Pandemic Affective Disorder (PAD): Seasonal Affective Disorder On Steroids
Late fall and early winter are a busy time in my clinical practice. The combination of cold temperatures and shorter days often bring on feelings of social isolation and despair. My patients are not alone. According to the scientific data, over 66 million people suffer from some form of winter dysphoria and over 6 million experience depressive symptoms so severe they are unable to function in their daily lives. Many of these individuals are suffering from what the psychiatric literature refers to as Seasonal Affective Disorder (SAD).
Symptoms of SAD typically start out mild in the fall and gradually become more severe as the winter approaches. This syndrome is often referred to as the "winter blues” because it is triggered by the lack of day light and the cold weather. Like other forms of depression, people who have SAD can be overwhelmed with feelings of guilt, anxiety and despair. They can feel like the energy in their body has been zapped resulting in sluggishness, poor concentration and little motivation to do activities that they once found to be pleasurable. Due to intrusive negative thoughts, they can easily become agitated. This high degree of irritability can make it hard to fall asleep and stay asleep, resulting in exhaustion and mood swings. One's appetite is often affected and accompanied by either weight gain or loss. Many people who have SAD suffer from low self-esteem.
There are many explanations for this negative shift in mood. In the colder months, people tend to exercise less, stay in more, socially isolate, drink more alcohol excessively and eat more sugar and carbohydrates. Some of the factors that seem to play a role in the onset of SAD is a change in circadian rhythm. The research suggests the reduction in sunlight disrupts the body's internal clock and throws off one's sense of well-being. Not having enough sunlight can also cause of drop in serotonin, a neurotransmitter, that when lowered results in mood changes associated with depression and anxiety. The change in seasons can also disrupt the body's level of melatonin. Melatonin plays an important role in sleep patterns, affect and energy level. Low or high sugar levels and diminished amounts of vitamin D can all lead to biologically induced mood instability.
This season, however, my practice has become busier than usual. With the onset of the pandemic, the increase in depression has become dramatic. It is like Seasonal Affective Disorder on steroids. The people I treat this year are suffering from a syndrome I have coined Pandemic Affective Disorder (PAD). As winter approaches, these individuals with PAD are suffering from severe social isolation, anxiety associated with political unrest, financial insecurity including unemployment, and fear of getting ill. Some may not be able to go in to work or school. Many are not able to be with family members, an additional hardship around the holidays. Some may not be able to be with an ailing family member or had to experience the death of a loved one remotely. My patients are not alone in their sense of dread and hopelessness. The American Psychological Association reports that over 80 percent of all Americans say they are experiencing some form of severe stress due to the coronavirus. The Center For Disease Control and Prevention (CDC) indicates that the level of depression amongst Americans since the outbreak of COVID-19 has gone up over 300 percent. During these trying times, being overwhelmed with depression and anxiety is no longer identified as a disorder, but rather, the current order of our everyday lives. Being overwhelmed with depression and anxiety can now be seen as a rational response during these horrific times of the coronavirus and the effects of political unrest.
There are many things people can do to help themselves during these dark and cold days of COVID-19. Try to be outside in the sun as much as possible. Exercise regularly, be it walks, yoga or exercise videos, or indoor exercise equipment. Develop bubbles of friends and family who you feel comfortable with, who have been socially distancing and have tested negative for the virus. Be creative with small outside gatherings, utilizing heat lamps, fire pits or warm blankets. Use technology to meet with friends and family on a regular basis via video conferencing or phone calls. Avoid over watching negative news on the TV and try to have more family movie nights. Buy a sun lamp and sit under it for a few hours a day. During the day try to sit by a sunny window as much as possible. Make an appointment with a psychologist and continue to see them on a weekly basis. Most psychologists are offering some form of video conferencing. Possibly talk with your psychiatrist or primary care doctor about taking medications to treat your situational depression and anxiety. Avoid alcohol. While alcohol can temporarily make you feel less anxious and numb, it may intensify feelings of depression and anger. Keep a daily activity journal so you can track of any mood swings, so you can remember the good times when you are feeling down. Perhaps even plan social events in the future so you have something to look forward to. Most importantly, keep things in perspective, for like the seasons, these dark times of the pandemic will pass.
Below is a link to an Interview with Dr. Klein about Seasonal Affective Disorder and the Pandemic.
Dr. Klein is a clinical psychologist who specializes in the treatment of depression and Seasonal Affective Disorder. He has offices in Westport, Stamford and Fairfield. During these difficult times, he is serving the greater Connecticut region via video conferencing.
