On the Fort Hood Tragedy

What happened at Fort Hood? Why would a psychiatrist, a physician trained in the treatment of “mental and nervous” disorders, go on a rampage against his own comrades? I suspect we will be reading about the following in the days ahead:

1. Did Major Nidal Malik Hasan, the accused murderer, have proper supervision of his work and his own fitness for duty? Did he suffer from a psychiatric disorder of his own and was he being treated? News accounts suggest that he was terrified in anticipation of an expected deployment to Iraq or Afghanistan.

2. To what extent did he feel marginalized within the Armed Services? He is said to be a man born in the USA, the son of immigrant parents. It is also reported that he had become increasingly devoted to his Muslim faith and might have experienced some harassment from other soldiers because of his religion.

3. Was the Major marginalized in other ways? He is described as a 39-year-old bachelor who had been looking unsuccessfully for a mate.

4. Major Hasan is believed to have treated numerous veterans suffering from PTSD (Post Traumatic Stress Disorder) returning from the Middle East. Is it possible that he suffered a form of vicarious trauma from hearing the disturbing, if not tragic stories of these young people?

5. To what degree have the Armed Services been able to reform an organizational culture that discourages soldiers from showing emotional vulnerability and seeking treatment before they become dysfunctional? It is one thing for the returning wounded veterans to get psychiatric services; it is another for them to believe, early on, that their anxiety, worry, and depression will not be seen as a weakness by their comrades, make it harder to perform their duties in war-time, and cause them to be ridiculed? Did Major Hasan, who apparently had not experienced combat himself, believe that his own inner-turmoil was acceptable and would have received support from his superiors?

6. Did Dr. Hasan have a history of having received treatment prior to his entrance into the military? If Dr. Hasan did seek treatment at any time, what was the result? Is their any routine assessment of the psychological status of both the soldiers and those who are given the task of treating them? Does the military realize that the nature of their work puts virtually all personnel at psychological risk?

7. What security procedures exist in military installations such as Fort Hood?

8. Is the military sensitive to cultural conflicts that are experienced by its uniformed personnel?

Most of us assume that mental health professionals have their own personal lives well under control. Unfortunately, such is not always the case. For more on this subject, please read my recent blog: “When Helping Hurts: Therapists Who Need Therapy.”

When Helping Hurts: Therapists Who Need Therapy

I’ve known therapists who slept with their patients. I’ve known therapists who took “down on their luck” patients into their homes. I’ve known therapists who made friendships with their patients and socialized with them outside of the office. And, I’ve known therapists whose sense of their own value depended on their patients’ approval and improvement.

There are problems here and I hope that most of them are obvious. But, just in case, I will explain. A therapeutic relationship involves unequal power. Authority figures, be they bosses, teachers, parents, clergymen, or therapists, usually have a power advantage. Patients assume that a therapist has only the patient’s best interests at heart. The patient might never previously have had someone in his or her life who seemed so interested, who listened so patiently, who seemed so caring. Under these circumstances, the patient is vulnerable if the therapist should pursue his own sexual agenda. For a time, it might feel good to both parties, but it is a fundamental corruption of the therapist-patient relationship and, in the long run, can do extraordinary damage to the patient and add one more life-injury to the long list of hurts that the patient has already suffered. This is true even if it is the client who provokes or initiates the sexual contact, as sometimes happens.

Dual roles are generally a problem. Thus, a therapist is well-advised to avoid the complication of being more than a therapist to his patient. Meaning he shouldn’t be a therapist/lover or therapist/friend. To take on more than one role inevitably confuses both the therapist and the patient as to which role takes priority. And, it compounds the potential feeling of rejection, if the therapist should say or do something that seems critical or indifferent. Expectations of friends, therapists, and lovers are different depending on which role you believe that person occupies in your life.

Even the anticipation of a possible future friendship or sexual relationship after therapy ends, can change the therapeutic relationship for the worse if either the client or counselor harbors such hopes. Imagine a therapist who desires a patient who is considering a possible divorce; if he anticipates the possibility of “dating” the newly divorced woman once therapy ends, might he not be more likely to encourage her to end her marriage? It is for reasons like this that the American Psychological Association’s ethical guidelines rule out any such contact between counselor and patient, during or after therapy, in virtually all cases.

