Category Archives: popular culture

Duck, Duck, Goose

Muscovy ducks are ugly.

There’s simply no getting around it. Perhaps some find them in the category of, “So ugly, they’re cute,” the befuddling phrase used to describe certain regrettable-looking breeds of dog with what seems to be a permanent, long drip of slime on their maws. I don’t see it, in either the dog or the duck.

Muscovy are also an invasive species here in west-central Florida, driving out our adorable and good-natured native ducks. Thus, they are unwelcome both in, and by, appearance.

During an Emmaus retreat at the Franciscan Center in Tampa, I was able to observe a female Muscovy along the river last weekend. She was waddling along, looking into the river on her right and then to the ground on her left, seeking food. She was followed closely by one, then two, then four, large, ugly and showy Muscovy males. She seemed oblivious. They were posturing: just short of chest-bumping one another, fluffing up their feathers, strutting in circles and then, realizing she had waddled on further ahead, scuttling up closer to the object of their desire before devolving into posturing observed only by one another, and me.

Ms. Muscovy did not feel obliged to wear shorter feathers in her nether region or walk on her webbed toes to gain their attention, and indeed, it was apparently unnecessary. She had the power of her femininity, and that was sufficient. God knows how large the flock of males out-strutting each other got before she made her selection; the bells rang and I hurried off to join my fellow retreatants for Morning Prayer.

Flash back to the 1980s, when wearing brassieres over one’s clothing, instead of under, was all the rage for a few unfortunate years. During a lunch conversation, a male colleague (middle-aged, recently divorced and apparently adjusting with difficulty) mentioned his amazement at seeing this while out in a nightclub. A few of the females opined we would never do such a thing. If we weren’t married, he said, and had to be out there, competing for male attention…whoa, whoa, WHOA. A man, I said, for whom I was to “compete” by wearing my underwear over my clothes would not be the man for me. My female cohorts agreed. Divorced-dude was amazed.

Alas, times have, apparently, changed. Somehow the power to vote, own property, and be paid the same for the same work (let’s not go to where we compare part-time clerical staff with chemical engineers and whine about salary differences, okay?) seems cast aside for the “power” to wear vagina-hats in public, insist that tights are business trousers, and gain fame by posting indecent pictures of oneself to (anti)social media.

In our little yard, I cannot, from a respectful distance, tell Mrs. Bunny from Mr. Bunny, but apparently they can, and so things work just fine. Mrs. Cardinal is subtle compared to her (to human eyes) flashy husband, but trust me, when the six or seven species of birds – almost all larger – are sharing the seeds I have flung onto the front yard, it’s little, softly hued Mrs. Cardinal who commands attention and sets the rules. Mr. Cardinal does not seem to have any objections about being partnered up with his gently-toned, energetic little mate. Likewise the pair of black snakes, the ever-expanding clan of blue jays, or our resident crows, Poe and Annabelle Lee, and their hapless but fun-to-watch adolescent offspring: all seem content without the females doing strange and torturous things in a craven attempt for male attention.

Why are humans so singularly dysfunctional when it comes to male-female relationships? Can we blame it simply on the Fall and the impact of a long history of bad choices that have turned us slowly away from what we could have, and might still be, towards this strange situation in which much of our culture finds itself?

For almost three decades now, mental health professionals have dealt with body-image and sexuality issues created by a pornographic culture so pervasive that too many young women believe they should engage in sexual activity whether they feel like it or not, and many young males have incurred physical damage on themselves due to excessive masturbation with porn as the stimulant. Conditioned to images on electronic devices, a normal, living female is just not as attractive and too much trouble. We’ve all, no doubt, heard of the teen magazine that explained sodomy in how-to terms. In my work, this isn’t some abstract issue; I listen to young women wrestle with their discomfort and shame over what they feel obliged to do and the fear that their hesitancy to engage in impersonal sexual acts means there is something “wrong” with them. I help couples whose relationship has been torn apart by the husband’s pornography addiction and disengagement from his wife.

I used to pity my male college students, assuming the heterosexuals had their ability to focus on psychology (endlessly interesting to me but, I realize, not to all) cruelly challenged because, for a healthy straight young male, the proximity of female peers would normally be distracting. Now the female peers are often dressed in revealing clothing. I assumed (naively) that this placed an unfair, even uncharitable, if you will, burden on the males. Now I wonder. I wonder if, drowned since childhood in a flood of hypersexualized images, the presence in the next seat of a young woman with her breasts pushed up to her collar bone is…nothing. Now I feel sad about that; they are both missing something about the joy of being human: they have lost the capacity to appreciate one another.

He may be sentenced, until he works to change it, to a life of seeking ever-more extreme forms of sexual stimulation, and she will be reduced to claiming that her power comes from the right to have sex indiscriminately and wear unflattering pink hats in parades.

Meanwhile, Ms. Muscovy is enjoying the riverbank and may eventually pick some posturing, squawking, ugly drake from among her admirers.

The ducks have it figured out. Guess who gets to be the silly, sad goose?

 

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

Not So Complicated

I channeled Mary Poppins: resplendent with unwavering decisiveness and spit-spot, lickety-split efficiency, two of us turned the spare-bedroom/storage-room into comfy guest quarters in less than 45 minutes. Easy-peasy…

…because it was not MY spare bedroom. No emotional investment, no weariness at once again facing the task at hand, it was, actually, fun. Change is refreshingly simple when it doesn’t cost you a thing.

When it costs something, change seems complicated and hard, even impossible.

Almost everyone I know has argued, in vain, with newspaper articles, the radio or television newscasts. As if briefly overcome with psychoses, they shout at the television and argue with the radio in their car. (Me, too). Whatever their position – progressive or conservative, libertarian or statist – they are frustrated and amazed, over and over, at officials’ protestations of how hard it is to make change happen.

Everyone has ideas on how to make change happen. Some are terrifying; others are naïve. Many, however, have the ring of common sense, and it makes one wonder, why are these officials, whether elected or snugly sinecured, acting as if everything is so complicated?

