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Goals, not wishes-- I'm a doctor, not a genie.

Thursday, February 9, 2012

The Giving Fee

Posted by fxckfeelings on November 17, 2011

Just as there are diseases that can compromise the human immune system, there are factors that can compromise our emotional immune systems, as well. If you’ve been abused or take too much pleasure in giving, you’re more susceptible, not just to bad relationships, but to more psychic damage from those relationships. There are ways for the emo-immuno-compromised to protect themselves by strengthening their minds and learning to avoid the kind of people that could hurt them the most. Until they develop a mental prophylactic, adopting strict self-standards is the best way for anyone to stay safe.
-Dr. Lastname

I was sexually abused quite a bit by my dad (and am de-repressing memories right now, fun-fun). I am realizing that I am very fearful of the people I love, and avoid them. Honestly, if I didn’t need to bond to keep from going insane, I would never have a close relationship, because anyone I care about enough can destroy me. But I’m in a lot of pain from loneliness as it is.

Many people believe there are tons of benefits to confronting your past, namely that it will teach you something that will bring catharsis to your present. The common notion being that if you can figure out what went wrong then you can avoid being victimized again.

The problem here is that reviving memories of sexual abuse by your dad will also bring back the old feelings of helplessness and having no choice, which, of course, is the opposite of your situation as an adult, so the lessons are the opposite of useful to your life now.

You’re not examining the past to drown yourself in feelings of helplessness, but to assure yourself that you can protect yourself from abuse. WAIT! There is more to read… read on »

Separation Anxiety

Posted by fxckfeelings on October 27, 2011

Intimate feelings should be a side-effect of relationships, not the other way around. When that intimacy becomes an end in itself, you forget, not just the other reasons why you’re spending time with someone, but the other things you need to be doing for yourself, your job, and the other people in your life. So the opposite of a strong attachment isn’t necessarily to break away, but to regain your sense of who you are and what you value the most, whether or not you’ve come down with a chronic partnership.
-Dr. Lastname

Approximately three years ago I realized my psychiatrist preferred other patients and liked other patients more than me. That realization was incredibly devastating to me. I want to deal with this reality, however, my psychiatrist keeps denying this is the reality and will not openly admit he does indeed prefer other patients. Part of me that hopes (wishes) this truly is not the reality (him preferring other patients) and I TRY to believe that what he says is the reality! However, I simply can’t believe him. I have told him I can’t believe something that I think isn’t true. Even though he has helped me immensely in many ways, and I’m extremely attached to him, I have lost trust, confidence and faith in my psychiatrist over this issue. I think he is preventing me from having the opportunity to deal with reality by denying he prefers other patients. I have a need to hear him say, “Yes I do prefer other patients and your observations/perceptions about this have been accurate.” I think if I hear him say these words I could actually work to deal with it. Since he’s obviously not prepared to say this, MY GOAL is to somehow “detach” from him, stop therapy with him and move on and forget about it.

When you do therapy right, a shrink is like a thesis advisor, helping you explore the toughest issues in your life until your work is complete.

If you lean on therapy too much, however (sometimes through no choice of your own), a shrink is a crutch, which makes deciding when and how to end therapy much more complicated. Remove the cast too early, and you still can’t walk on your own. WAIT! There is more to read… read on »

Guilted Lovers

Posted by fxckfeelings on October 6, 2011

The process most humans have for defining our sense of right and wrong develops with time; it starts with determining whether or not our parents are mad at us, goes to roommates, and then spouses (and after that, the law). One part of the process that should extend from cradle to grave (but often doesn’t) is consulting your conscience before you declare guilt or innocence. Sometimes it will protect you from false guilt; other times, it will tell you that, regardless of your rationalization, you’re guilty as hell (better to realize on your own without the law’s help).
-Dr. Lastname

I always suspected that I was attracted to women more than to men, but I liked my husband, and we’ve been good companions for the past 20 years. It hurt him deeply, however, that I wasn’t interested in him sexually and finally, when he pressured me to tell him what was wrong, I told him I thought I might be gay. Now he feels I lied to him, that our marriage has been meaningless, and he wants a divorce. Our life together is over and I feel totally to blame, like I’ve let down my husband and betrayed our marriage. What can I say to make amends?

