Posted by fxckfeelings on September 14, 2009
The not-MD here: Now that an actual health care bill is almost upon us, I thought this would be a good opportunity to ask my writing partner, as an actual health care provider, for his take on how we can improve health insurance.
We don’t like to get political, and everyone’s entitled to their own views (at least I think so—he’d probably tell you you’re just wrong), but this is not an entry about politics; at its core, the health care debate is about health care, and as a doctor, not a Democrat or Republican, this is his medical point of view. We’ll return to normal cases on Thursday.
–Dr. Lastname
One thing you learn as a parent is that there’s never enough time, money, or resources to provide perfect safety and security for your family. Worse, if you hold yourself responsible for providing it, you’ll go nuts the first time something goes badly wrong and you can’t control it. You’ll blow everything on something that can’t be helped, feel like a failure, and have nothing left, financially or emotionally, for those who need you.
As such, compromising on how you spend your resources is as much a part of good parenting as is nurturing, although it often makes you feel terrible. So it is with health care systems.
Democrats sometimes emphasize the nurturing part of this process, our shared humanitarian desire to provide more care, while Republicans sometimes emphasize the tougher part of this process, our desire to make sure that treatments work and are well delivered. But at the heart of good management there is always an unavoidable need to make good compromises, and that’s what I think needs more attention and reform. Not fewer denials from the insurance companies, but denials that are more fair and decided upon more ethically.
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Posted by fxckfeelings on September 10, 2009
No matter what your illness, medication should never be your first option for treatment. Everything you put in your mouth, from aspirin to spinach, has risks attached, so you should always proceed with caution before you add chemicals to the mix. Then, once on medication, most people are eager to get off it as soon as possible, but that has its own set of risks, as well. If you make your health the first priority, then the choice of whether or not to medicate won’t become risk-free, but it will become clear.
–Dr. Lastname
Before I got treated for depression, my marriage was rocky, but not doomed. I would be irritable and lethargic, which was tough for my husband to deal with, but mostly he was concerned and caring, and he was glad when I decided to get help. Now I’m taking medication, which has helped a lot in stabilizing my moods and keeping the black clouds away. The downside is that my meds have also, surprise, made my sex drive disappear, and this is doing way more harm to my marriage than my depression ever did. My husband isn’t a creep—he’s put up with a lot, and has always been supportive—but I can tell that there’s a distance growing between us. It’s different now that I’m the same old me but not interested in him physically, as opposed to a crying mess who wasn’t interested in him but also couldn’t get dressed in the morning. Is there anyway to not be depressed and not be libido-less? My goal is for both me and my marriage to be healthy.
Equating a happy marriage with a lusty sex life (as does every magazine in the supermarket checkout line) is dangerous, because it directly links the state of your union to something you don’t actually control.
If you could control it, you wouldn’t be writing to me in the first place. More than that, the fact that there are so many sex therapists should tell you how limited your control is (as is theirs).
That’s what the word therapy means in ancient Urdu: doing something that may or may not help for a problem you don’t control but think you should. And if therapy fails, then you’ve got a bad marriage because you’re libido-deficient.
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Posted by fxckfeelings on August 20, 2009
We teach children that lying is bad, period. As adults, we agree with that statement, but can find any number of reasons why our own lies should be considered an exception. Bad or not, lies will, more often then not, get you into trouble, so you have to weigh the pros and cons of each piece of bullshit before you unleash it. If you think your lie is justified because of unfairness, or if you just lie out of habit despite your better judgment—if you’re so full of bullshit you need a bib before you speak—then you should stop looking for excuses and learn to shut your mouth.
–Dr. Lastname
I’m a landscape designer, and I’ve just spent 6 months living in planning hell with a pretty difficult client. We had different visions from the start, but he insisted I was the man for the job, even though we differed on every decision, every step of the way. And really, I was willing to put up with it if it meant getting to do the grounds (you heard me) on this guy’s country estate, which was an extensive project that would’ve paid a ton and given me the chance to do something spectacular that could gain me a national reputation. Finally, we agreed to some blue prints, which he paid for…right before firing me. Now, I know that he paid for the plans and they’re technically his, but the thing is, I put half a year into putting this project together—and turned down a lot of other work because I thought I’d need the time to make it happen—and if he’s going to screw me over like this, I feel like he deserves to get screwed over right back. He’s called asking for the plans, and I keep making excuses as to why I can’t give them to him, but he keeps pushing, and now I’m stuck. Should I tell him the truth, that he’ll get those plans over my dead body, or should I relent and give him the plans along with a piece of my mind? I know you dismiss the notion of justice, but this is my livelihood, and my goal is to get what’s owed me.
Cases like this are the reason you have ethical rules, so you’ll do what you think is right, regardless of provocations by the egregious assholes who are drawn to be your clients. Lucky for you, you at least acknowledge this is a dilemma, instead of feeling entitled to a landscaper jihad, so there’s hope for you yet.
Look, if you’re in the landscape designing business, most of your clients are richer than you are. Just on a practical level for your quest, that means they can higher bigger lawyers and fund battles that can outlast any puny resources you can haul out of your pockets.
