What To Expect From Your Partner When Your Baby Arrives

January 2, 2010 by drgeraldstein

Sometimes the idea of a baby is a little different from the reality of a baby. Ask a parent. But the reality doesn’t comprise only the feeding and care of the little one. It also involves changes in the relationship to the spouse–the person who contributed half of the genes that make up your tiny new person.

Mostly I’m talking about a first child here, since the newness of the event and a number of other parts of it are things for which one cannot  prepare.

Let’s start with the sheer exhaustion you will feel. Babies are demanding creatures and will disrupt your sleep and test your stamina. Whatever schedule you had now must be altered to fit your child’s needs. How will you and your partner divide the new responsibilities?

Everything must now be planned out, so if you were a spontaneous, in-the-moment sort of person before, you will be thrown off your game. Do you want to go to the movies? Who will watch the baby? Are you breast-feeding? Will you leave some milk behind while you are out? Do you feel good about the person who is watching the infant? Is he/she conscientious and responsible?

The job of going out with the baby is not less demanding. Packing all his/her stuff, bundling him up, carrying or pushing him around, and trying to concentrate on driving or shopping or friends or your spouse at the same time.

Then there is the question of your parents and your in-laws. Do they want to be very involved with your new-born? How will you and your spouse feel if they are around more often? Will they be supportive or critical of you as new parents?

Of course, in order to go out, you must have a few dollars in your pocket. Most new parents have only a few–the mother has, at least temporarily taken time off from work. And now there is baby furniture and clothing and food to buy and baby sitters to pay for. Fewer dollars tends to mean more tension in the marriage and more decisions to be made about how to use those dollars.

New parents also face an increased sense of responsibility. After all, you have a little one who is entirely dependent upon you for everything–his life, safety, financial well-being, his clothes, food, and not least, his emotional health. Are you doing it right? Are you harming him/her? These concerns are enough to make nearly anyone insecure.

And, with the demands and responsibilities of this new life, you will necessarily have less time for each other and less time for yourself and your friends. Not surprisingly, especially among insecure men, jealousy can come into play. In an unexpected turn of events, the adoring sex-bomb he married just might have eyes for someone else–his own child! And, the needs of that kiddie will tend to come first. Moreover, if you have parents staying with you, your sexual spontaneity can be further diminished by their proximity. Later, you might also hear the phrase, “Not now–wait until the baby is asleep,” or later still “Not now, the kids might hear.” And one or both of you might occasionally find yourself thinking, to your surprise, that a nap sounds a lot better than sex.

In the time following the birth, the wife often feels less attractive, especially if her weight doesn’t come down to her pre-pregnancy number and the bags under her eyes reflect the sleeplessness of her new duties. Will the husband be understanding about this?

Heard enough? I haven’t even mentioned the differences in child-rearing styles that you will likely discover when your baby gets older.

Now that I’ve made the case against springing for a new off-spring, I will say something else: it can be one of the most wonderful times of your life. A time when you and your spouse pull together, find out new things about each other and about life, and glow with the love that only a child can evoke from you. If you are not dazzled by this new life, a life that you and your partner created out of nothing, a life that is different from any other one that exists now or ever existed, then you are missing one of the most wonderful experiences possible; it is a kind of falling in love, just as overwhelming as the romantic kind, but different.

Sure its a challenge, but what worthwhile tasks are not? It can be intense, delightful, joyous, worrying, demanding, and frustrating all at once.

But if you do it close to right and have a little luck, you will look back on your time on the planet knowing that it was the most important and rewarding thing you ever experienced.

Hope For the New Year: Old Words After a Tough Twelve Months

December 30, 2009 by drgeraldstein

Its been a tough year, but not the first in human history. These old words from the great nineteenth-century Scottish writer Robert Louis Stevenson seem just right:

“Give us grace and strength to forbear and to persevere. Give us courage and gaiety and the quiet mind. Spare us to our friends and soften us to our enemies. Give us strength to encounter that which is to come, that we may be brave in peril, constant in tribulation, temperate in wrath and in all changes of fortune, and down to the gates of death loyal and loving to one another.”

Going Out on Top: the Difficulty of Making a Graceful Exit

December 27, 2009 by drgeraldstein

Athletes know, perhaps better than the rest of us, the difficulty of a graceful exit. They must leave the playing field one last time while most of them are still reasonably young. It has been said that an athlete dies twice–once when his career ends and, of course, a second time when his life ends. Not an easy thing. As A.E. Housman put it in his poem To An Athlete Dying Young,

“…Now you will not swell the rout

Of lads that wore their honors out,

Runners whom renown outran,

And the name died before the man…”

The loss of that renown, the fortune and fame, the heady access to everyone and everything, and especially to the cheers–that must be a very tough thing indeed for the famous person to give up. Lots of names come to mind, the names of those who stayed on stage too long.

