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.Dr. Klein's new book Rethinking Cognitive Behavioral, Psychodynamic, and Existential Therapy: A philosophical Framework For A Unified Therapeutic Model will be published on November 7, 2025 by Routledge.
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 Everything that irritates us about others can lead us to an understanding of ourselves. Carl Jung 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 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 ,
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? Talking Heads 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 Westport psychologists Fairfield psychologists In our fast-paced modern world, the pervasive issue of insomnia, characterized by its disruptive impact on falling asleep and staying asleep, poses significant challenges to our ability to function in our everyday lives. While conventional remedies such as medication have proven effective for many, a combination of hypnosis and Cognitive Behavioral Therapy (CBT) can be an alternative approach to addressing insomnia in a more wholistic and non pharmaceutical manner.
Hypnosis is a state of heightened suggestibility and focused attention. In the context of insomnia treatment, its objective lies in rewiring the subconscious mind’s entrenched negative associations with sleep while concurrently fostering deep relaxation. What distinguishes hypnosis is its capacity to delve into the roots of insomnia, bypassing the mere management of symptoms. Hypnotherapy ventures into the deep-seated issues underpinning sleeplessness, such as anxiety, racing thoughts, and counterproductive sleep-related thought patterns. By uncovering and addressing these core concerns, hypnosis endeavors to effect enduring transformations in sleep behavior. During a hypnotherapy session, a clinical psychologist adeptly guides the individual into a profound state of relaxation. Within this receptive mental space, the therapist introduces affirmative suggestions and constructive imagery specifically tailored to sleep. These carefully curated suggestions and images work synergistically to reshape the individual’s negative perception of sleep. When blended, the integration of hypnosis and CBT presents a powerful approach for the treatment of insomnia. CBT, renowned for its empirical foundation, is designed to identify and alter maladaptive thought patterns and behaviors associated with a spectrum of mental health conditions. In the sleep context, CBT takes aim at dismantling unproductive beliefs and actions linked to insomnia. The relaxation engendered by hypnosis facilitates a more fertile ground for the absorption of cognitive restructuring and behavioral modifications imparted through CBT. While the latter concentrates on dismantling negative thought patterns about sleep, hypnosis acts as a facilitator, rendering individuals more amenable to reconfiguring these thought patterns in a state of profound relaxation. Hypnotherapy becomes a haven for quelling the anxiety often intertwined with nighttime wakefulness. In parallel, CBT propounds the utility of positive affirmations as an antidote to counteract negativity. Through hypnosis sessions, these affirmations gain a newfound potency, reinforced by the profound relaxation that accompanies the hypnosis trance state. This serene mental atmosphere creates an opportune setting for the assimilation of these affirmations, gradually fostering a healthier mental outlook towards sleep. By harmonizing both conscious and subconscious elements, the combination of hypnosis and CBT provides a dynamic framework for addressing sleep difficulties comprehensively. While CBT imparts cognitive tools to recalibrate thought patterns and behaviors, hypnosis serves as a catalyst, engendering a state of relaxation that nurtures receptivity to change. Dr. Martin Klein is a clinical psychologist who practices in Westport CT as well as remotely via video conferencing. He specialized in the treatment of insomnia utilizing hypnosis and CBT. 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." Closed Doors 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. Westport psychologists Farifeld psychologists Copyright November 2016, Martin Klein, Ph.D.  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. www.barrons.com/articles/coronnavirus-stocks-plunge-affecting-mood-dow-affective-disorder-51584543539 www.ctpost.com/opinion/article/Opinion-Steer-clear-of-Dow-Affective-Disorder-15139793.php 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. .
