REACH OUT AND HELP!

Many of this week’s headlines focused on the suicide of “yet another TV child star.”  This week’s death was that of Andrew Koenig, the actor best known for his role as “Boner” in the ABC sitcom Growing Pains.

That his suicide - as any suicide - is a tragedy was best illustrated by his family, friends and colleagues, all of whom described him as being loving, sensitive, and an activist who was concerned about the environment and about the rights of oppressed people everywhere.  And yes, he happened to have been be a talented actor.

What I take issue with is the emphasis placed on his having been “a star,” implying a sinister connection to his mental state.

Anyone interested in better understanding suicidology will discover that there is, in fact, a vast array of reasons leading people to take their own lives. They vary from chronic physical pain to the inconsolable pain of having been physically or emotionally abused; the death of a loved one; the loss of one’s income; a marriage ending in a bitter divorce, the loneliness and isolation of old age, and chronic depression.

Ironically, the loudest voice of reason heard after the discovery of Koenig’s body was from his father, actor Walter Koenig.  One has to wonder how he even mustered the energy to speak.  Yet, his heart-wrenching plea was expressed to anyone feeling as desperate as his son must have felt. He begged those suffering from depression to seek help, to know that there are people who love them and professionals who are able to help them.  The Koenig family also asked that donations in Andrew's memory be made to the National Suicide Prevention Hotline.  Clearly, this father’s wish is to spare anyone from suffering as his son must have suffered, leaving loved ones to deal with their own devastating pain.

As a society we should have learned this long ago, but it is becoming imperative that the majority of people be educated about the warning signs of mental illness.  We cannot stay idly by and pretend not to see what we see and/or not to know what to do even when we admit to seeing it.

Is it not time for us to focus on the triggers that lead to suicide?  Genetic predispositions certainly play a role in adding to the pain in some people’s lives, but not all.  Others may fall upon hard times and have no skills upon which to draw.  Yet, when we notice behaviors that lead us to believe that something is amiss with anyone we care about, do we not owe it to ourselves and to them to pay attention and to take action?

Perhaps the problem is that too many of us believe that we’re being respectful by not shaming those whom we care about into believing that we’re desperately concerned about them.  Perhaps too many of us believe that it’s best to stay out of someone’s private life and just take care of ourselves.

Anyway you think about this, it remains a problem that society must attend to more effectively if we are to save good people who just happen to be suffering – mainly in silence.  And it matters not whether the person is famous, well-educated, poor or rich.  That is all irrelevant.

It also doesn't matter how Koenig chose to end his life.  What matters is that he did so and that he’s left behind many people who loved and admired him. For whatever reasons that we’re not privy to, that love and admiration were not enough to relieve his agony.

It has been reported that he had suffered from depression and that he had stopped taking his medication. It’s no secret that some pain can only be relieved by medication and those who suffer from depression or anxiety can be helped enormously from any number of medications that do alleviate such debilitating states. Yet, it is not uncommon for people on medication to discontinue taking what has been prescribed once they begin to feel better. In states of greater equilibrium, they feel cured and do not understand the consequences of going off their medication. That is why those who are medicated should be seen by their prescribing psychiatrist and/or the psychotherapist who is offering them a safe place to talk about their progress, lack of progress, mood swings, lack of sleep, too much sleep, lack of appetite or over-eating. These are the tell-tale signs of those who are ill at ease in their own skin and whose judgment often leads them to misunderstand how others perceive them, appreciate them, love them.  Worse still, wth feelings of isolation and despair, they ultimately plan – as Andrew Koenig clearly planned – to end their lives.

What must not be ignored is that he did so in the most classic way, and that’s what needs attention, not the fact that he happened to have once been a TV star.

Apparently, he gave up his apartment a month prior to his death. He also gave away most of his worldly possessions and told everyone he was going on a vacation. And, yes, he did write a "despondent letter" to his father, but it arrived too late for his father or anyone to intervene.

As a psychotherapist and as the daughter of a mother who suffered from major depression, my heart goes out to Koenig’s family and friends.  More to the point, my heart aches for the victim himself. Whatever personal "growing pains" he had, and for however long he suffered from them, either he was not given the necessary care or he denied the care needed to beat the odds.

