|
,
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 Copyright, Feb. 2017, Martin Klein, Ph.D
0 Comments
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 It’s not that easy being green; Having to spend each day the color of the leaves. When I think it could be nicer being red, or yellow or gold- or something much more colorful like that. It's not easy being green. It seems you blend in with so many other ordinary things. And people tend to pass you over 'cause you're not standing out like flashy sparkles in the water- or stars in the sky. The Muppets Life can be hard. We are born into the world so helpless and dependent on others. As we get older we are faced with many challenges and unknowns. Learning to walk is no easy feat. The act of separation is painful. The first day away from your parents is traumatic and anxiety provoking. School is a challenge and requires more and more work as we advance. When school does finally end, we are faced with the anxiety of finding a good job and preparing to grind through the hoops of advancement. While there are many wonderful things about having a family, child rearing is much more difficult than anyone can imagine. Raising a family is beyond a full-time responsibility. The required sacrifice of one's freedom for the good of the family at times can be exhausting and not so personally rewarding. Yet we continue to tightly grasp onto our dreams. Many of the ideals that motivate us we digested even before we knew how to speak. We learn from our parents, teachers, and the many forms of social media who we should be, think, and become. We are told we can be outstanding. We want to "be all we can be." We believe we can become our idols if we dress or talk like them or buy their products. Even the child believes the commercials that the toy inside the box is the real thing, or that they can become the action figure or build a fighter jet just like perfect representation on the box top. We enter the socialization process and strive to be a good person, be responsible, have a good job, support our families and the community. When you are young time seems to go so slow. A ten year old dreams of being a teenager, a teenager dream of being a college student, a college student dreams of being an adult. However, as we get older, our sense of temporality seems to change -- time seems to quickly speed up. With a blink of an eye, you find yourself middle aged. When you look in the mirror you don't recognize yourself. You now look more like your own parent than your internal image of yourself. Your body is beginning to slow down and the wear and tear of aging results in aches and pains. For the first time, you are faced with the limitations of both your aging body and ability to live out your dreams and childhood aspirations. Like Wile E. Coyote, from the Road Runner cartoon, you realize, perhaps for the first time, you are hanging onto a fragile branch that in time will crack and fall into the abyss. You start to question the very premise of your existence. The metaphysical questions of the great philosophers no longer seem abstract and irrelevant. Who am I? What is my purpose? Can I ever feel whole or complete? Does my life actually matter? Am I a coherent self or a loose collection of fragment streams of thoughts and ideas? If I am going to die, does anything I try to accomplish count for anything in the larger scheme of things? Shakespeare's quote "to be or not to be that is the question" shakes your existential core. To face one's own death can be frightening. Much of what we do in our lives is about losing ourselves in the everyday busyness — to avoid, deny and repress our own limitation. One of my clients coined the term "ego cowardice" to describe this failure to face reality and continue living a life based upon false hopes, oneiric ideals and deceptions.” To face one's finitude takes courage. It might even feel a bit like bungee jumping without the cord. But the truth is that the cord was cut a long time ago. Perhaps Rose, in the movie Moonstruck, said it best when she finds out her middle aged husband is cheating on her with a younger woman: "I just want you to know Cosmo, no matter what you do, you're gonna die, just like everybody else." To accept one's existence might only be liberating for a moment. But in life -- a moment in time is all we have. Why not make the most of it. Dr. Martin Klein is a clinical psychologist who specializes in insight oriented existential psychotherapy. He works with people dealing with issues related to life transitions, identity, intimacy, relationships, careers, spirituality, grief, aging, illness, loneliness and meaningfulness. He has offices in Westport and Branford CT Baby, sweet baby, you're my drug Come on and let me taste your stuff Baby, sweet baby, bring me your gift What surprise you gonna hit me with I am waiting here for more I am waiting by your door I am waiting on your back steps I am waiting in my car I am waiting at this bar I am waiting for your essence Baby, sweet baby, whisper my name Shoot your love into my vein Lucinda Williams What Is Sex Addiction? In my practice I often get phone calls asking if I treat sex addiction. It is my experience the term means different things to different people. The majority of calls come from men. Often it involves an individual who has had extra martial affairs, is obsessed with internet pornography, put himself in a sexually compromising and/or illegal position, cannot stop sexual urges or fantasies, or suffers from excessive masturbation. All of these behaviors interfere with daily responsibilities and put strain on relationships, resulting in psychological distress to