Archive for the ‘Psychotherapy’ Category

Working At A Nursing Home Part II

Saturday, June 20th, 2009

In Part I, we looked at the trauma surrounding being in a nursing home from the patient’s point of view. But what’s it like for the staff at a nursing home? They’re dealing with people traumatized by the effects of aging, injury, and illness. These people are not happy about suddenly being in a dormitory-type setting with a bunch of other people with whom they have little in common except misery. You may be glad you’re alive but it’s not easy to be optimistic in that setting!

It isn’t easy on the staff either. They don’t have the immediate glory of saving a life quickly or seeing results on the spot. (Although I do work at nursing homes that post the number of annual successful discharges, which is optimistic and rewarding to both staff and patients.) But by and large, working at a nursing home means long hours, constant messes to clean up, constant medical treatment to be given, and everything that goes along with managing a large building full of very cranky people who are not particularly grateful that life put them there.

Imagine trying to handle keeping a large building clean, laundry restocked, meals prepared, etc., and at the same time that building is full of people who needs medicine administered, blood tested, physical therapy provided, baths and showers and changing of diapers and bandages on a regular basis, I could go on and on. But the point is, as we saw in Part I, those are people! Real human beings with all the complex emotions and behaviors they had before they got into this situation. This complicates the logistics and problems enormously!

All old and/or sick people are not alike. There are many possible ways a person can cope with aging and illness. Dealing with the shock, grief, and trauma that brought you here is just part of the situation. Finding the courage to take new steps is difficult when all about is already unfamiliar. Personality issues you haven’t resolved may resurface or become worse. Activities and hobbies are not passion; they don’t necessarily contain or encourage zest, an all-consuming interest, or motivation to continue

Repetition is not a substitute for motivation. Following someone else’s schedule is not the same as having a real life. Understanding and a sense of having choices is important to healing. Cognitive limitations and personality issues may interfere with this ability. Patients may keep up a front or drop masks entirely. They may be active or withdraw completely. They may try to consolidate the old and wish to explore new and unconventional behaviors. They may be feisty or stern or always cheerful. In short, you never know how someone will behave.

Worse yet, disturbing traits are likely to be exacerbated by stress, illness, and old age. The mean get meaner, the fearful get more afraid, and the apathetic sink into near paralysis.

But it denigrates their humanness to exempt the old and the ill from personal responsibility. They are not moral eunuchs. They can still do harm, and they can still atone. They are still capable of cruelty and greed and assorted misdeeds.

The good news is that, as human beings, we are never a finished product. We can refine and rearrange and reverse and improve. Change is inevitable, but it is up to us to use what choices we make to adapt to change with grace and dignity.

How can staff help these larger issues? By seeing their patients as the human beings they are. By knowing their names and respecting their humanity. By accepting that the patient didn’t ask to be in this situation. By keeping their focus on the larger goal, and not getting lost in the messy details. In a thousand tiny ways, everyday, nursing home staff can make healing more likely.

Remember that out of Chaos, through encouragement and initiative, can come Creation and Renewal.

Everybody who works at a nursing home (by whatever name it’s called!) has a vital role to play in the healing process. Because of all the differences among facilities, I’d leave somebody out if I tried to list all the jobs. It isn’t just Medical Doctors and Primary Care Physicians. There are Certified Nurse Assistants as well as Registered Nurses. There are Social Workers and Case Managers and Psychologists. There are Psychiatrists and PPN’s who function as psychiatrists. There are Physical Therapists and Occupational Therapists, Speech Therapists and Recreational Therapists.

That’s a partial list and it leaves out Administration, who have to make sure that the whole team and the whole building functions smoothly, because lives are at stake. Don’t make fun of bureaucracies because even those who never see a patient are making sure there are clean bandages, needed medicine, accessible medical records, and all the other things essential to the survival of the patients under their care.

Yes, I know there are nursing homes that get it wrong and lose sight of the very patients they are supposed to be helping. But before we can even discuss them, it helps to understand what an enormous job it is to begin with. I’m always amazed at the number of facilities that mostly get it right! I applaud the ones whose staff maintain their respect for the humanity of patients, who encourage healing and growth, and who, even when exhausted and trying to do the work of ten, remember to smile at a patient and greet him or her by name.

I ask for reform in many areas, and healthcare is a major one. But I always acknowledge the work of people who do do their jobs well, even under the most adverse conditions. Because they prove it can be done well! And I do work for understanding between different perspectives.
In this case, as with so many others, it’s very clear that both sides have a difficult job because of the very nature of the situation. There’s no magic pill or simple solution, not even throwing money at the problem. It’s going to take thought and creativity and personal responsibility, as well as a clear understanding of our priorities as a society.

