Psychotherapy

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I’m on my way to shoot a video with my dear friend Christelle Tachon that will end up on my new podcast site.  This is actually the second time I will have filmed with Christelle, and the first episode with her is nearly completed in the editing process.

Read more on New Podcast Is Available — Mona Jones, Part 2…

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Too many Americans can’t afford to and simply do not–take their medicines as prescribed. That estimate is based on information from the (American!) Centers for Disease Control). I have had patients come into my office who take their medications –in both cases, for life-threatening infectious diseases — only every other day, simply because that is all they can afford. I explained to each one individually the idea of the half-life of a drug. They only stay in your body for a certain length of time, then they leave your body in waste products.  That is why taking a drug every other day is not really effective. They both gave me almost exactly the same response — It was all they could afford, and it was probably better than nothing. Read more on Big Pharma Is Capitalism Out Of Control…

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Back in the days before Noah’s flood, a psychiatrist would take care of both the medical and the psychotherapeutic needs of a patient. Of course, we all knew that it took “a different kind of doctor.”  In the old days they said it had to be a Jewish doctor who was afraid of the sight of blood. Of which I am not — I mean, I used to be a surgeon so I put that one to sleep.

Read more on You Are The Boss of Your Therapy Sessions…

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Back in the days before Noah’s flood, a psychiatrist would take care of both the medical and the psychotherapeutic needs of a patient. Of course, we all knew that it took “a different kind of doctor.”  In the old days they said it had to be a Jewish doctor who was afraid of the sight of blood. I am not.  I mean, I used to be a surgeon so I put that one to sleep.

Read more on You’re the Boss…

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In my previous blog post, I talked about “Keeping Up With The Kardashians” — and asked some fans for advice for aspiring reality TV stars. If you got drawn in by that, I continued the topic in my private opt-in newsletter.  If you haven’t followed that, you can register for free by filling in that little form up in the top right-hand corner.  It’s a no-spam non-commercial commentary blog and you can opt-out at any time. But there is more to say — and this time, I’m reaching deep into the psychology of those who are in the spotlight and want to be in the spotlight.

The tie between the popularity of reality TV shows and celebrity worship was not immediately evident. But it is obvious that our American society is clearly increasing in — Narcissism. In Greek mythology, Narcissus was a handsome young man who was sitting on a stone precipice, admiring his own reflection in the water, when he fell in and drowned.  The spot where this happened was allegedly marked by the first Narcissus flower. In modern times — like at dinner last night — the narcissus is a wonderful edible flower that is often served as garnish with sushi. Go figure. The queen of the current American psychology of narcissism in unquestionably Jean Twenge, PhD., a professor at the University of California San Diego, who has written a couple of books and lots of articles on the phenomenon of modern narcissism, and has been much interviewed in the public media. In a recent article, she is defending her own research and findings. Frankly, my non-systematic review of clinical data suggest she is right on. She has been criticized — a badge of boldness and popularity, think I — for attributing narcissism somehow to children having been brought up to believe they are special. Once again, I personalize.  My parents filled my head with feelings of being special.  Comparing me to Wonder Woman” and, when I was very young, telling me that I was “smarter than the average bear” like Yogi.

But they also told me this gave me a terribly heavy responsibility,  They impressed this on me mainly through religion — most especially, making sure that I read parts of the (Jewish) prayer book before the service at all holidays and Sabbath.  And we got to temple early, long before services started, because my father of blessed memory had to “warm up” the organ. (He also directed the choir) They never failed to remind me that I was named after Queen Esther, the woman who saved the Hebrew people. In the Book of Esther, she did this by winning a (Royal) beauty contest.  I can’t have been older than 6 or so when I explained to her that if we were waiting for me to save the people by winning a beauty contest, then the people are in trouble. She told me I could maybe do this by working hard in school. I guess the rest is history.  Many have told me I must have been “raised right.”