themselves and their families. In some instances, it is the spouse that demands their partner seek profession help or face consequences such as separation or divorce. The History Of Sex Addiction Different names have been used to characterize individuals who engage in excessive and at times deviant sexual activities. Labels such as Don Juanism, nymphomania, satyriasis, erotomania, hypersexuality, impulsive disorder, overactive sex drive has been around for along time. The term “sex addiction,“ however, did not arise on the scene until the 1970s. It was originally coined by members of Alcoholics Anonymous who set out to apply their 12 step principles toward sexual recovery. In a similar vein as alcoholics, they identified those who suffered from excessive and disruptive sexual activities as being physiologically dependent. Based upon the AA paradigm, they believed that sex addicts cannot be cured; but rather their disease can only be controlled by complete abstinence. To suppress their sexual dependence, members must acknowledge the disease is greater than themselves, surrender to a higher power, participate in group meetings in order to muster up the collective power to battle the disease one day at a time. With the popularity of the 12 step movement, numerous organizations formed that follow the AA doctrine - - Sex Addicts Anonymous, Sexaholics Anonymous, Sex and Love Addicts Anonymous, Sexual Compulsive Anonymous and Sexual Recovery to name a few. Is Sex Addiction A True Addiction? As these organizations expanded and continued to help many people, its fundamental premise has been called into question by many in the mental health communities. Neither the American Psychiatric Association, the American Psychological Association nor the American Medical Association recognize “sex addiction” as a valid diagnosis. According to the American Medical Association, there is no clear evidence that “sex addiction” is a biological disease that leads to physiological dependence and withdrawal. While past editions of the American Diagnostic And Statistical Manual of Mental Disorders had a category called Sexual Disorders Not Otherwise Classified, the latest version does not. After reviewing the empirical evidence, it decided not to include the diagnosis of “hypersexual Disorder” in it’s current manual. Despite its absence, mental health professionals have found the following disregarded criteria for Hypersexual Disorder to be of diagnostic value: For a period of at least six months:
Compulsion Or Impulse Control? The World Health Organization’s (WHO) manual does includes the diagnosis “excessive sexual drive.” In their manual, this diagnosis is classified as a compulsive behavior and/or impulse control disorder and not an addiction. There is extensive research that suggests hypersexual disorders are of a psycho-social nature. For example, people who identify themselves as “sex addicts” often come from dysfunctional families and have a history of being abused. One study found that 82 percent of sex addicts reported being sexually abused as children. Sex addicts often describe their parents as rigid, distant, uncaring and critical. Many parents of sex addicts have similar tendencies and were also abused as children. Many of these families, including the addicts themselves, are more likely to be substance abusers. There continues to be great disparity as to the etiological and diagnostic criteria for hypersexual disorders. Is “sex addiction” a true addiction? Is it an obsessive compulsive disorder, impulse disorder, or perhaps not even a disorder at all? Where the responsibility falls - - the addiction, the learned character traits, or the individual’s bad choices - - has significant repercussions in terms of diagnosis, treatment and how society views and treats these individuals. The answer to these questions are not so clear cut. Perhaps individuals struggle with sexual dysfunctions for different reasons or a complex array of multiple reasons. Even if the evidence suggests sex addiction is not an addiction, this does not rule out the possibility that physiological factors can still play an important role in its constitution. The existence of a strong correlation between hypersexuality and anxiety and mood disorders has been well documented in the literature. In fact, it has been shown that the same neurological transmitters that are involved in anxiety and depression appear to play a role in obsessive and compulsive behaviors. Like many obsessions and compulsions - - be it video games, the internet, gambling, sports, the stock market or even watching TV - - sexual compulsions can only provide temporary relief from unwanted emotions. The moment the compulsive activity stops the unwanted thoughts and feelings do return with vengeance. Individuals who identify themselves as “sex addicts” tend to act out to mask or avoid unwanted emotions such as sadness, shame, loneliness, guilt, anger and fear. Many “sex addicts” also suffer from low self-esteem, impaired occupational, educational, social, family or relationship issues. Empathy, Acceptance And Self-Responsibility It is important to have empathy for individuals who suffers from hypersexual disorders. One must have an appreciation of the depth of their suffering, conflicts and daily struggles, be it of a physiological, psychological or self-inflicted nature. You must be aware of their personal histories, family dynamics, current stressors, sense of self, and underlying psychiatric issues such as mood, anxiety or character weaknesses. To overcome hypersexual tendencies, one must accept and take self-responsibility for their own limitations, dysfunctional tendencies and past discretions in order to harness their inner strength and move forward in a productive manner. In addition to the support of family, friends and organizational groups, having a seasoned clinical psychologist as your guide on this difficult journey is important to the healing process. Dr. Klein is a clinical psychologist who practices in Westport CT. He specializes in the treatment of sex and porn addictions as well as substance addictions. 