Start with Willie Mays, a meer shadow of his youthful speed and grace when he played his last games for the NY Mets at age 42, hitting .211 in his final season, well below his .302 lifetime average. Or Frank Sinatra, croaking out the oldies well past his prime. Then there were the twin titans of symphonic conducting in the first half of the twentieth century, Wilhelm Furtwångler and Arturo Toscanini. The former continued to direct symphonic concerts even though he knew his hearing was failing, while the latter famously went blank and stared into space during his very last concert with the NBC Symphony Orchestra in 1954 at age 87.

But every so often we have a different sort of model, someone who walks off stage with his head held high, at or near the peak of his performance, and so our memories of him in his youthful prime stay in tact. Think of Sandy Koufax, the great Dodger lefty, who won 27 games in his last season of play, deciding at age 30 no longer to endure the pain that his left arm exacted as the price of pitching excellence. Or Ted Williams, who hit .316 for Boston in his final season and hit a home run in his final at bat at age 42. Or Joe DiMaggio, hobbled by injuries and not at his best in his last year, ending his career before he embarrassed himself and let down his teammates.

It is always difficult to give up something you love, all the more if you are paid handsomely (in adulation and dollars) to do it. Indeed, we are at risk of holding on to lots of things too long: our children, a dead love affair, a common stock, a job, perhaps even a hair style or an old suit, and sometimes (a few would say) life itself.

They also say that timing is everything and, whoever they are, “they” are often right. “Going out on a high note,” or “knowing when to quit”–there are lots of phrases that emphasize the same point. And now the Baby Boomers, especially the teenagers of the 1960s who were advised not to trust anyone over 30 and thought they were the universe’s center, find themselves about to collect Social Security. When I’m Sixty-Four is no longer just a song title, but a place just around the chronological corner for a bunch of aging flower children. And even though most of them are not great athletes, heros, or symphony conductors, the timing of the retirement process may still be full of challenges–leaving with enough money, while you can still do the job, before you lose that ability and risk the humiliation that comes with letting down your colleagues.

I suppose it is easier if you realize at some early time that nothing is permanent, except perhaps, the Earth itself–at least if we don’t screw it up. In a sense, an occupation or even a life is a little bit like an apartment–something you rent, according to the late violinist Nathan Milstein, who, by the way, was still playing wonderfully at his very last public concert when he was 82. Seneca said it a little bit differently, suggesting that a man should live “as one who is on loan to himself and intends to return everything without complaint when the debt is recalled.”

Clearly, the way to leave the stage is with a smile and a bow–saying, in effect, “thanks for your attention, your applause, and the chance to perform for you, to do something I love.” We all have our share of chances to do this, whether it is quitting a job or a relationship or any other time when there is an ending and we say “goodbye.” So, if “practice makes perfect,” perhaps there is hope to do it right.

Good luck for those times when it is, inevitably, your turn.

When the Lover is Ready the Soul Mate Will Appear

December 23, 2009 by drgeraldstein

I’ve read or heard two different meanings attributed to the Buddhist saying, “When the student is ready the master will appear.” The first suggests that the universe is ordered in such a way that things happen when they are supposed to, and that when one is ready for knowledge, that knowledge will be offered by events in the universe (or God). If I am allowed to amplify the meaning slightly, the saying would also refer to the idea that when you are ready, the right person for you might also appear, not just a teacher, but your future love.

I prefer, however, another, more psychological way of thinking about this aphorism: that there are always available “masters” or other persons who might be important in your life, but that the “student” doesn’t notice the presence of those persons until he is ready. Or, to look at a different aspect of this notion, that important knowledge is always or almost always available to us, if only we are open to it, prepared by experience or mind-set to receive it. In other words, we must be ready to learn, to think and feel differently than we have before, in order to recognize that there is something important there to be learned.

Those in life who have all the answers, who are certain of everything, will never learn anything new. Those who are afraid to do new things are unlikely to learn, since in order for the “master to appear” one must have one’s eyes open and actually get out of the house–the master is unlikely to call you on the phone to make an appointment, unsolicited. But if you are humble about what you know, humble in the knowledge that there is always more to learn, you might just learn something. Branch Rickey, the baseball executive, said that “luck is the residue of design.” I’d add to that, so is learning the residue of design. And part of that “design” or preparation is to put yourself into situations where it is possible to be enlightened, whether by people or events or your actions, by books or theater, music or child-rearing or romance.

A good therapist is enlightened his patients. He experiences a whole world, the world of the patient, seen through the patient’s eyes. His patients’ also inform him, directly or by their response to him and to the therapy, what works and what doesn’t.

People in less formal relationships than therapist and client teach us too, and enrich our lives. For example, some people believe that there is only one person who represents our romantic destiny. So, when that person comes along, one might say, by the first definition I gave you at the top of this essay, that the universe or God put this person in our lives at just the right time. There is a Yiddish word that captures this notion nicely: “bashert” or “beshert.” In other words, to be “fated.” It is used when someone tries to say that an event was “meant to be,” and is often used with respect to a reference in the Jewish Talmud that God has chosen your soul mate.

