, you can't swallow the stuff.

The illness is really insulting, embarrassing.  You take the hot bath your doctor recommends to beat your chill, only to find your pajamas fall off when you get out of the tub and put them on.  You have literally shivered off inches.

Still.  You don't care if you're going to die, but you don't want to take everyone down with you and there are better ways to lose weight.

People who worry should be screened for anxiety before they’re allowed to get the flu.

Yes, in case you want to know.  I am the first person to ever have had the flu, the one with the cough.

When it’s over you feel so tough you want to wear a button or a tee-shirt that says,

I had the flu and survived!

Like the winter of 1978 tee shirts.

(7)   There's more, there's more.  But somebody's got to get back to work.

I apologize for not responding to emails and requests for things. You can link, copy to your heart's content, and if you let me know, I'll link back to you.  But get it in writing that it's okay to stream.  And please continue to shoot me suggestions, even if you might not hear back within your lifetime.  You have no idea. . .

It's been hard to get down to writing.  At some point you wonder if you even remember how.  Then you read stuff like this (check out the Erin Brockovich post, his first one) and although it's a little intimidating, you're inspired.


Fifty-five more days and counting until spring.

therapydoc

Loughner: Schizophrenia or Terrorist

a Glock 19—a lightweight, $500 semi-automatic commonly carried by law enforcement officials—to kill six people and injure 13 more, including Rep. Gabrielle Giffords. In 2007, Cho Seung-Hui used the same gun, a along with a Walther P22, to kill 32 people at Virginia Tech before committing suicide. And Giffords herself boasted to the New York Times in 2010: "I have a Glock 9 millimeter, and I'm a pretty good shot."

Readers beat me up for jumping to say that James Lee Loughner probably suffers from Schizophrenia, Paranoid Type, hears voices in his head, follows their directives.

I’m urged to read Slate,

Seena Fazel is an Oxford University psychiatrist who has led the most extensive scientific studies to date of the links between violence and two of the most serious psychiatric diagnoses—schizophrenia and bipolar disorder, either of which can lead to delusions, hallucinations, or some other loss of contact with reality. Rather than looking at individual cases, or even single studies, Fazel's team analyzed all the scientific findings they could find. As a result, they can say with confidence that psychiatric diagnoses tell us next to nothing about someone's propensity or motive for violence.

I'm reminded that most people with schizophrenia do not buy guns and do not shoot people. They try to get help.

As advanced as we are, that should be true.  But many of our homeless suffer from severe mental illnesses like schizophrenia and refuse help.  Suspicion of others, negative attribution, is the nature of the disease.  And the onset isn't usually until adulthood, so the premorbid space, when a person is beginning to get sick, is often overlooked as an adjustment disorder or depression, even individuation.

The problem is that the suffering of schizophrenia is incomprehensible to “most.” We're told to avoid people who talk to themselves, and that's probably not bad advice.  It is a very complicated illness, attacks cognition and emotion, feels primarily like anxiety. Behavior seems irrational to others, strange.  Thinking is different, careful, afraid, comes from a dark place.  This is a vulnerable population.

So the complaint is leveled.  How dare a therapist link violence and mental illness?  Such a gross injustice to millions who suffer mental disease.  Never my intention to claim statistical significance in any way.   These are idiosyncratic cases, off the charts, outside the norm.

And the real menace is that Glock 19.

This is not to say  that the individuals who perpetrated mass murders within the past three years in this country were not mentally ill. Two mass murders at large schools, Virginia Tech and Northern Illinois University, young assailants suffering from schizophrenia.  Access to guns.  Jared Lee Loughner seems familiar. Social profile detached, expelled from community college pending mental status exam, a lesson, no doubt, from past school attacks. The sheriff says, 20/20 hindsight, We knew about Jared.

But still, jump to a diagnosis of mental illness when so many other things predict violent crime, and mental illness is usually not one of them?