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.  To many parents a liberal arts education is no longer considered a realistic option for their children. Successful parents want successful children and as such expect them to go to highly competitive schools and study subjects deemed necessary to accelerate economic advancement. The external pressures to get into a competitive school, however, can be overwhelming to a child. Admission into a “good school” has become harder and more complicated. The world of higher education has changed dramatically over the past decade. Being a good student is no longer enough. In addition to good grades and high test scores, you now need to demonstrate that you participate in sports, extra curricula activities, do volunteer work and have completed several advanced placement courses. Even the college essay has become a monumental task, requiring professional assistance. In the “old” days students would apply to a handful of schools but now with the advent of the common application, a high school student can now send applications to 900 different colleges with a single click of a mouse. The common application has increased the pool of applicants at each college significantly, resulting is much greater competition. The college application process has become so complicated that it requires sophisticated strategies and the aid of a dedicated college coach with a specialized software program to develop a personalized strategic plan. Do you apply early decision, early admission, regular admission, how may schools should you apply to, how many safety schools, how many should be reach schools? You can now sit in front of a computer program and see how your child statistically stacks up to past applicants who applied to each respective school based upon grades, test scores etc. The severity of competition is even more intense for those kids who live in highly educated and affluent areas. It is difficult for a child to stand out from their peers when they live in a town where their cohorts all have grades and test scores two standard deviations above the norm. Being from a northeast suburb can also be a disadvantage when applying to colleges that desire student bodies that are geographically, ethnically and economically diverse. While many students are academically strong, some lack the emotional aptitude required to handle the intensity of the application process. The pressure from parents, peers and one’s self can be overwhelming to the child. Many kids I see in my practice suffer from low self-esteem. They fear that if they don’t get into a good school they will let down their parent or perhaps be ostracized by their peers. Going to classes each day, while your classmates flaunt their early admission acceptances on Facebook or by wearing collegial emblems on their clothing can bring up feelings of inadequacy. Overwhelmed by all this pressure, it is understandable why a senior in high school might become overridden with anxiety and exhibit symptoms such as an inability to relax, always feeling on edge, irrational fears of impending doom, restlessness, feeling tense and having difficulty concentrating. Sometimes general anxiety can manifest somatically as stomach pain, panic attacks, muscular tension, headaches or insomnia. Some kids try to overcome their fears by irrational thoughts or ritualistic behaviors. They become obsessed with the college application process and cannot think of anything else. They cannot control these intrusive thoughts and they find it difficult to relax or even perform chores. In many instances, the child’s academic performance begins to deteriorate due to an inability to focus. Some kids develop compulsive behaviors as a means of avoiding these negative thoughts. They watch television excessively, play endless video games, constantly surfing the internet, spend significant amounts of time on social media, or even watch hours of pornography. Many even turn to alcohol and drugs for temporary relief. High school students can also be plagued by depression. In children, depression can manifest in many different ways. For example, some kids with depression might feel sad, hopeless, have difficulty concentrating, sleep poorly, have little appetite or an inability to experience pleasure. Others can experience depression in how they interact with others. They can be socially withdrawn, avoid responsibilities, procrastinate, or become emotionally sensitive. Some kids manifest their depression by exhibiting oppositional behaviors. They can become agitated, aggressive or even antisocial. Kids who have been well behaved can suddenly become deviant. It is common for students to feel embarrassed, ashamed, or over ridden with guilt about failing to live up to expectations. Many kids, as well as their parents, have separation anxiety and get nervous even with the idea of the child going off to college is mentioned. Many high school students feel alone and isolated in their suffering. They feel like they have no one to turn to who can understand their pain and give unbiased advice. They fear rejection by their parents, teachers and friends. Kids are often relieved to finally have someone who they can talk to confidentially, in