Why Is “Nursing Home” a Scary Phrase? Part I

Saturday, June 20th, 2009

The reality is that most people equate going into a nursing home with a fate far worse than death or zombiehood. And what’s even sadder is that most people who work in nursing homes feel they are dealing with the most difficult patients in the world. Both of them have reasons for the way they feel. So in this two-part series, I’ll try to explain the problem from both sides.

Remember that nobody goes to a nursing home because they wanted to. Call it a Rehab Center, or a Sub-Acute or Skilled Nursing Facility, the fact is that people are there because something terrible happened to them! They had a terrible injury, a life-threatening illness, or a disability beyond their ability to cope. Or they just got old and didn’t have the financial, physical, or mental capacities to handle everyday life itself. None of these are pleasant things. All of them pull the rug out from under you and knock you flat on your rear!

It can make you pretty depressed, anxious, angry, and just plain unsocial for a while.

First of all, getting old has some real disadvantages. Earlier aspects of your life do not remain the main purpose of your life. You may have retired from your career, lost your spouse through death or divorce, and your children are grown and have their own lives now. Nothing is the same, and that can feel very unsettling.

Then there is the nearness of death itself. If you were born, the only thing I can guarantee is that someday you will die. Proverbs to the contrary, death is more certain than taxes! If you have lived a long life already, death feels a lot closer. If you have just come from a life-threatening crisis at the hospital, it feels pretty close no matter what age you are. How do we prepare for contentment and peace when life ends? It’s not an easy task, even if it is a necessary one.

If the physical strength or beauty that you possessed, and the joys of the senses were among life’s greatest values, what do you do when they ebb away?

Besides, you’re still the person you always were inside. In fact, you’re likely to get more so as you age. The down side is that unresolved problems can become intensified, and some patterns of behavior that were only mildly maladaptive before are now making you dysfunctional.

I can quote from Greek, Chinese, even Ancient Egyptian sources, and show you that people have always recognized this. Did you think you would escape the fate of being mortal? Sorry, but we move from the familiarity, safety, and security of the life we’ve built to the uncertainty and vulnerability of another. And we have no other choice! No wonder we feel pain and grief.

Being in a medical care facility, whether hospital, nursing home, or rehab center just adds to the burden. 1) All of the burdens cited above are intensified. 2) The loss of independence, self-respect, and dignity are all exacerbated when we are struck down by physical illness. 3) We must trust our very being to the care of total strangers. 4) We loss all privacy, all choices, and have very little control over anything.

Yes, I know it’s being done to save your life. But when it happens to you, it feels more like life has been taken away. In a sense, it has.

Human beings are simple, like a piece of furniture. We are composed of many aspects, and all of them are affected by age and illness. Nothing is “all in your mind” because the last time I looked, your mind and your body lived in the same place! And they are always interacting. In fact, when I think of the human, I have to add the heart and the spirit into the mix, because human beings are feeling many more things besides just thinking and physical sensations.

Actually, you can use any schema or worldview you want. Just be sure it includes all the complexities of being human. Bear with me while I try to explain it in my fashion:

The Body is deteriorating and weakening. It is now fragile and easily sickened. It may lose control of unmentionable things like peeing, shitting, or bleeding. This is not only hard to comprehend when it happens to you, it is also terrifying!

The Mind finds that its memory and attention span are decreasing. As things become difficult, our own expectations of ourself can become negative and self-defeating.

The Heart is grieving. Many friends have died or moved. We’re in a place where the surroundings, the environment, even the language of people around us may be un familiar. Grief and loss predominate in our immediate feelings.

The Spirit may know that the need to move to an inner life is normal at this stage. Some cultures even have a description or place in life’s stages for it. But that inner life must be enriched and it must be supplemented by a full outer life.

The deepest misery comes from those who feel they are doing nothing. Patients may feel that their potential is locked up by their illness, their physical limitations, or just by being in a medical facility.

A dear, dear friend, mentor, and colleague of mine gave me the solution. Dr. Roy P. Fairfield, educator, historian, author man of almost unlimited interests and talents, is now 90. And he, in his firm New England way, decided that this nonsense wasn’t for him. Re-Firement, not retirement became his motto. And so, with his permission, I share it with you.

Re-Firement is the way to avoid getting stale and cranky. The delight of self-discovery is always available to us. This is also a time when you can become more authentic and find your own identity. Exercise and movement slow physical aging and help heal illness. And even more important, activities done with real passion and a social life that isn’t superficial slow down the other aspects of aging and help the soul heal itself.

