Does medicine really work to cure people anymore? How can we do better? I’ve said before in public, “I’m angry and I can’t take it anymore.” I can’t believe it’s been 36 years since some good folks in France buttoned a black scarf trimmed with white bunny fur onto my shoulder and told me I was now a physician, with all the rights and privileges associated with that exalted profession.

Read more on Does Medicine Really Work to Cure People?…


“Dr. Goldstein; you aren’t going to sit there and tell me you believe in love, are you?”

I started nodding. slowly, trying to think quickly of what to say.  Soon to celebrate a quarter of a century–twenty five years, married to a guy I am actually crazier about now than I was the day I met him.

Read more on The Ultimate Valentine’s Gift — Happiness!…

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Men.  They really are different. They are psycho-socially different; this has provided for generations of standup comedy material about their inability to ask for directions when they are driving and lost, as well as their inability to move toward a restroom in groups. They got issues.

I learned a lot about this when studying and teaching psychotherapy.  It seems you can’t get men into psychotherapy unless they are adolescents, post-andropause, or gay. Read more on Men Aren’t What They Used To Be…


There can be no doubt that support for same-sex marriage is gaining momentum, which is fine with me.  News abounds all over the internet, including major network type media outlets. By March or so, the issue is expected to make it to the Supreme Court.  As much as this is an issue whose time is come, it is also a “push button” issue, one sure to evoke emotional responses as people hide behind pre-structured belief systems that preclude thinking.  I mean, once people say things like “Christian” or “right,” the issue is thought through or at least parroted and no thinking is necessary.

I am not surprised that the lovely stirrer up of right wing thought, Fox News, is already getting folks stirred up for March. My job, at least in part, is to put things in context.  By this I mean human — maybe clinical medical and psychiatric, but mostly human — context.  The world is a pretty awful and foreboding place.  It is also a lonely place, where a lot of people have trouble making dyadic, or one to one, relationships. Read more on Gay Marriage? Anything Between Humans Is Good With Me…

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The USA Today has highlighted a new study that says newlyweds who have “cold feet” going into marriage are more likely to divorce.  I say make sure those feet are warm because divorce can be hell and children can be enveloped in that hell if you wait long enough.
I found the abstract of this study, but the dry academic summary tells me very little about the actual study.  I can view a copy of the study if I pay for it, but I regard this as a low down dirty trick perpetuated by academics who want us to think their research is always worth something — which it’s not, necessarily.  Notably, I am unable to access any juicy gossip points that may actually tell me something useful, such as who paid for the study. 
This always seems to have something to do with results and can sometimes infer whose tenure was dependent on this thing getting published. I will also refrain from commenting on publishing papers by psychologists, other than to say that they can get away with publishing an awful lot of “questionnaire” based and “pencil and paper” studies.  Medical doctor psychiatrists always seem to have to sample at least one bodily fluid to get something published.

The author of the study — Justin Lavner of UCLA — basically says that people who have “cold feet” or “jitters” at the time of the wedding are more likely to divorce later. 
The study followed 464 newlyweds.  He says nobody can say for sure whether folks had doubts about their partner or about the institution of marriage in general.  This tells me the study could have been designed to answer this question in more detail.  But as it is, we do know that 47% of husbands and 38% of wives had doubts. 
After four years, 19% of women who had doubts were divorced, as opposed to 8% who did not.  For men, 14% who had doubts were divorced four years later, versus 9% of those who did not.  Of the 36% of those couples of which neither partner had doubts, 6% still got divorced. I basically like psychologists.  Like most psychiatrists, I have learned to live in a symbiosis with them, where they do the psychotherapy and the psychiatrists do the pill-pushing.  Notice, I am talking mostly about PhD psychologists and clinicians. 
I’ve worked with patients who have been seen by professionals with lesser degrees.  A few actually get well.  At any level, most are subject to professionals who try to provide the minimal necessary to charge some sort of insurance.  They are the devotees of the ‘easy hour,” people who do things like light candles and tell patients to spend an hour “relaxing” from their stress.
Read more on Cold Feet Might Mean No-Go for the Future of Marriage…

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Lovers spatThis seems to be a new era of people trying to change other people’s behavior. And no one asks me how to do it more often than women who are concerned about behaviors in their husbands.