Diagnosis is what therapists do, sorry. We make initial, provisional diagnoses. We consider context, but at the end of the day, we see the individual and it's our job to assess what hurts. Schizophrenia is an Axis I disorder, which implies the illness isn’t a function of personality development, or behavior. The disease itself hurts.

Social context affects that pain, can even predict the course of an Axis I disorder.   But in the case of schizophrenia, environment doesn't make it so. It is in the genes. Of the contextual variables associated with schizophrenia, the one thing we know is that it gets worse, symptoms “flare up,” when there is anger in the room.We urge families to tone it down.

We also know that the onset of the illness for young men tends to be young-adulthood, when developmental stressors collide with coping skills. Crunch time: What do I do with the rest of my life? I can’t live here forever!  And my skills, my learning even, seems limited. 

More hearsay about the Loughner case:

(a) neither of the two parents socialize with neighbors,
(b) his mother buys two cases of beer, 30 in each case, with the family groceries,
(c) she is the only one in the family holding down a steady job,
(d) neighborhood kids think of father as an angry man who irrationally yells at them
(e) only son Jared is considered odd, has access to the Internet, obsesses about political conspiracies, seems dangerous and disconnected to others, seems to be in his own world, laughs when no one else is laughing. 

We might think Jared is from an alcoholic family, was neglected/abused, perhaps an unfair assumption. We might wonder how anger affected him. And sure, we might diagnose him on the many spectrums of mental and behavioral illness, including autism/asperger’s, and attach various personality disorders, Axis II’s, the personality disorders, considering his odd behavior.   Or bullied, alienated, like millions of others, he found comfort on the Internet and inspiration for assassinations. Unhappy childhood, solace in socio-politics, a decision to end a quiet life of desperation with a bang. Save the world.

Not necessarily schizophrenia. But do we ignore a diagnosis of schizophrenia because it isn’t politically correct? Isn’t it possible that in some cases it can happen that people do hear voices or receive Internet messages that tell them to kill a dozen or so people in a supermarket parking lot?

Group statistics are there to find central tendencies, describe groups of people, averages over thousands. The men who pull triggers on innocent people are hardly average. They are so few and far between that they do not dent central tendencies. We’re grateful for that. Group statistics de-stigmatize. Most people who suffer from mental disorders are not violent. Would that we could say that about the non-clinical population.

These particular cases of mass murder are unique. We wouldn't be very interested in them if they were not. This is why I’m so interested when it happens. It does seem, in these cases of mass murder, that the offenders suffered from Schizophrenia, Paranoid Type.

We're not doing enough to detect and protect the mentally ill.

More salient to the issue is that everyone has access to guns, not only people who have no rational control, whose minds aren’t functioning in our reality, who should be on some medication, in groups, therapy, rehabilitation. Killing is glamorized on television fifty times a day, and in the movies, as are theoretical concepts, ideas about assassination, terrorism, taking justice into one’s own hands.

I used to think

terrorist = suicidal bomber packing nails and bolts on a bus

But why wouldn't terrorists use automatic weapons? We don't label terrorists with mental illness, we call them social activists with an agenda. What is gleaned from Loughner’s indecipherable rambling on the Internet is that he is anti-government, a terrorist, essentially. He has an agenda.  Something out there made sense to him.

Or others found him, perhaps a group sponsored his gun, ala  Lee Harvey Oswald. That's surely what they're saying.

But I'm putting my money, sad to say, on his illness.

therapydoc

Jared Lee Loughner

He didn't look like a particularly healthy guy, but they sold him an automatic in Tuscon. No mental status exam, apparently. Indigent, he bought a $500 gun. You have to wonder. How does that happen? 

Gabrielle Gifford is hurt and six others murdered, 19 injured.  Glock 9, an automatic weapon, in the hands of a "mentally unstable" person.  Holds a clip of 15.  The whole neighborhood knew he was "very troubled."

We're watching the morning news and my daughter asks me, Should the kids really be watching this? Vampires are okay, werewolves, fine. But reality is scary.

He left us notes:  I planned ahead.  My assassination.  Gifford.

Lest we give the credit to someone else. 

