Hawaii

Would you believe it? A shoe store capitalizing on the false nuclear alarm in Hawaii. Sorry, Famous. Bad taste.

You may know that I have a little annihilation anxiety, most of us do. But I’m still conscious of it, having had it most of my life. For years, as a little kid, then well into my adulthood, I had a recurring dream about home invaders, two big men climbing through my bedroom window or banging down the front door of our home. I could see them through the little triangular windows of the front door, used all my might to keep them from getting in. I'd wake up in a sweat. 

The dreams persisted once every month or so, until, as a middle-aged woman, as a responsible mother, they just faded away. There were too many other things to worry about, like the safety of the family, my children.

That, or the dreams stopped with the empowerment of Master Han, a Tai Quan Do instructor. I was too uncoordinated to do Tai Quan Do so he just gave me a couple of private lessons. Master Han taught me to bang an attacker's nose with my head, smack a groin with my knees, and box ears, if at all possible. Use your whole body, he told me.

That helped, and when I walk alone I flex my muscles, open and close my fists. Smack them, ready. But I still worried, even after Master Han, when I got on an airplane, that it would go down, worried to the degree that at one point I wrote last requests of my children, deep thoughts, a kind of a will. I found it recently and boy, am I glad I didn't die. They would have thought me beyond help. Dead, but beyond help.

Do not open unless I'm not here any more. 

I tore it up, irrelevant so many years later. Sometimes I think about this blog and think: I should take that down, too. 

Once, before getting on a plane to Israel, I glimpsed someone I recognized, also boarding, a teacher, a woman who contributed to the community's intellectual and spiritual growth, every single day. I was in awe of this person and thought, We’re good. This plane isn't going down. It was a great trip. I never relaxed as well.

And flying hasn't been a problem since.

Have I told you, that despite the nuclear scare in Hawaii, we went anyway? I started this post before we left but decided to wait to post it because the pictures would surely be worth the wait. They're going up in the waiting room. 11 x 9's.

The thing about Hawaii, what makes it a big deal, is that it is the kind of place we've wanted to visit for decades. I do mean decades. You get older and say, decades. We'd joke around and say, One day, before we die, we should go to Hawaii. But it is so expensive, and being committed to spending our tourism dollars in Israel (and seeing family there) we usually head the other direction, assuming there's time and money, a big assumption. So Hawaii was really kind of a dream.

But the miles build up, flying to Israel, taking domestic business trips. Then one day last October FD proclaimed:

"There's a conference in Maui. Why don't we go?"

Maui, as in Maui Hawaii?

Yes.

Book it, now! 

So no to Costa Rica, no to Barbados and St. John. No to Viet Nan or Thailand. Although I have been to China without him for a wedding, and we have been to Paris for a day and London to see relatives, also on the way to Israel, but that was years ago, decades even, so. .  .

YES to Hawaii, even with the stupid nuclear alert, and that it is so close to Korea, such a sweet, happy target. And YES to the new world view—It is the regrets, at the end of your life, you regret the most.

Between October and early February, however, the universe still conspired, fanned my latent annihilation anxiety, the nuclear alert in Hawaii a big part of it. But there was also The Crown.

BIG SPOILER ALERT!! If you haven't seen this docu-drama about the Queen of England, try to find it one day. We're about to ruin an episode is in the second season, the one where Charles goes to a physically taxing boarding school--Phillip's insistence, Elizabeth's objection. It was HIS school, Phillip's alma mater, thus the son must go. If you haven't seen this and think you might, then SKIP THE NEXT PARAGRAPH. You have been warned.

We flash back to Phillip as a child, away to this school. He hates it and is moody, oppositional and punished for that, not allowed to go home at semester break to see his beloved sister and her family. We're in Nazi Germany, pre-war. Since he isn't free to go home, his sister goes on holiday elsewhere, and we see her and her family on a small commuter or military airplane, not sure which, but there's terrible turbulence, and screaming, and it doesn't look good at all, and FD turns to me and says: Not the sort of thing we should see before a long trip, I suppose. And I think, Well, no, probably not. It ends badly for Phillip's sister, one of the only sympathetic people in his life.

So for about half a second I reconsider Hawaii, then recover my sanity. 

Young mothers and fathers feel this paralysis when they entertain the notion that something could happen to them, leaving their children orphans. They hold that baby, that child, and think: What will this helpless creature do without me? Good G-d, I have to stay alive!!