Identifying with Trump, the aggressor by Martin H. Klein, CT Mirror December 12, 2024 As a psychologist practicing in a liberal town filled with affluent and well educated people, I found myself in an unusual position the day after the election. Typically, my patients talk with me about their everyday concerns. The day after the election was different. Not only were all of my patients traumatized and anxious, so was I. How could this have happened? How did Donald Trump, a narcissist, felon, racist and sex offender win the popular vote? This was the line of questioning I heard session after session on that day. It is understandable why my patients were feeling so stressed out. However, I knew with time they would all calm down and be fine. Not only are they fortunate to live in a blue state, it so happened that while they were fretting over the election, their stock portfolios hit all-time highs, making their lives even more comfortable and privileged than before. What is not understandable, at least from a logical perspective, is why would the working class, minorities and even the disenfranchised vote for Trump? On the surface, it doesn’t make sense. Wouldn’t his economic, social and environmental policies hurt them the most? What if the outcome of this election was not rational, but emotional? Can it be that people are so angry they identify with his rage? They lived through a deadly pandemic, are struggling to make ends meet, feel discriminated against and are living amongst violent criminals and drug addicts. What if Trump’s popularity was not based upon reason, but rather an identification with his anger, his aggression, his role as the bully? This would not be the first time people chose to follow the irrational wrath of such a leader. As historians quickly warn us, there are parallels between the current mood of the country and the political climate in pre-Nazi Germany. During the 1930s, the German people were experiencing economic distress due to hyperinflation, the devastating consequences of a world war and the humiliation from defeat, as well as a deadly pandemic. Like today, the German people were enraged; creating the perfect opening for an authoritarian dictator to step in and promise retribution and radical change. If these historians are right, rather than reinvent the wheel, maybe it would make sense to turn to the psychologists of the pre-Nazi era for insight and understanding. Maybe they can help us better grasp why the majority of voters in this election cycle favored a candidate who promised dictatorship on day one and speaks with such venom. In 1936, Anna Freud, Sigmund Freud’s daughter, wrote about a psychological syndrome that she witnessed during the war, the “identification with the aggressor.” She observed that victims of aggression or abuse unconsciously adopted the characteristics, behaviors and attitudes of their aggressor as a means of gaining a sense of control and mastery. By imitating or aligning with the power of the aggressor, the individual symbolically attempts to reverse their role as a victim, and avoids facing their own feelings of helplessness, anxiety and despair. This syndrome not only occurred with individuals, but on macro levels as well, in social contexts where marginalized groups adopt the norms or values of oppressors to survive within oppressive systems. Freud referred to the rise of the Third Reich in Germany as an example of this social phenomena. Victor Frankl, a contemporary of Freud, who spent years as a prisoner in a concentration camp, also witnessed the playing out of this psychological syndrome. In the camps, he observed fellow prisoners aligning themselves with their captors by volunteering to be in charge of torturing their fellow prisoners, sometimes being even more brutal than their oppressors. This role not only allowed them a degree of emotional safety, avoiding inner weakness and gaining power and control, but also gave them more of a chance to come out of the camps alive. While both Freud and Frankl believed defense mechanisms such as identification with the aggressor served a purpose by helping people survive difficult, even traumatic situations, these defenses easily become highly maladaptive. Identifying with the aggressor, in this case a self-serving, vindictive bully, can cause one to lack empathy, and even behave in cruel ways. It encourages people to divide the world into good and bad, them and us, and prevents individuals and groups from seeing others as whole human beings with both strengths and weaknesses. If we see only the projections of our own fears and anger, we lose our compassion to see others as worthy, valuable and humane. As Jean-Paul Sartre, the existential philosopher who also lived through World War II, teaches us about the ramifications of living in bad faith: when a lion is chasing you, fainting is at best a temporary solution. Martin H. Klein, PhD. is a clinical psychologist who practices in Westport. This article first appeared on CT Mirror and is republished here under a Creative Commons license. Dr. Martin H Klein is a clinical psychologist who practices in Wesport CT. He specializes in clinical assessment, psychotherapy and executive coaching. At some point in life, we all experience an identity crisis. Whether it is the college student who feels overwhelmed by the pressure to declare a major, the 50-year-old executive who no longer identifies with the role he’s spent decades building, or the adolescent girl trying to define herself through an Instagram post or a selfie. Struggles with self-identity can emerge at any stage of life. The moment we begin to separate from our parents, we are thrown into a complex social world that constantly challenges us to define and redefine who we are and who we should become. As Sartre (1957) observed, “Man is nothing else but what he makes of himself… Man is not something that is, but something that is to be” (p. 13). At birth, we are given a name. Whether you are named after a family member, a famous movie star, or a popular name on the internet, this baby naming ritual is one of the first steps toward becoming a defined self. That given name, printed on your birth and death certificates, becomes a lifelong label, persisting throughout life and beyond one’s existence. After the fragile self begins its early childhood formation, the educational system—the agent and bearer of social norms and ideals—thrusts the child forward into the socialization process of becoming a recognizable and defined being in the world. Suppose a child is raised in a stable environment with secure and loving parental attachments. In that case, they are more likely to develop an integrated and resilient sense of self, eager and functionally able to enter the social order. In contrast, traumatic early experiences can give rise to a fragmented and fragile self, leaving the individual ill-equipped to meet the demands of society. As the psychoanalyst Otto Kernberg (1984) notes, such traumatized individuals will likely suffer from character flaws, resulting in unstable interpersonal relations and fragmented identities: “Failure to achieve this integration results in identity diffusion, a fragmented sense of self, and unstable interpersonal relationships (p. 17). In my practice, I sometimes see these sorts of patients who struggle with identity instabilities and unstable interpersonal relationships. Many appear to be floating through life, directionless, without knowing who they are or what they want to be. The analyst Carl Jung (1946) referred to such lost souls as the puer aeternus (Latin for “eternal boy”). These individuals psychologically do everything in their power to remain adolescent-like to avoid responsibilities, commitments, and perceived limitations, including being pinned down to a particular job, relationship, or identity. They are fragile and insecure, caught in a fantasy-driven longing to remain emancipated and free. They are often romantic idealists, full of grand visions for the future but with little progress to show in the present. The puer aeternus “protests against everything that would limit him, including the obligation to live in reality. He would prefer to remain wrapped in his dreams, far from the entanglements of the world” (Jung, 1964, p. 742). The eternal child clings to their inner fantasies of false hope, where they can pretend to avoid self-definition and remain unconditioned and free. Tragically, they fail to realize that avoidance itself is a way of being in the world that is not only dysfunctional and paralyzing but ultimately the most limiting of all possible ways to be. They choose to live an impoverished existence, with no relationships, career, or purpose, all just to sustain the illusion of being free. These individuals seek treatment when they realize that their constricted existence is self-constituted, devoid of meaningful content, and a function of their maladaptive early childhood experiences of the world as an unpredictable and mistrusting environment. It is challenging to convince patients that their beliefs are ultimately maladaptive and self-defeating because there is always a kernel of truth to what they are saying. The question of who one is and who one is becoming lies at the core of our existential condition, the metaphysical tension between identity and freedom that, conceptually and symbolically, affects our everyday existence. Human beings yearn to be someone with an identity and, at the same time, remain a free agent. We desire to be a coherent and well-defined self, an identity that remains the same and consistent. We also value our freedom to make choices, transcend limitations, and redefine ourselves. However, the desire to fulfill these two metaphysical needs simultaneously is impossible, since they are at odds with each other. Identity requires boundaries—if A then not B—whereas freedom implies formlessness, the ability to transform and transcend. Is it possible to be both self-identical and free, or do these two existential demands fundamentally conflict, making it impossible to be a substantial identity with absolute emancipatory powers? We each try to resolve this existential paradox of identity versus freedom through various symbolic forms and rituals. The perfectionist who insists on immaculate order in every corner of the house, except for one kitchen draw, a chaotic little sanctuary where things are freely thrown in random order. The middle-aged man, firmly settled into his career and family, keeps a young mistress on the side, not for love, but to re-experience the freedom he once had as a young bachelor. The older conservative gentleman, who typically acts restrained, sings in a punk band under the cover of night, angrily shouting out obscenities. The high-powered CEO, who on the weekends slips into anonymity, lets her hair down, and goes clubbing, dancing unrestrained with strangers, well into the night. The authoritative husband who, in the privacy