The future can always be happier! How much time it contains doesn’t matter as much as how happy it is.

In the second part of this article, I’ll talk about the other side of the situation: some of the cautions and concerns involved, and the problems nursing home staffs face in dealing with them.

Pluralism is the Strength of Our County!

Saturday, June 20th, 2009

I keep getting myself in trouble at social dinners for the simple statement that I am mixed blood. I simply refuse to self-identify as “white”, a meaningless term with lots of baggage that does disservice to my family’s wonderfully rich background. (Obviously I am turning into a somewhat controversial guest to have at dinner, albeit inadvertently.)

For one thing the word “white” has no meaning and no real definition. As one young dinner guest pointed out recently, “I thought white was just what everybody aspired to be?”  That’s not an unfair summary of U.S. history. I still have a sign from Boston dated 1918 that says “No Irish Need Apply!” In some post-Civil War southern states hiring the :shanty” Irish was considered an nearly-acceptable alternative to owning the African-American slaves who no longer existed as slaves. Leasing convicts was about the only other option available.

And I’m used to hearing “Canuck” applied in various tones of voice to other branches of my family tree. And then there’s my great-great-grandmother, the Algonkin who married a French merchant in Quebec City, Canada. Not only did she gives up her native tongue when she married, she wore French clothes and spoke only French ‘til the day she died. How do I know? Because I was lucky enough to meet some of my great-parents when I was a child and heard stories told with some pride in her sacrifice but more embarrassment over her heritage. Only one picture (a portrait, a daguereotype?)
Existed of her because, as the family said in hushed tones, “She was a bit dark skinned, you know.”

In Canada today, which has First Nations terms not used in the U.S., I would be considered “Metis”. (Someday I’ll talk about Louis Real and the great Metis Uprising that actually got the Canadian Pacific Railroad the government funding it needed for compleion so the Royal Mounties could be speedily swept to central Canada to quell these uppity “savages.” The word Metis itself literally means mixed, but I was brought up to deck anyone who called me a “half-breed.”

And then there’s my grandfather Nikolai. I didn’t even find out his name until my father lie on his deathbed in 1995. You see, grandfather Nikolai had died in the War To End All Wars (WWI) and his memory was preserved by denying his heritage and pretending he was “Polish.” But when I worked in Poland in the 1980’s and tried to trace my family tree, my Polish friends sadly informed me that his last name was not Polish and most likely Russian. (And possibly not a “true” Russian, but a gypsy or worse yet, a Jew!) He had apparently passed for Polish when he immigrated to the U.S. because of all the languages he spoke. Lost in a semi-safe crowd at the height of the Cold War, he disappeared from family respect.

When I describe my childhood, I explain it was somewhat like the United Nations backstage, with everybody squabbling or ignoring each other in a multitude of mutually-unintelligible languages. God help the poor victim who married into the family from another background and was subject to the hostility vented on the “outsider.” My favorite maternal aunt was shunned from almost the whole family because she had the nerve to marry an “Eye-talian” whom she loved. Fortunately, he had a large family who took her in with adoration, she learned to be a great Italian cook, and they lived happily with their children for decades.

My poor mother was Irish & French-Canadian (both suspect) and was never considered to belong. Since the big goal of every immigrant to this country was to pass for Anglo-British, she bleached my fine baby hair to straw with undiluted peroxide, pinned it into painful Shirley Temple curls, and harshly slapped me or washed my mouth with soap if I dared picked up a word of the many languages spoken around me. I had to pass for “white”, as in WASP, which left a bad taste in my mouth forever after.

I was half-raised by my grandmother Mary Katherine Lynch from County Claire in Ireland, and thank God for her intervention and that of her large brood of my mother’s siblings. My ancestors sit beside me at every dinner table and I wouldn’t desecrate their lives by labeling myself “white” a bland and vague word associated with white supremacy, the KKK, terror, and a general, overwhelming assumption of superiority and power, especially if they are male to boot!

In my teens I was “adopted” by Matchwaya Rom in New York City, and treated and taught as a daughter. I lived in Hawai’I and saw true pluralism in everyday life. I was befriended by a Japanese family who had lived through WWII, and knew how close they were to being interred in a U.S. concentration camp as an not-white enemy. In Nepal and India I was given a name and a caste (Matwali that of Sherpas and foreign anthropologists) to bring me into the group, and in Haiti, my friends introduced me as their cousine and insisted joyfully that I must be part African.

I could go on and on, but the bottom line is that I have been naïve enough to be believe that E Pluribus Unum actually means from the many to One. I believe we are humans, and cannot see each other in groups of us versus them.

