Monthly Archives: January 2015

Mirror,Mirror

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Lately I have been thinking about mirrors. I do believe my job was to create a mirror for people to see themselves clearly, or at least how they presented to me. The whole mirror thing got me thinking of the sex clinic we had at the hospital. We started because one of the Doctors had an in at Loyola with Dr. Domeena Renshaw. She was one of the leading sex therapists in the world and her sex clinic at Loyola was world famous. Four of us were chosen to go thru the training there. We would each be paired with a physician in training and given a couple to work with under Dr. Renshaw’s supervision. The clinic was mutual education for the couple and for the therapists. There was plenty of didactic material presented along with standard relationship therapy. However one session involved the therapist being present at a complete physical with the couple.

The physician examined each member and the therapist assisted. This was a “Complete” physical. They had to strip down to a hospital gown and the MD would examine them completely. The non MD (me) would assist as much as possible. When the woman was examined. I had a specific role. I had to hold up a full length mirror and the MD would carefully indicate and explain the function of each body part. The first time I had to do this, I began to experience extreme anxiety. My Irish Catholic genes came out full force. The temperature in the exam room must have gone up to at least 120 degrees. I did get thru it .Dr. Renshaw thought it was an important part of the whole process, both to educate the couple and to increase the bond between the therapeutic team and the couple.

After we completed the training, we returned to our hospital and started our own sex clinic. We used the Loyola model and the complete physical as part of the program. I still had to hold the mirror. I was never really comfortable doing it, but I did understand the reason for this. I tried to talk my wife into me holding a mirror for her so I would be more comfortable, but she wanted no part in it She thought I was just trying to use this as another excuse to have sex. She didn’t understand the real clinical reason (right!!)

One time we were working with an elderly couple. The woman, who was probably in her late 70s,was not thrilled with me being in the room. I tried to comfort her and explain the process. I certainly was not excited with an elderly woman stripping down. I held up the mirror for her and I still remember what she said. “Now no peeking !!”. I began to laugh and the mirror started to shake. I was able to complete the exam and I dont remember if we helped the couple , but they did complete the program. Dr Renshaw always said she never thought she had a clinical “failure” if the couple practiced what she said. The sex clinic at the hospital only lasted a few years because the supervising MD left and we became incredibly busy with our addiction program and had to stop participating. Other therapists were trained, but the hospital didn’t have the same level of commitment as when we started.

Thinking back , our clinic was pretty tame. Dr Renshaw wanted us to be very sensitive to the couple’s beliefs and the whole clinic was structured around gradually increasing their ability to communicate. The mirror image transfers pretty well to the therapy experience. The therapist has to be able to hear what the patient is saying. If you don’t understand you have to question and clarify until you do. How you do it is the secret. If you can bond with the patient and establish trust, the therapy can really begin. If you can present the mirror image clearly the patient can decide how and if they want to change.

Polyester

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We spend a lot of time looking at other people and judging them and we are often wrong. We also spend a lot of time thinking about how others see us, and are even more wrong .I know a lot of women who really think they are fat and will not hear otherwise no matter what their husbands say. This is not only true of women, but also of men. After graduate school I had to apply for my first grownup job. I had taught for a few years, but that was not the kind of job I thought was serious. Real teachers worked at it and thought of it as their career. I taught religion and philosophy to high school girls. I didn’t really prepare much and usually just winged it. I also dressed in the most casual way possible, had fairly long hair, lived with three other guys in a basement apartment, and thought that this was life. I still had some of the hippie “Don’t trust anyone over 30” stuff going on

Then I met my wife, got married, and finally had to get serious. So grad school happened and I had to go out on job interviews. I got a hair cut (razor cut—because that’s what I was told would make a good impression) and wore my one suit to the interviews. Now this suit was a polyester thing of beauty. I had gotten it to get married in and only worn it a few times. During grad school I had lost some weight, but that just meant I had to pull in the belt on the pants more. So I went to these interviews in all my polyester, razor cut glory. I was nervous but kept thinking that at least I was dressed right.

I had a few interviews and was offered jobs that didn’t quite fit, Then I was offered an interview I was interested in. A prominent hospital alcohol unit was looking for a social worker. The woman I interviewed with was younger than me, but had much more experience. I wasn’t sure how the interview went but somehow I did get the job and worked there for almost 20 years. It was only later that I found out she had laughed, like my wife, at my baggy polyester suit. It was a joke shared on the unit for many years.

The unit was a twenty bed 21 day inpatient program for alcoholics. It was based on what is now known as the “Minnesota” model. During the time I was there I learned a lot about individual, group, family therapy. I was sent to an additional two-year training program in family therapy, and a special program in sex therapy. I went to countless in-service and other training programs, but I can honestly say that I learned the most from the people I was there to help. Everyone of them had a story. Some of them were there to escape consequences from family, job or legal problems. Some of them just needed a place to ‘cool out’, but they all had stories.

