Monthly Archives: April 2015

“Hey Nineteen”

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“April is the cruelest month, breeding lilacs out of the dead land, mixing memory and desire, stirring dull roots with spring rain.”(T.S.Elliot). It is also the month of birthdays. My wife, two sons and two friends all have April birthdays. There is something about celebrating the day you are born. I still want to celebrate with all my loved ones, but there is something about my own that has lost much appeal. I remember as a child not being able to sleep because I was so excited about the gifts I was going to get. As I have gotten older my own birthday doesn’t mean as much. In fact I would like to forget this annual reminder of how old I am. There was recently a news story that 60 was the new 40. No it’s not, or at least there is a lot of deterioration between 60 and 70. Aging is highly over rated. Strange things begin to happen. Bodies and reflexes are not the same. It takes longer to recover. Memories come and go. All of a sudden a word, a picture, a fragment of a song brings back events of long ago.

I was talking to someone last week and all of a sudden I remembered a patient who came into our office building and lay down in front of the stairs to the second floor. She began weeping and calling my name. I had to be called out of my office to come and deal with her. I don’t remember much else about her except she was a difficult patient. In the same building we had just finished a group with some problematic adolescents. My colleague and I were called out into the hallway because they had started wheelchair races down the stairs. Another time a different group pushed a wheel chair with a smaller kid into the middle of an ice covered pond outside our building. Another time someone started a fire. I do not ever want to work with teen-agers again. I no longer have the patience.

This thing about memory is so strange. I can’t remember what I had for dinner, but events from years ago come flashing back. When my wife went into labor with our first son I was doing a staffing at the hospital. She called and said it was starting. I came home. We went to the hospital and they sent us home. We did this two more times before they admitted her. She had an emergency C-section. I remember hugging this rather distant female OB when she came out and told me that our son was born. It is so strange to think that he is now 38. Our second son was also a C-section. He was a scheduled delivery. When my wife was admitted to her room, the first phone call she received was from some guy trying to find out what birth control we used. He apparently was some type of deviate who had gotten the number for all the OB rooms. Thank God she hung up quickly. At that time there was a big effort to get fathers more involved in the birthing process. Since I was not allowed in surgery at that time for C-sections, the child was brought out and was to be given his first bath by me. The hospital hadn’t quite gotten this down so they brought out a trashcan filled it with water and gave me my second son. I put him in the water and he began screaming. I think he hated baths until he was 11 all because of that. He is now 34. How did both of them get so old so quick?

Memories of my own childhood come and go. I’m still surprised at some things my own cousins say and then it comes back to me. My father had his first heart attack in his 30s. Now we are not sure if it even was a heart attack and not something else connected with his poor health habits. He was a great guy but he was a chain smoker and drank too much. He really could never stop either one. I think a lot of guys from his generation grew up going to taverns and saloons. They were the social centers of the neighborhood. The smoking was what everyone did. His generation got really hooked while in service. My generation smoked because it was “cool” and almost expected. Everybody smoked. I stopped when my oldest son was in first grade. He asked me to stop because he learned in first grade it wasn’t healthy. I’ll always be grateful to him for that.

As I said memories keep flashing back. I know that even a smell can bring back memory of an event positive or negative. I have heard a lot of people have positive memories of cookies or bread baking. They talk about childhood and family events associated with those smells. I remember a patient who always had trouble in the summer during road construction season. The smell of asphalt reminded him of Vietnam and fuel for Helicopters. He would be fine all year until that season and then would begin showing up again with troubling dreams and increased anxiety attacks.

Music can do it too. Every generation has their own music. My Dad loved the big bands, especially Glen Miller. I think he always wanted to be a singer. “Stardust” was his favorite song. I have had patients tell me of breaking into tears hearing an old song and the memories it invoked. We had the Beatles, Stones, etc. In high school it was the Four Seasons and the Beach Boys. There really were two groups-the “Greasers” and the “Dupers”. I still think of “Help Me Rhonda” as one of my favorite songs. When we were dating there was a Rod Stewart song that played a lot -“Maggie May” -and we always thought of that as one of “our” songs. Whenever I hear it on one of the oldie stations it brings back memories of when we met—on a camping trip with a large group of our friends.