None of this is to say that doctors do not, sometimes, have feelings of attraction to clients. We treat the beautiful, the charming, and the handsome, as well as the less than beautiful and less than charming. But all counselors should be trained about and reminded of the boundaries concerning therapeutic relationships, boundaries that must never be violated.

Therapists run other risks, as well. Among them, is the need for approval from their patients. Certainly, it is human to want such approval. But the therapist needs enough confidence to be able to withstand the inevitable fact that he cannot help everyone; and, that in order to help some people, it will be necessary to tell them painful truths that may cause the patient to end the therapy and reject the therapist. If the counselor is too invested in the patient’s improvement for his own good, he can be laid-low if the patient does not get better. And, ironically, if the therapist is working too hard to help his client, harder (in fact) than the client is working, he is likely to steal the initiative of the client that is necessary for his or her improvement.

Anyone in a helping-profession faces a problem with respect to how close he should get to his patient. If he is emotionally distant from this person, his ability to help is compromised. Most people, after all, want a doctor who cares. If you think your healer doesn’t care, or is only in it for the money, you are likely (and correctly) guided to go elsewhere for treatment. On the other hand, however, is the problem of the health-care-professional who cares too much; who feels your pain almost as much as you do; who suffers the ups and downs of your mood as if he is a passenger on the same roller coaster, sitting right beside you. He is in danger of giving too much of himself, to the point of burning himself out. Moreover, when you reach out to him in your sadness or confusion, you are not likely to find a “rock” upon whom you can rely, but instead someone who is just as pained or disoriented as you are over the reverses in your life. From that vantage point, no therapist can be of any use.

Therapists need to be solid, emotionally and physically, to take on the complicated emotional and intellectual lives of the people sitting across from them. They need to be involved, but not to the point that their own emotional well-being is compromised by the sadness or turmoil of the people who they are treating. They need to know their own limitations and set limits on the extent that they provide care, lest they be sucked-dry by the process and be unable to be of any use to anyone, including themselves.

It can be useful for therapists to receive their own therapy. But when the counselor’s world is rocked from the outside, or when he is unable to navigate the white-water of human emotion that he is attempting to traverse, sucked into whirlpools beyond his control, he is well-advised not only to seek supervision and treatment, but sometimes, to refer the patient or patients in question to those who do have the equanimity to be able to do good for those same people.

Nearly all therapists mean well. Nonetheless, as the saying goes, “The road to hell is paved with good intentions.” If you think your therapist is unstable, too involved, or in some way inappropriate, it is time to consider your options: there are lots of good therapists out there, but there is only one of you, one life to live and set on the best possible course that you can.

Ricketts or Rickets? “What’s in a Name?”

When I heard that the Ricketts family had purchased the Cubs, I immediately began to worry. Rickets (note that the name has only one “t,” unlike that of the Ricketts family) is, after all, a childhood vitamin deficiency disease, typically caused by a lack of vitamin D. The bones, as a result, are softened and malformed. Just what we need on the Cubs, I thought.

Names. The value of names. That is really what I’m talking about. (More about the Cubs later in this essay). Early in their life in school, kids find out that names can be a problem. Kids will rhyme and twist names to make you wish you didn’t have one or could crawl under a rock. I remember a girl called Leslie who was the only female in my high school physics class. The class wit called her “Lester” and the over-matched teacher didn’t rein him in. Doubtless, Leslie felt miserable.

Someone I know has a nephew with the initials “F.U.” What were the parents thinking? In fact, it was pointed out to them, very early, that the name they had in mind would, because of these initials, cause the child endless grief. Did they care? Apparently not. Some parents will argue that they do this to “toughen-up” their little guys. I doubt it.

Most of us are sensitive about our names. We want them said correctly and written correctly. They are us, in effect. I’ve been corrected properly when I called a woman “Judy” whose name was Judith. We want to be noted and respected. We don’t want our names besmirched, mutilated, or forgotten. When speakers thank others in public, they often take pains to list everyone who deserves some credit. They do this with good reason. We want to be thought of fondly and well.

