Lassie , Where is Timmy ?

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Do relationships ever really end? The goodness or badness of a relationship is not as important as the intensity when it starts. Once a relationship starts it is always there somewhere in your consciousness. Any relationship is a commitment, but how people define that commitment is important. I think the romantic ideal of marriage of everyone living happily ever after is false. Life doesn’t go like that, but the living ever after does in one way or another. I have had people very upset because their significant other called them by an ex wife or husband’s name. This is obviously never a good idea. In romantic relationships one of the first stages is called limerance. This is when endorphins and testosterone and estrogen go wild. You literally get high being with the object of your desire. This stage can last for a while but then it passes. The next stages are commitment or abandonment. Some people can only manage the first stage and can never really commit. They have serial relationships and always leave someone hurt. They always look for the “one” where the limerance will last forever. They also begin comparing current partners with past ones. The past relationships still live on inside their heads

 

On the other hand some people stay in unhappy relationships/marriages because any other option is unthinkable. The commitment part is something they really bought into. There is a very old story of a couple in their 90s who decided to divorce. When questioned about this they both said they wanted to wait until all their children had died. I did see a patient who stayed with her very abusive spouse for almost fifty years. They lived in the same house, but literally had it divided with a line separating each one’s possessions. When I asked her why she stayed she got very defensive and said that she had made a vow and intended to keep it. The positive side of this is that one of my old mentors said that it was really possible to “fall in love” with your spouse many times over the course of a lifetime. Perhaps the whole idea of “falling in love” is to lose some control of yourself and be open to the possibilities of another person. “Grow old along with me! The best is yet to be”

 

I’ve been thinking of relationships and commitment since dog sitting my son’s Husky. I volunteered to stay at my son’s house and watch him while they were on vacation. He is a very smart dog. One of the strange TV memories of my youth is the Lassie TV show. I think it was on Sunday nights. Every episode continued to prove that Lassie was one of the smartest creatures in the Universe. I’m not just talking about dogs. This was a veritable Albert Einstein with four legs. Nothing was impossible for this creature. She would find Timmy who had fallen down a well at least every other week while fighting mountain lions, rattle snakes, criminals and having her own puppies on the side. You always knew Lassie would find a way to save the day. Timmy was a whole other problem. If I were one of Timmy’s parents, I would really have started to have some concerns for this kid. At the very least I would have had a chip implanted in him so we knew where he was most of the time.

 

My son’s Husky is in the Lassie mold. He is getting older and doesn’t move as well as he use too. Despite his age he still is a dog that should never be left alone for any long period. He was adopted when he was 2-3 years old. Prior to that he had lived on the street and survived by his wits. The fact that he had survived on the mean streets of Philadelphia says a lot about his intelligence. His diet was basically anything he could eat. Over the years we all have stories of this dog stealing food from us. Once he jumped up and took two steaks wrapped in plastic wrap off the stove. I chased him all over the house, but he swallowed the steaks whole-plastic wrap and everything. He has taken sandwiches, crackers, etc from all of us. He was good and really didn’t get into any trouble the week I was there. I would be woken up every morning by rolling over and seeing his face on the bad with his sad soulful eyes encouraging me to get up. He would go out, come in, eat and wait for me to take him for a walk. I can tell he is getting older because he did tire out on some of the walks, but he still wanted to go. The whole thing about deciding to have a dog is that is a commitment. As they get older they get more and more dependent and it can get to be a real burden. However the whole nature of the relationship demands you continue to be there. I know people who went into extended periods of grief after the death of their dog. The dog becomes part of the family and really a part of you. Losing them is like losing a part of yourself. Maybe we define ourselves by the sum of all the relationships we have had. Yet if you begin to think of all of the relationships with people and pets and even things that made you who you are, this becomes even more complicated. Perhaps it is just another reason to be grateful for those around us today.

 

“I’ve Fallen And I Cant Get Up”

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Dealing with memory issues is such a strange part of growing older. The smallest thing can trigger a memory of an event that happened 20 years ago. Other things just seem to fade away. Lately there has been a TV commercial about early signs of Alzheimer’s. It shows a woman who can’t find her keys and her husband tries to help her find them. The commercial ends with warnings that this could be an early sign of the disorder. So imagine how I felt this week when I lost a set of keys. I had just walked into the house with them and they “disappeared ”. I looked everywhere for them. I do mean everywhere—including the freezer, the bathrooms, under the furniture and the garbage. I was beginning to have paranoid fantasies of someone breaking into the home and stealing them. After two days I gave up and had another set of keys made.

