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

Life lessons from a pandemic

CT MIRROR VIEWPOINTS -- opinions from around Connecticut

Life lessons from a pandemic

A psychologist sees more worry, more depression, but some positive changes, too, in our daily lives

• CT Viewpoints
• by Martin Klein
• April 30, 2020

With the onset of the coronavirus,to say life has changed dramatically is an understatement. In our small communities, we all know someone who has been exposed to the virus or has contracted the illness, some mildly and others life-threatening. How we live, work, think, behave and even breathe is now radically different. We are living in a new time –one we were not prepared for or even equipped to adequately handle. To watch the news and see how this virus is spreading worldwide, and even more so in our own backyard, is beyond belief.

Like Noah from the Bible, we are all cooped up in our homes, isolated, socially deprived, praying for a sign of hope, be it a dove, a rise in our 401k, a job offer, schools reopening, a plateau of the pandemic curve or even a politician willing to tell the truth. How can we not feel frustrated and helpless, when we hear the medical experts say “the virus dictates how we live and react not the other way around.” How can you feel nothing but despair when we are told the pandemic is going to get exponentially worse before it gets better.
​
As a clinical psychologist who practices in Fairfield county, many of my patients are traumatized by how their lives have changed so quickly. We are no longer going in to work, our kids are now being home schooled, our food is delivered, we are home alone with our immediate families, socially isolated, financially insecure, and emotionally drained to the point of being numb. If we see neighbors it is from a distance, at best a walk together on opposite sides of the street. Nothing is the same. Nothing is normal. Even Amazon’s two-day delivery, something we have all taken for granted, is now a distant memory. Time seems to have changed. We are not moving as fast, a day home schooling or going food shopping can feels like an eternity. Each week that passes now feels more like a year than seven days.

The psychological profession has also adapted to this new reality. Like most other occupations, we are working remotely, doing video conference sessions from our homes, wearing the new business causal, a dress shirt with pajama bottoms. While at first slightly awkward, video sessions over time begin to feel natural. My patients are glad to talk, have someone there they can count on each week to listen and provide insight and understanding — perhaps a normal hour routine is much appreciated in the midst of uncertainty and worldwide angst.

There is no question, the people I talk with are having a difficult time. Our sense of normality, our everyday routines, the feeling of being in control of our actions and surroundings, which we have all taken for granted, is no longer present. The anxious are more anxious, the depressed are more depressed, the lonely never felt more isolated. In the midst of all the the tragic stories and emotional suffering I have witnessed as a result of this deadly virus, there are surprisingly some positive psychological changes that I have noticed listening to my patients. While people cannot go to work or the supermarket, go out to dinner, socialize with a friend, or even workout at the gym, they are spending a lot more quality time with their immediate families. Parents are playing with their kids, spouses are cooking dinner together, children are thinking about the well-being of their older parents and elderly neighbors. Even Democrats and Republicans are pulling together to pass necessary humanitarian aid across the global to help others.

Maybe there is a silver lining to the coronavirus pandemic. Perhaps the world was moving a bit too fast. Maybe there was too much divisiveness and intolerance in the world. Have we been taking things for granted, not appreciating the preciousness of our daily existence and the vulnerability associated with our own finitude? Have we forgot the principles of the Golden Rule? Have we not made time to smell the roses, let alone spend an evening playing a game or watching a movie with your kids? Perhaps isolation and solitude is not such a bad thing. Maybe it is time we all reflect upon the story of Noah and the Ark and look forward to the passage of 40 days and 40 nights, the passing over of this plague, and the signs of spring, rebirth and new beginnings.

When I was a college student I remember reading Carlos Castaneda’s books about his spiritual teacher, a Mexican Indian named Don Juan. Don Juan taught Carlos that he should remember “death is always over your left shoulder.” Perhaps this pandemic can teach us all a lesson of how important it is to remember our humanity and the importance of each moment when faced with one’s own temporal and fragile existence.

Martin H. Klein is a clinical psychologist who practices in Fairfield and Westport.

Barron's article March 18 2020 by Al Root

People’s moods can suffer as the stock market declines. Anyone with significant experience in the market can attest to that fact: No one likes losing money, and everyone likes making it. But in the most extreme cases, stock-market gyrations can lead to Dow Affective Disorder, or DAD.
Investors shouldn’t dismiss the idea out of hand. Staying happy in this market is hard.

The Dow Jones Industrial Average and S&P 500 are both in bear market territory, down more than 20% from recent highs. The Dow dropped almost 3,000 points, or 13% on Monday, only to rally 5.2% Tuesday. In fact, the Dow has moved more than 5% for seven consecutive days. The volatility has been extreme.

“A person with ‘Dow Affective Disorder’ experiences bipolar swings in mood as the market moves up and down,” wrote psychologist Martin Klein in a February blog post. “In a bull market they feel elated and invincible. They may spend freely, even to the point of living beyond their means.” But then comes the fall, which can lead to depression and anxiety.

Klein received his Ph.D. from the California School of Professional Psychology at Berkeley in 1986. He was an assistant professor of psychiatry at Yale School of Medicine before setting up private practice in Connecticut.

“I’ve dealt with a lot of people on Wall Street,” Klein tells Barron’s. Most people only glance at the value of their portfolio on a monthly or quarterly basis. The problems start when checking stock prices becomes compulsive. “Stock performance can be how some value themselves as people,” he said.

DAD is his term for stock swings affecting moods. It isn’t official. There are, of course, mood disorders based on things beyond people’s control. SAD, or seasonal affective disorder, for instance, is a recognized condition.

A ton of research is done into money and happiness. It’s hard to draw sweeping conclusions, but research has coalesced around the idea that to be happy, people need enough money to live, a purpose, and loving relationships.

DAD falls under the first of those criteria. Maybe people view stock- market drops as an existential threat to financial security.

The symptoms of DAD, according to Klein, look like those in other depressive disorders: stomach pain, back pain, neck pain, as well as an inability to sleep or a decrease in libido. If people are going through that, Klein wants them to ask for help.

“Severe emotional ups and downs are harmful to long term health,” he says. In the case of DAD, the ups and downs can hurt the pocketbook, leading to panic selling—in environments like the Covid-19 coronavirus selloff—or to euphoric buying at market tops.

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.

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.