There are many different government programs aimed at moving people from one place to another. Why many? Who knows? Could it be simplified? Yes, and probably elegantly. Everyone on Medicare, for whatever reason, use service A; everyone who meets whatever clearly established criteria (such as Medicaid) for need, use service B. Give every participant a chipped card to use, require photo ID (or put it on the card) to be sure the cards don’t turn into underground currency like food stamps sometimes do, and then the details entered into the program (A or B) for that individual will determine: medical taxi, van assistance, reduced or free bus fare? A bright STEM high school senior could write the bulk of the program in a day or so. If you immediately imagined the most complicated possible situations just to pick a fight with me: sure, those exist. If someone needs a wheelchair-accessible van, then that goes into the electronic info on their card; if they merely need a cab for doctor appointments, that’s on the card. As circumstances change, someone in a remote office can input the update. When Mr. X no longer needs a wheelchair van to get to his appointments, his account can (spit-spot, lickety-split) be adjusted to provide for the appropriate transportation benefit. Plus, with GPS it won’t be hard to figure out if the beneficiary had the cab drop them at Dr. K’s or at K-Mart: auditing for abuse becomes simple. Ta-da: not easy, but simple.

If the object was to make sure poor people had good quality healthcare, one might wonder, why not simply work with what we have? One, we have a public health department system and two, we have a VA system to serve as a model for comprehensive (albeit labyrinthine) healthcare. What makes it so complicated to appropriately expand the one, based on what we know from the other? Doctors are leaving, or not going into, private practice and instead signing on as employees in the private sector, so a nice government job with benefits and a pension seems like a tempting offer for many D.O.s, MDs, ARNPs, RNs, dentists, and other healthcare providers angling to be someone’s employee. Yes, we’d need more buildings and more staff, and probably some specialty services would be outsourced (the VA knows all about that, too). Who uses them? How about anyone who meets criteria for transportation assistance, as above? They already have the ID card; add that info. Outsourcing so little of it will lead to much less fraud, the latter a cause of handwringing for the same politicians who resist change.

Oh, I know. I can’t possibly understand. It’s far more complicated than that. Well, no, it’s not. It’s not going to be easy, but that is not the same as complicated. From out here, it is very clear that sometimes what is explained as “complicated” really means “not easy.” These are different things.

A marathon is not complicated. It is a matter of stepping forward and repeating that action for 26.2 miles. I know; I ran 79 of them. They were not easy. They were simple and hard. So are lots of things. It is just easier to see “simple and hard” from the outside than from the inside.

“Complicated” is a euphemism for something along the lines of, “Well, we don’t want to change anything; some people will be unhappy, and maybe we’ll lose some votes, so somehow we must give the appearance of changing things without actually changing anything.” The best we seem to get sometimes is the legislative version of buying storage containers during the January sales. It’s the same pile of junk, but it’s temporarily neat. If the object is to pretend to change, then, yes, everything we shout at the newspaper and radio about is quite complicated. I have no idea how to run AND not run at the same time, so how could a bunch of bureaucrats figure out how to simplify programs while simultaneously avoiding any changes?

Our ambivalent relationship with change makes it simple, and enjoyable, to help other people organize their stuff. The books were not MY books, the stuff was not MY stuff. People who have enough money and stuff hire people to come in and bully them into getting rid of stuff. The theory is that someone else, who is not emotionally invested, will be able to confront me. I can imagine the process:

Professional organizer: “Now, Lori, how many CS Lewis books do you really need?”

Me: “I dunno. How many ARE there? Ought I leave room for more?”

It goes downhill from there.

The analogy ought to fail because the people we elect should not be emotionally attached to ineffective programs. They behave like people suffering the deep heartache that leads to hoarding behavior, but I suspect the attachment is less suffering and more sinister: each entanglement serves a gratifying purpose or two.

Imagine members of Congress clinging, weeping, to the thousands of pages of regulations that describe the several programs to provide fuel (or rather, money for fuel) to poor people in winter. Why would they fret about merging these into one, clear, program? Where is the burning enthusiasm to ensure that the funds to help people stay warm are used prudently and effectively? I don’t want to read about one person collecting fuel benefits from multiple funds and using some of it for frills, while someone else freezes to death. I want everyone to be warm and cozy. If there were one program, would people find a way to abuse it? Surely; but simplicity reduces the camouflage.

I suspect we will all be shouting at the news for a long time. Meanwhile, I have to go pretend to be someone else so that I can impose some order on my stuff: a process that will be simple and hard.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

 

Plan B

I am very, very hopeful that, when I leave the office this evening and get into my Ford Fiesta, it will start when I first turn the key and that all four tires will be inflated. It gets regular maintenance and I expect it to start. My plans, including the amount of time I schedule for various commutes, revolve around the expectation (Plan A, as it were) that the little car will be ready to roll.

Sometimes, she is NOT ready to roll. She might have a flat tire, or a dead battery (Florida heat is rough on batteries). So, just in case of various emergencies, I have a jack, spare tire, some tools, a can of tire-inflator, a quart of oil, some water, jumper cables, a fire extinguisher, an owner’s manual and my AAA card. I also have a Bible and Rosaries for other sorts of emergencies. I would vastly prefer not to resort to any of these Plan B’s alone in a parking lot at night, but every so often I have been happy to have them readily available.

On a much more critical scale, military and police personnel have to have plan B at the ready in case of a worst-case scenario. Let’s say you are a special operator and you and your comrades are supposed to slip in silently, extract an American hostage or two, and slip out with the same seamless, silent efficiency. That would be Plan A: no one on your side gets hurt and maybe not even too many of the enemy. If enemies have to be hurt, they cooperate by succumbing very, very quietly. Plan B, entailing air support and extra personnel and a whole lot of messiness, is far from optimal. Plan A is effective if nothing goes wrong. If anything goes wrong, then you need Plan Bs. Plan Bs have a higher likelihood of success in the case of an uh-oh situation than Plan A, but are far less desirable.

Most of us don’t have to worry about extracting hostages or inflicting deserved mayhem on an enemy. We have to muddle through, discerning our purpose and doing our best to live rightly. Do we, who don’t have any expectation of being caught in a gunfight, need a Plan B? It’s become quite popular, especially in the business school world, to assert that a Plan B is an excuse to let Plan A fail.