of the bedroom, desires to relinquish control and is dominated by his wife, whipped into uncontrolled submission. Or the overworked medical resident, who on the weekend slides down the ski slopes, experiencing the rush of temporary freedom. Each symbolic gesture, whether mundane or extraordinary, reflects the complexity of our existential nature. As Yalom (1980) points out, human beings yearn to be somebody as well as a free agent: “The human being seems to have a deep need for ground, for structure, for something enduring to cling to. Yet at the same time, we long for freedom, for autonomy, for the exhilaration of leaving the ground and soaring” (p. 20). From an early age we learn to be silent. Embedded deep in our collective thoughts are proverbial beliefs such as “Children should be seen and not heard” and ‘If you have nothing good to say, then say nothing at all.” This “looking away” attitude of society has resulted in generations of adults who suffer the pain of silence -- the pain associated with being a victim of childhood abuse. How can a child, who must be dependent upon adults for nurturance and guidance, accept the terrible reality that his or her parental figures are non-trustworthy, out of control and capable of harmful abuse? How can such a child, whose basic trust and sense of self was violated, learn to trust another individual or allow for an intimate and bonding relationship? As a means of survival, victims of childhood abuse learn, early on in life, coping strategies to defend against thoughts and feelings to painful and frightening to put into words. While these defense mechanisms serve important functions at the time of the abuse, as the child psychologically develops they tend to hinder adaptation to adulthood. The traits and behaviors that were at one time beneficial in terms of helping the child survive an abusive situation become maladaptive when applied to more appropriate relationships. Healthy relationships rely upon basic trust and intimacy – two characteristics survivors of abuse tend to lack. The adult survivor relives the past in the present as if the environment they currently occupy is as dangerous, unpredictable and uncontrollable as their childhood realities. As a result, many survivors tend to be non-trusting, guarded, avoidant of intimacy and hyper vigilant. The three coping mechanisms most widely used by adult survivors to defend against painful and intruding thoughts and feelings are repressions, denial and dissociation. Many adults who have been abused as children are unaware of their own victimizations. They are unable to remember, at least on a cognitive level, their past history of abuse. By repressing these traumatic memories, the individual tempts to go on with life as if the abuse had never happened. “What I don’t know can’t hurt them” is the faulty premise upon which this defense mechanism rests. Repression, however, can only go so far. The more the individual attempts to push these negative thoughts and feelings out of mind, the more they can return in the form of flashbacks, nightmares and even psychosomatic symptoms. For example, repressed anger may result in tension headaches, fear of abandonment can manifest as gastro-intestinal problems, and feelings of guilt can appear as back or should trouble, not to mention the array of sexual, dysfunctions, eating disorders, addictions or characterological traits that can signify some form of unresolved issue related to the abuse. Victims tend to distort the facts surrounding the abuse. They deny their victimizations. They believe they desired, deserved, or willingly participated in the abuse. Many abusers threatened their victims into secrecy, leaving them to carry these concealed burdens well into adulthood. Certain victims blame themselves for the abuse as a means of gaining mastery over the abusive situation. “If I am responsible for the abuse, then I am also capable of controlling and possibly preventing the abuse.” Other victims blame themselves for the abuse because they confuse their age appropriate need for affections with abuse they received. “I am to blame because I wanted my father to come into my bedroom and cuddle.” Victims, who blame themselves for the abuse, tend to suffer from excessive guilt, depression, low self-esteem and self-defeating thoughts and behaviors, including suicidal thoughts and gestures. Dissociation in another coping strategy abuse victims use to defend against painful thoughts and feelings. When adult survivors are confronted with situations or events that symbolically remind them of the childhood abuse, they defend against these intruding recollections by either temporarily losing touch with reality or numbing their bodies so they don’t experience the pain associated with the abuse. Like a circuit breaker, dissociation shuts down a person’s cognitive and emotional processes in order to prevent an overload of painful stimuli. Dissociation, however, is only a temporary solution; it does not resolve the underlying issues that are triggering the problem. The moment the individual is confronted with internal or external stimuli that bring forth painful recollections, the maladaptive mechanisms arise and prevent the person once again from performing everyday functions. It is difficult for an abuse victim to seek professional psychological help. They are caught in a vicious circle of maladaptive defenses. To break the silence, develop trust and intimacy with a therapist, and begin to work through one’s pain is a frightening, but much needed process. 