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Saturday, November 30, 2024

Shut Up! Week, Part 1

Posted by fxckfeelings on April 12, 2010

Discovery Channel always does well with its sharks, so this week, we’re going to try cases that are variations of the theme of “Shut up!” In many ways, sharks and “shut up” have the same effect on people, be they swimming in actual water or metaphorical self-pity; it’s painful and humbling, but if you come through your confrontation intact, you feel indestructable. Now, if you please, shut up and read.
Dr. Lastname

I’m a 58-year-old gay man and it’s a long time since life has been any fun. I’ve been single for some time (with no real prospects of a relationship), my friends don’t seem to have time for me, and at the end of a hard day’s work running my own business, I’ve barely broken even and have nothing to look forward to but spending the evening alone. That’s when the depression closes in and I can’t stand living. I write all this because I know that I’m a miserable failure, and that facts, not depression or any other mental illness, are behind my reasoning. I mean, when I tell my few close friends how I feel, they tell me I’m being too hard on myself, but if you’re almost 60, alone, and a financial mess, doesn’t that mean you’re a loser? My goal is to be real about myself.

Sounds like your goal isn’t to be real about yourself, it’s to be mean to yourself because you’re in a bad mood. If you were to reread the above paragraph when your mood wasn’t so shitty, you’d see your treating “facts” with the same care as Bill O’Reilly.

So, to quote Bill, Shut up, I don’t want to hear it. You wouldn’t talk like that to a friend, or even probably your worst enemy, so don’t do it to yourself.

WAIT! There is more to read… read on »

Performance Anxiety

Posted by fxckfeelings on April 8, 2010

Many jobs, especially those involving leadership or sales, depend on making a good impression with the public. The risk is becoming so focused on public reaction that you end up like Ed Koch, asking “How’m I doin?” with such frequency that you lose track of exactly what you’re supposed to do (aside from getting people to curb their dogs). Most public jobs, however, involve lots of duties that only make an impression when done very poorly, so success can’t be defined by accolades, and you’re the only one who knows best. It’s up to you to be your own best judge before you end up so hungry for approval that you get stuck in deep dog shit.
Dr. Lastname

As rabbi of a medium-sized temple for 10 years, I’ve enjoyed a good relationship with my congregation and I love the work. My problem is that I rely on the temple Board to decide whether I get a raise, and, during the last recession, there wasn’t one because everyone felt too poor to pay more dues. When, recently, I began looking at what rabbis of comparable congregations are making, however, I found that my salary is well below the mean, so I’ve been wondering how to become more active without appearing to be greedy, selfish or unresponsive to the problems of the congregation. One way that occurred to me was to do a “360 degree review” and ask everyone to give me feedback on how I’m doing, including the congregation, the board, and people who work for me. My goal is to get a high approval rating and use that to get a raise.

Unlike the woman earlier this week who was too afraid to rock the boat by asking for a raise (until anger made her want to torpedo the ship), you’re inhibited by guilt, empathy, and that certain Jewish ne sais quoi.

Still, no matter how tempting it is, don’t ask the congregation to clap if they think the rabbi deserves a raise. You’re a scholar and a leader, not Tinkerbell.

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Crazy Scared

Posted by fxckfeelings on April 1, 2010

We began this week with people paralyzed by fear of the unknown. We now end it with people who get stuck, not due to fear of the unknown, but rather fear of the untenable; their lives are blocked by the effects, or even just the possibility, of mental illness. Everyone’s lives, even for the few of us who are sane, are fraught with danger, so there’s no point in letting any illness ruin you, at least not without a fight.
Dr. Lastname

I know that my depression is one of the main obstacles keeping me from getting a new job; I got laid off three months ago, and even though my meds had stopped working way before that, I had enough discipline to push through. Now I don’t have a workplace to go to, I have trouble getting motivated enough to do anything, so between my inability to get out of bed and the fact I look like a mess, interviews aren’t happening. My wife is pissed because I’m not motivated to get new work and I won’t go back to see the psychiatrist, but I don’t see the point in trying this new prescription, because it’s my fourth medication so far, and I don’t understand why the first medication I took, which worked the best, stopped working, and why none of the others since has done the job. I don’t see why I should waste my time getting treatment if it isn’t going to work, but my wife thinks I’m being complacent and lazy. My goal is to find some way to get better or at least get her off my back.

You’re reinforcing something I’ve been telling my children their whole lives; life is unfair.

It was unfair for them when I wouldn’t by them a Happy Meal or the latest Nintendo game, even when they deserved it, and it’s unfair for you now that you’ve lost your job and can’t find the right meds. Unfair is unfair, as they say (or at least as I say).

