cognitive-behavioral therapy

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I saw one of my brink-of-divorce patients yesterday.  I have plenty of them. They tell me how horrible their men are but they seem mysteriously held to this person who is generally, by their descriptions, a devil on the way to hell so he can commiserate with his demonic colleagues. He devalues her in front of the children or cheats on her of has more drugs in the medicine cabinet than your average pharmacy except they are not the kind where insurance pays for the prescription. And they tell me for all the world about what sounds like an incurable lout who has declined, avoided, or failed every available treatment for a condition she is convinced he is somehow enjoying or profiting from.

I had a colleague, allegedly my preceptor, who would treat woman patients by writing on a small piece of paper the words “Divorce the bastard,” and simply, but ceremoniously, handing it to her. Me, that’s not my style.  I would tell her, “You need to know where you came from, who you are, and what you believe.  You need to know the situation you are in.  And you need to know what you want for the future.” My current patient’s  marriage counselor (she still showed up for sessions.  Her husband had stopped) told her to weigh the “pros and cons.”  Rational.  Great. Read more on Divorce Is Not Death…

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She was 22 and dirty, poorly dressed, having been dragged into my clinic office by a social aide.  She knew her diagnosis.

Social Phobia“I got social anxiety disorder. I am social phobic. I don’t want to leave my apartment.”  She was looking me straight in the eye, through her tangled blond hair with a purple streak.  I think her clothes had been black, what the kids call “goth,” before they became soiled.

She didn’t do drugs; that was the good news.  She did drink; her friends brought her that in exchange for; guess what.  Yes, whatever charms she had, she certainly was not ashamed to exchange them for booze.

Read more on Social Phobia — Sometimes There IS A Happy Ending…

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