THOUGHTS from The HEADoc

My cat has lost her mind . . .

and I have no training in feline psychology. She's 3 years old now. What's that in human years, 16? Erroneously I thought I could keep her locked indoors and avoid having her fixed. Not! As a kitten she once ventured outside and got lost for a couple of hours. A neighbor returned her and for the next couple of years she didn't try that again. The first time she went into heat I had no idea what the heck was happening. She also had worms at the time, so I thought her behavioral changes had something to do with that. The injection at the vet cleared up the worms and he told me not to worry about the estrace cycle. Having her spayed could take care of the problem. I procrastinated. No, I just didn't do it.

I got pretty accustomed to her running to the door to greet me upon my return home from work. Sometimes she could be quite annoying by clinging to my every action. This Spring she developed a habit of running past me when I open the door. Once outside there would be an obvious look of confusion as if she didn't really understand why she did what she just did. She would then sniff the rug a few times and run back inside the door just as fast as she ran out. After seeing an apparent stray calico tom cat hanging around outside, I started to become suspicious. He was probably communicating to her through the door while I was away. He was perhaps planning a not so secret rendezvous. Two weeks ago she ran toward me as I opened the door to come in. This time she didn't even look back as she ran off into the darkness. There was no response to my meow calls for the next 4 days. Just when I was about to give up on her, she presents to the door meowing as if nothing has happened. She has lost considerable weight and seems to be starving. I figured she had learned her lesson. I was wrong. She's been away for 2 days so far this time. Anybody want a kitten, or two?

The HEADoc has become pretty crafty with his Chainsaw. . . 

and Beaver Saw brush blade through his Saturdays land clearing project. He's learned quite a bit about felling trees over the past several Saturdays of practice. During the last episode of Adventures of The HEADoc the pyromania party was crashed by the Siler City Fire Department. The HEADoc felt this was unnecessary. Oh what a difference a month can make.

This Saturday, The HEADoc experienced an apparent slip in judgment as he attempted to defy the laws of gravity and balance. He seemed to forget how recent it had been when he knew nothing about operating a chainsaw or cutting down a tree. Today The HEADoc would attempt to make a professional cut that at some point becomes the mistake of most amateur lumber jacks. Today he would make the tree he planned to cut fall away from the power lines in a controlled cut. Half way into the cut The HEADoc became acutely aware that he was in over his head. The hinge cut caused the chainsaw to be pinched firmly into the tree as gravity and balance refused to cooperate with The HEADoc's plan. As a public service The HEADoc wishes to remind all amateur chainsaw operators that this is the point to call the power company and swallow your pride. Tell them you are in the process of screwing up big time and need them to bail you out. They have the equipment to right the situation.

That said, most readers can probably assume that the HEADoc probably did not follow this prudent advice. He did learn a valuable lesson that will power is no match for physics. Yes, you guessed it. The HEADoc used the other saw to finish the cut. The tree refused to fall in the direction planned. The tree fell directly onto the power lines. The 4th of July came on May 3 for The HEADoc. The sparks and explosions were spectacular. The display culminated in a real fire this time. The HEADoc was not calm and collected this time because the situation was not under control. A passer by and a neighbor lended  a hand to help control the fire until the Fire Department arrived. The passer by offered the humiliated HEADoc some consolation by admitting that the same thing had happened to him before. The neighbor's father had once felled a tree onto their house. Maybe this behavior is encoded in the Y Chromosome.

Posted on Sat, May 3, 2008 at 10:13PM by HEADoc in Real Life Story | Post a Comment | Email | Print

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A few hours ago . . .

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Why  ?

The most appropriate answer to that question is probably the reply given by President Clinton when asked why he did what he did with "that woman." "Because I could," he replied to a probing reporter. I started posting almost 4 years ago because I could, and never really expected that many people would take interest in what I write. I really just needed a place to vent and explore and express my ideas from time to time. Other than my work, I have shown more commitment to this journal than any other project I've undertaken. My writing style is intentionally original and at times incorporates controversial ideas which on occasion may evoke emotional response from a commenter. I know my perspective on life is unique, mainly because of who I am and what I do for a living. When I feel passionately about something I will fight with everything I have to win the cause. Most people I associate with either love me or misunderstand me or may be in transition.