Witness Shakespeare’s Henry V motivating his men on the eve of the Battle of Agincourt, which was to occur on St. Crispin’s Day:

“…He that shall live this day, and see old age,

Will yearly on the vigil feast his neighbours,

And say ‘To-morrow is Saint Crispian:’

Then will he strip his sleeve and show his scars.

And say ‘These wounds I had on Crispin’s day.’

Old men forget: yet all shall be forgot,

But he’ll remember with advantages

What feats he did that day: then shall our names,

Familiar in his mouth as household words

Harry the king, Bedford and Exeter,

Warwick and Talbot, Salisbury and Gloucester,

Be in their flowing cups freshly remember’d.

This story shall the good man teach his son;

And Crispin Crispian shall ne’er go by,

From this day to the ending of the world,

But we in it shall be remember’d…”

Of course, being “named,” isn’t always a good thing. Being named in an indictment, for example; or, during the infamous days of Senator Joe McCarthy in the 1950s, having your name uttered by a witness as a possible Communist. The hearings in question concerned alleged Communist infiltration of the Federal Government and the entertainment industry. These could result in the subpoena of the named-individual to testify before the same congressional committee, not to mention the possibility of being fired from his job and being blackballed from making a living. Unless, of course, he too would be willing to go before the committee and “name names,” thus betraying people he knew and even, sometimes, people he was close to.

Back to the Cubs, we are told that there is little possibility that “naming rights” to Wrigley Field will be sold. If that were to happen, however, the fans of the Cubs would have their attachment to a name sorely tested. But, of course, one can only hope that the “Ricketts era” will bring the World Series that we have all been waiting for, and that many have died waiting for after leading long lives that began in late 1908 or later, and ended anytime since. And we’ve heard other, older names carrying the same promise: the infamous “College of Coaches” that was supposed to transform the Cubs in the early 1960s, the hiring of Leo Durocher to manage the 1966 team that finished in 10th place, the purchase of the Cubs by the Tribune Company and the installation of Dallas Green (named General Manager) to produce a retooling that would lead to the World Series; and, who can forget how Dusty Baker was touted as a savior a few years ago, only to be replaced by the naming of Lou Pinella, savior next-in-line, to replace Dusty in the dugout.

Will the Ricketts name be worth the paper it is written on? Will it be a better name than Chicago Tribune? Shakespeare gives us a hint, in the form of Juliet’s words to Romeo, who, after all, has a last name detested by her family, and visa versa:

“What’s in a name? That which we call a rose
By any other name would smell as sweet.”

So, it would appear that the real question is whether the “Ricketts Era” Cubs will pass the smell test.

Shakespeare knew everything.

Holiday Depression is Coming to Town

It is that time of year. The TV shows us happy families, all smiles, getting together around the Christmas tree or a turkey dinner. Festive window displays adorn your local department store. Greeting cards proclaim good cheer and the values of family and fraternity. And there you are, alone or lonely, wondering how it is that you haven’t been invited to the party.

The media often represent a version of American life that overstates the happiness quotient of the average person. It is difficult not to believe that many, if not most people are having a better time than we are; are more loved, more popular, and having more fun.

First off, don’t be fooled. You are not alone. Just because you are not represented in the media ads, doesn’t mean that you are solo in your suffering. Many of the “holiday singles” group keep a low profile at this time of year, fearful that they will be judged to be losers if they proclaim their isolation; few want to be objects of pity, and that is exactly what they expect if it should become known that they have nowhere to go and no one to be with on Thanksgiving or Christmas or New Year’s Eve.

But many people are alone: many of the divorced, widowed, and childless; many who live at great distances from their families; many who have recently broken-up with someone; many who are estranged from family or friends; many who have recently moved; and many of the unemployed, who have lost the connectedness to co-workers that was an emotionally sustaining source of support.

Holidays can also be difficult because of the haunting memories of better times. This is especially true if the loss of loved ones is fairly recent. The first holiday or two after a divorce or death is usually especially difficult to endure, so great is the contrast between the focus on family that the holiday brings and the solitary fact of being bereft. Moreover, holidays tend to rob the lonely of the distraction of work, generating significant expanses of empty time, filled only by reflections on one’s sorry state as the time moves with a dull, clumsy, funereal tread.

