Author Archives: jwlef1

Now is the Winter of Our Discontent

Posted on February 17, 2015 | Leave a comment

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I’m still trying to get this retirement thing down. We had two of my wife’s relatives over for breakfast this weekend. The husband is in his early 80s and has been retired for many years. The wife is in her mid to late 70s. They travel a lot, go to the gym, go to church, and maintain regular contact with their children and grandchildren. Basically they do what we have been doing. So I wonder is this retirement? I don’t know if I am ready to say that yet.

I still get excited about new ideas and I still get urges to be a therapist. It comes and it goes, but my patient load right now is often concentrated on my own family and that is NOT a good thing. Some of the guys I know can talk about their old jobs and the way they were treated by their bosses, or how their companies were taken over by larger corporations. They still have interest in the business of what they did. My job was people, so it’s not quite the same thing.

The winter may be also contributing to this. It is grey and cold and snow covered. Good day to stay inside and read. Sometimes that is OK and sometimes not so much. I recently heard that an old friend began stocking at Target “just to keep busy”. Another colleague of mine told me she didn’t retire, she just resigned from one job and is now in a very limited practice near her home. She has four grandchildren and is very involved in a number of other activities. She still gets bored and often works until she almost collapses. This chapter of my life-the working full time, being on call etc, is over, but the book is not done. I am still trying to write the next section. I remember I once had the husband of a patient tell me that you don’t retire from something, you retire to something. I do think that is good advice, but it is a difficult question to answer. Is just keeping busy enough ?

I want more than that, but not so much as to work full time or again begin to assume responsibility for a caseload. I guess I just have to keep searching.

I was touched by David Carr’s death. He seemed like a good guy. He was an excellent writer and he had been in recovery for many years. His book “Night of the Gun” details his first recovery. He relapsed after 14 years, drank for couple of years, and then got back into sobriety. An interesting man who was very passionate about his profession. I think the idea of passion is what I am missing. Victor Frankl used to ask his patients “What stops you from Suicide?” as an opening to his interviews. For me it’s not that so much as “What else is there?”

When I was working I would see a real difference between Women’s Therapy Groups and Men’s Therapy groups. No matter what they were there for, women would always talk about their relationships (or lack there of) as contributing to their problems. Men would talk about their jobs in the same way. Now I know that is a generalization and may be related to the demographic I was working with. Yet something of that still rings with me. Maybe I need to therapize myself, or maybe I just need spring. I guess I will see what April brings

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Posted in Meandering

Laid Out Like a Grid

Posted on February 11, 2015 | 1 comment

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When I was 10-11 y/o my family was going to Chicago for the day. We were going “downtown” to see a movie at the State Lake Theater. This was a very big deal back then. After the movie was over, we walked around and I was overwhelmed at the size of the buildings and the mass of people. I remember asking my Dad how he knew where to go so we wouldn’t get lost. He told me Chicago was a very easy city to get around in “Because it’s laid out like a Grid”. Since then I believe hundreds of people have told me the same thing. “You can’t get lost here because Chicago is laid out like a Grid!”

Well by God that has never helped me! I always get lost in Chicago (and most other cities too). I think I have a very peculiar type of learning disability related to directions. Once when I got my drivers license I picked up my sister at her high school. We had to run an errand for the family and it took almost four hours to get home. Another time the hospital sent me to a conference in Minnesota. I got off the plane, rented a car, and drove for almost six hours to get to a location that was 45 minutes from the airport. I always remember Blanche Dubois line about depending on the kindness of strangers because of asking for directions. Sometimes conflicting instructions would make it worse and I ended up going in circles. I do eventually get where I’m supposed to. I just don’t do it the way you are supposed to. Wandering around has led to many strange encounters. In Minnesota I ended up stopping at a church picnic to get directions. The people there were wonderful and helped me get on the right track. In Ireland a convenience store helped get me back to the hotel. It just takes a little longer

My family laughs about this now. My wife thinks it is genetic and tells me that the reason my grandparents didn’t emigrate until 1902 was because they got lost trying to find America. My sister has some of the same difficulty so maybe there is something to this. GPS has been a mixed godsend. My wife always wants me to take one and use it if I go someplace new or someplace complicated. I have even ended up swearing at the GPS. I hate the words “Recalculating” or “Make a U-Turn”. It seems even machines know how to frustrate me on this. The shortest distance between two places is a straight line just doesn’t seem to work with me.

I think that is why I had patience with people who were struggling with their own problems and decisions. With alcohol and drug users the “Just Say No” plan seems very logical. Marital problems, domestic abuse, anxiety attacks should all be able to be fixed quickly. However people don’t work that way. Addicts basically stop when they are ready and not one minute before. Everybody has their own speed. Sometimes the solutions people have to problems seem to cause more difficulty than their original situation. I had many people who had affairs basically to get out of their marriage. After the divorce the affair stopped, the abandoned lover would often end up in my office in their own crisis.

