Tuesday, December 25, 2012

What Jews Do on Christmas

I'm in the kitchen, stirring a hearty vegetable soup so it won't catch, singing Have Yourself a Very Merry Christmas, trying to sound like Judy Garland. It is embarrassing to say how much I love this music.

Judy Garland's Have Yourself a Very Merry Christmas

I didn't always, but the seasonal songs sound so much better now than in years past. Pa rum pum pum pum, orchestrated, mastered.

At this point in the essay the rabbi is throwing me into cherem (gutteral ch). Cherem is for Jews who do and say inappropriate things, things that are patently not Jewish, not a real place, like, say, Oklahoma.

But how can I lie? And he knows I'm just kidding.

Have Yourself a Very Merry Xmas  is from the 1944 musical  Meet Me in St Louis about a family that almost moves away from St. Louis because Daddy has a great job opportunity somewhere else. That’s the whole plot.  Judy Garland, of course, is unforgettable, the song, a heart-stopper. All this escapism while rockets fire, people die in Europe, WWII. Not so very merry.

It wasn't just that movie that took us all in. It’s a Wonderful Life, White Christmas, A Christmas Carol, -- Elf—   people gathered around their televisions during the holiday season, those innocent years before cable. There never were too many Chanucha or Kwanza flicks. We could use some, (add in any holiday you wish).

Jewish people, not being Christian, don’t celebrate Christmas as such. It is a national holiday, however, a work holiday, and we have no religious obligation to make a huge meal or to bake a fruit cake. With nothing to do, the city at our fingertips, some of us follow a tradition to play cards and order in Chinese food, rather than venture out or stick with the standbys, watching old movies in black and white. 

The history behind cards and Chinese isn’t clear, but it seems a fairly old tradition, although the card playing, poker in particular, isn't that old. Chess is more traditional. Having fun would seem to be the objective, but it could also be that Jews had to be on guard, only a century ago, had to stay awake on Christmas eve. Who knew what the Cossacks might feel like doing with a belly full of rum or vodka.

Pogrom*, pogrom, pagrom, pa rum pa pum pum.

Thus on Xmas eve, some observant Jews consider it wrong to engross themselves in learning the holy books, usually an activity they try to do day and/or night. Some do, in fact, play cards.

The Chinese food? Nobody knows how this tradition started or how far it dates back, but my guess is only about sixty or seventy years. (Someone correct me if I'm wrong). The kosher Chinese take-out place in my local Jewel has Xmas specials. If we didn't have such great Shabbas left-overs from Friday night, that feast we enjoy 52 Friday nights a year) it might have been a consideration.

This year seemed the right time for a new tradition. From the start the idea threatened to fizzle, badly.

I thought, How nice! It is Christmas and all of my Christian friends are going to church or home eating Christmas dinner, opening presents. We have the town to ourselves, really. And Les Mis is opening! (See Five Things You Needs to Know about the French Revolution a dynamite review).

So I called a few of my friends and suggested that they grab their spouses, and convinced my brother-in-law, who is visiting, too, that we all go to the opening of Les Mis. We'll sing the songs for weeks to comel.  I Dreamed a Dream, Master of the House, Do You Hear the People Sing -- these are songs that compete for mind space, heal any inner conflict, deserve a whistle. Shower choices, most definitely, even good for the locker room.
Hugh Jackman, Jean Valjean and Isabelle Allen, a young Cosette

Only a few deigned to join in, but before they committed not to commit, my anxiety set in. Critics panned the movie, at least had plenty of negative things to say.  It's too long at two and a half hours, they kvetched. They pouted that the voices are the voices of actors, not people who can sing, not opera stars. The bloggers wrote: Who said Hugh Jackman, Anne Hathaway, or Russell Crowe could sing? They can't! 

Oy vey. I'm toast.

Having nagged people to come out, stealing their valuable time, time they could have spent playing poker, eating Chinese food or tooling around downtown or the better-heeled suburbs looking at lights and decorations, I thought: What if Les Mis is terrible! What if it is so terribly long, so boring!

I obsessed over this, then text messaged everyone: If you don't want to go, or you don't know the music, or you have any doubts, I won't be mad. It's okay. It's really long. I don't want you to feel you have to do this for me.