One time one of our doctors proposed a small research project. He asked us to rate the chance for success (continuing sobriety) for each patient as they completed treatment. Now the staff was made up of medical professionals and addiction specialists. We thought we knew for sure who would make it. We did this for almost a year and then looked at our results. To our absolute amazement we were incredibly wrong.

Patients who had strong support systems, good jobs, health and real sincerity often didn’t stay sober a month. Other patients who appeared to have nothing, often turned their lives completely around. This led to one of my obvious insights in that people have to be ready to change and have to be willing to pay the price. Maybe the therapists role is to keep holding a mirror up so a person can see who he/she really is. We all know this, but an awful lot of time we forget. Sometimes the job is just to put out enough stuff to help people look at their own lives and decide what they want—like finally making a decision to throw out a polyester blue suit.

Rocks and Doves

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I remember the summer before I started Graduate School was fairly intense. We were married about one year and money was very tight. I had been teaching in a Catholic high school for three years and this was not going to be a long term career choice. I think I finished there making about $6500.00 per year. My wife was making between 8-10,000.00 and having a family was really not going to be possible with our limited resources.We both agreed graduate school would open more doors. I was accepted into George Williams School of Social Work and would start in the fall. After my high school class finished I was able to get a summer job as a security guard thru one of our friends. I was probably the worst possible choice for this. This was during my post hippie peace and love days. One of the jobs required us to wear a gun. On our rounds. I would carefully remove all the bullets before my round. Thankfully I never had any problems. The one good thing about the job (besides the pay) was it gave me time to read. George Williams had recommended a number of books to read before starting class. I just remember Freud’s Interpretation of Dreams and General-Introduction to Psychoanalysis. I would read and study these books and pictured myself in the analyst mode.

The first week of school I was given a field placement at Hines VA Alcoholism Treatment Center. At that time the VA was vast—almost a totally separate city. I found out that there were people who literally would go from VA facility to VA facility depending on the season. They would have a summer VA and a winter VA. This was happening right after the Viet Nam war ended. Vets from that and from WW2 and Korea were the patients.

So I started in all my new found Freudian grandeur. My first patient was an African American guy in his forties. He had been thru a number of programs without any real success- by our standards. By his he had found a way to survive. Our first few meetings consisted of me sitting in an old desk chair and asking him questions. I would sit in this chair and ask a question and rock back in the chair while I waited for him to answer. The chair was quite old and the floor it was on was old linoleum tile. One day I rocked back, the chair slipped and I ended up flat on the floor with the wind knocked out of me. My “patient” was standing over me inquiring about my welfare. I don’t remember much else about him or the course of his treatment. What I do remember is that it was the start for me of not taking myself too seriously

I think it is important to have a theoretical framework, but that framework should never come between meeting a person where they really are. In the beginning we all think we have to have theories and techniques. In the end we realize that the most important therapeutic instrument we have is ourselves.

There is an old story about Picasso walking along the beach with a reporter. The reporter asks him where he gets the ideas for his creations. Picasso picks up a rock and asks the reporter what he sees. The reporter says “A rock” . Picasso says “I see a dove” . The reporter is confused and asks where is the dove. Picasso says “I just take this rock and carve away everything until the dove appears”.

I am still chipping away at my rock. Sometimes the dove is very clear and sometimes not so much—I just have to keep chipping.

Long Time Between

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So I haven’t written for a while .—at least since April of 2013. Now I feel the need to start again. I have been retired for almost two years. We’ve traveled to Ireland, Scotland, Great Britain and Wales. We recently came back from a month in France and it was all great.

However I need more structure and perhaps this will help. I have often had the fantasy of being able to write. I know the only way to become a good writer is to write regularly. So maybe I can push myself. We’ll see

This retirement thing is still strange. I really don’t want to work again. That time is done. I don’t think I could see 35-40 patients a week. The farther I am from it, the more I see how I literally was swallowed up. I went back to visit two or three times. People said it seemed like I had been gone longer than 2 years. When I questioned them they were surprised at how long they had been working at the clinic .

I think the routine of seeing large numbers of patients for therapy begins to distort time. You do pay a price in your personal life. Thankfully I have been able to reconnect. I really thank my wife for that.

One of my friends and his wife had a long relationship with a therapist. After she retired they continued the relationship as ‘friends’. This lasted until one time they disagreed with some of her “advice’. She then insulted them and basically discounted all the work they had done. I told him there are a lot of messed up therapists. A lot of time we go into the field to help work on our own issues. Sometimes it works and sometimes it doesn’t. Too often we can get the impression that we are “always right” about other peoples lives—that, in fact, our advice is infallible. I think it comes from seeing too many people who don’t confront us about what we say and do.

I remember coming home one day when I was in graduate school. I think I was in counseling 101 or some other starter class. My wife had had a bad day at work and I tried to use some Rogerian techniques on her. She told me quite clearly to “leave that shit at work—I am not a patient, I’m your wife!!” I have never forgotten that. It s important to have people in your life that keep you grounded and I am grateful to those that were there for me