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.
Stock Market Fluctuations: Stress, Anxiety, Depression, Mood Swings
As a clinical psychologist, with offices in Fairfield and Westport, I work with many individuals who are heavily invested in the stock market. A significant portion of my clientele, in fact, work for financial institutions; and their bonuses are directly tied to the performance of the markets. With so much at stake, it is no wonder that the stock market can affect how they experience their own sense of financial stability and well-being.
For some, who may have lost their job or been wiped out by margin calls, a negative change in mood is understandable. For others, however, whose losses are just on paper, their sense of despair can become grossly exaggerated to the point of irrational fears about current and future prospects. These people suffer from what I call “Dow Affective Disorder.”
A person with “Dow Affective Disorder” experiences bipolar swings in mood as the market moves up and down. In a bull market they feel elated and invincible. They may spend freely, even to the point of living beyond their means. Some may even use leverage or credit to achieve a persona of grandeur. In a bear market, however, these individual may fall into a deep depression; and feel stressed out to the point of irrational panic. They fear the worst— financial apocalypse. Their self-esteem goes from good to bad. They feel like a failure and their excess spending grinds to a halt. They become overwhelmed with regret. “I should have sold before it crashed, what was I thinking, how can I be so dumb.” Just as they beat themselves for not being fully invested when the market is in an uptrend, they now torture themselves for not being smart enough to divest before the downturn occurred. They fail to see their losses as temporary and fall into despair.
In many instances their depressed mood causes a myopia and colors how they function and relate to others. They tend to withdraw from their families and friends and their focus narrows to only events related to the market. Rather than be with their children or complete work assignments, they are glued to the television watching a financial channel. They engage in self-defeating behaviors that intensify their sense of failure. For example, they panic and sell their holdings at a loss, which further confirms their sense of doom. They forget about the good times and feel as if their future will never be bright again. Their whole life style takes a dramatic shift — they feel poor, tighten their budget and radically reduce spending.
For most people, a stock portfolio performance signifies nothing more than the monetary value of an investment vehicle at a current moment in time. These people tend not to pay attention to the daily fluctuations in the market and perhaps only glance at their investment statements on a monthly or quarterly basis.
For those who suffer from Dow Affective Disorder, however, there is an irrational compulsive attachment to the stock market. They are hyper-vigilant to the split second movements of the market. They are glued to their phones and are watching the market throughout the day in real time. They are aware of how much they lost each day and continually think about their net worth. If the market spikes up they get a temporary rush, only to be crushed again when the rally dissipates later in the day.
For these individuals, the stock market has become more than a financial vehicle; it is an all encompassing obsession that controls all aspects of their lives. Their perspective of the stock market has become detached from reality and at time can resemble a delusion. Their portfolios no longer just signify the value of money, but rather it now also signifies how they value themselves as a person. How they do in the market becomes more of a symbolical signifier of self-worth and less about how they will meet their financial obligations. The signifier and the signified has become displaced and the stock market has now attached to an imaginary internalized scoreboard by which one’s sense of self- worth is judged. If the stocks they own are worthless then they as individuals are worthless is the kind of distorted thinking that leads to generalized despair.
The psychological pain associated with this disorder can have long term psychological effects. Like most depressive disorders, it can lead to symptoms such as gastrointestinal distress, back or neck pain, insomnia, change in appetite, decrease in libido, poor concentration and even suicidal ideations. It can destroy families and careers.
To ask for help is not easy for a person plagued by hopelessness and low self-esteem. However, it is essential for a person suffering from these issues to seek professional treatment and learn more adaptive ways of being. Nobody likes losing money, but cycles of severe emotional ups and downs are harmful both to one’s pocketbook and long term health.
The content of this blog was recently featured in Barron's Magazine as well as published in the CT Post.
Dr. Klein is a clinical psychologist who practices in Fairfield and Westport CT. In addition to being a psychologist, he is also an executive coach who specializes in working with people in the finance industry.
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
Everything that irritates us about others can lead us to an understanding of ourselves.
Couples therapy is more complex than individual psychotherapy. In individual therapy you are working with one person. In couples therapy you are dealing with a minimum of two. Not only are there twice as many people in the room, but each individual brings his or her own set of psychological issues to the relationship. These psychological issues are not static, but rather are dynamic and intertwine between the couple in a myriad of complex configurations and interpersonal entanglements.
