Posted by fxckfeelings on March 8, 2010
In my practice, I give patients with ADD a special appointment option. Instead of their taking responsibility for keeping a regularly scheduled appointment (which means they’re obliged to pay full freight, with no insurance support, if they don’t show up), I encourage them to line up for a walk-in appointment which may keep them waiting longer, but won’t cost them a cent if they forget to come. It’s not that I discriminate, I’m just trying to make the best of things. That, to me, exemplifies the best way to deal with Attention Deficit Disorder, both for my patients and as a third party; keep your expectations reasonable, your appetite for shit bottomless, and your shrink understanding.
-Dr. Lastname
My roommate calls me the Ritalin vampire, because once my meds run out around 5, I become a different person (or really just a depressed, anxious mess). My mood drops so low so fast, and my nerves become so raw, that I have to drink just to get through the evening and get some sleep. It’s obviously driving my roommate crazy, but more than that, it’s messing up my life—I wake up hung-over, my boss is pissed, I feel sick all the time, so even when I’m not anxious and wired when I’m on my meds, I still feel like shit. My goal is to figure out how to get my ADD under control when the sun is down.
Most Ritalin users don’t have a terrible comedown with severe anxiety every time their meds wear off—what you have isn’t normal ADD, but ADD plus anxiety, plus, probably, alcohol dependence.
The medical term for your three-pronged disorder is a trifuckedta. Surprise, the prognosis ain’t so hot.
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Posted by fxckfeelings on March 1, 2010
A lot has been made recently about how it seems like every child is being diagnosed with autism; celebrities like Jenny McCarthy, whose son is autistic, have led the charge to blame and outlaw vaccines in order to protect kids. In reality, as science progresses and our understanding of the autism spectrum deepens, the disease hasn’t expanded, just the diagnosis, i.e., there aren’t more autistic kids, just more kids being called autistic. While today’s cases aren’t autism-related, they both illustrate the myth of the power of diagnosis. Focusing too much on what your disease is does nothing to improve your health. Incidentally, Jenny McCarthy has revisited her take on vaccines—it turns out her son’s diagnosis was wrong.
-Dr. Lastname
In the last ten years, I’ve heard voices in my head and most doctors describe my symptoms as psychosis, but nobody can tell me exactly what’s wrong, or find a medication that makes them go away, or really do anything but listen to me give them my laundry list of “how I’m crazy” and try to take the problem apart. In the meantime, I’m struggling to hold onto my job, my wife is struggling to put up with me, and my kids (now grown) just worry and get more distant. My disease stays the same, my life gets worse, my diagnosis goes nowhere. My goal is to figure out what is causing the symptoms, get a real diagnosis, and make real progress.
I wish the word diagnosis meant “we know what’s wrong and what to do,” but it often doesn’t, except in certain special cases. (Like, right now I feel safe diagnosing your reaction as disappointment.)
Very often, all a diagnosis means is that we recognize a group of symptoms that often travel together in the same social circle, and often get a little bit better when they’re treated with a particular group of medications. Tada.
That’s almost always true when the doctor making the diagnosis is a psychiatrist, because we know less about mental illnesses than almost every other kind of illness (and less about the brain then we do about any other part of the body).
We really should use some other word than “diagnosis,” but we don’t, because we love to think we know more than we do, which goes to prove that doctors are just as vulnerable to idiot false hopes as everyone else.
Some people put a premium on hope of any kind, but false hope is dangerous, because we pay for it with unrealistic expectations that lead to feelings of failure. You expect that, once you get the right diagnosis, you’ll get the right treatment, but I diagnose that assumption as bullshit.
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Posted by fxckfeelings on February 11, 2010
Parents instinctually want to protect their children from distress, but that doesn’t mean that help will do any good; some kids run to their parents in a panic at every loud noise, some kids are too thick to even know they’re in trouble. Either way, it’s the parents who have to be more practical than sentimental before they jump in. If only more people did that before they decided to have kids in the first place, I’d have a lot less business.
