To many parents a liberal arts education is no longer considered a realistic option for their children. Successful parents want successful children and as such expect them to go to highly competitive schools and study subjects deemed necessary to accelerate economic advancement.
The external pressures to get into a competitive school, however, can be overwhelming to a child. Admission into a “good school” has become harder and more complicated. The world of higher education has changed dramatically over the past decade. Being a good student is no longer enough. In addition to good grades and high test scores, you now need to demonstrate that you participate in sports, extra curricula activities, do volunteer work and have completed several advanced placement courses. Even the college essay has become a monumental task, requiring professional assistance.
In the “old” days students would apply to a handful of schools but now with the advent of the common application, a high school student can now send applications to 900 different colleges with a single click of a mouse. The common application has increased the pool of applicants at each college significantly, resulting is much greater competition.
The college application process has become so complicated that it requires sophisticated strategies and the aid of a dedicated college coach with a specialized software program to develop a personalized strategic plan. Do you apply early decision, early admission, regular admission, how may schools should you apply to, how many safety schools, how many should be reach schools? You can now sit in front of a computer program and see how your child statistically stacks up to past applicants who applied to each respective school based upon grades, test scores etc.
The severity of competition is even more intense for those kids who live in highly educated and affluent areas. It is difficult for a child to stand out from their peers when they live in a town where their cohorts all have grades and test scores two standard deviations above the norm. Being from a northeast suburb can also be a disadvantage when applying to colleges that desire student bodies that are geographically, ethnically and economically diverse.
While many students are academically strong, some lack the emotional aptitude required to handle the intensity of the application process. The pressure from parents, peers and one’s self can be overwhelming to the child. Many kids I see in my practice suffer from low self-esteem. They fear that if they don’t get into a good school they will let down their parent or perhaps be ostracized by their peers. Going to classes each day, while your classmates flaunt their early admission acceptances on Facebook or by wearing collegial emblems on their clothing can bring up feelings of inadequacy.
Overwhelmed by all this pressure, it is understandable why a senior in high school might become overridden with anxiety and exhibit symptoms such as an inability to relax, always feeling on edge, irrational fears of impending doom, restlessness, feeling tense and having difficulty concentrating. Sometimes general anxiety can manifest somatically as stomach pain, panic attacks, muscular tension, headaches or insomnia.
Some kids try to overcome their fears by irrational thoughts or ritualistic behaviors. They become obsessed with the college application process and cannot think of anything else. They cannot control these intrusive thoughts and they find it difficult to relax or even perform chores. In many instances, the child’s academic performance begins to deteriorate due to an inability to focus. Some kids develop compulsive behaviors as a means of avoiding these negative thoughts. They watch television excessively, play endless video games, constantly surfing the internet, spend significant amounts of time on social media, or even watch hours of pornography. Many even turn to alcohol and drugs for temporary relief.
High school students can also be plagued by depression. In children, depression can manifest in many different ways. For example, some kids with depression might feel sad, hopeless, have difficulty concentrating, sleep poorly, have little appetite or an inability to experience pleasure. Others can experience depression in how they interact with others. They can be socially withdrawn, avoid responsibilities, procrastinate, or become emotionally sensitive.
Some kids manifest their depression by exhibiting oppositional behaviors. They can become agitated, aggressive or even antisocial. Kids who have been well behaved can suddenly become deviant. It is common for students to feel embarrassed, ashamed, or over ridden with guilt about failing to live up to expectations. Many kids, as well as their parents, have separation anxiety and get nervous even with the idea of the child going off to college is mentioned.
Many high school students feel alone and isolated in their suffering. They feel like they have no one to turn to who can understand their pain and give unbiased advice. They fear rejection by their parents, teachers and friends.
Kids are often relieved to finally have someone who they can talk to confidentially, in an open manner, without the fear of criticism or judgement. Many can finally admit that the issues that are bothering them have been around for a long time. They can explore their family dynamics in a safe environment and begin work through the age-specific developmental issues of separation and self-identity, which can be overwhelming and confusing to a child at this age.
Who are they? What do they they want to be when they grow up? How do they get their needs met? How do they become that person they want to be? What is the path they should pursue that will make them happy? And most importantly, what college do they want to go to and what subjects should they study?
Surprisingly some kids feel a sense of relief when they discover they will be going to one of their safety schools. Safety, especially to a child, is not always a bad thing, and often times a welcomed surprise.
Dr. Martin Klein Is a clinical psychologist who practices in Fairfield, Westport and Stamford CT. During these stressful times, he is currently offering video conferencing to all students and families across the state of Connecticut. He specializes in working with high school students who struggle with issues of anxiety, stress, depression, low self-esteem and addictions. He works closely with students and their families who are going through the college application process.
Everything that irritates us about others can lead us to an understanding of ourselves.
Couples therapy is more complex than individual psychotherapy. In individual therapy you are working with one person. In couples therapy you are dealing with a minimum of two. Not only are there twice as many people in the room, but each individual brings his or her own set of psychological issues to the relationship. These psychological issues are not static, but rather are dynamic and intertwine between the couple in a myriad of complex configurations and interpersonal entanglements.
Relationships can take on an ominous life of its own. When left unmanaged, it can throw couples into a whirlwind of interpersonal conflict and distress. Many couples become overcome by the negative patterns of their relationship. They feel beaten down and hopeless — victimized by how the dynamics of the relationship brings out the worst in each other. It is difficult to grasp how two individuals who at one point in time were in love now feel only contempt toward each other. How attraction can transform into repulsion so quickly is beyond all that seems rational.
What complicates couples therapy even more is how each person in the relationships carries within him or herself a vast array of influential voices that have been incorporated into their own sense of self. These voices shapes the ways each partner interacts with the other. Voices from the past, present and even future can be heard within the couple’s narrative — learned beliefs, views, even politics of parents, grandparents, siblings, children, previous relationships, colleagues or friends. In some ways couples counseling is more like group therapy than individual counseling.
To be successful, the psychologist must listen, comprehend, and map out all that is being said within, outside and between the two partners. It is the psychologist’s job to start the initial couples counseling sessions with a comprehensive psychosocial assessment. This is necessary in order to learn all that is being said and not said by each participant, who is being influenced by who, and how all these different voices interact and affect the dynamics of the relationship.
Couples counseling can sometimes feel like a tennis match. Couples arguing back and forth, volleying for their point of view. A therapist, however, is not a referee. It is not the job of the psychologist to determine who is right or wrong or resolve a dispute by compromise. Conflict resolution is the technique used in mediation where an arbiter assists the couple to negotiate the terms of a settlement. A settlement is something that is acceptable when you are getting a divorce, not when you are planning to stay together. To settle and sacrifice your needs for the sake of the relationship can only lead to further resentment, conflict and contempt. It is counterproductive. To stick with the tennis analogy, couples counseling does not lead to “Love” just because the participants both agree to being “at fault.”
Taking sides in couples counseling is a big mistake. What is important in couples counseling is for the psychologist to assist both partners to develop the ego strength to see outside their own personal assumptions and begin to understand the perspective of the other and how it relates to the dynamics of the relationship. A seasoned therapist knows the focus in working with a couple must be on insight and transformation, not on who is right or wrong.
I help couples pinpoint and understand the sources of their conflicts. I will work with you to achieve a better understanding of the external influences and family dynamics that play a role in shaping your relationship and cause dysfunctional interactions. I will assist you in developing new strategies to solidify your relationship and regain trust and intimacy. The work will include learning how to openly communicate, problem solve and develop new productive ways to discuss, understand and accept individual differences.
The goal of couples therapy is to learn to see your significant other in a new light, based upon insight and knowledge and not the blind subconscious forces we sometimes mistake for attraction and love.
Dr. Martin Klein is a clinical psychologist who practices in Westport and Fairfield CT. He specializes in couples therapy and marital counseling.
Westport marital therapist
Fairfield marital therapist
From an early age we are taught to fear the possibility of unwanted pregnancy. Our parents, teachers and clergy have educated us about the importance of protected sex and even abstinence.
We are lectured on how easy it is to become pregnant, and are warned how our lives would dramatically change if we or our partners became pregnant. We have all either experienced personally, or know someone who has experienced, the panic-like stress associated with a late or missed period.
Now you are older and ready to have a child. You are excited about the idea of becoming a parent. All of your friends around you are having babies. For the first time in your life, it is finally the right time to become pregnant and you are psychologically ready to take the leap into parenthood.
You read books and do Google searches to learn how to take care of your body to maximize chances of success. You and your partner learn many new things about human physiology and reproduction. You make sure that you are eating healthy and exercising because you know how important these factors are to a healthy pregnancy. You go out to the drug store and buy ovulation predictor kits and over the counter pregnancy tests. Now educated and prepared, each month you carefully monitor your cycles and begin trying to get pregnant.
At first, it is a very exciting process. You look forward to the time of the month when you are ovulating. You are and your spouse feels very close and intimacy feels magical. Weeks pass and you do your first pregnancy test -- you are excited but nervous as you both stare at that stick.
Minutes feels like hours as you anticipate the results. However, the test indicates that you are not pregnant. You are disappointed, but handle your disappointment in stride as you know that is can take several months to become pregnant.
You and your spouse repeat the process. However, as each month goes by you find that the act of intimacy has become more stressful. It has become harder to get excited during the act, and what has once been natural now feels strained, ridden with performance anxiety.
Each month the negative result of the pregnancy test becomes more and more painful. After numerous months of trying without positive results, you and your partner start to become stressed out and worried.
You relationship is beginning to become strained. You each begin to fear that there might be a fertility problem. Sexual intimacy has now begun to be associated with failure and sex has become a chore rather than the pleasurable experience it once was. Your thoughts are racing with negative ideas and you are feeling overwhelmed with different emotions – i.e., anger, depression, guilt, fear and loss.
It is important to know that what you are experiencing is not so unusual. Many couples go through similar experiences when they try to become pregnant.
In fact, according to recent surveys, 12% of the population has difficulty conceiving - over 7.3 million women and their partners in the United States alone. It is important to point out that these numbers increase with age.
By your middle thirties, your chance of having difficulty conceiving is 25%, and by the time you are in your late thirties to early forties it rises to over 40%. While most physicians would not consider a couple to have infertility problems until after they have been trying to conceive for at least one year, most couple becomes significantly concerned after 6 months of trying.
Most likely you and your partner are feeling very alone and don’t know who or where to turn for guidance. You feel like this is a private issue and you do not want to talk with family and friends. You might even have feelings of embarrassment, shame and self-blame.
Contrary to how you might feel, this is not the time to become withdrawn or paralyzed. The psychological literature suggests that communicating one’s thoughts and feelings about the fertility process can result in a stronger and more intimate relationship.
This is a time in your relationship when it is important to face the issues together and not either avoid them or get angry at yourself or each other. It is important to have a proactive plan of action. Medical research has shown that early detection of infertility problems can significantly increase the chances of becoming pregnant.
Meeting with a clinical psychologist who is experienced in working with couples struggling with fertility issues can be very helpful. He or she can help guide you through the different medical treatment options available as well as work through the emotional and psychological issues that are currently putting a strain on your relationship.
Whatever your fertility issues may be, working on your relationship by talking openly about your issues and having knowledge about your different options are the first step in improving your relationship as well as a positive step in the direction of parenthood.
If you would like to talk with an experienced clinical psychologist who is knowledgeable in the psychological and medical aspects of fertility, please feel free to give Dr. Klein a call. He will be glad to set up an appointment.