Relationships can take on an ominous life of its own. When left unmanaged, it can throw couples into a whirlwind of interpersonal conflict and distress. Many couples become overcome by the negative patterns of their relationship. They feel beaten down and hopeless — victimized by how the dynamics of the relationship brings out the worst in each other. It is difficult to grasp how two individuals who at one point in time were in love now feel only contempt toward each other. How attraction can transform into repulsion so quickly is beyond all that seems rational.
What complicates couples therapy even more is how each person in the relationships carries within him or herself a vast array of influential voices that have been incorporated into their own sense of self. These voices shapes the ways each partner interacts with the other. Voices from the past, present and even future can be heard within the couple’s narrative — learned beliefs, views, even politics of parents, grandparents, siblings, children, previous relationships, colleagues or friends. In some ways couples counseling is more like group therapy than individual counseling.
To be successful, the psychologist must listen, comprehend, and map out all that is being said within, outside and between the two partners. It is the psychologist’s job to start the initial couples counseling sessions with a comprehensive psychosocial assessment. This is necessary in order to learn all that is being said and not said by each participant, who is being influenced by who, and how all these different voices interact and affect the dynamics of the relationship.
Couples counseling can sometimes feel like a tennis match. Couples arguing back and forth, volleying for their point of view. A therapist, however, is not a referee. It is not the job of the psychologist to determine who is right or wrong or resolve a dispute by compromise. Conflict resolution is the technique used in mediation where an arbiter assists the couple to negotiate the terms of a settlement. A settlement is something that is acceptable when you are getting a divorce, not when you are planning to stay together. To settle and sacrifice your needs for the sake of the relationship can only lead to further resentment, conflict and contempt. It is counterproductive. To stick with the tennis analogy, couples counseling does not lead to “Love” just because the participants both agree to being “at fault.”
Taking sides in couples counseling is a big mistake. What is important in couples counseling is for the psychologist to assist both partners to develop the ego strength to see outside their own personal assumptions and begin to understand the perspective of the other and how it relates to the dynamics of the relationship. A seasoned therapist knows the focus in working with a couple must be on insight and transformation, not on who is right or wrong.
I help couples pinpoint and understand the sources of their conflicts. I will work with you to achieve a better understanding of the external influences and family dynamics that play a role in shaping your relationship and cause dysfunctional interactions. I will assist you in developing new strategies to solidify your relationship and regain trust and intimacy. The work will include learning how to openly communicate, problem solve and develop new productive ways to discuss, understand and accept individual differences.
The goal of couples therapy is to learn to see your significant other in a new light, based upon insight and knowledge and not the blind subconscious forces we sometimes mistake for attraction and love.
Dr. Martin Klein is a clinical psychologist who practices in Westport and Fairfield CT. He specializes in couples therapy and marital counseling.
Westport marital therapist
Fairfield marital therapist
The most important men in town would come to fawn on me.
They would ask me to advise them, like Solomon the Wise.
Posing problems that would cross a rabbi's eye!
And it won't make one bit of difference if I answer right or wrong.
When you're rich, they think you really know!
Tevye -- Fiddler on the Roof
Money plays a significant role in how we live our lifes. While money is usually considered an asset, how we relate to money has significant psychological consequences.
The utilization of money as a means to trade goods has been around for thousands of years, be it a shell, a coin, a piece of paper or electronic payment. Money is valuable because we know everyone else will accept it as a form of currency. The coin or piece of paper independent of what it represents, however, is worthless. Money only has value as a symbol of what it signifies -- I.e, an elaborate barter system where you exchange services and goods.
Sometimes symbols can become over ridden with personal meanings. Like many symbols, money can detach from its originally intention and take on a totally different meaning with a life on its own. For example, money can be associated with freedom, power, personal identity, self-worth, or even immortality to name a few.
Money with all its symbolism and psycho-social significance can play a major role in people's life. Money can affect one's mental health, marriage, families, friendships, job, and even political viewpoints. It is no wonder that money is one of the top concerns people have when seeking out psychological services.