And it is true. We know, quite well, that it is horrible to lose a parent young, a nightmare. We need our parents, especially the really good ones who love and love and then love us some more. It is a universal nightmare, the idea that we will die, will leave our dependents because face it, nobody could possibly nurture them the way we do. The thought of abandoning children keeps parents on their toes. They say no to the third or fourth drink, and when the joint is passed and they're driving, decline that, too. Young parents, even older parents, are wary of danger, and when they travel, say extra prayers, some take out extra insurance. (Is there still flight insurance? I don't think so, but my mother did that).

Knowing that anxiety is a family thing, and that we are little sponges as children, that we absorb our parents' feelings, I think I always knew, at some level, that this would be a personal lifelong curse. It seemed likely that my annihilation fears, which have generalized to worrying about everyone close to me, FD, my brother and his family, extended family, certainly my children, would linger despite the irrationality. We're all going to die, are we not? It is an uncomfortable feeling, anxiety, so I've learned to talk myself down, naturally, and mastered a thousand other ways to reduce anxiety behaviorally, never took a Xanax in my life. Without all that work, my thinking, I would be that apple that falls close to the tree, my mother's daughter. For her anxiety, especially about us, my brother and I, never faltered until the day she died.

What are the statistics of dying in an airplane crash? I only looked this up on Google, not the psych databases, because I had to pack for a trip and didn't have time. And now that I'm home, sorry, I'm too busy studying other things. But once I really did look it up for a patient. I can't find the results of the literature review right now, sorry, but learned that the best treatment for a fear of flying is virtual reality therapy, or desensitization, VRT. Get one of those head sets and a professional to hold your hand, or use your other tried and true interventions, breathing, muscle contraction, Headspace. The odds of dying on a commercial flight are 1 in 11 million, by the way. So bet on the pilot.

You get older and it isn't so scary anymore, the idea of dying, not that you want to abandon your kids. Even if it isn't scary, however, it isn't what most of us want, not having finished what we've started, fulfilled our dreams. We have more work to do, even if we're almost at retirement age. Some of us can't even conceive of retirement. Some of us. (And can't afford it, probably).

So did I worry about dying on that airplane?

I don't think I did. The anticipatory anxiety was all I needed, which is why the paradox intervention, even if you see it coming, still works. If you fear flying, be sure to do your preventive worrying regularly. If you're already doing that, kick it up a notch. Worry harder.

We started this post with that clip from an email advertisement from Famous Shoes, This is not a drill. . . It is likely that the CEO of Famous knew of Tom Leher. Mr. Lehrer, a satirist, wrote some great lyrics about nuclear war (see the video below to the end).

One more thing. Mr. Trump? If you're listening? Or Kim Jung Un? What about a little detente, some good relationship therapy. I'll take your insurance. Donald, you might have to apologize for what happened in the Korean War, just a head's up.

Oh, and both of you need a visit to Hawaii. It is a must before you die.

therapydoc

Snapshots, Books, and the Countdown: Five, Four, Three

I feel like there's so much to say; like we haven't talked in ages. 

(1) Parenting

My six-year-old granddaughter draws a stick figure picture of herself running away from my son. In the picture he's counting down: Five, four, three, two, one. Bedtime. He posts that he has no recollection of doing this, counting down.

I remember it. He and his brother are six, their sister, four.

Me: Better be in bed at the count of one.

There's a thrill to this intervention, despite the total lack of consequences.

The magic of counting down to bedtime is that it is a competition. Can I beat the parent? Can I make it to bed before he says, One?

And a kid needs a good reason to run, not walk to bed, because running is fun and walking is not, and it is much more fun jumping into a bed, feeling the fluffy pillows and covers receive you.

Probably the best reason for the countdown, however, at least from the kid's perspective, and maybe my son knows it, maybe he doesn't, is that the parent is going to slowly follow you to the bedroom, making this feel dangerous if you lose, and as soon as he catches up, as you dive into bed one step ahead, he'll snuggle his much larger face into your hair, and then your neck, and say,

"I love you. Now go to sleep."

(2) The Stinking Flu  


The primary care docs are compelled to prescribe the flu vaccine, and why not, it is cheap and sometimes effective. When it isn't effective, that's when everyone is up in arms, or shall we say, dead to the world, useless in bed.

My brain on the flu:

reading flu test

The season is almost over, but still worth advising that if you have a fever and flu-like symptoms, go to the doctor, not that he'll be paid, a topic for another day, but he can't charge you more than your co-pay.

Certainly don't go to work to spread the joy. Or to therapy.

(3) SADS

It is February so all my SADS (Seasonal Affective Disorders) patients have been coming in. We're all good sports in the beginning of the winter, those of us who live in the midwest. In the beginning, in December, our skies are blue.

