,
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.

When I was growing up I had a black and white television set with two antennae ears. At the tips of the antennae we wrapped tinfoil to extend the ears in order to improve reception. While the TV set was big and bulky, the screen itself was small. It kind of resembled the face of the robot on the television program Lost In Space, which was a TV series that was popular during my childhood. It had three manual knobs, one to adjust the sound, a second to change the channel and a third to control the picture so it stayed still and did not vertically roll up and down the screen. In those days, watching TV was a physical feat — it required getting up and having to adjust the different apparatuses on the set, including the rabbit ears. Growing up in New York City in the 1960s I was privileged to get seven channels – 2, 4, 5, 7, 9, 11, and 13. There always seemed like there were many options to watch.

Each night, at six o’clock sharp, my family would sit around the television set to watch the news hour. In those days, the evening news was an hour of serious public affairs coverage. Many historians describe the three network news hours on channels 2, 4, and 7 as the Golden Age of Cronkite, Huntley and Brinkley. My family was dedicated to watching the CBS network channel with the news anchor Walter Cronkite. Back then, there was no doubt that Cronkite was reporting the news in an object manner. He spoke with an authoritative tone and no one questioned the facts of his stories. Cronkite ended each program with the saying: “And that’s the way it was.”

In the 1960s, the news was broadcast in black and white, both literally and figuratively. It was about fact and was not allowed to be colored by ratings. The networks’ missions were to keep the news hour separate from the rest of their commercial broadcasting. This was due both to the image they wanted to present to the public as well as government regulations. The news hour was seen as a public service, and not a revenue base for the network.

As a child, I remember sitting with my family in front of the television, watching the news clips from the Vietnam war, each night seeing the number of casualties presented across the screen. The news was serious business. In the 1960s, the networks still had a code of ethics and sense of moral responsibly. Public figures were always protected by the media, their flaws and indiscretions were hidden from the public. The day John Kennedy was assassinated, the principal came into our classroom to tell us the sad news, and each student experienced his death as a personal loss. The nation grieved as if a family member had died on that day. John F. Kennedy was idolized as an iconic leader and his family’s life style set the cultural trends for the country.

In the 1970s, the Federal Communication Commission (FCC) began to deregulate the broadcasting networks, paving the way to the elimination of the divide between news and entertainment. Tabloid news shows, like Current Affair, blended news and entertainment. By the end of the 1970s, tabloid news programming became a significant revenue source for the networks. The more dramatic and colorful the tabloids became, the greater its ratings and profit. Around this time, the networks began to upgrade their picture transmissions from black and white to color. With the demise of black and white television, the clear distinction between fact and fiction also began to narrow.

With the televised impeachment of Richard Nixon, a certain innocence was lost. We were no longer living in “Camelot.” I vividly remember watching the president resign on television and being shaken by the feeling of uncertainty and disbelief. How can the president of the United States do something so out of character of the highest office? I thought this event was so significant, I decided to tape the president’s resignation speech with my cassette recorder. Interestingly, on the flip side of the same tape, I recorded a standup comedy routine from George Carlin. Looking back, the idea that I placed Richard Nixon and George Carlin on the same tape, perhaps signifies the sense of cynicism that I was beginning to experience by the end of the 1970s.

By the 1980s televisions were now hooked up to cable boxes. TVs began to look more like the digital computers on Star Trek than the clunky robot on Lost in Space. With remotes in our hands, we now had access to hundreds of channels bidding for our attention. We didn’t ever need to leave our seats to make adjustments. With cable television came the creation of CNN, a news station driven by ratings. CNN was the first network to bring you 24-hour live coverage. CNN not only reported the news, it became an interactive force that shaped and created the news in real time. With the replacement of the anchor person with “commentators” and “hosts,” the news no longer was grounded in fact, and the divide between truth and fiction began to blur further.