People got defensive, no question: (a) everyone seems to know the music. (b) nobody cares how long it is supposed to be, they will go or not go for other reasons, mainly that so and so is or isn't going.** 

FD tries to calm me down, rational as always. It is an opera, honey. Operas are long.

Oh, we love the opera, the two of us, and this made so much sense, made the length of the film an asset, not a liability. So off we go, guilt free.

The show is mobbed. The lines are long. We buy tickets online but are still sit in the fourth row from the screen, this because we're late. For any other movie, being in the fourth row might have been a deal breaker. I might have walked out, fearful of vertigo, neck strain. 

But Les Mis is fabulous, and even seeing every pore of every actor, disturbing as that can be, didn't feel that disturbing, and the dirt, the grime of France in the early 19th century, the misery! But they are supposed to be miserable, are they not? It is in the title of the Victor Hugo novel.  So they are miserable and often we feel miserable, seeing how miserable they are, but face it, none of us live in this kind of squalor so we walk out of the movie counting our blessings, clean, happy, and singing songs.

Which totally beats poker and Chinese take-out.

Have yourselves a very merry Christmas, dear friends. My hunch, your left-overs will be pretty good.


*a pogrom is the pillage, massive slaughtering and rape of a particular ethnic group, usually huddled in fear of clubs and bats, either  in small villages, or urban settings in Europe in the 1940's.

** my friends aren't really like this, it is a joke at their expense (sorry)

Sunday, December 16, 2012

Adam Lanza and Asperger's Disorder

Adam Lanza (Elite Daily)
I knew this would happen, that someone would slap Asperger's on Adam Lanza, a child so shy, so withdrawn, that he clung to the walls of the school. His mother took him out of school, home-schooled him.

She also told a babysitter, when he was a young teen, "Don't take your eyes off of him for a minute."

Mrs. Lanza kept a pristine, perfectly ordered home. People will say Adam was angry at her for that, or because he was enmeshed. At age twenty, two years after his last contact with his father Peter, he snapped, bought a gun, and became a mass murderer. Some will say it was about that. Others will say he was a bully, that he picked on people younger than himself. He attacked children.

And then there is always the sociopathic diagnosis, but Adam doesn't fit that as it appears in the DSM IV. He wasn't charming and he didn't con people.

We might have thought he had a severe version of Intermittent Explosive Disorder, except that these murders were premeditated, not a result of a simple tantrum.  It was a complicated tantrum.

Most people are saying that schools need better protection. I envision bullet-proof doors and intercoms. Even then, even after gaining admission to the building, visitors will first pass through a metal detector, with no one else in that lobby (this is my imagination on autopilot) and if they don't pass, won't be admitted through the second set of doors.

We can't afford to lose school guards, principals, psychologists to people who have lost all control, who are listening to voices in their heads that tell them, "Do it! Kill everyone!"

Life is precious. We are all in tears over this.

The Wall Street Journal posted excellent advice, what to tell your children, how to discuss these murders. They need to talk, and all week, this week, hopefully they will have that chance.

When the discussion comes to diagnosis, every child with Asperger's will be hiding under their desks!
It shouldn't be this way. It is not a violent disorder. Paranoid Schizophrenia-- that's a violent disorder, and Schizoid Personality Disorder, typified by aloofness characteristic of Adam Lanza, is sometimes premorbid to that.

The history we're hearing does not indicate any prior sociopathy. We're hearing he was shy, wore black.

I wrote about this when Cho Sueng Hu massacred 32 students at the Virginia Tech five years ago. Most professionals agreed that he suffered from Schizophrenia, Paranoid Type, and perhaps had Schizoid Personality Disorder, too.

For the record, since the DSM V (the American Psychiatric Association's diagnostic and statistical manual) isn't out yet, we're stuck with the DSM-IV. Here are the features of the disorders I think are relevant to Adam Lanza. Of course, I could be wrong. You be the judge.

Asperger's Disorder, 299.80

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:
    (A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
    (B) failure to develop peer relationships appropriate to developmental level
    (C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
    (D) lack of social or emotional reciprocity
(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
    (A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
    (B) apparently inflexible adherence to specific, nonfunctional routines or rituals
    (C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
    (D) persistent preoccupation with parts of objects

(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)

(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

Schizophrenia, Paranoid Type 295.30

The DSM IV-TR doesn't paginate, the following four all merge into one in the bible. Actual symptoms, that check list, won't help you at all.

