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When the healer can't heal himself: How this psychologist is battling major depression.

by Paul 8. October 2011 12:03

You've probably had the experience of grief at some time in your life. Someone very close to you is gone, and you feel empty, unable to take much pleasure in anything.

I'd wager you also know how it feels when everything has "gone wrong." Circumstances beyond your control caused you to miss an important meeting and you're concerned about your job. At the same time one of your children is in serious trouble at school. Your garden wall has collapsed into the neighbors' yard and they're mad as hell about it.

If you've had to recover from a major illness, you know what it's like to have no energy and no ambition. You're always tired. The littlest ordinary task seems overwhelming. It's hard to concentrate. You may even wish you could just go to sleep and not wake up.

Now, put all of those together, and multiply it by three or four. That's what major depression is like. Except when it's severe; for that you'd have to multiply by ten.

You can't just "pull yourself together" or just "snap out of it." Continue...

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Mental Health and Addictions | Stuff I've Learned

Marijuana is bad stuff. But let's legalize it.

by Paul 24. November 2009 14:38

Anyone who's studied the neurological effects of marijuana, including the long-term and sometimes irreversible effects, knows that it's not a harmless high. In some ways, I think it's the most dangerous recreational drug in our society, just because it seems so benign. You know that an overdose of heroin or cocaine can kill you instantly, you see hardcore alcoholics stumbling around on the street trying to bum enough money for another bottle of whatever. But you often can't tell a daily pot smoker from someone who's never touched a joint in his or her life.

Unless the individual has been a daily user for a number of years, and you've just given him or her a short-term memory test. Or it's someone who just happened to have some innate paranoid or sociopathic tendencies that got magnified many times by the cannabinol collecting in the cerebral cortex. Or a long-term user who's hard to motivate to do much of anything. Or someone who's high at the moment and carrying on what he or she thinks is a profound conversation, that runs something like "I'm just like, wow, you know, 'cause it's like, there for me, and, you gotta be there to understand..." Continue...

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Life in America | Mental Health and Addictions | Position statements

Why I called America a sex addict.

by Paul 7. October 2009 15:27

When I accused my nation collectively of qualifying for the admittedly unscientific definition of a sex addict, I promised that my next eruption of thought would explain why. Then, the Chicago Olympics fiasco came up, etc. (It's not you, honey, I was just too distracted to be interested in sex.) If you didn't read America is a sex addict, you can scroll down to it now. In my description of a hypothetical male sex addict, perhaps you already have an idea of why I level this accusation at the collective American psyche. That hypothetical person spends an inordinate amount of energy obsessing about sex, or looking for sexual titillation, or sexualizing every subject, or repressing his own sexual needs, or acting out in sexually inappopriate ways, or supressing other people's sexual freedom, or...need I go on?

Serially, or simultaneously, in any combination. Now, just consider some of the following.

We've had millions of dollars allocated for "abstinence only" sex education because there are parents and politcal powers who don't want children to even know about sex. During the impeachment of President Clinton, the words "oral sex" actually got into the news, and some parents protested "how am I supposed to explain that to my children?" I thought at the time if you can't tell your child about oral sex, you have a bigger problem than how Monica got white spots on her blue dress. In a Chicago suburb there was an interesting sculpture of three human figures, so abstract that they only vaguely resembled people, with a kind of scribble where one would expect pubic hair. It was on a major thoroughfare, and nicely broke up the monotony of suburban office parks ad nauseum. Then suddenly it had been moved into a grove of trees, barely visible from the road. I never asked, but I'm sure what happened was the same thing that happened to Michaelangelo's sculpture of David: Somone was shocked that he had genitalia. When a female performance artist's breast was exposed for a fraction of a second at a Superbowl halftime, the uproar that resulted was deafening, and even though the woman's nipple and aureola were concealed, the network was fined $550,000 for "indecency."

It can be argued that our government nearly stopped functioning during the inquisition into whether or not Monica Lewinsky had actually performed oral sex on President Clinton in the Oval Office. Through some bizarre reasoning this was supposedly related to whether or not he may have, years earlier, exposed his genitals to one Paula Jones, an employee of the State of Arkansas when he was governor. How one divides the cost of this investigation between Clinton's "b.j." and the Whitewater bubble is open to debate, but there is no doubt it was many millions of dollars. By contrast, less than a half million was spent on investigating whether the tragedy of 9-11 could have been prevented. (This is without assigning a dollar value to having the national security adviser commit contempt of Congress.)