When Ronald Reagan, a Hollywood actor, was elected president, a sense of what was real and what was theater was further called into question. I remember watching an episode of Saturday Night Live where they did a skit on Ronald Regan. In the skit he was portrayed as a tyrant to his staff, yet playing the character role of the goofy grandfather to an audience of children who were visiting the White House.

The 1990s saw the rise of several different 24-hour news channels. Each station tried to find its own niche in order to gain market share. For example, Fox News viewed the world from the political right, MSN and CNN more from the left. Networks no longer presented different perspectives of one reality, but different realities, based upon the political orientation of the channel you watched. The age of positivism — where we all shared a common black and white existence — has disintegrated into negative relativism — where different realities were strategic constructs devised by the networks to promote ideological agendas.

The networks no longer just presented the news, they now told you how you should think about the news. News now was less about facts and more about opinions. To quote Bill Moyers: “When you mix fiction and news, you diminish the distinction between truth and fiction, and you wear down the audience’s own discriminating power.”

The 2000s saw the arrival of social media. With the invention of the smart phone, individuals were now able to construct personalized realities and send them out on the World Wide Web. With a little bit of tech savvy, operatives were able to have their agendas go “viral” and target mass audiences. While social media has many positive applications, it also has a dark side in terms of its vulnerability to construct devious realities of lies and untruths. The internet’s ability to spread anti-social propaganda as well as harmful and infectious viruses has reached epidemic proportions. The news was no longer at home on your television, but it was now connected at all times and it followed you where ever you went. The news was 24/7, streaming in real time and in the palm of our hands.

By the year 2007, social media became a powerful controlling force, where in an instant a text or tweet was able to put thoughts directly into your head. Social media was like the Wild West, no regulations, ideas flying around from who knows where, with no sense of authenticity or legitimacy. Anybody can make news; even my friend Carla, letting the world know on Facebook that she had meatloaf for dinner.

Fake news has always been around. In previous times, it was referred to as propaganda.

Many people did not take Donald Trump very seriously during the 2016 election. They viewed him like one views an acting out child, not taking his antics with grave concern. I was in shock and disbelief when I woke up the morning after the election and discovered he won. During the campaign, I though he was just seeking attention and publicity, and did not actually want to be president. To many, it is still unclear whether Donald Trump is out of touch with reality, a calculative evil genius, or something in between.

While Trump was not a seasoned politician, at least by historical standards, he was in fact an accomplished Reality TV celebrity. He was well-schooled in the art of self-promotion and social media. For Donald Trump, what is right or wrong does not matter, what counts is how many clicks, and how much attention you get from your targeted audience. Trump created a unique message that resonated with a large enough disenfranchised population that enabled him to win the electoral college vote, despite not having the support of the majority of the population.

It was Donald Trump who invented the concept of “fake news.” Contrary to what the names implies, fake news does not signify news that is disingenuous. Rather it is a political tool utilized by a politician to destroy and suppress their opponent’s viewpoint, regardless of the validity of their arguments. Fake news is not the opposite of real news, but rather, the rewriting of history to promote one’s own personal agenda. In Reality TV, truth is not determined by facts, but rather, “the art of persuasion.” What is right or true has become replaced with who can shout or name-call the loudest, fastest and most often. In the world of social media, what mattered is no longer the content of your message, but rather how many eyeballs followed your tweet or “liked” your link so it can go viral or move up to the front page of a search engine.

Fake news has always been around. In previous times, it was referred to as propaganda. What makes fake news unique and different this time around, is the existence of social media — the internet’s ability to quickly spread propaganda worldwide in nanoseconds.

Despite other accomplishments, when historians look back upon Donald Trump’s legacy, it is his use of the term “fake news” that will likely be remembered as his most significant contribution to society. How he decisively divided the country into civil war — this time however, with tweets rather than ammunition.

As I sit on the couch in front of the TV with my iPad in my lap and the remote in my hand, I find myself surfing multiple sites in desperation to hear someone say “and that is the way it was,” rather than, this is the way I want you to think it is.