I see many individuals in my practice where money has become a symbol attached to one's sense of identity and self-worth. I saw one gentleman who was obsessed with how much he lost in the stock market 17 years ago. It still keeps him up at night. While he does well financially and lives a very comfortable life, he still looks back and beats himself up with "should have could haves" about his past investment strategies. No matter how good a person he is, his identity and self worth is dependent upon what he did with his money many years ago. He still owned this one stock that he lost a lot of money in. Each day he watches the stock market to see if this stock went up or down. If it goes up he feels good about himself, if it goes down, he has a bad week. He has a true case, of what I call "Dow Affective Disorder" -- an emotional roller coaster associated with perceived self worth based upon the paper value of an investment. You often hear that you should not be emotionally attached to investments, but to many, investments are the pillar upon which to value one's sense of worth. Is having a lot of money true wealth if you are still unhappy? Perhaps Benjamin Franklin had they right interpretation for this gentleman: "Wealth is not his that has it, but his that enjoys it."
I once saw a young man in his early thirties who was so successful in his career that he could retire. He did not seem to have much interest in the possessions that money could buy. However, he had no other interests than working and when he was not working he would become overwhelmed with anxiety. It was this anxiety that brought him to see me. Why did he continue to work so hard at making money and why did he get so anxious when he tried to relax? What was he getting out of the work that was so compelling? What he did for a living was about out-smarting others. Making the good deal and beating out his opponent is what made him feel good about himself -- gave him a sense of self worth. As I got to know him better, the connection to his childhood experience with his younger brother became apparent. He and his brother were always in competition, yet no matter how much he achieved, his parents always viewed his brother as being smarter and more successful. When he was winning the deal he felt good, but the moment he was not engaged in the game, he was once again overwhelmed with fears of being a failure.
I often hear stories of aunts or uncles who were thought to be poor, but died with millions of dollars in the bank. Why would a person live like a pauper, live so frugally to the degree of deprivation, yet die with so much money in the bank? What purpose did the money serve? Did it actually give them a sense of security or safety net from the unknown? Did they believe they could take it with them? Ironically, the distant relative that inherits the money often has a different sense of meaning attached to the money. Rather than deprivation for security, they see the money as something for nothing and freedom to spend. To quote Dire Straits: "Oh that ain't workin' that's the way you do it. Get your money for nothin' get your chicks for free."
Money is one of the top issues that comes up in marital therapy as a presenting stressor. What happens when two individuals, raised with very different financial values, become a family? What if he is a believer in saving and she believes in spending? What if one person comes to the marriage with much more money than the other person or has a significantly higher income? While the concept of two individuals become one under the eyes of God makes sense from a spiritual and emotional perspective, the merging of two bank accounts is far more complex and not so easy to work out. When you get married, should you keep separate accounts, have a joint account or have a little of both? How a couples handles their money can say a lot about a relationship. I often see couples in my practice, where one of the partners insists on having a separate account in his or own name. While under the law all wealth is communal, this separate stash gave this person a symbolic sense of control -- "without a separate bank account, I feel like I am vunerable and lose my sense of independence."
In premartial counseling the question of a prenup often comes up. The idea of a prenup by its very nature calls into the question the sancity of marriage. How can two people make a vow to be together forever if they they have a written contract prepared just in case it does not workout? I often hear, "I just don't find the idea of a prenup to be very romantic." Money can become a symbolic wall that protects individual interests yet keeps a wedge between couples.
Money clearly plays a significant role in how we relate to ourselves and others. At times, our real underlying concerns with money has to do with deeper issues such as identity, self-sufficiency, self-esteem, self-worth, freedom, stability, fear of loss, the battle for control and power and how one relates to mortality.
Perhaps there is more to wealth than money and more to money than wealth. Maybe Henry David Thoreau was right when he said: "Wealth is the ability to fully experience life."
Copyright Nov. 2016, Martin Klein, Ph.D.
Dr. Martin Klein, Ph.D. psychologist specializes in the treatment of anxiety utilizing a combination of hypnosis, mindfulness techniques and psychotherapy. He practices in Westport and Fairfield CT.
Westport hypnosis and hypnotherapy
Fairfield hypnosis and hypnotherapy
Baby, sweet baby, you're my drug
Come on and let me taste your stuff
Baby, sweet baby, bring me your gift
What surprise you gonna hit me with
I am waiting here for more
I am waiting by your door
I am waiting on your back steps
I am waiting in my car
I am waiting at this bar
I am waiting for your essence
Baby, sweet baby, whisper my name
Shoot your love into my vein
What Is Sex Addiction?