My own opinion, however, is that most of us might have met, fallen in love with, and married any number of good people and had equally good lives as we have with the person who we did marry; different, certainly, but just as good, more or less. That we didn’t marry someone else might have been due to a lack of maturity when that “other” person appeared, poor judgment about the value of the qualities in that person, or fear of rejection and heartbreak, to name just a few possible reasons. If you protect your heart against the poisonous arrows that can break it, you also might just be preventing Cupid’s arrow from reaching it.

One must be open, then, for the right person, for the master, for whatever knowledge or experience might enrich us. Vincent Van Gogh wrote the following to his brother Theo in 1880: “Many a man has a bonfire in his heart and nobody comes to warm himself at it. The passers-by notice only a little smoke from the chimney, and go their way… I am drawn more and more to the conclusion that to love much is the best means of approaching God. Love a friend, anyone, or anything you like, and I tell you, you will be on the right road to learn more. You must love with a high and intense determination, with your will and your intellect, and seek always to deepen, expand, and improve your knowledge…”

Which makes me think of my friend Mel. Mel is an old friend in both senses of the phrase–I’ve known him since the ’70s and he is now 89 years old. Less than two years ago he lost his wife of 50 years and was devastated. But, to his credit he has fought through and grieved his broken heart to the point that he just went on his first date! And so, Mel lives as he always did, learning, taking classes, counseling others, being with his children and grandchildren, making friends young and old; ever curious about politics, music, sports, medicine, and the world. In other words, open to life and whatever it will reveal to him.

My advice then, to you and to myself, is to keep learning and keep being open to “possibility,” including the possibility that there are things yet unseen, unexpected, or unacknowledged that will enlighten us if only we keep our eyes open and look.

We are all students of the greatest teacher of all: life.

Who are You to Judge?

December 19, 2009 by drgeraldstein

Judgment is problematic. We need it, but not too much of it. Sort of like food.

While I will say more of a secular nature, the most famous comment on judgment comes from the New Testament–the Christian Bible–and is attributed to Jesus:

“Do not judge, or you too will be judged. For in the same way you judge others, you will be judged, and with the measure you use, it will be measured to you. Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye? How can you say to your brother, ‘Let me take the speck out of your eye,’ when all the time there is a plank in your own eye? You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother’s eye.”

The point here is about the potential for judgment to be afflicted by hypocrisy–for us to judge others by a standard that is harsher than the one that we apply to ourselves. It is akin to the famous late addition to the Christian Bible about Jesus turning away the men who are about to stone a woman who had committed adultery, with the comment “Let him who is without sin among you be the first to throw a stone at her.” He later advises her to go and “sin no more.”

We judge lots of things. We need to judge the accused in the court room, lest wrong-doers do wrong with impunity. We judge ourselves and, one hopes, that it improves our future behavior and helps us make good decisions.

We judge for self-protection, too; to comfort ourselves with the belief that the misfortune of others is due to their bad decision-making. By implication, if we make better decisions–display better judgment than they did–fate will be kinder to us. If we are careful, thoughtful, smart, do our homework, live by the Golden Rule, and so forth, good things will happen to us and we will avoid bad things. This view seems to look at misfortune as some sort of anomaly, something that is outside of the normal course of events when, of course, it is not. All sorts of bad things happen to the innocent or unlucky. This is a troubling thought and our negative judgment of others–our attempt to make sense of their troubled lives or bad luck–makes it easier to sleep at night.

I’m not trying to justify all poor decisions here, many of which surely lead to disaster. Rather, it’s simply that not every bad thing is the result of some fatal flaw in the nature or conduct of a man or woman. Sometimes you can do everything right and have a bad result. Sometimes things just happen.

Judgment serves, too, as an attempt to guarantee immortality. Since most people see death as the worst possible outcome in any life, it shouldn’t be surprising that harsh judgment is often characteristic of religious fundamentalism. For the “by-the-book” parishioner, following all the rules of his or her particular religion guarantees a heavenly reward. And, for those who violate the doctrine, the faithful believe that there will usually be a trip to a darker place. Judgment in this instance provides some comfort that death is not final; and perhaps the self-satisfaction of believing that in visiting judgment on the unfaithful, one is only trying to move them onto a path that will lead to heaven. For some of the religious fundamentalists I’m sure that it is; for others, however, it might only be a justification for venting angry condemnation of those who are different and who do not believe what the self-righteous might wish they did believe.