One of those who cast the most and biggest stones at Clinton is now a governor. His political career is over because he's a married guy with a girlfriend. Apparently he spent some state monies to finance his foreign trips to see her, but the tidal wave of indignation was over his marital infidelity. A former presidential hopeful, John Edwards, is now a dark horse at best after his extra-marital affair was disclosed.

So we are shocked and indignant at the dalliances of our elected officials, and at the same time amused and titillated. We're afraid of sex and obsessed with it at the same time. The most popular issue of Sports Illustrated is the famous Swimsuit Issue, with so-called swimsuits that are about as concealing as two Band-Aids and a cork. Any major city has page after page of "escort" ads in its yellow pages, even though the "full service" for which the so-called escorts and their agencies receive the bulk of their income is illegal; ask Elliot Spitzer.

We may be horrified at stories of young women in third world countries being stoned to death for having consensual sex, but some American parents resist having their daughters vaccinated for human pappiloma virus; their refusal is like saying to the daughter "if you should have sex with a man who carries HPV, even if he's your husband, I want you to die for it." No matter that the girl's father may be purchasing pornography featuring "barely legal" females.

We devote valuable police efforts to arresting prostitutes and their customers, often with sensational televised street stings, while the aforementioned escort services operate more or less openly. In many cities, totally nude dancing is permitted in "gentlemen's clubs" that may not sell alcoholic beverages. Similar clubs sell alcohol, but women dancers are required to wear g-strings, which (barely) cover the pubis plus pasties over the nipples. Often the pasties are actually "cheaters," made to look identical to nipples. Male patrons stimulating themselves through their clothing may be arrested, and the club may be punished as well. In a club that sells alcohol, in most cases a glimpse of labia puts the liquor license at risk.

It's not uncommon for someone to be arrested for nude sunbathing in a fenced area on their own property that is almost impossible to view from an adjacent property. A woman exposing her breasts on a balcony, even at a free-for-all celebration like Mardis Gras, is subject to arrest. Changing clothes on a public beach can land you in jail. Yet we love music videos that would be less sexually provocative if the performers were nude, and dance contests that are borderline striptease acts.

Homophobia is everywhere in America, and men are subject to being murdered for the crime of having been born gay. Self-proclaimed prophet Jimmy Swaggart, the same one who bawled like a baby on nationwide television after it became public knowledge that he humped hookers even more often than he waved Bibles, announced that he would kill any man who ever looked at him "that way" and happily answer to God for it. Another famous homophobe, one Ted Haggard, was forced to make a public confession that he had indulged his urges to have sex with men. Senator Larry Craig, who had resisted gay rights laws and admission of homosexuals into the military, was arrested for soliciting other men for sex in an airport restroom and entered a guilty plea, which he later tried to rescind when the matter became public knowledge. That's when other men came forward to report that the good senator had volunteered to polish their own knobs in public restrooms.

Prior to the U.S. Supreme Court striking down all state sodomy laws in 2003, engaging in anal intercourse even with your spouse could earn you a prison sentence in many states, and in some, even oral intercourse was a crime. In Michigan, a first offense for sodomy, with the same or opposite sex, could be punished by 15 years in prison, and a second offense by a life sentence. To the best of my knowledge, the first state to repeal its sodomy laws was Illinois, in 1962. Florida's law stayed on the books until 2003, but the sentence was $1000 fine and 60 days in jail, compared to Michigan's 15 years! And it's supposed to be the same nation, right?

Our age of consent laws are a complete hodge podge. What is not even a misdemeanor in one state can earn you a long prison sentence in another. The minimum age at which a minor may legally consent to sexual intercourse ranges from 14 to 18. In most states, it's illegal to show pornographic material to anyone under the age of 18, so in a state like Michigan, for example, where the age of consent is 16, you could legally have sex with a consenting 16-year-old but go to prison for showing him or her a copy of Hustler. It's strange enough that you could be labeled a sex offender for the rest of your life for having sex with a consenting post-pubertal teenager, but downright bizarre that the same thing could happen for letting a 17-year-old see an "adult" video.

