She was 22 and dirty, poorly dressed, having been dragged into my clinic office by a social aide. She knew her diagnosis.
“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…
Filed under Psychotherapy by on Jan 6th, 2010. 1 Comment. 
She was a woman in her early seventies. She looked tired, almost haggard, although neatly dressed. She had obviously seen a lot of hardship in her life, but she wore it well. She looked like someone you could trust, a “salt of the earth” kind of person.
It is unusual to see a senior come to a psychiatric clinic for the first time. We see women of all ages, it is true; about 70% of the psychiatric patients in most average (not Department of Veterans Affairs) medical clinics are female.
She had been referred by a general physician who could do nothing for her headaches. He had wisely decided that starting her on any kind of potentially addictive painkiller was a very bad idea.
I took a detailed history. It seemed that the headaches came on when her husband yelled at her or threatened her. He did that often enough. He was of some kind of northern European origin. She had married him after the death of her first husband in an accident; her first husband had been her real love-match. But she was a traditional housewife, who wanted to keep house more than anything in the world.
Filed under Psychotherapy by on Dec 30th, 2009. Comment.
I know childhood is not the idyllic thing that reminiscing parents think it is. I remember being afraid I could not open the lock to my gym locker unaided in grade seven. I remember fearing the other girls would think I was too fat or too weird. I think I worried about everything except not being smart enough. I was lucky I had that one nailed.
If I work really hard and think back farther, I can remember being afraid of the dark. I got a teddy bear and a prayer book to deal with that one.
My mother spanked me exactly once, when I plucked a flower from a neighbor’s yard. It was wrong, and she explained to me why I got spanked. She never had to spank me again, as I was a rule respecting child.
I cannot remember and can barely understand, even now with my aggressive use of energy psychology, what it is like for a child to be a victim of assault or sexual or physical abuse, or even to live in fear of such abuse. It takes all my empathy to deal with such children as adults.
Read more on The Violence Epidemic (Against Children)…
Filed under Violence by on Dec 28th, 2009. Comment.
When we talk about sending troops out to fight with numbers that have lots of zeros on them, chance are that nobody is thinking about how the lives of the survivors will never be the same.
Recently, ABC News made an attempt, a praiseworthy attempt, to help people see at least a little of what the human devastation means. “PTSD” stands for “post-traumatic stress disorder,” which leaves lives devastated. People come out with devastated personal relationships, often unable to maintain marriages, unable to maintain jobs, with sometimes a high potential for violence. The devastation all too frequently progresses to suicide.
Adding to this the fact that the bureaucratic institutions do not generally encourage or even permit the most efficient means of treatment, we have a domestic mess and a domestic mortality of veterans, the very people who put their lives on the line, that is nothing short of horror.
Read more on PTSD — Often Denied, Resistant To Mainstream Treatment…
Filed under PTSD by on Dec 24th, 2009. Comment.
Query: Why won’t Santa’s elves work now that Santa has lowered wages and they have hastened the assembly line and there are no cookie breaks?
Answer: They all have low elf-esteem.
No I don’t know the origin of the above joke. I don’t even know about low elf-esteem, as Santa must be referring his (psychologically) non-functional elves to someone that takes his insurance.
I do know that the knowledge of “low self-esteem” as a problem has entered the language and the culture with an enthusiasm and vengeance reserved only for high-frequency psychobabble which has been divorced so completely from its academically-derived meaning that it was possible for me not long ago, when walking dangerously close to a Starbucks, to overhear two people saying it was the cause of their woes.
Our friends at Wikipedia define it as a term used by psychologists, an enduring aspect of personality encompassing beliefs, emotions and behavior.
Read more on Low Self-Esteem — Not Worth Much As A Diagnosis…
Filed under Personality Disorders by on Dec 23rd, 2009. Comment.
“I’m heterosexual and proud of it. Do you need a reference from my husband?”
Such was my response to a drop-dead-gorgeous male transvestite who sidled up to me once, at one of the unusual affairs my husband and I were accustomed to attending at the time, and wanted to know if I had been born male.
Oh, there were a couple like me, she said, and even if I were a lesbian, it would be so wonderful to have someone like me, a “professional” woman, for a friend.
Oh, there were a few like me, she said, who did not care as much as they ought about appearance, and she wanted desperately to have an opportunity to make me up a bit, and maybe even lend me some clothes.
I declined, as politely as I could. I actually gave her a card, told her we could have lunch, if she wanted. She (I had learned to call people by their publically identified sex) told me she had run out of cards. I told her to just call, and I would be available for lunch, and I was certainly open for friendship.
Filed under Gender Identity Disorder by on Dec 22nd, 2009. Comment.
There are actually people in southern California who complain about the winter. You have to get your jacket out of storage. It gets dark too early, but luckily some people start their night lives earlier.
There are flus and there are coughs.
There is cough syrup.
When I was in grade school, the only cough syrup our kindly family practitioner could give was something with codeine. I was a sick little girl who seemed to be allergic to everything she touched, so I got a little of some kind of precious substance when the winter snows hit New England, and my respiratory system remained intact with that little bit of codeine.
Filed under Substance Abuse by on Dec 21st, 2009. Comment.
I have learned my lesson. I have now done this long enough to know that not everything comes out initially. It takes time.
I had thought that more intelligent celebrities would have learned that public relations is best left to the professional public relations agents, to the “spin doctors.”
I guess Tiger Woods did not learn this valuable lesson. We heard a lot of reports, generally conflicting, but often sounding as if an attempt were being made to make something serious sound a great deal less serious.
“Stonewalling never works…” reads the Baltimore Sun post-mortem on the number of mistresses who have come out of the woodwork.
A chronology and an attempt at a sort of “fact” list by the Toronto Globe and Mail is not without use.
Filed under Celebrities by on Dec 19th, 2009. Comment.
Here is a letter signed by prominent Irish psychiatrists saying that there is no evidence whatsoever that antidepressants cause homicide.
The “PLOS” or “Public Library of Science” is supposed to be an easier and gentler place to get science published, although the esteemed (foreign) colleagues who have done research with me on natural substances have informed me it is not so easy a door to enter.
Nevertheless, here is a very scholarly angle. There is evidence that the prescription of antidepressants may engender aggression, violence, or homicide.
There is also an article cited by Dr. Peter Breggin in the Journal of Safety and Risk in medicine, to which I cannot seem to link anyone directly but a download is available through the wonderful people at this Irish foundation. These folks are trying to bring forth the truth and the light.
I am now of the opinion that the academic ideal I once pursued does not exist, and is, if it exists, a pack of lies at best.
There are FDA black box warnings about antidepressants promoting aggression, but I am unaware of such warnings having ever stopped a colleague from prescribing any antidepressant.
Read more on Seeking Truth In Drug Research — And Getting Frustrated!…
Filed under prescription drugs by on Dec 15th, 2009. Comment.
I first heard the term “helicopter parent” on some news broadcast. I started my search, as I do with all new concepts, with Wikipedia. Despite or perhaps because of its imperfections, I have come to rely on Wikipedia as my first line on what people think and do.
These are the folks who originated the name tag, and sell the products that are supposed to help fix the problem.
Read more on “Helicopter Parenting”: The Ultimate Over-Protection…
Filed under Family by on Dec 14th, 2009. Comment.