I would argue that Plan B is part of the backbone of successful planning. Consider, for example:

You have promised your small children that, if everyone cleans up their bedroom by 9 AM Saturday, you will all go to the zoo! Yay! You had better have a Plan B already presented to them, too, in case of rain (as in, if it rains, we will postpone the zoo and have lots of fun doing “X” at home). You do not have control over whether or not it rains on your zoo day, but you have control over creating alternatives that account for circumstances beyond your control. Would you rather have Plan A – a sunny, fun day at the zoo? Absolutely; but if it’s wet, cold and dreary, kids who are able to be disappointed but know that all is not lost are easier to deal with than children who are whining because “you promised we could go to the zoo,” and claim they care not that it is raining and all the animals will be hiding inside, out of the weather. You promised.

There are thousands of possible examples: the college application that is Plan B if the desired, and worked-for, scholarship at your Plan A school doesn’t materialize; the back-up work plan if it takes longer to get a job in your field than you’d expected; the gift you will get for your child if the most popular toy that holiday season is out of stock. Would you rather get a full scholarship to an Ivy League school, a great job that starts exactly two weeks after graduation and be able to score Tickle Me Elmo, the latest Transformer AND the talking pony? Yup, yup and giddy-yup…but those are not all within your control.

The business school model against Plan A, very interestingly researched by Doctors Shin and Milkman, focuses on short-term goals with brief time periods. One test, for example, was that some participants were asked to consider a Plan B if they failed at the brief task while doing the brief task. If you have 10 minutes to unscramble sentences, and the reward for success is a free snack and some are warned up front that, hey, you might want to think about where else on campus you can score some free food in case this doesn’t work out for you, those participants might be a bit distracted from the task at hand. You have given them two tasks. That doesn’t mean they were not motivated for Plan A (the free snack) but rather they had to do two tasks at once: the task for the free snack and figure out where to get free food if the buzzer went off before they finished the first task. This is one of several experiments in their research. Other business writers have emphasized the belief that asking people on a project to have a plan B is like giving them permission to fail at plan A.

This is an interesting perspective and very narrow in its focus. There are risks in over-generalizing the findings of any particular piece of research, something Doctors Shin and Milkman know. Unfortunately, readers who see a non-academic’s cheerful, “Hey, if you develop a plan B you plan to fail,” misstated summary of Doctors’ Shin and Milkman’s work might leap to the conclusion that Plan B means Bad Plan. That is not what the researchers concluded.

I would propose that there are a few common reasons for a bias against adequately thinking through a Plan B when preparing to execute Plan A. These are by no means comprehensive –

  1. “I have done everything that success requires and so I am entitled to success.” Ah, the entitlement myth, in which a benign and biased-towards-you universe bestows what you have earned even though there is far less of whatever you want available than there are hard-working and deserving candidates. Hundreds of people might apply for that scholarship, and all of them have great GPAs, hours of non-mandated community service and glowing endorsements from their local Mother Teresa. Yet the committee (and its computer program) can only give the scholarship to one applicant. Scholarship, job, internship…failing to achieve that one, ideal Plan A doesn’t mean you personally failed. It means that you didn’t get Plan A, probably for many reasons outside of your control.
  2. “I am terrified of not meeting the expectations of those close to me (parents, often) and so most pour everything into Plan A. Anything less than absolute success means I have failed them – and myself.” This speaks to the narcissistic parent (“I am a perfect parent and you, my ought-to-be-perfect child, are the Exhibit A in proof of my perfection”) projecting the need for boundless success and admiration onto the child. Spouses can do this to one another, and children might fall victim to Pygmalion coaches or teachers.
  3. “If I have a Plan B, it will surreptitiously make me turn into a lazy slug who will fail to put in the effort required for Plan A.” This is the, I can’t trust my own strength of character theorem, and one can only say in response to this, “Know thyself.” However, lack of a Plan B is not going to singlehandedly turn an unmotivated sloth into a laser-focused, goal-oriented powerhouse. If you know you need to work on your intrinsic motivation strength, now would be a good time to start.
  4. “Plan A is my heart’s desire and I cannot bear to consider life without it…so I will just not consider the fact that Plan B might be necessary.” This is idealistic and romantic, and if you are not a good-hearted male under age 21, you probably need to accept a teaspoon of reality. If you are a good-hearted male under age 21, I will cut you some slack. That is the healthy age range for passionate idealism with a dose of immortality myth. The rest of us have to deal with the reality that life changes constantly. Your robust good health, your vision and hearing, the career you love, your neighborhood…will all change. If there is not a Plan B, you will have the alternative of crushing despair on top of the burden of grief, time after time after time.

I began this essay, spurred by a friend’s report of an adult daughter who, failing to get the job she’d applied for after college, is moving back home without any particular plan. Apparently, there was no Plan B. This led to curiosity about the “Plan B” issue in general, and discovering Shin and Milkman’s research. Not long after I began this essay, the book Option B, by Sheryl Sandberg and Adam Grant was released. I am looking forward to reading Option B and have no idea of its contents other than it was born within the heartbreak of unexpected grief and the part of the grieving process that requires that we shift to an alternative vision of our future.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

Practical Psychology

My second book, 31 Ways/31 Days: Practical Psychology for the Frazzled Faithful, has just been published and is available via Amazon and other retailers, in both softcover and eBook. In it, I present information from the field of psychology as clear, simple action items for normal, busy people who want to make positive changes.

I love to turn psychological research into something a non-therapist can use, right now, to make relationships and life better.

Sometimes, research sounds ridiculous by the time it hits your news feed. Gleaning the nuggets that can change your life – today – is challenging. Consider, for example, that a cluttered environment contributes to parental stress to the point where it interferes with consistent parenting styles. Of course work, chores and piles of stuff to do covering every flat surface are stressful…but who knew that the clutter added enough stress to interfere with parenting? It’s easier to reduce stress by cutting a little clutter than figuring out what other source of stress to eliminate (hmmm…change jobs? quit working? send the kids to boarding school in Antarctica?) Implementing a manageable, meaningful change makes psychology, with its seemingly arcane tidbits of scientific research, useful to you. It’s not magic or a complete overhaul, but it’s a step in the right direction.

Another useful application of psychological research: even looking at pictures of nature helps reduce stress for everyone, and can improve cognitive skills in people with dementia. Whether it’s you at work, or your beloved elderly family member at home, some photos of nature to fill the eyes from time to time can help. It’s not going to make a miserable job a happy job, or reverse dementia, but it can ease the burden a bit.