This morning I found the keys. They were bunched up in the workout shorts I had been wearing. I had taken the shorts off and forgotten the keys were in them. They were not evident at first because of the material of the shorts. The more I think about this, the less concerned I get. I have always had things “disappear”. I once lost another set of keys for over a year and a half. I think this happened in my mid 40s. I have no idea what will disappear next. I just have to accept that this has always been an issue. My wife is trying to come up with some increased structure so it doesn’t happen as much, but I’m sure I will find a way to overcome any effort she makes.

Names, titles, events just seem to slip in and out. I can be talking and all of a sudden not remember the title of a book or an author’s name. It will come back to me later almost like the keys that magically reappeared. Last week I was with a friend and we both began to laugh about how frustrated he became one time with how slow a driver I am. He was sitting next to me and put his foot on the accelerator. I just had to steer and swear loudly. The more we talked the more it seemed that this had just happened. I think that’s the thing about getting older. I have this gigantic hard drive inside my head that is packed with material and images of the past. Lately I have been going thru old pictures for a project for my son’s wedding. I look at pictures of him as a child and have trouble accepting that he is a man in his 30s. I also look at pictures of my wife and I back then. We were so young. Our children were so young. It just doesn’t seem that long ago.

Every age has its challenges and it’s benefits. One of the benefits of getting older is all of the memories—especially the happy ones. I suppose I could focus on the sad ones too, because they are also a part of who I am. I once heard Carl Whitaker, one of the icons of family therapy, talk about this. He was then in his mid 70s. He told us that if he tried hard enough he could bring back all the memories, the sounds, the smells, the places, the words and the people that were present when his father had died more than sixty years ago. He used this to tell us that this meant relationships never die. People in our lives live on in one way or another. One of my colleagues used to ask how often you hear your parent’s words coming out of your mouth. This surprised me because of how true it was.

What are the important memories – the ones you really don’t want to lose? That is a really difficult question. I suppose we could all say weddings, births, graduations, vacations, etc. However the mind stores everything. Sometimes the memories we don’t want can come flooding back. I had a number of patients with PTSD from Vietnam. They were symptom free for years, until random sights, smells, people would start something. One man was walking in the city and he suddenly found himself next to a family group from someplace in Asia. He heard them talking in their language and immediately had a severe panic attack. Another man was locked in his basement for two days because of fireworks on the 4rth of July. They wanted to never think of their time in VietNam again.

I think the challenge to accept everything and work thru it is what makes us who we are. I keep thinking of how diamonds are made. Before they become diamonds they are lumps of coal and have to be subjected to immense pressures for thousands of years.

Sometimes I still feel like a lump of coal, but sometimes I do feel like I’m beginning to shine. I think it depends on just continuing to accept every part of where I’ve been, whom I’ve known, and what I’ve done. I know that there are people, places, and things that will continue to disappear. I just have to not get upset and be ready when they come back.

She Walks These Hills—-

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Lately I have been thinking about death, The recent deaths of a relative and the son of a co-worker who was only in his early thirties have probably brought this on. The death of any young person is very hard to understand. There is so much left unsaid and undone .My cousin’s husband died last fall. He was eighty and had lived a very full life. His funeral was full of children, grandchildren and great grandchildren. The difference in wakes was more than age. There was a different mood. The only thing they had in common was death.

My grandfather died in October 1950 when I was five years old. There was a three-day Irish wake at a funeral home. My cousin and I were brought in for two of the nights. My cousin has memories of us wandering thru the funeral home. I just remember it being very warm. After the funeral my grandmother went into a perpetual state of mourning. She always wanted my mother or one of her other children to take her to the cemetery. She lived with us off and on until her death eleven years later. She often wore black or dark clothes when she went out and would pray at least two rosaries a day for my grandfather until she herself died.

Another clear memory I have is when I was in grade school and the father of a classmate died. We all went to the funeral mass. The wife of the man who had died began screaming and threw herself on the casket. I remember that this frightened me because I had never seen this type of emotional response. When I think of it now I realize that the man who died was probably a young man who left this poor woman alone with a very young family. No wonder she was so upset.

