"Standing on Line to Get a Plain Slice to Stay": A Guide to Communicating with the New York Husband

The first time my husband and I went out to get pizza together I realized we had trouble.  We stood at the counter considering the menu and discussing crusts and toppings and sizes.  With the teenage cashier raising his eyebrows in that are-you-ready-to-order-NOW? manner we decided on two pizzas.  I would order one with my favorite toppings, and he would choose his.  I ordered the first pizza without incident.  Probably some combination like sausage and mushrooms and tomatoes and olives.  Then it happened.  The first of many future communication circuses.  Taking his turn to order the pizza he wanted, my husband looked directly at the cashier and said the second pizza should be, and I quote, "Plain."  Plain?  The cashier and I both stared at my husband in confusion and silence.  A few more moments and still silence.  I am not sure who asked first, but our mutual question was, "Huh?"  Or perhaps one of us asked, "What?"  And now it was my husband's turn to look confused, "What what?"  Back at him, "What do you mean 'what'?"  A few more rounds of this 'Who's on first?' schtick, and we finally began working together to investigate this mystery.  I was standing there wondering why in the world my husband would want crust with just tomato sauce on it.  My husband was standing there wondering why no one understood him.  And I am pretty sure the cashier was standing there wondering when someone was going to tell him what-the-heck kind of pizza we wanted so he could get back to checking his text messages.  After some further discussion that evening I came to understand that crust and sauce was not a "plain" pizza, and my husband came to understand that crust and sauce and cheese was considered a "cheese" pizza outside of New York City.

Before this incident I thought I had pretty good communication skills and some general grasp of the vernacular in different parts of the United States.  And then I married a New Yorker.  For anyone who is aware this unique language exists in the first place, a quick run through a search engine produces a number of results for 'New Yorkisms', but how do you know what you don't know?  I had no idea that sitting in my living room, standing in the kitchen, or walking through a park would become complicated events because a girl from the Midwest met a boy from NYC, and they attempted to carry on a conversation. . .

I have started a list of befuddling New York language for those of you whose relationships might be saved in the future or just in case you are traveling and find yourself trying to negotiate some sort of sanity in interacting with a New Yorker:

• "go inside" means going to another room (Note:  Please be aware, you are already inside and not outside when this phrase will be used, and any other room you are not currently occupying is the possible destination.)
• "run the dishes off" means to start the dishwasher (Note:  Not to be confused with scaring the dishes away.)
• "stand on line" means to stand in line
• "to stay or to go" means taking your food from a restaurant or eating it there rather than "for here or to go".
• "a slice" means a piece of pizza
• "plain" pizza means cheese pizza
• "pie" means pizza (Note:  I have not figured out how to describe pumpkin or apple or lemon meringue, but 'pie' is definitely pizza.)
• "bodega" means a small corner convenience store
• "sliding pond" means a playground slide (Note:  No ponds are near these.)
• “the floor” means the ground (e.g. When walking down the street with someone, and they drop a piece of food then pick it up your response should be “You can’t eat that! It fell on the floor!)

Additionally:

• "I live 'on' the Upper West Side" (Note:  No one lives "on Downtown", "on the Northeast", "on the Southwest", or "on [insert name of a neighborhood]".)
• "Jersey" is New Jersey, and while it wouldn't make sense to drop the "New" from New York only visitors or tourists say "New Jersey".
• "the train" is actually the subway, and anytime it's another train the actual name is used (e.g. Amtrak, MetroNorth, etc.)
• In NYC residents of upper Manhattan refer to 207 Street at "two seventh". This has resulted in visitors being told to go to the last stop on the A train getting out at 28th street.

If anyone has some more and can help a Midwestern girl out by sharing them my husband's patience thanks you in advance.  I'll get them added to the list just as soon as I go inside. . .

The Death of Happiness: Killing Our Children's Futures Device by Device

"Friendship? Yes Please." 

                                        ~ Charles Dickens

Now more than seven decades old, one of the longest continuous studies in the history of American Research is the Harvard Study of Adult Development, and one significant finding from this study is that a key to raising happy children and being happy adults is friendship.  

Collecting more objective evidence on the subject than researchers of any other study, The Harvard Study of Adult Development began in 1937, examining more than 268 physically healthy and "well-adjusted" Harvard sophomores.  Following its subjects for more than 70 years, this study has become the preeminent example of a longitudinal study.  Including the original study beginning in 1937, the study’s longtime director, George E. Vaillant, M.D. Professor of Psychiatry at Harvard Medical School, has studied adult development, including the lives of more than 800 men and women for over 60 years.  The consistent findings of all of this study show successful relationships are the closest thing researchers have been able to identify as the most significant key to happiness. Positive relationships beginning as early as childhood have shown to be the most important predictors of happiness and success as people age.

Brain science tells us that one way to make and keep friends is to be good at interpreting non-verbal communication.  Doing this accurately takes years of experience in face-to-face interaction with human beings, and studies in neurobiology have shown studying and playing a musical instrument increases this ability.  