Stock Market Fluctuations: Stress, Anxiety, Depression, Mood Swings
As a clinical psychologist, with offices in Fairfield and Westport, I work with many individuals who are heavily invested in the stock market. A significant portion of my clientele, in fact, work for financial institutions; and their bonuses are directly tied to the performance of the markets. With so much at stake, it is no wonder that the stock market can affect how they experience their own sense of financial stability and well-being.
For some, who may have lost their job or been wiped out by margin calls, a negative change in mood is understandable. For others, however, whose losses are just on paper, their sense of despair can become grossly exaggerated to the point of irrational fears about current and future prospects. These people suffer from what I call “Dow Affective Disorder.”
A person with “Dow Affective Disorder” experiences bipolar swings in mood as the market moves up and down. In a bull market they feel elated and invincible. They may spend freely, even to the point of living beyond their means. Some may even use leverage or credit to achieve a persona of grandeur. In a bear market, however, these individual may fall into a deep depression; and feel stressed out to the point of irrational panic. They fear the worst— financial apocalypse. Their self-esteem goes from good to bad. They feel like a failure and their excess spending grinds to a halt. They become overwhelmed with regret. “I should have sold before it crashed, what was I thinking, how can I be so dumb.” Just as they beat themselves for not being fully invested when the market is in an uptrend, they now torture themselves for not being smart enough to divest before the downturn occurred. They fail to see their losses as temporary and fall into despair.
In many instances their depressed mood causes a myopia and colors how they function and relate to others. They tend to withdraw from their families and friends and their focus narrows to only events related to the market. Rather than be with their children or complete work assignments, they are glued to the television watching a financial channel. They engage in self-defeating behaviors that intensify their sense of failure. For example, they panic and sell their holdings at a loss, which further confirms their sense of doom. They forget about the good times and feel as if their future will never be bright again. Their whole life style takes a dramatic shift — they feel poor, tighten their budget and radically reduce spending.
For most people, a stock portfolio performance signifies nothing more than the monetary value of an investment vehicle at a current moment in time. These people tend not to pay attention to the daily fluctuations in the market and perhaps only glance at their investment statements on a monthly or quarterly basis.
For those who suffer from Dow Affective Disorder, however, there is an irrational compulsive attachment to the stock market. They are hyper-vigilant to the split second movements of the market. They are glued to their phones and are watching the market throughout the day in real time. They are aware of how much they lost each day and continually think about their net worth. If the market spikes up they get a temporary rush, only to be crushed again when the rally dissipates later in the day.
For these individuals, the stock market has become more than a financial vehicle; it is an all encompassing obsession that controls all aspects of their lives. Their perspective of the stock market has become detached from reality and at time can resemble a delusion. Their portfolios no longer just signify the value of money, but rather it now also signifies how they value themselves as a person. How they do in the market becomes more of a symbolical signifier of self-worth and less about how they will meet their financial obligations. The signifier and the signified has become displaced and the stock market has now attached to an imaginary internalized scoreboard by which one’s sense of self- worth is judged. If the stocks they own are worthless then they as individuals are worthless is the kind of distorted thinking that leads to generalized despair.
The psychological pain associated with this disorder can have long term psychological effects. Like most depressive disorders, it can lead to symptoms such as gastrointestinal distress, back or neck pain, insomnia, change in appetite, decrease in libido, poor concentration and even suicidal ideations. It can destroy families and careers.
To ask for help is not easy for a person plagued by hopelessness and low self-esteem. However, it is essential for a person suffering from these issues to seek professional treatment and learn more adaptive ways of being. Nobody likes losing money, but cycles of severe emotional ups and downs are harmful both to one’s pocketbook and long term health.
The content of this blog was recently featured in Barron's Magazine as well as published in the CT Post.
Dr. Klein is a clinical psychologist who practices in Fairfield and Westport CT. In addition to being a psychologist, he is also an executive coach who specializes in working with people in the finance industry.
Pandemic Affective Disorder (PAD): Seasonal Affective Disorder On Steroids
Late fall and early winter are a busy time in my clinical practice. The combination of cold temperatures and shorter days often bring on feelings of social isolation and despair. My patients are not alone. According to the scientific data, over 66 million people suffer from some form of winter dysphoria and over 6 million experience depressive symptoms so severe they are unable to function in their daily lives. Many of these individuals are suffering from what the psychiatric literature refers to as Seasonal Affective Disorder (SAD).
Symptoms of SAD typically start out mild in the fall and gradually become more severe as the winter approaches. This syndrome is often referred to as the "winter blues” because it is triggered by the lack of day light and the cold weather. Like other forms of depression, people who have SAD can be overwhelmed with feelings of guilt, anxiety and despair. They can feel like the energy in their body has been zapped resulting in sluggishness, poor concentration and little motivation to do activities that they once found to be pleasurable. Due to intrusive negative thoughts, they can easily become agitated. This high degree of irritability can make it hard to fall asleep and stay asleep, resulting in exhaustion and mood swings. One's appetite is often affected and accompanied by either weight gain or loss. Many people who have SAD suffer from low self-esteem.
There are many explanations for this negative shift in mood. In the colder months, people tend to exercise less, stay in more, socially isolate, drink more alcohol excessively and eat more sugar and carbohydrates. Some of the factors that seem to play a role in the onset of SAD is a change in circadian rhythm. The research suggests the reduction in sunlight disrupts the body's internal clock and throws off one's sense of well-being. Not having enough sunlight can also cause of drop in serotonin, a neurotransmitter, that when lowered results in mood changes associated with depression and anxiety. The change in seasons can also disrupt the body's level of melatonin. Melatonin plays an important role in sleep patterns, affect and energy level. Low or high sugar levels and diminished amounts of vitamin D can all lead to biologically induced mood instability.
This season, however, my practice has become busier than usual. With the onset of the pandemic, the increase in depression has become dramatic. It is like Seasonal Affective Disorder on steroids. The people I treat this year are suffering from a syndrome I have coined Pandemic Affective Disorder (PAD). As winter approaches, these individuals with PAD are suffering from severe social isolation, anxiety associated with political unrest, financial insecurity including unemployment, and fear of getting ill. Some may not be able to go in to work or school. Many are not able to be with family members, an additional hardship around the holidays. Some may not be able to be with an ailing family member or had to experience the death of a loved one remotely. My patients are not alone in their sense of dread and hopelessness. The American Psychological Association reports that over 80 percent of all Americans say they are experiencing some form of severe stress due to the coronavirus. The Center For Disease Control and Prevention (CDC) indicates that the level of depression amongst Americans since the outbreak of COVID-19 has gone up over 300 percent. During these trying times, being overwhelmed with depression and anxiety is no longer identified as a disorder, but rather, the current order of our everyday lives. Being overwhelmed with depression and anxiety can now be seen as a rational response during these horrific times of the coronavirus and the effects of political unrest.
There are many things people can do to help themselves during these dark and cold days of COVID-19. Try to be outside in the sun as much as possible. Exercise regularly, be it walks, yoga or exercise videos, or indoor exercise equipment. Develop bubbles of friends and family who you feel comfortable with, who have been socially distancing and have tested negative for the virus. Be creative with small outside gatherings, utilizing heat lamps, fire pits or warm blankets. Use technology to meet with friends and family on a regular basis via video conferencing or phone calls. Avoid over watching negative news on the TV and try to have more family movie nights. Buy a sun lamp and sit under it for a few hours a day. During the day try to sit by a sunny window as much as possible. Make an appointment with a psychologist and continue to see them on a weekly basis. Most psychologists are offering some form of video conferencing. Possibly talk with your psychiatrist or primary care doctor about taking medications to treat your situational depression and anxiety. Avoid alcohol. While alcohol can temporarily make you feel less anxious and numb, it may intensify feelings of depression and anger. Keep a daily activity journal so you can track of any mood swings, so you can remember the good times when you are feeling down. Perhaps even plan social events in the future so you have something to look forward to. Most importantly, keep things in perspective, for like the seasons, these dark times of the pandemic will pass.
Below is a link to an Interview with Dr. Klein about Seasonal Affective Disorder and the Pandemic.
Dr. Klein is a clinical psychologist who specializes in the treatment of depression and Seasonal Affective Disorder. He has offices in Westport, Stamford and Fairfield. During these difficult times, he is serving the greater Connecticut region via video conferencing.
And you may find yourself
Living in a shotgun shack
And you may find yourself
In another part of the world
And you may find yourself
Behind the wheel of a large automobile
And you may find yourself in a beautiful house
With a beautiful wife
And you may ask yourself,
well...How did I get here?
From an early age we are taught to follow the rules of society very seriously. We are thrown into a predetermined set of familial, and more broadly, cultural norms that drive and define us. For most of our waken time, we act and do what we are told without question. We follow in our parent's foot steps and when we astray we are redirected back to the norm by modeling and conditioning.
As children we learn about ethics and morals. We learn to internalize what is right and what is wrong and how we should act, think and behave in different situations. Even before we are born, we have a name, a demarcation that already has significance and affects who we will become. We fear making a mistake; be it getting a "D" in school, not getting into the right college, choosing the right spouse, finding the right profession, raising your kids properly or saving enough in your 401k.
We live our lives propelled forward -- looking backwards only to remember where we came from, who we are, and the the ideals that guide us to who we become. Fredrick Nietzsche called it the "Herd," Martin Heidegger called it the "They," Sigmund Freud called it the "Super Ego," and Jacque Lacan called it the "the Symbolic." While these thinkers might not agree on all aspects of their philosophical presuppositions, their basic premise share a similar significance.
We are born into a historical world, with a language, ideology and common sensibility. Like in a familiar game or sport, we learn the rules so well, we are able to play our assigned roles so naturally, without even a moment of hesitation. Be it the language we speak, the activities we do, the popular styles or fashion we follow, how we communicate, feel or related to others. This human "belongingness" to a collective symbolic order is best illustrated in today's obsession with social media. In today's world, the toddler, before she can master walking, knows how to surf the World Wide Web. We live in a society where we communicate by text, are always "connected" and are absorbed in 24/7 media and news. Ask any parent about the panic that occurs when you try to take a child's I Phone away. The 'Internet Of Things" has become the the iconic symbol of our generation's alienation from our own subjectivity -- a constant connectivity to avoid self-reflection. This avoidance to be with one's own self has reached epidemic proportions in our current society; as manifested in the abundance of obsessions, compulsions and addictions to drugs, social media, video games and internet pornography.
For many of us, we are so absorbed living our lives we have no time to think about or question the very nature of our existence. It is only when we are jolted by a specific event or perhaps a developmental crisis, we find ourselves thrown into self reflection and ridden with existential doubt and anxiety. For many this existential crisis manifests in the form of psychological symptoms, be it panic attacks, insomnia, obsessions or compulsions, feelings of helplessness, a sense of directionless, lack of pleasure or molase. For many it is arises in the form of a mid-life crisis" or confronted by an illness or older age.
In my practice, I often here people say: it felt as if one day I awoken out of a deep sleep and found myself entangled into a strange life, surrounded by people I don't know and working a meaningless job I don't like. How did I get here? is a question many people ask when we meet for the first time in my office. Why did we turn out way we did? What were the underlining reasons that caused us to be who we are? How did our lives end up the way it did? How did things turn out so different from one's expectations?