The essential feature is the presence of prominent delusions or auditory hallucinations in the context of a relative preservation of cognitive functioning and affect. Symptoms characteristic of the Disorganized and Catatonic Types are not prominent. 

Delusions are typically persecutory or grandiose, or both, but delusions with other themes (e.g., jealousy, religiosity, or somatization) may also occur. The delusions may be multiple, but are usually orgnaized around a coherent theme. 

Hallucinations are also typically related to the content of the delusional theme.

Associated features include anxiety, anger, aloofness and argumentativeness.

The individual may have a superior and patronizing manner and either a stilted, formal quality or extreme intensity in interpersonal interactions.

The persecutory themes may predispose the individual to suicidal behavior, and the combination of persecutory and grandiose delusions with anger may predispose the individual to violence.

Schizoid Personality Disorder 301.20

A. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four or more of the following:

(1) neither desires, nor enjoys close relationships, including family
(2) almost always chooses solitary activities
(3) has little, if any, interest in having sexual experiences with another person
(4) takes pleasure in few, if any, activities
(5) lacks close friends or confidants other than first-degree relatives
(6) appears indifferent to the praise or criticism of others.
(7) shows emotional coldness, detachment, or flattened affectivity

B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder, or another medical condition.

Schizoid Personality Disorder is found premorbid to schizophrenia.

What did people say about him? Everyone has something to say. 


Tuesday, December 11, 2012

Snapshots December 2012

You know that therapists have to be out of their minds to go on vacation this time of year.  It borders on unethical.

And yet.

Off we go. Some of us.

And since you can't always rely upon your therapist, and many people don't even have a therapist, and considering that holiday anxiety starts before Thanksgiving (for some at Halloween), and that we spend the week after Thanksgiving processing Thanksgiving, consider reading Elizabeth Bernstein on Dysfunctional Family Bingo.  Amy Johnson, a doc in Detroit made up the game.

You play it with the people you would never have friended on Facebook if they hadn't been first or second degrees.

(1) Sandwiched

My grandson, age ten, has the window in Row 16 to my right.  He's taking his first trip to the South to visit his cousins. A well-mannered young man in his thirties has the aisle.

The one who just hit double digits is playing Shark Attack on his Ipod. He's tilting the device in four different directions, probably at least five times a second. A tilt. The shark will not eat tonight.
Shark Attack With Fewer Calories

Bike Race
The young man on my left is playing a similar game on his Ipad, except that he is tilting even more vigorously.

He's deftly steering a bicyclist down a mountain, then across a desert, trying to avoid that predictable ending, the crash.

The whole experience, being in the middle of this energy makes me feel old.

(2) On Feeling Old

My mother says that if you're past fifty and you don't hurt somewhere, you're probably dead.

It's a decade birthday for me and it has been wonderful-- best presents in years, the best cards.  But it still feels sad.  You look back and you wonder. . . look back. . . wonder.  Mostly look back.

My brother texts me:

Happy Birthday!  All birthdays are good birthdays.


Your Much Younger Brother

(3) Addicted
Spider Solitaire on the Computer, too

I can't talk about the kids and their gaming, not when my Spider addiction in full-throttle. I hate that I choose Solitaire before bed lately over reading real books.

I hate this volunteering to dumb down.

But it always works, numbs me.

But having it on my phone, I can see, something has to give.  I'm using during the day! And denial has set in, is telling me that writing about it, the jones will go away.

Most likely, nah.  So what is next?! Do I need to join a support group?  Perhaps create one? Now there's something to add to my Psychology Today therapist profile.

I could open the meeting, start with:
Hi. I'm therapydoc and I have a problem with electronics, mainly my phone. (pause)
I have texted while driving.
Anyone running such a group should emphasize these four dynamics:
(a) Empathy for those who are not addicted to electronics. These people are often insulted when we take calls in the middle of a conversation. They are deservedly hyper-sensitive, assume we think them less interesting, less intelligent, less important than an incoming text, an email, or whatever it is that is beeping or blinking in our pocket.
(b) The draw is precisely this, attention. Needing and seeking attention, applause. The ego is starving, craves the love, the beep, the ring. We're social animals, fairly helpless when it comes to wanting to be noticed. 
(c) It is important to let go of enablers, friends who are like us, who don't bat an eye at what some would consider egregiously poor social etiquette. Enablers are forgiving, more than happy to see another addict imbibe. You feel better about yourself, a person who also can't resist staring at an electronic device over looking into someone's eyes.  You are in good company.
It's like, I'm drinking in the middle of the day, you should too!
(d) Finally, if you must answer the phone, try, "I'll call you back later, I'm pretty tied up right now, can't talk."
Tied up?  Living, is what we used to call it.