On top of all this, there is the problem of Seasonal Affective Disorder (appropriately signified by the acronym SAD). Typically, the pattern is one of onset of a depressive episode in the fall or winter, with remission coming in the spring. Additionally, the seasonal condition is not due to some external event (such as the beginning of school in the fall), but rather is thought to do with the relative unavailability of “bright visible-spectrum light” that is characteristic of  “the dark months.”

What to do then, if you are suffering from the holiday blues? Here are a few possibilities:

• Although your unhappiness presupposes the absence of satisfying social contact, at least consider whether there is someone to whom you can reach out and who might even welcome your participation in his holiday celebration. Social withdrawal tends to feed on itself, only making us feel worse. While it is true that a rejection is painful, many people are more than usually welcoming at this time of year; the risk might be worth the reward.

• Keep busy doing something productive. Don’t spend hours watching television alone, if at all possible. Clean your house, build something, exercise, or perform some other useful function.

• Consider volunteering at a homeless shelter or a soup kitchen. Not only is this important work, but it will fill the time and might even make you aware that, however bad your situation, it is still better than that of some other people. One other benefit is the human contact that such volunteerism provides, including the possibility of making new friends, among whom might be some others who find themselves alone on the holidays.

• Make a list of the things about which you are grateful. Most of us take much for granted. Perhaps there are still things in your life that you can count as blessings. Such reminders are often useful in boosting a sagging spirit.

• If you have the means, travel can be a good and beneficial use of your time at the holidays. Fares are often cheaper on the holiday itself. Going to a warm climate or a new place might serve to break up your routine and, once again, give you a chance to do new things and meet new people.

• Social-networking sites on the internet may be worth investigating. While not usually as satisfying as face-to-face human contact, this new type of relatedness can lead to friendship for some, and reduce one’s sense of complete isolation.

• If you have been on the planet for a while, remember the past difficulties that you have overcome and how you did so. It is very likely that the same human qualities that enabled you to get past other tough times will get you over the holidays.

• If you have been diagnosed with a seasonal depression (SAD), consider obtaining a light box that provides a full light spectrum for your own in-home therapy. These can be found easily by googling “light box.” Such devices are typically not enormously expensive.

• Psychotherapy and/or anti-depressant medication are always available should you wish to take on your sadness in a most direct and powerful way.

When a “Van” Isn’t a Station Wagon

Language is a funny thing. Translations can be particularly amusing. Since I am a collector of classical recordings, I received an e-mail from a Japanese website offering a large set of discs conducted by Wilhelm Furtwangler. Furtwangler conducted lots of Beethoven, so I wasn’t surprised to find numerous performances of his music in the table of contents. But, I didn’t immediately understand why Beethoven’s name was listed as “Ludwig Station Wagon Beethoven.” After a few seconds, the answer came to me. The Japanese translator must have taken the table of contents of these recordings, including the actual name “Ludwig van Beethoven” as it is written in Japanese and, using one of the translating devices available on the web, attempted to convert it into English. Thus, the “van” (as in a type of motor vehicle) became “station wagon.”

Is it any wonder that we humans have misunderstandings? One thing is for sure: I’ll never be able to look at a mini-van in quite the same way again.

Classic Movies: Three to Treasure

I don’t go to a great many films and, perhaps unfortunately, don’t rent many either. But this wasn’t always he case. As a result, I can recommend three very old films that continue to move me every time I watch them:

1. The Best Years of Our Lives

On most every list of the 100 best films ever made. A 1946 film starring Myrna Loy, Frederick March, Dana Andrews, Virginia Mayo, Theresa Wright, Harold Russell, and Roman Bohnen, among others. The film won seven Academy Awards. It tells the story of three WWII vets returning to home to their small town. One, a banker turned infantryman. Another, a “soda jerk” (someone who worked behind the counter making milk shakes and the like) turned bombardier; and the third man, a star high school quarterback engaged (literally) to the girl next door, turned into a sailor who did not quite go down with his ship, but lost both his arms in surviving.