Be it the 75 year old man who does not recognize his own reflection in the mirror. Where did the time go? When he looked in the mirror, the image looked more like his father than he. How about the couple who met in high school and fell in love at first sight. They were soulmates, best friends and always had each other's back. Now they find themselves married twenty years with two kids and they can barely look at each other without a conflict. A man who dreamt of fame an fortunate as a child, now counts the days to retirement and his government pension. How could a man with such promise end up working such a personally meaningless job? How does a child of the sixties, who fought for freedom and equality, find herself working for a hedge fund helping the top one percent become even wealthier? Or, the man faced with illness, question the purpose of his very existence.
How did we get here? is the question that arises when the self takes a step back and reflects upon its own historical relevance. What is the purpose of my life? It is also the question that unhingers the deeper existential questions of self-identity, free will, meaninglessness and personal finitude.
There is such a contradiction to the human condition. We take ourselves very seriously. Who we are, how we want to be perceived, the importance and consequence of our actions, what we look like, what we achieved, our physical health, our relationships, who we want to become. Yet, when we sit back and reflect upon the greater existential questions, our sense of self-importance can shrink to utter confusion and meaninglessness. Are we not all "bipolar" -- faced with one's own finitude, we race to achieve what we were meant to be, yet why bother, if in the grand scheme of thing, what we do does not matter.
This is the human dilemma. Faced with a life crisis, getting older and an awareness of one's finitude, cracks begin to form in the foundation of one's everyday identity, purpose and significance. Panic sets in unleashing powerful waves of existential doubt and anxiety. Reflecting upon one's personal history, like a literary critic analyzing a narrative, the individual begins the process of self discovery and understanding the thematic motives upon which their lives and self identity were constructed.
Personal freedom can be both a blessing and a curse. While you are free to choose your own destiny, this freedom comes with a price, an awareness of the ultimate groundlesssness of your existence. To face death, is both freeing in terms of the anxiety associated with stress of everyday decisions and concerns, yet existentially wounding and anxiety provoking when confronted with one's temporality and ultimate lack of permanency and significance.
Perhaps the question "How did we get here?" naturally leads us to the question "How do we get out of here? I will let Bob Dylan have the final words.
"There must be some way out of here" said the joker to the thief
"There's too much confusion", I can't get no relief
Businessmen, they drink my wine, plowmen dig my earth
None of them along the line know what any of it is worth.
"No reason to get excited", the thief he kindly spoke
"There are many here among us who feel that life is but a joke
But you and I, we've been through that, and this is not our fate
So let us not talk falsely now, the hour is getting late".
Dr. Martin H. Klein is a psychologist with offices in Fairfield and Westport CT
It Was Meant To Be
People often repeat proverbs as explanations as to why certain events have occurred in their lives. One saying I commonly hear is: "it was meant to be." People use this expression to account for both positive and negative events in their lives. For example, "It was meant to be that I met the man of my dreams" or "the promotion at work that I did not get was not meant to be."
This saying implies that what has happened in a person's life occurred because of an external omnipotent force. These expression are stated in past tense, and is never said prior to an event as a premonition.
It Happened For A Reason
The proverb implies a sense of destiny -- the belief one's actions are predetermined and must have happened for a reason. In fact, some people actually say "it must have happened for a reason" rather than "it was meant to be" -- but both expressions have similar connotations.
In a predetermined world, one is no longer responsible for his or her decisions. One might think she is making a choice, but in actuality she is doing what is dictated by destiny. To use an an analogy, in a world where destiny rules, one's experience of having free will is like the child's experience of being the captain of the ship on a carnival ride where the toy steering wheel has no real control of the boat that in reality travels on a fixed circular track. In other words, free will and choice are illusory.
The Abandon Of Free Will
Why would someone want to accept a worldview that undermines their right to self determination? Isn't personal freedom what we all strive for? From an early age are we not taught the goal of life is to achieve as much freedom as possible, be it financially, socially, at work or in one's relationships? Why would a person want their freedom taken away or diminished by some sort of authoritarian force or being? Is it possible that personal freedom is not all that it is cracked up to be?
The Anxiety Of Choice
Some people have a hard time making decisions. Decisions are not always easy, be it what college to go to, who to marry, where to live, how to invest, should I have kids, take this job, divorce or retire? While you often hear personal freedom is a wonderful privilege, when faced with actual choices, individuals often become psychologically paralyzed. Fear of making the wrong decision can lead to overwhelming anxiety and despair. Once the choice has been made, many individuals often doubt their decision and experience the dread associated with regret. This regret sometimes manifests itself in an obsessive like rumination: "should have" -- "could have" --"what if." Other times, it is defended against by denying the the personal responsibility for the decision. It was not my fault, or I could not have choose otherwise because it was beyond by control -- "it was meant to be."
Paradoxically, to some individuals freedom can be experience as a limitation. To choose "A" means you did not choose "B". Decisions can be perceived as an act of eliminating options. Contrary to the popular saying, for these individuals, every time a door opens another door is closed. A closed door symbolizes one's finitude. Alexander Graham Bell said it so nicely: "When one door closes, another opens; but we often look so long and so regretfully upon the closed door that we do not see the one which has opened for us."
Should Have Could Have
Personal freedom can cause anxiety on many different levels. First, there is the fear of making the wrong decision. This anxiety manifests in obsessive thoughts, thinking over and over again about the pros and cons of each decision. Ironically, while it may feel like not choosing keeps open possibilities, in reality no decision is itself a choice, one that is nonproductive or forward-moving. Second, there is the anxiety associated with regret. This anxiety manifests in ruminative thoughts, the "should have" -- "could have."
Coping Mechanisms and Regret
Both types of anxiety are very painful and can result in despair. Many individuals develop coping mechanisms to avoid these intense negative feelings. For example, some might develop compulsions. -- repetitive rituals as a means of trying to gain a sense of control over fear of the unknown. Others might avoid the decision altogether -- perhaps alcohol or drug abuse as a means of not dealing with the question at hand. Several might deny there is even a choice -- if life is ruled by destiny -- "it was meant to be " you are not responsible for decisions, thus cannot have regrets.
From experience we all know that these coping mechanisms -- be it obsessions, compulsions, avoidance or denial -- have limited abilities to defend against these fears and anxieties associated with the responsibility and pressure of self determination.
Claustrophobia, Panic Attacks And The Fear of Death
There is one more level of anxiety worth mentioning that is intertwined with both the fear to decide and the regret of past decisions. This anxiety is much deeper and more cumbersome than the anxieties discussed above. For the fear of limitation when pushed to its root origin brings one to the fear of one's finitude. Perhaps the claustrophobia or panic associated with a closed door is intrinsically the fear of one's mortality. The existential psychologist refer to this ultimate cause of angst as "death anxiety." But the fairy tale of "happily ever after" is perhaps a topic for another blog.
Dr. Martin Klein is a clinical psychologist who specializes in the treatment of anxiety. He has offices in Westport and Fairfield CT.
Copyright November 2016, Martin Klein, Ph.D.
For the adult survivor of childhood abuse, what is most frightening about the therapeutic process is its demand for verbal communication and intimacy. Many victims are unaware of their past history of abuse or find it too difficult to speak openly about their painful memories, especially to a therapist.
Victims of abuse are conflicted about how they should relate to a therapist. They desire their therapist’s understanding and care, but fear if they let down their defenses they might become vulnerable once again to possible abuse.
Childhood abuse rarely appears as the presenting problem. To diagnose a victim of abuse, the therapist must learn to read between the lines of what the person is saying or even not saying. It is within the silence that victims express their suffering and need for help. The abuse victim communicates less with speech, and more with the symbolic language of the body.
There they sit facing the therapist, scared, frightened, hyper vigilant, numb, looking away from the therapist’s eyes in order to avoid what they perceive as their therapists’ piercing and critical gaze.
As a perceived parental figure, therapists can easily become screens for the victim’s projections. The individual may experience the therapist as if he or she is an abuser and the therapeutic session an abusive situation. If this occurs, the conflicts and struggles the adult had as a child may be acted out within the realm of the therapeutic relationship.
It is understandable why even a seasoned therapist might be disturbed by the victim’s inappropriate and situationally dystonic behaviors and actions. To cope with their own level of anxiety, some therapists might choose to relate to the patient in a defensive manner.
The most common form of defense used by therapists to create distance between themselves and the acting out patient is the diagnostic procedure. By labeling a person with a diagnosis, the patient as subject is transformed into an object that can then be defined, manipulated and controlled.
Because of their hyper vigilance, victims are sensitive to how others perceive them. If they feel the therapist is relating to them as an object rather than as a fellow subject, their acting out tendencies will escalate.
The feeling of being objectified by the therapist will serve as a catalyst for the victim to re-experience and reenact the past abusive situation within the present therapeutic relationship. In other words, the defensive therapist will be perceived by the victim as being manipulative and controlling and as a result will react in a defense fashion against what they perceive to be a threat.
The goal of treatment is not for the therapist to diagnose the victim, but rather for the victim to begin to learn how to identify and understand their patterns of thoughts, emotions and behaviors. By organizing their experiences into language, their victim will develop the psychological distance and personal integrity required to gain a sense of mastery and control.
Over and against the victim’s negative projections, the therapist must relate to the victim with unconditional compassion and support. For it only by developing a safe and highly structured milieu that the victim will be able to let down his or her defenses and begin to work through the issues related to the abuse.
It is understandable why the victim’s defense mechanisms might be interpreted by both the therapist and patient as maladaptive character traits. No one would dispute the negative effects these defense mechanisms have in terms of sabotaging and resisting the therapeutic process. However, to continue to view the victim’s defense mechanisms as a form of “resistance” will have a negative effect upon treatment. To critically confront the defenses can make the victim feel as defective and helpless as he or she felt at the time of the abuse.
By recontexualizing these defenses mechanisms, from within the horizon of a developmental/ historical perspective, the victim will begin to realize the important role these personality traits played in terms of their survival. Defense mechanisms are, in fact, coping strategies that, in the past, helped the victim adapt to a maladaptive environment.
By reinterpreting these defense mechanisms as coping strategies, the patient will begin to develop more positive self-image and begin to fell more integrated and in control. In time, they will realize that these maladaptive defenses mechanisms are no longer appropriate or needed.
In addition to basic trust, self doubt is a problem that also plagues victims of childhood abuse. The victim does not trust his or her own thoughts and perceptions – especially past memories associated with the abuse. In fact, many victims are unsure if their memories are fantasy or reality.
To help the victim overcome self-doubt, it is important for the therapist to validate his or her memories. What matters is not the historical facticity of the memories, but rather what psychological significance these memories have in terms of the person’s current experience.
To accomplish this goal, the therapist, must keep in mind that the victim’s recollections of the past are based upon a child’s perspective – a viewpoint that is very different from how we as adults perceive ourselves, others and the world. For example, children tend to perceive adults as being bigger than life and also do not have a proper understanding of sexuality, aggression, or even a clear demarcation of self and other. From this vantage point, it is understandable why the victim’s memories might have a limited or distorted child-like quality to their narrative.
Working through the defenses, learning to trust oneself and the therapist, reconnecting thoughts with feelings, and beginning to integrate the past with the present is both a frightening and exciting process.
What is most frightening about the process is that it requires the subject to face the unknown, What is most rewarding about the process is that if offers the subject the freedom for personal expansion and growth.
Dr. Klein is a clinical psychologist who practices in Fairfield and Westport CT. He specializes in the treatment of trauma, Post Traumatic Stress Disorders (PTSD) and adults survivors of emotional, physical and sexual childhood abuse.