For those feeling depressed and totally overwhelmed by life’s stressors, we know that they cannot fight this battle alone. There are local mental health centers that can be contacted as well as public clinics, private psychiatrists or psyhcotherapists, or any one of the hotlines listed in every telephone book’s Yellow Pages (e.g. The American Association of Suicidology, 1-800-272TALK).  Most importantly, THEY MUST BE REASSURED THAT THERE IS HELP to be found. NO ONE DESERVES TO SUFFER IN SILENCE.  That is surely a recipe for disaster.

These are difficult economic times. Some private physicians will not accept insurance or offer reduced fees. But, those who are suffering need not lose heart; there are many agencies that arrive at manageable fees and there are those of us in private practice who accommodate those who need help.

We all can help by not remaining silent and by offering an outstretched hand.

As with any trauma in life, we never know when or if we will ever be the one in need of another's outstretched hand.  If for no other reason, shouldn't we do for others what we might need done for us?

~ Linda

IS TIGER OUT OF THE WOODS?
It is not my pleasure to engage in gossip or speculation. However, as a psychotherapist and addictions counselor I would feel remiss if I didn’t express my concern for Tiger Woods, his wife, and the “other women.”

Whatever therapy he has had thus far has made him aware of the fact that his actions have had severe consequences. His family and fans have not been as forgiving as he might have assumed they would be. In fact, he hadn’t given that any thought, because as an addict (if we agree that he is one), he is guilty of not thinking but acting, satisfying an uncontrollable urge to gratify whatever his need may have been.

Without knowing his entire history, I’m not even certain that I agree with those who are labeling him a sex addict. It sounds to me as though he’s a relationship addict, because his drug of choice is not merely a one night stand or merely having sex with someone whom he doesn’t care about. Quite the contrary! He has, according to taped messages released to the media, confessed his love and devotion to nearly all of the women with whom he has carried on long-term relationships. He has lied to each of them, humiliating himself and, more importantly, his wife, in the process.

One of his mistresses was quoted as saying: “Once a cheater, always a cheater.” I wouldn’t go that far. If I didn’t believe that people are capable of changing, I wouldn’t be a therapist. Therapy has, no doubt, helped him find the humility to admit that he felt entitled and therefore acted irresponsibly. Ultimately, it may even help him to live a very different life, but unfortunately it will be harder for him to do so (as it is for all celebrities) and not easier. The world will be watching his every move and no matter how hard he tries he will not be able to maintain his privacy and walk the walk with any degree of ease, even if he learns to talk the talk.

Whether it’s Buddhism, psychotherapy, a 12-Step program or a combination of all three, he will still need to forgive himself. And for that forgiveness to occur I believe that anonymity is necessary. That's where I'm skeptical. I don't believe he will be afforded the privacy needed to heal and then to change.

If, for example, he returns prematurely to the world of golf, all the old triggers will be the same ones that led him to where he finds himself today. And how exactly will he be able to resist his old lifestyle? For those of us who believe in the disease model, self-control was not at the root of his problem and it will, in fact, have little to do with the actual process of recovery. On-going treatment and having a sponsor — someone who has been where he has been and who is available to help him face his fears and vulnerabilities and experience his pain and shame – is what he needs. Otherwise, he will never truly feel the remorse and subsequent courage necessary for change to occur.

When money and power has led to corruption, then those who are corrupted are easy prey. Why? Because at the core of each of us is our character. And while it is true that many men in power (presidents of the United States, other politicians, and those who became rich and/or rich and famous in a variety of arenas) have acted with the same degree of shamelessness, it doesn’t make it acceptable to the women with whom they have dallied and especially not to their wives.

So, while I wish Tiger Woods well, and I do hope he finds a way to allow recovery to work for him, I can’t in all honesty say that I think he is out of the woods or will ever be out of the woods. Forgive the pun, but if he had known himself better, he wouldn’t have married in the first place. Had he acted from his heart and from the Buddhist teachings he now claims to have strayed from, he would not have made the choices that he made.

Perhaps – and this is a big perhaps – if his wife stays with him and he is forced to prove day in and day out that he is a rehabilitated man, we will all witness someone whose personal and professional life has been redeemed.