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. Many children are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and such a diagnosis can be overwhelming for the child and his family. It can be even more stressful if your child is diagnosed with Disruptive Mood Dysregulation, which often is a disorder that accompanies ADHD. Most of us know what a child is like who has ADHD. They have a lot of energy, are impulsive, have a hard time focusing or siting still. Boys typically are diagnosed with ADHD earlier because they may be disruptive at school. Girls, on the other hand, tend to be more complicated to diagnoses because they tend to hold it together while at school, since they are so concerned about how they are perceived by others. Holding it together outside the home is not an easy task for children with ADHD. Pressure mounts, and when they are back home, in their safe environment, with the ones they love, their hair comes down, and like a shaken bottle of soda — they explode. This over the top pouring out of emotions is what professionals call Disruptive Mood Dysregulation Disorder (DMDD). Mood Deregulation is a fairly newly diagnosis, identified just a decade ago. The cluster of symptoms associated with this disorder include low tolerance for frustration, angry outbursts, irritability, mood lability with both highs and lows, irrational fears and anxiety, including panic attacks, social phobias, obsessional thoughts and ritualistic compulsions. In the past, kids with ADHD and DMDD were put into various diagnostic categories including, Oppositional Defiant Disorder, Conduct Disorder, Personality Disorders and Mood and Anxiety Disorders. Since the relationship between ADHD and the presence of the cluster of symptoms associated with DMDD was not recognized until recently, scientific research and targeted treatment protocols - both in terms of psychopharmacology and psychotherapy - have not been clearly defined and standardized. This lack of concrete treatment modalities often results in frustration on the part of psychiatrists, psychologists, families, and of cause, the child. Psychiatrists will often try to treat the child with different medication cocktails such as stimulants, antidepressants, anti-anxiety medications and mood stabilizers. Psychologists often apply psychodynamic, cognitive behavioral, family systems and dialectical therapies as a means to help the child cope and the family endure. It is not uncommon for a family, after exhausting numerous trials of medications and psychotherapy, to feel like nothing will ever work. It is no wonder children with ADHD and DMDD often feel frustrated with treatment. They, however, are not alone. Understandably their parents often feel the same way - frustrated, hopeless, alienated from friends and family who don’t get what they are living with, depressed and angry, as well as grappling with guilt and self loathing for their negative feelings toward their child. In psychology, this parallel feelings between a child and parents is called projective identification. Projective identification is when the child, by their own negative behaviors, cause the parent to feel and then react negatively, which in turn makes the child feel rejected and bad about themselves, thus confirming the child’s feelings about him or herself, thereby reigniting his or her anger, self destructive and oppositional behaviors. I believe it is this vicious circle of projected identification that reinforces the dysfunctional family dynamics and activates the repetition of the child’s emotional turmoil. The cycle must be stopped to allow all involved to get off this wheel of pain, dysfunction and hopelessness. In order to do so, I think the first step is to understand why the child reacts as she does. I believe, from an existential perspective, it is important to truly comprehend how the child thinks, feels and experiences the world from an early age. I think it is wrong to view a child who thinks differently from the norm as “disordered.” They are not disordered, they are ordered differently than what is considered socially acceptable by today’s standards. They usually are able to think quickly, can hold multiple thoughts at the same time, see things from a different angle and have a keen sensitivity to environmental stimuli. In other words, children with ADHD often think outside the box. Thinking and behaving differently however — be it due to their impulsivity, executive function deficits, speech issues or sensitivity and creativity — can result in being ostracized by peers and even teachers, resulting in feelings of alienation for the child. I believe it is this psychological reaction to not fitting in that is at the core of the child’s mood dysregulation comorbidity. In essence, it is their keen awareness of being different