In Treatment and Intervention

HBO's  In Treatment  is unbelievably believable . . .

as a portrayal of a week in the life of a psychoanalyst. The usual stereotypical myths seem to be done away with for the first time in a television program. The therapist is allowed to be viewed as a human being struggling with real emotions and real problems. The beauty is how well the boundaries are defined, giving the viewer a unique window into the lives of the characters that the characters themselves don't have full access to. The viewer is allowed to see dirty laundry air in an argument between the therapist and his wife. The viewer also witnesses the therapist receiving supervision from a colleague. In one scene the therapist uses a plunger to unstop the toilet. Interpretation? I found it quite interesting when a coincidental meeting happens between two patients leading to a potential hook up right outside the therapists door. The viewer has the unique perspective of being exposed to the intimate issues of both patients and the therapist. This makes it hard to wait to see what will happen next. Due to ethical standards this perspective is not a possibility in real life, making it all the more intriguing to view.

 Monday's case of Laura, a 30 year old attractive anesthesiologist, is an excellent portrayal of the process of erotic transference that sometimes occurs in therapy when a patient believes them self to be in love with their therapist. This boundary is sacred and simply can never be violated at any time for any reason by a therapist. A fitting metaphor is when God instructed Adam not to eat from the forbidden tree. Irreparable damage to a patient can occur from the therapist not protecting this boundary. All residency trainees in psychiatry are well instructed of the importance of managing this situation appropriately because so much is at stake. The usual protocol involves seeking appropriate supervision and considering transferring the patient to another therapist. Despite the preparation and instruction psychotherapists receive, occasionally there have been cases of therapist getting in over their head and risking and losing everything. This can only be attributed to the fact that therapists are imperfect and can be vulnerable to the same addictive impulses as anyone else. For the reasons mentioned, it is a treat to view the therapist character on this program deal with this issue in a realistic portrayal.

 

A & E's Intervention is essentially reality TV involving the life and struggles of addiction. It is valuable as an educational resource for understanding what pain addiction causes for the addict and all associated with them and what a challenge it is to overcome an addiction. Addiction is a disease of the brain itself that results in repetition of detrimental behavior. Though the addict is totally out of control they tend to either deny, rationalize, or minimize their behavior. Enabling individuals tend to fall into the void created by the addicts lack of self control and responsibility, thus allowing them to continue the process. An intervention occurs when family, friends, and a therapist invite the unsuspecting addict to a meeting where they are carefully provided confrontation and given an ultimatum to get help now or be cut off. The addict is provided an opportunity to change direction with a strong support base. Resistance is almost guaranteed to occur during confrontation. The addict must accept that they will eventually die if they do not accept this road to recovery. As far as entertainment goes, Intervention becomes less interesting to watch over time because the plot is always essentially the same. Lure the addict into confrontation, provide an ultimatum then hope and pray. HBO offers an additional resource with some interesting clips known as Addiction.

I think the shows above are quite useful for those involved with mental health care or substance abuse and  those with just a general interest.

A Valentine's Day Message from The HEADoc

What exactly is this thing we call love?

Philosophers categorize two forms of love; Agape love is the love a mother feels for her child or the love God feels for us. It is never ending and unconditional; Eros is the love man feels for woman. It usually starts in a lustful manner and may grow into something wonderful and Agape-like or it can wither and die if not tended adequately. The seed of Eros happens to two individuals but expression of the emotion is what ultimately matters. If you don't feel loved at any time during a relationship then you must accept that your partner does not feel love for you. It should be obvious but denial can be a real SOB. If you give and give and give but never receive, your partner does not love you or is a narcissistic individual incapable of expressing the emotion of love. Broken hearts always heal but one who is trapped in co-dependency will never be content or find true happiness. One who dwells in denial loses the ability for emotional balance.

We come into the world prepared to be nurtured. Unfortunately, we cannot chose our parents or our genes. When a parent is impaired by mental illness or chemical dependence they are not capable of providing this degree of nurturing and if others don't recognize the problem and intervene the child may be emotionally damaged for life. In theory, a personality or character disorder is born. Personality disorders are considered to be due to problems in infant and child development. Since this illness is wired into the brain cells (neurons) it cannot be easily reversed by giving medication or changing the environment later in life. This individual will grow up with a love deficiency, always yearning to be nurtured, but lacking a clear understanding of the proper dynamics of sharing love. The person may have the emotional development of an infant but be trapped in the body of an adult. They will pick an unsuitable mate have children and often perpetuate the cycle of dysfunction.

The human will possesses the power to overcome almost any adversity, given adequate time to do so. That is why I never lose faith in any patient genuinely putting forth an effort. This of course excludes all individuals who have smoked crack in the last seven days. Trust me, that situation is the definition of hopelessness and I am not one who quits anything easily. Crack addiction, as I have said repeatedly, is no different from AIDS or Cancer. It is the terminal stage of self medicating and is infectious in the sense of harming all enablers and innocent bystanders. As usual, I have digressed.