If psychology doesn’t make life better and improve our understanding and relationships, it’s not very practical…and if it’s not practical, what good is it?

 

 

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2017

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

When Media Lies Hurt: The Destructive Impact of Sloppy Journalism on Real People

(Originally published in USA Today Magazine, July 2016. A few updates were made for reposting to this blog)

It’s safe to say that most people have long since given up on the idea of unquestioning trust for the media. Walter Cronkite died in 2009. Despite vague mistrust, people are vulnerable to the effect that repeatedly hearing things has. Hearing something over and over engrains it in our brains, even if it’s not true. The repeated lie tends to rise to the top when a related topic comes up. This is one reason so many people believe that, for example, violent crime is up all over the country (it’s not) or that we know for sure exactly what schizophrenia is, or what it’s caused by (we don’t).

As a psychotherapist, I see the pain that sloppy journalism creates for real people on a regular basis. I don’t mean transient worry; I mean the possibility of a lifetime of unnecessary anguish inflicted upon people who believe that the information hurled at them by media must be based in truth.

Three examples will suffice to illustrate; you can no doubt generate plenty of examples of your own.

Media Misrepresentation: People considering suicide always give clues about their intention, and thus friends and family have an opportunity to see it coming and intervene.

According to A. Dadoly in the Harvard Health Newsletter (2011), professional estimates are that 30-80% of suicides are impulsive acts, with little or no planning beyond the immediacy of the moment. That means family members could usually not have read the signs, and could not possibly have intervened. Yet, most people believe, because they’ve been told repeatedly, that warning signs are just about always there and thus are tormented with guilt and self-reproach for failing to see something that was, tragically, probably not there.

Media Misrepresentation: Depression is a medical illness that is a lifelong condition. You’ll be on medication forever because there is something wrong with your brain.

The truth is, depression, or “major depressive disorder,” as it is currently labeled, is a construct. It is diagnosed off a checklist of symptoms. Meet enough of the symptoms for a two-week period of time and, bingo, you can be diagnosed, whether that sadness, poor sleep, lack of energy, poor concentration, etc., is due to grief because someone you love has died, or to some other life circumstance…or, perhaps, something medical. Some research indicates that most cases of depression will improve within 7 weeks whether you do anything to treat it or not. Plenty of evidence shows that lifestyle changes such as proper sleep, diet and exercise, plus social supports and a bit of emotional support via therapy, will create improvement in less time and leave you more resilient the next time life throws you a challenge (which, of course, it will). You can find a wealth of scientific research as well as specific steps to apply that research to real life in Stephen Ilardi, MD, Ph.D.’s wonderful 2009 book, The Depression Cure. There’s plenty of other research out there, of course, but for busy readers, Dr. Ilardi has done a masterful job of tying together many researchers’ work and working out a useful process.

Yet millions of people have been sold the lie that their symptoms are evidence of a brain disorder that requires lifelong medication. The medications change the brain, cause all sorts of unpleasant side effects, such as weight gain, loss of sexual interest and/or function, and general apathy towards others, and often cause terrible withdrawal symptoms. They also carry a risk for impulsive acts of self-harm, including suicide, and violence against others. Almost every adolescent and young adult mass killer in the US in the past couple of decades, with the exception of avowed Islamist terrorists, has been on one or more psychiatric drugs, including many antidepressants.

Do these medications help some people? Apparently so, according to them and their doctors. That does not, however, prove that everyone who is sad for more than two weeks has an incurable but manageable brain disease and is “mentally ill.”

Media Misrepresentation: Your gay son or daughter is going to burn in hell just because he/she is LGBT.

This lie is a criticism of many religions, and recently has been part of the background of a television show called “The Real O’Neals.” One part of the plot involves a gay young man whose supposedly Catholic mother is consumed with despair because “her religion teaches her that her son is going to burn in hell because he is gay.” That’s a paraphrase from interviews I’ve read with a star of the show. I have seen many families suffer under this belief. Parents are alienated from their children; children believe that their parents are condemning them; parents and children alike reject their faith. I will address this from my Catholic perspective; you can do the homework on your faith.

The Catholic Church has an international apostolate (a fancy term for an approved special ministry) called Courage, focused entirely on providing spiritual, emotional and social support for LGBT Catholics. Its intention is not to “make them straight,” but to help them live Catholic lives with the orientation they experience. The official Catechism of the Catholic Church isn’t exactly politically correct: like the psychiatrists of just one generation ago, it considers homosexual behavior disordered – but you could say Catholicism (and all orthodox Christianity) says about the same about any sexual activity outside of marriage.

However, the Catechism of the Catholic Church also says: (paragraph 2358):

The number of men and women who have deep-seated homosexual tendencies is not negligible…They must be accepted with respect, compassion and sensitivity. Every sign of unjust discrimination in their regard should be avoided. These persons are called to fulfill God’s will in their lives and, if they are Christians, to unite to the sacrifice of the Lord’s Cross the difficulties they may encounter… (that “uniting to the sacrifice of the Lord’s Cross, is of course, what all Catholics do when, faced with challenges, we talk about “offering it up” – this is not a unique imposition upon GLBT persons).

Paragraph 2359 ends with, “They can and should gradually and resolutely approach Christian perfection.” Hmmm. No ineluctable path to hell and damnation there.

One can, however, imagine the pain of a parent who imagines their child is immediately rejected by God. One wishes they were bold enough to seek right guidance.

Our Responsibility

It’s easy, of course, to blame the media. Journalists go to college and seem to take pride in getting the “real story,” or whatever they imagine they’re doing. So why don’t they do their homework? Why present the easy, available tale? Psychologically, they appear to indulge in confirmation bias: the tendency to seek out and focus on things that verify what they already “know.” We consumers of media need to check the facts.

Bad information creates pain and suffering. Don’t assume what you read is the whole truth. Do your research, and turn to people who might have access to information you don’t have. Someone’s peace of mind may be at stake.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2016

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

Internet Gaming Disorder? Is that a thing?

Yes, it’s a thing.

Are you (or someone you love) hooked on internet gaming?

