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Posts Tagged ‘psychotherapy’

I received the following letter concerning the tricky business of maintaining a relationship:

Dear Will,

I’m a recent law school graduate studying for the bar exam. I just got into another argument with my boyfriend of four years, and I’m feeling frustrated and upset.

Our relationship tends to break down when I’m going through a period of heightened stress — writing my law school admissions essays, studying for finals at the end of each semester, and now, studying for the bar. I know I can get moody and depressed during these times, but I’m up front with him about my state of mind, and I wish he could be more understanding.

The problem is that, on the one hand, I’m starting to feel like the girl who cried wolf, since these periods of stress have happened regularly throughout our relationship. On the other hand, I still feel hurt and upset when he loses patience with me, like I can’t rely on him during tough times.

Any thoughts or advice you can provide would be much appreciated.

Thank you,

L

And here’s my response:

To submit a question to Ask The People’s Therapist, please email it as text or a video to: wmeyerhofer@aquietroom.com

If I answer your question on the site, you’ll win a free session of psychotherapy with The People’s Therapist.
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Please check out The People’s Therapist’s new book, “Way Worse Than Being A Dentist”

I also recommend my first book, “Life is a Brief Opportunity for Joy”

(Both books are also available on bn.com and the Apple iBookstore.) 

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There’s a terrific opening scene in Stephen King’s novel, “Pet Sematary.”

I don’t read a lot of Stephen King novels. That’s not because I dismiss his skill as a writer. It’s because they scare the hell out of me.

In this one, the main character is a young doctor. He’s on his first day at a hospital when a college kid is rushed into the ER. The kid was hit by a car, so he’s all smashed up, his neck broken, blood all over the place, one eyeball hanging out – whatever. Just as the doctor is concluding he’s dead, an arm shoots out, grabs the doctor by the collar and the dead kid stares at him (with his working eyeball.)

“Stay away from the Pet Cemetery!” he intones.

In a flash, it’s over. The kid is stone cold, and the doctor wonders if he was hallucinating.

The suggestion to stay away from the pet cemetery, however, is a sensible one. Like most sensible suggestions, it goes entirely unheeded.

I don’t want to give away the ending (and I only read the first 20 pages because I got scared) but I suspect, if he stays away from the pet cemetery, flesh-eating zombies won’t become an issue.

But he doesn’t listen!

Lawyers are the same way. They just don’t listen!

Here’s another scary story. My client was in law school. With a big smile, she announced to her journalist boyfriend she was accepting a job at the big, prestigious law firm where she’d summered the year before.

He grabbed her by the collar, his face etched with horror, and intoned: “But you hated that place. It totally weirded you out. You said you were pursuing public interest. Why would you go back there?”

She didn’t listen. Now their relationship is over, and she’s hating her job and her life and weeping in my office.

“Why didn’t I listen?”

But she’s not the only one. You had moments like that, too – didn’t you? When someone tried to warn you?

My Pet Sematary moment came the summer before I started law school.

I was visiting home, went to a party and ran into an old friend – a guy I’d known since I was about twelve years old. I casually related the big news – I was going to law school! I expected one of several possible reactions:

  • an expression, feigned or otherwise, of happiness that I was finding my way forward in the world;
  • a tinge of jealousy that he was still a burn-out art student while I was on my way to wielding staggering corporate power; or
  • curiosity about law school and how he might follow in my tracks.

I didn’t get any of those reactions. I got disappointment and concern.

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An intriguing question from “A”:
My boyfriend’s ex has gone through therapy one on one and in a group setting.  She now thinks she can diagnose and help anyone.  In her mind she is “helping” but in reality she is being intrusive, causing more problems, trying to find out secrets.  I see this as someone who is in a delusion that she can fix anyone and is looking for someone who is in her opinion broken.  She thinks that she is bonding with people by “helping them”.  She even tries to make you feel comfortable by saying she is a “bleeding heart.”
I see it as she is prying into to people’s lives looking for dirt to use against them.  I guess being trusted with someones secrets somehow makes her feel that she has created an unbreakable bond.  My instinct is to run away as fast as I can from this person.  I think she is dangerous, manipulative, untrustworthy, and only motivated by money not true friendship.
This is the second one of his (my boyfriend) female friends that I don’t like or trust.  The first one was in love with my boyfriend and trying to break us up.
I know that everyone needs friends but I cannot help her.  I cannot be a true friend to her because I don’t trust her.  Life is hard enough without someone playing the therapist game.  Does she realize that this game she is playing is dangerous and can have severe consequences? What does it say about me that I don’t want to have anything to do with her?