Along with nude dancing, pornography is now legal in most places, but stores that specialize in sexually oriented videos and magazines plus "sex toys" generally have darkened windows and are prohibited from being located near schools and churches, and most frequently are confined to marginal retail areas. In some cases, an established sex store has had to move after a school or church opens in the neighborhood. Meanwhile, cable television is flooded with ads for products promising to cure erectile dysfunction, and others promising to increase the size of the penis, or that "certain part of the male body" as one spokeswoman seductively describes it to the camera. Dozens of TV spots throughout the day for exercise regimens and machines emphasize appearance over all else. The most important thing in life for a woman is to have firm breasts, a tight abdomen, shapely buttocks, beautiful legs, and in general to look like one of those "barely legal" porn stars. For a man it's the same tight abs, plus bulging pecs and biceps, and plenty of youthful hair.

Of course most of us won't look like the ideal sex object no matter what we do. Small wonder so many just give up and eat themselves into type II diabetes, making us the most obese nation on earth. After all, you could always have that indescribably wonderful sexual experience by just hiring an ideal sex object to make it happen, but oops! That's illegal.

I'm not even going to get into all of the ways you can qualify as a sex offender. Don't get me wrong. I take sexual coercion very seriously. I think, however, that we've gone overboard in how we define it. We're not much better than one of those third world countries in some instances, like so many restrictions on where a registered sex offender can live that some are limited to sleeping under bridges.

OK, enough about our messed up national sex life. If that's abnormal, what's normal? There are plenty of places where sexual mores are more strict than in the U.S. of A., and plenty more where they're more relaxed. I doubt there are many where they are more inconsistent. For the sake of contrast, I'll just tell you of one country I know something about personally, Germany.

One of the most beautiful cathedrals in the world is in Heidelberg. A substantial portion of Germany's population is Catholic, and the Christian Democrat party is one of the nation's most powerful. Membership in the party is not limited to Catholics, and most Orthodox Jews favor the Christian Democrats. Less than a block away from the cathedral is a sex shop, with a large sign proclaiming it as such. The windows are clear, the aisles are wide, the inside is brightly lit, and individuals and couples of all ages come and go openly.

The age of consent in Germany is fourteen. There are special laws to protect a child from coercion, and someone over the age of 21 can be prosecuted for taking undue advantage of the naivete of a 14- or 15-year-old, but it takes a compliant from the minor for a prosecution to occur.

When I've visited Germany, I did not see the overwhelming preoccupation with sex that exists in America. Some women wear revealing clothing, but the average is not at all shocking. While I haven't seen sexually provocative images being used to promote everything under the sun, on one trip I noticed some large posters featuring an attractive oblique rear view of a nude female; erotic, perhaps, but not obscene, and they didn't cause any kind of stir that I was aware of. Nor had anyone found it necessary to deface them or add juvenile sexual comments.

In Heilbronn, when my wife and I visited, there was a display of modern sculptures throughout the downtown pedestrian shopping area. All of these were nude. One which I'm sure would have caused an outrage in most American cities was a bronze of a woman's midsection, legs spread, with an artistic impression of the genitalia. It was interesting but certainly not erotic. I couldn't resist having my wife take a portrait of me, framed by the sculpture. If we wanted to be literal about it, you could say the abstract vagina would have appeared to be a few inches above my head. An elderly couple watching our picture-taking waved and laughed approvingly.

Freiburg im Briesgau is a colorful city of about a quarter million on the edge of the Black Forest, rich with medieval architecture and surrounded by natural beauty. In the center of the city is a plaza with an unusual fountain. Water runs around a circular ceramic trough, through a drain, where it is pumped back up into two square sculptures, about 18" x 18" x 24" high, if memory serves me well, from which it spills back into the circular trough. Very pleasant and restful, and amusing. You see, the the sculptures are chiseled to resemble human forms, one male, one female. The male is returning water to the trough from a small pipe protruding from -- you guessed it -- the groin area. The female, if you take a second look, appears to have her skirt slightly raised and her contribution to the trough is running from between her feet. In other words, both are represented as "peeing" into the trough. Among the families and groups of school children in the area, I didn't see any teachers or parents instructing anyone to close their eyes, and no one seemed the slightest embarrassed. On the city's magnificent cathedral are fearsome gargoyle figures, created in medieval times. Most are placed to direct rainwater away from the wall, typically through a screaming mouth. Many, however, are positioned to take in the runoff through a mouth and discharge it away from the wall via a cloacal opening. Like the fountain, created hundreds of years more recently, these are creative, rather tongue-in-cheek, and don't shock anyone. Except, perhaps, some prudish tourists.

