Victory

One of Dr. Milton Erickson's main treatment objectives was to make people productive members of society. With some patients it is necessary for them to understand that having a disability is not the same as being disabled. Dr. Erickson contracted polio when he was a teenager and had to fight its after effects all of his life. I doubt that he had much sympathy for people who whined, were lazy or were full of bitterness or self-pity.

A man I see went back to work this week. He had been unemployed for 24 years! He lives at home with Mom and Dad. He lost his last job when the factory where he worked closed. He was also a drunk back then. He eventually lost his license due to DUIs. His truck has been up on blocks since 1984. He got sober in the late '80s and has stayed dry since. That in itself is miraculous, but coming out of the drunken fog he realized that all the guys he grew up with had jobs, were now married and had kids. He vegetated another ten years before his parents finally tried to get him some help. That amounted to a psychiatrist telling him to apply for disability and then tossing some pills at him. He didn't tolerate the meds well and the idea of disability made him mad. On one hand he was scared, lazy and immature. On the other hand, he knew he could work and he was insulted by the insinuation that he couldn't. I told him later that it made me mad that his doctor had given up on him.

Now I am a stubborn woman but I am also patient. For one solid year I treated him with his parents in the room with him. Little by little he has become a lot more helpful around the house. Last summer he painted two porches on his house. This year he and his Dad replaced the guttering and he has been re-roofing the large wrap-around front porch where shingles have to be individually trimmed to fit. He has also been fixing up his truck. It is now drivable.

Last year he was evaluated by my esteemed colleague to the east. The testing confirmed my belief that he was ready and able to work. There was still a lot of anxiety and I said that if it became too great, I knew his family doctor would prescribed some "nerve" pills for him. That has not been needed. He not only managed his first week of work well but he even liked it.

I'm looking forward to additional changes in him. He has lived in a strange time warp. A part of him was stuck back in the year he graduated from high school because he had become so isolated from people his own age. Living and interacting almost exclusively with Mom and Dad, he acts like an old person discussing his health, doctors appointments and who had died recently. He may not interact much with his co-workers at first but he'll be listening in on their conversations. And learning.

Old Time Religion

It's hard to believe how far my mother has come in the past twelve months. A year ago she was pretty well bedridden and was on morphine to control her pain. I really didn't think she'd live until Christmas. I recall having one of those end-of-life talks with her back then. It didn't quite go the way I had envisioned. I talked about the richness of her life experiences. With her eyes shut, she nodded along in agreement as I went through the summary of her life. When I came to the part about joining her husband in heaven, she suddenly came to attention and snapped "I'm not ready yet". Oops, now what do I do? I didn't know so I backed off.

But now a year further down the road, she trolls the halls with her walker and other than a tremor in her right hand and poor vision, she's pretty darned healthy. And her pain is well controlled. She continues her slide into senility but most days she is quite content.

I hated the idea of nursing homes before all this. Now I am exceedingly grateful for the fine one we have here. It is short on frills with a plain decor but kindness abounds both from staff and from the many volunteers who serve the people on the unit. There are frequent religious activities: hymn sings, Bible lessons and devotions. The area churches do a fine job in that respect.

My only complaint is what many pastors chose to preach about to these people. The religious activities are attended by folks who would be in their pews on Sunday if they could. They are not reprobate heathens needing an altar call, yet one preacher after another seems to launch into threats that you better get saved before it's too late. Who do these Bible thumping pastors think these old people are? Do they think at all?

One week I happened to hear two of these zealous preachers give more or less the same "salvation" plug on subsequent days. I went away saddened. The old folks tuned out. They are good at that. But the next week, I caught a whiff of the Holy Spirit. A man was singing to the patients. And miracle of miracles they were singing along with him.They were even smiling. In his warm baritone, he was singing about laying burdens down and about what God has prepared for those that love him.I teared up when he launched into "One day at a Time, Sweet Jesus". I left the hospital with joy in my heart. I had a long tough day ahead, but from time to time I found myself singing softly "One hour at a time, sweet Jesus..."

