Coping with “Skin Hunger” in the Coronavirus Age: Entry from an Unwritten Journal

I’ve never written in a journal, despite offering the idea to many patients. Today I write because writing permits expression in the absence of nearness. At this moment, we mustn’t be close to others no matter what we want.

Yet we are the same creatures evolved to be social, to touch and more than touch: to shake hands, hug, embrace, caress, kiss, fondle, and lose ourselves in love and friendship.

We suffer from a pandemic side-effect called Skin Hunger by some, a too familiar, but unspoken condition among us, soon to be known by almost everyone. We have become experimental subjects in an unplanned scientific inquiry.

Still, today offered some small compensation. Here is a morning snapshot without mourning.

I wanted fresh orange juice. I’m lucky in many ways, including a meer 10-minute drive to a store that almost gives it away and a car to get there.

To minimize risk, I arrived early. Really early for those of you who aren’t seniors: at the high-risk age of our world’s coronavirus stage.

I entered at nine-minutes before dawn, a trip on night’s black edge: 6:20 AM.

Few people beat me in. The magic of automatic doors saved me from contact. Then a young woman employee walked by.

“Excuse me. Where are hamburger buns?

If we have them, they’re in aisle four.

I guess “if we have them” has turned into a reflexive response. Shortages because of the terror. I went to get the juice, whose location I knew, then to aisle four. Tons of buns.

One of the automated checkouts was in use, three empty. I completed the errand while maintaining social distance. Mission accomplished! We take our triumphs where we can find them within the constraints of our present moment.

Breakfast. I had a drink of water, then prepared my typical fiber-filled repast: shredded wheat manufactured without sugar, salt, and taste. With bananas today, though I often add blueberries if the price is reasonable.

Then coffee to feel alive. Most seniors require gallons, plus medications. I don’t take many of the latter, but the standard is relative. Friends report back problems and hernias from lifting all the pharmaceuticals they use!

Now for the major event of the day. Ta-da! Walking outside. Almost three miles.

People are friendlier but maintain distance. Almost everyone now waves or says hello, even from across the street.

An outlier on a bike, a woman, widened the footage between us from 15 to 25 feet.

Some folks walked dogs. Physical contact with a loving mammal. Think about it.

I passed modest homes and a few places an old friend compared to the Palace of Versailles. He was exaggerating, of course.

I got to thinking about how COVID-19 might alter our values. We take much for granted: life, health, work, restaurants, etc.

Perhaps, for a while, the condition of our being will be differently admired, differently evaluated, differently appreciated.

The status of simple things is getting a boost, decency among them.

The birds were out and a concert in progress. A legendary symphony conductor, Carlo Maria Giulini, told me he thought this the most beautiful music of all. No disagreement from me. Even the woodpecker with his built-in jackhammer joined the sing-along.

Some folks I know are stunned at the avalanche of bad news. The ones in feathered flight don’t care. Birds chirp, chatter, and sing in their first show of the day. We hear mostly males at that time, hoping to win a female heart and trying to mark their territory.

The scale of their satisfaction is smaller than ours.

Perhaps they offer something worth learning.

The Upside: How to Survive Psychologically in a Challenging Moment

I cannot say I’d choose to witness the Coronavirus pandemic, but here I am, and so are you. What follows is some help in reducing your distress.

I shall not minimize the dangers, but no good comes of either dismissing them or worrying over them as one would a train wreck sure to happen. The situation is neither.

If you are keeping up with public health recommendations, you know this. If you are taking the advised hand-washing precautions, you know this. Moreover, various branches of government in the USA are beginning to reinforce the societal safety net for those who need such assistance.

More action will come, though increased disease is inevitable for a while.

Assuming you are maintaining your social distance, you’ve taken a significant step. But what do you do with a less structured day now, time that used to be organized by meeting friends, going to restaurants or bars, and working in an office rather than your residence?