Validation of oneself is crucial but can be detrimental or meaningless if the validator is invalid. I think with my journaling I have sought validation, in a sense. There are other ways besides blogging to vent and to express oneself. So validation has been a source of motivating me to continue posting here. I was thrilled and in disbelief when Author Neale Donald Walsch actually read a few entries and used the word "intriguing" to describe his opinion. Last month Blog Burst and Reuters posted my In Treatment and Intervention article nationally in their entertainment section. Didn't get a lot of clicks but it did feel good to be accepted as a legitimate writer instead of just a novice. Sometimes the thrill of the chase is much more exciting than the capture. Strangely I feel less motivation than ever before to continue posting. I'm really not mad about much anymore. There were several personal crises over the past couple of years but they have only made me stronger and helped to clarify where to go from here.

At times I have tended to displace my frustrations on to politics. The Bush Administration made that quite convenient as an option. I think most people capable of critical unbiased thinking have seen for themselves how bad this President was for the country, in general. Due to the ending of an era I must redo my Satire Page. I think I'll focus less on politics, unless McCain wins the election in November.

I guess my reason for this post is to state that I will probably be making fewer posts in the future. I don't want to shut completely down at this time. I still have a lot of thoughts.

Posted on Sun, April 13, 2008 at 12:23PM by HEADoc in Weekly Entry | Post a Comment | Email | Print

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What if there were no stress?

There might then be no such thing as mental illness. People such as me would be out of work. I don't think I'd like living in a world with no stress at all, for our lives would become quite dull and lack excitement. I often wish that death didn't exist but then I remember that our reality is based entirely on the fact that an opposite is essential for anything to have value. Without bad, good could not exist. Without hot, there could be no such thing as cold. Without large, how could there be a such thing as small. So this world is meant to be transient. When we are aware that our time is finite, we should appreciate the opportunity to make the most of each day. I believe there is a place known as eternity and a thing known as infinity. I can't wrap my brain around the concept of either for I am contained within them both. Nothing is impossible within the realm of eternity and of infinity. If you can imagine it then it already exists. The minds of the greatest scientists have been blown by such thought.

The Big Bang Theory proposes that our rapidly expanding universe was birthed from the explosion of a singularity point of reference that was infinitely small. That means it was so small that it continues to get smaller forever. Imagine that! What happened before The Big Bang? Even Einstein is clue less on that one. When man became aware he had a conciousness he eventually gave birth to religion and to science. On the other side of the beginning of Creation or the Big Bang most of us believe God exists. Since God is believed to be the source of all. it is inherently impossible for us to escape our creator. Of all creatures on earth, only man is believed to have the ability to exercise a will that is completely free. Even the metaphorical Satan lacks this ability for he can do nothing that is sincerely good, despite a milliondisguises to appear good. Angels may do only what they are created to do. But man can cause the greatest pain and suffering for others or choose peace. love, and happiness. Free will is what gives real  meaning to such actions.

I began this entry because of thoughts I've had about the stressors faced by many of the patients seen over the past several days. Sometimes I'm given more credit than I deserve by patients for the understanding I seem to show involving the plight they may be facing at a given time. After doing this a few years a therapist/psychologist/psychiatrist develops an understanding of the most likely behavioral options for almost any person in a given situation. Humans respond emotionally to any stressful situation. There are only 4 basic emotions: happy, sad, fear, angry. Happiness is a derivative of Love. All other emotions are derived from the core emotion of Fear. If one can control a persons' fear then one pretty much has control of that person until they are no longer afraid. Fear usually trumps anger because fear will keep one alive much longer than anger alone. Sadness seems to exist basically to validate happiness or may be experienced in the absence of joy.

The human experience entails each of these emotions at the appropriate time and place. An emotional imbalance results in mental illness or mal adaptation. An emotional imbalance is precipitated by what is known as psychosocial stressors. There is actually a hierarchy of these stressors that was first proposed by Maslov or some other important Behavioralist. I do know that Maslov proposed the basic needs paradigm which essentially states that you won't get much done with treatment if your patient  lacks a source of food, clothing, shelter, and love. Even when the basics are met, certain life stressors challenge ones coping mechanisms. At the very top of the stress hierarchy is the death of a child. Patients I know who have survived this emotionally catastrophic event and put them self back together are exceptionally strong. They have passed the ultimate personal emotional test of enduring personal loss and pain. They have proven that whatever else befalls them in life can never hurt more than what this experience did for them. Second only to the loss of a child is the loss of a parent, sibling, or spouse. Further down the list are other major life stressors such as loss of health, loss of job/finances, relocating, and of course going through a divorce. Even pleasant events such as getting married or having a baby can tip the scales the wrong way at times.