And here’s my answer:

To submit a question to Ask The People’s Therapist, please email it as text or a video to: wmeyerhofer@aquietroom.com

If I answer your question on the site, you’ll win a free session of psychotherapy with The People’s Therapist!

==========
Check out The People’s Therapist’s new book: “Life is a Brief Opportunity for Joy

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I get asked this all the time:  “What if it’s only chemical?”

Good question.  Why talk to a therapist if you can take a pill and be done with it?

Freud was intrigued by the possibility.  According to Peter Gay, in Freud’s late work, “Outline of Psychoanalysis:”

“[he] speculated that the time might come when chemical substances would alter balances in the mind and thus make psychoanalytic therapy, now the best available treatment for neuroses, quite obsolete.”

It’s appealing to treat mental illness as a chemical problem because chemistry seems clean and precise.  The fundamental functioning of the brain is both chemical and electrical, based on the difference in potentiality between sodium and potassium.  No problem.  You identify an imbalance, add ingredients, stir, and restore order.

But there is a problem.  The brain is also a ball of flesh, soaking in countless compounds we scarcely comprehend.

Injecting a drug – one more chemical – into your bloodstream is a primitive way to fine-tune complex chemistry.

That’s why psychiatric drugs are most effective when blunt, simple results are called for.  They can slow you down.  They can speed you up.  They can numb you or narrow your emotional bandwidth.  If you are bi-polar, they may help stabilize your emotional swings.  If you are psychotic, they may bring you back to reality, or at least closer to it.

For subtler changes in brain chemistry, talk therapy – or maybe talk therapy in tandem with a drug treatment component – produces better results.

How could talking in a therapist’s office affect the chemistry of the brain?

Your emotions are chemicals.  When you feel angry, your amygdala, a region in the center of your brain, releases a chemical signal.  That chemical – or series of chemicals, is what you experience as “anger.”  Joy, fear, sadness – all the emotions you feel as fundamental responses to the world around you – are chemicals.

Your thoughts are also chemicals.  When you admire a sunset, you are releasing chemicals which trigger electrical impulses that race through the circuitry of your brain.

Your thoughts affect your emotions.  So if I can affect  your thoughts, I can affect the chemicals triggering your feelings.

The brain is extremely mutable – neural pathways can be rerouted.  If I can make you aware of your thoughts and feelings, I can reroute the neurons in your brain, so different chemicals are released.

This isn’t as far-fetched as it sounds.  Here’s an example:  If you are depressed and I tell you to go for a run because it will cheer you up, I’m not merely nagging.  Aerobic exercise releases endorphins in your brain.  These chemicals cheer you up, relieving depression.

In the process, you will also create a memory – a piece of stored chemical information – that links depression with going for a run and feeling better.  A faint, newly formed neural link, and a piece of memory supporting that link, have been created.

Here’s another example:  if you are denying your anger – the typical pattern that creates depression – and I arrange during a session of psychotherapy for you to address your father, or your mother, or your boss or your girlfriend, and you feel anger well up and put that anger into words, saying what you’ve kept silent for years…that’s going to have effects on the chemistry of your brain.

When you get the words out, and feel your buried anger, new pathways will form between the ancient regions governing emotion in the center of the brain and more recently evolved cognition areas in the outer cortex.

New thoughts circulate new chemicals, create new memories, and effectively rewire the way you think.

You leave my office realizing you were angrier than you thought, and knowing it felt good to get it out.  You experience a lightening of mood.  Your girlfriend, when you get home, senses that you are less defended – your resistances are down.  This alters her behavior towards you, and she starts to open up to you emotionally to a new degree.  You begin questioning your old responses to her, and your old ways of doing things in general.

Your brain is flooded with new chemicals, and new pathways have been formed, that might, with further talk therapy, begin to replace old ones.

