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 4, 2010
We all have different standards for bad behavior; some people hate themselves for eating more than 1000 calories a day, while others don’t understand why you think it’s such a big deal that they drive drunk. While the opinions of those close to you are worth considering, the only true judge for what’s right and wrong is, surprise, you. Just as long as you weigh all the risks and benefits (and eat a cookie and/or call a taxi).
-Dr. Lastname
Do you think sex addiction is a real disease that needs therapy, or is it a way to make a big deal out of nothing that helps cheaters and the people they cheat on feel better while people in your business get paid? I love my wife—we’ve been together for almost 20 years—but I don’t think anyone would say I have an disease because I grab a little extra action if the opportunity comes along. I don’t think she knows I’m not faithful, it doesn’t happen that often, and I don’t think it hurts our marriage at all. It’s not like I have a steady mistress; I just end up going home with women I meet when I’m traveling sometimes, because it’s nice to feel young and like I haven’t lost it, whatever it is. As far as I can tell, everyone wins, because I feel better and my wife is less annoyed by my constant begging for sex. So my goal is to figure out if the way I live my life, which seems to be A-OK, is actually reason to go into rehab.
To rehab, or not to rehab. That is the question.
You’re raising the timeless question, and obviously, we’re not going to tell you to let your feelings be your guide, or, for that matter, your daddy, your minister, your rehab counselor, or your parakeet, Ray.
As to the validity of sex addiction, it either doesn’t matter, or it depends on your definition of illness. I define illness as something wrong with your body that’s personal, important, and out-of-control, and it doesn’t matter whether it’s cellular or behavioral, neurological or psychiatric. Or kinky.
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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 25, 2010
One of the worst parts of looking for work, either when your self-employed or unemployed, is putting yourself out there and hustling for work; ex-drug dealers have written scores of hip-hop records about the subject, and the product they were pushing sells itself. It’s hard to network with employers or push clients to pay up, but you don’t have to feel good about it in order to do it. Just ask Jay-Z.
-Dr. Lastname
My partner and I are interior decorators (the ultimate gay cliché, I know), and while we love what we do, we also love getting paid. That’s why it’s rough when friends and family ask us to come take a look at a room or their whole house and give them advice, because what they’re really asking for us for is free services, and as much as we love those we love…well, we also love getting paid and being able to eat. The two of us have talked about how it makes us feel like our loved ones don’t appreciate what we do, or think so little of it that they figure they should get it for nada, but at the same time neither one of us has the heart to turn anyone down and we’re afraid that if we charge them for what we do, they’ll feel hurt and insulted. My shrink says I don’t value my work highly enough because I have a problem with self-esteem. My goal—our goal—is to figure out a way to get enough self-esteem to persuade our friends, and ourselves, that they should pay us for our work.
If it were necessary to improve your self-esteem before being able to ask friends to pay for your services, you’d be in trouble; most self-doubting, sensitive, I’m-afraid-to-impose-on-friends wusses don’t change their personalities, even with deep, deep therapy and a dollop of Dr. Phil.
Unfortunately, as you know, your reluctance to mention fees to friends can spiral into paralysis and frustration. If you respond to your friend’s request for professional help by sliding into an informal, glad-to-help, enjoying-your-company mode, your friend will shoot the breeze for the sheer pleasure of friendship.
Before you know it, you’ve lost a huge number of billable hours and can only blame yourself, because your friend didn’t know that you have no time for this shit (or that your quality time in the friend world was “shit” to you professionally).
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Posted by fxckfeelings on February 4, 2010
If someone’s related to you, there’s no guarantee they’re going to be honest with you, or even honest about you to anyone else. You can try to get them to own up to their problems with anger, eloquence, and/or the help of the court system, but the smarter choice is to stop pushing them towards the truth and hold onto the facts yourself. As long as you’re calm and factual, people can draw whatever conclusions they want and your relatives can stick to their version, but your part in the family affair is settled.