The movie is touching and heart breaking in its effort to present a frank appraisal (for the time) of the costs of even a just war, as these three good men struggle to readjust to civilian life. The newly returned banker (Frederick March) drinks too much and discovers that dollars and cents don’t have the same meaning to him as they did before he fought beside less well-to-do men of courage, loyalty, and integrity. Dana Andrews, the Air Force captain, finds that the beautiful wife he impulsively married isn’t a good match for him now that he suffers from “combat fatigue,” a disorder that would be labeled Post Traumatic Stress Disorder (PTSD) today. Moreover, he must contend with the fact that the heroism that he displayed during the war doesn’t guarantee him a good job after his service has ended. Harold Russell, a non-actor, gives an earnest performance as someone who cannot bear to be a burden on others now that he has primitive prosthetic arms, and does his best to discourage the young woman who still loves him, because he believes that her feelings are based only on pity.

For me, there are many extraordinarily touching moments in this film. I will mention only two: the moment that Frederick March first reunites with his wife after years away from home overseas, and Roman Bohnen’s understated, but oh so sensitive reading of the citation that his son (the Air Force Captain played by Dana Andrews) received for his heroism. That brief scene says all one need ever know about a parent’s pride in his child.

The film is long and slow-moving by contemporary standards, but the moderate pace allows more character development than usual. If you have the patience you will be rewarded.

2. The Prisoner of Zenda

First, a disclaimer. I love Ronald Coleman. He was a now largely forgotten matinee idol of the ’30s and ’40s, as elegant, suave, and handsome (but in a more refined, cultured way) than the male stars of today. I forgive him the fact that he was not a great actor. But then Gary Cooper, John Wayne, James Stewart, Tyrone Power, and Alan Ladd, all contemporaries, were much, much worse.

Coleman stars as a British citizen on holiday in a fictitious Eastern European country, who accidentally stumbles upon a cousin who is the crown prince. The catch? They look like identical twins (Coleman played both parts, of course). And when the Prince’s evil step-brother Michael poisons his favored sibling so that he can assume the throne himself, the British cousin is asked to substitute for the king-to-be at the Coronation, until the real prince can recover and take the throne. Things don’t go as planned and the charade continues on, long enough, in fact, for our British cousin to fall in love with the woman who is betrothed to the new king. This is an old style 1937 swash-buckler starring Douglas Fairbanks Jr., Raymond Massey, Alan Hale, David Niven, Madeleine Carroll, C. Aubrey Smith, and Mary Astor (of Maltese Falcon fame). And, it too will touch you, as its ending is bitter-sweet. The film is based on the popular novel of the same name by Anthony Hope. If you’ve already seen the movie or read the book, know that Hope wrote a less impressive sequel called Rupert of Hentzau (named after the character played by Douglas Fairbanks, Jr).

Do avoid the much inferior color remake with Stewart Grainger and Deborah Kerr, as well as the later comedy adaptation starring Peter Sellers.

3. Lost Horizon

Another 1937 classic, this one based on a James Hilton novel, again starring Ronald Coleman, along with Sam Jaffe and a very young Jane Wyatt (best known for her role as the mom in the ’50s TV series Father Knows Best, which also featured Robert Young). This time Coleman plays a disillusioned British diplomat who is kidnapped along with his brother and several recently rescued Brits and Americans, to be taken to a place called Shangri-La, a community situated in a temperate valley within the otherwise bitter cold of the Himalayan Mountains. Coleman discovers something unbelievable there, a utopian community where people are not only tolerant and understanding, but are rumored to live unusually long lives. Remember that this film was made on the verge of World War II and the character played by Coleman reflects the contemporary sense of discouragement about continents on a collision-course, as well as a “this is  too good to be true” response to his new home. Of course, there would be no story unless Coleman’s adjustment was less than perfect. He falls in love with Jane Wyatt, but also feels duty-bound to get on with the work in the outside world that is required by his career in His Majesty’s diplomatic corps. To further complicate matters, Coleman’s younger brother has fallen in love too, but with a woman who can’t wait to leave Shangri-La. What will Coleman do? And if he leaves, will he ever return to take over administration of the community, as this was the reason he was kidnapped in the first place?

The movie is interesting for another reason. Some of the footage in the original version of this film was cut because it was thought that there was too much anti-war and women’s liberation sentiment. Indeed, the character played by Jane Wyatt is an astonishingly independent and intelligent female for her time, when most actresses where docile and deferential by today’s standards. Unfortunately, the seven minutes of the cut film were never recovered, but the sound track of that portion of the movie remained in tact. Thus, the videocassette and DVD releases have used “still” and publicity photos, cleverly manipulated to simulate some action, to replace the minutes where no movie film remains. But be careful not to confuse this classic with a 1970s remake in the form of a musical.