-Dr. Lastname
My daughter drove me and my husband crazy the other day. She’s a great kid who does very well in school, but at the beginning of every term she calls us up in great distress to tell us she can’t figure out what courses to take because the ones she really wants to take aren’t available and it’s impossible to make a decision about the others. So she did it again, and, as always, when we asked about the courses and made recommendations, she told us we were doing nothing but making her more confused and then broke off the conversation. I talked to my wife and she agrees we were careful to listen and we weren’t overbearing. P.S., the next day my daughter made up her mind and found a perfectly good group of courses to take, as usual. How can we help her get less distraught and see that we’re just trying to help?
Nobody wants their child to be in pain or agony, but it’s important to ask yourself whether it’s important if your daughter is…distraught.
Yes, her panic hurts her and it hurts you, but life is pain, pain is often unavoidable, and it’s not getting in her way, so why make it more important than it has to be?
It’s hard not to come running when a kid is crying, but this is a situation that’s familiar, always turns out well, and can’t be helped with a band-aid and a kiss on the boo-boo.
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Posted by fxckfeelings on February 1, 2010
Nobody likes to see their partner suffer (well, some people do, but that’s their own perversion), especially when that suffering isn’t just out of your control, but their control, as well. We all want the people we care the most about to be happy, but, as we’ve said many times, ensuring happiness of any kind is impossible, no matter where you live, how likeable you are, or where you went to college. In the almost-words of another (recently departed) Harvard alum, “love means never having to say I’m sorry (that you feel like shit, leave it to me to fix it).”
-Dr. Lastname
About 10 years into our marriage, my husband and I got inspired by a trip down the Snake River in Idaho and decided we should move there as soon as we could afford it. Something about the wilderness eased our hearts and made us feel safer and more grounded than we ever did in the city. Well, now it’s 15 years later, and we made the move to a beautiful house with a breath-taking view and no visible neighbors, and I found a way to telecommute to a job, but my husband still has to fly back and forth every couple weeks and spend at least half his time in our old city. The problem is that I can tell my husband’s not doing so well; he complains about feeling lonely when he’s on his own, and he’s restless when he’s with us, and then he blames me and claims the marriage lacks “spark,” and I can see the wheels going in his head, wondering whether he’s ever going to be happy. My goal is to get my husband to enjoy our new life as much as the rest of the family does.
The danger of any moment of happiness or inspiration is feeling responsible for making it happen again.
You got inspired by going to Idaho, so you think it’s yours to recapture whenever you want, forgetting about all the usual shit that you don’t control. So you plan for years and finally make the big move, and your husband’s “inspired” to wonder what happened to the big pay-off.
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Posted by fxckfeelings on January 18, 2010
People get demoralized when they feel they’re not getting what they deserve, be it pain relief or respect. It’s natural to go on strike and either A, start raging against the machine of injustice, or B, go the other way and surrender to a life on the couch in sweatpants and a snuggie. Of course, the resulting fall-out will feel like a side-effect of the original injustice, not a direct result of your tantrum, but you’ll be too high on rage/comforted by your snuggie to understand. Understand this now, before you protest; better to suffer the original injustice in peace than the further demoralization of unemployment, stiff drinks and a blanket with sleeves.
-Dr. Lastname
I have a dedicated husband, three teenagers, a nice house, a well-behaved dog—it’s not a bad life—but I’ve had a nagging sadness my entire life, and I still do, despite all the good things I’ve got. I deal with it, admittedly, by drinking a bit. I wouldn’t say I’m a drunk, and my drinking doesn’t interfere with my parenting or my marriage anymore than my mood does, but I know that what I’m doing is self-medicating. My husband wants me to see a shrink because he thinks I should take real medication for depression, but if my drinking doesn’t mess up my life, and if, despite all I have, I can’t be happy, anyway, then I don’t understand what makes one medication better than the other. My goal isn’t to be happy, just to withstand my misery, my way, right or wrong.
I understand that chronic depression, which is what we call “nagging sadness” in the biz, isn’t fun. It can make you grumpy, negative, unmotivated, scattered, and lousy at whatever you’re trying to accomplish.
All that’s excluding the pain, so no wonder it can demoralize you into seeing a negative future for yourself. It’s enough to make you want to turn “what the fuck” into words to live by.