Assuming he suffers from Schizophrenia, Paranoid Type, the credit goes to the voices in his head that told him to do it. 

But voices don't buy anyone guns. Someone has to sell these. And the whole town knew he was a time bomb. They were afraid of him, he was so odd, so disturbed. Couldn't someone have reeled him in?

Supermarket parking lot, people there to meet their Congresswoman.  Nine year old, Christina Taylor-Green. Dorwan Stoddard.  Federal Judge, John M Roll, just leaving church.   Phyllis Schneck.  Gabe Zimmerman  Christina Taylor Green, Dorothy Morris.

And the Congresswoman, a gun owning Democrat who married an astronaut, loves motorcycles is clinging to life, a bullet through her head.   The Tuscon tragedy is associated with her politics, left of the tea party.  But the shooter was a liberal. 

Judy Clarke,  attorney of the indigent, including the Unabomber, Theodore Kaczynski,  and 1996 Olympic park bomber Eric Rudolph, and Susan Smith, the South Carolina mother convicted of drowning her two sons by allowing her car to roll into a lake with the two toddlers strapped in their car seats will be representing Loughner, who will likely be diagnosed as mentally ill. 

So far the assailant hasn't said anything.  That will be something, his statement, although it is unlikely he will make one. Maybe he doesn't suffer from Schizophrenia. The violence in this country isn't limited to people who have Schizophrenia, although these mass, public murders do seem to have that running theme.

If he has other reasons, we're all ears. Antisocial Personality Disorder, perhaps, associated with most criminals who feel no guilt. Or werewolf, maybe.

therapydoc

Sexting and Mental Health

The Brett Favre sexting case has been bothering me, mainly the thought that since he sexted, Mr. Favre has had nothing but bad luck.

It's probably a huge stretch, but I'm going to throw an idea out there anyway, wondering exactly how wrong I am. It's on my other blog, so here's the link.

Have a happy, healthy, thoughtful new year, everyone. See you in 2011.

therapydoc

The Holidays and Business

Housekeeping:  There's another poll on the sidebar, take a minute.  And this post feels long to me, so grab a bite to eat and come back.  Settle in.

"Last year you weren't nearly this busy," FD corrects me.

I had told him that I'm beginning to feel the effects of nonstop holiday happiness.

"Who can remember last year?"

I remember blogging about this once, getting ridiculously busy in October, the drama, the sadness, the relentless desperation not letting up until after New years. I wrote that it had something to do with the stress of planning, how planning extended lengths of time socializing with family brings back memories, and they aren't usually the good ones. Heaven forbid we should remember the good ones. 

The thought of Uncle Al getting wasted, Cousin Ina slamming the door, swearing,  "Okay, that's it, we're getting a divorce!"  This type of family dysfunction-- boozing, screaming, slamming-- anger-- even passive-aggressive anger, "Good to see you, too," especially this-- tends to be a downer.

Add to that the happy family script: We're supposed to like getting together as a family.  You've seen the commercials, especially the one with the cousins getting away from their parents to a restaurant for dinner, just the cousins.  Delightful, but how often does this happen?  Great when it does.  I think it was Leo Tolstoy who said, 

"Happy families are all alike; every unhappy family is unhappy in its own way." 

Anna Karenina.  He was right, of course.

A prescription to manage the anticipatory anxiety:

a) plan as little as possible, wing it
b) label dysfunctional patterns, but don't argue; discuss
c) have an escape plan
c) expect little
e) accept a lot
f) and when the catastrophic expectations materialize, laugh about them.

Because after all, they were all predictable, the catastrophes.  We know our family members well enough to predict their nahrishkeit (rhymes with bar-ish-kite, means foolishness).

So clear the snow off the getaway car and check the availability at the local hotels.

But getting back to FD. He is right. This season has been the worst in years. Something in the air, something other than poverty, although poverty, and the anticipation of poverty, doesn't help; it is bringing people down.