When our minds are left to themselves, they often travel to dark places. Here are a few suggestions to help you stay in the light:

  • Notice the changes in your life and the lives of others, without catastrophizing. The present is a remarkable time to be observing the world’s reaction to the virus. Be curious, watching and listening instead of evaluating and judging. Meditation may help with this.
  • Many of us have said, “Gee, I wish I had more time.” Now some of us do. What did you mean when you spoke those words? What dreams do you hold you now can begin to fulfill?
  • Reach out to people by phone, email, and social media.
  • Remind yourself of the things for which you are grateful. Daily.
  • Plan your activities for the next day before bedtime. Give yourself a sense of control and accomplishment. Focus on the doable without excess ambition.
  • Do not watch the news or political commentary at every moment.
  • Exercise, if possible in the morning light, to reduce anxiety and improve sleep.
  • Learn something new. The internet is full of educational possibilities, many without any cost. Perhaps something as simple as learning how to tie a Windsor knot:

 

  • Remember that if you are socially isolated, the prescription of interpersonal separation gives you much company, even if you don’t see those comrades on the street. We’ve been offered an opportunity to make ourselves interesting for ourselves and to ourselves.
  • If you lament the lack of a robust dating life, you needn’t apologize. Many more people are alone because of the dangers of visiting their usual haunts and loved ones.
  • If you are going through hell, keep going. Don’t stop until you find the path out.
  • Religious faith is sustaining at such times. Prayer and reliance on a higher power can be helpful.
  • People are fighting for you in the healthcare system, many also in government. Efforts are being made to ramp up diagnostic testing. Laws are being passed to make the tests free. Legislation providing paid sick leave from work is also in process, though not everyone is yet included in the plan. Watch the brief video below. The outcome is positive.
  • Much political activism is occurring online. I do not mean arguing with people. Engage in making the world better from your home to support your desire to improve the country.
  • The challenge of living in the time of COVID-19 is a chance to develop a new depth of psychological resilience. The Stoic philosophers believed we discover who we are only when we are taxed.
  • Make a list of the difficult situations you’ve survived. What strengths within you enabled you to do so? Tap such qualities once again.
  • Clean out your abode. Donate or dump all those belongings you no longer need.
  • Far more distractions are available than ever before in world history. Use them.

This crisis, too, will pass.

 

—–

The top image is called Sunset Dancer by Hurriagusto07. It was sourced from Wikimedia Commons.

The Danger of Secrets in Marital and Family Therapy

The watchword of therapy is confidentiality. Treatment success relies on the client’s trust. But, is it wise for mental health professionals to put themselves in a situation where keeping one person’s confidence can be used against others in the room?

Imagine the following. A couple comes to marriage counseling. They have a young daughter.*

Among the concerns expressed by the pair is the woman’s father, the child’s grandfather. He has accused his son-in-law of sexually abusing the little girl.

The woman tells the therapist her dad is unreliable, prone to irrational and outrageous statements. Moreover, he holds a long-standing grudge against the person she married.

The woman dismisses the idea of abuse by her mate, supporting his denial.

Several challenging weeks into the process, the man notifies the doctor he can’t attend the next meeting. He adds that it will be fine if his spouse comes for a solo session. She wants to.

On this occasion, she utters something never said to anyone: her father molested her when she was young. Indeed, her daughter is never permitted to be alone with the grandad for this reason.

Nonetheless, she doesn’t want the husband to know. The specialist affirms his intention to keep the confession secret.

The marital sessions remain on a downward trajectory, leading to separation and a divorce filing. The estranged woman now thinks her partner did touch the daughter inappropriately, consistent with her dad’s contention. Her earlier dismissal of this possibility, she claims, was part of an attempt to save the relationship.

Adding to the dilemma, the mother now aims for sole custody of the six-year-old. She also reminds the psychologist of his promise not to discuss or report the historical violation by her father. Legal action will follow if he breaches her trust, she threatens.

In hindsight, should the counselor have agreed to the individual appointment with the wife?