An excellent recent article on parenting in Real Simple, “Parenting Against the Internet,” cited a statistic that the average adolescent male spends 20 hours a week playing internet games, and the average adolescent female spends 10 hours a week.

The internet can be great: I can look up all sorts of research, read the news, check the weather, contact family and friends around the world, find obscure used books in a mom-and-pop used book store somewhere across the country…

But for some people, the something good turns into a real problem. The American Psychiatric Association, in its 2013 update on diagnoses, the DSM-5, named Internet Gaming Disorder as a “condition for further study,” rather than an official diagnosis with its own billing code. Tune in within a few years; no doubt, that will change.

Twenty hours a week is a lot of time to spend doing something that teaches little, if any, useful knowledge; isolates a person from contact with real people and real life; is sedentary; and creates a world that is not real but full of very real gratification in terms of the brain’s dopamine system. That’s the average; that means for some people, there’s little or none and for some, it’s the equivalent of a full-time job, absorbing time, energy and mental space that could be dedicated to learning real-life skills, creativity, and other parts of life. Please don’t bother emailing me with examples of games where prosocial behavior is rewarded or you have to know useful stuff to be successful; I know. I also know that at some point it’s unhealthy to live in an artificial land of make-believe, instead of taking that pro-social behavior and useful knowledge and using it to make the world, and yourself, better.

What are the warning signs of this disorder that warrants further expert study? Persistent preoccupation; withdrawal symptoms such as irritability when the games are taken away; tolerance (more time playing games as time goes by); unsuccessful attempts to control the amount of time playing (for example, promising to cut back now that school has begun and sliding right back into excess); losing interest in other activities; continued excessive use of games in spite of problems in relationships, job, school, etc.; lying about how much time is spent playing; using games to deal with other problems (the game is a drug to feel better at this point); jeopardizing or already lost significant relationship, job, educational or career opportunities because of involvement in playing internet games (American Psychiatric Association, 2013). Note that these are games – gambling on the internet is already an official diagnosis when carried too far.

Most people can easily see the degree to which these signs are awfully similar to what we would use to assess a problem with alcohol or drugs: preoccupied with drinking? Cranky or shaky when they can’t get their “fix?” Unable to cut back; getting behind in life in all sorts of areas; lying about how much is used…so why are parents apparently turning a blind eye to how much time their kids spend in this world?

Some theories:

  1. Some parents are as active in gaming as their children and have convinced themselves that those excessive hours are better than other things their child might do. Well, yeah; I suppose you could also argue that it’s better for your child to get drunk than to inject heroin, but that doesn’t make getting drunk a desirable behavior.
  2. Some parents are unaware. They do not realize what their kids are doing in their rooms, on their phones, half the night, or when they’re supposedly doing homework, or when they are in a college classroom, not paying attention.
  3. Some parents think it will be outgrown…although the social skills deficits these young addicts have will often interfere with their ability to successfully navigate college, trade schools and work.

Of course, it’s not just teens. There are adults who sometimes work full time, or part-time, and spent 30+ hours gaming each week. They tend to have marital problems, job problems, or both. Perhaps they have neither a relationship nor a job, but do have angry parents who want very much to be empty-nesters, any decade now.

Don’t think this applies to your child, or to you? Try cutting it off for a week. A week’s not that long. No exceptions. Notice what happens. If you’re afraid to even bring it up because you “don’t want to deal with it,” you have just told yourself something very powerful, and somewhat frightening, about your confidence as a parent and your child’s relationship with gaming.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2016

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

 

Surprise! Today is mostly the same as yesterday…

Surprise! For most of us, today is mostly the same as yesterday!

Huh?

Well, maybe I am letting a pinch of my grew-up-in-Jersey show, with an unhealthy indulgence in sarcasm…but I have a point.

Why are so many people surprised when every day, so much is the same?

Why do some sources tell us the “average American woman” tries on four or five outfits before leaving for work? Is it really possible this hypothetical average woman is perpetually surprised by the obligation to wear something besides yoga pants and a slept-in t-shirt? Imagine: “D’oh! Get dressed again???? What the…?” It’s much more likely that what-to-wear becomes, under pressure, an emotional decision (what do I feel like wearing) instead of a practical one. The cool, calm decision on Sunday (what makes sense based on the demands of each day of the week) turns into a workday morning emotion-fest for people who get caught up in “I feel fat” or “I look terrible.”

It’s not just about prepping for the non-surprising workday.

Why is anyone over the age of twelve stymied by the multiplication of dishes in the sink, the need to do laundry, or the fact that garbage cans get full? Worse yet, why are so many couples arguing, night after night, about “what to do about dinner,” as if the need to eat sometime between finishing lunch and going to bed caught them unawares?

I try not to be surprised by the every-day. Maybe I am flattering myself by mincing words here: I am dismayed that Darcy the twelve-year-old cat has once again thrown up in the middle of a wood floor. I am, regrettably, not surprised.

The school year is beginning here in West-Central Florida, and so families all over are waking up to unpleasant (non)surprises: pack lunches? Matching socks? Complying with uniform rules? What??? I am right there with you, folks, amazed that it is once again time to get into the autumn routine.

For me, that includes packing a week’s worth of lunches and ironing a week’s worth of clothes on the weekend. Crazy, right? Until you imagine it taking two minutes to get dressed for work and a few seconds to grab a lunch out of the fridge, instead of trying to figure out what to wear, heat up the iron or touch up shoes, wash fruit and veggies, etc., while the work day morning clock’s ticking. I have it figured out: less than 30 minutes total for all clothes- and lunch-prep on Sunday or cope with 15 minutes or more five times a week. I am saving myself, at minimum, 45 minutes

Emotions are what get in the way for families bickering about “what to do about dinner,” or “how are we going to get the laundry/kitchen/pet duties done.” People are tired, they are hungry, they are stressed out from the day. Tired, hungry, stressed people are not as good at negotiating and decision-making, whether at home or work. Instead of wishing you could come home, magically downshift to a Zen-like mindful state and engage in creative cookery and Pinterest-worthy home maintenance, why not just plan to deal with reality?

The reality is, you will be tired, you will be stressed, and you will wish you had something easy, tasty and nutritious. You will not want to spend a half-week’s worth of grocery money on takeout because the dinner hour caught you by surprise.