Coping mechanisms are crucial in surviving the stressors of human life. Stress can be thought of as rain. How can one stay dry in a heavy down pour? Certainly not by trying to push the raindrops back up into the sky. Using an umbrella or other means of shelter is much more feasible. With stress we cannot always avoid it or hope it will not return for it is guaranteed in this life. The better coping skills one has developed or inherited, the better one copes when the storms of life start to rage. Sometimes healthy coping may exist simply of accepting help when it is offered. Or resisting the urge to withdraw in fear and isolation when those negative emotions try to take over. 

Posted on Mon, March 31, 2008 at 10:45PM by HEADoc in Weekly Entry | Post a Comment | Email | Print

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    ANOTHER SATURDAY IN THE PARK

The HEADoc took his newly purchased used chain saw from the A-1 Pawn Shop in Burlington to Siler City last Saturday searching for some physical action with nature.

Those poor trees and brush didn't stand a chance. On the third pull of the starter cord it broke loose and there were no tools to fix it with so The HEADoc had to go back to the bush axe and the bow saw to resume his project to reclaim the land of his birth place from the over growth that rendered the place totally unrecognizable. The HEADoc complained of pains in the back and the legs and the hands after a couple of hours of this rigorous activity. His chest felt tight from the exertion and he breathed heavily but he knew his heart was strong and the fatigue was just a result of the sedentary lifestyle he had become accustomed to over the years of practicing his healing craft. He had become a stranger to the gym and the master of all procrastinators in his come back plan to recondition his once lean and hard body. Gone were the days of the gridiron, the full court hoops, and even the ball diamond. These were now replaced by the sofa, remote control and the keys used to enter this essentially useless information to be made available to your approving eyes.

The HEADoc did enjoy wrestling with the trees, briars, and brush in a way that might cause an observer to maybe question his sanity and ask why a grown man would choose to spend his Saturday afternoon chopping and sawing on that poor helpless vegetation. The work was unbelievably strenuous and tedious and it would take many days of work at this pace before notable progress could be really appreciated by anyone other than The HEADoc himself. Yet he forged ahead on his quest to clear the land where he played as a child. To the outsider this patch of woods was just the forest next to Old Highway 421. To the HEADoc this was perhaps the most special place on earth because of the memories associated here.

The HEADoc was soon struck by a brilliant idea. He would use one of the oldest forces of nature to assist him in clearing the growing pile of trees and brush which had become quite considerable in size. The HEADoc did not wish to make the Chatham News as the one who foolishly burned down half of the County so he checked the moisture level of the ground and saw that the recent heavy rains had made it improbable that a brush fire could get out of control. He summoned the memory of watching his uncle burn off overgrowth 40 plus years ago. Alas! The fire was started but there was little that would burn other that the small evergreens on the pile and the surrounding leaves. There was, however, smoke. Lots and lots of smoke. Smoke that could probably be seen for miles away. The HEADoc was unimpressed with the actual fire so for the sake of interest he allowed the leaves to burn on the surface of the ground. These flames moved fairly fast but burned out almost instantly after consuming the top layer of dry leaves. There were natural barriers on every side of the fire to limit the spread so the HEADoc was starting to relax and enjoy his pyromaniac adventure. The flames to him seemed to have a calming effect.