I think of all the stories I’ve heard over the last 40-60 years. I’m sure my family and friends get tired of hearing them, but as I have said , sometimes they just emerge. I don’t know when this is going to happen or what is going to come out. It’s like I have this huge hard drive inside my head just waiting to remind me of the past. I always heard about how for many seniors the past was more present than the actual present. Thankfully that’s not quite true for me yet, but I know all those stories are just lying in wait. This is still an unknown journey for me. I just hope my family can put up with me while I am going thru it. I think of the line from a Steely Dan song “She thinks I’m crazy, I’m just growing old”.

How Dumbo Left The Hotel California

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Do you remember the first movie you ever saw? I remember taking my 6 y/o and 2 y/o sons to see a Star Wars movie. My youngest son napped thru the first part and then woke up when the Ewoks appeared. He began talking loudly and stayed awake the rest of the movie.

I think the first movie I saw was Pinocchio. I still remember the start of the film. All of the old Disney films were hand drawn and were beautiful. They all had happy endings and promoted positive values. Cinderella, Sleeping Beauty, etc, all taught a lot about kindness and inner goodness. My favorite was Dumbo. The little elephant with big ears that everyone rejected. He finally was able to discover his talent and fly with help of a “magic feather”. I’ve often thought about that as a therapist. The “feather” obviously wasn’t what made Dumbo able to fly, but because he believed in it, he was able to. When he finally let it go he found that he had the ability to fly all along. I think that a lot of therapy is about giving someone a “magic feather”. If they believe in it strongly enough, change can happen. There are lots of techniques to do this from cognitive behavioral therapy to mindfulness, meditation and even anti-depressant medication. Some people report almost immediate results from the meds when we know most medication take from 3-12 weeks to achieve results. It’s the individual’s own belief in the ‘cure’ that is important.

There is a very old study about troubled couples deciding to enter therapy. The results of the study were that the decision to enter therapy often was at least as helpful as the therapy itself. Couples who were on long waiting lists often showed as much improvement as couples actually in therapy. The authors hypothesized that this didn’t show the uselessness of therapy, as much as it showed the decision to enter therapy was the key factor in achieving change—the “magic feather”.

There is still so much stigma attached to seeking counseling/therapy. It is still looked on a sign of weakness. We often had people trying to hide if from their insurance companies. I had people who didn’t want their spouses, parents, or children to know that they had made the decision to ask for help.

A lot of people would come in for their first session and be surprised that there wasn’t a couch in my office because that’s what they imagined therapy was about. The importance of helping people relax and begin to trust was essential. I would try to be as supportive as possible to help achieve this. The importance of developing trust and a developing a therapeutic alliance is what the beginning of therapy is all about.

The “magic feather” part comes later when the therapy is progressing. You get to know each other and talk about what is really possible. Not everyone can fly, but everyone has the ability to change. It just depends on how change is defined. In the hospital many years ago, a 16 y/o girl was admitted. Her parents didn’t know how to handle her and told us she was out of control. She was doing drugs, flunking school, and staying out all night. She was the youngest of four girls. Her sisters had all run away from home at 17 by leaving out a rear window. They would come home a year or so later with a husband, a baby, or both. The parents wanted their youngest to not make that same mistake. After she left the hospital she did well for a while, but then began to slip. Her parents were able to set some clear limits. When she left at 17, she left through the front door after saying goodbye to her parents. She had some additional struggles, but then settled down and has had a fairly successful life. Now this might not seem like an important change, but it was to her parents. They thanked the whole hospital staff for the change in their daughter when it was probably them that changed the most. It’s important to help people accept that they are the ones who are doing the work.

