Covid-19 Intro

Time to resurrect the blog. There's a pandemic going on. People are anxious, not that anyone can blame them. What would a therapist have to say about it?

We could go into the various types of anxiety disorders, agoraphobia, generalized anxiety disorder, panic disorder. There's the fear of contagion, health obsessions. Hypochondriasis. Easily suggestible disorder (made that up).

Obviously obsessive-compulsive disorder. 

But let's talk about me. 

Let's say a person is still going to the health club or swims every day. Does she have a gambling disorder? The virus hasn't yet hit Chicago, but it is in Illinois. Just saying.

In my family no one would argue that we have genetic and experiential programming to lean toward anxiety. We're set up. We catch it from anything. 

So really I should be flipping out about the coronavirus, Covid-19, but I’m not. And it helps that FD is not. He had a patient with another type of Coronavirus, not 19,  who was very sick. We're hoping because of that we are both immune.

He treated it like he treats sick people and the patient is fine. 

Strangely enough, perhaps the most anxious/OCD person that I know isn’t flipping out either. I saw him yesterday and we talked about everything but coronavirus and it was liberating, at least for me. Him, too, one can hope.  (There's much to be learned from his therapy and why he is not freaking out. We'll get to that in another post).

Everyone at my office is talking about this, at least right now, no matter what the presenting problem: depression, anger, grief, anything. My mix is quite concerned about coronavirus, if not particularly freaked. We could talk about this phenomenon the entire visit. 

What is there that someone like me could add to the conversation that hasn’t been said already? Because frankly everything has been said. Am I right? 

Fact is, there is a lot to talk about. We want to know about the progression of the disease; we want to know if we are at risk; we want to know if we can travel; we want to know if we can send our children to school, if we should go to work, if we can go to work. Must we disinfect every doorknob, and on, and on, and on. Because of all of that, we do need to listen to the news; we have to get updates from television, email and social media. 

Every mention Covid 19 is triggering whatever latent fears. Our anxiety is triggered, if only a tad more. 

You would think that all this flooding would help, but it doesn’t! So what does?

I can't go into it now. They're picking me up downstairs and it isn't nice to keep people waiting. But let's say this. Let's stay present. And make the present good, happy. Do those kinds of things. 

And breathe. Any old way. More on that later.

Wow, it's good to be back. 

therapydoc

What's in a Name

No matter the family dysfunction, if you have children you have an opportunity to change direction. And it does seem, that if you come from a family that was functional, you can change that, too, with the right match.

But for now, let's stick to the former idea, the hopeful one, that no matter the family dysfunction, we can change direction somehow. Let's stick with this thesis that we can direct fate, for everyone likes thinking they can. We don't have to be slaves to circumstance.

Those of us with anxiety disorders especially like this world view.

As are those in The Business. They know that we go to the movies to see how others fumble at controlling their lives, and how other people, ordinary people, make it all work out somehow. Satisfactorily.

The people in the business know that some of us really need happy endings. We need to see change that will make it all functional, and we're so grateful for this art, for the places we can go to see that things really do work out for the best. Our favorite drug, seriously.

Therapists like me try to model our personalities, actually, off of therapists in the movies. We assume that they get paid better, so why wouldn't we? I admire them, but can't really bring myself to behave like them.

Like the therapist in the movie Ordinary People (played by Judd Hirsch, a natural therapydoc) leaves his office and chases down his patient, a fifteen year old kid. He goes where ever the kid's pathology takes him.

The little guy, poignantly played by Timothy Hutton, has watched his brother drown in a boating accident and has significant post-traumatic stress. Timothy is not going to go to therapy voluntarily. His mom, Mary Tyler Moore, isn't a touchy-feely Mom. She apparently isn't chasing him. So Judd chases him.

When the doc catches up with him, the conversation goes something like this:

The kid says, "I needs control."

Judd says, "We therapists aren't real into control."*

And it is true! I clap loudly, of course, when I hear this and get dirty looks from people all around me in the theater, but I can't help it. Who could? It's true. You want to control your life, but life basically takes over, does whatever the __ it wants.

We have a Yiddish expression, and I always get it wrong, so forgive, me, correct me, put me in idiom jail, Mann tracht und Gott lacht. Man is busy making things happen, plotting the details, and God laughs. I'm sure He/She has a serious knee-slapper or seventeen million of them every single day.

Anyway, one way of doing this, controlling your life, plotting the course of destiny, is to name a child after someone you respect. I'm pretty sure that several cultures do this.

For example, a guy named James might name his son after himself, making his son James II. James II names his son James III, and so on. This pattern continues generationally. Pretty soon you have many, many respectable guys named James in the family tree.

This makes it a lot easier to be a family therapist plotting names and dysfunction in the family forest. We don't have to ask, "So what was your great-great grandfather's name?" We're pretty sure that it is James and a Roman numeral.

On my husband's side, there's a David in every family. At least one David. I had no idea how important the tradition of naming the first son David could be until I failed to name either of my first born male twins, David. In my family's tradition, if a living uncle or an aunt is named David, you wouldn't name your kid David. It's just not done. So we didn't.

And we're paying to this day.