Sometimes it seems like there are people who go from crisis to crisis. They get one problem solved and almost immediately find another. The Grateful Dead has a song with a line like “I may be going to hell in a bucket, babe. But at least I’m enjoying the ride”. This can be very frustrating for anyone trying to help, until you step back and let them find their own way thru the maze. I know early on I would want to solve everyone’s problems. I thought if they would just listen to me everything would be fine. I soon learned that was not a good idea. I would often end up being blamed and just another problem in their lives. I was the GPS being sworn at. So instead I would just end up trying to support them in their struggles and complimenting any small gain. I would gently confront any backsliding and continue to urge them on towards whatever goal they had. Defining the goal is important because otherwise people can just wander. If you stop drinking and become sober, now what? If you get divorced and are still unhappy, now what ? Often relapse would happen because the answer to that wasn’t available. If there is a genuine positive for stopping, changing, deciding, then the journey doesn’t seem that long. Helping people find it is what I was supposed to do. I just had to learn that there is no grid that fits everyone

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Posted in Family Story

Every Person Tells a Story Dont They

Posted on February 5, 2015 | Leave a comment

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The thing is I’m not good with names. At least once a day I’ll try to tell someone something about a person in the news or TV and I’ll blank out. I’ll say “you know the one with ‘What’s His Name in it’ ”. My wife will have the same blank look on her face and we may go on for 10 or 15 minutes having this mysterious conversation that only we can understand. I’ve talked to other people our age and they have the same experience. I have even been in conversations with a group of us where we all are lost for the specific identity of individuals/movies/books etc. We all sound like we’re talking in code until someone comes up with the right answer and we all nod appreciatively.

I can remember the plot and major content. It’s just the names that escape me.

I know that when I was working I would have difficulty with names, but as soon as I saw the person, or read some of my notes, the whole case would come back to me.

I have always liked fiction over non-fiction. The “story” would grab me and I would be immersed in another world—no matter how strange or different from my own. When people came to see me, I would have them tell me their story. I would ask questions as to why they came and what they wanted. I would fill in the blanks by doing a fairly structured interview. I was literally opening a book on their lives. To this day I may not remember patient’s names, but if I see them I can remember their stories. I think the ability to listen, really listen, is a skill that can be learned by any therapist. It’s important to be patient and just let people talk. Sometimes that’s all they need.

I once saw an elderly WW2 veteran who kept getting in trouble with the police and his neighbors. He would appear threatening and the police would be called. After a number of these occurrences he was arrested. He was “sentenced” to come and see me. After a few sessions it became apparent that all he wanted was to be listened to. His wife was in early stages of dementia and he had no real family support. He just wanted to talk. He would come in and talk and talk. He reminded me of the old time radio host Paul Harvey. I didn’t really say much back to him except for him to not threaten his neighbors or he would have more serious consequences. He would always leave the sessions telling the staff and me how much he liked our time together. He just needed someone to listen to his stories.

Some stories that people told were very common and some were over the top. There was a heroin addicted dominatrix with an autistic son. There was a 62 y/o Vietnam veteran who suddenly was overcome with memories of the war. There were parents who didn’t know what to do with their 14 y/o daughter who was telling them what to with their lives. Wives who didn’t like the way their husbands dressed because it embarrassed them and on and on.

Maybe in our lives now we really don’t have enough people who really will listen. I know we can email and text and twitter, but maybe we still need someone who is there to talk to.

It’s not just being there, it really is listening. I know sometimes I fade out with my wife. She can be talking and I’m really not hearing her. I know many of my friends have laughed and said the same things happen in their marriages. However when it really is important we can be there for each other. I think a lot of people who go to see therapists don’t have that. They can have the appearance of good friends, good relationships, but no one that can really be “there” when they need to talk. We all have stories that need to be told. It’s the finding someone to listen that’s the hard part.

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Posted in Stories

Mirror,Mirror

Posted on January 27, 2015 | Leave a comment

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Lately I have been thinking about mirrors. I do believe my job was to create a mirror for people to see themselves clearly, or at least how they presented to me. The whole mirror thing got me thinking of the sex clinic we had at the hospital. We started because one of the Doctors had an in at Loyola with Dr. Domeena Renshaw. She was one of the leading sex therapists in the world and her sex clinic at Loyola was world famous. Four of us were chosen to go thru the training there. We would each be paired with a physician in training and given a couple to work with under Dr. Renshaw’s supervision. The clinic was mutual education for the couple and for the therapists. There was plenty of didactic material presented along with standard relationship therapy. However one session involved the therapist being present at a complete physical with the couple.