And the saddest thing to me is that we as a country cannot see Mr. Obama as our first truly mixed president because way too many people are so obsessed with just one strain of the many rich traditions and bloodlines that make him what he is: a man with just as rich a heritage as most of us have, more truly representative perhaps than any before him of the real population of this United States!

What I’ve Been Up To!

Thursday, May 7th, 2009

If you have noticed some erratic behavior on the part of this site, it’s because so much has been happening! With the book published in December 2008, and the ordeal nearing an end, I knew I wanted to be in an area with far more resources than I’d been in the last five years. So on the 1st of March, 2009, I closed my office doors in Butte County and moved to San Jose, California, in what is basically considered the South Bay area of San Francisco. It’s been 2 months and I admit to living out of a suitcase for 3 weeks, but with the help of my sons, life is finally beginning to settle down. There are far more medical facilities here for me to work at. I have a private office and a rapidly growing practice, both in clinical therapy and in forensics.

Many universities abound in the area, and in Palo Alto is the Stanford Center on Interdisciplinary Policy, Education, and Research, where I hope to be able to pursue my interests in making this a safer world for all of us. I’ve been nominated to the American Board of Intelligence Analysts, and I look forward to serving Homeland Security interests in a humane and valuable way.

Meanwhile, I still pursue legal system and healthcare system reform, and have found many more resources and opportunities than have been available in other locations. In addition, I get to do more publicity regarding the sad state of affairs in legal corruption in California. It wasn’t safe to publicize the book until April10th, 2009, so I’ve finally been able to push hard to get the story out. A number of organizations are helping to get the word out, and I look forward to talks and book-signings across the area soon.

There are volunteer activities, and museums and libraries to explore, and I’m in heaven with all the doors that are opening. The welcome that I’ve received in the area has exceeded every expectation that I had, and I am delighted with a rapidly growing support system of friends and colleagues. I’m working on at least two papers fro presentation, and another (more positive!) book to be published by the end of the year.

And not to forget the spiritual side of life, I have to admit that the wealth of interdenominational dialogues here has been a source of joy and comfort. I know we have to co-exist on this world and in this country, with respect, kindness, and personal responsibility to each other. I seem to be receiving a multitude of chances to do so, and I am so grateful.

I admit it! Despite all the agony of relocation, being here in the Greater San Jose Area is balm to my soul, and therapy for my mind and body. Those who have read Surviving Human Venom will understand how incredibly healing my new life here is.

Wish me well and make prayers for me in whatever way suits you best; I welcome all your good wishes and give thanks to Creator daily!

Is It Possible to Reform Health Care?

Wednesday, April 22nd, 2009

Sometimes a topic is just so big that I find myself gathering data until the pile is enormous but unable to write about it until a specific incident triggers an outpouring of all the information I’ve stored! Healthcare is a good example of this. Since I’m right in the middle of the maelstrom of controversy, I find myself almost overwhelmed by it all. Not that incidents don’t occur almost daily that should act as triggers. But where do I begin?

There are patients who’ve never seen their actual M.D.’s, or only seen them for a total of 15 minutes over the course of a year. Multitudes of people are multiple medications, with no idea of which is for what symptoms or of the side-effects or drug interactions. There are patients who need to change life-style or unhealthy habits who can’t get a 30-minute consultation with their primary care physician. Well, the M.D. just doesn’t have time! He or she has to see too many patients just to pay his administrative costs, which have risen over 25 % in recent years.

I didn’t even mention paying off school loans for the arduous process of becoming an M.D., or of rising malpractice fees. I’m sympathetic to the realities of practice. As a psychologist, my own time spent on paperwork and non-patient time has risen to the point where I have to pay someone else to fill out forms, code procedures, follow up on billings and payments, etc. etc. etc. No wonder there’s a shortage of family physicians in the U.S.

And if you have Medicare or MediCal or worse yet, no insurance, it’s often difficult to even find a doctor who will accept you as a client. A government survey done in 2007, quoted by the AARP, states that the more than 1.3 million people on Medicare have difficulty finding a doctor. And since seeing a specialist often requires the referral of a primary care physician, you’re out of luck even if you have a clear idea of what you problem is.

With economic conditions getting worse, and people losing their coverage or cutting back, the situation is just getting worse. I found this out after my serious auto accident in 2004, as described in my recent book Surviving Human Venom. Even recommended treatments can be delayed or not covered, and the insurance company can cut those treatments off or raise your premiums beyond your ability to pay for reasons that often make no sense to the poor patient. I’ve seen Workers Comp patients have treatment delayed for years, while their condition worsened, because the insurance company argued with the need.