Subtle changes have been made to the chemistry of your brain – to who you are, how you think, and how you behave with others.

That’s what psychotherapy is all about:

Better living through chemistry.

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If you enjoyed this post, please check out The People’s Therapist’s new book.

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An interesting question that touches on some basic Freudian theory:

I’ve been reading your blog for the past few months and I really enjoy it. I hope you can help with this problem that has completely stumped me.

Eight years ago I left an abusive relationship.  In general things are much better now, I don’t have nightmares anymore, and it doesn’t generally affect me on a day to day basis. Or so I thought.

I have a deep hatred for one of my coworkers that I was never really able to explain.  It suddenly occurred to me that he reminds me of my abusive ex.  That is, he reminds me of the way my abusive ex appears when you first meet him.  Friendly but in a really jokey way, a little awkward, a little self involved.  They’re like twins, on the surface. I try to tell myself that this does not mean he’s like my ex once you really get to know him, but it doesn’t help. I hate him. And now that I’ve realized why I hate him I only hate him more.

What can I do about this? I’d like to stop hating him but if I can’t do that, how do I handle it?

Thank you for your help,

S

And here’s my answer:

To submit a question to Ask The People’s Therapist, please email it as text or a video to: wmeyerhofer@aquietroom.com

If I answer your question on the site, you’ll win a free session of psychotherapy with The People’s Therapist!

Check out The People’s Therapist’s new book.

Read Full Post »

A therapist colleague recently agreed with me that the funniest things we’d ever heard were told to us by our clients.  Summer break (and the week of the bar exam) seems like an appropriate time for a laugh.  So…without further ado…here are some of my clients’ funniest utterances from the past few years:

  • (An Arab client) “Don’t worry, Will – my name is Saif (pronounced “safe”), so all the sex I have is ‘Saif sex!'”
  • “My mother did everything around the house.  If my father asked her to do an extra chore she’d say ‘fine, and I’ll stick a broom up my ass so I can sweep the kitchen floor at the same time!'”
  • “I prefer the term ‘MoHo’ – Fag Hag is so last year.”
  • Diet coke and vodka.  It’s a dieter’s drink.  Just order a “skinny black bitch.”
  • “My best friend and I played a game called “MFK” – Marry, Fuck or Kill.  You pick three random people and decide which you’d marry, fuck and kill.  But that got boring.  The new variation is ‘Oral, Vaginal or Anal.'”

  • “My husband’s an investment banker and works in Abu Dhabi half the year.  I’m a ‘gulf widow’.”
  • (A gay man, about his ex) “I tried to detard him.  That’s when you un-tard a retard.  Needless to say, I failed.”
  • “I’m a ShoMo – a big Broadway musical queen.”
  • (An obstetrician) “Dr. Jones, at your cervix.  Dilated to meet you!”
  • “I thought my boyfriend was a guido, going to Atlantic City to party with his yo-bro’s.  It turned out he was a ‘mo.  Those yo-bro’s were his mo-bro’s.”
  • “My boyfriend is kind of kinky.  I call him a ‘BOB’.  A ‘bend-over boyfriend.'”
  • (A leather queen patiently correcting me): “The phrase ‘ass-less chaps’ is redundant, Will.”
  • (On a Skype session with a client in Japan) “I feel like I’m having an earthquake.” “You mean, from the session?”  “No, the house is shaking.” (Indeed, she’d been experiencing an earthquake during our call.)
  • “When I was 11 years old, a bully beat me up and I refused to go to school the next day.  My mother told me we were immigrants, and I had to be brave.  She gave me a $10 bill and said, find a big kid and pay him to beat up the bully.”
  • “He wasn’t really hot.  He was “lawyer-hot” – as in, I was stuck at work and horny.”
  • “My friends have a party game – match the most unlikely Asian surname to a Western given name.  My personal favorite is ‘Tyrone Ramachandran.'”
  • “So he came on her back while she was sleeping and stuck the sheet on it.  That’s called ‘superman-ing the bitch.'”
  • “He rolled his foreskin over my foreskin – that’s called ‘docking.'”
  • Told by a woman with a particularly wicked sense of humor: “What do 9 out of 10 people enjoy?  Gang rape.”
  • “He tried to omelet me.  That’s when he comes in my ear and folds it over.”
  • Told by an attractive young blonde: “This cab driver in Rome asked me the time.  He was about 70 years old, four feet tall and didn’t speak English.  I shook my head.  So he gestured like this (facing the palms of his hands over one another like two people in bed) and said ‘meesh-meesh?’  Now I say “meesh-meesh” instead of ‘have sex.’ (So, eventually, did the rest of her therapy group, after hearing that story.)
  • “I’m Filipino.  I don’t talk about sex.  But we did stuff.  That’s all I’ll say – we did stuff.”  (…which is how “did stuff” became the official euphemism for sex in my other therapy group.)
  • (Asian client) “Once you’ve had Asian – there’s no more Caucasian.”
  • (Black client) “Once you’ve had white – you go white back to black.”
  • Client in my HIV+ gay men’s group: “My thing is low-hangers.  I love low-hangers.” (This brought the group to a stand-still.)