The 1990s bestsellers by Elaine St. James (Simplify Your Life, Living the Simple Life, etc.) included very down-to-earth, helpful tips: have a weekly menu that rarely varies. It keeps life simple. That doesn’t mean you can’t have wonderful, complicated meals, but it does mean that you can also plan for: Ugh, it’s been a 14-hour day door-to-door and that homemade soup from the freezer/half a lasagna/whatever ready to go and bag of salad are going to taste really, really good…in about five minutes, instead of spending a half-hour bickering, grumbling, and absent-mindedly eating a half-bag of chips while you try to figure out what to do.

Slices of the culture are having a virtual love affair with simplifying, decluttering, etc. How about decluttering and simplifying the routines of life, the predictable little tasks that are the same each day, so you have more time and mental energy for the things you’d rather do?

 

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2016

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

Reports, Commands and Rules

Many years ago, on the first day of class in the graduate-level course on Abnormal Psychology, our instructor held up the then-current version of the DSM (Diagnostic and Statistical Manual of Mental Disorders) and said,

“Always remember…you never know what flick is playing in someone else’s head.”

Words of wisdom: much goes awry because we forget that simple fact.

Honestly, don’t you ever wonder if some people are actually going out of their way to deliberately misinterpret what is said?

Have you never sat in slack-jawed wonder at the psychological gymnastics required to wrest a particular interpretation from something that meant nothing of the kind, as you witnessed someone gallop away, flush with a gross (and possibly deliberate) misunderstanding?

Sometimes, there may be bad intentions, or at least the intention, all along, to make some point, whether or not it makes any sense in context. We see this often in every level of politics. Commentator Smith had a well-rehearsed point to be made during the allotted few minutes on-air and by golly, Smith is going to find a way to interject it even if it makes no sense in context. Smith hopes that the point thus calculatingly made is so clever, so memorable, that it will be the “take-away” point for most listeners, even though, within the transcript, it seems arbitrary at best.

Among the well-intentioned, the problem may sometimes be a lack of clarity…more often, I think, it is a lack of clarification.

In family therapy and family systems theory, we refer to a metacommunication concept called “Report and Command.” The “report” is what someone actually says. The “command” is the meaning of that statement to them. It is the hidden expectation. In a final exam question for a family therapy course, I give the following example:

Matthew states, “Susan never makes my favorite meal anymore.” From a metacommunication perspective, “Susan never makes my favorite meal anymore,” is the report. The command portion might be:

  1. “I feel hurt because she doesn’t care to do this for me anymore.”
  2. “…And she should make my favorite meal.”
  3. “because she knows I’m supposed to watch my cholesterol.”
  4. There is no command in this communication

Students are expected to pick an answer and defend it briefly. There are multiple “right” answers. It is telling that, given the statement, “Susan never makes my favorite meal anymore,” more than half the students regularly assume that the command – the hidden meaning – is b, “And she should…” rather than the plaintive option, a, or even the matter-of-fact and somewhat complimentary c. The choice of b, of going negative, tells them, and me, a lot about how they make assumptions about what people might mean, and points out the risk of assuming rather than clarifying the deeper meaning of even seemingly mundane remarks. Here, then, if Matthew is passively expressing hurt at his wife’s apparent disinterest in nurturing him, and Susan instead “hears” a chauvinistic, boorish demand that she slave over a hot stove, well, I may have an appointment open, week from Tuesday, at 6 PM.

Another recent example: a friend observed a parent telling a child engrossed in a video game that the child’s sporting event was to begin in 10 minutes. To only the parent’s surprise, this barely nudged a response from the child. The parent actually said, “Hey, your race starts in 10 minutes.” The parent believes he communicated, “Hey, dude, we gotta get going NOW so you can be in position for the race in less than 10 minutes.” Dad made a vague observation about time that meant nothing to a child and the child took it literally: Dad is updating me on the passage of time. I leave to your imagination the subsequent exercise in frustration for Daddy and his swimmer.

Some people claim they don’t have a lot of expectations. Nonsense. Of course they do. They expect the lights to go on when they flip a switch, though for the most part they know not how it happens. They expect politicians to magically create more jobs and higher wages. They expect their spouse to read their mind when they make that little throat-clearing noise and bulge their eyeballs at dinner with extended family or friends. They expect their loved ones to know what they might want for their birthday. We all have lots of other day-to-day subtle expectations, without which we couldn’t get through the business of living. There really isn’t time in a day to treat every iota of experience as a new and undiscovered country. Some things have to be on autopilot (which implies expectations, however buried they may be).

If you are happily married, you expect your spouse to come home; you expect compassion; you expect at least well-feigned interest in much of what you say. You probably have a reasonable expectation that certain tasks will be done and that you will be warned before in-laws or ne’er-do-well friends, down on their luck, take up residence on the couch. If, to your surprise, perpetually unreliable Cousin Pete has been invited for an extended and slovenly stay, you might reasonably say to your spouse, through gritted teeth in a whisper in the kitchen, “I had no idea your Cousin Peter was coming to visit,” (report) with the unsaid (command), “…and I am perfectly right to expect that you would have asked before letting him set foot in our house.” “But honey,” your spouse might say, “Pete’s family.”

Ah, the family card. Now we move from Reports and Commands to Rules.

Everyone has rules. Some rules are overt: my husband has asserted that I am not permitted to give up chocolate for Lent. This is one of a few rules in our house. Have I mentioned his strong survival instinct?

Most rules are not even verbalized; they are taken for granted, as if a law of nature. In the example of your spouse’s unwelcome cousin Pete, “family are allowed to be here without either of us consulting the other,” is apparently the inviter’s rule. You might be thinking, “Yeah, well, maybe a nice family member but not stinky, rude, mooching Cousin Pete,” or, “for dinner, maybe, but to sleep on my couch for some indefinite period of time, no!,” but, you see, that is an entirely different rule.

A lot of clashes arise because people have not clarified their expectations and their rules, both to themselves and to others; and because they speak in terms that they believe are perfectly clear when actually they are not clear at all. Next time you find yourself in a gross misunderstanding with someone you love, perhaps it would be worth revisiting whether you actually communicated what you thought in the privacy of your head…and to ask more questions about what someone means before you assume that what you heard is what they intended you to understand.