If there was some way to relieve your pain that was risk-free and didn’t affect your other life priorities, that would be wonderful (for you—the aforementioned biz would probably dry up).
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Posted by fxckfeelings on January 14, 2010
Changing your habits is a lot like changing your physique; it takes a lot of hard work and effort, and after a while, most of us revert to our old selves, which means our habits/fat pants reenter our lives. Still, wanting to change or help someone change is not an entirely dismissable goal, it just requires a lot of will power, patience, and the right degree of responsibility for what you can and cannot control. In either situation, try to eat less fast food.
-Dr. Lastname
I love my girlfriend, but I noticed that she drank like a fish at parties and carried lots of credit card debt, so when we began to think seriously about getting married, I told her I needed her to cut way back on her drinking, stick to a budget, and pay down her debt. She was hurt, but since then she’s been doing what I asked, and we’ve been getting along well. What I’ve noticed since then, though, is that she’s lost some of her spark and generally seems less happy. I wanted to help her, not hurt her, but at the same time, I don’t know how we can finally get married if she still wants to act like an irresponsible kid. My goal is to help my girlfriend (or really both of us) without making her miserable.
It’s natural to feel responsible when your words do, indeed, wipe the smile off her face—instead of a diamond, you gave her an earful—but it’s a dangerous way to think because your words are also her best warning against greater pain to come.
So you’re right, there’s no way your marriage will work if she can’t control her drinking and spending, so your real goal isn’t to avoid hurting her feelings. Instead, it’s to protect both of you from creating a family just to watch it fall apart.
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Posted by fxckfeelings on January 11, 2010
We’ve often made the point that shrinks are doctors, not magicians, but we got a couple of cases this week take that point even further; not only aren’t shrinks magicians, they’re also people (and it turns out that surgeons are doctors and people, but really don’t want to be confused with shrinks). Not surprisingly, even doctors need a doctor once in a while, even if it’s an e-MD…with no magical powers.
-Dr. Lastname
I’m a therapist who takes great pride in being available and supportive to my patients, but I’ve got one who’s driving me crazy. At first, he thought I was great at helping him get more confident and functional, but lately he’s been slipping and drinking too much and fighting with his wife, and, instead of seeing me as a supporter who wants to help him control behavior that’s hurting him, he blames me for giving bad advice and being critical. I asked if he’d like to see a different therapist but he said he wants me to apologize and listen to him more carefully so I can make up for the pain I’ve caused. I’ve listened, and all he does is give me an endless earful about how badly I and other people have treated him and how I’ve made him feel worse, not better. I want to refer him elsewhere, but I can’t, because I wouldn’t wish this guy on my worst enemy but I can’t abandon him, and I don’t want to get sued or burn any bridges in what’s a pretty small professional community in this area. My goal is to get rid of this guy without feeling like I’ve abandoned him or triggering a malpractice suit.
If your goal as a therapist is to make people feel better, then it’s no wonder you’re fucked; as such, you’ll have no defense against the kind of asshole who feels you (or really, anyone but them) is responsible for their happiness and pain (mostly pain) and therefore deserves punishment when things go bad.
Under your rational exterior, you seem to agree that you’re responsible, Dr. Feelgood, so he’s got you, and he knows you speak his language. Asshole 1, Therapist 0.
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Posted by fxckfeelings on January 4, 2010
In fxckfeelings.com terms, most resolutions are just grand, annual wishes, not goals. Goals, as we define them, are realistic, while wishes are failure-prone yearnings that are usually best ignored. The holidays are over, and so are the excuses n’bullshit, so for our own New Year’s babies/cases, happy New Year, and it’s time to ditch these resolutions, stat.
-Dr. Lastname
My girlfriend got mad at me on New Year’s Eve and now she tells me it’s blown over, but I can’t believe her. I’ve always had these massive how-stupid-could-you-be thoughts that I can’t get out of my mind after I say something that might be stupid, even if it isn’t really stupid, but I keep on thinking about what I said and have to tell a friend about it and then, when they re-assure me, I can’t believe them and have to ask them again until it drives them crazy, and I start to worry about how stupid I sound to them, and so on. So my big New Year’s resolution was to stop myself from being so insecure, but now it’s happening again and, even though my girlfriend is a pretty uncritical person, I can’t stop wanting to ask her for re-assurance. My goal is to be able to tell myself that I didn’t say anything stupid and have more confidence in myself and finally become the person I want to be.