The doctor is in a box. If he reveals the mother’s history of molestation by the little girl’s gramps, she will bring suit. If he does not uncover this fact, his lack of reporting what he knows permits the woman’s demonization of her spouse to appear more convincing than it otherwise would.

The law, depending on the state in question, might yet offer a remedy.

In the event the therapist’s records of the unaccompanied session are subpoenaed by the husband’s attorney, a judge might overrule the wife’s desire to maintain the information as privileged and, therefore, outside of consideration by the court in a trial.

Nonetheless, this is a cautionary tale for all marriage and family counselors. A somewhat similar problem can occur in the absence of the child custody issue.

Within couples therapy, one party might tell the therapist of an ongoing extramarital affair in an unaccompanied interview. A different conundrum would be created thereby.

If the psychotherapist informs the naive partner of the infidelity, he has breached the confidence of the adulterer. If he continues the therapy, he is violating his responsibility only to provide care if he believes it can be potentially useful.

More examples might be offered.

An unseasoned health professional can find himself in a predicament with both ethical and clinical implications

Precise guidance to prevent such difficulties is not commonly found in the ethical guidelines of the various helping professions.

Therapists, one hopes, obtain enough supervision in the practicalities of their work to avoid horror stories of the kind described above.

Most of us achieve a measure of wisdom with hard experience and training. Of course, the truth of such a statement applies to much more than what happens in the clinic.

——-

*This essay is based in part on “Legal and Ethical Issues for Mental Health Professionals: Revised 2020″ by Psychotherapy.net Academy.”

The second image is Der wilde Mann (the wild man) by Paul Klee.

The Therapist as a Secret Keeper

 

If Zora Neale Hurston is right, the “oldest human longing (is) self-revelation.But to whom should we show ourselves? How much is safe to disclose? When? At what risk?

We’ve all thought of this, but perhaps not of the costs and responsibilities of the one who listens to the secret.

I’ll try to address both the teller and the Secret Keeper.

The act of unveiling is fraught. We believe the uncovered one is alone in taking a chance. She gambles with her psychological nakedness.

Will she be mocked, rejected, used? Will her confidence be shared with others, publicized? Will the knowledge that comes to the listener/observer be turned against her? Will her vulnerability be exploited?

Priests hear confessions, therapists too: the speakers are ashamed or tentative. Their confidences are like objects packed with care, wrapped in cellophane, new and easily damaged. They’ve often never been opened.

To the client, they seem tarnished, in need of cleansing, but impossible to free of stain.

The disclosures must be understood as a gift. Here is the most delicate and fragile beauty the individual owns, no matter how ugly he believes it.

The “oldest human longing” takes the form of “admitting,” out loud.Admitting” as in a ticket to enter and a statement of guilt. The terror in the treatment room bursts the confines of a confessional space because here, unlike in church, the listener also sees you.

Your face is known.

Though priests in the confessional want to know everything, counselors should be hesitant. To the extent they control the conversation, timing is critical. A too-early disclosure might cause the patient to flee therapy, overwhelmed by the early exposure, his armor melted.

Whether in or out of psychotherapy, most of us share parts of our lives. The external elements include appearance, words, and actions: the public portion of ourselves. Though this evidence of our person carries dangers (as when we make formal presentations), it is commonly without oversized hazards.

Not so our “off the record” existence. Think of the whole of your history, personality, and behavior as individual pieces of a mosaic, like a stained glass window. All the excellence and perfections, flaws and cracks: the light and the dark.

Some parts are shared with some people, but often not enough for them to imagine the assembled multicolored glass. The therapist, however, comes to know the entirety of it or can conjure a perceptive, imagined awareness of the nondisclosed portions.

He should ask himself a question. Does he want to possess the most sensitive, private, anguished knowledge of you? What is the cost to him of keeping safe what he hears? He, too, is at risk. A different kind.

The more the psychologist knows of untold stories, shames and “weaknesses,” hurts and horrors, the more he might be perceived as an indispensable and unique person to the client.