Those familiar with The HEADoc know that he rarely shows much excitement. It takes a lot to rattle him. He finds most of today's news stories to be hyped up for ratings and designed to keep the public a bit frightened and needing to tune in for the next scare. The HEADoc is the ultimate skeptic. So the thought of wildfires shown to the public on the news never really crossed The HEADoc's mind in any serious way on this day. By the way, The HEADoc also hates cell phones, most of the time. Had the HEADoc been thinking on this particular Saturday he may have considered getting a burning permit but he apparently was not thinking that astutely and thought he might be able to enjoy his late afternoon flames uninterrupted. Not so! Some loyal motorist with a cell phone felt obligated to notify the local fire department of a horrendous forest fire out of control. Thus, the action begins. The sirens begin to sound off for miles around disrupting the blissful trance enjoyed by The HEADoc as he listens to the faint crackles of the burning leaves and admires the modest flames. The HEADoc felt as though there were two totally different worlds as the fire trucks arrived, one after another. He felt as though his party had been crashed as he witnessed the enormous hoses extinguish his soothing entertainment for the day. The HEADoc could not quite understand what all the excitement was about. In his mind he knew that the fire was under control. He began to feel a bit concerned when the fire chief told him he was burning the forest. That's when it dawned on The HEADoc that others were incapable of seeing what he envisioned. He saw himself reclaiming his home whereas others saw a reckless nut burning down the forest.

In the HEADoc's defense, no laws were broken on this day since, fortunately, the state wide burning band had been lifted by Govenor Easley on the previous day. He was burning on his own property. The fire department could argue that The HEADoc lacked sufficient means to prove he could stop the fire from spreading beyond his control. The HEADoc of course disagrees and would have called the fire Dept himself if he had felt he needed them. In the future he will follow the foresters advise of giving a courtesy call to the fire Dept the next time he burns so they will know not to crash the party.

Posted on Mon, March 3, 2008 at 09:32PM by HEADoc in Real Life Story | Post a Comment | Email | Print

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HBO's  In Treatment  is unbelievably believable . . .

as a portrayal of a week in the life of a psychoanalyst. The usual stereotypical myths seem to be done away with for the first time in a television program. The therapist is allowed to be viewed as a human being struggling with real emotions and real problems. The beauty is how well the boundaries are defined, giving the viewer a unique window into the lives of the characters that the characters themselves don't have full access to. The viewer is allowed to see dirty laundry air in an argument between the therapist and his wife. The viewer also witnesses the therapist receiving supervision from a colleague. In one scene the therapist uses a plunger to unstop the toilet. Interpretation? I found it quite interesting when a coincidental meeting happens between two patients leading to a potential hook up right outside the therapists door. The viewer has the unique perspective of being exposed to the intimate issues of both patients and the therapist. This makes it hard to wait to see what will happen next. Due to ethical standards this perspective is not a possibility in real life, making it all the more intriguing to view.

 Monday's case of Laura, a 30 year old attractive anesthesiologist, is an excellent portrayal of the process of erotic transference that sometimes occurs in therapy when a patient believes them self to be in love with their therapist. This boundary is sacred and simply can never be violated at any time for any reason by a therapist. A fitting metaphor is when God instructed Adam not to eat from the forbidden tree. Irreparable damage to a patient can occur from the therapist not protecting this boundary. All residency trainees in psychiatry are well instructed of the importance of managing this situation appropriately because so much is at stake. The usual protocol involves seeking appropriate supervision and considering transferring the patient to another therapist. Despite the preparation and instruction psychotherapists receive, occasionally there have been cases of therapist getting in over their head and risking and losing everything. This can only be attributed to the fact that therapists are imperfect and can be vulnerable to the same addictive impulses as anyone else. For the reasons mentioned, it is a treat to view the therapist character on this program deal with this issue in a realistic portrayal.

A & E's Intervention is essentially reality TV involving the life and struggles of addiction. It is valuable as an educational resource for understanding what pain addiction causes for the addict and all associated with them and what a challenge it is to overcome an addiction. Addiction is a disease of the brain itself that results in repetition of detrimental behavior. Though the addict is totally out of control they tend to either deny, rationalize, or minimize their behavior. Enabling individuals tend to fall into the void created by the addicts lack of self control and responsibility, thus allowing them to continue the process. An intervention occurs when family, friends, and a therapist invite the unsuspecting addict to a meeting where they are carefully provided confrontation and given an ultimatum to get help now or be cutoff. The addict is provided an opportunity to change direction with a strong support base. Resistance is almost guaranteed to occur during confrontation. The addict must accept that they will eventually die if they do not accept this road to recovery. As far as entertainment goes, Intervention becomes less interesting to watch over time because the plot is always essentially the same. Lure the addict into confrontation, provide an ultimatum then hope and pray. HBO offers an additional resource with some interesting clips known as Addiction.

I think the shows above are quite useful for those involved with mental health care or substance abuse and  those with just a general interest.

