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.

,
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

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.

Alcohol is legal and socially acceptable. It plays an important role in our culture and daily lives. To make a toast on a special occasion or engage with your associates at a happy hour is considered to be normal and even proper etiquette. While low dosages of alcohol might reduce social inhibitions or improve cardiac health, it has long been known that excessive drinking is detrimental to most of the organs in your body and in fact can be deadly if done to excess.

Over the long-term, heavy alcohol consumption can cause severe illness such as liver and brain damage and increase risk of cancer. A recent study concluded that drinking as little as 10-14 glasses of wine or beer a week can reduce one's life expectancy by several years. While alcohol may not be seen by society as a deadly drug, in our country over 15 million people are reported to have some sort of alcohol use disorder, and over 88,000 people die from alcoholism on an annual basis. Alcohol is a highly addictive substance. In fact, trying to detox off of alcohol without medical assistant can have dire physiological consequences. It is no wonder that alcoholism is viewed as a chronic and sometimes fatal disease.

However, alcoholism has not always been considered to be a disease. Prior to the twentieth century, a person's inability to "hold their liquor" was seen more as a personal weakness. Alcoholics were identified as "drunks," with flawed character and low morals. It was not until the 1930s that the medical community began to define alcoholism as a disease and Alcoholics Anonymous (AA) was founded and embraced the disease model as a core principle. The disease model allowed the medical profession to begin to treat addicts as victims of their illness rather than derelicts who should be punished for their sins.

The disease model has its merits -- it offered alcoholics the opportunity for recovery rather than social scorn. However, it also had an intrinsic flaw -- it did not address the underlying psychological issues that caused the substance abuse in the first place.

Many people who abuse alcohol suffer from some sort of underlying anxiety disorder. In an attempt to self-medicate their underlying psychological issues, the alcoholic develops an addiction. The alcoholic now has dual presenting problems -- 1. anxiety and 2. alcohol dependence. It is my clinical view that to achieve sustained sobriety, the alcohol abuse and the underlying anxiety dysfunctions must be concurrently treated. In fact, between 20 to 50 percent of people do relapse right after the completion of disease model treatment program and nearly 90 percent of people relapse within 4 years of completing an alcohol rehabilitation program.

Being human is not a easy feat. We don't have control over many variables in our lives and we must all face possibilities that tragedies can happen at anytime, including one's own mortality. For most of us, however, we adapt to our existential condition. We learn how to put things out of our heads so we can function in the world and limit our fears. Anxiety is a normal part of life and in many instances it arises for good reason. For example, if a lion is chasing you in the jungle, anxiety and fear are not only appropriate, they are essential to one's survival instinct.

Alcoholics tend to be individuals that did not grow-up in ideal family settings. They did not develop a basic sense of security or trust and thus never felt safe with others or even natural in their own skin. They tend to be overwhelmed by irrational anxieties and uncontrollable fears even in situations that don't justify these feelings. Their high degree of anxieties can manifest in different ways. Some individuals suffer from general anxiety; constant worrisome thoughts and unnecessary fears about routine events and everyday activities. Others have social anxieties; fear of being scrutinized by others, humiliated or embarrassed in public. Many are plagued by obsessions or compulsions; paralyzed by the "should've could've," find it difficult to make decisions, stop ruminations or unwanted behaviors. Many cannot slow down their thought processes and suffer from an inability to relax or insomnia. Others have phobias; public speaking, going in an elevator or meeting a stranger can result in a feeling of panic, chest pain, tightness in the throat and shortness of breath. A history of trauma or past abusive can result in the avoidance of intimacy, low self-esteem, intrusive thoughts and self-destructive behaviors.

Alcoholics can have have one or more of the types of anxiety disorders described above. To achieve sobriety and avoid relapse, a person has to do more than stop drinking, they have to learn better coping mechanisms to handle their underlining anxieties that are at the root of their substance abuse problem.

AA meetings can play a significant role in helping the alcoholic address their anxieties. More than just focusing on alcohol as a disease, there is a significant psycho-social component to the AA group meetings that address the alcoholic's anxieties head on. AA group meetings can be viewed as a form of exposure therapy; whereby the alcoholic faces its irrational fears and learns more adoptive interpersonal modalities of functioning. AA offers a type of re-parenting experience; a safe environment of unconditional support that promotes basic trust and a sense of social well being. Attending meetings and sharing with others in an open and honest manner is self empowering; it reinforces that one is okay for who they are. By surrendering to a high power, the alcoholic comes to terms with the reality that many existential fears are not in their control. By bonding with a sponsor, honesty and intimacy is achieved perhaps for the first time. By taking one step at a time, the person stops ruminating about future and past decisions. By having to attend groups and speak in front of others, irrational interpersonal and social fears are called into question.

However, for many AA meetings are not the right mileu to address their psychological issues. They need more individualistic and intensive psychotherapy to work though their childhood and family issues and learn more adaptive ways to improve self-esteem communication, interpersonal relationships and abilities to handle existential issues as they arise. Existential psychotherapy can help you learn how to differentiate between appropriate anxieties, the fear one feels when a lion is chasing you in the jungle, and irrational anxieties, the fears of low self-esteem, being around others or being a failure.


