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Couples Communication: The Rules

An experienced couples therapist once told me that “good communication and persistence would cure most problems.” (more…)

Seasonal Affective Disorder in Children

Some people suffer from symptoms of depression during the winter months, with symptoms subsiding during the spring and summer months.  This may be a sign of Seasonal Affective Disorder (SAD). (more…)

Emotional Distress: Counseling or Medication

Emotional distress comes in many forms and shapes. There are no x-rays or blood tests to explain what is going on or what is wrong, just your verbal description. The two most common mental health problems are anxiety and depression. (more…)

The Game Of Rescue: BE Careful, You May Become A Victim.

Offering to help someone who is in need of assistance just seems like the right thing to do. We’ve all had the opportunity to lend a helping hand, or go out of our way for a friend, relative or even a total stranger. The scene, more than twenty-five years ago, of that fireman diving into the freezing waters of the Potomac River to save victims of a passenger jet that crashed while taking off from National Airport during an ice storm lingers in my mind. We praise the heroic actions of first responders who risk everything to save total strangers. So, when someone who is familiar to you asks for help would you rush to assist them and do whatever is required? We’ve heard it said: ‘A friend is a friend – no matter what!” What if that “friend” is engaged in a behavior that violates the law or, your moral judgment. What if their behavior is, in some way, pathological? In those cases, helping that individual might wind up jeopardizing you. Your intentions were honorable but you wound up in trouble or having a major problem!

The complexities of our interactions became the focus of a theoretic formulation known as Transactional Analysis. TA is a method of analyzing and understanding communications and interactions ( transactions) between individuals. The goal of TA is to eliminate dysfunctional behaviors and develop effective coping strategies in our relationships. Clients learn to identify disruptive interactions and replace them with direct, Adult – Adult, communications.

Eric Berne developed the concepts of TA after extensive study and training in traditional therapy and the practice of psychiatry and psychology. He suggested that we develop “life scripts” early in our development that influence how each individual chooses to live and behave. The role of therapeutic intervention would be to “re-write” destructive and self-limiting script messages.

As a result of problematic script messages and learned styles of interacting, Berne noted that we develop dysfunctional patterns – called Games – in which we intend to gain positive “strokes” but actually reinforce negative feelings. Further, Games can be a way of interacting while avoiding intimacy (intimacy here defined as revealing the “real self” to others). Take, for example, the game of “Psychiatry.” You meet someone at a party. He is quite engaging and asks many questions about you. He seems interested in you and appears to be a good listener. However, when the conversation ends, you realize that he has revealed nohting of himself – thus avoiding intimacy. A second example is a game called “General Motors.” Same party: a bunch of guys stand around talking about the virtues and limits of Camaros and Corvettes. In the end, after a discussion of camshafts, transmissions and engine displacement, they part knowing nothing about each other. They interacted, but easily and skillfully avoided any personal knowledge of one another.

You may have heard the saying: “No good turn goes unpunished.” If we offer to help someone who has not requested it, we force them into the role of a “Victim.” They can easily turn and become hostile toward us, shifting from “Victim” to “Persecutor.” Claude Steiner points out that we are encouraged to be selfless, generous and cooperative with people, even if they are deceitful, selfish, stingy and uncooperative with us. Engaging in this type of interaction is guaranteed to take us from the position of “Rescuer” to the “Victim” position while the so-called “Victim” becomes the “Persecutor.”

In the game of “Rescue,” the Rescuer (that’s you) views that problematic, needy person as the “Victim” and thinks: I’ll save you!” As the paradigm progresses, the “Rescuer” becomes the “Victim” and the “Victim” becomes the “Persecutor.” Let’s look at a real life example.
rescue triangle

Archie (not his real name), a recovering alcoholic, was planning to go out on New Years’ Eve. He had tickets to a fancy gala and had rented a tuxedo. His date lived some distance away and he had planned to leave his house no later than six o’clock.

Early in the afternoon, he received a call from Edith(not her real name) whom he had met at a meeting of Alcoholics Anonymous. She was “in a jam” and asked if she could borrow his car for a brief errand. Archie quickly agreed (boosting his own ego and self esteem) and told her to return the vehicle by 4 o’clock . “No problem,” she replied, as Archie watched his washed and freshly waxed car roll out of the driveway.

Of course, 4 o’clock came and went with no sign of Edith. By 5 o’clock Archie, agitated and concerned, started calling some of Edith’s favorite haunts (bars). He located her at a neighborhood pub and asked her to bring the car back immediately – she (now drunk) hung up on him. Furious, he called the police and reported the car stolen. He told them where the vehicle could be found and the police went to the bar to confront Edith.

When they arrived, Edith told them that Archie had assaulted her and she had “fled for her life!” She filed assault charges against Archie and the police arrested him! Archie spent the evening at the police station, in his tuxedo. By the time he had arranged bail and was released, it was too late to go out- Happy New Year, Archie! The “Rescuer” had become the “Victim” and the “Victim” had become the “Persecutor.”