In my practice I often get phone calls asking if I treat sex addiction. It is my experience the term means different things to different people. The majority of calls come from men. Often it involves an individual who has had extra martial affairs, is obsessed with internet pornography, put himself in a sexually compromising and/or illegal position, cannot stop sexual urges or fantasies, or suffers from excessive masturbation. All of these behaviors interfere with daily responsibilities and put strain on relationships, resulting in psychological distress to themselves and their families. In some instances, it is the spouse that demands their partner seek profession help or face consequences such as separation or divorce.
The History Of Sex Addiction
Different names have been used to characterize individuals who engage in excessive and at times deviant sexual activities. Labels such as Don Juanism, nymphomania, satyriasis, erotomania, hypersexuality, impulsive disorder, overactive sex drive has been around for along time. The term “sex addiction,“ however, did not arise on the scene until the 1970s. It was originally coined by members of Alcoholics Anonymous who set out to apply their 12 step principles toward sexual recovery. In a similar vein as alcoholics, they identified those who suffered from excessive and disruptive sexual activities as being physiologically dependent. Based upon the AA paradigm, they believed that sex addicts cannot be cured; but rather their disease can only be controlled by complete abstinence. To suppress their sexual dependence, members must acknowledge the disease is greater than themselves, surrender to a higher power, participate in group meetings in order to muster up the collective power to battle the disease one day at a time. With the popularity of the 12 step movement, numerous organizations formed that follow the AA doctrine - - Sex Addicts Anonymous, Sexaholics Anonymous, Sex and Love Addicts Anonymous, Sexual Compulsive Anonymous and Sexual Recovery to name a few.
Is Sex Addiction A True Addiction?
As these organizations expanded and continued to help many people, its fundamental premise has been called into question by many in the mental health communities. Neither the American Psychiatric Association, the American Psychological Association nor the American Medical Association recognize “sex addiction” as a valid diagnosis. According to the American Medical Association, there is no clear evidence that “sex addiction” is a biological disease that leads to physiological dependence and withdrawal. While past editions of the American Diagnostic And Statistical Manual of Mental Disorders had a category called Sexual Disorders Not Otherwise Classified, the latest version does not. After reviewing the empirical evidence, it decided not to include the diagnosis of “hypersexual Disorder” in it’s current manual. Despite its absence, mental health professionals have found the following disregarded criteria for Hypersexual Disorder to be of diagnostic value:
For a period of at least six months:
Compulsion Or Impulse Control?
The World Health Organization’s (WHO) manual does includes the diagnosis “excessive sexual drive.” In their manual, this diagnosis is classified as a compulsive behavior and/or impulse control disorder and not an addiction. There is extensive research that suggests hypersexual disorders are of a psycho-social nature. For example, people who identify themselves as “sex addicts” often come from dysfunctional families and have a history of being abused. One study found that 82 percent of sex addicts reported being sexually abused as children. Sex addicts often describe their parents as rigid, distant, uncaring and critical. Many parents of sex addicts have similar tendencies and were also abused as children. Many of these families, including the addicts themselves, are more likely to be substance abusers.
There continues to be great disparity as to the etiological and diagnostic criteria for hypersexual disorders. Is “sex addiction” a true addiction? Is it an obsessive compulsive disorder, impulse disorder, or perhaps not even a disorder at all? Where the responsibility falls - - the addiction, the learned character traits, or the individual’s bad choices - - has significant repercussions in terms of diagnosis, treatment and how society views and treats these individuals.
The answer to these questions are not so clear cut. Perhaps individuals struggle with sexual dysfunctions for different reasons or a complex array of multiple reasons. Even if the evidence suggests sex addiction is not an addiction, this does not rule out the possibility that physiological factors can still play an important role in its constitution. The existence of a strong correlation between hypersexuality and anxiety and mood disorders has been well documented in the literature. In fact, it has been shown that the same neurological transmitters that are involved in anxiety and depression appear to play a role in obsessive and compulsive behaviors.
Like many obsessions and compulsions - - be it video games, the internet, gambling, sports, the stock market or even watching TV - - sexual compulsions can only provide temporary relief from unwanted emotions. The moment the compulsive activity stops the unwanted thoughts and feelings do return with vengeance. Individuals who identify themselves as “sex addicts” tend to act out to mask or avoid unwanted emotions such as sadness, shame, loneliness, guilt, anger and fear. Many “sex addicts” also suffer from low self-esteem, impaired occupational, educational, social, family or relationship issues.
Empathy, Acceptance And Self-Responsibility
It is important to have empathy for individuals who suffers from hypersexual disorders. One must have an appreciation of the depth of their suffering, conflicts and daily struggles, be it of a physiological, psychological or self-inflicted nature. You must be aware of their personal histories, family dynamics, current stressors, sense of self, and underlying psychiatric issues such as mood, anxiety or character weaknesses.