-Dr. Lastname
I’m fine now (I’m 14), but I’m trying to figure out how to deal with a crazy father who physically abused me until a couple of years ago—that’s when my mother finally figured out what was happening and had me come live with her. The trouble is, I guess you could say my father doesn’t see reality the way other people do and he never remembers hitting me. In his mind, when he’d hit me, it was because I was trying to destroy him, so what he tells the judge is that he loves me and that my mother is a raging alcoholic who has brainwashed me to hate him (my mother stopped drinking after the divorce, years ago) and he really believes what he says. My goal is to get him to stay away from me and convince others that his version of reality isn’t real.
Kids aren’t the only ones who have trouble accepting the fact that we often can’t protect ourselves from scary crazy boogeymen, particularly when the craziness isn’t obvious, and the boogeymen are family.
We’ve said it here before: certain crazy people are not obviously crazy and are particularly good at persuading other people to see them as injured victims because they truly, truly believe they are, no matter what really happened. It’s a kind of sickness for which no one has the cure, and nobody feels sicker than the victims in the wake of these sickos, who don’t necessarily feel sick at all.
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Posted by fxckfeelings on January 25, 2010
If you hate someone or something for reasons beyond your control, then those feelings are, in essence, beyond your control, so resistence is essentially futile. Hating something is one thing, but then feeling guilty for hating, then angry for feeling guilty, depressed for feeling angry…so it goes down the feelings spiral, down the emotional toilet.
-Dr. Lastname
When I broke up with my girlfriend, I felt like I didn’t have a choice; she was smothering me, she made me feel guilty and like a bad person all the time, and I just couldn’t take care of her anymore. We’d been together for a relatively long time and I had reached the end of my rope (she’d even started hitting me and breaking things in our apartment). The problem is now that I feel even worse because, in the months since I ended it and she moved out, she’s started getting high a lot and has threatened to kill herself more than once. If she goes through with it, I don’t know what I’ll do with myself. My goal is to feel less awful about breaking up with her (which I did to feel less awful).
As a not-sociopath, you can’t feel less than awful about your ex-girlfriend’s drugging, depression, and self-destruction.
It’s the feeling responsible, as well as awful, that will not only do nothing to help her recovery, but will also turn your sorrow into well-entrenched, call-the-doctor depression. So…Dr. Lastname here, how can I help you?
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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 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 December 10, 2009
Most of us make a big deal out of apologies, but the sad truth is that “sorry” doesn’t serve as a guarantee of lessons learned or absolution, just a band-aid on our hurt feelings until one party messes up again. For all our emphasis on forgiveness, it’s hardly a virtue, Christian or otherwise, if it requires you to assume that people have more choices than they really do.
-Dr. Lastname
My daughter is turning into a petty criminal. She’s getting kicked out of school again, she won’t stop messing around with drinking and drugs, she has unprotected sex, and her boyfriend is probably the guy who broke into our house and stole our TV, though she refuses to believe it. My husband and I have tried so many times to get her to see what she’s doing wrong and steer her in a better direction—we’re our own private “scared straight” program at this point—but every time we confront her about where she’s headed, she says she feels terrible, that she’s sorry, that she never wants it to happen again…and then she gets wasted and everything repeats itself. If only we could get her to understand the harm she’s doing, maybe we could get through to her and turn her around. Meanwhile, it’s killing us. We try to forgive her, but it’s hard. My goal is to forgive her and get her to see what she’s doing to herself and everyone who loves her.
There’s no point in getting your daughter to see what she’s doing wrong if she can’t really stop herself from doing it, and she really, really can’t. You can’t scare straightness into a boomerang.
Regret and remorse will make her feel bad, and you might think that will stop her from fucking up next time. Well, au contraire, my dear unHarvard-educated sap. It’s not fair, but that’s the way it works. You should know that since you’re the one missing a TV.
According to Christmas movies and sentimental parts of the Bible, repentance leads to redemption, but I say, goddammit, that’s just wishful bullshit.
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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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