And despite the high cost of medical care, assuming you can afford appropriate treatment on a timely basis, the U.S still has much lower positive outcomes than many other developed countries. We’ve got over 46 million Americans without health insurance, and we spend over $8000 per year per capita on all Americans, but we have lower life expectancies, a higher rate of preventable deaths, and higher child mortality rates than many Western countries.

I haven’t even mentioned quality of life issues yet! Billions are spent on advertising to convince us that some magic pill will solve all our problems. But chronic conditions and chronic pain persist, and the suffering from depression and anxiety continue to escalate. To really put patients first, psychologists and other behavioral specialists should be part of every treatment team. But more often they’re relegated to the last resort of a frustrated and busy physician, who dooms you to failure by saying, “It’s all in your head! Go see a shrink!” That hardly sets up a positive expectation of success.

I hate to keep harping on personal responsibility. But it always gets back to that, doesn’t it? LBJ brought up the idea of healthcare “regionalism,” where every doctor, clinic, and hospital was affiliated with a regional medical educational center. But instead of thinking “teamwork and collaboration,” when the idea is brought up, most doctors think “oversight and supervision” and panic. Is this just ego?

Many doctors are afraid of any program that is designed to reward efficient, high-quality services because they are afraid they don’t want measures of provider effectiveness applied to them. Insecurity and a sheer meanness of spirit make them resist being accountable for the quality of their care. Integrated care approaches help cut costs while improving services, but that would mean sharing the “golden halo” with other specialists on the team. The most difficult patients often require the most care, but even they have an improved prognosis when evidence-based treatment models and a multi-person team that includes mental health professionals, nutritionists, and other specialists are used to really treat all aspects of the patient.

Putting the patient first should be the first characteristic of healing. And if that means evaluating what you’re doing, consulting with colleagues, working with emotions and thoughts and other intangibles, then so be it! Taking better care of all patients, not just the wealthy ones, should be the goal of any reform plan. Not just splinting the bone or bandaging the wound, but actually educating, reassuring, and motivating the patient, something you can’t do in a 10-15 minutes office visit!

The major psychological organizations are busy coming up with ways to integrate psychologists into interdisciplinary teams, to ensure quality in mental health practice, and to encourage support, consultation, and collaboration among providers. Let’s see that extended to all areas of medical care.

Since I’m more familiar with sub-acute and skilled nursing homes, I’ll put my thoughts into an article or two that should help both professionals and lay persons understand how these ideas of teamwork can be put into effect. Look for them next week or so, because I’ll try to explain all the parts of being human that need care if we’re actually going to heal anybody!.

The Masks of Hypocrisy or: What Planet is Cheney Living On, Anyway?

Sunday, February 8th, 2009

How dare ex-VP Cheney even use the phrase the “civil rights of U.S. citizens.” I got really angry when I heard his hypocrisy this week! It’s people with his attitude of entitlement that have led to the mess the United States is in! Having just finished an entire book detailing the violation of rights by local government officials, I couldn’t help wondering where the hell he has been lately! 

And I’m going to use his individual name throughout this article because I don’t want to fall into the trap of labeling and then assuming everybody in that category is bad. This isn’t about political affiliation, gender, ethnicity, or religion. It is about a type of pathology. Whatever your background or characteristics, grabbing for power and money at other people’s expense is wrong! Period! Wrong! 

True patriotism means working to keep this country living up to its stated ideals of human dignity, fair play, and civil rights. Walk your talk, Cheney! Because I don’t see you doing anything to help improve the widespread violation of human rights committed on everyday citizens. 

This isn’t about Gitmo. It’s about you and me! I don’t see any evidence that Cheney or his cronies encouraged an atmosphere of “to serve and protect” the U.S. public. In fact, quite the opposite! Corruption and destruction of the average citizen has run rampant. Just look at the headlines! And it’s because of the lies, hypocrisy, and attitude of ‘”I’m always right; you’re always wrong.” 

What rights do U.S. citizens still have? The Attorney General, the SED, the FDA –all government bureaucracies don’t investigate “individual cases” of misconduct. That way they don’t have to discover or face a pattern of widespread malfeasance! It took ten years for the whistleblower on Madoff’s case to even be heard!  

How are you and I, the average citizens, supposed to have the resources or information to prove a “pattern of misconduct” when we don’t even have the resources to understand our individual case?!!! So people die of salmonella, lose their life savings, send their kids to battlefields, and are shot, tortured, or destroyed by their own government officials.  