The physician examined each member and the therapist assisted. This was a “Complete” physical. They had to strip down to a hospital gown and the MD would examine them completely. The non MD (me) would assist as much as possible. When the woman was examined. I had a specific role. I had to hold up a full length mirror and the MD would carefully indicate and explain the function of each body part. The first time I had to do this, I began to experience extreme anxiety. My Irish Catholic genes came out full force. The temperature in the exam room must have gone up to at least 120 degrees. I did get thru it .Dr. Renshaw thought it was an important part of the whole process, both to educate the couple and to increase the bond between the therapeutic team and the couple.

After we completed the training, we returned to our hospital and started our own sex clinic. We used the Loyola model and the complete physical as part of the program. I still had to hold the mirror. I was never really comfortable doing it, but I did understand the reason for this. I tried to talk my wife into me holding a mirror for her so I would be more comfortable, but she wanted no part in it She thought I was just trying to use this as another excuse to have sex. She didn’t understand the real clinical reason (right!!)

One time we were working with an elderly couple. The woman, who was probably in her late 70s,was not thrilled with me being in the room. I tried to comfort her and explain the process. I certainly was not excited with an elderly woman stripping down. I held up the mirror for her and I still remember what she said. “Now no peeking !!”. I began to laugh and the mirror started to shake. I was able to complete the exam and I dont remember if we helped the couple , but they did complete the program. Dr Renshaw always said she never thought she had a clinical “failure” if the couple practiced what she said. The sex clinic at the hospital only lasted a few years because the supervising MD left and we became incredibly busy with our addiction program and had to stop participating. Other therapists were trained, but the hospital didn’t have the same level of commitment as when we started.

Thinking back , our clinic was pretty tame. Dr Renshaw wanted us to be very sensitive to the couple’s beliefs and the whole clinic was structured around gradually increasing their ability to communicate. The mirror image transfers pretty well to the therapy experience. The therapist has to be able to hear what the patient is saying. If you don’t understand you have to question and clarify until you do. How you do it is the secret. If you can bond with the patient and establish trust, the therapy can really begin. If you can present the mirror image clearly the patient can decide how and if they want to change.

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Posted in Family Story, Meandering

Polyester

Posted on January 23, 2015 | Leave a comment

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We spend a lot of time looking at other people and judging them and we are often wrong. We also spend a lot of time thinking about how others see us, and are even more wrong .I know a lot of women who really think they are fat and will not hear otherwise no matter what their husbands say. This is not only true of women, but also of men. After graduate school I had to apply for my first grownup job. I had taught for a few years, but that was not the kind of job I thought was serious. Real teachers worked at it and thought of it as their career. I taught religion and philosophy to high school girls. I didn’t really prepare much and usually just winged it. I also dressed in the most casual way possible, had fairly long hair, lived with three other guys in a basement apartment, and thought that this was life. I still had some of the hippie “Don’t trust anyone over 30” stuff going on

Then I met my wife, got married, and finally had to get serious. So grad school happened and I had to go out on job interviews. I got a hair cut (razor cut—because that’s what I was told would make a good impression) and wore my one suit to the interviews. Now this suit was a polyester thing of beauty. I had gotten it to get married in and only worn it a few times. During grad school I had lost some weight, but that just meant I had to pull in the belt on the pants more. So I went to these interviews in all my polyester, razor cut glory. I was nervous but kept thinking that at least I was dressed right.

I had a few interviews and was offered jobs that didn’t quite fit, Then I was offered an interview I was interested in. A prominent hospital alcohol unit was looking for a social worker. The woman I interviewed with was younger than me, but had much more experience. I wasn’t sure how the interview went but somehow I did get the job and worked there for almost 20 years. It was only later that I found out she had laughed, like my wife, at my baggy polyester suit. It was a joke shared on the unit for many years.

The unit was a twenty bed 21 day inpatient program for alcoholics. It was based on what is now known as the “Minnesota” model. During the time I was there I learned a lot about individual, group, family therapy. I was sent to an additional two-year training program in family therapy, and a special program in sex therapy. I went to countless in-service and other training programs, but I can honestly say that I learned the most from the people I was there to help. Everyone of them had a story. Some of them were there to escape consequences from family, job or legal problems. Some of them just needed a place to ‘cool out’, but they all had stories.

One time one of our doctors proposed a small research project. He asked us to rate the chance for success (continuing sobriety) for each patient as they completed treatment. Now the staff was made up of medical professionals and addiction specialists. We thought we knew for sure who would make it. We did this for almost a year and then looked at our results. To our absolute amazement we were incredibly wrong.

Patients who had strong support systems, good jobs, health and real sincerity often didn’t stay sober a month. Other patients who appeared to have nothing, often turned their lives completely around. This led to one of my obvious insights in that people have to be ready to change and have to be willing to pay the price. Maybe the therapists role is to keep holding a mirror up so a person can see who he/she really is. We all know this, but an awful lot of time we forget. Sometimes the job is just to put out enough stuff to help people look at their own lives and decide what they want—like finally making a decision to throw out a polyester blue suit.

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Posted in Family Story, Uncategorized