Relatives from far away will visit and gaze at photographs that I have elegantly stapled to a wall in the hallway to the kitchen, giving up on picture frames (they break) long ago. I dedicated the entire wall to pictures and when I get depressed I go there and visit everybody.

So visiting relatives will look at the pictures, too, and say, "So which one is David?"

I'll point to my fourth child.

"Wait a minute. He's not the b'chor (first son)." I tell over the Explanation.

Ice.

Nah, I'm just kidding. They smile as if to say, "Well, you figured that one out." That's how it is in most families with strong traditions about names. Keep it functional, they're saying, or we'll show you the door. And we want to please them, too, and keep the wheels of history well-oiled.

It's about wanting control. Well, some of it is.

We really do want to change history, change tomorrow if we can. That's what therapy is all about. It's why we go to see therapists. And if the therapist is a behaviorist, we begin to play around with the future. This is exactly what we do in therapy, some of us. We play around with the future.

For example, a patient will mourn seeing the next day, dread going to work: "Tomorrow I'm going to go to work and the boss is going to beat on me something fierce." Therapists hear this at least once a week.

And we'll say, "Ha! You're not going to work! Are you crazy?"

Forgive me. Forget that line Are you crazy.

We say, "You're not going for three weeks! Maybe more. You have to get better." And we all bless Bill Clinton and FMLA, the Family and Medical Leave Act.

Or we discuss other ways of handling situations and teach assertiveness. If you're not really sick, and face it, you're probably not, we work with the system, and sure, teach assertiveness. We teach this even if you are sick, but we wait until you're well enough to absorb it.

You'll say to your boss, at some point, "Boss. I have two hands only."**

We can control quite a bit when we open our mouths, sometimes.

Therapy is hard, however, so the simplest way to control destiny really is to have a child or adopt a child and to name the little peanut after someone you totally admire and respect, someone who probably wasn't always saintly, but grew into the role.

If we're smart about this, we'll look into the family tree or perhaps our communities, or even to history, and will find someone born with an easy disposition, someone thoughtful who doesn't automatically get riled up just because everyone else is riled up. We'll name a child for a person who thinks before speaking, responds rather than reacts, has a ready smile and if at all possible, an aptitude for music, even song, for song is music; someone who assumes the best in people, rather than automatically suspecting the worst.

Then the little miracle, robed in this fabulous name of a fabulous person tells people, "I'm named for So and So. Let me tell you about So and So."

And So and So lives on.

Talk about controlling destiny.

therapydoc

P.S. You can read about imagination, control, and addiction at The Second Road. I post over there once a week.

*Thanks Paramount. For sure. The best line in movie history. Whatever it was.

**And thanks, Helen, for the two-hands-only line.

Staying Connected

I'm not going to get too wordy here because it's Monday and the implications are scary, so much to do. But the lesson here is worth a quick post.

The "he" in the story could be a female or a Martian, there are no true identifying features in this post.

Several years ago I had a professional acquaintance who called to give me a head's up that she had referred her father to me for therapy. Her father's sister committed suicide and she worried her father was at risk.

He called that day, and I couldn't get him in immediately, told him it would have to wait a couple of weeks (!). Could he wait? Sure. I've waited this long.

He presented with two Axis I disorders, severe anxiety and dysthymia (ever-present depression, the low-grade fever thing). You would think the two can't co-exist, but they can. You're never depressed ALL of the time. You're never anxious ALL of the time.

His sister had just committed suicide. I should have done that a long time ago, he whispered

Would you want this case?

Past retirement age, our guy still worked, very responsibly, even though each day he felt inadequate.

He had been in and out of therapy for over thirty years.

His crippling anxiety, which surely did come from severe childhood emotional abuse, made parenting (and partnering) very difficult. His wife left him while the children were small (she took them with her), and he never had any meaningful contact with the kids after that, even though they begged him to talk to them, to be a part of their lives. He just didn't have the social skill to listen or to talk. There were four children. Four children, no contact. It really does happen.

Never had anyone discussed repairing his cut-offs with his children. The therapies, according to him, all addressed his relationships with his parents, his marriage, and his childhood problems, his lack of sexual/relationship attachment.

See, it's not that difficult, this case. There is a universal need to be loved by one's parents, and a universal need to be loved by one's children, and that can be repressed, of course. But it's there. And it has to be addressed if meaning in life is at all important.

Tiny steps, of course, he had to make the first moves, the calls, the visits, the toys for the grandchildren, the birthday cards and gifts. He didn't have to really talk very much at all to anyone in this therapy, but he eventually did, all on his own. It's a behavioral family therapy. Say hi, visit, go to the grandkid's baseball games. Quick guerrilla visits. Hi, Bye.

Put yourself on the map. You don't need to be a star.

No idea what those other therapies were about. Don't care. He did so well.

It's just an example, right? Anyone could see the need for that kind of intervention.

Was he still at risk? I thought so. You know how it is when people feel a little better. They have the strength to hurt themselves, whereas they hadn't before. But the thought of hurting the little ones like that, the grandkids, served as a deterrent. He said as much. And I lay on guilt big-time when it's deserved.

But I kept an eye on him over the years.

What's lovely is that I never even had to bring any of his children into my office to do that family therapy. The family system was in the room, everyone was in his head.

That's how you need to think.

Copyright 2007, therapydoc