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


This article was originally published on January 15, 2020 in the CTMIRROR.  A shorter version of the article was published in the CT Post and New Haven Register on January 25, 2020.  Click on the buttons below to see articles.

One day in May the CDC had decided that it was safe for fully vaccinated individuals to remove their masks in public.  For many this was a joyous occasion. For some, however, this historic moment appears to come with much confusion, hesitation and fear.  

In my practice, many of my fully vaccinated patients still exhibit social hesitancy and find it difficult to take off their masks. The latest research, from the American Psychological Association, suggests my patients are not alone.  According to the APA, nearly half of all Americans still feel uneasy about in-person interactions, and  expect to exhibit social cautiousness even after the pandemic is declared over.

If the science says it safe, why are so many people hesitant to take off their masks and return to normalcy?  I think the answer comes down to the human need for control and basic trust.

It is human nature to want to be in control. When we feel like we are not in control, we tend to become uncomfortable and psychologically distressed. Martin Seligman, a research psychologist, referred to this phenomenon as “learned helplessness.” According to learned helplessness theory, anxiety and depression can result from real or perceived absence of control over the outcome of a situation. For example,  if you beat a dog every time it comes out of its crate, the dog quickly becomes fearful of leaving the crate and becomes paralyzed with fear.  Over time, even if you stop beating the dog, it still remains in the crate, frightened and helpless.  In many ways we are like the beaten dog.  For the past 15 months, we have been told by the media that leaving our homes can be fatal. Like the dog, we have been conditioned to feel uncomfortable leaving our homes, even if breathing the outdoor air is no longer deemed harmful.

We no longer trust the politicians, the scientists or even the virus itself, which seems to be continuously mutating. Not only was the corona virus unfamiliar to most of us prior to March 2020, even when it was finally known, it’s infectious characteristics appeared to remain a mystery.  
We were originally told masks were unnecessary. Then the CDC did a 180 turn about and mask wearing became mandatory. One  day the virus was thought to be transmitted via objects and we were bleaching our groceries. In time the “science” changed and the virus was now deemed to be transmitted solely through air particles. Should we wear masks, should we bleach our food, elbow bump, or limit our greetings to a distant wave?  Should we listen to the scientists or the politicians? Who can you trust during a time of crisis, when even the president of the United States recommends the unthinkable — inject bleach to kill the virus. 

Trust is a basic human need.  If you cannot trust either the scientists or the politicians to tell the truth or protect you from the ills of society, how can you possibly feel safe outside your home and around others. Prior to the vaccine, the mask was all we had to protect ourselves and others from the virus. We have all lived through the trauma of the pandemic. In the face of such adversity, aren’t we are all a bit like frightened children holding their teddy bears tight to get themselves through the darkness of the night? Perhaps it will take some time to overcome the trauma of the past 18 months, begin to feel safe again, heal and have the courage to dispose of the mask and all it represents.

This article was originally published in the ctmirror:


ctmirror.org/category/ct-viewpoints/why-are-we-frightened-to-take-off-our-masks/


Dr. Martin H.  Klein is a clinical psychologist who practices in Westport, Fairfield and Stamford.  He also provides remote video conferencing session for the Greater Connecticut area.

Barron's article March 18 2020 by Al Root

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

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

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

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

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

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

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

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

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

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

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.

 A psychiatric diagnosis is a cluster of psychological and behavioral conditions as defined by  the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.  Over the years, there has been numerous revisions of this manual.  With each revision, there tends to be significant changes to the different menus of diagnoses and how each diagnosis is defined. For example, in the most current manual the diagnosis of "Asperger's disorder" has been removed and is now considered  as a part of  the class of "Autistic Spectrum disorders."  In one of the earliest manuals there was diagnoses termed "Neurotic disorder."  The term " neurosis"  is no longer considered a proper diagnostic disorder and it has been eliminated from the manual. 