Pausing to highlight two significant things I just said. . .

Doing this accurately takes years of experience in face-to-face interactions with human beings

and

studies in neurobiology have shown studying and playing a musical instrument increases this ability

Pausing to review what I just retyped. . .

Okay.  Nope.  Just making sure.  Still not there.  Text-messaging, internet chatting, status-updating, mp3 player-listening, television-watching, and video game-playing are not there.  Interestingly enough, these things don't fall into the 'face-to-face interactions' or 'studying and playing a musical instrument' categories.  So now I will pause for you to consider the implications that having increasingly plugged-in lifestyles has on our children's skills in making and keeping friends and, subsequently, on their current and future happiness.  

. . .Still considering?

And now I will pause for you to consider the implications that having families and parents and caregivers who fail to recognize, acknowledge, and/or take responsibility for managing technology in their homes has on our children's skills in making and keeping friends and, subsequently, on their current and future happiness.

. . .Still considering?

Children's ability to recognize and respond to non-verbal cues, forge and maintain significant relationships, and build future long-term happiness is being inhibited by texting, online chatting, and the assortment of other technological activities that are being done in front of screens rather than participating in activities or one-on-one face-to-face interactions with live human beings.  Sorry, 'Guitar Hero' does not count as playing a musical instrument.

What is it going to take for adults to begin showing concern and accountability for their laziness, apathy, and immaturity in parenting their children and become motivated enough to take action to make necessary changes?  Investment in your children's lives is not about dollars and cents.  Parenting is an verb, not a noun.  Parenting is hard work, emotionally-laden, and a challenge to be the grown-up.  Is it easier to give in to badgering about cell phones and game systems and wireless gadgets and gizmos?  Is the guilt gone about your long hours at work, or your depressed mood, or having your children grow up watching bickering parents?  Is your life "all better" because you didn't risk having your children not 'like' you or see you as 'cool'?  More importantly, are your children's lives better?  In an increasingly instant-gratification driven society do you sacrifice long-term happiness for 'happy now for now'?  Grow up.

Educational success ('Wake Up, It's Time for School') and now lifetime happiness.  What will be the next casualty of your teched-out home?

. . .plug in, turn on, and stay tuned.

Life on the Line: Negotiating Relationships with Persons With Borderline Personality Disorder

~
Borderline. . .

Feels like I’m going to lose my mind.   

You just keep on pushing my love over the borderline. . .

                                                          ~ Madonna - Borderline

A few days ago I discussed the difficulties with establishing boundaries and setting limits with persons in our lives who have personality disorders or personality disorder traits.  Fear, exhaustion, confusion, panic, apathy, and Guilt with a capital 'G' are intimate companions in the lives of  many people who resign themselves to existing in a sort of half-life as they enable and perpetuate the very behaviors that are sucking the life from them and the ones they love.


Complicating relationships and interactions involving a person who has personality disorder traits is the fact that personality disorders seem to like to congregate in herds. . .or in professional jargon, the APA states in the DSM-IV-TR, "Individuals frequently present with co-occurring Personality Disorders from different clusters."  That means there are typically more than one or two unpleasant behaviors grazing nearby, and our happy tranquil picnic is oftentimes interrupted by charging, stomping and snorting.  And what do we do?  Do we jump up madly waving our arms and charge, stomp, and snort our way into the melee?  Do we snatch up our watermelon, juggle our lemonade, and try not to trip over the blanket as we run lickety-split in the other direction?  Or do we sit still and quietly while hoping our warmth and compassion will be enough to slow the charge before we are errantly gored by a horn or crushed by a hoof?

Randi Kreger, owner of BPDcentral.com and author of the well-known books "Stop Walking on Eggshells:  Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder" and "The Essential Family Guide to Borderline Personality Disorder: New Tips and Tools to Stop Walking on Eggshells" has a blog on PsychologyToday.com.  After reading a recent blog on About.com by clinical psychologist Kristalyn Salters-Pedneault, PhD, in which Kristalyn voiced her thoughts and feelings after receiving what she described as "incredibly hateful" reader comments and email toward people with Borderline Personality Disorder.  Kristalyn  stated that she was "shocked by the level of vitriol," that "People with BPD deserve your compassion." and "Be grateful that you don't have to live with BPD.  And do something to help, rather than spewing out hate.  It's not helping you or anyone else." http://bpd.about.com/b/2010/12/23/have-compassion.htm

Randi dedicated a blog of her own to thoughtfully discussing the nuances involved in validating not only persons with Borderline Personality Disorder but also the persons who are partners and family members http://tinyurl.com/49y2c7t.  She asserts that these people are compassionate persons who hang in and hang on "Despite their BPD FM's (Borderline Personality Disorder Family Member') unexpected and unexplained anger; their impulsive, possibly reckless behavior; despite their inconsistent abandonment engulfment pattern; despite the fact the FM's (Family Members) often don't get their own needs met." Randi discussed healthy and unhealthy anger and grief.  All in all, a relevant and well  thought out discussion.