For all practical purposes, prostitution is legal in Germany for anyone over the age of eighteen. The system is not perfect, and the government periodically tries different methods of limiting, licensing, and taxing prostitution. In Munich, near the famous Hoffbrauhaus, is a cabaret named the Lola Montez. In case you don't know, Lola Montez was the stage name of an Irish woman who became a Spanish dancer, then the mistress of Kind Ludwig I of Bavaria, and later moved to California during the gold rush. My wife and I stopped in for a few drinks and watched the nude dancers one evening, and enjoyed watching another interesting show: German efficiency in the world's oldest profession. Three men entered and took a booth not far from us. After about twenty minutes and one drink, three attractive women, obviously summoned by the management, approached the table, and one of them saying almost formally "Also, guten Abend," or roughly, "Well now, good evening." Individual men were approached by individual women. Pairs were approached by pairs. Some male-female pairs moved to tables where privacy could be assured by a curtain. Some left together. But unless we had been traumatized by knowing what was taking place, nothing happened that would have made my wife and me feel uncomfortable, nor did any of the other obviously married couples in the place seem to offended. I'm sure that many Germans would not go to the Lola Montez or any other such establishment, but the clientele certainly was not limited to riff-raff. Given the kind of transactions that were taking place, I have to say it was done rather tastefully.

On another visit to Munich I spent some time in a park along the Issar River, where people of all ages sunbathed, waded, and swam. A few of both sexes went a little distance from the main crowd and changed clothes, stripping naked and putting on bathing suits. No one stared, or objected. I couldn't help thinking how easily any of them could have been arrested in the U.S., and even been labeled as sex offenders.

One evening my wife and I were watching television with another couple. A female reporter was covering a soccer match. The camera followed her into the locker room where she spoke to some of the players as they prepared to shower, standing there for all the world to see, talking to a woman, with it hanging there plain as the nose on one's face. Without self-consciousness or apparent shame. It was a brief segment, and wasn't done for sensationalism. Our friends, both German, laughed a little about it, and said "well, if you want an interview right after the game, you go to the locker room, and in a locker room, people are naked, so?"

If you're one of those people who believe that America is the ideal in every way, you could easily say "well, Fauteck, if you like Germany so much better than the U.S. why don't you get the hell out and go live there!" Fact is, I love America. I also love my grandchildren, but I know they need to grow up, and I think that's true of my country as well, as I've said before. Or you might say "that's just fine for them; it sounds like a place with low moral standards and we just don't want to live like that."

I disagree. Let me just give you three facts to chew on.

Rape is only a third as common in Germany as it is here. America has 4.7 times as many teen pregnancies per capity as Germany, and 3.4 times as many abortions. Still think our moral standards are superior?

I've been to other nations where the attitude toward sexuality is much more conservative than Germany's. I've never been anywhere, or even heard of another place, where it is more inconsistent than in America. We're not oversexed or undersexed; we're just, collectively, sexually confused and obsessed. Just like a sex addict. 

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Life in America | Mental Health and Addictions | Morality Defined | Stuff I've Learned

America is a sex addict.

by Paul 27. September 2009 08:38

Let's get this out of the way first: "Sex addiction" is not a scientific diagnosis of a mental disorder. If we trace it back, we'd probably find that the term was first used by one of those who think everyone belongs in a half dozen 12-step groups and that any problematic behavior is a disease. As a practical matter, however, I believe most psychologists, even those who are sticklers for correct language like myself, know that there are people whose sexual behavior, beliefs, attitudes, and values are problematic in various ways. If there's such a thing as the collective American psyche, I believe that would describe us.

Let's take a hypothetical male sexual addict. He may be such a prude that he wants bikini bathing suits banned from the beaches, but goes to strip clubs. He's often unable to perform sexually, or avoids sex altogether by pursuing work and hobbies to exhaustion. At other times he's insatiable, and pays for several encounters with prostitutes in one day. He strongly suspects that his wife may be having an affair with a man from their bridge club, and at the same time finds the idea somewhat stimulating. He has mixed feelings about sex education in grade school and thinks the textbooks are sometimes too explicit. Yet he's the one whose jokes at office parties are so off-color that they embarrass others.

Depending on the attitude of his mate, he may eventually join a swinging club and spend an inordinate portion of his time planning get-togethers with other couples.

Or he may wind up divorced, spending most of his spare time at a computer looking for increasingly exotic pornography.