Posted on Sat, February 16, 2008 at 12:17PM by HEADoc in Weekly Entry | Post a Comment | Email | Print

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I logged on this morning and to my astonishment discovered subscriptions to Quest 4 Sanity had increased by 6 fold.

I have continued to refresh the screen all day to try and be sure that an error hasn't occured. Things of the sort just don't happen for me. If it does turn out to be true I fear the pressure may increase for me to produce more quality entries. In the words of Homey The Clown, "I don't think so!" I'll just keep right on writing what I feel as it comes to me. I'll continue to ramble, rant, rave, preach, and teach in my own unique little way. Still there will be those who insist I'm so wrong about certain issues and get bent out of shape and not read another word I write. This buds not for them anyway. There will also be the faithful few who find what I write to be as intended which is entertaining, informative, and thought provoking. You know who you are.

I know I'm not always completely right about some topics and my views are usually modifiable when the evidence supports that. I do pride myself in having a keen sense of things that are simply wrong in principle and not negotiable. This is usually what sparks my interest in politics, or politicians more so. Politicians are just characters who play a role in a system that boasts more than it ever delivers. The system really does little for the people until it is forced to do so. This goes as far back as The Emancipation Proclamation. I doubt much of the Civil Rights legislation would have been passed had Dr. King not been murdered and angry rioters threatened to end the peace for all. The killing of Dr. King actually backfired if the goal was to halt progress for minorities.

For many years I have studied Dr. Kings life and his effect on people and the nation in general. I learned every word of his I Have a Dream speech and used to recite it before audiences to an amateur music track. This helped me to feel and understand the greatness of this man. Of interest, he never even set out to become an icon of greatness but accepted the call when others insisted he lead the Montgomery Bus Boycott, and the rest is history. He lived daily with threats against his life and the lives of his family. Sure he felt fear, as any human would, but he possessed the courage to face the danger anyway. He knew that his life would be short but he was committed to accomplishing his mission. His mission wasn't to deliver Black Americans, but to heal relations between all people and make it possible for all to have access to the American Dream. Has this really occurred?

If the question is approached from the perspective of "has racism ended?" the answer is obviously a resounding NO. Racism may never end but its power will one day be neutralized if we choose to carry on Dr. Kings legacy. Many dislike Rev Al Sharpton, but credit must be given where it is due. He led an impressive and effective protest against the injustices brought against Michael Bell, the college student/athlete charged with capital crimes unfairly, recently in Louisiana. The case made it clear that racism is alive and well. The protest made it clear that it can be defeated. The KKK will march on Dr. King Day Monday, and it is their right to do so. But who really cares? I view the KKK as a perverse organization of cowards with damaged self esteem and too much paranoia. Just like the stepfather who molests his stepdaughter, there is no more power and no more terror when the truth comes to light. At that moment he is exposed for what he really is. That stepdaughter will now be protected by adults who really care for her. Without hoods, darkness, and secrecy, the KKK is rendered impotent and irrelevant.

As I do every year, I will celebrate King Day by going to work. I know that Dr. King would be proud and that this is what he would expect of me. Had Dr. King not lived, I most likely, would not have the job I have to go to daily. I am an African American Psychiatrist with a patient base that is mostly Caucasian. I don't think it's naive for me to believe that, for the majority of my patients, my race is not a major factor. Whether I can help solve their problem is much more important. Most of the attitude I get has traditionally been from those of my own race. This, I believe, supports the theory that the best way to keep Blacks down is to keep them fighting amongst themselves. Sad but unfortunately, I believe  that to be true. Thus, gangsta rappers are provided a platform of priority to Black professionals or intellectuals (except Clarence Thomas and Condoleeza Rice). The media does dumb the public down but that is a topic for another time.

Hope everyone has a Happy King Day! Do something he would be proud of.

Posted on Fri, January 18, 2008 at 06:17PM by HEADoc in Weekly Entry | Post a Comment | Email | Print

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Feeling a bit like I've lost my mojo lately.