In the minds of people like Cheney, it appears to be all right to bully and lie to U.S. citizens.  As long as he had money and power, he turns away from the “trivial” concerns of ordinary citizens. Under the guise of “national security” he has helped to undermine the very foundations of American ideals. I guess he thinks we’re too stupid to understand the facts. I guess he thinks that our concerns about paying bills, living in a safe and clean neighborhood, and being treated equitably by our legal system are too small for people like him to worry about.  

I have two sons in the Army. I’ve worked with law enforcement, and with the Army. I thought we were all defending the principle of human dignity and the sanctity of human life. Is Cheney the kind of person who thinks that just pasting a label on someone gives you the right to ignore due process and humane behavior?   

He reminds me of the callous people who invented a particularly dumb slogan back in the 60’s. They’d say “America: love it or leave it!” What happened to the idea that loving your country meant staying to correct injustice.  Jack Kennedy and Martin Luther King didn’t just give up and leave. Neither did Gandhi. Why then should we even consider not helping to improve the country we love? What can you do for your country? Improve it!  

I’m trying to do psychotherapy to help people make better choices, live happier and healthier, and maintain caring connections with others. I help them to not feel helpless and victimized. I want people in positions of authority should be better role models. Is that too much to ask? I’m tired of false patriotism masquerading with hypocrisy and lies. I’m against corruption. I think that makes me more patriotic, not less. 

If one of my patients was paranoid and greedy, lied to his family, and ignored all rational values, we’d consider him mentally disordered. If a family ignored budget constraints and insulted and assaulted their neighbors, if they spent their neighbors’ money on their own bad behavior, we’d consider them disgraceful. Why then do so many bureaucracies get to behave this badly? 

It’s hard not to feel discouraged. But each of us, with our individual actions and individual voices, can add up to a powerful force. We must. Because change and repair are necessary, and constructive disagreement is the only way we are going to have a future. But let’s put a time limit on the discussions, and get some positive actions started. Please? Soon?

Characters Welcome?

Monday, February 2nd, 2009

I admit it: this is not one of my more thoughtful pieces. It’s more my expression of confusion! At the age of 60, I sometimes get accused of being “out of it” when it comes to popular culture. Well, my recent attempts to catch up to popular culture have not necessarily made me feel any less out of it!  

Oh yes, I’ve found some television shows that I like. I’ve even found one stations that advertises “characters welcome.” I just don’t think they’ve been to my neighborhood. Characters around here are frowned on. If you don’t fit into a mold, you’re shunned. Sometimes it’s done politely and hypocritically, sometimes not. But you’re definitely treated rather like one of the non-pod people in “Invasion of the Body Snatchers.”  

The problem with not fitting into any mold is that the specifications of those molds are usually decided by people on the basis of little-to-no information. Someone takes a look at you and decides “you’re not one of us” without a second thought. It’s not just me I’m talking about. I hear stories from friends and clients all the time. And they don’t just mention skin color. One brow piercing or turquoise hair streak is enough to elicit a pointing and screaming that outdoes the body snatcher movie! 

I remember when the only quirky people on television were William Petersen (CSI) and Vincent D’Onofrio (Criminal Intent). (I know ‘cause I had a crush on both of them.) Now there’s quirky people everywhere, many of them women! There’s an Israeli ex-Mosad agent who mangles every metaphor, brilliant flaky artists with strong scientific skills, lab rats who dress Goth, forensic anthropologists with esoteric specialties, – most of them with high IQ’s who don’t get popular culture any more than I do. (Whoops! I mean “did.”)  

There are people almost too young to be working and people old enough to remember cultural references I can remember! There are also FBI agents who remind me of people with whom I’ve worked. Yes, there’s vain, shallow people, but also surprisingly complex people. Sometimes they can be obnoxious but they are very human. They care about humans and puzzling human behavior. They like to argue with those who think differently for the fun of learning. They are, all in all, very interesting. They are not one-dimensional, and they can’t be defined by one physical characteristic. 

But I still don’t get some things. I don’t understand jokes about “shoes.” I find “dishing” distasteful and boring, and the word “fashionista” makes me cringe. And there’s some shows I don’t understand any more than I understand people laughing over old Seinfeld episodes. 

Once at a mental health training I made the mistake of asking why people would watch a show after work that showed people behaving so badly that you wouldn’t want to work with them during the day. A female psychologist (yes, a psychologist, and one older than I am!) tartly responded that I was a “freak” from “another planet.” But that only made me feel more shunned and didn’t help my understanding of the issue at all.

If the people on that show were considered “normal,” it just didn’t seem like good advertising for being “normal.” Rudeness, hypocrisy, and human venom just didn’t seem funny to me. They still don’t.  