Alcohol is legal and socially acceptable. It plays an important role in our culture and daily lives. To make a toast on a special occasion or engage with your associates at a happy hour is considered to be normal and even proper etiquette. While low dosages of alcohol might reduce social inhibitions or improve cardiac health, it has long been known that excessive drinking is detrimental to most of the organs in your body and in fact can be deadly if done to excess.
Over the long-term, heavy alcohol consumption can cause severe illness such as liver and brain damage and increase risk of cancer. A recent study concluded that drinking as little as 10-14 glasses of wine or beer a week can reduce one's life expectancy by several years. While alcohol may not be seen by society as a deadly drug, in our country over 15 million people are reported to have some sort of alcohol use disorder, and over 88,000 people die from alcoholism on an annual basis. Alcohol is a highly addictive substance. In fact, trying to detox off of alcohol without medical assistant can have dire physiological consequences. It is no wonder that alcoholism is viewed as a chronic and sometimes fatal disease.
However, alcoholism has not always been considered to be a disease. Prior to the twentieth century, a person's inability to "hold their liquor" was seen more as a personal weakness. Alcoholics were identified as "drunks," with flawed character and low morals. It was not until the 1930s that the medical community began to define alcoholism as a disease and Alcoholics Anonymous (AA) was founded and embraced the disease model as a core principle. The disease model allowed the medical profession to begin to treat addicts as victims of their illness rather than derelicts who should be punished for their sins.
The disease model has its merits -- it offered alcoholics the opportunity for recovery rather than social scorn. However, it also had an intrinsic flaw -- it did not address the underlying psychological issues that caused the substance abuse in the first place.
Many people who abuse alcohol suffer from some sort of underlying anxiety disorder. In an attempt to self-medicate their underlying psychological issues, the alcoholic develops an addiction. The alcoholic now has dual presenting problems -- 1. anxiety and 2. alcohol dependence. It is my clinical view that to achieve sustained sobriety, the alcohol abuse and the underlying anxiety dysfunctions must be concurrently treated. In fact, between 20 to 50 percent of people do relapse right after the completion of disease model treatment program and nearly 90 percent of people relapse within 4 years of completing an alcohol rehabilitation program.
Being human is not a easy feat. We don't have control over many variables in our lives and we must all face possibilities that tragedies can happen at anytime, including one's own mortality. For most of us, however, we adapt to our existential condition. We learn how to put things out of our heads so we can function in the world and limit our fears. Anxiety is a normal part of life and in many instances it arises for good reason. For example, if a lion is chasing you in the jungle, anxiety and fear are not only appropriate, they are essential to one's survival instinct.
Alcoholics tend to be individuals that did not grow-up in ideal family settings. They did not develop a basic sense of security or trust and thus never felt safe with others or even natural in their own skin. They tend to be overwhelmed by irrational anxieties and uncontrollable fears even in situations that don't justify these feelings. Their high degree of anxieties can manifest in different ways. Some individuals suffer from general anxiety; constant worrisome thoughts and unnecessary fears about routine events and everyday activities. Others have social anxieties; fear of being scrutinized by others, humiliated or embarrassed in public. Many are plagued by obsessions or compulsions; paralyzed by the "should've could've," find it difficult to make decisions, stop ruminations or unwanted behaviors. Many cannot slow down their thought processes and suffer from an inability to relax or insomnia. Others have phobias; public speaking, going in an elevator or meeting a stranger can result in a feeling of panic, chest pain, tightness in the throat and shortness of breath. A history of trauma or past abusive can result in the avoidance of intimacy, low self-esteem, intrusive thoughts and self-destructive behaviors.
Alcoholics can have have one or more of the types of anxiety disorders described above. To achieve sobriety and avoid relapse, a person has to do more than stop drinking, they have to learn better coping mechanisms to handle their underlining anxieties that are at the root of their substance abuse problem.
AA meetings can play a significant role in helping the alcoholic address their anxieties. More than just focusing on alcohol as a disease, there is a significant psycho-social component to the AA group meetings that address the alcoholic's anxieties head on. AA group meetings can be viewed as a form of exposure therapy; whereby the alcoholic faces its irrational fears and learns more adoptive interpersonal modalities of functioning. AA offers a type of re-parenting experience; a safe environment of unconditional support that promotes basic trust and a sense of social well being. Attending meetings and sharing with others in an open and honest manner is self empowering; it reinforces that one is okay for who they are. By surrendering to a high power, the alcoholic comes to terms with the reality that many existential fears are not in their control. By bonding with a sponsor, honesty and intimacy is achieved perhaps for the first time. By taking one step at a time, the person stops ruminating about future and past decisions. By having to attend groups and speak in front of others, irrational interpersonal and social fears are called into question.
However, for many AA meetings are not the right mileu to address their psychological issues. They need more individualistic and intensive psychotherapy to work though their childhood and family issues and learn more adaptive ways to improve self-esteem communication, interpersonal relationships and abilities to handle existential issues as they arise. Existential psychotherapy can help you learn how to differentiate between appropriate anxieties, the fear one feels when a lion is chasing you in the jungle, and irrational anxieties, the fears of low self-esteem, being around others or being a failure.
Dr. Martin Klein, Ph.D. is a clinical psychologist who practices in Fairfield and Westport CT. He specializes in alcoholism, addictions and anxiety disorders. He is trained in existential psychoanalysis and psychotherapy.
Westport addiction psychologist -- alcohol and drug abuse
Fairfield addiction psychologist -- alcohol and drug abuse
The most important men in town would come to fawn on me.
They would ask me to advise them, like Solomon the Wise.
Posing problems that would cross a rabbi's eye!
And it won't make one bit of difference if I answer right or wrong.
When you're rich, they think you really know!
Tevye -- Fiddler on the Roof
Money plays a significant role in how we live our lifes. While money is usually considered an asset, how we relate to money has significant psychological consequences.
The utilization of money as a means to trade goods has been around for thousands of years, be it a shell, a coin, a piece of paper or electronic payment. Money is valuable because we know everyone else will accept it as a form of currency. The coin or piece of paper independent of what it represents, however, is worthless. Money only has value as a symbol of what it signifies -- I.e, an elaborate barter system where you exchange services and goods.
Sometimes symbols can become over ridden with personal meanings. Like many symbols, money can detach from its originally intention and take on a totally different meaning with a life on its own. For example, money can be associated with freedom, power, personal identity, self-worth, or even immortality to name a few.
Money with all its symbolism and psycho-social significance can play a major role in people's life. Money can affect one's mental health, marriage, families, friendships, job, and even political viewpoints. It is no wonder that money is one of the top concerns people have when seeking out psychological services.
I see many individuals in my practice where money has become a symbol attached to one's sense of identity and self-worth. I saw one gentleman who was obsessed with how much he lost in the stock market 17 years ago. It still keeps him up at night. While he does well financially and lives a very comfortable life, he still looks back and beats himself up with "should have could haves" about his past investment strategies. No matter how good a person he is, his identity and self worth is dependent upon what he did with his money many years ago. He still owned this one stock that he lost a lot of money in. Each day he watches the stock market to see if this stock went up or down. If it goes up he feels good about himself, if it goes down, he has a bad week. He has a true case, of what I call "Dow Affective Disorder" -- an emotional roller coaster associated with perceived self worth based upon the paper value of an investment. You often hear that you should not be emotionally attached to investments, but to many, investments are the pillar upon which to value one's sense of worth. Is having a lot of money true wealth if you are still unhappy? Perhaps Benjamin Franklin had they right interpretation for this gentleman: "Wealth is not his that has it, but his that enjoys it."
I once saw a young man in his early thirties who was so successful in his career that he could retire. He did not seem to have much interest in the possessions that money could buy. However, he had no other interests than working and when he was not working he would become overwhelmed with anxiety. It was this anxiety that brought him to see me. Why did he continue to work so hard at making money and why did he get so anxious when he tried to relax? What was he getting out of the work that was so compelling? What he did for a living was about out-smarting others. Making the good deal and beating out his opponent is what made him feel good about himself -- gave him a sense of self worth. As I got to know him better, the connection to his childhood experience with his younger brother became apparent. He and his brother were always in competition, yet no matter how much he achieved, his parents always viewed his brother as being smarter and more successful. When he was winning the deal he felt good, but the moment he was not engaged in the game, he was once again overwhelmed with fears of being a failure.
I often hear stories of aunts or uncles who were thought to be poor, but died with millions of dollars in the bank. Why would a person live like a pauper, live so frugally to the degree of deprivation, yet die with so much money in the bank? What purpose did the money serve? Did it actually give them a sense of security or safety net from the unknown? Did they believe they could take it with them? Ironically, the distant relative that inherits the money often has a different sense of meaning attached to the money. Rather than deprivation for security, they see the money as something for nothing and freedom to spend. To quote Dire Straits: "Oh that ain't workin' that's the way you do it. Get your money for nothin' get your chicks for free."
Money is one of the top issues that comes up in marital therapy as a presenting stressor. What happens when two individuals, raised with very different financial values, become a family? What if he is a believer in saving and she believes in spending? What if one person comes to the marriage with much more money than the other person or has a significantly higher income? While the concept of two individuals become one under the eyes of God makes sense from a spiritual and emotional perspective, the merging of two bank accounts is far more complex and not so easy to work out. When you get married, should you keep separate accounts, have a joint account or have a little of both? How a couples handles their money can say a lot about a relationship. I often see couples in my practice, where one of the partners insists on having a separate account in his or own name. While under the law all wealth is communal, this separate stash gave this person a symbolic sense of control -- "without a separate bank account, I feel like I am vunerable and lose my sense of independence."
In premartial counseling the question of a prenup often comes up. The idea of a prenup by its very nature calls into the question the sancity of marriage. How can two people make a vow to be together forever if they they have a written contract prepared just in case it does not workout? I often hear, "I just don't find the idea of a prenup to be very romantic." Money can become a symbolic wall that protects individual interests yet keeps a wedge between couples.
Money clearly plays a significant role in how we relate to ourselves and others. At times, our real underlying concerns with money has to do with deeper issues such as identity, self-sufficiency, self-esteem, self-worth, freedom, stability, fear of loss, the battle for control and power and how one relates to mortality.
Perhaps there is more to wealth than money and more to money than wealth. Maybe Henry David Thoreau was right when he said: "Wealth is the ability to fully experience life."
Copyright Nov. 2016, Martin Klein, Ph.D.
Dr. Martin Klein, Ph.D. psychologist specializes in the treatment of anxiety utilizing a combination of hypnosis, mindfulness techniques and psychotherapy. He practices in Westport and Fairfield CT.
Westport hypnosis and hypnotherapy
Fairfield hypnosis and hypnotherapy
Baby, sweet baby, you're my drug
Come on and let me taste your stuff
Baby, sweet baby, bring me your gift
What surprise you gonna hit me with
I am waiting here for more
I am waiting by your door
I am waiting on your back steps
I am waiting in my car
I am waiting at this bar
I am waiting for your essence
Baby, sweet baby, whisper my name
Shoot your love into my vein
What Is Sex Addiction?
In my practice I often get phone calls asking if I treat sex addiction. It is my experience the term means different things to different people. The majority of calls come from men. Often it involves an individual who has had extra martial affairs, is obsessed with internet pornography, put himself in a sexually compromising and/or illegal position, cannot stop sexual urges or fantasies, or suffers from excessive masturbation. All of these behaviors interfere with daily responsibilities and put strain on relationships, resulting in psychological distress to themselves and their families. In some instances, it is the spouse that demands their partner seek profession help or face consequences such as separation or divorce.