After reading Randi's blog I decided to take a look at Kristalyn's blog and comments as well as a NY Times article with comments that Randi had referenced.  As much as I appreciated Randi's and Kristalyn's thought-provoking blogs, I appreciated even more the discussion and comments by the people I consider to be the true 'experts' on this topic, persons having Borderline Personality Disorder traits and family members and friends of persons having Borderline Personality Disorder traits.  As a counselor who has worked with clients with Borderline Personality Disorder traits and diagnoses, but, most importantly, as a family member of persons with these challenges I find myself in the constant struggle of trying to balance compassion with limit-setting and maintaining a safe emotional and physical place for me and three 16 month old toddlers.  As the June 16, 2009 NY Times article by Jane Brody describes:

People with the disorder are said to have a thin emotional skin and often behave like 2-year-olds, throwing tantrums when some innocent word, gesture, facial expression or action by others sets off an emotional storm they cannot control. The attacks can be brutal, pushing away those they care most about. Then, when the storm subsides, they typically revert to being “sweet and wonderful,” as one family member put it.

"Brutal" attacks are indeed brutal, but that brutality may take a much more insidious form than overt aggression.  It is patronizing toward family members of persons with personality disorder traits to define "brutal attacks" as yelling and cursing and name-calling and slamming and throwing without understanding the more dangerous brutality in quiet, seething, passive-aggressiveness.  Ask anyone who is a survivor in a relationship with a family member who mixes up their traits-of-the-day potpourri with flavors from other personality disorders and metes out his or her brutality through ambiguity, “forgetfulness”, blaming, obstructionism (resentment and opposition), victimization (complaining about feeling underappreciated or cheated), stubbornness, , inefficiency, procrastination, sullenness, irritability, AND/or cynicism.

As I related in my discussion about personality disorders a few days ago, it is problematic to openly express genuine feelings about our personal experience of the chaos that oftentimes occurs in relationships with persons with Borderline Personality Disorder traits.  I described one of the reasons for this being because it is not 'politically correct' to say something negative about a person who has an illness, and in a timely manner I happen upon Randi's and Kristalyn's blogs and readers' comments discussing this very issue.  Sure enough, some people maintain that your sainthood will be revoked, and you may be burned at the stake for uttering a disparaging remark about someone with an illness. . .  Another obstacle to expressing  how we feel or describing our experiences may be because discussions with persons with these traits can oftentimes be quite frustrating and dangerous on many levels.   

Adding another layer of complication is being a professional counselor or in some other helping field because your family member may nastily complain that you are NOT his or her counselor, nurse, doctor, teacher, etc. AND THEN LATER nastily complain that you should be more "understanding" (i.e. allow whatever negative behaviors he or she wishes to exhibit at the moment) because you ARE a counselor, nurse, doctor, teacher, etc.  So to say that it is easy to vacillate between anger and guilt and empathy and compassion and exhaustion and apathy is an understatement.  Not only is it easy, but I maintain it is normal. 

Anger is one of the many emotions we experience when we are dealing with the up and down and back and forth and black and white of the Borderline Personality Disorder experience.  How we express that anger is the key issue.  You can feel angry and express anger without reacting aggressively - and aggression being not just a physical behavior but also an emotional tone and verbal script.  Although persons with Borderline Personality Disorder traits tend to balk against, be unable to tolerate, and launch an attack against anyone expressing anger or any sort of negative emotion toward them, if we do not remain genuine to ourselves we can lose our hearts and our spirits.  And, ultimately, we can lose the person we love with Borderline Personality Disorder traits.  I firmly believe that some people end up stuffing their feelings because they feel they cannot express them with full-on empathy and compassion, and this can become toxic and poison the interactions as resentment builds and builds.  It is certainly a precarious line to walk because you may very much want to be gentle and supportive while also taking care to neither enable nor perpetuate the unpleasant behaviors.

I have experienced the range of severe behaviors one might experience when having a family member with Borderline Personality Disorder traits, and I experienced many of the worst while pregnant with triplets.  Trying to stay alive in a world that doesn't make sense during the times when someone with Borderline Personality Disorder is having difficulties managing his or her behaviors can be a challenge, and there may be times that simply breathing seems to take more effort than you are able to expend.  So ensuring that you filter all of what you say can be a crazy unreasonable expectation for even the most compassionate of peaceful love-muffins.  I desire to be a person who thoughtfully responds rather than impulsively reacts, but the humanity in me allows me to have moments of ugly thoughts and accidental verbal vomiting. 

Do I sometimes feel so angry that I can't imagine ever feeling compassion for the evil monster my family members with personality disorder traits can become?  Yes.  Do I still love my them even after the unmentionable things I have experienced in the throes of personality disorder rages?  Yes.  And one of the reasons I can still find love in my heart and go on after a particular grueling episode is because I have looked within myself and decided that I am not an infallible victim of Borderline Personality Disorder.  What I am is a regular human-being with a full range of emotions who sometimes sits quietly hoping.  . . .and sometimes charges wildly with an occasional snort.