Breaking up is hard to do

Last week, I saw a fellow for the first time whose wife of thirteen years has told him to move out. I am also treating a woman who is going through a divorce after thirty some years of marriage. And there's the fellow who has been in love with a gal for ten years. It's been on and off again but she's moving to another state this week. She has another man. And there was a teary conversation with a gal who thought the guy she met on the Internet was the man of her dreams. He stood her up for the second time. Only she believed that he would magically get over his 'fear of intimacy' and come around.

Having walked enough people through break ups, I've learned a thing or two.

1. The person initiating the break up is having just as rough a time as the person who has been dumped. Dr. J, a wise analyst, taught me that the next relationship the initiator runs to is usually disastrous. That's what I've seen too.

2. It is grief that is experienced with its concomitant denial, rage, sleep disturbances, and depression. It comes in waves, some manageable and some so strong that it almost bowls one over.

3. The underlying strength of the personality is a huge factor in the ability to withstand and heal from the experience. For example one woman, pooled in misery, wailed that this current break up only proved that no one could love her. I pointed out the difficulty might not be any inherent unlovability but her skill at picking men. She found men who were cold, distant and rejecting replicating the cold, distant and rejecting parents of her childhood.

4. The acceptance that it is really over takes some time. One gal didn't totally accept it was over until her ex-boyfriend married another gal and he gave his wife the baby his ex-girlfriend had always wanted. He had told her he didn't want children. She was furious at him even though she had been married and divorced in the interim...which leads me to:

5. Break up rage can spray everywhere if it taps into old unresolved infantile rage. The greater the frustration and unmet needs from childhood, the more intense and global the rage will be as a result of a breakup. The headlines are full of this stuff.

6. Basic support is helpful. Feel good platitudes are not. Sometimes people just need space and time to lick their wounds. They snap at anyone who approaches them.

7. People can and do heal. With some help, they learn what went wrong. Not infrequently they can look back in a few months and see what a blessing the break up was.

I like Skeeter Davis' song Gonna Get Along Without Ya Now where she sings:
Gotta along without ya before I met you
Going to get along without ya now...

Skeeter has several other very fine heartbreak songs such as The End of the World. Some of my favorites are Neil Sedaka's Breaking Up Is Hard to Do, Travis Tritt's classic Here's a Quarter, Call Someone Who Cares, REO Speedwagon's Time for Me to Fly and don't forget the broken heart sobbing operatic Italian arias and of course the blues. Oh yeah....

Ira Glass did a wonderful show recently on This American Life about break-ups where he introduces us to a woman who decides after listening to endless hours of break up songs to write her own even consulting Phil Collins in the process.TA gives book after book after book on grieving to those who are mourning...until the bereaved one becomes sick of grieving. There are also only so many break up songs one person can stand.

The Designated Patient

When Mom or Dad consult me about their child, I request that the parents come in too. In later hours, I'll even bring in the entire family which is always an illuminating experience. The child who "needs" help is the designated patient. If that kid gets squared away, the family tells itself, everything will be great. It's that kid who has the problems, not us. No, it's the family system that is sick and the difficulty is typically between Mom and Dad. The kid malfunctioning actually keeps Mom and Dad together. Mom and Dad can gripe about the kid instead of looking to their own marital problems. They even use the kid to attack one another. For example the parents may undermine each other's discipline of the child. If the child is treated alone, he/she will get yanked out of treatment once there is improvement. In some cases, another child in the family takes over the role of designated patient.

Recently I began treating a family whose thirteen year old daughter talked about killing herself. I'd seen the mother one time five or six years ago and her history was unbelievably sad. It didn't surprise me that her daughter was having problems. The girl described a life of being a social misfit, the butt of every one's jokes and years of being excluded by other kids. Now I'm asking myself why this is so. The kid seems immature and perhaps would do better hanging with kids a year younger than herself. I find out later that she has done exactly this successfully. So the social skills are there. She is very thinned skinned. She is the only girl with four far older brothers. Mom pervasive anxiety has engulfed this girl and this is a good deal of the problem. Dad wants the girl to grow up. Mom is afraid of he daughter's growing up and leaving her.