an open manner, without the fear of criticism or judgement. Many can finally admit that the issues that are bothering them have been around for a long time. They can explore their family dynamics in a safe environment and begin work through the age-specific developmental issues of separation and self-identity, which can be overwhelming and confusing to a child at this age. Who are they? What do they they want to be when they grow up? How do they get their needs met? How do they become that person they want to be? What is the path they should pursue that will make them happy? And most importantly, what college do they want to go to and what subjects should they study? Surprisingly some kids feel a sense of relief when they discover they will be going to one of their safety schools. Safety, especially to a child, is not always a bad thing, and often times a welcomed surprise. Dr. Martin Klein Is a clinical psychologist who practices in Westport CT. He specializes in working with high school students who struggle with issues of anxiety, stress, depression, low self-esteem and addictions. He works closely with students and their families who are going through the college application process. Major Depressive Disorder (MDD) Major depression is a disabling condition that can last for long periods of time. Without treatment, a major depressive episode can last months, years and even a lifetime. While the condition can worsen during the holiday season or winter months, it is most often triggered by a personal loss or negative situational event. MDD can run in families. In many cases, the mood disorder can be biologically or socially based or a combination of both. How one was raised as a child is an important contributing factor in MDD. Individuals who suffer from dysthymia, a low-grade continuous depression, are most vulnerable to bouts of major depressive episodes. People who have never experienced major depression might not understand the depth or severity of the syndrome. There can be nothing more frustrating to a depressed person than someone telling them they should just “snap out of it,” “you have no reason to be unhappy,” or “you just need to pull yourself up with your own boot straps.” Major depression is not something that tends to go away on its own without professional intervention. When you are clinically depressed you can feel totally helpless and have little hope that you will ever feel better. You tend to forget what it feels like not to be depressed. If someone tries to remind you of past times when you were happy, you quickly view their opinions as ill informed and agitating. You feel depressed and exhausted all the time. Your mind is occupied with negative obsessions, self-deprecating thoughts, and low self-esteem. There is a melancholia to your mood. You might feel sad, overwhelmed and psychologically paralyzed. You might feel that your life has no purpose or meaning. You have a hard time falling asleep and if you do fall asleep you tend to wake in the middle of the night worried and frightened . You cannot shut off your mind. You thoughts are racing with irrational fears and anxiety provoking self doubts. When you are depressed you can become easily agitated and angry. Even the smallest gesture by another person can be misinterpreted and set off a tirade. Some people become so frustrated that their anger rises to the level of rage, whereby they become capable when provoked of doing bodily harm to themselves or others. Depression can cause difficulties in focusing and concentration as well as deficits in abstract reasoning and memory. Being productive at school, work or at home can be difficult, if not impossible. In severe cases, a person might not have enough energy to get out of bed, care about their appearance or perform basic activities of daily living. Suicidal thoughts or actual attempts are not out of the question. If you or someone you know suffers from clinical depression, it is important that seek professional help as soon as possible. Clinical psychologist are trained in the diagnosis and treatment of mood disorders. Depression is treatable. Utilizing a combination of cognitive behavioral therapy (CBT), insight oriented psychotherapy and sometimes medication, the clinical psychologist can come up with an action plan to alleviate your symptoms and make changes to how you think, behave, relate to others, and experience yourself and the world around you. Dr. Martin Klein is a clinical psychologist who specializes in the treatment of depression. He has offices in Westport and Branford CT.  A man says to his wife: "Listen honey, whoever dies first, I want to make sure it is okay that I remarry." Sigmund Freud Jerry Seinfield on Choosing a Psychotherapist www.youtube.com/watch?v=fG7ymv0ptLo Bob Newhart on Brief Focused Cognitive Behavioral Therapy www.youtube.com/watch?v=4BjKS1-vjPs Woody Allen on Long Term Psychoanalysis www.youtube.com/watch?v=ocMOJXkz9eI Kelsey Grammer (Frasier) on Hypnosis www.youtube.com/watch?v=LbyzC07HLow Ray Ramano on Martial and Family Issues www.youtube.com/watch?v=CHS-tXxHl1w Robin Williams on Alcohol Dependence www.youtube.com/watch?v=uLtPp_xIpC4 Jackie Mason on Self-Identity and Psychiatry www.youtube.com/watch?v=n3ZDslOxPhI Stephen Wright on Early Childhood Memories www.youtube.com/watch?v=MdDEz1aJSAc Jim Parsons (Sheldon) on Facing Your Fears www.youtube.com/watch?v=QV6DpJKW6a0 Bill Murray on Hypochondriasis www.youtube.com/watch?v=1bYO-mm_MvMhttps://www.youtube.com/watch?v=1bYO-mm_MvM Richard Lewis on Psychotherapy and Termination www.cc.com/video-clips/9auw7c/stand-up-richard-lewis--out-of-therapy 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. |