It’s very common for people to put their therapists up on a pedestal and give them all the credit for any positive change. I would always resist this. I had no need to be anyone’s false idol. We are all responsible for our own lives. Some patients don’t want to accept this. They want their therapists to “fix them”. The problem with taking credit for anyone’s success is you also make yourself liable for their failure. I didn’t want anyone to be that dependent on me. The decision to enter therapy is hard enough; the decision to stop can be even harder. In the old days therapists would see their patients weekly to semi-weekly (2x per week) for 90 minutes or longer. This could go on for years with patients making very small incremental changes. Now it is a lot different. Insurance companies and the real business of everyone’s lives wont allow that. I did have patients that came to see me for years and some patients only for months. I would tell them all about the Hotel California. “You can check out any time you like, But you just can never leave!” Therapy shouldn’t be like that.   Dumbo didn’t have to hold on to his magic feather forever. He was able to let it go and get on with his life. Therapy should be about supporting and encouraging you to realize your own strengths and abilities. You should always be able to leave when you get what you want. This doesn’t mean you can’t come back if something else happens. Just remember the address and phone number.

 

Once Upon A Time

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How we picture ourselves is important. The narrative of our lives is our own movie. I have seen my grandson and other small relatives literally change into various superheroes just by putting on a costume or even just a hat. They wont answer their given names any more. They have to be Batman or Captain America or Elsa from Frozen. As we all get older it is interesting to think how we define ourselves. What is our narrative? How do we get there? One of my first memories is standing in a playpen and watching Howdy Doody on a tiny black and white television. Buffalo Bob, Clarabelle, and the puppets that seemed so real are still very clear in my head. It’s hard to explain the part TV played in growing up. Saturday morning cartoons, Walt Disney, Davey Crockett, Roy Rodgers were all important parts of my childhood. Even in grade school we would come home for lunch and watch Lunchtime Little Theatre with Uncle Johnny Coons (until he showed up drunk one day and shared some new words for us kids). Our parents had the radio, but we had real TV. We didn’t have Batman costumes, but we had coonskin hats, cowboy hats, Lone Ranger masks or something similar. I think every one in my generation from the southside of Chicago has a picture somewhere of sitting on a pony with a cowboy hat.

On rainy Saturdays there were movie matinees on TV. Our parents could just park us in front of this small black and white box to watch a collection of B movies that all seemed to have the same plot. Jon Hall, who was also Ramar of the Jungle on Lunchtime Little Theatre, seemed to have a starring role in all of them. He was always a sailor/explorer/etc who endured some type of shipwreck/kidnapping/disaster and ended up with a native tribe. He would fall in love with the chief’s daughter. Everything would go well until this massive volcano or monster showed up. The only way to stop it was to sacrifice a virgin who was always the chief’s daughter. The rest of the movie was about their struggle to escape. They would endure fights with animals, reptiles, and nature itself to get out. As I got older I wondered if a simpler mechanism would just have been for Jon Hall to have sex with the princess so she wasn’t a virgin anymore – but that would have been a different kind of movie. It probably wouldn’t have made it to Saturday afternoon.

I often used the plot of that movie to talk about the role of savior and scapegoat in families. Both play very important parts and often have the same function of distracting families from the real problem. I would even use it in talking to women who were in abusive relationships and just couldn’t find a way to leave. I would ask if it was worth sacrificing yourself to calm a volcano who would still end up destroying the rest of your loved ones .I remember one very petite woman who was a construction manager for a very large company. She would end up bossing and criticizing all of these contractors who weren’t living up to her specifications. She was very successful at this job, but not so much in her own marriage. She had a very suspicious and abusive husband. He would continually accuse her of having affairs. He even put a tape recorder in her car to catch her. No matter how abusive he was, physically or emotionally, she stayed. When I asked why, she told me she had no other options. I began to tell her that she was like a female version of Clark Kent. She would start off from home in her mousy little outfit and somewhere on the way to work she would turn into Superman. Once there she was unbeatable. On the way home she would change back. This went on for about 15 months until she discovered her husband was the one having the affairs. She was then able to confront him and eventually divorce him. She continued to blame herself for the end of the marriage. She was unwilling to let go of that part of her own narrative that “if only I had done—“ the marriage could have been saved. She just couldn’t accept a new story.

The movie/story analogy is a good one. What happens if you’re stuck in a bad movie? Do you continue to watch it? Or do you walk out, turn it off, and go do something else? You can do the same thing with your life. It is just harder, but any story can be rewritten and there really are a lot of good movies out there. This again gets down to the ultimate question of how people change and when they are ready to do it.