Often judgment is made by those who have no experience of the situation or circumstance in which the “judged” behavior occurred. To take a current example, consider Tiger Woods (or some other celebrity) reported to be unfaithful to his spouse. I am certainly not here to apologize for, or attempt to excuse Tiger Woods’s behavior. But I would say this: I suspect that non-celebrities have no idea of the temptation available to a man or woman in Woods’s position nearly every day of his life. And, as Oscar Wilde famously said, “I can resist anything but temptation.”

But, let us move away from the always controversial area of sex to give this idea a different look. I once asked the great Italian symphony conductor Carlo Maria Giulini about his judgment of the behavior of the German conductor Wilhelm Furtwängler. Furtwängler chose to stay in Germany during the period of the Third Reich, although he was not a Nazi. While he was helpful to some Jewish musicians, he also was used (and allowed himself to be used) as a propaganda tool by the Nazis. Giulini , who began his career as an orchestral violist, had played under Furtwängler in Italy before the war. Moreover, during World War II, Giulini, never a fascist, had defected from the Italian army into which he had been conscripted and gone into hiding for nine months, during which time he was a “wanted” man. But when I asked him about the controversy surrounding Furtwängler’s decision to stay in Germany and to allow himself to be a representative of a corrupt regime, Giulini was hesitant to judge: “It’s very, very difficult to judge the position of a man. It’s difficult for you in America to understand the problems we had in Europe. It’s difficult to put yourself in a position, in a special moment (in history), that is absolutely impossible to imagine if you didn’t live in that time. That last thing I should do is to express my opinion on this point. I had my personal political opinion, I took my position–very precise. I was not a fascist (laughs), and at the moment that I had to make a strong decision, I took it. But I am not in a position to do any criticism of another person.”

We judge ourselves and others, to the extent that we do it, with the perfection of 20/20 vision that only comes in looking back, in hindsight, at what was done. We sometimes say “he should have known better” than to (make that business deal, marry that person, visit that neighborhood, smoke, drink–take your pick). Well, it is sometimes true. And, after all, I’m in the business of trying to help people to make better judgments. But mostly, that experience tells me that all people make mistakes and, assuming that they don’t mean to injure others, they mostly pay for those mistakes with their own blood, tears, and sweat. As much as I recognize that judgment has its place, as a therapist, I try to meet people on their own terms, not coming from “on high” as a stern taskmaster or a fundamentalist-style religious figure “laying down the law.”

No, if you want that, you shouldn’t consult me. I am not here to condemn, although I don’t shy away from identifying right from wrong when it can be clearly seen.

Instead, I am here to help, to understand, to provide a bit of solace, to be a guide to a better way, if I can.

Unloading Your Therapist: Breaking Up is Hard to Do

December 16, 2009 by drgeraldstein

Ending a relationship is difficult. Most of us have been on the receiving end of a relationship “break up” of some kind. We know that it doesn’t feel good. Indeed, we know that it can be taken as a rejection (and often that is exactly what it is). Nonetheless, that doesn’t stop some of the same people who decry the insensitivity of others who unceremoniously “dumped them” from doing the very same thing, in the very same way, when they wish to be free of seeing someone else ever again. With that in mind, here are a few guidelines for thought and action, and some examples of what people do, when and if it comes time to end a relationship with a therapist. Today, I won’t be talking about the sense of loss or sadness that sometimes accompanies therapy’s end. I’ll leave that weighty topic to another time.

1. The “I’ll call you” strategy. Usually, this is delivered by phone message. The patient probably has an appointment with the therapist and cancels it, adding that he will call to reschedule. Experienced therapists know that many people will attempt to end the therapeutic relationship in this way. It avoids a face-to-face conversation which the patient might imagine as uncomfortable, and it avoids actually giving any reason for terminating therapy. It leaves the therapist a bit in the dark, not knowing whether the predicted call will ever come, and probably not knowing what the reason is for the decision to end treatment.

2. The “end of session” termination. Patients often wait until the end of the therapy session to say something of importance, in part because it is uncomfortable or they don’t want to discuss it in any detail, at least not yet. This method of termination has the advantage of being done face-to-face; what it doesn’t do is to allow the two parties to process the reasons for that decision and discuss any concerns. Without some time to talk, the therapist cannot be helpful to the soon-to-be-departed patient, or find out much about the client’s reasons for his decision. Without knowing what those reasons are, its hard for the therapist to learn from any mistakes he might have made, anything he did (or didn’t do) that made the patient uncomfortable, etc.

3. The “no-show” departure. Some individuals who are receiving counseling decide to end therapy by simply being absent from their next scheduled appointment. This is rude, of course, and also risks that the therapist will charge you for the time even though you didn’t come to his office (most therapists expect 24-48 hours notice of cancellation in order to relieve you of the obligation of payment).

4. The “nasty phone call” ending. While this is a rare event, sometimes people want to hurt the therapist because they believe that they have been hurt or neglected by him. They leave an angry phone message and avoid any chance for the therapist to find out why they are hurting, just as they make it impossible to come to a more amicable resolution of the issues at hand.