In any case, the feature remains a worthy one. Its portrayal of a better world, not on heaven, but heaven on earth, is attractive. To paraphrase one of the lines in the movie, let us hope that we all find our own Shangri-La.

Is There Such a Thing as Bad Luck?

I once met a man called “Lucky.” My garage door had failed and he was the repair man. I saw the name on his jacket and asked him about it. He said that until about 10 years before, everything had worked out just right in his life, hence the nickname. But then the wheel of fortune turned and illness and death followed, including the death of his wife. “Lucky’s” luck had run out.

Shakespeare had a sense of such things. Thus, in Hamlet, following the death of Polonius and Ophelia, we read the words, “…When sorrows come, they come not single spies, but in battalions.” More colloquial usage tells us that bad events come “in threes.” Same idea.

The other side of bad luck, is the good. Branch Rickey, the baseball executive, famously said,  “Luck is the residue of design.” Of course, he was talking about good luck and how careful planning and persistence helped create it, or made it look as if it had been created. And a woman of my acquaintance, someone who lost a parent early and a husband late, has only recently met the love of her life. Better to have good luck late than early, it would seem. Still, if one reads Greek mythology, one finds Solon, a wise man, counseling that no one should consider himself (or be considered) happy, until the last possible moment of his life, because misfortune yet has time to occur. “Lucky” would agree.

Some believe that there is no such thing as luck: that you get what you deserve and you deserve what you get, a Karmic view of things. Churches of prosperity promote “right thinking and right living” in the belief that you will be rewarded in this life and the next for such action and the correct form of religious observance. And if we read the Book of Job, in the Hebrew Bible (the Old Testament) we find a man who has all manner of bad fortune thanks to a friendly wager between the angel Lucifer and God. Job had been a prosperous, religious, happy, and good man. But he is made to suffer all sorts of loss and pain so that his devotion to God might be tested. Three friends come to ask him what he could have done to deserve such misfortune. Surely, they tell him, he must have done something iniquitous. Clearly, they don’t believe in the notion of “bad luck.”

Many years ago a social psychologist name Melvin Lerner proposed something called “the Just World Hypothesis.” Lerner contended that when we observe misfortune occurring to another person, we prefer to believe that the individual has done something to deserve the negative events befalling him. But, if it is clear that he did nothing, then we will tend to devalue him personally, in effect saying, “well, maybe he didn’t do anything to cause his problems directly, but he isn’t a good guy, so, in a way, he deserves what has happened anyway.” Lerner maintained that people do this sort of mental gymnastics unconsciously in order to fend off the notion that something bad might happen to them. “Terror Management Theory” has picked up where Lerner left off, looking at how we manage and try to mute the anxiety caused by our mortal state.

You say you don’t believe in luck? Well then, you must believe that all disease and all accidents “happen for a reason,” that the explosion of a volcano, for example, is guided by some divine hand. But when those illnesses, accidents, and misfortunes target the innocent, especially little children who are raped or tortured, you will be hard pressed to find a reason that is adequate. “Ah,” some say, “we, on earth, don’t understand God’s ways; but surely, this will be for the best in the end.” The conversation is never ending, and it is unlikely that either side will persuade the other.

Finally, there is the question of how to define when a thing is good luck or bad. According to another Greek myth, Cleobis and Biton were the two sons of Cydippe, who needed to attend a religious festival at some distance from her home. However, oxen to draw her cart were not available, and so these two good young men yoked themselves to the cart and got mom to the festival on time. Their act of devotion to their mother won wide praise, but since they were exhausted, they soon needed to nap. Cydippe, who also had been praised for having raised such offspring, prayed that her sons would receive the best that any man could obtain. And, ironically, this wish was granted in the form of the their painless deaths as they slept, dying after having received great accolades at the pinnacle of their lives; now they would not have to suffer whatever else might come as they aged.

Good luck? You be the judge.

“Mad Men” and “The Sopranos:” Not So Different

“Bad people behaving bad,” might be an equally good title for either of these two critically acclaimed cable TV series. “What,” you say, “but they are so different!” I’m not sure that you are right.