But by now everyone's saying, enough already. The days are still too short, the nights, too cold.

Brain feels frozen, landscape dirty, dull, like a futuristic movie. People are saying, "It doesn't know if it should rain or snow" and our cars beg washing, not that it will last more than a day.

Oh! As Alan Sherman used to sing in Hello Mudda, Hello Fadda, about the kid complaining about malaria, the poison ivy and the weather at summer camp.

Wait a minute, it's stopped raining. Guys are swimming, guys are sailing, playing baseball, gee dat's better. Mudda-Fadda kindly disregard this letter.

It IS sunny out there, and a toasty 50 degrees!

But since we've started, let's finish up.

SADS sufferers have to fool the brain. All that light therapy, do it, spend the money on electricity in the winter, turn on everything that holds a lightbulb, anytime you're home. Raise the shades, open the blinds.

And take up one of those health club offers to try the machines on the cheap for a month, even a week, if that's all they give you, but pay in cash so they can't keep your credit card. The fine print is blinding. Then quit when the weather gets warm, get outside and see what's green.

Sledding in February

Or take someone mud-sledding, now, before the snow is completely gone.

One more month to go.

(4) Annihilation Anxiety  

Not phallic symbols. Weapons 

Most people don't know this about me, but before I get out of my car, before I leave the office to head home, I peek outside and look around. Basically I'm worried that someone will want to kill me for no reason.

Not that the neighborhood is bad, it isn't. But if you hear enough neighborhood lore, or read the local news police blotter, you can become hyper-vigilant. Secondary trauma.

Last night, seeing the sidewalk clear of dangerous-looking citizens, my car dusted with new, wet snow, I reached into the back seat and grabbed a new retractible snow brush. When I flipped it across the windshield, the brush extended easily to the width of the car.

Snow drifting in my face, I felt I'd emerged from work victorious, waving the snow brush high into the air, daring the traffic or anyone on the street passing by.

Ditto, the selfie stick. On a vacation we rented bikes, stopped at the beach to take a picture. The stick whips out to three feet, maybe more. Light-weight, FD declares that a slap from one of these will hurt. He's reading my mind.

Paranoia?

For sure. But still.

One more. This time it is a Soda Stream canister. The slim canister that makes the fizz has lost its CO2. I take it into my hand, really feel it before exchanging it for another at Target, my grip naturally testing the weight. The shape, the feel, it is powerful, wieldy.

In the spring, when we ride bikes to work, it will be the titanium lock that magically saves us. Something a coyote won't forget, is what I tell FD, who nods empathetically.

(5) Being Alive

A new one from Colin Beavan

Feeling quite dead from the first few snapshots, this book appealed to me.

Colin Beavan (he's been on Stephen Colbert, enough street cred for me), thinks that most of us merely go through the motions, don't live the life we want to live.

You could say that therapy is all about that, finding ways to live life, in a way that we feel it, feel alive. Nobody's happy all of the time, after all. We get a few minutes a day if we're lucky, and have to work at those (says your therapist). We know some of what works, what is tried and true.

You feel alive when. . .you finish a brisk workout. When a baby smiles at you. When the IRS refund is in hand. When you ask your adult kids on a random afternoon:

Hey, anyone want to come for potluck dinner?
 and they say, Sure.

That's happiness.

Colin will tell you these thing effect the world, your smile, the one inspired by the baby's smile, spreads a wave of goodness into the ecosphere. The potluck dinner, because there are multiple good vibes buzzing into the cosmos.

His new book is an attempt at debunking the myths most of us buy into, the ones that keep us (his opinion) from doing what we would really want to do. Whether it works for you will be a personal thing, because How to Be Alive recycles (appropriate for a book designed to help the world) what self and cognitive psychologists have said before. Yet he offers so many different stories, metaphors, and examples, that you have to learn something new. And he squashes irrational thoughts like gnats.

So this is a non-sequitur, but speaking of gnats, a year ago January I started my first herb garden ever, little pots on a window sill; the yield amazingly, shockingly successful, a jungle in the kitchen. But by summer the house was inundated with midges, little bugs that land on white shirts. They look and act like gnats. But we still had a lot of basil and dill, so could only complain so much, and handed out plants first come, first serve. That's being alive.

Getting back to that book, it could have titled Green Therapy. But How to Be Alive: a Guide to the Kind of Happiness that Helps the World  has so many more key word.

You might remember a story somewhere on this blog, about the people in the park, and dogs off their leashes, me, and maybe you, too, on bikes, becoming a part of that ecology. It is one way to connect with the world.