So what happens to an individual who has a diagnosis that the American Psychiatric Association decides no longer should exist?  What happens to the child I work with who has been labelled "Aspergers"  for the past several years and now has a new diagnosis?  What about poor Woody Allen?  If he can no longer be considered a  "Neurotic"  can he still make movies? 

As several of the great existential thinkers have pointed out, psychiatric diagnoses are not objective disorders, but rather are social constructs that change over time (i.e., Szasz, Lang, Foucault). 

When I worked in a psychiatric hospital 25 years ago, the most popular diagnosis was "Schizoaffective Disorder."   What did that diagnosis mean?  Basically the person was having problems with his or her thought process (schizo) and well as his or her mood (affective).  I remember doing an inpatient group with 10 individuals, all diagnosed with "Schizoffective Disorder".  All of the people in group did have something in common -- they were not thinking clearly and had mood issues.  However, the similarities stopped there.  Each person was unique. Each had a different reason for being in the hospital as well as different backgrounds and issues.  In fact, at the time, I remember thinking to myself,  I would not be thinking clearly or be in a very good mood if I was hospitalized in a psychiatric hospital against my will either.

Today the new popular diagnosis is "Bipolar."  Almost everyone coming out of a psychiatric hospital comes out with a diagnosis of "Bipolar."  If  you are not thinking clearly or having mood issue you are now identified with this now popular disorder. The other widely popular modern day diagnosis is "Attention Deficit Disorder (ADHD)".  So many kids these days are being put on speed to improve their attention.  Does speed improve one's attention, most definitely. Should all children who have focusing issue be diagnosed with "ADHD" and put on speed?   I personally feel it is a significant social problem.

Psychiatric diagnoses are clusters of symptoms.  They change over time dependent upon what is popular in the current culture; and more specifically the psychiatric community.  Diagnoses are tools people in the field of mental health use to describe a cluster of symptoms and behaviors.  There are many theories as to what causes a person to be and act a certain way, but these theories also change over time and are historically dependent on the culture and trends in the psychiatric field.

So what is my point?  You should not define yourself by your psychiatric diagnosis.  Diagnoses are helpful in understanding psychological symptoms and patterns of behavior.  They can be a great tool for the clinician or the psychiatrist in determining the best treatment or medication.  A person diagnosed as "Bipolar"  is an individual who is possibly struggling with his or thought process or mood.  Therapy and medication can help.  However, having these cluster of symptoms, thought or behavioral patterns, do not define who you are as an individual with unique personal issues and struggles.

Dr. Klein is a clinical psychologist who practices in Westport CT.  He specializes in psychiatric assessment and psychological treatment  from a humanistic existential orientation.


Copyright April 2016, Martin Klein, Ph.D.

I often see patients who want to know why they do certain activities that on the surface do not seem to make sense.  From a practical perspective, these odd behaviors seem out of character or of a compulsive nature.  "I cannot stop doing the action, even though it seems irrational and a waste of time." 

In the therapeutic process, the reasons whey we do certain things or act out in a particular fashion is not always transparent and may take awhile to figure out.  It is a wonderful part of the psychology process -- an "aha moment" -- when the person and his or her psychologist discovers the meaning of an action. 

Many people want a quick fix -- they want the negative  behavior or the painful symptom to go away quickly and effortlessly.  In some cases this makes sense.  But sometimes, it does not.  To use an analogy, does it make sense to turn off the fire alarm while there still is a fire burning or a lack of understanding as to the cause of the fire?