There’s one important step people sometimes forget to take before making amends– asking yourself what you’ve done wrong.

Obviously, your husband is hurt and he thinks you’re to blame, but, as we’ve said many times, that’s the whole point of marriage—having someone to blame. Real sin requires knowing that you have something to hide, and that doesn’t seem to be the case. WAIT! There is more to read… read on »

Up In Smoke

Posted by fxckfeelings on September 1, 2011

It’s hard not to think of stoner weirdos as victims of bad choices who need a haircut and a good, tough talking-to. In reality, many misfits, potheads especially, have no control over the fact that life offers them no good fit for their talents and temperament, and the belief that they should have or could have done better makes them more passively resistant, unpleasant, and prone to mass consumption of tacos. So, instead of moralizing and breaking out the shears, confront their negative behavior by accepting the fact that stoner misfits are who they are while offering suggestions about how they can do better with themselves (starting with fewer tacos).
-Dr. Lastname

There’s a guy on my team at work who drags everyone down, but the boss does nothing to confront him, and it really prevents us all from doing good work. This guy does just enough to get by, and he sucks up to the other guys, so they’re somewhat protective of him. Meanwhile, he’s dismissive with me and the other women on the team and has a way of passing the buck to us, losing what we give him, and then blaming our hormones if we complain. No surprise here, he’s a heavy stoner and smokes during the day, but everyone at work seems to think it’s no big deal. I like the job and the people, but I’m afraid that complaining to our boss will be seen as petty and disloyal to our team. I don’t mind telling this guy to his face that I’m unhappy with his work and attitude, but it would just make him even nastier and impossible. At the same time, I don’t want to be silent just because the boys don’t respect what I’m saying. What can I do to make this work?

When you’ve got a job where you like the work and the people you work with, it’s natural to feel that the bad behavior of a single jerk shouldn’t be able to ruin it for you (and everyone else), let alone a lazy, sexist jerk with a drug problem.

Trouble is, his behavior can totally ruin it for you and everyone else unless your boss or other co-workers are reasonably good at managing his behavior instead of just avoiding conflict and sharing dumb jokes.

Unfortunately, as you may have noticed, they’re not really rising to the task so far, and that’s something you don’t control. At least it seems you’ve been good about controlling your own rage. WAIT! There is more to read… read on »

Relationship Rehab

Posted by fxckfeelings on April 6, 2011

When love goes sour but doesn’t go away, of course you want to find an answer that will set things straight, even if that means indicting yourself for crimes against your relationship that didn’t take place. As eager as you may be to plead guilty, don’t ever accept an indictment for love-crimes until you’ve given yourself a fair trial. More often than not, you’ll find your only crime is robbing yourself of your ability to move on.
-Dr. Lastname

For years (e.g. 9 years or more) our marriage has been almost completely sexless. Within the past few years, affection has largely gone out of the window too. Our relating is often bitter, and this happens in front of our poor 8-year-old son, too. I don’t think I can feel attracted to my husband again, even though I think we could be friends if he hated me less and trusted me more. My goal is to have a relationship with my husband that does not f*ck up our son, or a “healthy” separation from him which causes the minimum of damage to him (our son).

When affection and sex seem to have worn out of a marriage, you might immediately wonder whether or not the marriage is over. That, however, would be jumping the gun—a premature evaluation, as it were.

Before you go deciding a sexless marriage means no marriage at all, consider whether you’ve done all you should to fight marital fatigue.