Being rich also brings out the inner asshole, so your profession will naturally attract more of them than a Crane’s white porcelain standard edition. So if you feel that war is your calling, drop this business and go carve out runways and golf courses for a tour at Fallujah.
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Posted by fxckfeelings on August 17, 2009
As Yogi Berra once said, “It ain’t over ’til it’s over,” and while that’s surely the case for the current Red Sox season, it’s also true about relationships. Due to anything from a shared possession to a shared child, couples often end up tied together when they’re not together anymore. For those couples, they have to tread even more lightly now that they’re apart, or, when it comes to conflict between exes, it will be deja vu all over again.
–Dr. Lastname
After my husband and I got divorced, I started going to a therapist, because I was really leveled by the whole experience. Plus I worried I was facing a custody battle over our son, who was only five, and wanted to make sure I kept it together for him. Ultimately, custody went more smoothly than I expected (my son lives with me over the school year and spends summers and some holidays with his dad), and my ex and I are on civil terms. To make a long story short though, in talking to this therapist about my ex and his odd family (with whom he spends lots of time in the summer), the therapist asked me if my ex-husband had ever talked about being molested—the family behavior I described as odd, on top of my ex-husband’s own quirks, seemed indicative of a pattern of abuse. I got up the courage to confront my ex about it, but he shut me down pretty fast. The problem is that he has our son with him and his family, and I’m worried absolutely sick, but there’s nothing I can do. I’d like to help my ex in a way, but my goal, really, is to do what’s best for my son.
Let’s imagine, just for the sake of argument, that your ex-‘s family is eccentric but not abusive. You push your ex-, he tells his family, they’re all offended and can’t talk about you without snarling with anger. Now they’re not just eccentric, they’re enraged.
Then, your son picks up on the vibrations and starts walking on eggshells with everyone, including you. That’s how dangerous it is to try too hard to protect your son from abuse; declare war on those who threaten him, and he could be your first casualty.
A better goal is to do whatever you can to protect him from abuse while also trying to protect him from the potential conflict an allegation will trigger. It’s certainly a fine line, and you must be able to tolerate fear and uncertainty to walk it. You don’t really have a choice, because the alternative is worse. And, anyway, it’s part of your parental job description.
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Posted by fxckfeelings on August 6, 2009
One of the basic tenets of the fxckfeelings.com philosophy is this: you can’t change people. As such, even trying to change someone’s mind by making their anger go away is never a good goal, whether it’s the anger of a naggy spouse or a misbehaving kid. Instead, change your line of reasoning: go back to basics and define the issues for yourself. Then, if you’re lucky, they’ll change their own minds.
-Dr. Lastname
My wife and I are both artists—her painting, me sculpture—but after our son was born, it became clear that one of us was going to have to get a real job in order to pay the bills. I was making more money from sculpting at the time, so she was the one to take the plunge. Her job is actually somewhat creative, and she doesn’t hate it completely, but now that I’m not having as many shows and selling as many pieces, she’s leaning on me constantly to work harder or find a better-paying job. I try to tell her that I’m doing the best I can, but she doesn’t accept that, and if I even suggest that she’s bitter that she had to give up her art and I didn’t, she absolutely loses it. The truth is, I think my career is worth holding on to, but I don’t know how to convince her unless I make a windfall in the next six months. My goal is to get my wife to get off my back.
Never try to get your wife off your back, because that a), implies you’re already trapped underneath her, and b), means you’ll be lying, squirming, and generally pulling all the stops to change her mind/get her to move, which will just strengthen her resolve.
In fact, if you look behind you, you’ll notice you’re giving your wife a piggy-back ride at this very moment. So your goal will wrench your back.
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Posted by fxckfeelings on August 3, 2009
Like almost every useful treatment, medical or otherwise, psychotherapy can be dangerous, particularly when you rely on your (say it with me now) feelings to decide whether or not to continue. Ironically, feeling good is one of the worst reasons to stay with therapy, and feeling crappy is one of the worst reasons to end it.
–Dr. Lastname
My therapist is about to depart on vacation for one month, and I’m feeling f*cking nervous and tense about it. I’d like to know what I can do to make the best of this break in therapy and come back refreshed and ready to start work again when my therapist returns, and also how to keep the unpleasant feelings of missing her to a minimum.
Congratulations! While your question seems like a short-and-sweet query (or maybe a chance to cheat on the classic back-to-school essay, “What I did on my therapist’s summer vacation”) it’s actually a perfect example of the dangers of focusing too much on feelings when you’re undergoing psychotherapy. A+
Look, there’s nothing wrong with enjoying therapy, experiencing emotional relief or a feeling of personal growth, or liking or missing your therapist. Just remember—you’re paying for this and should never forget what you’re getting it for. Or you’ll be sorry.
If you rely on your feelings to tell you whether to continue therapy, you may never have reason to stop. You may continue to like your therapist, find the subject interesting, learn something new, and feel the treatment supports you in a way nothing and no one else does.
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