 (4) The Naked Eye
Sea Anenomes

We're at the Georgia Aquarium, an amazing museum, and if you know me you know that nothing makes me happier than a salt water fish tank with a couple of healthy fish swimming around. It totally takes me in and there's nothing electronic about it, unless we're talking electric eels or filtration systems.

But I have an electronic device with me, my phone, so I'm snapping pictures constantly, want to bring home my memories.

In other words, I'm at the aquarium thinking about a screen-saver.

Jelly Fish, therapydoc

Salt water fish Screen-Saver

Sea Dragons, therapydoc

(5) Putting Kids to Sleep

There are so many wonderful things about life, and grandchildren are at the top of the list. When you visit them you relish them, life itself. Blessings, you think. You get into a seriously grateful mode.

My oldest granddaughter seems to really like me, and when it is bedtime, I get the honors.  She insists that I tell her a story, sing her a song (my pick!) and say the bedtime prayers.  There is perhaps nothing more delicious than this.

So we're in her bed and she's under the covers and I'm on top of the covers, but we are eye to eye. Hers are so large it is nothing short of intimidating.  We have a discussion about teeth and brushing. The song, the story, the ritual is over, and she's supposed to go to sleep now.

She grabs me around the neck, hugs me tight. "Don't go. Don't go now and don't go back to Chicago tomorrow.  Stay one more day.  Miss your flight."

This is an old routine. She's been doing it for years. She's not yet seven, so not too many years. But she's good.

My job is to tell her I'll stay a little longer, and she's content with that.  She's very tired. She did walk that entire museum and her little legs worked double time.

As her eyes close, mine are looking for my phone.  I see it on her desk and get up to grab it. She sees me, pounces.  "You said you would stay!"

I did, indeed.

So I stay. And it occurs to me that in this special moment, a once in four months moment at best, a big part of me just wants to check my phone.

This is not living in the moment. It is not living rich at all.

When we're about to leave for the airport, the carry-on bags are packed, much lighter now.  She is hugging her cousin. "Don't go! Stay another day!" A true drama queen.  He smiles a little smile, doesn't quite know what to say. He's only 10, looks to me for advice.

"He'll Skype with you!" I cry.  "We'll all try to be better at that, call and video-chat once a week."

In a couple of years they'll be saying, "See you on Facebook!"

We can only hope nobody needs a 12 Step program.


An Oh By the Way Post Script:  When Facebook took off, Ther Apy Doc had a page. But it got scary (you know I'm not very tough, have those home-invader thoughts, hate conflict, bullying, etc. ). My thinking, being terrified-- this will somehow come to no good. So down it goes.

But a few years (a few years!) later, it appears I have toughened up and the page is back up! TherapyDoc is still anonymous, too, despite the Facebook bias that if you can't identify yourself, if you're not man enough to tell the world who you are, then you probably don't belong in most clubs.

An admitted voyeur, one who loves looking into people's lives, this feels authentic. Therapists have that interest in the way people live, the way they think. And their faces, their clothes, too.

In Chicago when it starts to get cold, you look for friends.  Most of them are hibernating.  It takes very little coaxing to get them to go out for dinner with you. When they do, you feel you out-ate them since everyone is on a diet. Still, it is a great way to hear about the best sales.

So another way to find friends and not have to face the cold, would be Facebook. Nothing better than a good regression. Do you remember being very young and asking someone, "Will you be my friend?"  It took guts!

This could be a lot of fun.
Or it could be I'll have to take it down again.

Seems a good way to get book and movie recommendations.

Or show off pictures from an aquarium.

New name:  TherapyDoc Doc  (Doc is a last name, apparently).  Here's a movie of a few jelly fish.  My grandson took it with my Iphone..

