Ask Dr. Frank

Family therapist Frank Pittman, M.D., imparts his wit and wisdomon the fine art of fatherhood, the hateful habit of smoking, the aftermath of sexual abuse, and family secrets.

DEAR DR. FRANK: FOR HEALTH REASONS, MY HUSBAND SHOULD NOT SMOKE CIGARETTES. HE CAN AND SOMETIMES DOES GO DAYS AT A TIME WITHOUT SMOKING, SUGGESTING HE'S NOT ADDICTED. BUT MOST OFTEN, HE SNEAKS CIGARETTES, EITHER BORROWING THEM FROM OTHERS OR BUYING AND HIDING A PACK OF HIS OWN. I CAN OFTEN TELL WHEN HE'S SMOKED--THE SMELL IS OBVIOUS. I HATE HIS LYING, AND I DON'T SEE HOW THE SNEAKINESS CAN HELP HIM FEEL GOOD, WHICH I AM CONCERNED ABOUT BECAUSE HE IS SUBJECT TO DEPRESSION. IS THERE ANYTHING I CAN DO TO HELP HIM STOP OR SHOULD I JUST FORGET ABOUT IT?

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Dear Forget About It: Smoking is a dirty, smelly, dangerous habit. It will not only turn you into an invalid and eventually kill you, it will make you socially unacceptable. It is hard for you to understand how anyone sane could do such a disgusting thing--unless of course you have been a smoker yourself. You must understand that nicotine is not just a highly addictive drug, it is an effective antidepressant that makes anything else in life tolerable.

Nicotine is the only addiction I've ever had, and it took me 30 years to break the lovely, comforting, deadly habit. I quit many times, going through the hell of withdrawal. I was irritable, depressive, and quite sure I was going crazy about the third day off the cigarettes. I would make a pact with myself that I would not have a cigarette until I was right on the verge of total insanity. Every time, I would go nuts.

Even if I could go for days without smoking, merely obsessed with it, I was still addicted. I was just spending my life in a state of withdrawal. Meanwhile, anyone who tried to make me quit was my enemy. Finally, one afternoon, I was so disgusted with my weakness that I decided I would quit smoking even if I went crazy. That was eight years ago. I haven't had a cigarette since, knowing that once I did, I would be back in the same completely engulfing game with myself. I have not been an especially happier person since then, but I have been far healthier, and more socially acceptable.

Your husband is still addicted and is not prepared to go through the horrendous experience of withdrawal yet. Please, take seriously the power of nicotine addiction. Any addiction brings out the worst in the addict--smokers not only beg, borrow, and steal, they sneak, lie, and hide. You don't need to ask him if he's smoking, you can smell it easily enough.

You have every right to insist that he not smoke around you. But the more you turn it into an issue between you and him, the more you banish him to the company of those few remaining smokers left in the world. He is in the grips of a force more powerful than you. Don't try to control him, and don't take it personally.

Smoking may look like an infantile and self-indulgent character flaw to you, but nicotine addiction is a quite serious matter to the smoker, and withdrawal is dreadful. Understand the difficulty not only of withdrawal, but of life without this effective, however smelly, antidepressant companion. Take it seriously and sympathetically.

Dear Dr. Frank: When I was a boy, around eight I think, my father woke me up during the night several times and made me give him oral sex. I never told anybody, even my brother and sisters, because I was ashamed. I thought I should have been strong enough to resist. The more I read about incest survivors, the more I worry about myself Am I going to go crazy because of what he did to me?

I worry about the rest of my family, too. One of my sisters won't let our father babysit with her children, but she won't tell why. Another sister had a baby when she was in high school, and I've wondered if it could have been my father's child. I finally broke down and told my wife. She thinks I ought to talk to my brother and sisters and find out if he did anything to them, too. We've all turned out fine, but we are all very shy and inhibited, talking about sex. I think it would embarrass them to talk about it.