Colin, on connecting:

Your life is equal to all of your relationships added together.
All of your relationships together are equivalent to your relationship to the world.
Therefore, your life is equivalent to your relationship to the world.  

 And, what you do in your life, affects the world
 And what happens in the world, affects you.
 Therefore, you are important to the world and the world is important to you.

So make a dent, he's saying. Or grow something other than roots and give them away, maybe develop a community garden. Or a community compost.  Or both. There's a story on that.

(6)  Sheer Numbers

NAMI APP for HELP

Recently a reader wrote to thank me for universalizing her problems, for reminding her that she's not alone, not the only one who finds life difficult, who has bizarre thoughts or brain twists that no one else seems to understand.

We all have bizarre, irrational thoughts. See above.

The letter got me thinking, however, looking up statistics.

NAMI, the National Alliance on Mental Illness has always been a wonderful resource:

43.8 million people experience mental health problems is a given year

1 in 5 adults in America experience a mental illness.

Nearly 1 in 25 (10 million) adults in America live with a serious mental illness.
One-half of all chronic mental illness begins by the age of 14; three-quarters by the age of 24

1 in 100 (2.4 million) American adults live with schizophrenia.

6.9% (16 million) of American adults live with major depression and 18%, or 42 million have anxiety disorders

There are many more statistics like this. My friend, you are not alone. 

The one that blows my mind is that nearly 60% of adults with mental illness had no services in the previous year. Did we notice? I think we did. 

Visit to the NAMI website for resources and more stories. And write to your governor if you don't like how he's balancing his budget. 

(7) Prison Isn't Good for Us

The Mental Health and Safe Communities Act , S.2002,or Cornyn Law is waking us up to what goes on in jails and prisons.

Mary E Buser is a social worker

We know about homelessness, that the chances that the woman in the park, the one in the sleeping bag, might be suffering a mental illness or addiction are high.

Most of us don't know, however, that a quarter of our prison population has a recent history of mental illness. It isn't all about sociopathy, which is what you would expect. They have garden variety depression, anxiety, and psychoses.

And being in jail aggravates it. 

And naturally, we pay to take care of the treatment, which every prisoner wants, because it gets them away from other prisoners. So while the healthy but sociopathic fake it, resources are squeezed for the truly ill.   

The Cornyn Law is a snapshot of the remedy, proposes training for police and first responders by way of the

 National Criminal Justice and Mental Health Training and Technical Assistance Center. 

Here recruits learn to recognize mental illness, steer future "convicts" away from federal custody, and divert them o community social services. In a perfect world.

Mary E. Buser's book, Lockdown on Rikers reads like a diary, what it's like to be a social worker at the famed Rikers Island, New York City's jail. Buser exposes the tragedies of the system, the pain of inmates who might be innocent but can't afford bail, who wait for months on end, sometimes years, for a day in court. A plea bargain gets them out, but with a record.

At the jail, waiting for the hearing, innocent men and women miss visits to sick relatives in the hospital, funerals. They can't help their families financially, too many cases for the system to process. You'e seen The Good Wife, Law and Order. You read about them and wish that the varied stories about Rikers are exaggerations.

But they're not.

Solitary, by the way, is hell.

As is the flu, but hey, wait a minute, it's stopped raining.

therapydoc   

That was a lot, but March will be busy for me, and I forgot to mention Vessels, a love story I promised to review. You think it is a love between a couple, but the story is much more mysterious, more cryptic than that. Written like poetry (the kind you actually get), rich in paradox and metaphor, VESSELS is a story about art, an artist, and bad breaks, and keeping a marriage together under the most trying of circumstances. 

I've already given too much away. 

Daniel Raeburn teaches non-fiction writing at the University of Chicago. 

Just one more thing, bear with me. For links to therapy experts, check out Social Work Careers. 

Experts

Schizoaffective Disorder, Ethics, and Brian Wilson of the Beach Boys

Love and Mercy

We’re in Miami, FD has a cardiology conference. 
Miami Beach is nice but it's not 

Bermuda, Jamaica, gee I wanna take ya’ to Key Largo, Montego, honey why don't we go.  .   .  to the Kokomo. 

It gets in my head (you're it) and wanting to know where exactly Kokomo might be, a little research yields the following.  

According to the band, the inspiration for the song (is) a pool-side bar at a hotel in Islamorada, one of the little island towns in the Florida Keys.  

So we’re not that far away. 

We saw the Brian Wilson- Beach Boys movie last week, Love and Mercy. If you haven't seen it, there will be spoilers. But most of today's story is from YouTube interviews and Rolling Stone.