The giver’s sense of debt for his acceptance of the gift and the tenderness with which the counselor treats it, the bigger the challenge and responsibility. Some think of the Secret Keeper almost as a being out of fiction, one who holds the divulgence in his soul.

For therapists, this can be too much for the small enclosure in which it is contained. If he cannot help to disentangle the patient’s transference toward him, his overlarge hopes and expectations, growth and eventual termination become difficult.

If the sufferer does not come to take risks and confide in others, the pedestal on which the healer finds himself is too high for his client’s benefit and for his own long term occupation.

Most of those in psychotherapy detach without a long lingering empty space which the practitioner used to occupy. The aura of absence shrinks as the patient’s world widens. If the therapist was skilled and his patient courageous, growth and awareness of new possibilities lead to unveilings and disclosures outside the clinic.

The analyst is a guide and an expert, but his job is temporary. Enhanced flourishing gained through treatment doesn’t smooth all the roads ahead.

At its best, the patient becomes a better driver over and around those potholes and a more resilient survivor of the worst of them. He seeks places and people new to him, free of the claustrophobia of his head. Reward and compatibility with others encourage the continuing adventure.

The encounters with new people and their acceptance of him might call up thoughts of the counselor, the one who first saw and valued what he disclosed.

Now, however, there is a larger, freer world elsewhere.

_______

The second image is The Whisper by Charles Blackman, sourced from Wikiarts.org/ The final object is Whispering Zephyr by Thomas Ball, sourced from the Art Institute of Chicago.

What Were You Doing Twenty Years Ago Today?

On January 1, 2000, my old buddies and I visited a weathered Chicago landmark.

Would you like to know why?

The story behind the
men on the museum steps

by Bob Greene, Chicago Tribune, January 10, 2000

WHEN YOU MAKE AN APPOINTMENT, you’re supposed to keep it.

Of course, if you’re 16 or 17 years old when you make that appointment, and the appointment is for 37 years in the future. . . .

The year was 1963. There were 10 of them — juniors at Mather High School, on the North Side of Chicago. They weren’t the most popular bunch of guys, they weren’t the biggest sports stars. They were. . . .

Well, they were best friends. Ten guys who, during the course of their high school years, became each others’ best friends.

They even had a name for themselves. They had planned on calling themselves the Culligan Men — they had a summer softball team, and they asked the Culligan bottled-water-and-water-softener company (whose advertising slogan was “Hey, Culligan Man!”) to sponsor the team, pay for the softball jerseys. But for whatever reason, the Culligan company said no. So the 10 guys decided to name their team — to name their group of friends — after a chemical that one of them recalled learning about in class. Zeolite, the chemical was called. If they couldn’t be the Culligan Men, they would be the Zeolites.

One day junior year — they were eating lunch at the table they always shared in the Mather cafeteria — one of the 10 came up with an idea. He said that the 10 friends should make plans to meet up again someday far in the future — that no matter what they were doing or where they were living, they should agree to meet on a specific day at a specific place.

They wanted to choose a day that would be easy to remember. They came up with Jan. 1, 2000 — the first day of a new century. They set noon for the time. And for a place, they wanted to choose somewhere that, even in 1963, they could be pretty certain would still be standing 37 years later.

They chose the Museum of Science and Industry — specifically, the outdoor steps of the museum.

How serious were they, that day at the lunch table in ’63?

“Well, we meant it,” said Gerald Stein, who was one of the Zeolites at the table, and who now is a clinical psychologist in the Chicago area. “But we didn’t spend a whole lot of time talking about it.”

Because they thought that none of them would really show up?

“It wasn’t that,” he said. “It was just that we knew that, on the first day of the 21st Century, we would all be 53 years old. We could never picture ourselves being that old, so it didn’t seem real to us.”

They graduated from Mather in ’64. They went out into the world, and did not stay in especially close touch. They moved to different parts of the U.S., took different kinds of jobs. There were marriages, children, some divorces, more children. Years would go by between the times they spoke to each other.

But they never forgot. They never forgot when they were best friends, and when they made the appointment for Jan. 1, 2000.