 

~ 

You cause me so much pain.   

I think I’m going insane.   

What does it take to make you see?   

You just keep on pushing my love over the borderline. 

                                                          ~ (still) Madonna - Borderline

Personality Disorders: To End or Not To End the Reign of Terror? That is the Question. . .

Let me hear from you.

Do you have something to say on any or all of these?  Or maybe something more to share.

• Who out there has been effected by someone. . .or many someones in their life who have personality disorders or personality disorder traits, or do you have a personality disorder yourself?
• What is the craziest thing that ever happened to you because of personality disorder craziness?  
• If you have been able to maintain something resembling a sense of humor, is there something funny that you recall? 
• What questions do you have about things?  
• And, most importantly, what have you done to survive?

I believe that of all the mental health disorders and diagnoses out there the most insidious and the most nasty are personality disorders.  Countless numbers of people out there have never been formally diagnosed, but there are legions of us who are still effected by these people with "traits."  You know the people, the ones who keep the pot stirred and leave a nasty taste in your mouth.  The people you dread being around and who you attempt to avoid entirely whenever possible.  The people who seem to suck the very life out of a room and color the world black with their negative energy.  These are people who create conflict and chaos and then are in crisis because they have been 'victimized'.  Or at least that is their story, and they are sticking to it.  And if you know what is good for you then you had better stick to it too because anyone who has had to deal with one of these people knows that World War III is not far behind any confrontation of this person's craziness.  And so, unfortunately, many people end up enabling and perpetuating the very nasty thought patterns and behaviors that need to be extinguished.

Why?  Why, you ask, would someone do ANYTHING that would allow these people to continue on with their crazy-making?  The answers are varied, but while it may be easier to just avoid the craziness of acquaintances and distant relatives and appreciate the built-in respite from co-workers when you leave the office each day, when the crazy person or people are your spouses/significant others, parents, children, or other family members with whom you are forced to frequently and more intensively interact then the situation becomes more complicated.  And overwhelming.  Some people allow these toxic persons to continue their reign of terror because they are immobilized by fear, exhausted, confused, panicked, or lazy, or they may have developed a self-protective sort of apathy.  Some people are either unable or unwilling to establish boundaries and set limits with these persons who poison everything in their paths.  Perhaps, similarly to the cycle of abuse and violence where the abuser acts out, expresses remorse, then promises change, and since no one is always 'evil' or always 'good', during those times that small windows of relief open up we are so busy catching our breaths that we can't mobilize into action.  Whatever the reason, at some point we all feel as though we cannot go on one more minute, but on we go.

Perhaps that is when we become sad, or perhaps that is when we get angry.  Sad as we grieve the loss of healthy relationships as they could have been or 'should' have been, and angry at this villain who would have us remain prisoner of our guilt for being mad at someone with a mental health disorder.  It is not seen as politically correct to 'blame the victim', and on some level most of us can rationally wrap our heads around the idea that the person with the disorder is a victim, but as the people with these personality disorders go crashing through our lives we are the ones standing. . .or sitting. . .or laying in the devastation while they dance off to create more chaos.  Sometimes with no insight but oftentimes knowing perfectly well what they are doing  they shout their innocence and demand retribution for their own victimization.  And what is too often lost in the effort to empathize with these 'victims' is the sight of the countless other victims left in their wake.

For myself, I know that while it has always seemed uncomfortable to me I have very different feelings and interactions when it comes to people in my personal life who have personality disorders versus my clients who have personality disorders.  While I can empathize with my clients with personality disorders, and I have even liked some of them quite a lot, I have almost no tolerance for people in my personal life who infect my space with their personality disorder traits.  Cognitively, I remind myself of all the things I 'know', but emotionally, I can't stand the distorted thinking and the crappy behaviors.  I don't feel especially therapeutic, and I want to scream, "Go get a therapist!"

When I was in graduate school a guest speaker in one of my classes was a private practice psychotherapist who specialized in working with people who had personality disorder traits and/or diagnoses.  Little did I know at that time that just a few years later I would find myself in a situation where I was receiving numerous referrals and requests from colleagues and other professionals to transfer clients to me because I had gotten as reputation for doing good work with clients with these specific challenges.  At the time I was listening to this speaker I found her to have some head-shaking interesting stories, but the relevance was lost on me since my focus was a tract in children and families and school social work.  I had no idea that in less than a year I would be beginning an 18 year career as a psychotherapist.