There was a time when a certain brand of music summoned up barefoot on the beach, surfing, fast cars, and a paycheck lost to buying records at K-Mart; 45's or the long-playing 33’s. Some of us bought albums by the Beatles, but there was always a kid who loved the Beach Boys. Paul McCartney is quoted as saying that Pet Sounds, an innovative Beach Boy album, is his favorite of all time.* But the Beach Boys had so many hits.

Surfin', California Girls, Surfer Girl, Don't Worry Baby, Do You Wanna' Dance, Good Vibrations, Fun, Fun, Fun; God Only Knows, Caroline No; Help Me Rhonda, I Get Around, Wouldn't It Be Nice, Kokomo. To name a few.

Surfin' USA

And In My Room, a slow dance song that Brian Wilson, now 73, the primary writer, composer and musical director of the group, says expressed his inner feelings and thoughts. In My Room makes Brian's private world public, invites you inside, universalizes the need for safety. So many of us still do this, retreat to our rooms, or would if we had one, for personal space.

Mr. Wilson has an amazing recovery story, beginning with the decline to severe mental illness, a "nervous breakdown" in his twenties. He hears voices telling him he isn't as good as the public says he is, that he ruined the band; his orchestrations, far from brilliant. He rationalizes, in a psychotic but sensible way, that the voices aren't able to keep up with his success, that they are jealous, want him out of the way. It is likely they told him to self-harm.

After dropping out of sight in the seventies, a hermit due to mental illness and drug addiction, Mr. Wilson is in recovery by 1999, twenty years later, working again, producing records, even Smile, the long awaited unfinished album of 1965. "I'm anxious, depressed, I get scared a lot,"  he tells his fans. But he's out there, brilliant as ever.

In 2006 he tells a reporter that he still hears voices, every single day, that he has most of his life. A community of angry, critical people in his head.

His whole adult life he's been begging them to shut it up.

How does it present, an illness like this, Schizoaffective Disorder? There are two types, F25.0 bipolar, and F25.1 depressive. Voices in the head, delusions, can be features of either.

The DSM 5:

 In schizoaffective disorder, a mood episode and the active-phase symptoms of schizophrenia occur together and are preceded or are followed by at least 2 weeks of delusions or hallucinations without prominent mood symptoms.

According to Mr. Wilson the voices started soon after his first LSD trip as a very young star.

This changes everything, as far as diagnosis goes, foils schizoaffective as the obvious choice, because if you read the criterion, you find the all important D.

D. The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

Technically he couldn't have schizoaffective order because the effects of a substance triggered the illness. That being the case, the diagnosis has to be:

 Substance/Medication-Induced Psychotic Disorder (F16.959), without use. 

Without use means that he doesn't have to be using anymore to suffer the delusions, hear the voices of psychosis. He stops abusing drugs in treatment, but his disorder has its hold. Without use, still delusional, it is an F16.959.

Your mom was right when she said that drugs are dangerous. During the frolics of the sixties, the more anxious worried about friends who took LSD. We heard stories of people flying off rooftops. They needed designated watchers, really.

The most famous of the Beach Boys might not have suffered Schizoaffective Disorder, a combination of symptoms that present in both Major Affective Disorder and Schizophrenia. Had he not used LSD his bout with mental illness might have been much less horrific. But we really don't know.

And there is another theory, that children with a predisposition to major affective disorder or schizophrenia manifest their symptoms under stress. Brian undoubtedly had stress, beginning with a family group that depended upon him and a rabid desire to succeed, and a father who physically and mentally abused him, deliberately made him feel badly about himself, fed his self-doubt with critical, harsh words, and the fist. Wilson boxed Brian in the head, permanently knocked out the boy's hearing in one ear when Brian was little.

Murry is the voice behind the voices, cold and withholding, jealous, a spare the rod, spoil the child kind of father who strips a kid of his confidence.

The son still wants the father’s approval, plays down the abuse in interviews, although in the film it is the first thing he talks about with Melinda, the woman who tries to save him from an exploitative psychologist, Eugene Landy. He won't demonize Murry for traumatizing him, triggering his illness. He can't embarrass his father. It was the drugs, Brian insists.

He even credits his Murry with the success of the band. Murry is the one with connections, the one who arranges the initial recording contracts. When things sour financially and the band doesn't like his decisions, they fire him. Vengeful, he sells their songs for a fraction of their worth, keeps the whopping $700,000 for himself. Bermuda, Jamica, come on let me take ya'.