My father lives with me now since my mother died. He's old and frail. I don't want to upset him, but I want to ask him why he did it. I've been haunted by it all these years. Even if he's forgotten about it, I think about it every day.

Dear Haunted: Your story is very painful, and very familiar. Your brother and sisters might have had similar experiences, felt similar shame, and likewise never mentioned it. If the sexual encounters were unsettling for them, they would probably remember them. The secrecy and the silence surrounding child molesting like this makes kids feel alone and ashamed. The lingering silence may be worse for them than the abuse itself.

Back in the '60s, I wrote the first paper on incest in family therapy literature. I've gotten a lot of incest referrals since then. It's pretty common--several percent of boys and girls get molested by fathers or stepfathers, several dozen percent get molested by other adults, and practically every child gets molested by other children. Any molestation can be traumatic, but betray al and exploitation by a trusted adult can be devastating, especially if it must be kept a secret.

Even if it is kept secret as yours has been, incest does not usually drive people crazy later in life. In fact, most survivors of such abuse are people much like yourself, sensitive men and women who are concerned with everyone's feelings and emotional rights except their own. Talk to your brother and sisters. It might be a great relief to all of you, and it is likely to bring you all closer together.

You can be sure your father remembers it, even if he hopes you all have forgotten it. Getting it out in the open may be a great relief to him, too. In fact, there is a good chance he was abused when he was growing up, too. Back then, people didn't talk about it as much and didn't realize just how damaging and confusing it could be for children throughout their lives.

It may help to carry out these confrontations in the presence of a therapist, but only if you can find a therapist who can deal with incest without hysteria. The therapeutic setting may be more comfortable than talking it over at a restaurant or during a break in the ball game.

Contrary to all the uproar in the media about the so-called recovered memories of forgotten childhood sexual abuse (a highly questionable business), incest does not necessarily lead to severe adult mental illness--neither schizophrenia, multiple personality, nor any other form of craziness. Instead incest is likely to produce sexual inhibition and/or fuzzy sexual boundaries.

For example, in one case I saw recently, a young man had had sex, growing up with all three of his brothers, his sister, and his mother (she liked to dance naked for her sons while they masturbated together). He never had sex with his father, who slept routinely with the sister. No one in the family had considered this behavior abnormal; they laughed about it then, they laugh about it now.

However, this young man's wife brought him to see me because he routinely had sex with her relatives, with their friends and neighbors, male and female, and with his patients (he was a chiropractor). The man had no sexual boundaries, and was often in trouble about it. His wife was afraid he would have sex with their children as well. His family's comfort with the casual sexuality left everyone uninhibited, free of sexual shame, but unfit for relationships in the real world.

The predictable legacy of sexual abuse in the family is not spectacular insanity, but sexual boundaries that are too tight or too loose. Still, incest is not good for children.

Dear Dr. Frank: My wife and I are expecting our first child in a few weeks. We just found out the baby will be girl. I'm really disappointed. I don't know how to be a father to a girl. I would be uncomfortable changing her diapers. I wouldn't want to play rough with her--I might hurt her. I don't know anything about girl things, so we just wouldn't have much in common.

In my family growing up, my mother took care of me and my brothers until we were old enough to play sports and go hunting and fishing with my dad. I was all boy growing up and I'm a man's man now. I hoped I'd get a chance to be a father like my father, but now I don't know what to do.

My wife tells me I'm afraid of anything female. I don't think I'm afraid exactly--it's just so foreign to me. I want to be a good father, and I especially want my wife to see me as a good father, but it seems such a waste for me to sacrifice so much of myself to be a father to a girl when she'll grow up to be a woman who'll have no need or use for the things I have to teach. How can I be a father to a girl when girls are the opposite sex from guys?

Dear Disappointed Dad: Congratulations! You now get a chance to learn how to be, not just a man, but a full-scale human being.

You grew up in a family, like so many, in which nurturing and loving were women's work, while men played games. Your daughter can help you get over your fear of females and teach you all the things you have categorized as "girl" things and avoided up until now. You finally get a chance to clear up the mystery of gender. Whatever wonderful things you do as a father to your daughter, she'll do some things just as important for you. She can show you that females are not at all opposite, and not really very different, from you.