True, “Mad Men” is set in the early ’60s and “The Sopranos” more closely approximates our time. True, one show is about a legal business, the ad game, while the other is about the mob. True, in the former show the protagonists wear suits and ties, expensive ones, while the cast of “The Sopranos” is rather more casual.

But, below the surface, there are lots of similarities. Both shows are about the importance of money and power, and the willingness to hurt others to get those things. Even if their methods of hurting others are non-violent, the “Mad Men” do their share of hurting: to competitors in the industry and to spouses and co-workers. The “Mad Men” are better tailored than Tony Soprano and his compatriots, know better table manners, have more formal education, but have learned how to get what they want without leaving marks on their opponents’ bodies, leaving them only on their psyches and in their hearts.

Women are second-class-citizens in both of the worlds depicted. Each world is “a man’s world.” Infidelity is the norm, it seems.

Both shows feature a closeted gay man, one called Sal, the other Vito. Once each one is exposed, trouble awaits. Sal is fired from the ad agency, while Vito is murdered by the mobsters.

Each of the two television-universes exist in the New York City/New Jersey area. But the real location is the jungle, where the jungle’s law prevails: survival of the fittest or, perhaps, the most brutal.

And neither show features particularly likeable people. Nearly every one–men and women and, to some extent children–seem enormously self-serving. Yes, they have their own pain, sometimes to the point of driving them to seek psychotherapy. Yet, whether on or off  the therapist’s couch, the players in these mini-dramas appear insensitive to or unaware of the pain of the people closest to them. Witness, Betty Draper, Don’s stay-at-home, Grace Kelly-knockoff wife and her treatment of her children. Or, of course, the mob-wide blindness to the human havoc wrought by corruption and murder in “The Sopranos.” If nothing else, both series let us know that even the most self-involved, narcissistic, and corrupt individuals can be sensitive to their own injuries, regardless of the insensitivity they show to others.

There is emptiness at the core of these lives, too. The men and women are unhappy, think that they know what they are doing, but seem unaware of what really drives their behavior below the surface. They have little self-awareness and don’t reflect on their lives, their direction, or question their values and the contradictions between what they think they are and what they really are.

I keep looking for some redeeming human qualities in the “Mad Men” characters, but the players instead seem to have lost most of those that they had earlier in the series. As for “The Sopranos,” no point in looking for something that was never there.

I must admit that it is getting uncomfortable to watch “Mad Men,” watch the moral degradation of characters I’ve come to know a bit. I’m still hoping for a turn away from “the dark side.”

But I’m not optimistic.

Unfaithful and Feeling Guilty: Now What?

Infidelity happens. I’m not condoning it, but humans are known for mistakes, and this is simply another example of our fallibility. Still, what should you do if you have realized the error and broken off the affair? Assuming that your spouse or significant other doesn’t already know what happened, should you confess?

Let’s add two more conditions to the hypothetical situation that I’m describing: first, that you feel guilty; and second, that you have no intention of ever violating your partner’s trust again. Let us further assume that it is unlikely that your spouse will find out about the affair from someone else.

This, in other words, is one of those moments between you and your conscience. I’ve counseled people who felt so guilty that they believed they had no choice but to confess. I’ve also treated people who didn’t tell, believing that they would injure the spouse unnecessarily.

Sometimes these affairs are very old. I remember the first patient who reported a situation such as this to me. The infidelity had actually happened years before. It had gone on for a few months, then ended. The man had been faithful ever since and, it was clear, had every intention of being faithful from then until the end of time. But he felt terrible about what he had done and couldn’t shake the feeling despite the passage of time.

One consideration that such a person needs to take into account is that, for the spouse, the event is new when it is uncovered, even if it happened years ago. The wound happens at the moment of discovery or confession and doesn’t exist until that time (assuming that no STD has been communicated). But once the indiscretion is revealed, the emotions of anger and sadness are triggered, as is the sense of betrayal, and the lack of trust. Even if the infidelity is 100 years old, it typically feels to the injured party as if it happened today. And the long climb back to marital accord now begins, with no guarantee that the summit will be reached and good relations will be reestablished.