 I once had a patient with a unique presenting problem.  For dinner he would eat the same thing every night --  steak, string beans and creamy mashed potatoes.  He would eat the steak first, then the string beans and then finally  the creamy mashed potatoes.  He would always save the creamy mashed potatoes for last, it was his favorite.  However, each night,  by the time he finished the steak and string beans, the creamy mashed potatoes were cold.  That is right, his presenting problem was cold creamy mashed potatoes.  Now if I was a "practical type of psychotherapist", the fix would be easy -- after you finish the steak and string beans, stick the creamy mash potatoes in the microwave and warm them up.  But to follow-up with my fire analogy, it is my view that such an action would be like shutting off the fire alarm and not dealing with the real burning issue.  For this gentleman, this compulsive pattern was symbolic of a greater issue that in fact affected the very core of how he lived his life. I would call it the "you cannot win syndrome."   In his life, he felt like he works very hard, but the reward that he expects for his hard work never comes or when it does finally come,  it is cold lumpy and does not taste good.   The creamy mash potatoes was symbolic of personal freedom -- the "easy life" -- the effortless melting in your mouth  -- an experience this person never seemed to get to.

As many of the great existential thinkers have taught us, human beings  are symbolic creatures and think, act and behave with in the realm of the symbolic (Freud, Jung, Eliade, Ricouer).  Many of our activities have deep symbolic significance. While  these symbolic actions resonates with our sense of well being, their meanings tend to stay hidden. 

The most obviously place where the symbolic realm can be most seen is in the world of games.  What is the attraction of tennis?  Is tennis a working through of some deeper issue?  I often talk about tennis when I am doing marital therapy.  Isn't tennis a game about relationships  --  who is left with the ball in their court  --who is at fault? --  are we equally at fault? -- ah then we have "love."

Why do we love to watch football so much -- the  great American obsession?  What is the symbolic meaning of the game? What is the goal of  football, if not to  get the ball, which is shaped like a egg  -- the symbol of perfection -- to the goal post without it falling and cracking. Why do they pile on the player who is already down with the ball?  Why is it so important to make sure the other team does not get back up?

Why are our kids so addicted to video games?  Are the themes of these games resonating with our children's needs or desires on a symbolic level?  In 1980s, when I was working as a school psychologist, I was fascinated with adolescents' obsession with "Pac-Man."  This was before computers, and kids would spend endless hours after school  at the arcades.  In 1984, I published an article entitled "The Bite of Pac-man" where I explored the symbolic allure of the game.  Why did the theme of the  "Pac-Man"game resonate so much with adolescents?  As I discussed in the article " The themes and strategies of the game perfectly accommodate the adolescent's relation to the world.  The Pac-man creature, which the player controls and symbolically becomes, is all mouth and is referred to as "Jaws."  "Jaws" spends his time and energy running from the engulfing monsters.  There are four different types of  monsters, each with its own personality: "Shadow" always follows you; "Bashful" will run away when you turn around; "Ambition" is always willing to attack you; and "Speedy" is fast and will run over you.... If the player engulfs enough monsters before they engulf him, he becomes a winner." While the game of "Pac-Man" might be a safe place to work out  issues of  separation and individuation, it is still a game -- a feel good fantasy -- not an achievement of personal maturity and a true reflection of one's ability to survive in the world.

What are some of the symbolic things you do or participate in as you live your life?  Do you have activities or compulsions that you are addicted to and are not sure why? 
 
Symbolism and everyday actions, it is something to think about.

Dr. Klein is a clinical psychologist who practices in Westport CT.  He specializes in life transitions, relationship issues, identity,  personal growth and self understanding.  He is trained in both clinical psychology and existential philosophy.