Many people don’t grow out of their “I-hate-myself-for-being-so-stupid” reaction, no matter how much they accomplish, or get reassured, or seek professional help. They never find out why they’re so stupid, but they never stop asking.
The reason for their so-called immaturity is a kind of painful mental tic that hurts like hell when it happens, and can’t really be prevented or eliminated (other than by lobotomy, which is a skill I’m trying to acquire, as soon as I can find a willing test patient/Jon Gosselin returns my calls).
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Posted by fxckfeelings on December 17, 2009
We keep saying that Christmas is hard on everyone, but that’s because religion is hard on everyone, no matter who or what you believe in, and religion is around all year long. Just because religion is hard, however, doesn’t mean it’s bad. It’s good, actually, because it expresses essential differences and gets people upset, confused, and heading towards my office.
-Dr. Lastname
I recently had to relocate my family for work, so we were forced to move from a fairly large east coast city to a small town nowhere near water (unless you count the great lakes). My wife and I are Jewish, and we’re raising our kids in the religion, but that was much easier where we used to live than where we are now, where our 12-year-old son, who was always a bit of an outsider, is now facing a lot of teasing at school for all the ways he’s different, which includes his religion. It’s been especially bad for him lately, given that the town is very Christian, with prayers before high school football games and lots of school-centered Christmas activities, and he’s even further on the outside of what the other kids are doing. As you may or may not know, Channukah isn’t Christmas—it’s a minor holiday—and we don’t try to pretend otherwise by giving smaller gifts and not playing it up so much. My son is younger than his age, though, and he likes to tell everyone he’s not interested in Christmas and then they pick on him and he accuses them of anti-Semitism and it’s a mess. My goal is that he should be proud of being a Jew while getting along better with people at school.
It’s painful to watch your kid get picked on and called a dork, particularly when he is a dork and does dorky things that you know are going to make his troubles worse.
If you tell him to shut up and keep his opinions to himself, you may be destroying the paltry remains of his self-esteem. If you try to get his tormentors to stop, you may stir up additional trouble.
You could argue that it’s your job, and society’s, to give him a positive school experience that supports differences in religion and personal style. I would argue that’s bullshit. It’s not in your power and idealistic expectations will often make things worse.
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Posted by fxckfeelings on December 7, 2009
At fxckfeelings.com, we’re never afraid to tackle the ickier topics; we deal with not just the feelings that come out of us, but the solids, as well (although often they’re equivalent). So if someone can’t hold it down or you can’t hold it in, sure, it’s an awkward situation, but it’s not the end of the world. You’re not responsible for what goes in or what comes out, just for what you do about it, whether it’s your problem or your neighbor’s.
-Dr. Lastname
I just started at college, and I like my roommate, but she’s bulimic and hard to be around. Not just because she’s sick (and everybody on the floor knows about her problem, it’s hard not to), but because when she binges, it’s on my food because that’s what’s closest, and she always feels really bad about it and cries that she wishes she could stop, but then she doesn’t offer to pay for it and it’s costing me a lot of money. Part of me just feels bad for her, because she’s clearly really messed up, but another part of me is pissed because I’ve lost a lot of money this year on food that she’s eaten and thrown up, and that just makes me feel guilty like I’m a bad person for putting my lost money above her health. I want to move after the break, but I don’t want her to feel abandoned. My goal is to help her and myself.
Welcome to that other part of college, Hard Knocks University, where the class Helplessness 101—what to do when you can’t help both someone and yourself, and sometimes you can’t help at all—is a frosh requirement.
The tough part is not the decision, but accepting the shitty nature of your options. Bulimia, like any chronic condition (depression, addiction, etc.) is not completely curable, not by you or certainly the patient herself.
If you buy into the psychobabble about body image and low self-esteem, you might think you could help her by praising her strengths, noticing her attractive qualities, or getting her to think about the superficiality and limitations of attractiveness. Ha!
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