So, what if you don’t tell your spouse? Will your guilt last forever, undiminished? That depends on an enormous number of factors, including your religion (if any), your anxiety that your husband or wife will eventually find out (no matter how unlikely that might be in reality), your need for forgiveness/absolution, your ability to rationalize mistakes, your own capacity to forgive yourself, and so forth. If you need absolution and have a religious background, confessing to a priest, or fasting and prayer on the Jewish “Day of Atonement” might be helpful, depending on your particular faith. Therapists sometimes also serve the role of unofficial confessor.

If you were hoping that I would give you a clear answer, a “right” way to handle this situation, I undoubtedly have disappointed you. I frankly don’t think there is a right or wrong way in this type of case, at least not in the abstract. There are only ways that work better or worse; well, less well, or poorly; and it will depend not only on your own psychology, but the psychological makeup of your spouse. Thus, a solution that might be effective or useful for one couple, might be awful for another and lead to the end of the marriage.

Best, of course, not ever to be unfaithful. But, as I said at the start, these things do happen and, when they do, can have an overwhelming emotional wallop on all concerned. How you handle it shouldn’t be automatic. Much depends on your decision.

Choose wisely. As carpenters like to say, “Measure twice, cut once.” And know that the news will “cut.”

“Not Invited,” “Picked Last,” and Other Small Tragedies of Childhood

Unless you were an unusually charismatic or talented child, you know what it feels like to hear about a party that virtually all the other kids were invited to, and realize that you weren’t; or to be the last person chosen for a team of your peers, and chosen only after even the marginally talented athletes were picked. And then, if worse than that is possible, to be assigned to play right field, the spot on the baseball diamond where you were expected to inflict the least damage to your team. Or, if you are female, you might remember trying to join a group of girls engaged in conversation, only to find them falling silent upon your approach, and then being told that the conversation is private.

Humiliation, embarrassment, sadness, and chagrin, call it what you may, that feeling lingers. And it lingers long enough, dear reader, that you are probably just now thinking of an example of it from your own life.

Bummer.

Most kids don’t want to stand out from the group, but want to be a part of the group. And to be the last one chosen, or not to be invited at all, makes you stand out in the worst possible way. Your secret is out. Until the moment of your “unchoosing,” you probably only suspected that you were a lousy athlete or an unpopular person. Now, not only do you know it for certain, but so does everyone else.

It can even happen to adults. I’ll give you one rather singular example. The event occurred at a staff meeting of a psychiatric hospital. The psychology section was having an election for the offices of President and Secretary. Two people were running for the former office and only one for the latter. It was the custom to ask all the candidates to leave the room when the vote was about to be taken. The Presidential election was quickly completed. Now came the vote for Secretary, presumably a formality, since the only person who wanted the job was unopposed on the ballot.

But things were not so simple as they seemed. The candidate for Secretary wasn’t well-thought-of by his peers. And so, someone nominated the just-defeated candidate for President to run against the solo petitioner for the unfilled office. Sure enough, the previously unopposed gentleman was defeated. It was the only time in my experience that I ever heard about or witnessed someone lose an election in which he had been running as the sole office-seeker only moments before. And you can imagine how this turn of events must have struck the man who had left the room thinking that his ascension to the office of Secretary was just a formality. Playing right field would have felt good by comparison.

No, no one wants to stand out in that way. You don’t want to be the kid who brings the worst gift to your friend’s birthday party. You don’t want to wear clothes that are different from those of your friends, or outdated, or too big, or too small, or too worn. You don’t want to be the kid whose mother cuts his hair. And, if you are female, you don’t want to be the only one who “isn’t allowed” to wear makeup or lipstick, or have one’s hair done in the latest style.

Clearly, all the psychic injuries inflicted during childhood don’t happen at home. It’s a wonder that there isn’t a medic on the playground to deal with the walking-wounded. The resilience of little children must indeed be impressive to permit us to survive and flourish despite the hard experience of our youthful innocence.

So, the next time your son or daughter comes home looking a bit sad, perhaps you will find a way to encourage him or her to recount just such a fresh defeat on the playground that is sometimes also a battleground or a forge in which a young personality is shaped. And, if they do, remember your own hard time when you were your child’s age. It just might make the moment a bit more poignant and allow you to “be there” for your precious offspring in the best possible way.