  • “I went to a meeting of a nudist book club, but it was movie night.”
  • “She DIH-n’t!” (Said by a gay Latin client.)  “Yuh-huh she did!”  (I was coached to say this precisely in sync with him.)
  • (A Cameroonian client) “My mother’s family tried to bury my aunt on our property, so they could build their house there – but we chased them off.  It is our land still.”
  • (A drag queen) “A sidecar, in a wine glass, with three cherries.  That’s a drag queen drink.”
  • (A young woman experimenting with swinging and group sex.) “He ‘Houdini-ed’ her.  That’s when you do a girl from behind, against a big window.  Then you pull out, and your buddy takes over, while you run around the front of the window and wave at them.”
  • “I suppose my boyfriend might have been more aware of my feelings if he weren’t FUCK-TARDED.”
  • (A plus size woman making light of her predicament) How is a moped like a fat girl?  They’re both fun to ride until your friends see you.

That’s enough for now.  You get the idea.  Enjoy your summer and good luck on the bar!

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A New York Times article from a few weeks ago holds enormous potential ramifications for lawyers bent over their desks at big law firms. The tentative conclusion of the piece was simple: if you are dealing with minor depression, or in fact, with anything other than massive, serious depression, popping anti-depressant pills is probably a waste of time. In fact, a placebo might do you more good.

How many lawyers are currently taking anti-depressants? According to the admittedly anecdotal evidence from the lawyers I’ve seen over the years in my private practice, quite a few.

It’s such a lawyerly thing to do. You figure out you’re depressed, so you do something about it – march over to your doctor, or maybe a high-powered shrink with a top reputation, get diagnosed, and get your pills. The whole thing takes a few minutes, and you’re back on the job. No wasting billable hours, no whining and complaining on a therapist’s couch – you take care of the problem and move on. Take a pill and knock it off with the martyr routine.

However, there are a few problems with anti-depressants…

First, like I said, they might not work. Don’t believe me? Here’s an excerpt from the article:

Some widely prescribed drugs for depression provide relief in extreme cases but are no more effective than placebo pills for most patients, according to a new analysis released Tuesday.

The findings could help settle a longstanding debate about antidepressants. While the study does not imply that the drugs are worthless for anyone with moderate to serious depression — many such people do seem to benefit — it does provide one likely explanation for the sharp disagreement among experts about the drugs’ overall effectiveness.

Second, the side-effects. This includes the “sexual side-effects” – which might mean, if you’re a guy, erectile dysfunction, and whichever gender you are, inability to reach orgasm. And there are “regular” side effects, too – like weight gain.

Third, anti-depressants only work while you’re on them. I’ve heard of people staying on anti-depressants for decades, but I have no idea what the long-term effects are because no one knows. If you’d like to experiment on yourself, I’m sure the pharmaceutical industry would be fascinated to find out.

Fourth, to the extent they do work, it’s by erasing feelings. Anti-depressants tend to narrow the bandwidth of what you feel, chopping off the top and the bottom – no more highs, no more lows. That can bring relief, but at a cost.

Fifth, other than the vague explanation that they “affect neurotransmitter levels,” no one really understands how they work. Anti-depressant medications, especially the new generation of drugs, are a relatively recent development, and the exact mechanism that produces the results isn’t fully understood.

Is there another option?

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