His Empire of Dirt...

My uncle Bobo is nearly 98 years old.  He's probably going to die soon as he has had several medical issues arise in recent months.  He's spent the past two months in a rehab facility;  instead of getting better, he's gotten worse.  Just today, my aunt told me that he will be returning to their apartment tomorrow after a failed attempt at transitioning him into his great nephew's home.  My aunt is upset that he is having to come back to their apartment;  I think his urinating on her couch pretty much sealed that deal before he went away to rehab.

You have to understand my aunt and uncle.  They have been married for nearly sixty years and were the quintessential "don't call us...we'll call you" kind of couple.  Except for the fact that they rarely called you unless they wanted something.  I can remember running away to their home from the local grocery store when I was about nine years old.  I begged them to let me move in with them as they didn't have any kids of their own and (I figured) had to be a damn sight better than my own parents to live with.  Unfortunately, what I remember most about that evening was my uncle pointing to their telephone and ordering my aunt to "Call them now."  Did I mention that Uncle Bobo is not my blood relation?  After my parents picked me up that night, all I remember was a lot of yelling, screaming, and discipline ala the "board of education" on my backside.

Needless to say, things didn't change much as the years progressed and I made my various attempts at "connecting" with Uncle Bobo.  Beyond the language barrier, he made it quite clear on numerous occassions that unless the subject being discussed centered around (1) his native homeland, (2) his family, and/or (3) himself...he wasn't having it.  Since my aunt was his willing servant in every way, shape, and form imaginable ("I can't talk to you now, I have to serve Uncle Bobo his coffee!"), they were two very hard nuts to crack.  Literally and figuratively.

Flash forward to the present day.  Uncle Bobo has been miserable.  Since becoming incontinent, immobile, and barely able to speak above a whisper---he is now a man out of control.  Without getting into too many gory details, he did a lot to try and ensure his quality of care in advance of his present circumstances.  Inotherwords, he made his plans and (as the old saying goes) God laughed.  I should also add that his attempts at greasing the palms of his preferred future caregivers resulted in no caregiving at all...and no financial stability on behalf of my aunt's own future. 

I don't know if my aunt will ever truly recognize the type of man she was "really" married to for these past several decades;  there is a big part of me that hopes she will be successfully deprogrammed once he has moved out of this world and into the next.  For you see, my uncle Bobo was an Emperor in his own mind.  Unfortunately the empire of dirt he created is crumbling fast in spite of my aunt's attempts to keep shoveling it back into place. 

When all is said and done, nobody learns how to comfortably serve others by becoming comfortable with being served by others.  Uncle Bobo happens to be one of those people who got way too comfortable---and who is only learning now how paybacks are a---well, you know what they are.  And so do I.

Until next time...

Anxiety for Dummies...

I was cleaning out my office the other day and came across an old patient pamphlet on the topic of anxiety disorders.  When I trained in an inpatient psychiatric unit over a decade ago, these pamphlets were handed out like candy to the new admissions on our unit.  Then, just last night, I was talking to an old friend whose son was recently hospitalized after he chose to stop taking his medication to treat his bipolar disorder.  She told me how, back when he was an eleven year old, he told her "Something is really wrong with me mom.."  She claims that was the beginning of their family's journey through the mental health care system in trying to initially treat his overwhelming and debilitating anxiety.  Between our conversation last night and finding that pamphlet the other day...I figured it was time to open the doors wide on this topic of "anxiety" and what it's all about once and for all.

Anxiety disorders represent the common cold of mental health.  In and of itself, anxiety is not a "bad" thing to experience.  It is meant to prepare us physically and mentally to successfully overcome literal danger.  I've often said in therapy that it's perfectly o.k. and acceptable to wet onself and/or grab the nearest available "weapon" and/or freeze and/or get up and fight or run away if someone came busting into our session threatening to kill us.  Any of those responses are "normal" in the context of reacting to an unexpected and immediate literal threat to your own personal safety.  When the brain receives (for lack of a better term) the "Danger Will Robinson!" signal, our bodies start pumping out certain hormones designed to assist us in protecting ourselves to the fullest extent possible.  Blood literally rushes to our extremities so we can run away---or use our fists---or pick up a weapon.  Our pupils dialate so we can "see" better and more clearly all around us.  Our breathing and heart rate increases;  it's actually quite fascinating to understand how everything within the body works together to help us prepare for the "appropriate" reaction to danger...