There are countless examples of this paradigm: the house guest who never left; the loan that was never repaid. However, the key to avoiding the game of Rescue is to carefully analyze whether the alleged “Victim” is really a victim; or have they created their own problem. After all, we are each responsible for our own behaviors. What is the “payoff” for you as the “Rescuer?” If you can understand your own motivation and can take an objective look at the so-called victim, you may discover your own co-dependency or realize that you are “enabling” the pathology of the other person.

Depression strikes anywhere

Depression strikes anywhere

At some point, someone in the wine industry found some physicians and suggested that they come up with a plan to convince all of us that drinking wine was a great idea. Since that time, we have been told, repeatedly, that drinking some red wine – everyday- is really good for us.

The health enhancing basis of this medically proven assertion is that red wine contains anti-oxidants and we need these compounds in order to maintain our health. It is a fact, we need anti-oxidants to maintain our immune systems and promote good health.

A brief scan of the health food literature clearly indicates that antioxidants play a significant role in maintaining physiological balance in our bodies.  As oxygen interacts with the cells in our bodies, one to two percent of our cells will be damaged and turn into free radicals.

The term free radical refers to the fact that molecules from damaged cells are missing one molecular component and search for that missing molecular side chain in other cells. These free radicals attack other cells (attempting to add their missing parts) and can injure these cells, thus leading to disease.

Usually, antioxidants maintain control over the free radicals in our bodies. However, if the system is over loaded with free radicals from cigarette smoke, pollution or excessive use of alcohol, a cascade of free radicals causes more cell damage and may be a causal factor in heart disease, Alzheimer’s disease, Parkinson’s disease and cancer.

Increasing our intake of Vitamin C and Vitamin E can neutralize and disrupt free radical reactions. Flavonoids and Polyphenols in fruits and vegetables are also valuable sources of antioxidants. In addition, research has demonstrated that our bodies require a complex mix of vitamins and minerals to neutralize these free radicals.

So, infusing our bodies with flavonoids from blueberries and strawberries as well as the chemicals in broccoli and green tea is clearly advisable. It is also suggested that we should stop smoking and reduce our intake of alcohol.

If it is true (and it is) that wine contains anti-oxidants, then what’s the problem with drinking wine everyday- as proposed and recommended by many physicians? When we ingest alcohol, it is metabolized in the liver by certain enzymes that break alcohol into substances that can be used by the body. As you consume more alcohol, you increase the enzyme allowing the body to metabolize more alcohol.

People who rarely drink alcohol notice that their tolerance is quite low. By contrast, individuals who drink significant amounts of alcohol, on a regular or daily basis, show an increased tolerance for it.   For example, I once saw a stylish forty-something woman who had been referred for sleep problems. She reported that she started to take “just a dram” of wine, in the evening, from time to time, to help her sleep.

This had started about two years before her visit. Now, she was consuming a large tumbler of wine each night and was still having problems. Her tolerance had significantly increased and her difficulty with sleep patterns had continued.

Does daily drinking always lead to problem drinking?
No, certainly not always. However, if the body is able to metabolize alcohol a bit more effectively, then there is the opportunity for daily drinking to lead to problem drinking. The use of alcohol, on a daily basis, gives the children at the table, the idea that the daily use of alcohol is O.K.  Giving kids a “taste” of the parent’s beverage gives the message that underage drinking is tolerated.

Years of clinical experience have indicated that alcohol acts as a “magnifier” for conflicts between family members.  If someone is using alcohol on a daily basis, and it is readily available within the home, there is a minimal boundary between use and inappropriate abuse. In addition, there is a clear relationship between the use of alcohol and aggressive behaviors. Further, significant chronic use of alcohol leads to other illnesses.

Liver disease, cardiac concerns and kidney disease may also be a result of significant intake of alcohol.   Also, when alcoholic brains are weighed at autopsy, they are “lighter;” – they weigh less than normal brains. That’s not a good thing.

So, when you do a risk/benefit analysis, it would seem that if you want to increase your intake of antioxidants, don’t justify that glass of wine by thinking that you are doing something that produces health benefits. If you want to increase your intake of antioxidants, eat blueberries!

When people come to treatment, they will often ask me to recommend books that they might read to assist them in solving the problems that are challenging their lives. They gaze at the books, which line the shelves in my office, possibly expecting that some perfect kernel of wisdom is hidden within one of those tomes (if paperbacks can be tomes).

They search for that one statement, or fact, which absolutely and clearly elucidates their particular problem and explains the exact formula for a quick and enduring fix. “Give me something to read,” they ask. Sometimes I say: “if you could get all of the answers from books, we wouldn’t need therapists!”

At times, however, I do recommend certain books and we will discuss some of them in this forum from time to time.

(more…)

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