The social scientist in me says it is entirely random, this year, and I'm different, too.  It is the luck of the draw, the draw of my particular patient mix, and really, mine is great, but this is work, not cocktails.  If you accept a lot of new patients, the complexity, the responsibility, will overwhelm. Never launch them, is the answer.  And take frequent vacations.

Maybe, however, there's a global confluence of variables at work, too. The unemployment, terrorism, the economic collapse of governments, the senseless murders and suicides hashed over repeatedly on the ten o'clock news. Kids voluntarily foregoing childhood, sexting.  War in Iraq, no pay raises for military families.  Riots.  Explosions in the Middle East.

Business as usual? Maybe yes, but these nagging toothaches add to what we already have, pain in our own ecosystems, in our own families, somewhere there is pain.

So avoiding the worst of times* is the prime objective.

We could start with ourselves, logically. Others might act out, Uncle Al, Cousin Ina, but we're affected, too.  Under the spell of what is supposed to be intimacy, I think the healthiest among us regresses. Where else can we be ourselves, the ones we used to be as kids, if not with family? 

We're a little different when we're with them, our siblings, parents, grandparents, aunts and uncles, cousins.  We slip into old patterns in the same context, eating and drinking with them, the same dinner table, hearing the same snarky jokes at somebody's expense.  The context triggers the synapses, old nerve pathways, thoughts and feelings of childhood come alive, like some ghost of holidays past.

Once we're there, we lose our more mature defenses-- intellectualization, rationalization -- the ones that make us think things through, forgive; and we regress to the childish ones, denial, projection.  The ones that blame.  The fun started with planning; being together finishes us off. 

You might think it isn't worth it, going home, but I think it is.  It's worth watching how this happens to us, and better even, it is worth labeling what is going on, appealing to the intellect of others in the family, the ones who might get it, who work programs or have had some therapy, or maybe caught on years ago, as children.  Also appeal to the heart of the family, the place in each of the first degrees, second degrees, thirds, that wants this to be a happy family.  Enjoy the best of everyone, and fight the regression to denial, projection.  Stay adult.

Just don't referee.  That's what you spent money on the tune-up to avoid. 

Not everyone goes home, goes anywhere is the truth.  If we didn't have good holidays as children, if there were no presents under the tree, if there was no tree, if there was no dad, no mom, if nobody filled in, if there was no Santa Claus, if someone died,  then for sure, no matter if we have reinvented ourselves, now have a functional family, a home, it is still sad, remembering. And if we haven't reinvented ourselves, if we have successfully abandoned the dream of the happy family, then there is no reunion.  No matter, sad.

And if our parents didn't make it as a couple, if there was violence in the home, if there is violence in the home now, then LOSER is written all over us, we're sure.  Adult Children of Losers, ACOL's, and sadness. And the expectation that our spouse should have helped us correct this by now, by the holidays, for crying out loud, and didn't, then the blame game is in full swing, and it can be a very loud game.

Conflictual couples conflict the most before and during the holidays (probably associated with license to drink/use). It is wishful thinking, peace on earth.

My son asked me, "Why do you think this is, that people lean on their therapists more during the holidays? You would think they would be busy baking cookies. Eventually everyone needs cookies."

He is thirty-two, responding to my late office hours. I tell him that time's running out.  Fix it now, fix it now, people tell themselves.  Count down. . .Ten more days . . ., nine more days . . ., eight more days . . ., seven . . .

And the days are getting colder, and darker, and what we really want, all of us, is to snuggle up close with people we love, or one person, maybe by a fire, and sip something warm, maybe hum, turn on Johnny Mathis, sing.

That would be the goal, I suspect. And by the time we get to December 24, some people pull it off.

therapydoc

*Different author, Charles Dickens, A Tale of Two Cities.  Bring one of these, a good book, on vacation.

Elizabeth Souter: The Editor

Oops! Housekeeping: I forgot to tell everyone to please check the sidebar and vote.  It was an impulse post, and once someone votes you can't edit it.  It should read:

__M-Th between 7-10 pm, CST
__Sunday 1-5 pm, CST
__M-F 9-12 am, CST
__No Thank you.

The lectures are about intimacy regulation, what else.