 

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2016

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

 

If you won the lottery…!

We all know the stats: that six months after a major windfall, such as the lottery jackpot, people are no happier than they were before they won. Most of us assure ourselves, WE would do better. WE would know how to manage that blessing in such a way as to increase the happiness of many people – including ourselves – on an ongoing basis. WE would be happier, not succumb to dopey decisions and would never blow up our lives with self-destructive, self-indulgent bad behavior.
Here’s a question: what would you do if you won the lottery, and why aren’t you doing some version of that already?
If you imagine you’d travel, see new places and try new cuisines, are you saving money for a trip and seeking free/cheap adventures in your own area, experimenting in the kitchen and otherwise exploring here at home?
If your job is a poor fit, are you meeting your intellectual and creative needs via outside pursuits, or investigating how to transition to something that’s a better fit, or are you just feeling “stuck”?
Most changes people imagine making after winning a lottery are really superficial and thus, much to their surprise, they show up in that new, changed life with the same “them,” with all their flaws, quirks, and preferences. That means that we all would tend to level out at whatever our prior level of contentment was, pre-jackpot. If you’re a happy person, you’ll keep on being happy…and if you’re cranky, well, you’ll just be a rich, miserable person to be around instead of a not-rich miserable person. Worried people will keep on worrying until they decide to learn how to change that – which doesn’t require a lottery jackpot.
You can be happier today. You can find a new adventure in your town this weekend. You can learn something exciting and be on the way to mastering a new skill this week. Alternately, you could sit around and wait to win the lottery. You get to pick.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC
© 2016
Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.

Military Mental Health

It seems as if daily we are told how shamefully the military handles the problem of psychological distress and emotional pain for our men and women in uniform. In May, the USA Today newspaper empire asserted that the “Pentagon [is] perpetuating stigmas that hang over treatment, study finds.” (Zoroya, USA Today, May 6, 2016). The military is criticized because it takes mental health issues seriously enough to reconsider security clearances…unnecessarily “stigmatizing” those who have sought treatment.

This supposed stigmatization merits careful consideration. These include the depth and breadth of existing mental health services for active duty personnel and veterans; the conflicted American mindset on mental illness and emotional distress; and the logical outcome of this strange ambivalence.

A person not in the military or close to military personnel, may reasonably be under the carefully groomed media misimpression that the emotional well-being of our soldiers, sailors, airmen and marines is some sort of vague afterthought. Perhaps the general public is unaware that military mental health officers (people who are qualified to be licensed solo practitioners in the civilian world) are found in forward operating bases, combat outposts, and other deployment settings, providing critical incident debriefings, assessments, counseling, and referrals for more comprehensive care. When young men in harm’s way are despondent over a wife’s philandering, or are heartbroken over missing their child’s birth, the mental health officer is there. When there are incoming mortars, the mental health officer is there. When someone’s reaction to the weekly required malaria medication is extreme (malaria meds cause short-lived anxiety in about 1 in 10 people, and for some of that 10%, paranoia kicks in briefly, too), the mental health officer is the one who can figure out what’s going on and have the physician provide an alternative medication for the soldier – saving a military career from dissolving due to what looks like psychosis but is a transient medication side effect. In short, when crises occur, the “doc” or “shrink” or “combat stress lady” (quotes from military personnel) is there.

It is understandable that most civilians are unaware of mental health clinics on military bases, where military personnel and their families can receive counseling. Besides basic counseling services, mental health personnel provide services such as outreach before, during and after deployment, support while preparing for new babies, parent training, marriage counseling, couples’ retreat weekends, substance abuse education, and more. All these are part of the routine in military mental health clinics. Mental health officers are also able to veto a transfer if any member of the transferring family’s health or mental health needs cannot be adequately met at the new location. So…if Mom is being transferred to Base “A” and that area doesn’t have the specialized services that one child in the family needs, the transfer is nixed – possibly by a licensed clinical social worker at Lieutenant rank. The 2nd Lt. just overrode the entire command structure, in the military that is decried for not taking mental health needs seriously.

Then there are the VA system and the Vet Centers. Vet Centers are cousins of the VA. Unlike the VA, Vet Centers require only a DD 214 to provide free individual, couple or family therapy. It doesn’t have to be service-related…but if the problem seems to be service-related after all, the Vet Center personnel can help facilitate connection to the VA proper. These, too, are staffed by people licensed in their respective states as solo practitioners. There are no “not good enough to make it in private settings” amateurs serving in mental health positions.

Finally, there is the difference between benefits (think, Tricare, which is insurance for post-military service) versus service-connected health care (think, the VA system). A lot of veterans get that confused, and any of us who have tried to deal with health insurance and making sense of what is/is not covered, copays and coinsurance, and in and out of network…well, it’s understandable that almost anyone would find it confusing. Fortunately, the VA system and Tricare have professionals who do a lot of work (and get yelled at a lot) in trying to help people understand their benefits/insurance/service-connected health care, and connect them to the right services.

There are mental health services for military personnel and veterans. There could certainly be more, and the services available could be better marketed. In addition…there are stigmas.

Those stigmata comprise one more disgraceful example of too many Americans wanting to have their cake and eat it, too.

The regrettable medicalization of mental health has resulted in the mythology – happily embraced by many in the medical, pharmaceutical and professional-helper fields, as well as by many in the general public – that all mental disorder diagnoses are brain diseases. For example, many professionals will assure you that depression is strictly medical in nature; a brain disease, incurable but treatable by manipulating brain chemistry. Likewise, anxiety is (supposedly) purely a physical issue. People collect Social Security Disability, disability from their employers’ insurance, and other benefits, based upon having some sort of lifelong brain disease (according to psychiatry).