Or he may become celibate, with an occasional binge of sexual adventures.

In other words, his sexual maladjustment has made his overall life to a large extent dysfunctional. I think that describes America.

To be sure, we're not the worst. In my opinion, a nation that allows the "honor killing" of a daughter because she may have been raped simply has no honor. Likewise nations where men are so insecure that they require women to be obscured from public view, or allow women to be subjected to genital mutilation. The collective psyche of those nations is gynophobic and psychopathic. We don't even come close.

But we may be the worst among the major industrialized nations, or what I think of as the most enlightened nations.

The next time I sit at the keyboard, I'll go into detail on this. I'll tell you why I think our sexual attitudes and behaviors are so paradoxical and problematic. But why wait? If there are reasons you agree, please hit the "comment" button. On the other hand, if you think America is well adjusted sexually and I simply have my head up my arse, well, please hit the "comment" button and tell me why.

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Life in America | Mental Health and Addictions | Morality Defined | Stuff I've Learned

The twelve-step two-step. (by Paul Karsten Fauteck, Psy.D.)

by Paul 24. January 2009 17:07

Groups like Alcoholics Anonymous and Narcotics Anonymous have been a God-send to many of those addicted to drugs and alcohol. In my clinical practice, I often urged patients with drug and/or alcohol problems to make that difficult call and gave them the phone number. Typically, once the patient had gotten involved with the programs, he or she got away from the addictive substance, and expressed appreciation for the support received.

It was often a mixed-blessing.

Some individuals in therapy have problems that stem mostly from an addiction, but, at least in my own practice, there were more often far-reaching problems. Some may have become addicted in an attempt to self-medicate, and/or avoid facing some hard realities about themselves. Sometimes as therapeutic discoveries became painful, patients wanted to drink more or use more drugs.

I was always pleased and encouraging when it turned out that, without drugs and alcohol, individuals turned out to be capable of dealing with conflicts, internal and external, and really had no further need for my services, at least not on a regular basis. I've never intended to be in competition with twelve-step groups.

Unfortunately, I can't say it was mutual.

All too often the twelve-step group member hears that all psychotropic medicines are just happy pills that are at least as bad as alcohol and drugs. True, there was a time when the behavioral sciences didn't have the variety of medicines available today, and well-intended physicians, usually general practitioners, prescribed barbiturates for anxiety. More recently, some general pracititioners prescribed Valium like handing out M & M's. But for decades, mental health specialists have had much better chemical treatments and are much better trained in the dangers of addiction, yet twelve-step "sponsors" hand out opinions that might have had more validity in the 1930s.

Further, some twelve-steppers condemn psychology and psychiatry as generally toxic. One twelve-stepper I met said that psychology had no validity because since there have been psychologists around, the world has gotten worse, not better. This is a person who leads groups of very vulnerable individuals. The premise is, of course, preposterous for two reasons: By what stretch of the imagination do psychologists control the world? And in whose delusion is the world substantially worse than it was in, say, 1880, when child prostitution was accepted, when police brutality was the norm not the exception, when fully ten percent of the American population was addicted to opium, and . . . need I go on?

So the patient whom I may have spent hours getting to call AA soon decides that therapy is dangerous, quits, and continues life severaly depressed, although sober. A bi-polar patient stops taking mood stabilizers because someone said in a meeting "you don't need that s----," goes into a full-blown manic state, goes through the family savings in a month, and attacks strangers with little provocation. A patient of mine, who was in AA before coming to me, was told by his sponsor that recreational drugs were OK so long as he didn't drink. This was a man who already had one felony conviction for cocaine. A few months later he died of a cocaine overdose.

The reason I call this the twelve-step two-step is because these groups claim that they do not practice medicine. But someone who claims to have special knowledge of the effects of medications is practicing medicine, period!

Legitimate self-help groups do not practice mind control. That's the province of cults.

For some people, the twelve-step approach may be ideal. But it is no longer one of a kind. If I were in private practice again, talking to a patient with addiction problems, I'm not sure I would make a referral to AA or NA. If I did, it would be in combination with information about other approaches that anyone can learn about by simply Googling "alternatives to AA." Before encouraging anyone to contact a 12-step group, or accepting a patient already involved with one, I'd be sure the person knew about this unfortunate one-sided "turf war" in which, ultimately, the addict is likely to be the only casualty.

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Life in America | Mental Health and Addictions

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