The marriage is horrible. There are lots of screaming matches. I thanked the girl for doing an excellent job of getting Mom and Dad some help. She had to pull the suicide trump card to do it but it worked. The kid grinned as she sat safely between Mom and Dad.

Wingshooting

I'm not sure if the gal on the left had a bad day on the range, or if the boys wouldn't let her play or what. I'd say to her, come with me girlfriend and we'll blast some clay pigeons together.

Yes, Gemother played with guns yesterday. I participated in a wingshooting clinic for women. Actually we were two women and two girls in the morning. In the afternoon two more women joined us. Wingshooting is the style of shooting one uses for hunting doves, pheasant, quail, geese, ducks etc. It is a totally different style of shooting than is used for deer. We used .28 gauge shotguns which are light and don't have much of a kick.

I'm pleased to report that I did not disgrace myself. Each time I shoot I get a bit better. And I enjoy learning from a variety of instructors.

Some poor DNR employee spent the day crouched behind a sheet of plywood. His sole purpose was to release a target every time we called "pull". The targets were thrown above our heads, away to the right, away to the left, and away from in front. The most fun were the doubles because there was a second chance.

One of the gals had never done much shooting. She couldn't hit a thing at first but was a really good sport about it. It had come up in conversation that she had recently left a bad marriage. The instructor laughingly suggested she imagine each target was her ex-husband. She did and she started hitting one after another. She did the best shooting of the afternoon.

The Great Outdoors

The cabining trip was a rousing success in spite of a few mishaps like a wasp sting, the fire extinguisher falling on my head (got a goose egg from that), the skewers of shrimp falling in the coals and a burnt baked apple. The shrimp got rinsed off. Damned if I'd waste it. It crunched a bit but it was edible. I think should there be further attempts at baking apples in coals, I'll add the sugar later. I believe that's what cause it to burn.




I hiked a lot and found fishing more enjoyable than I had imagined. Didn't catch anything but I had some bites and more or less got over my squeamishness about handling night crawlers. I was too tired to read. I listened to music, napped, did crosswords, and played solitaire...with real cards..the kind you shuffle. The last night I just listened to music and watched the fire and the fading daylight.

If I go back I'll have to take the canoe. The big lake would be great fun to explore. I wonder if Cabela's makes some kind of canoe hoist. I doubt highly if I could get our canoe up onto the top of my car by myself.

I came home to a wonderful surprise. Son had picked up the old teacher's desk I won at the auction. Hubster had stripped it and revarnished it. At first I thought Son had picked up the wrong desk, but at second glance I saw that it had already been refinished to the original oak. I hope it doesn't cause old heretofore unknown school phobias to surface in my patients. If so, we do what we always do: analyze.

Cabining

Hubster and I did marvelous work in the basement. Decades of old toys, junk, dead mice and odd things that we've been given over the year have been hauled outside to a pile which will sit until son's buddy from the fire department hauls it away. Oldest daughter moved to California seven years ago. I had consolidated the ten boxes she left in her room after college into five. Today there are none! I did unearth a few finds like her old Gameboy that still works great, three power strips, two screwdrivers, a box of 80 Band aids, and a nice pair of gloves. Squatters rights here unless she wants to wrestle me for them.

In between sessions in the basement, I have been pulling stuff together for the cabining trip. Since I'll be in a cabin, I can't call it a camping trip. I plan to do a lot of cooking over the old camp fire. I have been culling ideas from Camp Recipes and from Camping Recipes. There's the classic canned biscuit on a stick which you cook over the fire and then sprinkle with cinnamon sugar. A neat trick I'm trying is to marinate chicken breasts and freeze them in a plastic bag. They keep cold during transport and then you just plop them on the grill. I have shrimp marinating in a plastic bag for my supper tomorrow.

On the way I plan to stop at Lost Creek Orchards in hopes that their apples are ready. Apples can be wrapped in foil and baked in hot coals I've learned. There are marshmallows packed to roast as the sun sets over the lake. Perhaps there'll be an old owl hooting. No doubt mosquitoes to swat and a semi-tame raccoon wandering by hoping for a handout. Nothing much to do and that's precisely the point.