5. The “I need a break” message. It is, indeed, sometimes appropriate for patients to take a break from treatment. It can get too intense for some, who realize that taking a breather might be helpful. On other occasions, the complications of life outside of the counselor’s office make continued therapy difficult for the moment. However, when giving the message that you “need a break” is simply a way of leaving therapy, with no intention of return, it doesn’t allow for any closure to the relationship, or any of the benefits that such closure provides (which are described below).

6. The “best” way. Whether you have been seeing the therapist for a long time or a short one, the issue of termination is an important one. It is appropriate for you, even from the start of treatment, to ask how long it is expected to last. If you are finding counseling unsettling or unproductive at any point, it is best if you discuss your concerns with the therapist as they happen. Since many people who enter therapy have a hard time with being assertive and direct, it might well be tempting not to talk much about anything that you believe the therapist doesn’t want to hear, and simply to end the relationship unilaterally. Unfortunately, you and the therapist are short-changed if you do this.

Ideally, your concerns should be expressed early in a session, when there is sufficient time to talk about them. Be prepared for your therapist to ask you why you are thinking of ending treatment. You might be surprised that the therapist agrees with you. Alternatively, you might be persuaded if he makes a good case to continue for a while. But if you are certain that it is time to end things, be sure to hold your ground. A good counselor should accept this without trying to make you feel bad about your decision.

Once an understanding is reached about ending treatment, that doesn’t necessarily mean that it must end at precisely that moment. You and the therapist might decide to taper-off sessions or to have at least one additional session to sum up the history of your work together and to say “goodbye.”

There are several reasons for having just such a final session. First, it should allow the two of you to review what you have accomplished, how your life has changed, and what you have learned. Equally, if nothing or little of value has occurred, it can give you the chance to inform the therapist where treatment went wrong. Therapists should be grateful for this information since it allows them to learn, adapt, and improve so that they can help those patients who will follow you into their offices. And, a last session gives the therapist time to point out treatment alternatives or refer you to other available therapists who you might wish to consult.

Finally, a good therapist who has known you for a bit of time usually has some very nice things to say about you, about your courage, wit, grace, intelligence, and the guts it took to look your problems in the face and try to change your life. The last session also gives you a chance to say “thank you,” if that is something that you believe appropriate. The counselor will usually let you know that he would be grateful to hear from you again, just to know how you are doing. And, the door is almost always open if a return to therapy is required.

So, therapy, even when it wasn’t as helpful as you had hoped, can and should end with an expression of respect and good wishes for your future well-being. You will usually feel good about being direct in doing what you believe is in your interest, and having the self-confidence and respect to tell it to the therapist face-to-face. Your therapist will be grateful too, in almost all cases.

No losers here. Only winners.

Are You Too Emotional?

December 12, 2009 by drgeraldstein

You’ve heard it before–”You are too emotional!” Surely you heard it as a child, at least once. But, what does it mean? How do you know if it is true? What is the proper place of emotions in any life? And, if you are “too emotional,” what should you do about it?

First let us establish some ground rules. Emotion is necessary. Imagine a life without it. No  love, no families based on that love, no compassion, no empathy, no righteous anger. What would be left? A life of relating to others as objects, like chairs or tables, their only value in utility–the function that they perform; only reason would be left– cold computation of what to do and how to do it. No laughter, no tears, no gratitude, no passion.

If you agree with what I’ve just said, then it is clear that emotion has a place. It binds us to others, plays a part in letting us know when others have hurt us, allows for the possibility of good relationships and a joy in living. It also creates an energy that is necessary for self-defense and for the pursuit of causes. Emotion motivates us and permits the creation of communities.

But, when you are called “too emotional,” the accuser usually isn’t referring to love or happiness or even anger. No, usually he means that you are too easily hurt. And, when you are young, especially if you are male, you are encouraged to “be a man” and live by the “athlete’s creed;” if you are hurt, in other words, rub some dirt on the injury and get back into the game. Don’t complain; that is for whiners and wimps and little kids.

Well, if you are an athlete, that is what you have to do. Think too much about the injury and you won’t be able  to perform. Moreover, if you even think too much about your past failure in the game, you won’t have the confidence and focus to be able to succeed in the remainder of the contest. So, under those circumstances, being “emotional” does, indeed, get in the way. Similarly, emotion interferes with necessary behavior in war-time or in other crises that require focus, indifference to pain, and steadfast action.

But how about other situations, less demanding and fraught with danger or competition?

For me at least, emotion has become, for the most part, a friend. I can be moved by the sadness of my patients and those in my life who I love. I do not consider it a weakness. It is simply a part of being the responsive, sensitive person I aspire to be. And I can be moved by music or drama, again to the point of a tear. Life seems richer, warmer, more eventful and worthwhile that way. I don’t feel the need to keep up a brave front, an appearance of having tamed my emotions. No, I’m not often whipsawed by my feelings, but, in part, that is because I give them their place in things and don’t keep them all bottled-up, looking for a way to burst out of the container that I would otherwise have put them in. And, when it is required, I am prepared to seek solace from a few of those closest to me, just as I give solace to my patients and those I love.