To overcome hypersexual tendencies, one must accept and take self-responsibility for their own limitations, dysfunctional tendencies and past discretions in order to harness their inner strength and move forward in a productive manner. In addition to the support of family, friends and
organizational groups, having a seasoned clinical psychologist as your guide on this difficult journey is important to the healing process.
Dr. Klein is a clinical psychologist who practices in Westport CT. He specializes in the treatment of sex and porn addictions as well as substance addictions.
When I was growing up I had a black and white television set with two antennae ears. At the tips of the antennae we wrapped tinfoil to extend the ears in order to improve reception. While the TV set was big and bulky, the screen itself was small. It kind of resembled the face of the robot on the television program Lost In Space, which was a TV series that was popular during my childhood. It had three manual knobs, one to adjust the sound, a second to change the channel and a third to control the picture so it stayed still and did not vertically roll up and down the screen. In those days, watching TV was a physical feat — it required getting up and having to adjust the different apparatuses on the set, including the rabbit ears. Growing up in New York City in the 1960s I was privileged to get seven channels – 2, 4, 5, 7, 9, 11, and 13. There always seemed like there were many options to watch.
Each night, at six o’clock sharp, my family would sit around the television set to watch the news hour. In those days, the evening news was an hour of serious public affairs coverage. Many historians describe the three network news hours on channels 2, 4, and 7 as the Golden Age of Cronkite, Huntley and Brinkley. My family was dedicated to watching the CBS network channel with the news anchor Walter Cronkite. Back then, there was no doubt that Cronkite was reporting the news in an object manner. He spoke with an authoritative tone and no one questioned the facts of his stories. Cronkite ended each program with the saying: “And that’s the way it was.”
In the 1960s, the news was broadcast in black and white, both literally and figuratively. It was about fact and was not allowed to be colored by ratings. The networks’ missions were to keep the news hour separate from the rest of their commercial broadcasting. This was due both to the image they wanted to present to the public as well as government regulations. The news hour was seen as a public service, and not a revenue base for the network.
As a child, I remember sitting with my family in front of the television, watching the news clips from the Vietnam war, each night seeing the number of casualties presented across the screen. The news was serious business. In the 1960s, the networks still had a code of ethics and sense of moral responsibly. Public figures were always protected by the media, their flaws and indiscretions were hidden from the public. The day John Kennedy was assassinated, the principal came into our classroom to tell us the sad news, and each student experienced his death as a personal loss. The nation grieved as if a family member had died on that day. John F. Kennedy was idolized as an iconic leader and his family’s life style set the cultural trends for the country.
In the 1970s, the Federal Communication Commission (FCC) began to deregulate the broadcasting networks, paving the way to the elimination of the divide between news and entertainment. Tabloid news shows, like Current Affair, blended news and entertainment. By the end of the 1970s, tabloid news programming became a significant revenue source for the networks. The more dramatic and colorful the tabloids became, the greater its ratings and profit. Around this time, the networks began to upgrade their picture transmissions from black and white to color. With the demise of black and white television, the clear distinction between fact and fiction also began to narrow.
With the televised impeachment of Richard Nixon, a certain innocence was lost. We were no longer living in “Camelot.” I vividly remember watching the president resign on television and being shaken by the feeling of uncertainty and disbelief. How can the president of the United States do something so out of character of the highest office? I thought this event was so significant, I decided to tape the president’s resignation speech with my cassette recorder. Interestingly, on the flip side of the same tape, I recorded a standup comedy routine from George Carlin. Looking back, the idea that I placed Richard Nixon and George Carlin on the same tape, perhaps signifies the sense of cynicism that I was beginning to experience by the end of the 1970s.
By the 1980s televisions were now hooked up to cable boxes. TVs began to look more like the digital computers on Star Trek than the clunky robot on Lost in Space. With remotes in our hands, we now had access to hundreds of channels bidding for our attention. We didn’t ever need to leave our seats to make adjustments. With cable television came the creation of CNN, a news station driven by ratings. CNN was the first network to bring you 24-hour live coverage. CNN not only reported the news, it became an interactive force that shaped and created the news in real time. With the replacement of the anchor person with “commentators” and “hosts,” the news no longer was grounded in fact, and the divide between truth and fiction began to blur further.