During the year just past, they began to make contact with each other. They were, in fact, 53 now; it no longer seemed to be such an impossible age.

And they made their plans. Vacation days were put in for; airline reservations were made.

One of the 10 had to be at work on New Year’s day — he worked in the computer industry in Texas, and was assigned to Y2K duty. Another simply chose not to come — he was going to be on a vacation with his family.

But the other eight — the eight would-be Culligan Men, the eight Zeolites–were there. They wouldn’t have missed it for anything.

Three live in Illinois; two flew in from California, one from the state of Washington, one from Connecticut, one from Michigan.

And at noon on the first day of January — at noon exactly — they walked together onto the steps of the Museum of Science and Industry.

“There is nothing in the world that feels better than being with people who remember the same things you remember — who remember the reasons that you liked each other in the first place,” Gerald Stein said.

The meeting on the museum steps didn’t last all that long — they had meals and other activities planned for the weekend. But the steps were what mattered — keeping the appointment they had made when they were 16 was what mattered.

“The people you can laugh with,” Stein said. “The people with whom you don’t feel the need to be guarded — how many people do you find like that in your life?

“We said we’d be there. And we were there.”


I promised you a sequel. Thanks to a surprise gift of $2,000 from the Culligan Corporation, we began the Zeolite Scholarship Fund. Eight of us pitched in to match Culligan’s donation and gave a college scholarship of $4,000 to a Mather High School senior.

As time passed, we reached out to many of our former classmates. Thanks to them, the Zeolite Scholarship Fund eventually awarded approximately $250,000 in additional college tuition assistance to more of Mather’s graduating seniors.

The fund also honored former teachers and accomplished classmates. Many of them returned for our May scholarship dinners during the approximately 16-years of the charity’s existence.

The men on the steps 20 years ago were: Rich Adelstein, Jeff Carren, Harmon Greenblatt, Steve Henikoff, John Kamins, Bernie Riff, Neil Rosen, and yours truly. Ron Ableman (aka the High Potentate) joined us by phone from Texas.

On that day, and every day we awarded scholarships, we felt like the luckiest people on earth.


The photography above was donated by a most generous and talented classmate, Michael Kaplan. The bottom photo is of Ron Ableman and Neil Rosen, left to right.

What Your Therapist Didn’t Tell You

Many therapists spend most of a session without uttering a sound. The more they talk, the less they are heard. The more they speak, the less the patient does his own emotional processing.

The more they offer answers, the less the client claims ownership of his happiness, responsibility, and control.

When treatment works, the seeker isn’t passive but active. The new thought is taken, not given. He grasps the reins, a voluntary effort.

Clinicians should rarely propel the train, though they may clear some of the tracks. Persuasion and insistence have limits. A parental, authoritative position creates a struggle for power or dependency.

Repetition is tiresome. Some people won’t change. They sought a remedy with the wish for someone else to do something.

We are not surgeons who administer an anesthetic so you can be redesigned while unconscious. If we possessed a storeroom full of magical potions, we’d be drinking them ourselves.

The counselor asks questions, points in a direction, and monitors the strength of the resistant wind. He manages the temperature and allows hope to enter the room.

Who will reach for it? Not all do.

Like marriages and friendships, there are signs of trouble. The sessions drag, the medic becomes a debater, misunderstandings occur. The analyst drains his life force; perhaps he dreads the next appointment. The psychologist tries too hard, his counterpart too little.

Though the lesson is unwanted, the other’s life is not ours to reshape. The patient has the right to stay where he is, no matter the suffering.

The only adult we can alter is the one in the mirror. The man reflected in the silvered glass must reflect, claim his own agency, and act.

Mallets won’t hammer others to the shape desired. We are not sculptors or portrait painters. Sometimes the best we can do for another person is to give up on our capacity to do him good.

At least this permits him to take back his life.

Some people, including a few “helping professionals,” listen to be heard, to make pronouncements. They do better to listen to understand.