The History Of Sex Addiction
Different names have been used to characterize individuals who engage in excessive and at times deviant sexual activities. Labels such as Don Juanism, nymphomania, satyriasis, erotomania, hypersexuality, impulsive disorder, overactive sex drive has been around for along time. The term “sex addiction,“ however, did not arise on the scene until the 1970s. It was originally coined by members of Alcoholics Anonymous who set out to apply their 12 step principles toward sexual recovery. In a similar vein as alcoholics, they identified those who suffered from excessive and disruptive sexual activities as being physiologically dependent. Based upon the AA paradigm, they believed that sex addicts cannot be cured; but rather their disease can only be controlled by complete abstinence. To suppress their sexual dependence, members must acknowledge the disease is greater than themselves, surrender to a higher power, participate in group meetings in order to muster up the collective power to battle the disease one day at a time. With the popularity of the 12 step movement, numerous organizations formed that follow the AA doctrine - - Sex Addicts Anonymous, Sexaholics Anonymous, Sex and Love Addicts Anonymous, Sexual Compulsive Anonymous and Sexual Recovery to name a few.
Is Sex Addiction A True Addiction?
As these organizations expanded and continued to help many people, its fundamental premise has been called into question by many in the mental health communities. Neither the American Psychiatric Association, the American Psychological Association nor the American Medical Association recognize “sex addiction” as a valid diagnosis. According to the American Medical Association, there is no clear evidence that “sex addiction” is a biological disease that leads to physiological dependence and withdrawal. While past editions of the American Diagnostic And Statistical Manual of Mental Disorders had a category called Sexual Disorders Not Otherwise Classified, the latest version does not. After reviewing the empirical evidence, it decided not to include the diagnosis of “hypersexual Disorder” in it’s current manual. Despite its absence, mental health professionals have found the following disregarded criteria for Hypersexual Disorder to be of diagnostic value:
For a period of at least six months:
Compulsion Or Impulse Control?
The World Health Organization’s (WHO) manual does includes the diagnosis “excessive sexual drive.” In their manual, this diagnosis is classified as a compulsive behavior and/or impulse control disorder and not an addiction. There is extensive research that suggests hypersexual disorders are of a psycho-social nature. For example, people who identify themselves as “sex addicts” often come from dysfunctional families and have a history of being abused. One study found that 82 percent of sex addicts reported being sexually abused as children. Sex addicts often describe their parents as rigid, distant, uncaring and critical. Many parents of sex addicts have similar tendencies and were also abused as children. Many of these families, including the addicts themselves, are more likely to be substance abusers.
There continues to be great disparity as to the etiological and diagnostic criteria for hypersexual disorders. Is “sex addiction” a true addiction? Is it an obsessive compulsive disorder, impulse disorder, or perhaps not even a disorder at all? Where the responsibility falls - - the addiction, the learned character traits, or the individual’s bad choices - - has significant repercussions in terms of diagnosis, treatment and how society views and treats these individuals.
The answer to these questions are not so clear cut. Perhaps individuals struggle with sexual dysfunctions for different reasons or a complex array of multiple reasons. Even if the evidence suggests sex addiction is not an addiction, this does not rule out the possibility that physiological factors can still play an important role in its constitution. The existence of a strong correlation between hypersexuality and anxiety and mood disorders has been well documented in the literature. In fact, it has been shown that the same neurological transmitters that are involved in anxiety and depression appear to play a role in obsessive and compulsive behaviors.
Like many obsessions and compulsions - - be it video games, the internet, gambling, sports, the stock market or even watching TV - - sexual compulsions can only provide temporary relief from unwanted emotions. The moment the compulsive activity stops the unwanted thoughts and feelings do return with vengeance. Individuals who identify themselves as “sex addicts” tend to act out to mask or avoid unwanted emotions such as sadness, shame, loneliness, guilt, anger and fear. Many “sex addicts” also suffer from low self-esteem, impaired occupational, educational, social, family or relationship issues.
Empathy, Acceptance And Self-Responsibility
It is important to have empathy for individuals who suffers from hypersexual disorders. One must have an appreciation of the depth of their suffering, conflicts and daily struggles, be it of a physiological, psychological or self-inflicted nature. You must be aware of their personal histories, family dynamics, current stressors, sense of self, and underlying psychiatric issues such as mood, anxiety or character weaknesses.
To overcome hypersexual tendencies, one must accept and take self-responsibility for their own limitations, dysfunctional tendencies and past discretions in order to harness their inner strength and move forward in a productive manner. In addition to the support of family, friends and
organizational groups, having a seasoned clinical psychologist as your guide on this difficult journey is important to the healing process.
Dr. Klein is a clinical psychologist who practices in Westport CT. He specializes in the treatment of sex and porn addictions as well as substance addictions.
When I was growing up I had a black and white television set with two antennae ears. At the tips of the antennae we wrapped tinfoil to extend the ears in order to improve reception. While the TV set was big and bulky, the screen itself was small. It kind of resembled the face of the robot on the television program Lost In Space, which was a TV series that was popular during my childhood. It had three manual knobs, one to adjust the sound, a second to change the channel and a third to control the picture so it stayed still and did not vertically roll up and down the screen. In those days, watching TV was a physical feat — it required getting up and having to adjust the different apparatuses on the set, including the rabbit ears. Growing up in New York City in the 1960s I was privileged to get seven channels – 2, 4, 5, 7, 9, 11, and 13. There always seemed like there were many options to watch.
Each night, at six o’clock sharp, my family would sit around the television set to watch the news hour. In those days, the evening news was an hour of serious public affairs coverage. Many historians describe the three network news hours on channels 2, 4, and 7 as the Golden Age of Cronkite, Huntley and Brinkley. My family was dedicated to watching the CBS network channel with the news anchor Walter Cronkite. Back then, there was no doubt that Cronkite was reporting the news in an object manner. He spoke with an authoritative tone and no one questioned the facts of his stories. Cronkite ended each program with the saying: “And that’s the way it was.”
In the 1960s, the news was broadcast in black and white, both literally and figuratively. It was about fact and was not allowed to be colored by ratings. The networks’ missions were to keep the news hour separate from the rest of their commercial broadcasting. This was due both to the image they wanted to present to the public as well as government regulations. The news hour was seen as a public service, and not a revenue base for the network.
As a child, I remember sitting with my family in front of the television, watching the news clips from the Vietnam war, each night seeing the number of casualties presented across the screen. The news was serious business. In the 1960s, the networks still had a code of ethics and sense of moral responsibly. Public figures were always protected by the media, their flaws and indiscretions were hidden from the public. The day John Kennedy was assassinated, the principal came into our classroom to tell us the sad news, and each student experienced his death as a personal loss. The nation grieved as if a family member had died on that day. John F. Kennedy was idolized as an iconic leader and his family’s life style set the cultural trends for the country.
In the 1970s, the Federal Communication Commission (FCC) began to deregulate the broadcasting networks, paving the way to the elimination of the divide between news and entertainment. Tabloid news shows, like Current Affair, blended news and entertainment. By the end of the 1970s, tabloid news programming became a significant revenue source for the networks. The more dramatic and colorful the tabloids became, the greater its ratings and profit. Around this time, the networks began to upgrade their picture transmissions from black and white to color. With the demise of black and white television, the clear distinction between fact and fiction also began to narrow.
With the televised impeachment of Richard Nixon, a certain innocence was lost. We were no longer living in “Camelot.” I vividly remember watching the president resign on television and being shaken by the feeling of uncertainty and disbelief. How can the president of the United States do something so out of character of the highest office? I thought this event was so significant, I decided to tape the president’s resignation speech with my cassette recorder. Interestingly, on the flip side of the same tape, I recorded a standup comedy routine from George Carlin. Looking back, the idea that I placed Richard Nixon and George Carlin on the same tape, perhaps signifies the sense of cynicism that I was beginning to experience by the end of the 1970s.
By the 1980s televisions were now hooked up to cable boxes. TVs began to look more like the digital computers on Star Trek than the clunky robot on Lost in Space. With remotes in our hands, we now had access to hundreds of channels bidding for our attention. We didn’t ever need to leave our seats to make adjustments. With cable television came the creation of CNN, a news station driven by ratings. CNN was the first network to bring you 24-hour live coverage. CNN not only reported the news, it became an interactive force that shaped and created the news in real time. With the replacement of the anchor person with “commentators” and “hosts,” the news no longer was grounded in fact, and the divide between truth and fiction began to blur further.
When Ronald Reagan, a Hollywood actor, was elected president, a sense of what was real and what was theater was further called into question. I remember watching an episode of Saturday Night Live where they did a skit on Ronald Regan. In the skit he was portrayed as a tyrant to his staff, yet playing the character role of the goofy grandfather to an audience of children who were visiting the White House.
The 1990s saw the rise of several different 24-hour news channels. Each station tried to find its own niche in order to gain market share. For example, Fox News viewed the world from the political right, MSN and CNN more from the left. Networks no longer presented different perspectives of one reality, but different realities, based upon the political orientation of the channel you watched. The age of positivism — where we all shared a common black and white existence — has disintegrated into negative relativism — where different realities were strategic constructs devised by the networks to promote ideological agendas.
The networks no longer just presented the news, they now told you how you should think about the news. News now was less about facts and more about opinions. To quote Bill Moyers: “When you mix fiction and news, you diminish the distinction between truth and fiction, and you wear down the audience’s own discriminating power.”
The 2000s saw the arrival of social media. With the invention of the smart phone, individuals were now able to construct personalized realities and send them out on the World Wide Web. With a little bit of tech savvy, operatives were able to have their agendas go “viral” and target mass audiences. While social media has many positive applications, it also has a dark side in terms of its vulnerability to construct devious realities of lies and untruths. The internet’s ability to spread anti-social propaganda as well as harmful and infectious viruses has reached epidemic proportions. The news was no longer at home on your television, but it was now connected at all times and it followed you where ever you went. The news was 24/7, streaming in real time and in the palm of our hands.
By the year 2007, social media became a powerful controlling force, where in an instant a text or tweet was able to put thoughts directly into your head. Social media was like the Wild West, no regulations, ideas flying around from who knows where, with no sense of authenticity or legitimacy. Anybody can make news; even my friend Carla, letting the world know on Facebook that she had meatloaf for dinner.
Fake news has always been around. In previous times, it was referred to as propaganda.
Many people did not take Donald Trump very seriously during the 2016 election. They viewed him like one views an acting out child, not taking his antics with grave concern. I was in shock and disbelief when I woke up the morning after the election and discovered he won. During the campaign, I though he was just seeking attention and publicity, and did not actually want to be president. To many, it is still unclear whether Donald Trump is out of touch with reality, a calculative evil genius, or something in between.
While Trump was not a seasoned politician, at least by historical standards, he was in fact an accomplished Reality TV celebrity. He was well-schooled in the art of self-promotion and social media. For Donald Trump, what is right or wrong does not matter, what counts is how many clicks, and how much attention you get from your targeted audience. Trump created a unique message that resonated with a large enough disenfranchised population that enabled him to win the electoral college vote, despite not having the support of the majority of the population.