The problems arise when we are thrown into this "high alert" mode interally and externally over "stuff" that is otherwise completely benign.  I mean, when was the last time you had a melt down over the local mall being "too crowded" for you?  When one's day-to-day anxiety ends up significantly impacting the person's ability to do his or her job...or go to school...or be socially active...or even leave their home and/or take care of oneself on a day-to-day basis, there are problems.  Anxiety disorders are typically at the root of these aforementioned problems.  WHICH anxiety disorder specifically is at the root of what's going on is what people like me are for.  To help diagnose exactly which anxiety disorder is wrecking havoc and why---and then working to treat it successfully over time.

Phobias represent the first type of anxiety disorder a person may most struggle with.  There are three main types of phobias.  All phobias are based on irrational fears.  This just means that the fear a person has about "whatever" is not realistic or rational.  Remember back in the 50's when all those sci-fi movies came out such as "Them" (giant ants), "Attack of the 50' Foot Woman" (giant human), "The Blob" (giant jello), etc.?  Well, simple phobias are like that.  A peson is unrealistically and irrationally afraid of a specific object or situation.  Some simple phobias are extremely easy to identify:  flying, snakes, spiders, dogs, mice, heights, the inside of an elevator, etc. etc.  Others are not so easy to identify:  water, butterflies, dirt roads, urine, ATM machine, the inside of a bus, etc. etc. 

The second type of phobia is referred to as social phobia, or social anxiety.  With social anxiety, the person is unrealistically and irrationally afraid of being judged by others and/or doing something in front of one or more "others" that is embarrassing to themselves.  Public speaking is the number one social phobia/anxiety issue we have as people.  Dale Carnegie would have never made a nickel off this particular phobia had they not recognized the extent and magnitude of it going back several decades. After public speaking, meeting "new" people is the next largest issue for socialphobes.  As you can imagine, this makes attending parties, classes at school, shopping, and a whole other host of "benign" social activities virtually impossible for those with this particular phobia.  Using public restrooms is yet another common issue for those struggling with social phobia/anxiety.  There are more, but you get the picture. 

Lastly, agoraphobia is our third main type of single phobia.  Agoraphobia literally means fear of the marketplace.  Not marketplace like the local grocery store or shopping mall...but "any" place where other people are going to be.  With agoraphobia, the person is most afraid of not being able to "escape" if they needed to.  This is why so many agoraphobics never leave their home...sometimes for years or decades on end.  A twist on this same theme are those individuals who manage to find and maintain a "job" of some kind or another---but can never leave that job/company.  In this case, the person is avoiding their fear (and phobia!) by leaving home only to go to work---and coming back home again.  Day in and day out.  Year in and year out.  Decade in and decade out.

Please keep in mind that simple phobias are like potato chips.  You may think you can have just one, but generally speaking that's not how it works.  A person can very easily struggle with some combination or all three "types" of simple phobias at the same time. 

Is this the time I should also mention that any given anxiety disorder can also have specific or simple phobias attached.  Sorry to have to break it to you this way, but that's the way it can be for those who are REALLY anxious and have been for a very long time.  Call someone you trust and find out who is where and available to help you.  You really can get and be better.

The Tragedy of 9-11...and its Aftermath

My friend Mel contacted me yesterday to say she got us a couple of tickets to enter the World Trade Center Memorial park when we go to New York City in mid-November.  The tickets were made available just yesterday and she was amazed how she was able to obtain them as she did.

It seems surreal that during our next weekend trip to Manhattan, we are going to be visiting a place no one would have ever imagined into existence in their worst nightmares.  Unless you live under a rock, the events of 9-11-01 represented a profoundly horrific time in contemporary American history.  It is the date when America, as a whole, lost its innocence.  Over three thousand people lost their lives in three separate plane crashes designed to punish America and its citizens for a whole lot of reasons many still do not fully understand.  Just this past weekend marked the ten-year anniversary of 9-11;  I didn't try to count how many television programs ran on Sunday to commemorate it.  It just seemed like no matter what time of day or evening it was, there were at least four or five programs airing about 9-11.  My hope is that we never ever forget what happened that day ten years ago...or ten hundred years from now.

What I know I will always remember and never forget was how the power of love overcame even the most henious form of evil on that day in mid-September, 2001.  As people were pressed up against the windows of each firey WTC tower, there were those who decided to jump while holding hands with someone else.  How is this last act not the ultimate expression of showing care, concern, and love for one's fellow human being?  For all the first responders who went into each tower focused on saving lives rather than potentially losing their own.  For all the dead we will never know about who spent their last moments comforting, praying with, and consoling someone else while waiting to die.  And for all the survivors who still love today in spite of the tremendous and devastating personal loss(es) they suffered...

When I go to the WTC Memorial this coming November, I hope to come away with an even deeper understanding of what it means to love...to sacrifice...and to know who and what matters most during our brief time on this planet.  Let's not trivialize "ever" what it means to be human, to love, and to have a bigger purpose in this life than we could ever imagine....