Onward.


A few months ago, a Harvard educator contacted me and asked if she could take a stab at editing a few posts on Everyone Needs Therapy for free. Of course I jumped.

Free? The only thing anyone has offered me for free is a set of screwdrivers from Home Depot. Which I declined. First accepted, then declined.

But this? A dream come true. We talked while I waited for the good people at 7-11 to make me a pot of decaf (between patients, don't think the phone ever stops), and I told her that I barely pulled a C in Rhetoric in college, probably because I didn't understand the meaning of the word, rhetoric. They assume you know what it means when you're in college, the name of the course.

Anyway, Elizabeth, tzideikat, (rhymes with lid-ay-not, means a female saint) took a red pen to my work. It got pretty crazy, reading the edits,

but she was nice enough to also show me how it looked edited, which is what you got.  After the second pass.

Plenty of bloggers are really writing for themselves, as they should, because as you know, writing can be therapeutic. But if you write for an audience, you're talking performance art, and everyone wants a good performance. Most of us need a good coach for that to happen.

A few months ago I watched my granddaughter's ballet class, and the patient coaching of Miss Vanessa, well, it was a thing of beauty watching her work with those kids.  Not that the raw performances weren't amazing, and let me tell you about my granddaughter. . .

That would be a digression.

So Elizabeth -- professor, writer, editor, and blogger at Motherhood is Not for Wimps – was kind enough to doctor a post or three, and the five-year old in me gazed up and said, Plie' away.

She teaches blogging at Harvard Extension School, so she's probably bleary-eyed at the end of the day, and I hated to overtax her. Still, she asked for it, and she took my scribble scrabble, delivered line-by-line feedback, evaluated how I write, the voice and constructions, my strengths and weaknesses. (Two of the edited posts are up, one will require a lot more emotional energy from me before you'll ever see it.)

Of course, it was like good therapy. Lots of encouragement and validation, things to think about, stuff to work on – enough to jump start the critical thinker in anybody, planted firmly, as you well know, by some previous mentor you surely merited along the way, probably by a first degree.

But the results of those critical introjects!  You have to thank the coaches, the moms, the dads, the teachers, the sibs, the neighborhood folks, that guy at Little League.

Thanks Elizabeth.


therapydoc

P.S. If you want to work on your blogging, strengthen your voice and the quality of your work, Elizabeth Souter tells me that she is not too wiped out too take on another client. (She writes, too, is a published author). Check her out at Motherhood is Not for Wimps, but for an editing appointment, check out her personal website.

In Treatment Versus 30 Rock Chain Reaction

Having only watched the 45-second HBO web clips of  In Treatment, I don't have a right to judge.  But these are fairly delicious.

Dr. Paul Weston (Gabriel Byrne), a dark, Jewish Dr. House-ish parental child with abandonment issues and at least three seasons worth of conflict, explores his feelings openly with a therapist, hits on his therapist, is hit on by his patients. What could be more compelling than this?

How does it happen that in over thirty years of doing therapy, no one has hit on me? I must be doing something wrong.

In Treatment surely grabs us where we want to be grabbed-- emotionally, of course-- fully engages our empathy sensors. Someone told me the show feels voyeuristic, as if we're watching true stories, the scripts seem so real.  I took a look at the Wikipedia recaps and no surprise, the stories really do match the kinds of narratives we hear off screen in therapy. 

As time passes for a therapist, stories like these lose their edges, blend in with one another.  Patients I haven't heard from in ten years will call and ask, Remember me? I do and I don't.  But I remember them as soon as they plug in their key words: drug dealer, death of a family member, affair, domestic violence, rape, cancer, cut-off.

So much is universal.  Sometimes telling over bits and pieces of case studies here on the blog, changing the names, gender, race, location, etc., feels like overkill.   So much trouble just so that nobody can exclaim, Hey, you told my story!   Just not that special, is the truth, our stories.  At some point your story, like my story, is just like the story of somebody else.  There's a Jewish expression, Ain chadash tachat hashemesh.  There's nothing new under the sun.  Ecclesiastes, I think. 