We all have limits. We all have goals and choices. Regarding the latter pair, here are mine for 2020:

To better understand myself and others. To discover an enlightening idea, an unexpected sight or sound.

I choose to search for these; and perhaps to change the world.

An Unconventional Therapist in “The Booth at the End”

His “office” is unconventional. The gent’s appearance ranges from casual to shabby. Be assured, however: he provides a potent therapy.

The man’s consulting room is a diner. He doesn’t advertise. Nor will the “counselor” give you his name or say much about himself.

The offered service is free, but not without cost.

A woman finds him in “the booth at the end.She’s heard about the gentleman, been informed he can “do things.

The interview begins. The lady belongs to a religious order, though she dresses in everyday clothes. Her residence is a convent where she lives with others like her.

Sister Carmel’s faith vanished. She no longer hears God’s voice, the Almighty’s call. She wants the fellow’s help to get it back.

The “helper” starts by listening. He writes what she relates in a book. Once the Sister states her goal, he flips through the pages for a prescription:

You must become pregnant.

The nun is startled, horrified. Her vow of chastity would be violated. She doesn’t fathom whether or how to proceed.

Can she bargain for another way?

No.

The stranger is eating as they talk. He doesn’t insist anyone take on the remedy he suggests. The decision to go ahead with the required task is always “your choice.

I can’t do anything. You have to do it.

Little guidance is presented as to “how” to manage the job. Achievement of the chore requires the seeker’s own ingenuity. Those who come with desires often ask for alternatives, something less demanding, dangerous, or harsh.

There are many different resolutions to any given problem. I offer only one. I’m a messenger of opportunity.

Questioning him is unavailing:

Do you believe in God?Answer:I believe in the details.

When they hesitate, he reiterates, “It is up to you.

Additional sessions continue the dialogue. Those who want the help of the person at the diner’s last table are obliged to report their headway. They are promised that once their assignment stands completed, they will receive what they want.

The treatment makes each individual uncomfortable. Their job is difficult, complicated.

Sounds similar to therapy, doesn’t it?

Like psychotherapy, “What one begins one must finish,” an article of faith in the universe of healing, though no one will be forced to complete the process.

Some worry that their actions will harm others. Those repercussions can be severe.

They also wonder how their benefactor accomplishes his work:

There are things I do not know about this world, about people, about how things will turn out. But I know this: there are consequences.

When you start changing the world, you don’t know when the changes are going to stop. No matter what you choose to get, you will be breaking the world as it is.

Indeed, like conventional therapy, the alterations you make in yourself will impact your social network, your family, and your friends.

As the meetings in the restaurant progress, we discover that some of the guru’s visitors hope for the wrong thing. Psychologists call this “miswanting.” They make the mistake of believing if only they could have something — say a dream job or a new baby — life would be transformed for the better permanently.

We are poor affective forecasters — weak at predicting the emotional residue of our choices. Daniel Gilbert and Tim Wilson tell that as time passes, most losses prove less devastating than we first imagined. Equally, most hoped-for gains lose their capacity to sustain the temporary euphoria they offer.

The café “magician” doesn’t say this to his seekers. Yet even without asking, existential dilemmas reveal themselves in the course of their table talk: the shortness of life, the terror of disease and loss; the desire to be prettier, more talented, happier.

The therapist’s business is trading, but it is his clients who must decide what they are willing to trade for what the want. Not just their effort, but their safety, honor, conscience, or freedom.

A detective who is his client gladly goes to jail, though incarceration was not a stated part of the proposed arrangement. The officer was told to find and protect a “corrupt cop.He has learned of his own corruption and expresses gratitude for the knowledge.

Not all are so satisfied with the work they agree to take on in the diner.

This cable TV series ran for two seasons. It is available on Amazon Prime Video and elsewhere, as well as on DVD.

Though the episodes are quirky, therapeutic truth resides in each of them.

I suggest you tune-in, but remember the words of the man in the eatery:There are no guarantees.Just as in the counselor’s office.

Should you watch?

That would be up to you.