When Ronald Reagan, a Hollywood actor, was elected president, a sense of what was real and what was theater was further called into question. I remember watching an episode of Saturday Night Live where they did a skit on Ronald Regan. In the skit he was portrayed as a tyrant to his staff, yet playing the character role of the goofy grandfather to an audience of children who were visiting the White House.
The 1990s saw the rise of several different 24-hour news channels. Each station tried to find its own niche in order to gain market share. For example, Fox News viewed the world from the political right, MSN and CNN more from the left. Networks no longer presented different perspectives of one reality, but different realities, based upon the political orientation of the channel you watched. The age of positivism — where we all shared a common black and white existence — has disintegrated into negative relativism — where different realities were strategic constructs devised by the networks to promote ideological agendas.
The networks no longer just presented the news, they now told you how you should think about the news. News now was less about facts and more about opinions. To quote Bill Moyers: “When you mix fiction and news, you diminish the distinction between truth and fiction, and you wear down the audience’s own discriminating power.”
The 2000s saw the arrival of social media. With the invention of the smart phone, individuals were now able to construct personalized realities and send them out on the World Wide Web. With a little bit of tech savvy, operatives were able to have their agendas go “viral” and target mass audiences. While social media has many positive applications, it also has a dark side in terms of its vulnerability to construct devious realities of lies and untruths. The internet’s ability to spread anti-social propaganda as well as harmful and infectious viruses has reached epidemic proportions. The news was no longer at home on your television, but it was now connected at all times and it followed you where ever you went. The news was 24/7, streaming in real time and in the palm of our hands.
By the year 2007, social media became a powerful controlling force, where in an instant a text or tweet was able to put thoughts directly into your head. Social media was like the Wild West, no regulations, ideas flying around from who knows where, with no sense of authenticity or legitimacy. Anybody can make news; even my friend Carla, letting the world know on Facebook that she had meatloaf for dinner.
Fake news has always been around. In previous times, it was referred to as propaganda.
Many people did not take Donald Trump very seriously during the 2016 election. They viewed him like one views an acting out child, not taking his antics with grave concern. I was in shock and disbelief when I woke up the morning after the election and discovered he won. During the campaign, I though he was just seeking attention and publicity, and did not actually want to be president. To many, it is still unclear whether Donald Trump is out of touch with reality, a calculative evil genius, or something in between.
While Trump was not a seasoned politician, at least by historical standards, he was in fact an accomplished Reality TV celebrity. He was well-schooled in the art of self-promotion and social media. For Donald Trump, what is right or wrong does not matter, what counts is how many clicks, and how much attention you get from your targeted audience. Trump created a unique message that resonated with a large enough disenfranchised population that enabled him to win the electoral college vote, despite not having the support of the majority of the population.
It was Donald Trump who invented the concept of “fake news.” Contrary to what the names implies, fake news does not signify news that is disingenuous. Rather it is a political tool utilized by a politician to destroy and suppress their opponent’s viewpoint, regardless of the validity of their arguments. Fake news is not the opposite of real news, but rather, the rewriting of history to promote one’s own personal agenda. In Reality TV, truth is not determined by facts, but rather, “the art of persuasion.” What is right or true has become replaced with who can shout or name-call the loudest, fastest and most often. In the world of social media, what mattered is no longer the content of your message, but rather how many eyeballs followed your tweet or “liked” your link so it can go viral or move up to the front page of a search engine.
Fake news has always been around. In previous times, it was referred to as propaganda. What makes fake news unique and different this time around, is the existence of social media — the internet’s ability to quickly spread propaganda worldwide in nanoseconds.
Despite other accomplishments, when historians look back upon Donald Trump’s legacy, it is his use of the term “fake news” that will likely be remembered as his most significant contribution to society. How he decisively divided the country into civil war — this time however, with tweets rather than ammunition.
As I sit on the couch in front of the TV with my iPad in my lap and the remote in my hand, I find myself surfing multiple sites in desperation to hear someone say “and that is the way it was,” rather than, this is the way I want you to think it is.
Dr. Martin H. Klein is a clinical psychologist who practices in Fairfield and Westport CT.
This article was originally published on January 15, 2020 in the CTMIRROR. A shorter version of the article was published in the CT Post and New Haven Register on January 25, 2020. Click on the buttons below to see articles.