I have treated many addicts who have taken their recovery very seriously and have gone on to live honorable lives, but I do think that when someone’s in the spotlight – as Tiger will no doubt be – his chance for success is slimmer, not greater.

There are simply more distractions for those who are famous. Staying focused while the entire world is watching – whether it’s on a putting green or elsewhere - is far more challenging, the stakes far higher!

Tiger’s early rise to fame, his enormous wealth and seemingly picture-perfect life give us all pause to reflect upon our own values, our own vulnerabilities, and the consequences of whatever decisions we make and actions that we take.

Please share your thoughts with me.

~ Linda

                                                   "... AS TIME GOES BY ... "



If you’re not familiar with Frank Sinatra singing: The world will always welcome lovers AS TIME GOES BY ... do go online and listen. It’s worth it. Love is worth it!

Whether or not you pay homage to St. Valentine, cater or do not cater to Hallmark, or honor your loved ones in other ways on this day or any other day, I think we’d all agree that LOVE is the emotion we've associated with February 14th ever since we were children ... and even now, as time goes by.

In that spirit, I’d like to share some of my favorite Valentine’s Day quotes with you:

-Lao Tzu:

Being deeply loved by someone gives you strength, while loving someone deeply gives you courage.

-William Shakespeare:

Romeo and Juliet:
My bounty is as boundless as the sea,
My love as deep; the more I give to thee,
The more I have, for both are infinite.

-Anais Nin:

Age does not protect you from love.  But love, to some extent, protects you from age.

-Antoine de Saint-Exupery:

Life has taught us that love does not consist in gazing at each other but in looking outward in the same direction.

-Johann Wolfgang von Goethe:

Love does not dominate; it cultivates.

-Dorothy Parker:

Love is like quicksilver in the hand.  Leave the fingers open and it stays.  Clutch it, and it darts away.

-Alice Walker:

I have learned not to worry about love; but to honor its coming with all my heart.


Although I could write pages about each of these quotes, when Alice Walker wrote that she learned not to worry about love, I assume she meant that given the emphasis placed on the significance of Valentine’s Day, not worrying is something she did, in fact, have to learn.

And every year at this time I find myself reminding patients and friends alike who are not in a loving relationship at the moment or who are depressed about not having something to do, someone with whom to share THE day, that it is just that.  A day!  If it’s a fun-loving day, well that’s great!  But, if worrying or feeling sad doesn’t allow you to have hope and doesn’t permit you to remind yourself of all the love you have received and have given throughout your life, then you’re cheating yourself and giving too much power to what, after all, is just one day!

That doesn’t mean that without the capacity to love and/or never having experienced genuine love from another person that one’s life isn’t impoverished. It is! To paraphrase Anais Nin:  The experience of love breeds a feeling of youth, a sense of being fully alive and empowered with energy.  And who amongst us would choose not to feel fully alive?

So, on this Valentine’s Day, I wish to say a public and personal thank you to all the people who have made my life richer by sharing their loving thoughts and feelings with me and hope that all of you are able to do the same for those who have shown you love.

After all, acknowledging those who love us is as rewarding as receiving their love. The two do go hand in hand!

With warm wishes to one and all, I hope your day is filled with – at the very least –loving thoughts and heart-felt gratitude.

Have a great day!
~ Linda

STIRRING CONTROVERSY WHEN LIVES ARE AT STAKE!


In one of the many responses to Sharon Begley’s cover story in NEWSWEEK magazine, (Feb.8,2010) "THE DEPRESSING NEWS ABOUT ANTIDEPRESSANTS" - Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse: Therese J. Borchard, author of BEYOND BLUE, states that as a writer and someone who feels her life was saved by antidepressants, she found last week’s cover story “irresponsible.” Though she is someone who respects the subjects Begley usually writes about and often appreciates her perspective, she takes issue with both the title and subtitle of this one. Had the subtitle alone stressed that, in general, antidepressants work better for those with severe depression than for those who suffer from mild to moderate depression and had she then gone on to omit saying that taking them can be worse than taking a placebo, her article would have been far less misleading. Case in point: Borchard knows that her personal experience has not been validated by the findings of the recent study from which Begley based her conclusions.