that results in insecurities, anxieties and low self-esteem. Since kids with ADHD are different, they cannot always be parented in the same way a neurotypical kid is parented. Even therapeutic interventions and parenting techniques tailored specifically for ADHD children can be difficult to administer or apply consistently, which can make positive outcomes a challenge to achieve. Kids with ADHD/DMDD typically do not react well to traditional parenting techniques that rely on correction, limit-setting, and punishment (or in today’s lingo “consequences”). For example, threatening to take the child’s electronics away for bad behavior might result in worse behavior, e.g., them throwing the iPad on the floor in a fit of rage or destroying their favorite stuff animal in the midst of a temper tantrum. Rather than react to the bad behavior, the parent needs to take a step back and ask what is truly causing the child to act out, and then empathize with those feelings. Parents of children with ADHD/DMDD need to try to turn their attention from their child’s provocative, dysregulated behavior, and try to maintain a stance of empathy. For many parents, this feels like a dramatic change in the child-parent relationship, and does not feel natural. It may be antithetical to the way you were raised or how your friends are parenting their children. Parents may feel like they are letting their kids “get away” with “bad behavior”. They are subjected to well-intentioned advice from family and others that they need to learn how to say “no” to their children, not “be their friend”, and never fail to impose consequences to unacceptable behaviors. In most cases, I believe what you will find is an anxious child ridden with insecurities, fears of failure, and a deep-rooted sense of not being seen or heard, especially in a positive light. These kids get a lot negative attention due their anger and low frustration tolerance, however positive reinforcement by others is rare. This is understandable as it is hard to hug an angry porcupine, even if it is hurting and in need of love and attention. If the child is activated, rather than react to the presenting behavior, you must be attentive to what underlies and triggers the negative actions, and focus on interventions that can comfort and reduce the child’s stress. For example, if the child misbehaves, rather than punish the child, comfort the child so she feels safe and understood in terms of her needs. Over time, by soothing, his or her high level of anxiety can diminish over time. You need to know when to disengage, ignore, or distract the child. There is no science to this and it relies on trial and error. Changing the topic or pulling the child in a different direction with a different activity or line of thinking can be helpful strategic tools. Sometimes the child needs a soothing activity, so rather than pull the iPad away as a punishment, let her use it in a positive manner such as listening to music or even mindful relaxation videos. Then, provide praise for engaging in self-soothing, and successfully lowering her own arousal level. This, then teaches the child that she can indeed have control of her emotions like other people do. Improving the child’s sense of self esteem is also important. Try to focus on the child’s successes and talents rather than focus on limitations and inadequacies. Children with ADHD/DMDD tend to demand a lot of attention. Try to be attentive of their needs to be seen and heard, and react positively, rather than annoyed at their neediness. These shifts in approach are hard and take practice and patience. The good news is kids with ADHD can do better as they get older as neuronal networks mature. Older kids and adults may be more tolerant around people who are different or somewhat quirky. In fact many adults with ADHD, due to their ability to think outside the box, become the future innovators of change or models of excellence in their respective fields. The internet is filled with success stories of adults who excelled who had ADHD tendencies. For example, in sports Michael Phelps, Michael Jordon and Simone Biles, in entertainment Walt Disney and John Lennon, in technology Bill Gates and Sir Richard Branson. Perhaps as a parent of a young child with ADHD/DMDD there is light at the end of the tunnel — not the headlight of an oncoming train, but rather a fast paced shooting star. Dr. Klein is a clinical psychologist who practices in Westport CT and also works remotely via video conferencing. He works with parents who are struggling with children who have ADHD and DMDD.  