The trouble is, it isn’t a fair world for anyone, young or old, and you won’t survive if you can’t take your lumps and keep on going.

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Paranoid & Destroyed

Posted by fxckfeelings on March 29, 2010

For our 100th post, we address a problem that causes loads of people useless worry, and that is…useless worry. Just because horrible things may happen to you or someone you love (or because of someone you love), life shouldn’t end. Prepare yourself the best you can for whatever trouble you think you see coming, and then continue your regularly scheduled, useful life.
Dr. Lastname

Living with my mentally ill 30-year-old daughter is wearing me out. My wife and I can never leave her alone, but we also can’t take her with us because she gets uncomfortable when she’s around people she doesn’t know and says inappropriate things in a loud voice and has to get up and leave. The problem isn’t her, though, it’s my wife, who is so worried about what will happen if we put her in a half-way house with other sick people that she can’t think clearly about it. We’ve got some money, but if we paid for my daughter to have her own condo and a nurse to keep an eye on her, the money wouldn’t last long. Then again, if she continues to live with us, we won’t last long. My goal is to get my wife to see that we have to get her into a state-supported program, for her sake and ours.

You hope to get your wife to see that your mentally ill daughter needs to live independently, but if you were making any progress in that direction, you wouldn’t be writing.

Let’s assume then, at least for the moment, that your hopes are false and your wife can’t let go, and if she can’t let go, she’ll always be thinking of new ways to make your daughter feel more comfortable and better understood. Which makes your goal a more and more distant dream.

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Confrontations, Complications

Posted by fxckfeelings on March 18, 2010

When you’re upset about someone’s behavior and a talk is unavoidable, it’s hard not to see the next step as an emotional showdown in which you’re armed with guilt, anger, and intimidation to persuade the other guy to do what you want. This technique works, too…if what you want is to get the other guy annoyed and unmotivated. Luckily, we’re here to provide a Confrontational Plan B.
Dr. Lastname

My husband has been coming down hard on our 15-year-old daughter because she recently got caught drinking at school, and it’s undeniable now that she has a problem. I’m worried, too, but not like my husband, maybe because I was a bit of a wild child myself in high school, or maybe just because I don’t think the problem is insurmountable since I got over my bad habits and turned out just fine. Besides, yelling at a kid often drives them into just the kind of trouble you’re trying to save them from. The problem is that when I try to calm my husband down by telling him that things are going to work out, it makes him even worse. He tells me I’m not taking the situation seriously, but I am and I’m just trying to help. My goal is to find out what I can say to my husband to make him feel better (without making him angrier).

It’s tempting to express anger and fear when kids misbehave; for whatever reason, parental instinct tells us that if reason doesn’t work, terror will.

On the other hand, there’s a reason “Scared Straight” had kids being barked at by tattooed prisoners, not suburban parents.

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Parenting Under/Overkill

Posted by fxckfeelings on March 15, 2010

Part of being a kid is testing your limits with your parents-how late can you stay up, how many times can you hit your sister, how frequently can you have keggers in the garage-but what’s discussed less frequently is how parents have to test their own limits with their kids. While you might not want to be too forceful with your kid, part of being a parent is making choices and enforcing them. On the other hand, you don’t have to be so pushy that you go from parent to endless nag. It’s a careful balance, but the family buck stops with you, so you’ve got to make the call. Besides, if you don’t get it right, then those keggers will be the least of your problems.
Dr. Lastname

My son was diagnosed with severe depression when he was a freshman in high school. I know it’s supposed to be a hereditary disease, but neither I nor my husband have any history of it; we both come from stiff-upper-lip backgrounds, and when our son attempted suicide, we were completely taken by surprise. He was also doing drugs, and we didn’t know it. He’s doing much better now, seeing a therapist weekly, but I still worry about his going off to college next year. He doesn’t share much with us, but I know he wants to do what’s “normal.” I don’t want to intrude on his relationship with his therapist or undermine his confidence or make him feel pressured, but we need to decide whether he’s ready to go. My goal is to make the right decision without hurting him in the process.

You can’t protect your son from of having an illness and all the trauma that goes with it, so for your own sake, and against all your instincts, don’t try.

On the other hand, if you try too hard to avoid all potentially painful issues with your son and stick to being stoic and reserved, you’ll be helping him avoid the hard choices he has to make, instead of doing your job.

Life is hard, precisely because it includes illness and drug abuse on top of the usual high stresses of being adolescent and finding a way to be independent. It’s a clusterfuck, and you’re the motherclusterfucker; you’re all in this together.

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ADD 101

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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Rehab Redux

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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Diagnose This, *sshole.

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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Right Of Refusal

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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