Even though absolutely anybody from AA and Co-dependents Anonymous to most PhD psychologists would tell them that it can’t be done, it CAN be done by those who have great self-control and great patience.

Curiously enough, like so many of the things that I’ve seen work in humans as well as animals — like offering conditioning — they have their forerunners in the ancient wisdom coming from My-Grandmother-Of-Blessed-Memory. If she heard someone say something stupid or do something stupid and talk about it, she would mutter in Yiddish something that sounded like, “Af alle narishkeit eaft’min nisht anferin!”

What this means is, “You don’t answer every single foolishness!” Read more on How To Change Your Husband…

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As I write this, a song is running through my head.

Ah, look at all the lonely people
Ah, look at all the lonely people*

Not surprisingly, of the people, of all ages, the overwhelming number of those who complain to me about loneliness are female. If and when the adolescents get past any and all of the awkwardness without contracting any life-threatening depressions, I really think most of them will be all right. I am a little more worried about those in their late thirties, maybe around forty, who tell me they are lonely.

Plaque Dedicated to Eleanor RigbyThey have generally had at least a couple of relationships, maybe even a marriage.  Their associations with males, sometimes disastrous and maybe even violent, are over.  Happily over, I should think, but they are not so sure.

The lonely women of this age are generally truly beautiful — maybe more beautiful, physically than I have ever been or might ever be.  Sometimes, they have devoted all of their lives to beauty, and are now on maintenance.  I have never met anyone in the same boat I am, who have been brains all of their lives and suddenly find that being physically attractive is something like the ice in your drink that rushes up and hits you in the teeth when you are expecting a rush of cool liquid.  It hits you and you got to deal with it.

“I am sorry to hear that you feel so lonely,” I say. “What would you have to do to stop feeling lonely?  Just do it.” They look at me confused, as if the answer is magically obvious and I have magically missed it.

In a way they are right. Few are those whose loneliness can be relieved by church friends or bingeing on rich ice creams in the middle of the night. Most of them have enjoyed a sexual relationship at some time during their lives and now they miss it. Sometimes, I think they just need masturbation lessons.  But there are several live links to that on the internet, and heaven knows they are NOT hard to find. Read more on The World Is Full Of Lonely Women…

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No small part of the life of psychiatrists (and other doctors, I suppose) is made up of writing papers and reports.  A rather astonishing part of this are reports that are supposed to predict other people’s behavior.

This is basically impossible.  I remember hearing and never forgetting, early in my training, a supposedly ironclad rule of behavior prediction.

“If they did it before, they will do it again.”

Sometimes it had slightly different forms, made to appear more authoritative. “Past behavior is the solidest predictor of future behavior.” Read more on Prediction and Propinquity…

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I was at a Midwestern medical center, taking internal referrals.  The referring physician was a medical doctor I had never heard of.  Of course, there was no information about why a 70 year old grandmotherly woman with white hair and a surprisingly pleasant smile had been referred.

She told me she had headaches.  She was very happy that she did not have one on that day.  They were horrible and even an emergency room injection of narcotics did not do anything for them once they started.  They were variable, sometimes brief and sometimes lasting a whole day.  They could be on either side, or both, but most often cut a line from above one ear to above the other ear.  They were getting worse and quickly.

One of the smartest things anyone ever told me (It was an ancient professor in France, who was so experienced he had to say smart things once in a while) was that if a patient could not be diagnosed, or did not make any sense, just spend more time with the patient and get more history.  He said that very often patients knew exactly why they had the problems they had. Read more on Unconventional Cure — Leave The Headache Behind…

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I remember the time when the only person who ever held my hand was my mother of blessed memory, with my father of blessed memory as a rare substitute.  I mean, if the four of us, both parents and my brother and I, went for a walk, my father would get the better behaved child, who was definitely me.

Mommie had told me quite clearly that I could not cross the street without holding a hand.  We lived near an expressway, and cars went fast.

Many years later, when I brought my husband to the parental house to meet her, she was gratified that I did not have to navigate this treacherous place without the anchor of my hand, and that I never had.  A tad overprotective, perhaps, but like a therapist colleague once said after meeting my family, better they are like this than like the ones who don’t give a damn. Read more on I STILL Wanna Hold Your Hand…

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