To her credit, although Begley admits at the outset that addressing the placebo effect is a dilemma for her, and even adds that:  “To be sure, the drugs have helped tens of millions of people."  Her disclaimer is that she “is not advocating that patients suffering from depression stop taking their drugs.” She does, however, conclude they may not be the best first choice.  In so doing, she has left many of her readers (patients and physicians alike) wondering why the findings from each new study released to the public leaves us more confused, less confident, and, worse still, questioning whether or not the findings themselves are, in fact, harming us?

The implications surely have the potential for being dangerous. After all, if someone believes that a medication is helping him to function, to live life more fully, and not be burdened by the overwhelming darkness of depression and then is told that scientific studies claim that the reason is merely because he or she believes it is helpful and that it does NOT, in fact, change something for the better in the chemistry of the brain, the patient could easily stop taking the medication, relapse into depression and become less functional and more disabled than before taking the drug(s).

In fact, I would venture an educated guess that if anyone asked a patient who suffered from overwhelming feelings of anxiety or severe depression (neither of which is a temporary feeling but rather a paralyzing, long-lasting one) whether taking medication is helping them, more often than not, you’d hear, “It’s saving my life.”

Although I do not treat patients who are psychotic or those who suffer from severe mental illness, I do work with patients who, at times, need medication to help take the edge off from feelings of debilitating anxiety and/or depression. And while, as a psychotherapist, I cannot prescribe such medications, I work with psychiatrists who do, and often the correct dose of the right drug in combination with the talk therapy – which I do offer – makes all the difference in the world. (And that includes tricyclics as well as serotonin re-uptake inhibitors [SSRI’s].

In my work with patients for more than twenty-five years I have, of course, known patients who have had to try several drugs before the one that proved to be helpful was found.  And, as with any medication, antidepressants can have side effects, for some people minor and tolerable, for others not. But that alone can’t be the criteria upon which we base whether or not medications are, in fact, helpful.

Also, since most of my work is with patients who usually do not require medication and are helped by talk therapy, proper nutrition , sufficient sleep, exercising and/or studying relaxation techniques such as Yoga or T'ai Chi, as well as being taught other means by which to help quiet themselves when moments of anxiety or depression interrupt an otherwise okay day, I find myself asking why I, too, had such an intensely negative reaction to Begley’s article. I must admit that my response was only further fueled yesterday when I read in the Wall Street Journal's Feb.5,2010 issue that GlaxoSmithKline PLC is stopping their research into new antidepressants and will be focusing instead on “diseases for which it believes it can develop more valuable drugs.” In their case – a company that has developed some of the largest selling antidepressants on the market during the past twenty years and now finds that generic drugs have replaced the number of sales of all their brand named ones – their reason is clearly driven by how much profit they see themselves making, and that, too, is infuriating when we realize they are talking about an issue concerning our nation’s mental health.

In taking a personal inventory, I realize that I also have very real reasons for my reactions.

For those of you who have read my memoir, FOUR ROOMS, UPSTAIRS: A Psychotherapist’s Journey Into and Beyond Her Mother’s Mental Illness, you know that when I was growing up in the 1940s and early 50s, the primary treatment available to my mother when she entered one of her “states” was electric shock therapy and/or hospitalization. Her depressive episodes demoralized and destroyed her as it did the rest her family who loved her. And not until years later – and fortunately she did live to experience the benefits of some of the new medications – did she experience any real periods of relief. But, by then she was too old and had been at the mercy of doctors who gave her anything but confidence – to be helped by talk therapy. Swallowing pills was not emotionally intrusive, was most assuredly beneficial, and was the route she chose to take.

So, while the jury is still out and many more studies will, no doubt, be conducted that will contradict the latest findings – because that is, after all, what always does seem to happen – I hope that more and more physicians (as opposed to the pharmaceutical industry) share their stories, along with the numbers of lives they know have been saved by patients taking anti-depressants, so that science editors and others will be more mindful the next time they attempt to share such findings when what it accomplishes is to stir controversy, sell copies, and create chaos.

Do let me know your thoughts and opinions on this very important topic.

Best regards ~ Linda