Narcissism is a concept that originated with Freudian psychiatry.  It was believed to originate in a man when his relationship with his mother was overly close.  Other theorists have suggested in may be related to excessive closeness or neglect from either parent. Here is a good summary of the evolution of the concept, as well as the currently accepted diagnostic criteria. There seem to be biological and/or genetic factors, as well as psychological reasons that people can end up diagnosed as the full blown “Narcissistic Personality Disorder.” A personality disorder is a way of dealing with the world that a human “develops” during adolescence that is dysfunctional, causing pain to the individual and/or to the people in the world who deal with this person. Estimates of prevalence (frequency) of this disorder in the general population is estimated at about 6%.  If you know more than 20 people (you do), chances are you know at least one. They come across as egotistical, to put it mildly.  They are not particularly empathic, blame other people for their problems.  Their self-esteem is inflated. Their attitude toward themselves fluctuates between feeling “omnipotent” and feeling “devalued.” Curiously enough, I seem to be more likely to meet people with this disorder as colleagues or associates than I am to see them as patients.  I believe that to be because when they have troubles in life, they invariably believe the difficulties that caused them are other people’s problems, and not theirs. So it is no surprise that folks with these problems don’t usually show up in a psychiatrist’s office seeking treatment. I can think immediately of a couple of technically excellent surgeons who would meet criteria, as well as a couple of psychologists and psychotherapists.  Especially one who believes herself so gifted in application of a certain psychotherapeutic method that nobody else should perform psychotherapy in any other way.  Of course, it just ain’t so. I shall avoid discussing narcissism in presidential candidates for now, although it is not hard to imagine another posting about that one. When people note there is an increase in narcissism, they do not usually mean the same full-blown personality disorder we are discussing above.  Very often we diagnose narcissistic “traits” for people who have some aspects of narcissism in their personality. There is a fair amount out there. In case you are curious, there is an online test (with a bunch of disclaimers that it should not be used for a clinical diagnosis) to see if you are in any way a little narcissistic. Narcissism seemed historically to be just a little more frequent in men than in women.  However, most of the followers of the Kardashians known to me are women. Some statistics suggest that the growth in narcissism that has taken place in our generation comes mainly from women. Remember, they want to be admired, but may also feel “devalued.” While all these changes in the world have been going on, I have been aging.  I do look at objective research findings to confirm observations whenever I can. Still, I think the page indexed below is correct when it infers more people will look at a woman’s physical appearance than at her character development. Put this into the context of the age of the internet and most particularly, Facebook.  It is possible for a woman who craves more admiration and self-esteem than she has got, to vicariously live the life of someone with the ascribed status that comes with wealth, fame, and physical attraction. This page adopts Twenge’s work and associated studies into a set of directions to help men avoid “hooking up” with narcissistic women. By this time, I have pretty much made up my mind that I am not terribly likely to get a Kardashian-type status in any social context known to me. But I am still wondering — what do I really know about the people, the women who make up a non-negligible amount of people I know either casually or as folks on a professional staff? What do I know about them if they like and follow the Kardashians? Yes, the obligatory formal academic type psychological studies do exist, and have been reviewed. Note that this article focuses on “celebrity worshipers,” who have taken a scale relevant to that entity, which seems to be far from having 100% consistency with the designation of “narcissist,” although I suspect there may be more than a little overlap. This paper specifically cites a fairly large study (343 folks) where 4 of 5 scales on the inventory for narcissism correlate with the Celebrity Attitudes scale for “celebrity worship.” Aspects of psychopathology (that is, mental illness) that are found in the population of celebrity worshipers more frequently than in the population at large include a “proneness” to fantasy and a “tendency” toward addiction, and criminality, depression and anxiety. This particular combination sounds like more than a few of my “dual-diagnosis” patients — that is, folks being treated simultaneously for addictions and mental illness. As for me, I have at least decided that I am not suited for Kardashian-type celebrity worship.  Given the above psychopathology, I am very glad I do not encourage such psychopathology, for I was imprinted with the notion that with great power comes great responsibility (many years before the popular Spiderman movies picked up this slogan). Somehow, I still want to believe that every human has the capability of elevating the entire human race by elevating individuals to higher moral situations. I will cling to these beliefs of my childhood, as anachronistic as they may seem. I feel somehow noble that I have put this effort into explaining what is going on.