That’s the fatigue that sets in from feeling like you’re carrying more weight than your spouse, letting him know, finding out he feels the same way, kindly offering to take over his job, and arguing to a standstill until things blow up again. It’s unavoidable in most marriages, at least those that do heavy lifting; after all, the main reason for marrying is to have someone to blame.

WAIT! There is more to read… read on »

Prudent Parents

Posted by fxckfeelings on January 24, 2011

As a general rule, the worst kind of advice is unsolicited, but when you’re a parent, it often feels like giving your two cents is your duty, even if no one asks for it. Of course, it’s hard to offer good advice to your children about touchy, questionable decisions they’ve already made. It’s amazing what you can say and get away with, however, if, instead of giving them a piece of your mind, you take the time to ask them questions about where their mind’s at without any negativity or judgment. Hopefully, you’ll come to a conclusion that makes sense to both of you, and you can save your two cents for a rainy day.
-Dr. Lastname

I wish I could be sure that my daughter is getting the right treatment for my grandson. He’s 7-years-old and been diagnosed with Bipolar Disorder and his doctor started him on a drug called Abilify, which has some nasty side-effects. I’ve read on the internet that Abilify can be harmful to kids and I wish my daughter and her husband would think twice before allowing themselves to be talked into using it, but I don’t want to intrude into their decision. My goal is to make sure my grandson isn’t harmed.

Never ask someone if they’re sure they know what they’re doing, because if they weren’t sure, you wouldn’t need to ask in the first place.

If you do end up asking your daughter why she’s exposing her son to a dangerous medication, not only will she answer yes, but she’ll give you an annoyed earful as to how she’s doing the right thing, how you don’t know what you’re talking about, and how you should just mind your own business.

She might not know what she’s doing, but neither did you when you opened your mouth.

WAIT! There is more to read… read on »

Med Dread

Posted by fxckfeelings on September 30, 2010

There’s something about the decision to take or not take medication that makes people very reactive to feelings, both theirs and others, instead of just weighing the important stuff, like the risks, their symptoms, etc. The only good way to make medication decisions is to think about what will happen to you without them and decide for yourself what will do you the most good. Until the day others can feel sick on your behalf, their reactions to your own carefully thought out medical choices shouldn’t come first.
-Dr. Lastname

Given all my issues, I’m not doing so badly, although it’s true I have a $400/week speed habit. Even with that though, I’m doing well at a demanding, high-powered job, meeting all the overtime demands, and then, at quitting time, when I’ve gotten paid and don’t want to feel bored or alone, that’s where speed comes in. A few years ago, I had a crazy, manic mental breakdown and they started me on medication, which I’ve taken regularly, but I’ve been doing fine ever since, my mood is great, the speed hasn’t bothered me, so I don’t see why I can’t start cutting back on the meds. That’s my goal: to feel OK without meds.

Whether it’s bad for you to use speed or stop your bipolar medications depends a lot on what you believe you need for your future survival, assuming that you care about it.

Since I don’t think that’s a safe assumption, let’s assume you’ll at least consider caring about it after you read my response.

WAIT! There is more to read… read on »

Second Story

Posted by fxckfeelings on June 14, 2010

While most people have multifaceted personalities (or should), there are an unlucky group whose personalities aren’t so much nuanced as they are binary; fewer shades of grey, more Jeckyll and Hyde. If you’re dealing with someone who’s double sided, or trying to hide a part of yourself from the world, it can feel like a never ending battle to reconcile and/or expose both halves. Occasionally, it’s worth exposing your secret side to end your own torment. Other times, it’s better to let people keep their Mr. Hydes to themselves if it means keeping their drama out of your own life.
-Dr. Lastname

Most people thing my mom is really fun, if a little flaky and emo, but they don’t see how crazy and mean she gets when there’s no one around but my brother and me (my parents are divorced). When she’s in a bad mood, she tells us we’ve been mean to her, and reminds us of things we’ve said that hurt her, and tells us how bad we are until we’ve apologized, and then she forgets it ever happened. There’s one cousin who’s seen what she gets like and I rely on him to remind me that it’s OK, she’s crazy, but the other day he seemed charmed by her and then, when I complained, he told me I had to get over her and not be so angry, and now I feel totally unsupported. My goal is to get someone to understand what’s going on.