Knee Bone Connected to the Thigh Bone

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Easter!! Rebirth!! Spring and Easter Egg hunts! This Sunday my sister had an Easter Egg hunt for her grandchildren and our grandson. It was absolute chaos with the little ones running around trying to get the eggs and eat the candy inside before their parents caught them. The children were all beautiful, charming, funny and wonderful. I think my own parents would have loved to be there. I still hear my mother’s laugh sometimes.
Ever wonder why when you least expect it, you hear one of your parent’s words coming out of your mouth? Maybe even think beyond that and wonder if it’s your parent’s words or their parents. Families are such organic entities. We not only share genes, appearance, personality, but also strange mixtures of all of the above. Anytime we have a family gathering I think of that. I see my own sons, my grandson, my nieces, nephew, and their children and begin to see all the various connections. Whenever a baby is born a female relative, (rarely a male), will begin this by saying. “He looks just like his mother, father, sister, grandfather etc”. The connections begin.
Then families begin imparting values, language, beliefs and everything else.
Sometimes families can pass on qualities and values that are not very positive. This can open them up to severe criticism from others who simply don’t understand where that has come from. My maternal grandparents emigrated from County Cork in Ireland in 1902. The reason they came is still somewhat mysterious. My grandfather was the oldest son of a farmer. Supposedly the farm would have been his, but Ireland at that time was suffering from overwhelming poverty. County Cork was also the site of much political turmoil due to still being under English rule. It is uncertain if they came to better themselves or to escape. He and my grandmother also sponsored a number of their relatives from Ireland so they could emigrate.

 

David & Mary BohanMy grandfather’s trade was listed as a blacksmith. Now this was in the beginning of the 20th century. Automobiles were soon to become regular means of transportation and blacksmiths were not needed as much. They had six children. Five survived. Their oldest son died as a child from heart disease due to complications from scarlet or rheumatic fever. They were able to buy a brick 2 flat on the south side of Chicago. They could augment their income by renting one of the apartments. They survived the great depression and were able to keep their house. My grandmother was supposedly a very good financial manager. She had to be. My grandfather had a number of different jobs in factories and as a watchman. He may have had a drinking problem. He certainly had some difficulty adjusting to the complexities of modern life. My grandparents depended on money from their older children to survive. Thus was due to my grandfather’s difficulty in keeping jobs and also to the economy of the times. They never saw any of their children get married and may have tried to prevent all of the marriages because of their growing financial dependence on their children.
In the post war period neighborhoods began to “change”. This meant that black families were trying to improve themselves by moving to nicer areas. There were “Blockbusters”. This usually meant the first black family to move into an area. This caused much conflict. Neighborhoods were strictly divided in those days into Irish, Polish, and Italian areas. There was concern that black families would not just take over the neighborhood, but also take over the few jobs available then. In the late 1940s this happened in my grandparents neighborhood. My grandfather had stopped working by that time. He was probably 70-71 years old. There was a riot due to a black family moving in. The police had to be called to control it. My grandfather went to see what was going on. He saw the police struggling with a young friend of his. He tried to intervene and was arrested himself. He was in jail at least overnight. This was devastating to him. He had his first heart attack shortly thereafter and was dead within six months.
Due to this and the circumstances of the times, the whole family had a strong prejudice against black people. The family moved and became part of the “white flight” from the city to surrounding suburbs. The “N” word was used frequently. Not only had our grandfather died, but we also all had to move out of our comfortable environments. This was the way we grew up. It took a lot to change. There was family resistance to that change and some family members still hold on to the old ways.
Our generation went thru all of the civil rights movements, assassinations, Vietnam, to struggle to make some progress. Our children are now often colorblind and can’t understand how anyone can have prejudice because of the color of someone’s skin, religion or their sexual orientation. There are obviously still remnants of these old beliefs and values in certain areas and groups, but there is progress. I am proud of both of my sons and their partners in the beliefs they all have. I see them being passed to my grandson. Someday he will certainly wonder where a certain phrase came from, but he hopefully won’t have to deal with some of the more negative values his grandparents dealt with.