The Affordable Care Act, more commonly known as Obamacare, is a perverse twist on the Robin Hood tale. Rather than steal from the rich, Obamacare has taken from the middle class.
Prior to ACA, the self-employed middle class had many options for comprehensive insurance. They were largely able to afford their premiums and deductibles, and out of pocket costs were manageable. Most importantly, they were free to choose their own doctors and hospitals from a nationwide provider network.
To use my family as an example, four years ago I had a PPO plan that cost around $16,000 a year and had a maximum out of pocket expense of $2,500. The plan offered a national network and I was able to go to any doctor or hospital. Today you cannot buy such a plan at any price. The option that comes closest to the plan we had is a “Gold” HMO policy, with a premium of around $44,000 with a $9,600 out-of-pocket maximum. For the middle class, such a policy is financially prohibitive.
Over the past four years, medical costs for the self-employed have gone up over 300 percent and the coverage of the plans has deteriorated. For a middle class family of four, making around $98,000 there are no subsidies. You have two options — buy what amounts to an expensive catastrophic policy with constricted benefits, or pay the tax penalty, be uninsured, and hope for the best. And while many middle class families — whether they qualify for subsidies or not — may be able to afford their premiums, they may not be able to afford their deductibles. How many of us can afford to pay a $13,500 bill that comes in the mail? In effect, they will be able to afford their policies but be unable to utilize them.
On the individual market, there are only two insurance companies to choose from — Anthem or Connecticare. Connecticare’s rates are slightly less expensive. But for the most part, the plans are similar.
There are only two places where you can buy insurance — on the exchange or off the exchange. The exchange plans tend to be significantly cheaper than the off-exchange plans. For example, a Connecticare plan is about 35 to 40 percent cheaper on the exchange than on off the exchange.
From a cost perspective, the exchange plans make the most sense. However, from a network perspective, the plans on the exchanges are extremely limited in terms of the size and scope of their networks.
On the exchange, the provider network is restricted to the state of Connecticut, and even then many of the best doctors and hospital programs in the state are not on the panels.
While many of the exchange plans offer out-of-network coverage, this benefit has even higher deductibles, and poor reimbursement rates – often less than half of the customary rate. So if you choose to go to an out-of-network provider, your out-of-pocket costs can be through the roof.
In terms of coverage, the off-exchange plans are better, but not much better. Off the exchange, your network will be larger and you will have a better chance of finding a provider you like or one that is taking new patients. Some plans even let you see providers in some of the surrounding areas beyond the borders of Connecticut. However, even if you go with an off-exchange plan, the networks are still limited and are not national in scope. They do not compare to an employer-sponsored policy.
Once you’ve decided whether you want to buy a plan on or off the exchange, the next decision, is the type of plan — a high deductible or low deductible plan.
There are three sets of numbers you have to look at to compare plans: premiums; deductibles; and maximum out-of-pocket costs. For the most part, it all boils down to a simple equation: the higher the premium, the less the out-of-pocket expense; the lower the premium, the more the out-of-pocket cost.
From a financial perspective, I believe it makes sense to go with the lowest premiums and the highest out-of-pocket cost. If you have few health care needs during the contract year, you will have to spend little out of pocket towards your deductible. So whether you pay the actual amount of your deductible is not necessarily a given.
If you are fortunate and do not meet your $13,500 deductible, you end up saving money with the lower premium plans (lower premiums in my family’s case is $28,500 a year, with a $13,200 out of pocket maximum). I think you have nothing to lose by taking the lower premium plan, and much to save. But some people, from a psychological perspective, prefer to pay higher premiums and then not have to worry about having to pay for services rendered.
But whichever route you go, maximum out-of-pocket costs, (premiums, deductible, out-of-pocket max) for all the plans ends up being about the same.
In summary, if you are OK with only going to a Connecticut hospital, and most of your doctors are on the exchange network, the exchange plan makes sense. If you might want to go to a New York City hospital, there is a strong possibility that there can be a significant out-of-pocket expense. If you want to go to a provider or facility in Ohio or California, this is no longer possible, no matter which plan you choose, except in the case of emergencies.
For the behavioral healthcare provider, the ACA has been problematic as well. While they have raised premiums, they have not raised what they pay providers in over a decade. In some cases, they have actually decreased their allowable rates by over 50 percent. Member cost have gone up over 300 percent, provider reimbursements have stagnated or have gone down – yet the stocks of these managed care companies have gone up over 400 percent in the past four years. No surprise there.
At risk of being labeled the “L” word, I believe that everyone — middle class included — should be entitled to good health coverage.

Martin H. Klein, Ph.D. is a licensed clinical psychologist practicing in Westport and Fairfield CT.

This article was originally published in the CTMirror. Click below to see link to original article