True, being emotionally vulnerable means that you can be injured. But, don’t fool yourself, life will have its way with you whether you are deadened to feelings or not. By killing your emotions, you are probably only succeeding in limiting the fullness of your life while attempting to create an illusion of strength.

Put another way, it is only human to have emotions and best if you are comfortable with that fact almost all the time.

But, beware when the emotions have you!

At the extreme is a condition called Borderline Personality Disorder (BPD).

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, states that “the essential feature of BPD is a pervasive pattern of instability of interpersonal relationships, self-image, and affects (emotions), and marked impulsivity that begins by early adulthood and is present in a variety of contexts.” These folks are, unfortunately prone to “frantic efforts to avoid real or imagined abandonment,” instability, recklessness, suicidal behavior, rapid and intense mood changes, emptiness, and anger. They are the flesh-and-blood definition of what it means to be “too emotional.” And, not surprisingly, they are difficult to treat, although Dialectical Behavior Therapy is a treatment specifically designed to do so, and has demonstrated great promise with this patient group.

For those who are not categorized with this diagnostic label, how do you know if you are too emotional? Here are a few questions you might ask yourself:

1. Do people, not only family members, often tell you that you are too emotional?

2. Do you tend to make impulsive decisions in an over-heated moment that you later regret?

3. Do you have many arguments and blow up easily?

4. Do friends and relatives have to handle you with kid gloves?

5. Do your emotions suck the life out of you, change easily and quickly, and generally whip you around?

6. Do you weep easily and often in the absence of major set-backs or great losses (I’m not talking about having a tear come to your eye here, but something more gut-wrenching)?

7. If you are in mid-life, are you no less emotional than you were in your teens? (Most of us become less volatile, more in-balance, over time).

If you’ve answered too many of these in the affirmative, you may want to seek counseling.

A last word or two. Life is challenging. We need to permit ourselves feelings and we need to express them, within limits, and to have a sympathetic soul there to bear witness and listen to us. Balance is the key most of the time. It may help to remember a portion of the “serenity prayer:”

“God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.”

If you do not “know the difference” often enough and go to emotional extremes over the routine ups and downs of life, if even the little things seem too big, then it might be time to seek professional help. Not to kill your feelings, but to make sure that they don’t destroy your ability to have a good life.

Letting Go of Your Children

December 9, 2009 by drgeraldstein

One of the hardest things a parent has to do for his child’s well-being is “letting go.” The attachment between a parent and child, at its best, is profoundly intense and rewarding to both parties. But, at some point, earlier than most parents think, the tie must be loosened. There are at least two reasons for this.

The first involves the danger of overprotection. While the world is a harsh place at times, children who are not seriously disabled need to begin to obtain some mastery of that world. They will not do so if the parent hovers too closely, watches every move, makes every decision, and doesn’t permit the child to get a sense of accomplishment and independence.

Secondly, if the child is ultimately to break-free, the parent must prepare him and encourage him. Kids will make bad decisions; they will get hurt by life. All that is a part of growing up and, in fact, a part of life as an adult, too. If they are to succeed in life, attach to others outside the family (mate), produce children, and develop a personality that is different from that of either parent, they will profit from the permission and encouragement to do so.

There is no perfect guidebook for how to disengage–how to, little-by-little, give your child more freedom, less oversight. It is easier, of course, if the young one is reasonably outgoing, a good student, and doesn’t get into much trouble with authorities. But even with kids who are having difficulty, micro-management can create resentment and rebellion, while constant criticism can be depressing and efface the child’s shaky self-esteem. A parent needs to know which children need a heavy hand, which a light touch, when to praise, when to correct, and when to punish. No one can provide  precise direction to this in the abstract, because each child is different and each parent is different. That said, here are a few pitfalls to watch out for:

1. Don’t try to raise each of your children the same way. While this should be obvious, it rarely is. Some parents even brag: “I treated all my kids the same.” This is preposterous, but, even if you came close, you probably shouldn’t have. All children aren’t the same and therefore require the kind of attention that works for them. Why would it make sense to raise an active child in the same way as a passive one, or an outgoing offspring just like an introspective little person? One size doesn’t fit all.

2. Don’t “own” your child’s life. He isn’t you. He needs to have his own ideas, not some Xeroxed version of what you think he should be. He ultimately needs to “own” his direction in life, meaning that the desire to do well in school and in other things needs to be his. If he only does his school work because he is required to, even when he is in high school, somehow the transfer of responsibility from you to him hasn’t been made. You’ve got about 15 years to accomplish that hand-off; after that, demands from parents to “do better” usually generate diminishing returns.