Dr. Martin Klein, Ph.D. is a clinical psychologist who practices in Fairfield and Westport CT. He specializes in alcoholism, addictions and anxiety disorders. He is trained in existential psychoanalysis and psychotherapy.

 Westport addiction psychologist -- alcohol and drug abuse
Fairfield addiction psychologist -- alcohol and drug abuse

The most important men in town would come to fawn on me.
They would ask me to advise them, like Solomon the Wise.
Posing problems that would cross a rabbi's eye!
And it won't make one bit of difference if I answer right or wrong.
When you're rich, they think you really know!
Tevye -- Fiddler on the Roof


Money plays a significant role in how we live our lifes. While money is usually considered an asset, how we relate to money has significant psychological consequences.

The utilization of money as a means to trade goods has been around for thousands of years, be it a shell, a coin, a piece of paper or electronic payment. Money is valuable because we know everyone else will accept it as a form of currency. The coin or piece of paper independent of what it represents, however, is worthless. Money only has value as a symbol of what it signifies -- I.e, an elaborate barter system where you exchange services and goods.

Sometimes symbols can become over ridden with personal meanings. Like many symbols, money can detach from its originally intention and take on a totally different meaning with a life on its own. For example, money can be associated with freedom, power, personal identity, self-worth, or even immortality to name a few.

Money with all its symbolism and psycho-social significance can play a major role in people's life. Money can affect one's mental health, marriage, families, friendships, job, and even political viewpoints. It is no wonder that money is one of the top concerns people have when seeking out psychological services.

I see many individuals in my practice where money has become a symbol attached to one's sense of identity and self-worth. I saw one gentleman who was obsessed with how much he lost in the stock market 17 years ago. It still keeps him up at night. While he does well financially and lives a very comfortable life, he still looks back and beats himself up with "should have could haves" about his past investment strategies. No matter how good a person he is, his identity and self worth is dependent upon what he did with his money many years ago. He still owned this one stock that he lost a lot of money in. Each day he watches the stock market to see if this stock went up or down. If it goes up he feels good about himself, if it goes down, he has a bad week. He has a true case, of what I call "Dow Affective Disorder" -- an emotional roller coaster associated with perceived self worth based upon the paper value of an investment. You often hear that you should not be emotionally attached to investments, but to many, investments are the pillar upon which to value one's sense of worth. Is having a lot of money true wealth if you are still unhappy? Perhaps Benjamin Franklin had they right interpretation for this gentleman: "Wealth is not his that has it, but his that enjoys it."

I once saw a young man in his early thirties who was so successful in his career that he could retire. He did not seem to have much interest in the possessions that money could buy. However, he had no other interests than working and when he was not working he would become overwhelmed with anxiety. It was this anxiety that brought him to see me. Why did he continue to work so hard at making money and why did he get so anxious when he tried to relax? What was he getting out of the work that was so compelling? What he did for a living was about out-smarting others. Making the good deal and beating out his opponent is what made him feel good about himself -- gave him a sense of self worth. As I got to know him better, the connection to his childhood experience with his younger brother became apparent. He and his brother were always in competition, yet no matter how much he achieved, his parents always viewed his brother as being smarter and more successful. When he was winning the deal he felt good, but the moment he was not engaged in the game, he was once again overwhelmed with fears of being a failure.

I often hear stories of aunts or uncles who were thought to be poor, but died with millions of dollars in the bank. Why would a person live like a pauper, live so frugally to the degree of deprivation, yet die with so much money in the bank? What purpose did the money serve? Did it actually give them a sense of security or safety net from the unknown? Did they believe they could take it with them? Ironically, the distant relative that inherits the money often has a different sense of meaning attached to the money. Rather than deprivation for security, they see the money as something for nothing and freedom to spend. To quote Dire Straits: "Oh that ain't workin' that's the way you do it. Get your money for nothin' get your chicks for free."

Money is one of the top issues that comes up in marital therapy as a presenting stressor. What happens when two individuals, raised with very different financial values, become a family? What if he is a believer in saving and she believes in spending? What if one person comes to the marriage with much more money than the other person or has a significantly higher income? While the concept of two individuals become one under the eyes of God makes sense from a spiritual and emotional perspective, the merging of two bank accounts is far more complex and not so easy to work out. When you get married, should you keep separate accounts, have a joint account or have a little of both? How a couples handles their money can say a lot about a relationship. I often see couples in my practice, where one of the partners insists on having a separate account in his or own name. While under the law all wealth is communal, this separate stash gave this person a symbolic sense of control -- "without a separate bank account, I feel like I am vunerable and lose my sense of independence."

In premartial counseling the question of a prenup often comes up. The idea of a prenup by its very nature calls into the question the sancity of marriage. How can two people make a vow to be together forever if they they have a written contract prepared just in case it does not workout? I often hear, "I just don't find the idea of a prenup to be very romantic." Money can become a symbolic wall that protects individual interests yet keeps a wedge between couples.

Money clearly plays a significant role in how we relate to ourselves and others. At times, our real underlying concerns with money has to do with deeper issues such as identity, self-sufficiency, self-esteem, self-worth, freedom, stability, fear of loss, the battle for control and power and how one relates to mortality.

Perhaps there is more to wealth than money and more to money than wealth. Maybe Henry David Thoreau was right when he said: "Wealth is the ability to fully experience life."

​Copyright Nov. 2016, Martin Klein, Ph.D.