Of all the things she must have said that day I remember only one thing.  It stayed with me into my first job when I had one of those "A ha!" moments that quickly become an "Oh no!"  The adage that the ones who are hardest to love need it the most  was embodied for me on one particular day as I paced back and forth between my office and the front desk every few minutes wondering if she was going to show up late again and quietly hoping the phone would ring in the next minute with her leaving a message canceling until next week.  She was a young woman in her early 20s with a lot of issues she wanted to address (i.e. Me to 'fix'.).  To say that her appointments were draining was an understatement.  If she arrived at all she would typically show up for her appointments 30 to 45 minutes late.  Then she would make herself comfortable on the couch in my office and look as though she was settling in for a long winter's nap.  Okay, not a nap because a nap would have meant that I could relax a bit and be a little less vigilant about what she was going to say next.  And to be more clear, with people with personality disorder traits it is oftentimes not what they say but how they say it.  The actual crisis or events occurring in their day to day lives may indeed be distressing to even the most ordinary individual, but the subjective experience of people with personality disorders takes things to a different level.

To say she irritated me or to admit out loud that I just didn't like her seemed like a betrayal to all clients I had ever seen, would ever see, and most importantly to myself.  That just wasn't who I am.  I felt that if I didn't like her I was a complete failure as a therapist because what warm, caring, "good" therapist would not like another human being???  Isn't that somewhere in our professional code of ethics?  It certainly felt as thought it should be.  I felt guilty for even having the thought that I didn't like her and hoping on a weekly basis that she would either call to cancel her appointment or just not show up at all.  I knew that 'no-shows' were a "very bad thing" for community mental health centers who depended on keeping their sessions filled, so I heaped another helping onto what was slowly becoming a small hill of guilt.  But I couldn't deny the relief that would wash over me when I realized that I was free from our appointment together for one glorious week.  I mean how many times could one moderately sane counselor explain to a client that it was really a bit difficult to do any work in a 15 minute session?  And how many more times would I find myself pushing back the rest of my appointments for the day because as she slowly put her hand upon the doorknob to leave she glanced back over her shoulder and dropped some dangerous bomb out of her mouth.

I don't remember how long it took me to come to my "Ah ha!. . .OH NO!" moment, but it couldn't have been much longer than a few weeks because of the way our diagnosing system worked in that mental health center.  A few veeeerrrrrry long weeks.  And then it came.  I realized that I had the piece to this puzzle in my memory all along!  Yes!  This was exactly how she described it!  I recalled that guest speaker from my class somehow managing to look serious but yet slightly amused and telling us that a significant diagnostic indicator (not in any books, mind you. . .) for a person with a personality disorder was when you found yourself hoping the hell he or she would not show up for your appointment, and if that didn't happen then counting the seconds until your session was over.  Something else about that client exhausting you until you felt as though you wanted to crawl into a cave and hibernate until the next spring.  Or maybe the one after.  Check, check. . .and after a quick confirmation from the trusty diagnostic manual, yep.  There we have it.

I would say that this young lady was my baptism by fire into the realm of interacting with people with personality disorders.  And during our time together I developed a fondness for her, and she was able to make some amazing positive changes.  Within the next couple of years more and more clients with personality disorders kept being directed my way labeled as "difficult to treat" or "unsuccessful" with other counselors.  These clients seemed to be able establish relationships with me that helped them make improvements, and my personality seemed to lend itself to a good skill set and good practice that helped reign in the craziness of characterological, or what most people call personality, disorders.  Some of them you may have heard before:  Paranoid Personality Disorder, Antisocial Personality Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder, and Dependent Personality Disorder.  Then there are the less familiar Schizoid Personality Disorder, Schizotypal Disorder, Avoidant Personality Disorder, Obsessive-Compulsive Personality Disorder (not to be confused with Obsessive-Compulsive Disorder), and the most nasty diagnosis of them all, Personality Disorder Not Otherwise Specified, which includes both situations where someone may have mixed traits of several different personality disorders without meeting the criteria for one specific diagnosis AND/OR situations where someone meets the criteria for a personality disorder but the diagnosis is not included in the current diagnostic classifications - such as Passive-Aggressive Personality Disorder or Depressive Personality Disorder.

I will be talking in more detail about some of the specific disorders later, but now I am looking forward to what you have to say.  Please feel free to leave your comments here, email me at kristie@kristietalk.com.

Wake Up, It's Time for School

The 'Huffington Post' reported on 12/07/10, "Citing concerns over the country's education performance compared to other nations, and the long-term impact of the shortcomings on the future economic viability of the country, the Obama Administration has pushed for comprehensive reforms.

According to the AP,

"This is an absolute wake-up call for America," U.S. Education Secretary Arne Duncan said in an interview with The Associated Press. "The results are extraordinarily challenging to us and we have to deal with the brutal truth. We have to get much more serious about investing in education." "

Reforms? Investing? We do have to get much more serious. It is time for parents and families or caregivers to lay the blame squarely where it belongs. If they would pause their whining and complaining about the state of the educational system they could hear the faint whirrings and beepings and tap-tap-clickings that lead across their doorsteps and straight into the center of their own homes. . .desktop computers and laptops and notebooks, cell phones and game systems, and MP3 players. Pixels and screens and sound-bytes, logins and passwords and user accounts.