3. Don’t set unreasonable expectations. Most middle-class folks see their children, at least a little, as a reflection of themselves; someone to carry the family banner into the future. But, you can make yourself a little crazy by wanting great fortune and fame for your kids, and letting them know you will settle for nothing less. Harvard isn’t for everyone and there is no guarantee of a good life that comes with admission to Princeton, Northwestern, Yale, etc. If your child can make a living, find love in his life, behave honorably, and experience some measure of fulfillment, that just might be quite enough.

4. Don’t make your child feel guilty over leading his own life, not providing you with grandchildren, and not being as close to you as he was when he was little. He needs to break-free and take care of himself. He should (and probably will) want to have you in his life, but don’t be an anchor around his ankle.

5. Don’t live and die with every success and failure on your son or daughter’s path. Easier said than done, by the way. Learn to accept things as they are. Get some distance. Meditate. Get a life of your own. As a famous basketball coach once said, “If every game is a matter of life and death, you’re going to have a problem. You are going to die a lot.”

6. As your kids move into adulthood, don’t preach and do be careful about giving advice, especially if it hasn’t been requested. Let your children know that you are proud of them. Not because they became captains of industry, but because they are good, decent, and loving people. Give your grown kids support and encouragement. Enjoy them, don’t manage them.

7. Remember that they aren’t you, they won’t always do what you would do, what you think wise, believe what you believe to be true. They might belong to a different political party, root for a different baseball team (God forbid!), change religion or give up religion. They might marry someone you don’t completely fit with. Remind yourself that what is important is your child’s happiness and fulfillment and decency.

8. Take good care of yourself. Find a meaning in life that is not 100% about your adult children. Try to get there gradually, not on his or her 21st birthday.

If you are lucky, your children will turn out well, and be grateful for all you did, and for your wisdom in not “doing it all” for them forever. It’s quite an adventure for the concerned parent, and you will never stop being concerned. As Sir Francis Bacon wrote, “He that hath wife and children, hath given hostages to fortune…” But, with practice, you will sleep at night even on many of the nights that your adult child is having some bumps in the road.

When you look at her, fast asleep in her crib, all of that seems impossible and impossibly far away. But it can happen.

I’ve been there.

Cigarette Smoking, Bull-Fighting, and the NFL

December 5, 2009 by drgeraldstein

What connects the words that make up the title you’ve just read? More than you might think. And they represent a dark-side to daily life in the USA and around the world.

Yet we tend not to think about them and it (that dark-side) very much. The main link among the three is that they involve varying degrees of destructive behavior; indeed, they all risk a needless acceleration of death; an increase in the chance of an early demise for those who participate in the activities in question: smoke cigarettes and you roll the dice on emphysema, heart disease, cancer, and more; fight a bull and you just might not leave the stadium still breathing; play in the NFL (National Football League) and you increase your risk of dementia and a shortened life expectancy. All while the promoters of these actions and events make money.

Football, smoking, bull fighting, and (one might add) boxing have another thing in common. They are activities performed (or at least begun) when one is young; when one is in full leaf and flower, like a tree on a mid-spring day. And just as the tree cannot imagine (having no consciousness) that it will turn brown and dormant before the year ends, young people have difficulty really believing that they are mortal, and imagining a time when they could be enfeebled or worse.

Tears and strains, bumps and bruises, broken bones, and bouncing brains; bodies busted and bent. That is what I am talking about. According to the NFL players association, the average professional career lasts 3.5 years. No wonder that some say the letters NFL actually mean “Not For Long.” Certainly, many players are cut from the team for under-performance in an enormously competitive environment, but many leave because of injury. The average life-span of an ex-NFL player is 55 overall and only 52 for linemen. No doubt, this is due partially to factors beyond the punishment done to their bodies by the violence of contact, particularly weight and diet related problems. But do not dismiss the direct effect of that punishment on producing life that is diminished and shortened. A recent University of Michigan study of 1063 retired NFL players found dementia-related conditions at a rate five times higher than the national average for men 50 or older; in ex-NFL players 30 to 49, the rate of dementia-type conditions is 19 times higher than for other men in the same age group.

And what is the reaction of most of us to this? Perhaps we say, “that’s interesting, but its a free country and the smokers and the football players are free to take their chances.” And on Saturday or Sunday we cheer for the football teams and the young players, just as you might yell “ole’” at a bull-fight. No one does pep-rallies for smokers, of course, but we do not prevent their slow self-injury, even if we limit it to certain places and conditions.

Somehow, the bull fights seem a bit more honest to me. The injuries are plain to see. And, the bull will spill blood and die while we watch, unless it first injures the matador to the point of his own bloody and usually visible injury. By comparison, we won’t see, for the most part, the smokers wheezing, or lying gray in ICU, holding on, if they can, to dear life; or the ex-football line man (unless he is as famous as the boxer Muhammad Ali), rendered almost mute by the effects of repeated head injuries. We won’t be there for the knee and hip replacements; we won’t spell the over-taxed spouse who married the daring young athlete-hero in his prime, and now must change his diapers.