It Was Meant To Be
People often repeat proverbs as explanations as to why certain events have occurred in their lives. One saying I commonly hear is: "it was meant to be." People use this expression to account for both positive and negative events in their lives. For example, "It was meant to be that I met the man of my dreams" or "the promotion at work that I did not get was not meant to be."
This saying implies that what has happened in a person's life occurred because of an external omnipotent force. These expression are stated in past tense, and is never said prior to an event as a premonition.
It Happened For A Reason
The proverb implies a sense of destiny -- the belief one's actions are predetermined and must have happened for a reason. In fact, some people actually say "it must have happened for a reason" rather than "it was meant to be" -- but both expressions have similar connotations.
In a predetermined world, one is no longer responsible for his or her decisions. One might think she is making a choice, but in actuality she is doing what is dictated by destiny. To use an an analogy, in a world where destiny rules, one's experience of having free will is like the child's experience of being the captain of the ship on a carnival ride where the toy steering wheel has no real control of the boat that in reality travels on a fixed circular track. In other words, free will and choice are illusory.
The Abandon Of Free Will
Why would someone want to accept a worldview that undermines their right to self determination? Isn't personal freedom what we all strive for? From an early age are we not taught the goal of life is to achieve as much freedom as possible, be it financially, socially, at work or in one's relationships? Why would a person want their freedom taken away or diminished by some sort of authoritarian force or being? Is it possible that personal freedom is not all that it is cracked up to be?
The Anxiety Of Choice
Some people have a hard time making decisions. Decisions are not always easy, be it what college to go to, who to marry, where to live, how to invest, should I have kids, take this job, divorce or retire? While you often hear personal freedom is a wonderful privilege, when faced with actual choices, individuals often become psychologically paralyzed. Fear of making the wrong decision can lead to overwhelming anxiety and despair. Once the choice has been made, many individuals often doubt their decision and experience the dread associated with regret. This regret sometimes manifests itself in an obsessive like rumination: "should have" -- "could have" --"what if." Other times, it is defended against by denying the the personal responsibility for the decision. It was not my fault, or I could not have choose otherwise because it was beyond by control -- "it was meant to be."
Paradoxically, to some individuals freedom can be experience as a limitation. To choose "A" means you did not choose "B". Decisions can be perceived as an act of eliminating options. Contrary to the popular saying, for these individuals, every time a door opens another door is closed. A closed door symbolizes one's finitude. Alexander Graham Bell said it so nicely: "When one door closes, another opens; but we often look so long and so regretfully upon the closed door that we do not see the one which has opened for us."
Should Have Could Have
Personal freedom can cause anxiety on many different levels. First, there is the fear of making the wrong decision. This anxiety manifests in obsessive thoughts, thinking over and over again about the pros and cons of each decision. Ironically, while it may feel like not choosing keeps open possibilities, in reality no decision is itself a choice, one that is nonproductive or forward-moving. Second, there is the anxiety associated with regret. This anxiety manifests in ruminative thoughts, the "should have" -- "could have."
Coping Mechanisms and Regret
Both types of anxiety are very painful and can result in despair. Many individuals develop coping mechanisms to avoid these intense negative feelings. For example, some might develop compulsions. -- repetitive rituals as a means of trying to gain a sense of control over fear of the unknown. Others might avoid the decision altogether -- perhaps alcohol or drug abuse as a means of not dealing with the question at hand. Several might deny there is even a choice -- if life is ruled by destiny -- "it was meant to be " you are not responsible for decisions, thus cannot have regrets.
From experience we all know that these coping mechanisms -- be it obsessions, compulsions, avoidance or denial -- have limited abilities to defend against these fears and anxieties associated with the responsibility and pressure of self determination.
Claustrophobia, Panic Attacks And The Fear of Death
There is one more level of anxiety worth mentioning that is intertwined with both the fear to decide and the regret of past decisions. This anxiety is much deeper and more cumbersome than the anxieties discussed above. For the fear of limitation when pushed to its root origin brings one to the fear of one's finitude. Perhaps the claustrophobia or panic associated with a closed door is intrinsically the fear of one's mortality. The existential psychologist refer to this ultimate cause of angst as "death anxiety." But the fairy tale of "happily ever after" is perhaps a topic for another blog.
Dr. Martin Klein is a clinical psychologist who specializes in the treatment of anxiety. He has offices in Westport and Fairfield CT.
Copyright November 2016, Martin Klein, Ph.D.
Dr. Martin Klein is a clinical psychologist who practices in Westport, Stamford and Fairfield CT. He works with children, adults and couples.