How many homes have a dictionary? And I don't mean online or via smart phone. What about a Thesaurus? I can still feel the thin onion-type paper pages of the old blue dictionary that sat on the bookshelf beside my father's chair for as long as I can remember. His mother bought that dictionary when she attended nursing school, and it was passed down to my father as he studied late nights after working long days for his Masters Degree. That dictionary with the worn blue cloth cover was the dictionary I looked to for spelling and definitions and the assortment of other interesting information and facts held in one of the many charts and graphs at the back of the book. I lost track of how many times I heard my dad's familiar words, "Look it up," and how many times I sat cross-legged on the floor or curled up on the couch absorbing the answers to the same questions countless little girls before me had asked countless daddies before mine. Consumed in my own world of wonder and worries and excitement and plans that is appropriate for children, I am certain I never considered the years and years and more-years-than-I-could-imagine that busy hands flipped through well-worn pages of dictionaries in homes much like mine and not so much like mine. And now consumed in my own world of wonder and worries and excitement and plans that is appropriate for mommies, I am amazed at the importance one book can have in a home. One very memorable night I argued with my father over bananas. Why, of course, everyone knew they were fruits. Except for my dad who told me I was quite wrong and to "Look it up." With a shake of my head and certainly a big huff and a sigh I plunked down on the floor to flip to "banana." I wish I could have seen my father's face as he sat in his chair behind my back while I read the words that I knew would prove my superior intelligence. . ."perennial herb". WHAT??? This was a beginning to just one of many many wonderful and interesting conversations I have had with my dad over my lifetime. And our worn blue dictionary oftentimes played a role in our talks as I was growing up. I found out peanuts grew under the ground and confirmed that tomatoes were fruits. I never asked my parents how to spell something and heard them spell it out to me. Instead I heard. . ."Look it up." Which means I had to know how to alphabetize. I learned that if I wanted to know the meaning of some unknown word in a book I was reading the answer was waiting for me in an old worn dictionary. And as I copied spellings and read definitions I saved this information from this amazing book somewhere in my memory. And it became knowledge.

When I began college I remember using another dictionary for the first time. A collegiate dictionary was on my required book list so I purchased one along with all of my text books from the bookstore on campus. As exciting as it was to have this new red book which had a spine that had never been creased and a title across the front attesting that I was a real college student as I now owned a real collegiate dictionary, I remember my thoughts wandering to home and knowing that a beautiful old blue dictionary was still sitting there on the bookshelf next to my father's chair. By the time I began graduate school computer monitors were still as big as small tvs, and the world wide web was a strange new concept that hadn't quite showed up yet. Spellcheck was included on some computer programs, but online dictionaries were a vision of the future scribbled in someone's spiral-bound notebook. Thank goodness. Because of my parents and because of that old blue dictionary I am a good speller who won the third grade spelling bee, my vocabulary is pretty good, and I love words.

So now how many homes have a dictionary? How many parents or families take responsibility for their children's education with the ways they guide and teach and interact with their kids? What examples are they setting? Why are Leapfrog and V-Tech in business? Why are there 9,880,000 results for "interactive educational kids' online games" on a popular internet search engine? What happened to flash cards and museums and zoos and planetariums? What happened to drawing and singing and playing and reading together? What happened to "interactive education" being about what is going on in the home with everyday interactions being teaching opportunities? . . .Or perhaps they are. Many children are growing up with families who are more connected to technology than to one another. Parents are using their smart phones around their children, and text messages, telephone calls, emails, and other social-networking interrupt interactions and conversations. I have seen parents walking down sunny sidewalks with children in tow while chattering away at the phone between their ear and shoulder. I have seen children eating in silence at restaurant tables while their parents stare at handheld screens while type-type-typing away. I have seen children tugging at their plugged-in parents' arms in unsuccessful attempts to get their attention for some amazing-to-a-child thing that crosses their path.

The "educational system" is in crisis? The educational system is a victim to lazy, apathetic, self-focused parents who refuse to manage technology use in their homes and do not accept responsibility for raising their children. For them, their responsibility stops at paying the bills and buying things. It is easier to plug their children in to some device with information rather than provide it themselves. Children and teenagers rely on Spellcheck and drop-down menus with auto-correct options. Search engines provide answers to questions that are mangled misspelled fragments by 'helpfully' "showing results for. . ."what should have been typed correctly. A glance and a quick click of a button is only one example of how the emphasis in learning has shifted from deep-thinking or processing to obtaining superficial knowledge fast. This process change effects people's memory and knowledge retention. Why would children be invested in putting in the time and effort to remember something when they can just 'search' for it again?

China and South Korea have declared internet addiction their number one public health threat. The United States' refusal to address or even acknowledge the very real existence of this problem underscores "the brutal truth" about the concern for and the commitment to the often lamented educational "crisis."

This "is an absolute wake-up call for America."

whirrrrr, beeeeep, tap-tap-click. . .Is anyone listening?