No picnic for our hero, the path to superstardom is disrupted, spotty, an illicit drug marathon. He hides in his room for two to three years (!), fears the shower (the shower-head is a spy), eats constantly (weighs over 300 pounds), and stays stoned 24-7. Tired of it, the family hires a psychologist to bring Brian back. 

Eugene Landy claims to have done it, but his methods? Full of textbook professional ethics violations. 

Landy marginalizes his patient, squirrels him away in a rented beach house, taking Brian’s home from him for himself, a house that is also on the beach. He renovates it on Brian’s nickel. We might call it messed up milieu therapy, Landy protecting the patient from family, denying all visitors. He snows Brian with psychotherapeutic drugs that he has no license to prescribe, and beats on him emotionally about his weight. All the while, Brian takes it on the chin, follows the doctor's orders, alternatively idolizes but fears him.

You don't have to be a professional to connect the dots when it comes to father figures.

The family has always known Brian to be fragile and afraid, but that the young man has plenty of confidence when the band is recording. He's on them for every sound, controls exactly what each musician plays, every note, each harmony. He arranges meetings in swimming pools, probably assuming that the voices can't spy on him there. Manic? Certainly, which is why the schizoaffective disorder, F25.0 bipolar is everyone’s first choice, as if it really matters, the diagnosis. 

But it does matter, at least for us mental health professionals. We have to get it right, think about what is really going on, assume nothing. If we think about the history we find that the triggers for schizoaffective disorder are rife in Brian’s world before the LSD.  

1.  He had a difficult young adulthood. Psychoses often present in the twenties or late teens

2.  He suffered extreme stress, had to produce the perfect record, face audiences of thousands.  

3. He surely suffered post traumatic stress, the negative, or “expressed emotion” inherent in child abuse. 

So maybe he had schizoaffective after all.

Looking back on how he cut off his wife Marilyn and his two daughters, Carlie and Wendy, in that stoned, depressed, psychotic two-year episode in his room, he regrets his decisions, his decent, especially listening to Eugene (Gene) Landy for prolonging the family abandonment another five years. He doesn't seem to care that Landy made millions off of him, but it infuriates the mental health community.  

See, most of us want a few well-off patients.  But we would never consider this kind of thing. 

Landy persuaded Brian (coerced, because Brian suffered a disorder) to become partners, a business collaboration, Brains and Genius (Brian and Gene). Landy takes half of Brian's earnings from investments contracts, books, and records in this great deal. If a sponsor gives Brian a sports car, Gene gets one. If Brian lands an upright piano in a deal, Gene gets a baby grand.

Sickening, taking advantage of a patient like that.

Marilyn Wilson ends the marriage, and his daughters grow up missing him, yearning for him. They team up with Chynna Phillips, daughter of John Phillips, another addicted, dysfunctional father (Mamas and the Papas). Wilson-Phillips will successfully produce and perform their own songs. You know the songs, they're that popular. Hold On, for example.

We want to give the father, the genius a big hug and say, It's not your fault.

As therapists, of course, we can’t hug him. We have our ethics and touching is touchy.  (See the new page on ethics on this blog).

Eugene Landy will lose his California license.

Later in life Brian will produce more records, and children all over the world will perform his songs in choirs. He and his wife Melinda establish a foundation for mental health awareness.

Watching the film isn't easy, but it is so well done. And hearing the rest of the story cleared my head, for I could hear Eugene Landy telling Brian Wilson, “They (his family) don't love you.  I do.“ This is what cult leaders tell their followers, young and old, who also pledge their allegiance and all of their money to an idealized father figure.

Ultimately Eugene Landy is listed as the sole beneficiary of Brian's will. You'll have to watch the movie to find out what happens with that, or read the biographies.  The Rolling Stone article is wonderful, too. 

Not surprisingly, Landy has other ethics violation accusations: one for rape, another for free-basing cocaine. We can diagnose him with an Antisocial Personality Disorder.

Because that's what he has.

therapydoc

*Brian refers to George Gershwin's Rhapsody in Blue, a masterpiece in his opinion, the great musical influence in his life. The seventeen minute composition is just shy of one side of a microgroove vinyl record album (bigger even than CD's) back in Wilson's day. Gershwin inspired Wilson, and Wilson inspired the Beatles.

 

Nittel Nacht

Translate that, Nittel Nacht, it would be . . .  well, I don't know.  I know that Kristallnacht is the night that the Nazi's broke every Jewish storefront in Germany. 

But on Nittelnacht Jews play cards and watch Elf. Or maybe Titanic. Or Meet Me in St.Louis. 