There are plenty of people eager to buy into this. We hear depression is epidemic (what else could we call something that apparently affects at least 20% of women and 10% of men each year, based on prescriptions for drugs?). Well, here is a recipe for depression:

  1. Maintain a sedentary lifestyle
  2. Eat a lot of junk food and assiduously avoid adequate portions of healthy foods
  3. Smoke cigarettes and/or abuse illegal or prescription drugs
  4. Drink more than one drink daily (females) or two drinks daily (males), or more than your physician recommends, given your particular health profile.
  5. Cultivate poor sleep habits. Watch television before bed; heck, watch television in bed, or use your smart phone, or tablet, etc. at bedtime. Drink caffeine less than six hours before bed. Wait until night time to argue with your spouse. Have a “nightcap,” which is a short word for “the alcoholic drink that will let you fall asleep more quickly and then wake up at 2 AM and have difficulty going back to sleep.” Eat salty foods before bed to activate your dopamine system and feel a little hyper.
  6. Avoid exposure to natural daylight.
  7. Watch lots and lots of television, or streaming video, or play video games, or surf the internet. The more the better. Strive for the national average of 6 hours or more daily (non-work related).
  8. Spend lots of time on social media. In particular, notice how much your life stinks compared to other people’s (supposed) lives.
  9. Shop for recreation. Spend money you don’t have on things you don’t need and then keep being surprised when, no matter how fancy the clothes or pricy the electronics, you are still, well, you.
  10. Be selfish.
  11. Don’t apologize, and don’t say thank you.
  12. Think a lot about how much other people are unkind, selfish, lazy, and how generally you are not getting your fair share.

Yes, I just described what an awful lot of people do, and yes, if you do enough of these things, you will probably feel depressed. Yet, as can be seen, every single one of these behaviors is optional for most people. Perhaps someone has physical challenges that prevent them from being active, but otherwise, these all represent choices made, choices which could be changed. If you were to do these things, and feel sluggish, unhappy, uninterested in life, helpless to make things better, etc., and reported this to your doctor, you could easily be diagnosed with depression.

The label depression, of course, is itself suspect. Within the mental health field, we are well aware of a dirty little secret. This secret is carefully hidden by pharmaceutical companies from the unsuspecting, suffering, and happiness-seeking public. That is, the criteria for almost every mental disorder diagnosis is a checklist. Committees review the research, argue about what should and should not be on the various checklists, have professional feuds, and publish the criteria. People are then diagnosed based off a checklist of symptoms or complaints. Those categories are fuzzy – a complaint I hear regularly from graduate students who, perhaps naively, expect pure, clear science. As soon as one set of criteria is published, the process starts all over again. This is how it came to be that, in the current diagnostic manual for the American Psychiatric Association, there is no such thing as bereavement. If you are still moping around after two weeks because someone you love has died, the American Psychiatric Association, in its infinite wisdom, has decided you meet criteria for Major Depressive Disorder. That’s the same Major Depressive Disorder diagnosis that many forces are pushing us to believe is simply a brain disease that requires lifelong treatment. I am not being sarcastic or flippant; it’s their decision, not mine. I was Hospice-trained and, even absent that, I am human and understand that bereavement is a long and painful process, even for the resilient among us.

The decision to eliminate the “bereavement exclusion” was supposedly made, in part, to allow people to use health insurance to pay for grief counseling. (At least, that’s the gossip I hear in mental health circles.) In other words, you are despondent. Someone has died. You go to a counselor. They diagnose you with depression, which is supposedly a brain disease, because you meet checklist criteria. You are now labelled with what many people assert is a lifelong condition due to your sick brain. You will now be able to have insurance cover your counseling (after your deductible has been met, of course). The diagnosis of a major mental disorder will last forever – long after you have forgotten whether you paid a copay or full fee for a handful of sessions, or went to a support group in a church conference room that a therapist facilitated as a volunteer.

Depression is worth discussing as one of the most common diagnoses. Psychiatrists and other physicians provide prescriptions for antidepressants, for example, to about 15% of the adult population annually – and many assert that depression is just a disease, like any other disease, and you have to face that you will be sick and need medication for the rest of your life. If that is the case, then why criticize the Pentagon for being concerned about someone whom psychiatrists assert has a lifelong brain disease having their finger on a trigger, or button, or sensitive data? Why should one person with a particular diagnosis be placed on perpetual disability and another maintain top secret clearance? Which do the people complaining about how the military stigmatizes mental health want?

To be clear, this is not unique to the military. People seek counseling, are unwittingly diagnosed, and discover later that they are deemed mentally ill and a high risk for suicide; perhaps their life insurance rates increase, or their health care premiums increase, and when the premium bills come in, they can’t remember having any mental problems except that time they saw a counselor after their grandparent passed away. The labelling can happen without any mental health treatment at all; if your physician lists a mental disorder as a possible diagnosis (fatigue, depressed mood, and poor sleep being symptoms of lots of problems, psychological and physical) while ordering blood tests (for what turns out to be something medical), that possible mental disorder diagnosis is in your health record, now part of your profile, even if you turned out to be anemic, not depressed.

Even if you are diagnosed with depression, the diagnostic categories don’t adequately describe what is happening, and they should. It is reasonable to expect that professionals, viewing the diagnosis on a chart, immediately discern the difference between these types of experiences:

“I’m depressed and exhausted because I’m having hideous nightmares ever since my buddy was blown up and died in my arms” versus,

“I’m depressed and exhausted because the 5 years I spent doing meth have caught up with me and my brain has been damaged,” or,

“I’m depressed and exhausted (and right now no one, including me, realizes it’s because I am among the one in 10 women who suffer depression as a side effect of chemical birth control).”

Right now, the label doesn’t differentiate. As you dig into the chart, yes, it’s there – but the most superficial record just shows the diagnosis code.

So, let us not pretend that the military is some big, horrid bully for treating serious mental disorder diagnoses as a possible risk factor for clearance. As long as those in power – throughout the medical, insurance, pharmaceutical and government arenas – are manipulating the definition of mental illness, one can hardly blame the military for being overly solicitous about the mental health of our men and women in uniform.

The conundrum of diagnoses and the risk of damage to one’s life explain why some military personnel are suspicious about seeking mental health treatment. We ought not to assume ignorance when they instead go to chaplains (who may be precisely who is needed) for wise and useful guidance. Similarly, they may choose to be self-paying for marriage counseling, stress management or other issues…off the record and off the base, their privacy is as sacred as mental health treatment ever was, before psychiatry yielded to intrusive insurance, and, as the big player in the mental health field, dragged most mental health professionals with it.

 

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

© 2016

Posts are for information and entertainment purposes only and should not be construed to be therapeutic advice. If you are in need of mental health assistance, please contact a licensed professional in your area.