Small Steps

Finally kicking back: How years of work on the couch paid off at the beach this summer

Carla Cantor — Mon, 31 Aug 2009 18:44:39 +0000

It wasn't how I imagined it. I thought I'd devour a few novels. Or maybe I'd work on a book proposal in one of the shore-town libraries I'd mapquested. I never set foot in one. Instead, I loosened up. I leafed through magazines. I stared at the sea. I enjoyed my family and visiting friends, good food and expensive wine. I even took a nap - which I rarely do (without Xanax).

Vacation = Relaxation + Fun. Hardly news. But that equation has rarely worked for me. Just ask my husband. Too much time on my hands, catapulted out of structure, and I get depressed and anxious. In Cape Cod or California or Paris there I am searching relentlessly for distractions. I become obsessed with finding the right hotel or restaurant, the right tour, the right hour to go, the best bargain. I try to recreate a routine and become jostled by the unexpected and then get hard on myself, feeling guilty because I'm not a happy vacationer. I can't produce the perfect holiday. And when my husband inevitably says those two words, "Just Relax," as he frequently does, I want to sock him.

But this summer I learned to chill. It happened in a two-week rental at a house with too many chachkas in a tranquil, historic Jersey shore town a block from the beach. No, I didn't shut myself away from computer or cable. I brought along my Mac, made sure I had fresh Netflix, and joined a 24-hour gym (gritty but air-conditioned and less than a mile from the house).

Something was, indeed, different this year. I allowed myself a break. I enjoyed being with myself and others. I embraced some spontaneity. I indulged in naughty food. I let go. All of which shows - my therapy is working!

Here are some other things that happened:

• Took three long ocean swims, frolicking, yes, frolicking in the waves

• Stared at the sea with amazement and at children playing in the sand. I stopped myself from bemoaning my age and thought instead: Wouldn't it be nice someday to have a grandchild?

• Kept my mouth shut when my daughter invited six college friends for two nights and they smoked about 400 cigarettes on the porch and deck and whooped it up ‘til all hours. At least they used ashtrays.

• Was visited by three female friends and one couple and I didn't take it personally when an invited guest or two canceled

• Saw the movies Funny People with my two young-adult children and (500) Days of Summer on a rainy day by myself (I was good company.)

• Took twice-a-day walks and played ball with my much-neglected Labrador Angie, but on a busy weekend when she became a burden

I placed her in a fancy boarding place and refused to feel guilty about the three-day expense

• Ran three miles a day on a treadmill, except for the two I took off. And that's knowing that other people I'm training with for the New York Marathon are up to 17.

• Ate pizza twice - a rarity for me

• Ate real (not light) ice cream, a double scoop - a bigger rarity

• Delighted in all my visitors - brother, father, in laws, friends and especially my children

• Enjoyed my husband (yes, we managed to squeeze that in)

• Attended a funeral of my father's best friend and the 50th anniversary party of an aunt and uncle and was glad I could be at these events

• Hosted my supervisor and colleagues for a full-day beach retreat - I took back that vacation day - and celebrated the fact I have a job and boss I don't dread coming back to

Rested and tan, I have returned to cool weather ready for fall, a season that can be intense when you work for a university. But I have that new-penny-loafers-and-school supplies feeling I had as a kid and I'm ready for anything - all because of a good vacation.

So, next summer. Same time period, same town. I'm already researching 2010 rentals. I guess this means I'm starting to slip back to my hyper-drive self. But this year won't be so bad.I now know I am now capable of giving myself a respite. Down time with people you love is both fleeting and precious. Perhaps you have to grow older to cherish it.

What Does Hollywood Have Against Therapy?

Carla Cantor — Fri, 24 Jul 2009 15:53:40 +0000

The indie "dramedy" Shrink, starring Kevin Spacey, is scheduled to hit theaters this weekend in a limited release. Spacey plays a psychiatrist to Hollywood's elite who, after his wife commits suicide, turns into a pothead increasingly unable to manage his private life or help his patients. For a synopsis of the movie, read the New York Times article "On the Screen, the Shrink Has Shrunk."

Just another therapy-bashing film by Hollywood, which has a long history of negative stereotypes of therapists and mental illness. Take last year's The Wackness, in which Ben Kingsley, as Dr. Jeffrey Squires, lights a bong while trading his psychoanalyst services to Luke Shapiro for pot. Kingsley, a long-haired, cranky narcissist, spends the sessions living out a vicarious horny adolescence through his patient.