So I think I’ll stick with today’s characters. And if you know a place where quirky and interesting people are not shunned, please let me know. I’d love to move there! Meanwhile, I have some friends nearby who today are celebrating Groundhog Day, Imbolc, and Dia e la Candelaria. I think I’ll head off to celebrate with all of them! Fooey on “normal”!

Obama’s Fight With Tyler Durden!

Wednesday, January 28th, 2009


In case you’ve missed it, there’s a whole cult of interest forming around “Fight Club” and its manifesto of destruction. The theory seems to be that any action is better than no action at all. Well, I disagree strongly! Good action is best, even if it doesn’t always provide instant gratification. 

I feel sorry for President Obama. He’s in the same boat. He seems to understand that some fundamental systems in this country don’t work well. But he also seems to realize that “deliberate and prudent” are not bad words. Decisive action implies making a decision, which in itself implies thought and choice. 

I’ve also worked for change and improvement my whole life, sometimes with exhausting results and sometimes with very few results. (See my last book if you don’t realize how difficult it can be!) So the young people I know ask the legitimate question:  Do you really believe you can reform from within?  

They ask if it’s evil, isn’t it better to destroy it? Well, if it’s evil because it destroys the minds, bodies, and souls of people, how are you any better for acting in a destructive way? You become the very evil that you fight! Decisive action implies making a decision, which in itself should imply some thought! 

I’ve spent much of my life feeling like I had no patience. I was always the one being called a troublemaker for pointing out when something is being done badly. (i.e. hurtful to humans!) I’ve suggested and implemented ways of improving poorly run systems, either individual or agency-wide. And I still feel like the wait to see change is endless.   Even lately I tend to complain “So many good leads to follow, so little instant gratification!” 

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Senseless Violence?

Wednesday, January 21st, 2009

For many people, just using the terms “senseless violence” equates with “evil.” They don’t see their anger or bigotry as evil because they see through the filter of their own biases. Their rage is justified; their violent actions have reasons. Whether they swat a fly or burn a human, they will tell you they had their reason. 

Actually, using the term “senseless violence” just mean that the violent action doesn’t make sense to us, the viewer. After nearly forty years of working with the most bizarre, in prisons and in jails, in closed wards (when they still had mental hospitals!), in short, with every variety of strange and “senseless” behavior that can be observed, I have had the chance to observe many “reasons” for violence. None of them really make sense to me. 

Please let me be clear that I do not condone or excuse violent behavior. No matter how strong the emotion, the action is still a choice. No substance use or psychiatric disorder, in my mind, excuses the wrongness of behavior that hurts other people. In fact, it is exactly that element of choice upon which this article is focused.  

Many academics have written about the idea of innate aggression as a characteristic of being human. Anger and rage are seen as built-in responses to threat, with aggression and violent actions a result. I am convinced that, while the emotions may be a natural part of the human response to fear, the actions we do are always a choice we make. Whatever your reasoning is, you still have a choice of how you express it. 

I have found over the years that to help people heal, it is necessary to understand the internal pattern behind their seemingly bizarre behavior. Only then can you help build a path out of the morass and into healthier patterns. But when it comes to anger and people who commit horrible violent acts, I have seen a growing tendency to skip the more difficult path and just retaliate with vicious vengeance. 

The problem is that this only continues the cycle. The consequence of acting with venom against those who hurt us only creates a world with more violence and more venom. So what would happen if we tried to figure out the twisted trail that leads to aggression so that we could turn it in another direction? I’m not talking about simply getting into the criminal mind, with the corresponding danger of getting lost in that landscape. No, I’m talking about actually trying to understand. 

Understanding the seemingly twisted logic of another doesn’t excuse evil. Hopefully, it might give us clues as to how to prevent similar destructiveness in others in the future. But the first step is a comprehension of the rationale behind the violence. If common sense means widespread, then, as the saying goes, common sense isn’t all that common. But understanding the un-common reasoning of the violent may lead us to some ways to stop it.  

When it comes to violence “common” sense just doesn’t seem to exist. The reasons humans give for acting badly boggle the mind. Thank goodness everybody doesn’t think the same way or the human race would have destroyed itself by now.  But there are moments when I feel the species is headed in that direction.  

My professional experiences with violent felons over the last fifteen years, as well as my personal experience of the last five years, has made me want to explore the topic of why people do bad things in more depth and with more objective analysis of all its parameters. I feel like I’m just beginning on a jigsaw puzzle and I have to admit that there are pieces that completely elude me at the moment! There are problems in this whole area of study that totally baffle me.  