Arguable, no doubt.  The way things present, the way the stories play out, the infinite variations of a theme, the content, the details, these are new.  The variations of narratives, like jazz, keep people like me in the game.  They are why people like you like to hear about therapy, talk about it, share the compelling, heart-tugging details of your lives. Every story really is special.

But back to teev.  The TV docs do have fabulous offices, don't they? At first I thought Paul Weston had an amazing office, but then I learned that his patients come to his apartment for therapy.  Dr. Jennifer Melfi, (Lorraine Bracco) Tony Soprano's doctor, he's not.

Still, he's compassionate, handsome, engaging. And although he really needs to get an office, just to be sure he doesn't get too comfortable with his patients, something tells me the show will have a very, very, nice run.

Chain Reaction: Mental Anguish, a 30 Rock episode is completely different. (Spoilers coming up) It's a comedy, for one thing. Liz Lemon (Tina Fey) can no longer deny needing therapy but has no time. So sunny Kenneth -- God gave us two ears and only one mouth because listening is more important than talking-- fills in at work.

Liz lies down on the couch to talk it all out- the betrayal, the lies (Santa)- and Kenneth grabs a pencil and a legal pad to take it all down. A therapist really only needs an ample supply of legal pads, fine tip pens, and a good sofa to go to work, much more important than tea or coffee service. These tend to distract. What, no latte machine?

Listening to Liz brings up unresolved history for Kenneth, which starts the chain reaction. Liz, having told her story, feels better, but Kenneth, the listener, feels sick. So Jack Donaghy, their boss, (Alec Baldwin) steps up to play therapist for Kenneth, and of course, he's next in the chain reaction.

Jack's the one in the suit.

Everyone helps everyone else is the idea. Any one of us can be a pretty decent therapist, given the opportunity (interface be damned). It is why so many of us do dinner with our friends, leave our families behind so that someone else can listen. We may not lie down, but there's something about the process.

The lay therapists on 30 Rock are really funny, of course, at least everyone in my family room laughed out loud. But I couldn't (well, not so much), not because their timing was off, not because the lines weren't funny or didn't fit. They did. But there were too many of them, words. Certainly for a first visit.

If you go to dinner with friends for therapy, you know, to make it work, you really do have to pencil in as many hours as there are eaters. And choose your friends carefully, make sure they know how it goes, the rule not to monopolize. And no need to punctuate, not really.

Leave that for the guys on TV.

I could stop right here, but did read some research on therapy in the media, and learned is that it is variable. Sometimes what we see is spot on, sometimes not. But one thing's for sure. If most of it is like what I've seen lately, it is narrow.

They all seem to do the same thing! It's all a talk therapy, so 1930's, so forties. Whatever happened to the fun therapies of the fifties, sixties and seventies? And what about now, now that we have the Internet? Do you think I don't log on with a patient at least once a week? Look at somebody's facebook page? A single's profile?

There are probably as many different styles of treatment, as many therapy "aps" as there are therapydocs. The personality of the doc is a force of nature, and as hard as some try to be blank slates (the better to read your transference, my dear), it's just not fun, isn't always effective, and it takes forever.

Much more powerful to listen as a kid reads his poetry, or recites a rap, snapping his fingers. Nothing better than this. Or let a patient put someone in an empty chair, describe this imagined larger than life influence, often a parent or a boss, and scream away, express feelings in a safe venue. Or assert, learn to say it nice. The old Gestalt techniques of Fritz Perls are still powerful.

So is Joseph Moreno's psychodrama, literally playing out domestic scenes with family members, real dramatizations of power and control, conflict.

Virginia Satir, a mother of family therapy, had parents standing on chairs, pointing down at their kids, berating them. Virginia made parents feel ridiculous, acting as dictators.

We could go on, and on. Just wanted you to know. TV therapy? Enjoy. But it doesn't compare to the real thing.

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