In the writing department that is. By that I mean it seems much harder than usual to find something to passionately write about. Usually politics or the frustrations of our health care system are enough to get me started but as of late the angst and fervor have failed me. Just the fact that Bush will be gone in less than a year should be plenty but I'm not feeling too excited about even that. I think I may have become disillusioned by the political system over the years, expecting more of it than it can really deliver. I no longer have any trust in the system and see the politicians mostly as actors that paint an illusion of reality for the citizens. I should be elated and jubilant for the accomplishments of Barack Obama but when I think of him I see images of John and Robert Kennedy followed by the voice of Dr. Martin Luther King, Jr. playing over in my mind. I'm not a pessimist by nature nor am I a true conspiracy theorist but I do feel that some skepticism and no gullibility diminish disappointment.

I remember the feeling when I found out Santa was a fake. Christmas was never the same. I wasn't bothered nearly as much about that cheap tooth fairy. As an adult, I questioned the validity and plausibility of the Good Book. Still haven't quite got that one worked out. We need things to believe in so that we can make some kind of sense out of this sometimes senseless existence. I've grown to define my job as helping people find their way back on track. The stressors encountered during life often lead to such derailment. Since that person may be on a different track from myself it's amazing to witness the clarity of his or her problem or situation when exploring these things with a patient. Many patients end up in treatment for the very reason of overlooking their own problems to try and help another fix theirs. I can say that at least I do get paid for it, most of the time.

I thank God for the ability to understand the dangers of denial. I've found the core of most addictions and emotional dissatisfaction to be denial of reality. If you don't believe me just asked the drinker who drinks daily or the pot head who smokes daily for years but insist on not having a problem. Or the woman wearing the arm cast and black eye who insists that "he loves me." I remember reaching my mid thirties and becoming almost irate at the cleaners for shrinking my pants. It was much easier to do that than face the fact I was eating too much and exercising to little. Psychologists call this defense mechanism "externalization." As a human being, it is much easier to just blame someone or something else than to exercise self responsibility and fix our own behavior. The longer an individual engages in externalization, the harder it is to change the behavior.

I saw an exceptionally bright 15 year old young lady earlier today who absolutely refuses to accept having ADHD. Her impulsivity has repeatedly put her in dangerous situations. A few months ago a date rape drug was successfully used on her by a 25 year old predator. Her mother who is receiving treatment for ADHD now watches her around the clock like a hawk to help her stay out of trouble. She has finished her high school curriculum at age 15 but adamantly refuses to take a simple pill daily that could help control her symptoms. She insists there is not a problem despite a gradual escalation of errors in judgment to the most recent sexual assault. Fortunately her mother recognizes the severity of her condition, even though her plan of babysitting 24 hours is in vain. This case of denial is less benign than not facing putting on a few extra pounds.

Breaking through denial is really just the beginning, which is probably the reason most of us fight so hard to hold on to and hide behind it. We know that facing reality means pain and hard work to actually fix the underlying problem. Unfortunately, each additional day of living in denial leads to more and more pain and unhappiness. In some cases it leads to injury or death. This is indeed a serious matter. A true friend will not allow one to live in denial about a behavior that is detrimental. Only an enabler would allow such. A true friend is willing to risk evoking temporary anger and hurt feelings to help another get back on track. A true friend is part of the solution, not the problem. A true friend must also recognize their own boundaries and not allow themselves to get in over their head or they could end up like the mother mentioned above. If you have a friend in need and you have gone as far as you can with them it's time to refer them to a good therapist.

Posted on Thu, January 10, 2008 at 07:05PM by HEADoc in Weekly Entry | Post a Comment | Email | Print

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     The time is once again upon us to usher in the new and release the old. . . 

at least in a symbolic or intentional manner. Turning such intentions into reality is quite a difficult task. After a string of failures to accomplish New Year's resolutions, the very idea of changing a behavior itself can become part of the stagnation of the procrastinator's world.

Most people change unwanted behaviors exclusively through a process of accepting their current state of reality and then recognition of the unwanted result of that behavior, followed by commitment, will power, and perseverance to reach the goal committed to. There are no shortcuts to changing behavioral patterns. Compulsions must be countered repeatedly and consistently in order to neutralize and eradicate the obsessive thought patterns that drive our unwanted behaviors. Think of an unwanted behavior as a mathematical  integer such as negative 10. The ideal desired behavior would be positive 10. Much of ones initial efforts receive no psychological reward (positive re enforcement) since even a major effort would not be enough to even come close to even zero.

It has been stated that it takes 50 times