It was Donald Trump who invented the concept of “fake news.” Contrary to what the names implies, fake news does not signify news that is disingenuous. Rather it is a political tool utilized by a politician to destroy and suppress their opponent’s viewpoint, regardless of the validity of their arguments. Fake news is not the opposite of real news, but rather, the rewriting of history to promote one’s own personal agenda. In Reality TV, truth is not determined by facts, but rather, “the art of persuasion.” What is right or true has become replaced with who can shout or name-call the loudest, fastest and most often. In the world of social media, what mattered is no longer the content of your message, but rather how many eyeballs followed your tweet or “liked” your link so it can go viral or move up to the front page of a search engine.
Fake news has always been around. In previous times, it was referred to as propaganda. What makes fake news unique and different this time around, is the existence of social media — the internet’s ability to quickly spread propaganda worldwide in nanoseconds.
Despite other accomplishments, when historians look back upon Donald Trump’s legacy, it is his use of the term “fake news” that will likely be remembered as his most significant contribution to society. How he decisively divided the country into civil war — this time however, with tweets rather than ammunition.
As I sit on the couch in front of the TV with my iPad in my lap and the remote in my hand, I find myself surfing multiple sites in desperation to hear someone say “and that is the way it was,” rather than, this is the way I want you to think it is.
Dr. Martin H. Klein is a clinical psychologist who practices in Fairfield and Westport CT.
This article was originally published on January 15, 2020 in the CTMIRROR. A shorter version of the article was published in the CT Post and New Haven Register on January 25, 2020. Click on the buttons below to see articles.
One day in May the CDC had decided that it was safe for fully vaccinated individuals to remove their masks in public. For many this was a joyous occasion. For some, however, this historic moment appears to come with much confusion, hesitation and fear.
In my practice, many of my fully vaccinated patients still exhibit social hesitancy and find it difficult to take off their masks. The latest research, from the American Psychological Association, suggests my patients are not alone. According to the APA, nearly half of all Americans still feel uneasy about in-person interactions, and expect to exhibit social cautiousness even after the pandemic is declared over.
If the science says it safe, why are so many people hesitant to take off their masks and return to normalcy? I think the answer comes down to the human need for control and basic trust.
It is human nature to want to be in control. When we feel like we are not in control, we tend to become uncomfortable and psychologically distressed. Martin Seligman, a research psychologist, referred to this phenomenon as “learned helplessness.” According to learned helplessness theory, anxiety and depression can result from real or perceived absence of control over the outcome of a situation. For example, if you beat a dog every time it comes out of its crate, the dog quickly becomes fearful of leaving the crate and becomes paralyzed with fear. Over time, even if you stop beating the dog, it still remains in the crate, frightened and helpless. In many ways we are like the beaten dog. For the past 15 months, we have been told by the media that leaving our homes can be fatal. Like the dog, we have been conditioned to feel uncomfortable leaving our homes, even if breathing the outdoor air is no longer deemed harmful.
We no longer trust the politicians, the scientists or even the virus itself, which seems to be continuously mutating. Not only was the corona virus unfamiliar to most of us prior to March 2020, even when it was finally known, it’s infectious characteristics appeared to remain a mystery.
We were originally told masks were unnecessary. Then the CDC did a 180 turn about and mask wearing became mandatory. One day the virus was thought to be transmitted via objects and we were bleaching our groceries. In time the “science” changed and the virus was now deemed to be transmitted solely through air particles. Should we wear masks, should we bleach our food, elbow bump, or limit our greetings to a distant wave? Should we listen to the scientists or the politicians? Who can you trust during a time of crisis, when even the president of the United States recommends the unthinkable — inject bleach to kill the virus.
Trust is a basic human need. If you cannot trust either the scientists or the politicians to tell the truth or protect you from the ills of society, how can you possibly feel safe outside your home and around others. Prior to the vaccine, the mask was all we had to protect ourselves and others from the virus. We have all lived through the trauma of the pandemic. In the face of such adversity, aren’t we are all a bit like frightened children holding their teddy bears tight to get themselves through the darkness of the night? Perhaps it will take some time to overcome the trauma of the past 18 months, begin to feel safe again, heal and have the courage to dispose of the mask and all it represents.
This article was originally published in the ctmirror:
Dr. Martin H. Klein is a clinical psychologist who practices in Westport, Fairfield and Stamford. He also provides remote video conferencing session for the Greater Connecticut area.
Barron's article March 18 2020 by Al Root
People’s moods can suffer as the stock market declines. Anyone with significant experience in the market can attest to that fact: No one likes losing money, and everyone likes making it. But in the most extreme cases, stock-market gyrations can lead to Dow Affective Disorder, or DAD.
Investors shouldn’t dismiss the idea out of hand. Staying happy in this market is hard.
The Dow Jones Industrial Average and S&P 500 are both in bear market territory, down more than 20% from recent highs. The Dow dropped almost 3,000 points, or 13% on Monday, only to rally 5.2% Tuesday. In fact, the Dow has moved more than 5% for seven consecutive days. The volatility has been extreme.
“A person with ‘Dow Affective Disorder’ experiences bipolar swings in mood as the market moves up and down,” wrote psychologist Martin Klein in a February blog post. “In a bull market they feel elated and invincible. They may spend freely, even to the point of living beyond their means.” But then comes the fall, which can lead to depression and anxiety.
Klein received his Ph.D. from the California School of Professional Psychology at Berkeley in 1986. He was an assistant professor of psychiatry at Yale School of Medicine before setting up private practice in Connecticut.
“I’ve dealt with a lot of people on Wall Street,” Klein tells Barron’s. Most people only glance at the value of their portfolio on a monthly or quarterly basis. The problems start when checking stock prices becomes compulsive. “Stock performance can be how some value themselves as people,” he said.
DAD is his term for stock swings affecting moods. It isn’t official. There are, of course, mood disorders based on things beyond people’s control. SAD, or seasonal affective disorder, for instance, is a recognized condition.
A ton of research is done into money and happiness. It’s hard to draw sweeping conclusions, but research has coalesced around the idea that to be happy, people need enough money to live, a purpose, and loving relationships.
DAD falls under the first of those criteria. Maybe people view stock- market drops as an existential threat to financial security.
The symptoms of DAD, according to Klein, look like those in other depressive disorders: stomach pain, back pain, neck pain, as well as an inability to sleep or a decrease in libido. If people are going through that, Klein wants them to ask for help.
“Severe emotional ups and downs are harmful to long term health,” he says. In the case of DAD, the ups and downs can hurt the pocketbook, leading to panic selling—in environments like the Covid-19 coronavirus selloff—or to euphoric buying at market tops.
Life lessons from a pandemic
CT MIRROR VIEWPOINTS -- opinions from around Connecticut
Life lessons from a pandemic
A psychologist sees more worry, more depression, but some positive changes, too, in our daily lives
With the onset of the coronavirus,to say life has changed dramatically is an understatement. In our small communities, we all know someone who has been exposed to the virus or has contracted the illness, some mildly and others life-threatening. How we live, work, think, behave and even breathe is now radically different. We are living in a new time –one we were not prepared for or even equipped to adequately handle. To watch the news and see how this virus is spreading worldwide, and even more so in our own backyard, is beyond belief.
Like Noah from the Bible, we are all cooped up in our homes, isolated, socially deprived, praying for a sign of hope, be it a dove, a rise in our 401k, a job offer, schools reopening, a plateau of the pandemic curve or even a politician willing to tell the truth. How can we not feel frustrated and helpless, when we hear the medical experts say “the virus dictates how we live and react not the other way around.” How can you feel nothing but despair when we are told the pandemic is going to get exponentially worse before it gets better.
As a clinical psychologist who practices in Fairfield county, many of my patients are traumatized by how their lives have changed so quickly. We are no longer going in to work, our kids are now being home schooled, our food is delivered, we are home alone with our immediate families, socially isolated, financially insecure, and emotionally drained to the point of being numb. If we see neighbors it is from a distance, at best a walk together on opposite sides of the street. Nothing is the same. Nothing is normal. Even Amazon’s two-day delivery, something we have all taken for granted, is now a distant memory. Time seems to have changed. We are not moving as fast, a day home schooling or going food shopping can feels like an eternity. Each week that passes now feels more like a year than seven days.
The psychological profession has also adapted to this new reality. Like most other occupations, we are working remotely, doing video conference sessions from our homes, wearing the new business causal, a dress shirt with pajama bottoms. While at first slightly awkward, video sessions over time begin to feel natural. My patients are glad to talk, have someone there they can count on each week to listen and provide insight and understanding — perhaps a normal hour routine is much appreciated in the midst of uncertainty and worldwide angst.
There is no question, the people I talk with are having a difficult time. Our sense of normality, our everyday routines, the feeling of being in control of our actions and surroundings, which we have all taken for granted, is no longer present. The anxious are more anxious, the depressed are more depressed, the lonely never felt more isolated. In the midst of all the the tragic stories and emotional suffering I have witnessed as a result of this deadly virus, there are surprisingly some positive psychological changes that I have noticed listening to my patients. While people cannot go to work or the supermarket, go out to dinner, socialize with a friend, or even workout at the gym, they are spending a lot more quality time with their immediate families. Parents are playing with their kids, spouses are cooking dinner together, children are thinking about the well-being of their older parents and elderly neighbors. Even Democrats and Republicans are pulling together to pass necessary humanitarian aid across the global to help others.
Maybe there is a silver lining to the coronavirus pandemic. Perhaps the world was moving a bit too fast. Maybe there was too much divisiveness and intolerance in the world. Have we been taking things for granted, not appreciating the preciousness of our daily existence and the vulnerability associated with our own finitude? Have we forgot the principles of the Golden Rule? Have we not made time to smell the roses, let alone spend an evening playing a game or watching a movie with your kids? Perhaps isolation and solitude is not such a bad thing. Maybe it is time we all reflect upon the story of Noah and the Ark and look forward to the passage of 40 days and 40 nights, the passing over of this plague, and the signs of spring, rebirth and new beginnings.
When I was a college student I remember reading Carlos Castaneda’s books about his spiritual teacher, a Mexican Indian named Don Juan. Don Juan taught Carlos that he should remember “death is always over your left shoulder.” Perhaps this pandemic can teach us all a lesson of how important it is to remember our humanity and the importance of each moment when faced with one’s own temporal and fragile existence.
Martin H. Klein is a clinical psychologist who practices in Fairfield and Westport.
CT Viewpoints -- CTMirror June 17, 2020
As a child my parents considered themselves to be political independents. With their thick blue collar Brooklyn accents they always told me you should “vote for the person not the party.” Sometimes they voted democratic and at other times they voted republican. My dad was proud to have voted for both the democrat Edward Koch and the republican Rudolph Giuliani for Mayor of New York City. On some occasions, my parents did not always vote for the same person. I remember in the 1984 presidential election, my mother voted for Walter Mondale and my dad voted for Ronald Regan. While their political views were not always aligned, they always had mutual respect for their divergent opinions.
They valued their freedom and especially took the 15th Amendment, their right to vote, very seriously. They knew the importance of expressing one’s voice; a privilege their parents did not have prior to coming to the United States. My parents felt it was patriotic to stand up for what was right. During the 1960s, I remember being with my mother as we participated in numerous peaceful demonstrations. Voting and speaking out for human rights made them feel proud to be an American. They believed that their vote, their freedom to voice their political views and demonstrate for what they perceived to be human rights and justice, would create a better world for their children.