Murdering Peek-A-Boo

Piercing shrieks of joy and infectious fits of giggles dance through the air as three beautiful children crawl and toddle and tumble over me, each other, and countless toys littering the floor of the bedroom. Two shirts that have not made it into the dresser yet have been liberated from the laundry basket and are now priceless treasures clutched in somewhat sticky fingers and catching under knees and feet as they are determinedly being transported to their destination. With our bedtime story finished it would normally be time for kisses and hugs and rides in Mommy's arms to bed. But someone came skirting around the bed with a mischievous grin and a shirt to begin our newest favorite game - Peek-A-Boo. If one shirt is great fun then two is even more exciting so here comes baby number two with shirt number two and an impossible-to-ignore light of love in his eyes.

Sometime during the last few weeks the babies have discovered the joy of playing Peek-A-Boo. As children can be, they are most resourceful and will work together to push the side of their play-yard until they have gotten close enough to the couch to reach a blanket and pull it back through the bars or grasp a pillow and launch it over the top. If these items are not accessible they have been resourceful in using clean diapers, washrags, small cloth wipies, or most recently socks, shirts, or any other article of clothing within reach of baby hands. After securing a necessary cloth item to begin the game then someone places the item either on his or her own head or on someone else's head. If possible, covering more than one head at the same time is even more fun! A quick snatch at the veil to reveal the face underneath it results in a laughing symphony so lovely you find yourself holding your breath hoping it never ends. Just as much fun as revealing a face is the simple act of arranging the item on your own head or on someone else's head. And as socks do not provide quite the same coverage as blankets, and shirts have pesky sleeves that tangle and dangle about, covering the head or face is really just a general idea. Oftentimes the head and face are left uncovered completely as the Peek-A-Boo veil drapes around the back of a neck or flops over an ear. But no matter. The end result is the same - smiles and laughter and joy for as long as someone will play this wonderful exciting amazing game with you.

According to a study done by German Psychologist Dr. Michael Titze, children smile and laugh spontaneously 300 to 400 times a day while adults smile and laugh less than 15 times a day. Additionally, fifty years ago people laughed 18 minutes a day; however, today they laugh for only six minutes a day.

From the first day that I stopped in my tracks to watch this perfect joy that three babies were creating I pondered, and mentioned to others, and pondered some more a question that wouldn't leave me alone, "What in the world happens to us?" Not yet having seen search engines giving up page after page of references to studies supporting this finding that children smile 300 to 400 times a day while adults only smile less than 14 or 15 times a day, I wondered at my realization that something happens somewhere along the way that murders the joy of Peek-A-Boo.

What do we do to babies and children, or what do we do to ourselves that the joy of something like playing Peek-A-Boo is killed and replaced with the demand for more More MORE??? People have developed a sense of entitlement that breeds a "need" to be constantly stimulated in order to feel entertained. They must be constantly plugged in or turned on. Computers and MP3 players and video games are required. Television must include HD and cable and DVR. Cell phones must have internet access, and text messaging, and games, and calendars, and maps, and music, and books, and. . . Anything less is not enough. Blankets and socks lay forgotten, and silly food-smeared faces of people we love stay covered while empty hearts and thoughtless minds passively await their smile allotment from boxes and screens and little hand-held gizmos.

Magic Pill? *sigh*

Anyone who has been a client of mine has undoubtedly heard my soliloquy on "No Magic Wand." While there is no magic wisdom to impart, question to ponder, step to dance, or ceremony to perform for a quick fix to those thoughts, emotions, and behaviors that challenge our lives, there is also no magic pill. And on that point I am vehement.

Now, anyone who has been a client of mine would also undoubtedly know my stand on using psych meds. Absolutely, without a moment of hesitation, I believe that psych meds can be invaluable tools in our tool chest to help effect positive changes with people. I have seen adults who suffered for years since childhood and heard children themselves describe for me their tortured experiences until some psychiatrist happened upon the right medication(s) at the right dose for them and their particular difficulties. I have witnessed medications work what seems like 'magic' simply because the symptom relief may be so incredibly significant in the life of someone, but the danger lurking around the corner is the potential for someone to have tunnel-vision in his or her endeavor to get some relief from whatever is bothersome and rely solely on another pill.

While I would say that most of my clients took the long road and lots of repeating, cajoling, bargaining, and downright badgering to consider being evaluated for psych meds when I felt strongly they might be helpful, there has been the handful of others across my practice who showed up for their initial appointment, plunked down in a seat, and waited for the time they thought was 'right' to inform me that they didn't really think counseling would help them, but what they needed was a pill. Ummm. Well, that is not exactly the way it works. Yes, a pill may be a useful tool. I mentioned that already, didn't I? But it is like putting a bolt in without having a nut for the other end. Sort of useless in holding things together.