The rabbis forbid learning Torah on Christmas Eve. Except to learn about why it is forbidden to learn Torah on Christmas Eve. Learning is what observant Jews do, or wish they did, most nights, most days, in their discretionary time. It is one of those pastimes that keeps on giving.

So you would think that learning is definitely something Jews should do on Xmas eve. But no. We'll get to the reasons.

Last night FD finishes the last slice of pizza, 47th Street (New York) pizza, but made in Iowa, sold in Chicago. He asks me if I want to join him, walk over to the synagogue to hear a shiur (she-your, Hebrew for class) about the origins of nittel nacht.

Nittel Nacht 47th St Pizza

Nittel Nacht Movie teev

This is enticing, but no thanks. "You go. Take notes.*"

Nittel nacht (pronounced knit-tell nah-cht.) is hard to translate, but it amounts to goofing around, playing chess or poker, eating Chinese food. Why would I go to a class?

This is an underground holiday, isn't even on the Jewish calendar. The reason for the camouflage is that Jews, historically, needed to be hidden, needed to avoid attention. In Europe, if caught learning Torah, they were likely to be victims of violent crimes. On Xmas Eve, especially.

We're still thinking about old history, movements like the Crusades (Kill the Jews!) and the Spanish Inquisition, (Chop off their heads!). Whose heads?  Guess. Theology as an excuse to murder is something of a trigger to our collective annihilation anxiety and PTSD.

Because we're a tiny minority, perhaps there are 13 to 16 million people who identify as Jewish in the world today, compared to 2.5 billion Christians,  1.5 billion Muslims, we're hardly a threat to anyone.

But I worry. Do people still believe in blood libels? Can such rumors, excuses to kill, still make press? There are so many ways to propagate misinformation.

For most us (I'm always asked) Christmas is pretty much just another day. But the true sentiments of the holiday, the whole idea of giving, selflessness, makes me happy. And patients want to give me gifts, but I have to say No, warn them in November.

No gifts, please, it is unethical (see this version of professional ethics) for therapists to take stuff from patients. You pay us, it's enough. And please, no cookies.

I used to be tempted to say, Merry Christmas to patients who told me they celebrated the holiday. But now, that is just wrong. We're completely bamboozled, paralyzed by political correctness, so we don't know what to say. Chanukah is over, so Happy Chanukah makes no sense, even when the patient is Jewish, and Happy Holidays seems so lame. But that is the preferred, politically correct, substitution.

There's a story in yesterday's Wall Street Journal, The Year Christmas Died, about Fifth Avenue. The high end retail stores in New York no longer let Santa and the elves into their windows. We've seen the last of the red and white, all is now white and electric blue. The only references to holidays are seasonal snowflakes, windows that aim to evoke a winter wonderland.

As if any of us really want to see snowflakes, seriously.

Although I grew up in a Jewish neighborhood, Christmas was a seasonal part of my childhood, window shopping downtown, driving out to the suburbs to see the lights and decorations. Cars lined up for blocks in the better neighborhoods.

A father like mine, at the end of the season (the retail season), after he passed out the last of the end-of-year bonuses, wanted to kick back and relax. We had a big dinner, a turkey or a roast on Christmas Eve. Why not? They give gifts, we sell them. It's is a win-win!  Kind of like the celebration of Chanukah. They tried to kill us. We won. Let's eat.

Then, after dinner, we settled in and watched Its a Wonderful Life.

Because it is, you know.

Here in the United States, gratefully, we have the freedom to worship however we choose, we celebrate that we have the option, that our country is diverse and everyone is different and we can all learn from one another, the original melting pot. Which is exactly why the stores are methodically eliminating Christmas. It is a retail nod to the new paradigm: Christmas is no longer assumed, and we don't have to listen to that music for months and months and months anymore. We're not bombarded with reindeer, either, although I miss them.

And yet, last I looked, Christmas is still a national holiday, a bank and U.S. mail holiday. Most of us aren't going to school, or to work, except maybe to keep the hospitals going, make sure people on the street are safe, not so easy anymore, but it never was.

Maybe to balance it out, other religious holidays should become national holidays. Let's take off for Kwanza, Chanukah, Ramadan (that's a lot of days), all of them!

Or maybe they should just call December 25 something else, something we all can join in on.

Nittel Nacht?

Happy holidays, friends.

therapydoc

*FD told it over, the shiur, but the only thing I remember is that Jesus studied under Rabbi Yehoshua ben Perachia, best known for the idea that we should all give one another the benefit of the doubt (1st perek of Mishna, Ethics of the Fathers).

A little more about that dirtyword: Blame

Should I sue the hotel?

Not saying there's anything new, here. But is is a practical application, something to keep in mind when someone is busy blaming you for God knows what. 