I know .... they're just movies. But the media and entertainment industries' often negative and inaccurate portrayals of psychiatrists, psychologists and other therapists - as well as the therapeutic process itself - have a profound impact on the public and patients themselves, their family members and policy makers. Not only do such depictions give a distorted view of mental illness, they also diminish continuing efforts to combat its stigma.

The mental health community appears to be fighting back. Mental Health America's Stigma Watch program tracks news and entertainment coverage of mental health issues for fairness and accuracy, with the goal of correcting and preventing stigmatizing portraits. You can even submit a "stigmatizing incident report" on a website.

It doesn't help the cause when celebrities make off-the cuff, disparaging remarks about psychiatry and psychology. That would include our Hollywood Scientology cultists such as Tom Cruise who believe that psychology and psychiatry are not only ineffective, but evil. I didn't, however, expect to hear a bashing of the therapeutic process from Larry David, but there it was in a recent Wall Street Journal interview.

Here is a snippet of David talking with WSJ's John Jurgensen about his film Whatever Works.

Jurgensen: What is it about your work that makes people want to psychoanalyze it so much? This armchair analysis often extends to you....

David: I don't mind that. I've been in therapy. I know enough about myself now to know that I really don't need to know anymore. I get sick of it.

Jurgensen: But you're not in therapy any longer?

David: No, I don't need to do that. It's such a self-indulgent activity that when I was doing it made me kind of sick. It turned me off to myself. It's so self-indulgent to talk about yourself for 45 minutes to an hour.

Considering the handsome living David makes off of playing misanthropic and neurotic characters (mostly himself), it makes sense that he wouldn't want to cultivate a more likeable persona. Working out his anger means he'd be out of work.

You have to look to the music industry to find affirmation for psychotherapy. Singer-songwriter Dar Williams is one of the artists who has lent her support to Musicians for Mental Health, a campaign that's using the power of music to change youth attitudes. Her song, "What Do I Hear in the Those Sounds? is the most accurate and soulful ode to psychotherapy I've ever heard. She makes no secret of her emotional struggles. Said Williams in an interview, "I make it perfectly clear in many of my songs that I have experienced clinical depression, that it was a disease I survived, and that therapy is nothing to be afraid of." that enlightens and educates people about the process.

If you haven't heard it, I've posted a video performance of the song as well the lyrics.

DAR WILLIAMS: WHAT DO YOU HEAR IN THOSE SOUNDS?

I don't go to therapy to find out if I'm a freak
I go and I find the one and only answer every week
And it's just me and all the memories to follow
Down any course that fits within a fifty minute hour
And we fathom all the mysteries, explicit and inherent
When I hit a rut, she says to try the other parent

And when I talk about therapy, I know what people think
That it only makes you selfish and in love with your shrink

But oh how I loved everybody else
When I finally got to talk so much about myself...

And I wake up and I ask myself what state I'm in
And I say well I'm lucky, 'cause I am like East Berlin
I had this wall and what I knew of the free world
Was that I could see their fireworks
And I could hear their radio
And I thought that if we met, I would only start confessing
And they'd know that I was scared
They'd would know that I was guessing
But the wall came down and there they stood before me
With their stumbling and their mumbling
And their calling out just like me, and...

The stories that nobody hears, and...
I collect these sounds in my ears, and...
That's what I hear in these sounds, and...
That's what I hear in these,
That's what I hear in these sounds."

Putting your words out there, trying to be heard

Carla Cantor — Fri, 26 Jun 2009 23:43:34 +0000

The irony does not escape me. I am writing about a story by a New York Times journalist writing about a group of psychotherapists who write. But I've been thinking about the article "Therapists Wired to Write" ever since a morning earlier this month when my husband plopped a section of the Times on the bed, saying "here's something for you to read."

The therapists touched on a number of themes that resonated: how people need to tell stories to make sense of their lives, how deeply connected they feel in each other's presence, and how risky it is to put your words out there. (It was also risky for them to allow a journalist into their group. The comments section consists of people criticizing the therapists for using patients' stories as grist for their work. But that's another subject.)