Divorce is a life-altering event that can leave a profound impact on one’s mental and emotional well-being. Divorce unleashes a whirlwind of emotions, ranging from grief and anger to guilt and anxiety. At the beginning of the process, individuals may experience shock and denial, unable to come to terms with the reality of their failed marriage. As the divorce proceedings unfold, these emotions can intensify and transform, creating a roller coaster of feelings that can be overwhelming. One of the primary sources of psychological stress during divorce is the uncertainty about the future. Questions about where you’ll live, how you’ll support yourself, and what the relationship will be like with your children can weigh heavily on your mind. This fear of the unknown can lead to anxiety and sleepless nights. Marriage often becomes a core part of one’s identity. The process of divorce can result in a profound loss of identity, leaving individuals struggling to define themselves outside of the relationship. This loss of self can trigger feelings of worthlessness and lead to a deep sense of emptiness. For parents, the stress of divorce is compounded by concerns about how it will affect their children. The guilt of potentially disrupting their children’s lives can be emotionally devastating. Balancing the needs of children with the need to move on can create an intense internal conflict. Divorce can carry a social stigma that leads to feelings of shame and isolation. Friends and family may not always be supportive, and individuals may withdraw from their social circles to avoid judgment. This isolation can exacerbate feelings of loneliness and despair. The financial implications of divorce can be substantial, causing additional stress. Individuals may worry about their financial security, especially if they were financially dependent on their spouse. Navigating property division and spousal support can be emotionally draining. While divorce is undoubtedly challenging, there are healthy ways to cope with the psychological stress:
Dr. Klein is a clinical psychologist who specializes in working with individuals and couples going through separations and divorce.  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. Seems like I have had these same old blues now since old time began So I went to talk my troubles to the hoodoo man I told him all about my problem, and I asked him what was wrong He said you got to live the blues, if you want to sing your song Seems like I'll always lose, you've got to suffer if you want to sing the blues David Bromberg When potential new patients call they often ask: “What is your approach to psychotherapy?” It is understandable that such a question is being raised, especially if the caller found me via a google search, rather than by visiting my website or by referral. It is not always so easy to provide a comprehensive explanation of my clinical approach within the context of a brief introductory phone call. My strategy has been to ask a lot of questions before I answer such inquires as a means of trying to figure out what exactly the person is looking for in terms of an explanation. Often times people just want simplistic answers. Do you do Cognitive Behavioral Therapy (CBT)? Brief Focused therapy? Do you work with people who have my specific issues? How many sessions will it take to fix my problem? While brief focused treatment might be appropriate for some people, for others, a different approach might make more sense. As a seasoned psychologist I believe I have earned the right to say “I have seen it all” when it comes to clinical treatment. Yet, I can also say, that each person I have met within my 30 years of practice has been different, with a unique story and set of presenting problems. In clinical practice no two people are alike and one size does not fit all when it comes to the psychotherapy process. It might be popular — and even financially and politically motivated by some — to view psychology as a rigorous science with precise tools. Therapy, however, is an art and has more in common with spiritual pursuits and literary analysis than physics or organic chemistry. At the heart of the psychotherapy process is the relationship between the patient and the therapist, not just the tools in his bag of tricks. What is important is trust, confidentiality, empathy, understanding, insight, and motivation for change, rather than quantifiable outcomes and objective criteria. As a clinical psychologist I believe it is important to do a thorough psychological assessment and psychosocial history prior to committing to a certain approach or treatment plan. You need to understand the person and his or her unique circumstances before deciding on a clinical modality. For some, brief therapy like CBT makes sense. They are dealing with a particular symptom or behavior they want to go away. For others, however, symptoms are symbolic of something deeper, perhaps struggles with self destructive patterns, chronic feelings of depression or anxiety, or negative personality traits that are maladaptive. In these cases, focusing solely on symptom reduction would be equivalent to a fireman deciding to shut off the fire alarm rather addressing the underlining issues that are causing the fire. Symptoms can be a valuable tool both as an indicator that something is wrong as well as a motivator for personal change. Sometimes shutting off the alarm temporarily as you proceed to put out the fire makes sense, but just shutting off the alarm without doing the necessary work to resolve the underlying structural issues will more often than not lead to poor outcomes. David Bromberg, the folk singer once said “you have to suffer if you want to sing the blues.” It is my experience that sometimes you have to suffer