Death is going to happen. Nobody knows when and most of us dont want to think about it.. Whenever I had a suicidal patient I would work hard to have them think of the others in their life. I would try and get some type of contract with them so they wouldn’t do it. . This is standard practice, but if someone is really serious, it is very hard to stop. There was a young man in the hospital that hung himself with his own pajamas. My wife told me a story about a patient at Rush who killed himself with his hospital bed, , Then there are the sudden unexpected deaths from accidents/heart attacks/aneurisms, and whatever. These are usually very hard on the family because there is no real closure. It is most hard when there are many ambivalent feelings about the person who died.

There was a woman who was in a terrible marriage with long history of verbal and physical abuse towards her and possible sexual abuse towards her daughter. She had finally decided after almost fifty years of marriage to divorce. On the day she was going to tell her husband, he died while driving in a car with her and two of their friends. The friends and the woman suffered minor injuries, but the husband had a major heart attack and died on the scene. This woman who had bemoaned her fate for years was now not sure how to behave. The marriage was over, just not the way she wanted.

Another man told his wife in my office- “One of us is going to die and then the survivor will finally have a chance to be happy”. He ended up drinking himself to death, but she had developed Parkinson’s and is now in a nursing home. I doubt if she is happy.

Later this summer I will be 70 years old. I can’t even begin to accept that. My denial system is extremely strong and every time I am confronted with the reality of my age , I turn the music up louder. I like it when people say, “I can’t believe it—you don’t look that old!” However the reality is I am. I wonder what my wake will be like. I told my wife jokingly many years ago that I wanted a Rolling Stones song played as they were carrying me out. Now I am not so sure. Perhaps some bagpipers? I can picture people coming up to my casket and saying “Doesn’t he look good?? They did a great job on him!!” The thing about any wake or funeral is that it is a reminder of mortality—and that is still something I am working on.

We recently spent a week in Door County Wisconsin. I am an early riser and would usually go for a morning swim. One morning after the swim, I went for a walk with a cup of coffee and came upon two deer. They were only a few feet from me. They looked at me and then continued to graze until they slowly walked away. It was a moment of wonder. These moments are few and far between, but they still exist and continue to make me glad to be alive. Maybe I need to focus more on the wonder of now and not so much on the end. There is still a lot to see.

“Come Holy Ghost”

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I was raised a Roman Catholic and that really has influenced much of my life. Thoughts of right and wrong don’t just appear in a humanistic form in my head. I think the good nuns and priests that have taught me over the years are still there whispering in my ears. I do have my own doubts about the Church and right now I am probably still a cafeteria Catholic in that I can take most of their teachings, but let some of the others go.

I think I am writing this because of some thoughts about our new pastor. He is somewhat more conservative and formal than the previous pastor. He reminds me of some negative contacts with religious that I have had over the years. Due to this I am thinking of joining a new parish. He probably is a very good man, but my own stuff is getting in the way.

To understand this you really would have had to grow up in the 1940s and 1950s. My wife doesn’t understand some of this. I remember being taught by nuns all thru grade school and priests all thru high school. We looked down on the kids that went to public schools. We used to classify kids as Catholic or Public. I remember the “Marian Year” in Chicago and tens of thousands of people marching to Soldiers Field. I remember in grade school how the statue of Mary would be passed from house to house so families of the school children could say the rosary. I remember how priests were treated as royalty and their words as almost commands. Divorce was unheard of and birth control was never talked about. My mother was once criticized for only having three children when families with ten or more were praised.

This whole thing begins to make me think about the nature of power. In my childhood and adolescence the clergy and religious were the ultimate rulers of right and wrong. There was even a Legion of Decency that listed what movies a good Catholic could watch. The Church infiltrated every area of life.

Things are obviously somewhat different now. Divorce is part of the norm in the 21st century and families are more complex than ever. Birth control is never talked about because it is assumed that every couple practices it. I am writing this about two weeks after Ireland passed a law making same sex marriage legal. This was totally against what the Church wanted. People who were interviewed about this basically said that the Irish had grown disillusioned with the Church and were not listening to them as they had in the past. The scandal of clergy abuse has turned many away.

Pedestals are difficult to stand on. It’s very easy to fall off and very difficult to get back on. Right now there is also an ongoing scandal with a former Speaker of the House of Representatives. I think it was Warren Buffet who said, “It takes 20 years to build a reputation and five minutes to ruin it”. The Church has lost much of it’s splendor because of the scandals and also because the world has changed. The clergy used to be the most highly educated members of the community. This is no certainly no longer true. It was easy to do what “Father, Sister says” because of what they represented, but now that has been tainted. Perhaps that is not all bad.