In the past century, the two-party political system has always been viewed as a crucial aspect of our great democracy. The parties’ ideological differences were seen as a check and balance mechanism that led to compromise; the coming together of best practices, thus resulting in historic progress.
As I raise my own children, however, I find myself in a country that is very different from when I grew up. Both parties have become extremely polarized, the Democrats to the left and the Republicans to the extreme right. There is no debate. There is no compromise. There is no coming together somewhere in the middle. Everybody is shouting and no one is listening. Our leaders are acting like 8-year-old children holding their hands over their ears, jumping up and down and calling people derogatory names.
And then it happened. A pandemic. A “lynching in broad daylight.” Protests and rioting in the streets. Peaceful protesters being shot with rubber bullets and tear gas. Is this Washington D.C. or is it Tienanmen Square? Photo opportunities reminiscent of Marie-Antoinette “let them eat cake.” Large corporations getting bigger and stronger while the working class and small businesses are unemployed or going bankrupt. The stock market is going up, while the poor have no food to eat.
The country is exhausted. Enough is enough. We are all feeling vulnerable, anxious and isolated. Despite the pandemic, the country has taken to the street. There is anger in the air. It is time for change. We have reach a tipping point. It is no longer about Democrat versus Republican. It is now beyond politics. It is about the very principles that define us as a country. It is about equality verses racism. It is about democracy versus fascism. It is about environmental survival versus financial profits, science versus mythology, women’s rights verses chauvinism and sexual harassment. It is about compassion verses brutality. It is about being decent, morale, honest and having the psychological capacity to have empathy for others. It is now about good versus evil.
As a country we need hope, we need leadership. We need a grownup to tell us it is all going to be okay. We need to be on the right side of history before it is too late. We all need to vote, even if we have to wear masks.
Martin H. Klein, Ph.D. is a clinical psychologist based in Fairfield and Westport. He is currently offering tele-conferencing sessions.
It’s not that easy being green;
Having to spend each day the color of the leaves.
When I think it could be nicer being red, or yellow or gold-
or something much more colorful like that.
It's not easy being green.
It seems you blend in with so many other ordinary things.
And people tend to pass you over 'cause you're not standing out
like flashy sparkles in the water- or stars in the sky.
Life can be hard. We are born into the world so helpless and dependent on others. As we get older we are faced with many challenges and unknowns. Learning to walk is no easy feat. The act of separation is painful. The first day away from your parents is traumatic and anxiety provoking. School is a challenge and requires more and more work as we advance. When school does finally end, we are faced with the anxiety of finding a good job and preparing to grind through the hoops of advancement. While there are many wonderful things about having a family, child rearing is much more difficult than anyone can imagine. Raising a family is beyond a full-time responsibility. The required sacrifice of one's freedom for the good of the family at times can be exhausting and not so personally rewarding.
Yet we continue to tightly grasp onto our dreams. Many of the ideals that motivate us we digested even before we knew how to speak. We learn from our parents, teachers, and the many forms of social media who we should be, think, and become. We are told we can be outstanding. We want to "be all we can be." We believe we can become our idols if we dress or talk like them or buy their products. Even the child believes the commercials that the toy inside the box is the real thing, or that they can become the action figure or build a fighter jet just like perfect representation on the box top. We enter the socialization process and strive to be a good person, be responsible, have a good job, support our families and the community.
When you are young time seems to go so slow. A ten year old dreams of being a teenager, a teenager dream of being a college student, a college student dreams of being an adult. However, as we get older, our sense of temporality seems to change -- time seems to quickly speed up.
With a blink of an eye, you find yourself middle aged. When you look in the mirror you don't recognize yourself. You now look more like your own parent than your internal image of yourself. Your body is beginning to slow down and the wear and tear of aging results in aches and pains. For the first time, you are faced with the limitations of both your aging body and ability to live out your dreams and childhood aspirations.
Like Wile E. Coyote, from the Road Runner cartoon, you realize, perhaps for the first time, you are hanging onto a fragile branch that in time will crack and fall into the abyss.
You start to question the very premise of your existence. The metaphysical questions of the great philosophers no longer seem abstract and irrelevant. Who am I? What is my purpose? Can I ever feel whole or complete? Does my life actually matter? Am I a coherent self or a loose collection of fragment streams of thoughts and ideas? If I am going to die, does anything I try to accomplish count for anything in the larger scheme of things? Shakespeare's quote "to be or not to be that is the question" shakes your existential core.
To face one's own death can be frightening. Much of what we do in our lives is about losing ourselves in the everyday busyness — to avoid, deny and repress our own limitation. One of my clients coined the term "ego cowardice" to describe this failure to face reality and continue living a life based upon false hopes, oneiric ideals and deceptions.”
To face one's finitude takes courage. It might even feel a bit like bungee jumping without the cord. But the truth is that the cord was cut a long time ago.
Perhaps Rose, in the movie Moonstruck, said it best when she finds out her middle aged husband is cheating on her with a younger woman: "I just want you to know Cosmo, no matter what you do, you're gonna die, just like everybody else."
To accept one's existence might only be liberating for a moment. But in life -- a moment in time is all we have. Why not make the most of it.
Dr. Martin Klein is a clinical psychologist who specializes in insight oriented existential psychotherapy. He works with people dealing with issues related to life transitions, identity, intimacy, relationships, careers, spirituality, grief, aging, illness, loneliness and meaningfulness. He has offices in Westport and Branford CT
Major Depressive Disorder (MDD)
Major depression is a disabling condition that can last for long periods of time. Without treatment, a major depressive episode can last months, years and even a lifetime. While the condition can worsen during the holiday season or winter months, it is most often triggered by a personal loss or negative situational event. MDD can run in families. In many cases, the mood disorder can be biologically or socially based or a combination of both. How one was raised as a child is an important contributing factor in MDD. Individuals who suffer from dysthymia, a low-grade continuous depression, are most vulnerable to bouts of major depressive episodes.
People who have never experienced major depression might not understand the depth or severity of the syndrome. There can be nothing more frustrating to a depressed person than someone telling them they should just “snap out of it,” “you have no reason to be unhappy,” or “you just need to pull yourself up with your own boot straps.” Major depression is not something that tends to go away on its own without professional intervention.
When you are clinically depressed you can feel totally helpless and have little hope that you will ever feel better. You tend to forget what it feels like not to be depressed. If someone tries to remind you of past times when you were happy, you quickly view their opinions as ill informed and agitating. You feel depressed and exhausted all the time. Your mind is occupied with negative obsessions, self-deprecating thoughts, and low self-esteem.
There is a melancholia to your mood. You might feel sad, overwhelmed and psychologically paralyzed. You might feel that your life has no purpose or meaning. You have a hard time falling asleep and if you do fall asleep you tend to wake in the middle of the night worried and frightened . You cannot shut off your mind. You thoughts are racing with irrational fears and anxiety provoking self doubts. When you are depressed you can become easily agitated and angry. Even the smallest gesture by another person can be misinterpreted and set off a tirade. Some people become so frustrated that their anger rises to the level of rage, whereby they become capable when provoked of doing bodily harm to themselves or others.
Depression can cause difficulties in focusing and concentration as well as deficits in abstract reasoning and memory. Being productive at school, work or at home can be difficult, if not impossible. In severe cases, a person might not have enough energy to get out of bed, care about their appearance or perform basic activities of daily living. Suicidal thoughts or actual attempts are not out of the question.
If you or someone you know suffers from clinical depression, it is important that seek professional help as soon as possible. Clinical psychologist are trained in the diagnosis and treatment of mood disorders. Depression is treatable. Utilizing a combination of cognitive behavioral therapy (CBT), insight oriented psychotherapy and sometimes medication, the clinical psychologist can come up with an action plan to alleviate your symptoms and make changes to how you think, behave, relate to others, and experience yourself and the world around you.
Dr. Martin Klein is a clinical psychologist who specializes in the treatment of depression. He has offices in Westport and Branford CT.
A man says to his wife:
"Listen honey, whoever dies first,
I want to make sure it is okay that I remarry."
Jerry Seinfield on Choosing a Psychotherapist
Bob Newhart on Brief Focused Cognitive Behavioral Therapy
Woody Allen on Long Term Psychoanalysis
Kelsey Grammer (Frasier) on Hypnosis
Ray Ramano on Martial and Family Issues
Robin Williams on Alcohol Dependence
Jackie Mason on Self-Identity and Psychiatry
Stephen Wright on Early Childhood Memories
Jim Parsons (Sheldon) on Facing Your Fears
Bill Murray on Hypochondriasis
Richard Lewis on Psychotherapy and Termination
A psychiatric diagnosis is a cluster of psychological and behavioral conditions as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Over the years, there has been numerous revisions of this manual. With each revision, there tends to be significant changes to the different menus of diagnoses and how each diagnosis is defined. For example, in the most current manual the diagnosis of "Asperger's disorder" has been removed and is now considered as a part of the class of "Autistic Spectrum disorders." In one of the earliest manuals there was diagnoses termed "Neurotic disorder." The term " neurosis" is no longer considered a proper diagnostic disorder and it has been eliminated from the manual.
So what happens to an individual who has a diagnosis that the American Psychiatric Association decides no longer should exist? What happens to the child I work with who has been labelled "Aspergers" for the past several years and now has a new diagnosis? What about poor Woody Allen? If he can no longer be considered a "Neurotic" can he still make movies?
As several of the great existential thinkers have pointed out, psychiatric diagnoses are not objective disorders, but rather are social constructs that change over time (i.e., Szasz, Lang, Foucault).
When I worked in a psychiatric hospital 25 years ago, the most popular diagnosis was "Schizoaffective Disorder." What did that diagnosis mean? Basically the person was having problems with his or her thought process (schizo) and well as his or her mood (affective). I remember doing an inpatient group with 10 individuals, all diagnosed with "Schizoffective Disorder". All of the people in group did have something in common -- they were not thinking clearly and had mood issues. However, the similarities stopped there. Each person was unique. Each had a different reason for being in the hospital as well as different backgrounds and issues. In fact, at the time, I remember thinking to myself, I would not be thinking clearly or be in a very good mood if I was hospitalized in a psychiatric hospital against my will either.
Today the new popular diagnosis is "Bipolar." Almost everyone coming out of a psychiatric hospital comes out with a diagnosis of "Bipolar." If you are not thinking clearly or having mood issue you are now identified with this now popular disorder. The other widely popular modern day diagnosis is "Attention Deficit Disorder (ADHD)". So many kids these days are being put on speed to improve their attention. Does speed improve one's attention, most definitely. Should all children who have focusing issue be diagnosed with "ADHD" and put on speed? I personally feel it is a significant social problem.
Psychiatric diagnoses are clusters of symptoms. They change over time dependent upon what is popular in the current culture; and more specifically the psychiatric community. Diagnoses are tools people in the field of mental health use to describe a cluster of symptoms and behaviors. There are many theories as to what causes a person to be and act a certain way, but these theories also change over time and are historically dependent on the culture and trends in the psychiatric field.
So what is my point? You should not define yourself by your psychiatric diagnosis. Diagnoses are helpful in understanding psychological symptoms and patterns of behavior. They can be a great tool for the clinician or the psychiatrist in determining the best treatment or medication. A person diagnosed as "Bipolar" is an individual who is possibly struggling with his or thought process or mood. Therapy and medication can help. However, having these cluster of symptoms, thought or behavioral patterns, do not define who you are as an individual with unique personal issues and struggles.