to stop singing the blues. For it is each person’s discomfort that motivates them to call me up, ask about my philosophical approach and get the help they need to become happier, more free and confident in who they are and what they want to become. Psychotherapy is an inward journey, and the therapist is a guide on the path of change, not a scientist with a white coat, stethoscope and prescription pad. Dr. Martin Klein is a psychologist who practices in the County of Fairfield. He utilizes several treatment modalities in his practice including cognitive behavioral therapy (CBT), existential psychodynamic analysis, insight oriented couples counseling, hypnotherapy, supportive client centered counseling, and action focused motivational Executive Coaching. In the realm of psychotherapy, various approaches have emerged over the years to help individuals grapple with their psychological struggles. One such approach is existential psychotherapy, a philosophical and psychological framework that delves into the fundamental questions of human existence. Rooted in the existential philosophy of thinkers like Søren Kierkegaard, Martin Heidegger, Jean-Paul Sartre, and Viktor Frankl, existential psychotherapy offers a unique perspective on understanding and addressing the challenges of life. Existentialism is not just a therapeutic technique; it's a a way of viewing human existence. At its core, it seeks to explore the profound questions of existence, meaning, and purpose. It acknowledges the anxieties and uncertainties that are inherent in human life and aims to help individuals confront these existential concerns. Key Concepts 1. Freedom and Responsibility: Existential psychotherapy emphasizes the importance of personal freedom and the responsibility that comes with it. It encourages individuals to recognize their agency in shaping their lives, even amidst challenging circumstances. 2. Death and Mortality: Confronting the reality of mortality is central to existential psychotherapy. The awareness of our limited time on Earth can prompt individuals to reflect on how they want to live and what truly matters to them. 3. Isolation and Connection: Existentialists recognize the paradox of human existence—our inherent sense of aloneness, coupled with our longing for connection. Existential psychotherapy explores how individuals can find authentic connections while respecting their unique identities. 4. Meaning and Purpose: The search for meaning is a central human endeavor. Existential psychotherapy encourages individuals to explore their values, passions, and pursuits that give life a sense of purpose and fulfillment. 5. Anxiety and Dread: Existential anxiety emerges from the tension between the desire for certainty and the reality of uncertainty. The therapy aims to help individuals navigate anxiety by embracing ambiguity and finding ways to live meaningfully despite it. 6. Authenticity: Being true to oneself is a cornerstone of existential psychotherapy. It involves examining societal norms, values, and expectations to determine what genuinely resonates with an individual's essence. Existential psychotherapy is practiced by psychologists who adopt a collaborative and exploratory approach. Rather than providing quick solutions, therapists create a space for clients to engage in deep introspection and dialogue. They assist clients in understanding their beliefs, values, fears, and aspirations, guiding them toward a more authentic and meaningful life. Benefits of existential analysis includes gaining a sense of agency and empowerment by recognizing their capacity to shape their lives, through self-reflection becoming more attuned to their emotions, desires, and values. By confronting one’s existence, a person can develop a better appreciation for the present moment and find joy in life's experiences. In other words, facing one’s own finitude — and ultimately one’s death — can challenge attachments to their everyday seriousness and transient mundane concerns. Existential psychotherapy offers a profound journey into the depths of human existence. By exploring questions of self- identity, meaning, freedom, and connection, individuals can confront their fears and anxieties, ultimately finding a path to greater authenticity and fulfillment. While not a one-size-fits-all approach, existentialism provides a unique lens through which individuals can engage with life's complexities and challenges. Dr. Martin Klein is a Westport CT psychologist who is trained in existential philosophy and psychological practice. 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. 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. www.discovermagazine.com/health/this-winters-double-whammy-of-pandemic-blues-and-seasonal-depression 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. 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 Lucinda Williams 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: ctmirror.org/category/ct-viewpoints/why-are-we-frightened-to-take-off-our-masks/ 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. “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. 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. |