For example, some people cannot resist the temptation of the delusion that causes others to suffer equals “power.” In my writing and teaching over thirty years ago, I defined power as the capability of getting things done. All these years later, I still see more sense of achievement in actually accomplishing a project than in just being able to force people to do things. I assumed that over the years more people would come to this realization. (Well, I never said I wasn’t naïve!) 

With all the misconduct and theft in government and financial officials growing daily, 

Trying to understand why some people want power and money and will hurt others to get them makes my head ache. I understand wanting to make a living and provide for your family and future, but conspicuous consumption just seems so boring to me. At some point, enough is enough. At any point, forcing others to suffer should detract from your self-esteem not bolster it! 

Then there’s the problem of people who crave anger. I’ve written a lot over the years about how to manage anger. But I’m finding there are people who don’t want to manage their anger. Instead they just want to feed it. They say things like “I get my energy from being angry” or “I don’t feel like myself if I don’t get angry.” Of course, I don’t understand! That’s because I’ve always felt that I get my energy from love and sex, art and play, life-nurturing rather than life-destroying activities. 

That’s the kind of statement that really worries me because if there’s one thing I’ve learned in sixty years, it’s that fear leads to anger, anger leads to hate, and hate leads to destruction and suffering. In the last fifteen years of turning more and more into the study of how to prevent gangs and how to prevent terrorism, it’s clear that just responding with anger means turning into the evil that one is trying to avoid.  

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Finding Hope

Monday, January 19th, 2009

With all the news stories about corruption, violence, and just plain rotten behavior, my sons often ask me “Has it ever been this bad before?” In my 60 years of life, I’ve looked back and struggled, not knowing how to answer that question. 

I think I had this fantasy that as I got older, things around me would make more sense. And looking at personal events in my life didn’t help! When I first wrote the original bio sketch below, I had no idea that I would end up writing a book about the worst in human beings and an example of a legal system gone toxic.  

The last four and a half years has been a maelstrom of disillusion and despair in everything I had believed in. Since I covered the worst events in the book, I wanted to find some of the idealism, hope, and optimism that had always led me. I even had the courage to put a photo of myself on this website. Granted, it was from my 50th birthday. I’ve been rather camera-shy since the accident described in the book.  

My friends said the winds of change were blowing through the country. I’ve been working hard to find hope and new enthusiasm. 

Then I spent Martin Luther King Day watching a two-hour special by Tom Brokaw about “1968.”  Reliving the events of that year and remembering the effect they had on my personal life shocked me into tears. I heard Tommy Smothers say “I miss the optimism.” I heard Arlo Guthrie say he too thought we would “begin to relax as human beings and get along.” 

And I began to understand why I was having trouble answering my sons’ question. It wasn’t the venom I’d experienced since 2004; it was that venom hadn’t gone away. I have no idea whether we cover up more corruption now or then. I have no idea whether there is actually more violence. I just know there was too much venom then and there’s too much now! 

Someone interviewed complained about those foolish young people who “thought what you thought was right” and would go to any lengths to change the system. Someone else said the “culture wars began” then. But class disagreements have always existed in this country. My impression is that the 1960’s were just the first time people complained loudly in public instead of griping in private. 

And I can’t blame one generation of youth. I’m not certain there is a difference between the instant changes demanded by the radicals of the ’60’s and the demand for a magic pill, cure-all surgery, or financial bailout of this generation. Both want instant gratification. If the baby boomers are sometimes called “spoiled and self-indulgent,” then what is the characteristic of this nation listening to a constant barrage of commercials promising instant cures for pain, age, and fear? People today who hate those who disagree with their beliefs are no less venomous than officials of the Inquisition! 
 

Mr. Brokaw asked what was worth keeping and what should be thrown out? The first thing I thought of was that silly old slogan “Love it or Leave it.” I had the idealistic notion that if you loved this country, you should stay and try to improve it. I still do. I still prefer troublemaking whistleblowers to polite hypocrites. There are things wrong that need to be fixed. Love means having the courage to tackle the job of repair. 

We went to the moon that same year. One of the astronauts recalled seeing the earth rise over the moon’s horizon and realizing for the first time “really how fragile the Earth is and how limited our resources.” Amen! That’s still true. And it’s as simple as this: if we’re not doing things to improve conditions, we’re allowing their destruction. That’s as true for the welfare of human beings as it is for the physical environment. 

No matter what your politics, no matter what your religious beliefs, no matter what your race, no matter what you see as differences, we are all human. There’s only one way for us to survive: Co-exist and Cooperate!  

Mr. Obama, I wish you well. Don’t let the venom discourage you. Keep trying and we’ll all find hope. Because the alternative is despair!