The End

 

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Like many others, I am of the type who has been made to feel less.  Less than healthy, less than human; whatever, the kind of feeling that sells diet food and diet plans. Read more on A Few Extra Pounds Might Not Be So Bad…

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I enjoy having friends, like just about everyone does. But that’s not why I’m in this business. When a patient needs help, I will do my best for them every single time.  And if a few colleagues get bruised egos along the way, so be it.

She was a 53-year-old woman, but I don’t think she even would have liked to hear me to refer to her as a woman.  We’re talking about someone who was short and stout and wore the kind of cap one would expect to see on a newsboy during World War I.  She wore a very male looking zipper jacket, and told me she had the name of the other woman to whom she had dedicated her life tattooed on the back of her neck.

Regardless of all this, her face was red and she was crying. She told me she was chronically suicidal and never thought about anything else.  Despite being medicated, her depression seemed to have gotten worse. Read more on What is there to Treat?…

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I remember vividly and will never forget when a home-made bomb blasted the Alfred P. Murrah federal building in Oklahoma City, Oklahoma. It was April 19, 1995, and I was in the midst of morning rounds at a major hospital’s inpatient psychiatry unit.

A lot of people were “decompensating” — going psychotic, had beliefs the world was coming to an end and needed extra medicine.

They called it the worst homegrown terrorist attack on U.S. soil up to that time in our country’s history.

I thank the basis of my personal belief system that I was not closer to the explosion at that time, and that I was not personally involved in the later and more catastrophic attack on the Twin Towers of the World Trade Center in 2001. Read more on Which Should You Choose — Therapists Or Friends?…

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I had seen this woman as a patient only once before, but I had seen more like her than I could count. She was in her late fifties, like me. Her gray hair fell in waves down her shoulders, Alice-in-Wonderland style. All of her clothing was childlike, too. If her hair had been blonde (as she had insisted it once was and was still meant to be) she would have looked, from the back, like a little girl in her calico dress.

She had been “traumatized” by her family. She didn’t want to talk about details and was more than a little surprised that I made no effort to push her to divulge them. She wanted to tell me about all the types of psychotherapy she had studied and learned, or even more she wanted to tell me about all of the great and famous figures of psychology she had met personally, and how wonderful they were.

Tap Dancer“I don’t care if you met God himself or—–herself.” She was not happy with my response, but by now she had enough sense not to be surprised. She was labeled as a “borderline personality disorder” as well as a “treatment resistant depression.” She had refused anything even remotely resembling an antidepressant; she was worried about all kinds of side effects. She was on diazepam (generic Valium) and would accept nothing else. Among other things, this drug would do a fine job of keeping her depressed. She would not consent to anything else and it seemed to have helped minimally with anxiety. The choice of medication had been only one in a garden of self-sabotaging choices. She had been a training patient for a couple of generations of therapists, none of whom seemed to have been able to do her the least bit of good. Read more on If You Are Stuck — Try Dancing…

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Sam Jackson and Co-starLast summer, there was a movie, called Snakes on a Plane which I think my husband wanted to see.  The “plot” (which obviously fell a little short of classic Shakespearean construction) has something to do with a witness transported on a plane and somebody tries to “whack” him with a bunch of snakes.  I absolutely did not want to see it. (To my husband’s credit, we still have not.  Yes, there are men who love their wives THAT much.) I don’t much like snakes.  I tend to avoid them.  I do not run screaming if I see a garter snake.

Incidentally, they say the film initially did quite well, probably because of a lot of internet hype.  It went on to do less well than expected.  I cannot help but wonder if that had something to do with the way a lot of people feel about snakes.

In college when I took comparative vertebrate zoology, they called it “herpetophobia,” which literally means fear of reptiles.  The more correct term is ophidiophobia,” more specifically meaning fear of snakes. Read more on Getting Rid of Phobias Without Drugs…

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