Dr. Klein is a clinical psychologist who practices in Westport CT. He specializes in psychiatric assessment and psychological treatment from a humanistic existential orientation.
Copyright April 2016, Martin Klein, Ph.D.
I often see patients who want to know why they do certain activities that on the surface do not seem to make sense. From a practical perspective, these odd behaviors seem out of character or of a compulsive nature. "I cannot stop doing the action, even though it seems irrational and a waste of time."
In the therapeutic process, the reasons whey we do certain things or act out in a particular fashion is not always transparent and may take awhile to figure out. It is a wonderful part of the psychology process -- an "aha moment" -- when the person and his or her psychologist discovers the meaning of an action.
Many people want a quick fix -- they want the negative behavior or the painful symptom to go away quickly and effortlessly. In some cases this makes sense. But sometimes, it does not. To use an analogy, does it make sense to turn off the fire alarm while there still is a fire burning or a lack of understanding as to the cause of the fire?
I once had a patient with a unique presenting problem. For dinner he would eat the same thing every night -- steak, string beans and creamy mashed potatoes. He would eat the steak first, then the string beans and then finally the creamy mashed potatoes. He would always save the creamy mashed potatoes for last, it was his favorite. However, each night, by the time he finished the steak and string beans, the creamy mashed potatoes were cold. That is right, his presenting problem was cold creamy mashed potatoes. Now if I was a "practical type of psychotherapist", the fix would be easy -- after you finish the steak and string beans, stick the creamy mash potatoes in the microwave and warm them up. But to follow-up with my fire analogy, it is my view that such an action would be like shutting off the fire alarm and not dealing with the real burning issue. For this gentleman, this compulsive pattern was symbolic of a greater issue that in fact affected the very core of how he lived his life. I would call it the "you cannot win syndrome." In his life, he felt like he works very hard, but the reward that he expects for his hard work never comes or when it does finally come, it is cold lumpy and does not taste good. The creamy mash potatoes was symbolic of personal freedom -- the "easy life" -- the effortless melting in your mouth -- an experience this person never seemed to get to.
As many of the great existential thinkers have taught us, human beings are symbolic creatures and think, act and behave with in the realm of the symbolic (Freud, Jung, Eliade, Ricouer). Many of our activities have deep symbolic significance. While these symbolic actions resonates with our sense of well being, their meanings tend to stay hidden.
The most obviously place where the symbolic realm can be most seen is in the world of games. What is the attraction of tennis? Is tennis a working through of some deeper issue? I often talk about tennis when I am doing marital therapy. Isn't tennis a game about relationships -- who is left with the ball in their court --who is at fault? -- are we equally at fault? -- ah then we have "love."
Why do we love to watch football so much -- the great American obsession? What is the symbolic meaning of the game? What is the goal of football, if not to get the ball, which is shaped like a egg -- the symbol of perfection -- to the goal post without it falling and cracking. Why do they pile on the player who is already down with the ball? Why is it so important to make sure the other team does not get back up?
Why are our kids so addicted to video games? Are the themes of these games resonating with our children's needs or desires on a symbolic level? In 1980s, when I was working as a school psychologist, I was fascinated with adolescents' obsession with "Pac-Man." This was before computers, and kids would spend endless hours after school at the arcades. In 1984, I published an article entitled "The Bite of Pac-man" where I explored the symbolic allure of the game. Why did the theme of the "Pac-Man"game resonate so much with adolescents? As I discussed in the article " The themes and strategies of the game perfectly accommodate the adolescent's relation to the world. The Pac-man creature, which the player controls and symbolically becomes, is all mouth and is referred to as "Jaws." "Jaws" spends his time and energy running from the engulfing monsters. There are four different types of monsters, each with its own personality: "Shadow" always follows you; "Bashful" will run away when you turn around; "Ambition" is always willing to attack you; and "Speedy" is fast and will run over you.... If the player engulfs enough monsters before they engulf him, he becomes a winner." While the game of "Pac-Man" might be a safe place to work out issues of separation and individuation, it is still a game -- a feel good fantasy -- not an achievement of personal maturity and a true reflection of one's ability to survive in the world.
What are some of the symbolic things you do or participate in as you live your life? Do you have activities or compulsions that you are addicted to and are not sure why?
Symbolism and everyday actions, it is something to think about.
Dr. Klein is a clinical psychologist who practices in Westport CT. He specializes in life transitions, relationship issues, identity, personal growth and self understanding. He is trained in both clinical psychology and existential philosophy.
The Affordable Care Act, more commonly known as Obamacare, is a perverse twist on the Robin Hood tale. Rather than steal from the rich, Obamacare has taken from the middle class.
Prior to ACA, the self-employed middle class had many options for comprehensive insurance. They were largely able to afford their premiums and deductibles, and out of pocket costs were manageable. Most importantly, they were free to choose their own doctors and hospitals from a nationwide provider network.
To use my family as an example, four years ago I had a PPO plan that cost around $16,000 a year and had a maximum out of pocket expense of $2,500. The plan offered a national network and I was able to go to any doctor or hospital. Today you cannot buy such a plan at any price. The option that comes closest to the plan we had is a “Gold” HMO policy, with a premium of around $44,000 with a $9,600 out-of-pocket maximum. For the middle class, such a policy is financially prohibitive.
Over the past four years, medical costs for the self-employed have gone up over 300 percent and the coverage of the plans has deteriorated. For a middle class family of four, making around $98,000 there are no subsidies. You have two options — buy what amounts to an expensive catastrophic policy with constricted benefits, or pay the tax penalty, be uninsured, and hope for the best. And while many middle class families — whether they qualify for subsidies or not — may be able to afford their premiums, they may not be able to afford their deductibles. How many of us can afford to pay a $13,500 bill that comes in the mail? In effect, they will be able to afford their policies but be unable to utilize them.
On the individual market, there are only two insurance companies to choose from — Anthem or Connecticare. Connecticare’s rates are slightly less expensive. But for the most part, the plans are similar.
There are only two places where you can buy insurance — on the exchange or off the exchange. The exchange plans tend to be significantly cheaper than the off-exchange plans. For example, a Connecticare plan is about 35 to 40 percent cheaper on the exchange than on off the exchange.
From a cost perspective, the exchange plans make the most sense. However, from a network perspective, the plans on the exchanges are extremely limited in terms of the size and scope of their networks.
On the exchange, the provider network is restricted to the state of Connecticut, and even then many of the best doctors and hospital programs in the state are not on the panels.
While many of the exchange plans offer out-of-network coverage, this benefit has even higher deductibles, and poor reimbursement rates – often less than half of the customary rate. So if you choose to go to an out-of-network provider, your out-of-pocket costs can be through the roof.
In terms of coverage, the off-exchange plans are better, but not much better. Off the exchange, your network will be larger and you will have a better chance of finding a provider you like or one that is taking new patients. Some plans even let you see providers in some of the surrounding areas beyond the borders of Connecticut. However, even if you go with an off-exchange plan, the networks are still limited and are not national in scope. They do not compare to an employer-sponsored policy.
Once you’ve decided whether you want to buy a plan on or off the exchange, the next decision, is the type of plan — a high deductible or low deductible plan.
There are three sets of numbers you have to look at to compare plans: premiums; deductibles; and maximum out-of-pocket costs. For the most part, it all boils down to a simple equation: the higher the premium, the less the out-of-pocket expense; the lower the premium, the more the out-of-pocket cost.
From a financial perspective, I believe it makes sense to go with the lowest premiums and the highest out-of-pocket cost. If you have few health care needs during the contract year, you will have to spend little out of pocket towards your deductible. So whether you pay the actual amount of your deductible is not necessarily a given.
If you are fortunate and do not meet your $13,500 deductible, you end up saving money with the lower premium plans (lower premiums in my family’s case is $28,500 a year, with a $13,200 out of pocket maximum). I think you have nothing to lose by taking the lower premium plan, and much to save. But some people, from a psychological perspective, prefer to pay higher premiums and then not have to worry about having to pay for services rendered.
But whichever route you go, maximum out-of-pocket costs, (premiums, deductible, out-of-pocket max) for all the plans ends up being about the same.
In summary, if you are OK with only going to a Connecticut hospital, and most of your doctors are on the exchange network, the exchange plan makes sense. If you might want to go to a New York City hospital, there is a strong possibility that there can be a significant out-of-pocket expense. If you want to go to a provider or facility in Ohio or California, this is no longer possible, no matter which plan you choose, except in the case of emergencies.
For the behavioral healthcare provider, the ACA has been problematic as well. While they have raised premiums, they have not raised what they pay providers in over a decade. In some cases, they have actually decreased their allowable rates by over 50 percent. Member cost have gone up over 300 percent, provider reimbursements have stagnated or have gone down – yet the stocks of these managed care companies have gone up over 400 percent in the past four years. No surprise there.
At risk of being labeled the “L” word, I believe that everyone — middle class included — should be entitled to good health coverage.
Martin H. Klein, Ph.D. is a licensed clinical psychologist practicing in Westport and Fairfield CT.
This article was originally published in the CTMirror. Click below to see link to original article
Seasonal Affective Disorder (SAD) is a type of depression that is related to the changes in the season. Symptoms typically start out mild in the fall and gradually become more severe as the winter approaches. This syndrome is often referred to as the "winter blues” because it is triggered by the lack of day light and the cold weather. Like other forms of depression, people who have SAD can be overwhelmed with feelings of guilt, anxiety and despair. They can feel like the energy in their body has been zapped resulting in sluggishness, poor concentration and little motivation to do activities that they once found to be pleasurable. Due to intrusive negative thoughts, they can easily become agitated. This high degree of irritability can make it hard to fall asleep and stay asleep, resulting in exhaustion and mood swings. One's appetite is often affected and accompanied by either weight gain or loss. Many people who have SAD suffer from low self-esteem.
Some of the factors that seem to play a role in the onset of SAD is a change in circadian rhythms. The research suggests the reduction in sunlight disrupts the body's internal clock and throws off one's sense of well-being. Not having enough sunlight can also cause of drop in serotonin, a neurotransmitter, that when lowered results in mood changes associated with depression and anxiety. The change in seasons can also disrupt the body's level of melatonin. Melatonin plays an important role in sleep patterns, affect and energy level.
There are several treatment options for individuals who suffer from Seasonal Affective Disorder. It is important to discuss your symptoms with your primary care physician (PCP) to rule out the possibility of other medical conditions that can cause mood changes. If your PCP does diagnose you with SAD, he will most likely refer you to a clinical psychologist for psychotherapy to learn strategies to identify and change negative thoughts and behaviors as well as learn relaxation techniques to reduce stress, bodily tension, and elevate one's mood.
Light Therapy, also called phototherapy is often utilized to treat SAD. Utilizing a special light box, a person sits in front of this special bright light for an hour each morning. The light therapy mimics the natural light that occurs in the spring and summer months and affects a change in the brain's chemicals linked to moods. Light therapy typically begins working within a few weeks and there are few negative side affects.
Some people benefit from medications. Wellbutrin is an anti-depressant that is often used to treat severe cases of SAD. The medication can be taken during the SAD season, from late fall until the end of winter each year. Exercise, meditation and stress management tools can also be helpful to reduce SAD symptoms.
Dr. Martin Klein is a clinical psychologist who specializes in Seasonal Affective Disorder. He has offices in Westport and Branford CT.
Dr. Martin Klein is a clinical psychologist who practices in Westport, Stamford and Fairfield CT. He works with children, adults and couples.