When we think back later, we say, What a silly argument!

This morning FD left without his keys. He returned right away and knocked on the door. It took me awhile to open up and he was angry--at me-- for taking so long, making him late. The best possible spin on this is to assume that sharing emotions is a good thing, better out than in. Permission to let off steam is what healthy couples do.

So why does it feel so bad?

A few months ago, after stubbing my toe on the metal frame of a hotel bed, I cried out. Maybe I even cursed the hotel. It hurt a lot, warranted expletives, facial grimaces. The object of the anger, unclear. A person can't exactly rant at a bed frame, it is inanimate, doesn't care. Hotel management might care, but it is inconvenient to go to the front desk, ask for the manager, complain about a bed frame. So I let it go. Somehow we survive such things.

The mystery is when something happens and someone could be blameworthy, just a little, but still. Perhaps a child leaves a tricycle on the walk and someone trips. Or, looking around to answer a Where Question, we bang our shin on a coffee table. Or a document is missing, a bill, a check. If a housekeeper has been around in recent history, she's the first scapegoat. If not, anyone will do.

What could have been bad luck, clumsiness, or simple short-sightedness, becomes a gotcha' moment when someone's around. We assign blame. The front desk is in the room.

I've thought of a few reasons that people lose it, act either as little children or very scary adults when something goes wrong. We've all got at least of few of these working for and against us.

(1) Social Needs

We're born social  animals, and as infants can't get very far in life unless somebody takes us there, cleans us up, too, feeds us, etc. That first social experience, a mixture of biological and learned dependency, is never erased entirely. Our memories packs primitive, but powerful social expectations, Someone else should protect us, anticipate our needs, prevent us from harm, The best parenting, the most charmed childhood, won't erase the imprint. But it might make us less reactive to the thought of abandonment, more independent.

That primitive memory, our infant ego, unfortunately, is fed with wedding vows. (Not that you shouldn't get married, but it is a good thing to discuss).

(2) Generalization

Spouses or intimate partners become our mothers, fathers, sisters, brothers, aunts and uncles, friends and lovers, all in one. They represent any and all of our people in the here and now and the past, too. Those who have systematically disappointed or hurt us get top billing. We might not have been able to punch back as kids, but maybe we acted out. As adults, the force is with us--displacing anger on a loved ones just feels right.

(3) Stress

Stress, perhaps from hunger or lack of sleep (new parents are particularly susceptible), often makes us testy. Add to that testiness a sense of hopeless over life's inevitable dilemmas and one more potch (rhymes with watch, means slap in Yiddish) becomes the proverbial straw that breaks the camel's back. A decent crisis, post-potch, even over something that will seem silly later, evokes a  rise in adrenaline. Then the fight or flight relief response kicks in.

Except there's no place to go, because the problem, the crisis, has to be solved, the key found, the broken glass swept up. So flight isn't an option.

But fight is.

You're going to say, but not everyone does this, displaces anger, goes on the offensive when things go wrong. Some of us prefer to mutter to ourselves, shake our heads back and forth, occasionally pound a pillow, even when someone is home to take the blame.

So maybe something else is at work, perhaps annihilation anxiety is the answer. That might explain both the aggression for some people, and self-control for others.

(4) Annihilation anxiety.

If you have ever held an infant, you might be familiar with what is called the startle response, a noticeable shiver that disappears as an infant develops. But some of us know it is still there. We feel it when we're afraid. When we are small we are afraid quite often, everything feels dangerous, a bee buzzing around us, a parent with a frown. This feeling has been described as fear of annihilation, which might sound extreme, but if you're little you just don't know, especially if you've been subjected to child abuse,

Abused kids get negative messages about who they are. They are told that they are deficient, blameworthy, to explain frequent punishments, displacement of a parent's negative emotions about God knows what.

So when things go wrong, an abused person, to avoid more abuse, might jump to apologizing even if they have nothing to do with anything. This averts a crisis, owning responsibility,and functions to avoid annihilation. If they don't apologize, they keep it quiet, have learned that passivity is better than saying more, getting into more trouble.

Alternatively, abused kids identify with the aggressor, learn that the best defense is a good offense.

But not only abused kids learn that. It is a social response to stress that just works. Anger puts everyone off. So use it to your advantage, is the thinking.

The rest of us learn variations of the above, probably much less extreme.

So in the end there are no easy answers, no one size fits all.
But at least I know, when I stub my toe, that I have only myself to blame. And FD? Just a guy with too little sleep, maybe not enough food, and too much stress. That's all.

therapydoc