The moment I finished the article I knew I wanted to write about writing. I started in one of my notebooks - less threatening than the computer - then headed to the library to continue this activity about which I feel such ambivalence. I hate it because it's never good enough. I love it because time rarely goes so quickly as when I'm tackling words, trying to beat their unwieldiness into submission.

Yes, it's risky to write and writing is hard. Then why are so many people doing it?

According to a report by Technarati, a search engine that tracks blogs, there are more than 70 million weblogs in existence and 130,000 blogs being added to blogosphere each day. That includes about 7,000 splogs (spam blogs), a new term for me. Since the report's publication in 2007, these numbers have likely increased by more than 50 percent.

It used to be that before getting published writers had to go through a vetting process: You either got hired by the media as a journalist or you became a freelance writer. Got a good idea for an article? Send the editor a well-thought out query accompanied by published clips. Now all you have to do is log onto Blogger and WordPress, choose a blog template and, pronto, you can hang up your shingle as a writer.

So does that make web writing less worthy? On one hand, as a former newspaper reporter, I find it sad to watch the traditional news media shrinking away. But on the other, I welcome this democratization of self-expression. Here I am writing about mental health and other issues that matter to me when I want, how I want. There's no editor asking me to deliver a 400-word service sidebar - "Five tips on how to fill an empty page."

But with so many blogs out there, you have to wonder: Will anyone read mine? We're all getting published, punching in our keywords, hoping that someone will listen.

At least when your work is in print, you can imagine you're connecting with readers. You don't have to see them thumbing through a magazine or newspaper page right past you.With a blog, you know exactly how many people are at the very least clicking on your post (if you have the guts to check the metrics). Sure, you can promote yourself. Send your blog to other bloggers who might what to link to what you have to say. You can always email it to friends and family, but then you put them on the spot. They have to read you and may feel obligated to give you feedback or comment on the blog itself.

None of this should matter to your average blogger, however, if you agree with what blogging doyenne Arianna Huffington has to say. In her introduction to the recently published The Huffington Post Complete Guide to Blogging, Huffington writes," The majority of the 112 million blogs out there will never grab more than a few readers. That's OK." Okay for Huffington, whose Huffington Post gets about 8.9 million unique visitors a month, according to Nielsen NetRatings. Huffington goes on to cite a Pew Research Center survey (from 2006) that found 37 percent of bloggers blogged primarily to keep in touch with friends and family; 52 percent said they blogged mostly for themselves rather than an audience.

Then why not just keep a journal?

Writers write for many reasons: to center themselves; take time for themselves; to discover or tell the story inside them; or stay sane and connected. As Toni Morrison said in a recent interview with Oprah Magazine: "There are all sorts of ways people try to stay connected, try not to live in hate. Religion may be one of them, but for me the central thing is the writing. The art itself. Putting my intelligence and my humanity to the best possible use ..."

Whether or not we think about it consciously, I believe we are always writing for an audience. Being heard is one of the most fundamental needs a human being can have.Writing, however, is by and large a solitary endeavor, which may be part of its appeal. It's a good excuse to turn off the cell phone. Take time away from the demands of the kids, the husband, and the dog. But it can also breeds loneliness, insecurity and, in too many cases, alcoholism or substance abuse.

Which brings me back to the therapists' writing group.The six women who meet Friday mornings on the Upper West Side have been writing away in their "safe cocoon" for seven years. The session is only 90 minutes once a week but that seems to be enough to keep them going: Among them, they've produced screen plays, short stories, novels and nonfiction books.

I am jealous of these women - not for their publications but for their camraderie, their shared history. I once had a writing group.There were four of us. We worked with writing prompts and a timer. We might get 10 minutes to write about A Person We Would Most Like to Tell off or five to write about Six Disgusting Things in Our Refrigerators. Maybe a little longer for something like What I'd Like to Tell my Father. We commented on each other's work, never criticized, and I found their voices soothing. I have notebooks filled with the writing I did in that group, some of which has already found its way into published work. I thought that the group would go on forever. Then one woman moved away; another started graduate school, and we fell apart.

The article made me hunger for that touchstone once again, and I am more determined than ever to find a new group of women who want to write, support, and encourage one another. A women writers' group (sorry guys) can offer refuge and perspective: the perfect antidote to an activity that is solitary, difficult and risky.