Tuesday, December 04, 2012

Conversion Therapy and California Law

California, always a progressive state, outlawed conversion therapies for people under the age of 18. But the court put a hold it, is reconsidering the issue.

A conversion or reparative therapy is a hotly disputed treatment designed to change sexual orientation.  The therapies consist of a hit or miss tool box  of interventions, as in:

(1) psycho-dynamic therapy-- The assumption is that something went missing, or wrong during early childhood;

(2) cognitive-behavioral therapies, or strategies, including but not limited to: 
(a) desensitization to the ego-dystonic (dreadful) thought of heterosexual sex 
(b) flooding thoughts about sin, where it leads, ultimately
(c) dating heterosexually
(d) exhaustive bible study
(e) in vivo exposure to normal, or heterosexual culture, literature, photographs, movies, even pornography
(f) hypnosis
(g) self-hypnosis, and
(h) aversive therapies that punish homosexual thoughts or behavior.
 But there's more, apparently.  CNN:
The therapy techniques described in that lawsuit included having participants strip naked in group sessions, cuddling and intimate holding of others of the same sex, violently beating an effigy of their mothers with a tennis racket, visiting bath houses "in order to be nude with father figures," and being "subjected to ridicule as 'faggots' and 'homos' in mock locker room scenarios."
 There are so many things to try, it could take years of work in treatment and never make a dent in anybody's sexual orientation.

Conversion therapies are not about conversion disorders, keep in mind.  A conversion disorder is the way a person manifests a symptom.  I might be agoraphobic, for example, but instead of being conscious of it and treating it by making myself gradually leave the house, maybe take a daily walk to the curb, I'll get a very sharp pain in my ankle each time I think about getting out about the town, one so sharp that I can't possibly go.  The doctors will find nothing wrong with my ankle.

But we're not talking about conversion disorders here, unless the State of California wants to call therapists who try to convert gays disordered.  What the state legislature wants to say is that these therapists, the ones who practice conversion therapies, are out of line, unethical even.

Conversion, or reparative therapies have metastasized over the past fifteen years.  The goal?  Change a person's sexual orientation.  They popped out of nowhere because parents feared religious proscriptions against same-sex romantic/sexual behavior, and their kids were coming out to them, risking getting tossed out of the house for an honest relationship with their parents. 

It didn't seem, not at the time, the late nineties, that greed had anything to do with it. Many a minister, pastor, or priest suggested sexual orientation change therapies to worried parents of sexual minority kids.

Not only Christians bought into it. Jews did, too.  They looked for answers, ways to turn their kids back to heterosexuality, to get them to leave the lifestyle.  Project JONAH is under attack right now as disappointed hetero-hopeful sue the organization.

For Christians, Exodus International was the mainstay, the anchor for unhappy religious parents who hoped their kids might someday change. Their support group, Parents and Friends of Ex-Gays, (PFOX) is now rethinking their philosophy.  Empowered adults who suffered through reparative therapies as children are filing suit in droves for damages. Parents paid any amount of money to therapists who promised they could could change the sexual orientation of their children, make then heterosexual.  Ka-ching.  Now everyone is thinking twice. 

The American Psychological Association and the National Association of Social Workers abjured conversion and reparative therapies from the start, discouraged parents from subjecting their children to these cruel, misguided approaches to the "problem" of sexual orientation. Embrace your children, therapists advised.

Those filing suits against conversion therapists are saying the treatment hurt them much more than it helped. Conversion and reparative therapies are associated with the child's growing self-hate, self-doubt, a lack of self-acceptance, hopelessness, worthlessness, drug and alcohol addiction, suicidality, depression, anxiety, chronic doubt-- almost every negative symptom imaginable.

The lesson, clearly, is humility. Professional humility. Some things we can't change.  That's all there is to it.  Mental health professionals are so talented, have so many tricks of the trade, so much insight into what does work, that this is a hard concept for many of us to grasp.

What turns people on seems to be in that mix.  Changing one's appetite is nearly impossible. I want ice cream, not tuna fish, sorry. And desire, the desire to love and to be loved by someone, no matter the biological sex, is either there or it isn't.

PFLAG has better advice.  Find a parade.  Consider pride.  It won't happen over night, but it can happen, that feeling, pride, if you work on it (therapy can help that, actually).   

That's change that is possible.


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