So when someone tells me that a pill is the solution for this or that I have to be careful not to either vomit on his or her feet, stand shrieking with fists full of my hair, his or her hair, a mix of hair, or a combination of vomiting and shrieking. The pill addresses a symptom. Under which is lying the cause. Which, if not taken care of, will not change and will be there bubbling away and waiting to potentially suck an assortment of innocent people along with the pill connoisseur into the mire when the timing is most sucky.

And let's face it, as much as I respect some of the psychiatrists I have known and feel confident that there is some good practice going on out there is it not completely obvious that evaluating for medications, prescribing medications, and then monitoring medications is their specialty??? And isn't it somewhat obvious that prescribing a 'helpful' medication is the solution a psychiatrist may recommend as front-line treatment? I do not think most doctors are above maintaining some measures of job security by suggesting their services are the best answer to the problem. Might counselors do this too? Sure. Most definitely. There must be slimy unethical professionals in every profession out there including counselors who might drag out treatment by scheduling session after session after billable session, but as I see it the chief difference in what a good counselor should be doing from what many psychiatrists are doing is that a counselor should be working from the first session to make himself or herself unnecessary to clients. If I am doing my job then my job is to get you to the point that you are ready to stop coming to see me. If a psychiatrist is doing his or her job then his or her job is to get you to keep coming to your appointments for medication monitoring.

So when someone I know told me today that his psychiatrist prescribed a psych med for being tired I was stuck somewhere between disbelief, dismay, and disgust. Eegads. Trying to keep the vomiting at bay and the shrieking under wraps I had a brief discussion about what exactly had transpired at the doctor's appointment this morning. Perhaps a little background information would be helpful first. This person has been going to appointments for over a year and a half with medication changes, dosage adjustments, and more changes and adjustments, and more changes and adjustments. Sometimes because the medication combination didn't seem to quite help mood and thinking, and sometimes because, as with many people struggling with mood and thought disorder processes, the patient had one of many new reasons to insist on a change. Oftentimes confusing, and sometimes making a shadow of sense, but nevertheless change it was. Then a good mix seemed to be found. More stable mood? Check. Less irritability and aggressive behavior? Check. Less distorted thinking and reactivity? Check. Both objectively and subjectively the reports were good that the psych med combo seemed to be what Goldilocks ordered. . . just right. And with this good result the person told me a few days ago that because the medications seemed to be adjusted so good at this point he was absolutely not going to have the doctor make any medication changes at this point; however, he did want to talk to him and get some ideas on what to do for the tiredness he was feeling.

During that conversation we discussed that, unfortunately, some of the unpleasant side effects of the medications that were working were tiredness, but the benefit outweighed the cost in this situation. We also talked about the fact that this person is in his late 40s and some of the tiredness that he may be experiencing may be the result of not being 20 years old anymore. And we talked about various things he had not been doing for his overall health that might help with feeling less tired such as diet, exercise, supplements, and nighttime sleep behaviors.

My belief was that he would be talking with his psychiatrist about his tiredness and desire to make no medication changes and hear similar ideas with, perhaps and hopefully, some interesting and useful other options we had not considered. To say I was taken aback when I received a telephone call saying that the psychiatrist had recommended addressing the tiredness BY ADDING A STIMULANT to the psych med combo is a nice euphemism (refrain from cursing in blog. . .refrain from cursing in blog. . .). Let me get this straight. The front line solution to feeling tired was to add a stimulant to a medication course for a patient with irritability, anger, and negative thought patterns. Ummm. . .

When I asked about the plan to not change the medication course the person tried explaining that this is why they didn't change any of the meds he was taking. They just added a new one. What? Apparently there is some alternate reality with which I am unfamiliar where adding a medication is not making a medication change. I did make an attempt to explain that "just adding a new one" did, in fact, change the chemistry of the combination and create a change with mood, thoughts, and behaviors. Perhaps for the better. Perhaps not. Either way, this change was going to effect not only this person but also significant people involved in his life. People who were beginning to be a little less gun-shy and a little more hopeful that there was going to be some consistency with the good changes that had finally happened after over a year and a half of appointments and adjustments. Now everyone was going to have to live with this adding-a-new-one-nonchange.

*sigh*

And my take on this -
A big jumble of inability to tolerate discomfort, self-focus, a desire for instant gratification, and laziness. Is it easier to swallow a pill than to exercise or eat healthier or take a vitamin, or stop the habit of drinking copious amounts of soda (so there are subsequent multiple bathroom breaks from sleep each night) and eating snacks in the middle of the night? Sure. But there is cost. Both with another prescription drug charge, more follow-up appointments with the psychiatrist to monitor this non-change, and, in my opinion most importantly, the impact on the relationships in this person's life if adding this pill disrupts the good thing they had going. So is it really worth it to just take one more pill rather than exert some effort? Wow.

Yes, psychiatric medications can be a positive life-changing tool, but by prescribing a medication for tiredness before looking at the bigger picture and considering the impact of adding more sludge to the mire is more suckiness. What a disservice we are doing to people if we are enabling them to maintain the illusion that there is a 'magic' pill so they can take the "easy road". . .to the mire.