February 14th can be one of the happiest days of the year for the couple who truly love one another or are in the early stages of a relationship. The chocolates re-enforce the endorphin flow from their brains as they enjoy the blissful insanity nature lures and teases us with. This, strangely, is the same euphoria sought by the drug addict. Unfortunately, drugs nor dealers of drugs cannot return love but only deepen the yearnings and cravings for the missing love. For those who have chosen the crack pipe, the vicoden, xanax, or Jack Daniels as their lover, Valentine's Day will likely not be a day of joy or happiness. Those substitutes for nurturing and affection will never suffice. I no longer try to fix such individuals, but try not to contribute to their problems. Often the most I can do is try and understand them and hope that one day they choose to use their God given will power to try and improve their situation and not yield to indifference and self destruction.

My cat has taught me more about love than any woman ever has. Our agreement is that I will keep some food and water in the bowl and clean the litter box once and a while. She will never say anything bad about me or do anything to hurt me. We get along pretty good. I tell her to clean the apartment while I'm away at work. She instead turns over all of the trash cans but I never stay mad at her. If I want to stay in and watch the game, she just curls up on the sofa without a word and watches quietly as I curse and yell at the screen. No matter what time I come in she is glad to see me. In fact, the longer I'm away the happier she is to see me. We have never had a fight about anything. She always treats me the same. Sometimes I'm bad and ventilate and displace the anger and frustrations I may be feeling onto her. She doesn't even see it as abuse. She instead listens to every word with a look of bewilderment then shakes her head with a look of pity and walks away to groom herself. For these reasons I can honestly say that I love my cat.

Be Careful What You Ask For. . .

I logged on this morning and to my astonishment discovered subscriptions to Quest 4 Sanity had increased by 6 fold.

I have continued to refresh the screen all day to try and be sure that an error hasn't occured. Things of the sort just don't happen for me. If it does turn out to be true I fear the pressure may increase for me to produce more quality entries. In the words of Homey The Clown, "I don't think so!" I'll just keep right on writing what I feel as it comes to me. I'll continue to ramble, rant, rave, preach and teach in my own unique little way. Still there will be those who insist I'm so wrong about certain issues and get bent out of shape and not read another word I write. This buds not for them anyway. There will also be the faithful few who find what I write to be as it is intended which is entertaining, informative, and thought provoking. You know who you are.

I know I'm not always completely right about some topics, and my views are usually modifiable when the evidence supports that. I do pride myself in having a keen sense of things that are simply wrong in principle and not negotiable. This is usually what sparks my interest in politics, or politicians more so. Politicians are just characters who play a role in a system that boasts more than it ever delivers. The system really does little for the common people until it is forced to do so. This goes as far back as The Emancipation Proclamation. I doubt much of the Civil Rights legislation would have been passed had Dr. King not been murdered and angry rioters threatened to end the peace for all. The killing of Dr. King actually backfired if the goal was to halt progress for minorities.

For many years I have studied Dr. Kings life and his effect on people and the nation in general. I learned every word of his I Have a Dream speech and used to recite it before audiences to an amateur music track. This helped me to feel and understand the greatness of this man. Of interest, he never even set out to become an icon of greatness but accepted the call when others insisted he lead the Montgomery Bus Boycott, and the rest is history. He lived daily with threats against his life and the lives of his family. Sure he felt fear, as any human would, but he possessed the courage to face the danger anyway. He knew that his life would be short but he was committed to accomplishing his mission. His mission was not to deliver Black Americans, but to heal relations between all people and make it possible for all people to have access to the American Dream. Has this really occurred?

If the question is approached from the perspective of "has racism ended?" the answer is obviously a resounding NO. Racism may never end but its power will one day be neutralized if we choose to carry on Dr. Kings legacy. Many dislike Rev Al Sharpton, but credit must be given where it is due. He led an impressive and effective protest against the injustices brought against Michael Bell, the college student/athlete recently charged unfairly with capital crimes in Louisiana. This nationally covered case made it clear that racism is alive and well. The protest made it clear that it can be defeated. The KKK will march on Dr. King Day Monday, and it is their right to do so. But who really cares? I view the KKK as a perverse organization of cowards with damaged self esteem and too much paranoia. Just like the stepfather who molests his stepdaughter, there is no more power and no more terror when the truth finally comes to light. At that moment he is exposed for what he truly is. That stepdaughter will now be protected by adults who really care for her. Without hoods, darkness, and secrecy, the KKK is rendered impotent and irrelevant.

As I do every year, I will celebrate King Day by going to work. I know that Dr. King would be proud and that this is what he would expect of me. Had Dr. King not lived, I most likely, would not have the job I have to go to daily. I am an African American Psychiatrist with a patient base that is mostly Caucasian. I don't think it's naive for me to believe that, for the majority of my patients, my race is not a major factor. Whether I can help solve their problem is much more important. Most of the attitude I get has traditionally been from those of my own race. This, I believe, supports the theory that the best way to keep Blacks down is to keep them fighting amongst themselves. Sad but, unfortunately, I believe that to be true. Thus, gangsta rappers are provided a platform of priority to Black professionals or intellectuals (except Clarence Thomas and Condoleeza Rice). The media does dumb the public down but that is a topic for another time.

Hope everyone has a Happy King Day! Do something he would be proud of.