Nothing gets people more stirred up than dramatically pitched false accusations and punishments by a powerful, inescapable, totally two-faced authority, like your mama.

The good news is that, while you’ve got the makings of a perfect soap opera, it sounds like you’re not getting swept away by it.

The trouble with soap operas, of course, is that they trap the good guys into endless rounds of angry, hurt reactions to crazy bad guys. In the process, they take up huge amounts of time and energy for tears and talk, talk, talk before, finally, there’s a glimmer of comfort and validation…before the cycle starts all over again.

WAIT! There is more to read… read on »

Pathetic Genetics

Posted by fxckfeelings on May 24, 2010

Parent/child conflicts can get particularly brutal when people are scared for and determined to save one another. Emotions run stronger, stakes are higher, and the gloves are never on. Instinctively, kids and parents fight for control and submission, and regard it as defeat to accept a new reality and get over it. The reason the instinct is so foolish is because control is impossible, so the battle becomes endless. Conflicts like these need to be handled with great care; they must call them kid gloves for a reason.
-Dr. Lastname

When my mother starting dating my soon-to-be-step-father, I was upset. It’s not just that my father had only died six months earlier, but that this guy was clearly a user and a nowhere near good enough for her. I’m in college, so at least I didn’t have to live under the same roof as this jerk, but I’ve already gone out of my way to avoid him and it’s really annoyed my mom that I haven’t tried to get along with him. Plus it means I’ve spent last time with her, and we used to be really close. When she told me they were going to get married, I freaked out, and now she’s says that if that’s how I feel then I’m not invited to the wedding. I think what my mom and I need is a face-off to get everything on the table and sort out this mess. My goal is to get my mom back.

You’ve got every reason to worry about your mother’s taste in men and its impact on your relationship; after all, her choice has the potential to cause you (and possibly her) great pain, at a time when you’re grieving your father’s death.

Unfortunately, however, all you can do is worry, and after that, you’re fucked. There’s nothing you can do to make things better and lots to make things worse.

WAIT! There is more to read… read on »

Therapists’ Turn

Posted by fxckfeelings on May 3, 2010

Poor, well-meaning, dedicated therapists and the patients who love/destroy them. After all, it’s enticing to let someone persuade you that you’re their guardian angel and the only therapist that can help. It’s a fun ride for everyone, at least until you realize that you’re responsible for something you don’t control, and they’re even less responsible than before for dealing with reality as it is. While this is a shrink-based site, we are the first to admit that therapists are not perfect people, especially when they get in in their heads that they actually are.
-Dr. Lastname

I have a 30-year-old patient whom I’ve been seeing in weekly psychotherapy for 6 months and he had a terrible history of sexual and physical abuse and years in state care. Amazingly, despite all his trauma and several prior failed treatments, he settled into a trusting relationship with me. He tells me I’m the first person he’s bonded with, and he’s been able to stop using cocaine, and, for the first time, sees some hope for himself. The problem is that he just got a new job, and I’m not covered by his new insurance plan. He wrote me a letter telling me how much he feels his recovery depends on continuing the treatment we’ve started and I feel professionally obliged to put his welfare ahead of my financial needs, but I’d like to get paid. My goal is to do right by my patient, and not trigger the feelings of abandonment that underlie much of his negative behavior, but I’m not sure how long I can afford to see him for nothing.

There are many therapists who believe the best thing you can do for a troubled patient like this is to “be there,” providing the steady acceptance and secure relationship that they need for healing. I’m not one of them.

The sad fact is that the healing power of currently available treatments is vastly over-rated and a good example of false hope and the harm it can cause.

WAIT! There is more to read… read on »

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