Start early. Change lot of diapers; that should get you over your fear of your daughter's femaleness. As a father, you must do your share of the nurturing and loving, and in the process learn how to love others. You don't have breasts full of milk to offer her, so you'll have to be more creative about entertaining and stimulating her. Babies, like puppies, are easy for amateurs to love since they like anything and they don't try to tell you how to do it right.

As a father to a daughter, your job is to teach her everything a man knows about the way the world works, and at the same time to show her what a man is like and what it feels like to be a man, so she'll be comfortable with men as she grows up, but won't be overly impressed. Everything a boy needs to know, a girl needs to know, too--anything she doesn't know will leave her at the mercy of mates.

Don't spoil and pamper her by treating her feelings as if they are too important and treating her as if she is so fragile she has to get her way. You can be tough with her without being cruel. Females do not have to get their way, any more than you have to get yours. Support her tough ness, her activity, and her assertiveness.

Don't try to protect her from anything. Her success in life will depend on your faith in her and your belief that the world is a safe enough place for her to embrace and conquer. If you convince her the world is dangerous) that men (other than you) are treacherous, and that she better play it safe and stay close to daddy, you cripple her.

Don't put down girls' things, even if at adolescence she forgets about conquering the world and becomes preoccupied with clothes, makeup, and who has a crush on whom. That is by no means sillier than the stuff boys worship in adolesence, like muscles, cars, scores of ball games, and player statistics.

Above all, treat her mother with respect and equality, not just fairness, but with the firm belief that her mother's activities, tastes, and opinions are just as valid as your own. I don't know how your daughter will turn out but you follow this, but You'll turn out great.

Dear Dr. Frank: My brother let it slip once that my father, now deceased several years, had had an affair. He refuses to talk to me about it further, saying that he was told in confidence by Dad.

Indeed he was: At the time he himself was having an affair (which y led to the breakup of his marriage). But I feel I am entitled to know more about the man who was as much my father as his. My father was a difficult man, and my mother is an emotionally unreachable person who still suffers in her emotional isolation.

I feel this information may explain a lot, make me feel more sympathetic for her, and find a way to successfully get through to her, before it's too late.

Dear Entitled to Know: Yes, you should know any information that might explain your father, your mother, your parents' marriage, and your brother's belief that men's pecadilloes should be kept secret from the womenfolk.

There is an interesting pattern of loyalty among the men in your family: They can betray the women in the family, even their own wives, but they maintain their commitments to one another. The way in which the men keep secrets from the women reveals much about the gender attitudes of your father and brother, which undoubtedly color your mother's life and your own.

You already know your father had an affair. Are you awaiting your brother's permission before you discuss it with your mother? Have you bought into the family attitude that your women must not be privy to men's secrets?

A man or woman cannot betray a husband or a wife without also betraying the children in the family. Family secrets do great harm, often for generations. They disorient people and make them dependent upon people who are lying to them. And those who lie are willing to drive their loved ones crazy rather than admit their own weakness or error.

Does your brother just naively hope your mother didn't know she was being betrayed? Or does he just believe that women prefer being lied to? It is the lie and the secret of infidelity that do the great damage--not the sex itself. People who are biding a secret shame are indeed likely to be difficult--just as those who are being lied to and disoriented by those who love them are sure to become emotionally unreachable and isolated.

Knowing those things is helpful but not sufficient; only if you know the details of this significant crisis in your parents' lives can you become fully sympathetic with your parents and reach the crucial point of forgiving them.

Your brother needs to understand, among other things, that people don't need to worship their parents and think of them as flawless, but we do need to understand who they were and why they were the way they were. Only then can we be different from them, while still honoring them.

We're all, even your brother of the misplaced loyalty, merely human.

PHOTO: Dr. Frank Pittman, M.D.

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