As a therapist I often had to deal with the tendency of my patients to put me on a pedestal. I would continually try and climb down because I really didn’t want to be put in that position. I never wanted to make decisions about other people’s lives. That is up to them. I think that one of the goals of all therapy is to help people take responsibility for their own lives. It may seem easier to have someone else take over, but that is usually the way to disaster.

One therapist used to tell a story that he felt like someone on a hill watching two trains rushing toward each other. He would jump and shout and wave his arms, but it was up to the trains to stop. He couldn’t make them. This again brings up the difficulty in letting go and trusting people to make their own choices. Sometime this is easier said than done. I am still struggling with this and when I have someone telling me what to do, I have a very difficult time. I can respect what the Church is saying, but I still have to make up my own mind. I have to work on doing this without being a rebellious teenager or a stubborn child. I still feel the need for what the Church offers. I am still working on how to accept it.

“Well, my mind is goin’ through them changes”

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“For there’s a change in the weather. There’s a change in the sea. So from now on there’ll be in change in me”. This the time of year when there are quick increases and decreases in temperature. It can be sunny and eighty degrees and then rainy and forty. Weathermen talk about high and low pressure fronts moving in. Huge rainstorms related to El Nino and man made climate change are shown on very detailed TV screens. It all sounds very scientific until you have to experience it. Changes in our own moods can be like that and can be very difficult to deal with for all of us. Why is it that one day you can be happy and everything looks wonderful and the next you feel as if you are in Death Valley ? Bi-Polar Illness ,or Manic-Depressive disorder as it used to be called, is a very popular illness. Countless celebrities claim to have it. It is constantly used as a defense in criminal cases ,but how much of it is real. It used to be that all it took was one “manic” episode over a lifetime to be diagnosed with it. Now there are various gradations of the condition.

I remember the extremes. There was a man trying to row his small fishing boat across his grass-covered lawn; another man tried to convince the psychiatric unit that he had discovered a new theory of relativity. There was a man who was a top advertising executive. He refused to take any medications because he was most successful when he was in a manic phase. Then there are the cases where people really do get into trouble. There were suicides from people in extreme depressive states. There was a nurse who had literally crawled out of her illness and was managed quite well on meds. She became a top flight psych nurse and was the head nurse at her hospital. She had been managed on lithium for years, but then the lithium began to attack her kidneys. Other meds were tried, but none of them worked as well . She had a series of severe manic episodes and lost everything. She has now been on psychiatric disability for years.

One man came into my office extremely upset because the FBI and CIA had targeted him and were eavesdropping on his phone calls and all of his conversations. He was convinced that there were even listening in on our conversation. He was thankful that he always carried a gun to protect himself. After much maneuvering and convincing, he finally agreed to go into the hospital. He improved and stabilized, but he was furious when he found out that his hospitalization had cost him the ability to own firearms. After a few years he was able to get that privilege back, but he continued to bring it up in therapy and still had a real distrust of the government and all health care providers.

I think it’s the loss of ability to reality test that is the concern. The extremes that end up as psychoses can be pretty obvious. When you talk to someone in the middle of a cycle, they really don’t want to accept that there is anything wrong with them. Everything seems logical and they cannot understand why you don’t “get it”. Some people have milder forms of the illness. They can either go on meds or not. They seem able to deal with the sudden mood swings. One woman said that for her it was seasonal. Every spring and in late fall she would experience this. Another person had a bad experience with a recreational drug that triggered his manic episode. For him it was inability to sleep, heightened irritability. For some people it is compulsive shopping, gambling , promiscuity, poor judgment. These episodes can often lead to comments like “What the hell is wrong with you ?” No incident of the illness is exactly the same. I think that is why mental illness is so poorly judged.

Measles, Chicken Pox, Intestinal Flu all have symptoms that can be seen and measured. This doesn’t happen so much with mental illness. It is hard to measure someone’s internal state. Years ago there was a patient who tried to explain this to some of his friends. They couldn’t understand why he couldn’t drink. He tried to tell his friends that when he drank he “broke out”. When they asked his what kind of break out, he told them “I break out windows ,doors and peoples teeth!”  His friends suddenly were not quite so enthusiastic in pushing him to drink.

Unfortunately most mental illness cant be explained like that. There is no one answer. If you are going thru it, don’t give up, there is help. Just try and be open to the possibility of things getting better. Hope and support are probably the best medicines we have. Just keep trying.