It’s only a short step from this to war, don’t you think? Again, it is the young who fight for us and who suffer for us, mostly out of our sight in a place far away.

Are we really so far removed from the days of gladiatorial combat in the Roman Coliseum? Dig not too far below the surface of civilization and you will find more than a little brutality. And, too often, if you look a bit more closely, there we are, the two of us, preparing a tail-gating party to witness the carnage, bundling up to sit in the stands, cheering it on.


He Who Hesitates is (Sometimes) Lost

December 2, 2009 by drgeraldstein

Fear and hesitation go hand in hand. The trick is to separate the two, to recognize that you needn’t wait until you are free of fear in order to act. Indeed, if that were the case, most of the people whom we consider brave would still be waiting for the moment of bold action that earned them the appellation “hero.”

Years ago I heard a panel discussion on the subject of Wagner’s opera cycle The Ring of the Nibelung that actually touched on the issue of courage and decisive action. The experts focused on the character Siegfried, who is described as someone who has never known an instant of fear in his life. Should we therefore consider Siegfried’s fearless behavior to be indicative of heroism and bravery? The panel in question concluded it did not. After all, they reasoned, how can one be a hero without fear to overcome? Only a fool would rush to action without being aware of the attendant dangers. But a brave and courageous man would know the perils facing him and choose to act in any case.

Most of us won’t face dragons or fire, of course, but we still will all have numerous chances to act decisively or to hold back. Here is a trivial, but instructive example from my own life. In college, I was fulfilling a PE requirement by taking fencing. Now, I wasn’t a very good fencer, despite being a reasonably good athlete. And, my heavy academic course load didn’t permit me the luxury of spending time outside of class to practice fencing. Thus, in the first seven matches I had against my classmates, I won only three, a pretty mediocre showing.

Nonetheless, I was competitive enough to want to win more often, so I reasoned that there just might be a way that wouldn’t take time away from my other studies. I realized that I was a relatively tentative fencer, and so I decided to become more aggressive. I set myself the task of getting in the first “touch” as soon as each new match began. The strategy worked. Of the next 17 matches, I won 14. I was almost always able to get a 1 to 0 lead within a few seconds of the start of the competition by catching my adversaries off-guard. Yet, despite my new found success, I was really no better at fencing than I’d been when my record was three wins and four losses. I was simply less hesitant, more aggressive.

I once had a biology professor named Hudson who conducted the “Quiz” portion of his classes in a way to encourage behavior similar to my fencing experience. You were graded on the number of questions you answered correctly and lost points if you answered the interrogatories wrong. Hudson asked the questions aloud and it was a race to get your hand up first and have him call on you to answer. Naturally, you had to make a quick decision as to whether you had the right answer. Very fast indeed. Those who hesitated were, as the saying goes, “lost.”

But how does this all apply to daily life, the life outside of the university. You might say that “normal” life is less competitive than my examples suggest, but is it? To answer that question, ask yourself how often you hesitate to do things, take chances, give public voice to concerns that might engender disapproval, avoid tasks that are difficult or challenging? Do you ask out the beautiful woman, or do you wait until you feel “ready,” only to watch someone else beat your time in getting her attention? Do you, at least sometimes, see a crisis as an opportunity? Or do you hold back, put things off, wait and hope that another or better time for action will come? Sometimes it will, but sometimes it won’t.

If your “default” strategy, your habitual tendency, is to wait, you have a similar problem to those whose standard operating procedure is to act impulsively, without thinking. It may be the case that “fools rush in where angels fear to tread,” but it is also true that you are an equal fool if you forever hold back, hesitate, and watch the moment pass or see someone else “seize the day (carpe diem).”

What I am talking about is fear and the uncertainty that fuels it. When we are fearful and decide not to take action, most of us feel an immediate sense of relief. That relief reinforces our hesitation, while simultaneously depriving us of the opportunity to succeed in the endeavor. Soon enough, the relief will pass, but not the self-doubt and lack of personal esteem and confidence that might have been won by an effective action.

The danger in allowing too many chances to pass by is a life of “quiet desperation,” a life on the sidelines, watching others play the game, but not playing it ourselves. And, at the end of life, regret for the opportunities passed and the chances not taken is more likely to be troubling than the failed efforts made. Beware the heartache of the words “what if?” True, acting boldly often fails; but, it also sometimes succeeds.

No wonder, then, that musicians spend relatively little time passively listening to music. They are too busy making it.

Make music of your life, then. Let the trumpet announce (or remind) the world of your presence. Sing your song. And if you cannot, find a therapist who will give you the tools to beat back your fear and help encourage you.