Dr. Paul helps me too

Carla Cantor — Wed, 27 May 2009 21:37:54 +0000

Some of my friends find it too wrenching to watch. My therapist is overly conscious of Dr. P's mistakes, which she says feel like chalk on a board. But for me - who has seen my share of good, bad and in-between therapists over 30 years - the HBO dramatic series In Treatment gets it just right - or right enough. Okay, the sessions are only 25 minutes instead of the usual 50, and I can't figure out why Paul (Gabriel Byrne's Dr. Weston) doesn't consult a physician on some of his cases. A low dose of Zoloft or Prozac could go a long way during the weeks his patients are learning to trust him while shedding defenses.

But what happens psychodynamically in almost every session - the unraveling and the breakthroughs that might take months or years sped up for the sake of the medium - is the most realistic depiction of psychotherapy I've ever seen on screen. And I'm not the only one. Much the psychoanalytic community has embraced the series. (Check out the recent UCLA conference convened in celebration of the show's second season.) Some clinicians are even screening sessions to illustrate concepts like transference and resistance, and what does and doesn't work in therapy, to psychologists in training.

There are many reasons to love this show, adapted from the successful Israeli series Be' Tipul: the powerful dialogue, the masterly performances and Byrne's extraordinary portrayal of Paul Weston, the handsome, caring and well-trained psychoanalyst with troubles of his own for which he is in treatment. But that's all been said. What I don't think has been said is how gratifying the series is for a person who has struggled in therapy - talking, talking, talking - for many years.

I ventured into the world of psychotherapy during the 1970s with a visit to a mental health counselor on my college campus. When the counselor suggested a consultation with a psychiatrist, I freaked and flat out refused. With all my problems at the time (anorexia and depression among them), the stigma of seeing a shrink was just adding one more to the pile.

That changed, of course - living in New York City helped - but many of us
who entered into therapy to undo destructive patterns of behavior, find love, forgive ourselves, or to simply learn better ways of coping still feel that there is something wrong with us: that we see a therapist because we are at the core dysfunctional individuals. And, worse, self-indulgent ones.

The series shows how psychotherapy works and makes the case for its basic tenet: that insight into your past can help you move forward. Most important, it expands the picture of what a functional human being looks like, thereby, lessening the stigma of having emotional problems in the first place and seeking treatment for them in the second.

In Treatment patients are, for the most part, competent, highly functional individuals who wrestle with intrapsychic conflict: a tension between opposing (often unconscious) thoughts and feelings that can wreak personal havoc. Weston himself is as damaged as some of his patients, continuing to work out old, unresolved conflicts in sessions with his former supervisor Gina, the amazing actress Diane Wiest. But despite Paul's wounds and problems, he toils away in an authentic attempt to make his patients whole - through listening, through insight, through caring. As a therapist, Paul makes some mistakes. But what therapist doesn't? It's all part of being human.

When I watch the lives of the characters unfold on In Treatment there is a shock of recognition. How many women have I met like Mia, the successful attorney played by Hope Davis: women who are attracted to unavailable men, longing for intimacy and a baby, afraid they will end up alone? The character I most identified with is the first-season's Sophie, a 16-year-old anorexic gymnast so in denial that she isn't sure whether her collision with a car on her bicycle was a suicide attempt. Sophie, with whom Paul has his biggest success, brought me back to thoughts of an earlier time when I, too, was that out of touch - and the skilled psychoanalyst who I believe may have saved my life.

Thank you Hagai Levi, creator of Be'Tipul and an executive producer of In Treatment, for providing a telescopic view into a place that is seldom seen. Therapy, of course, is not always as exciting as In Treatment might suggest; anyone who has stuck with it knows that there is a lot of painful and painstaking drudgery involved. But a lot can happen in a room when you make yourself vulnerable to another human being. In Treatment helps to reveal the essence of the unique therapist-patient relationship, within which lies a second chance.

Post script: For a thoughtful analysis of the series, check out Alan Sepinwall's blog. Sepinwall is the film and TV critic for The Star-Ledger in New Jersey - and a huge fan.

My Plumber, Myself

Carla Cantor — Thu, 21 May 2009 15:56:29 +0000

Not long ago a basement pipe burst and I took the morning off from work to wait for Chris, our plumber. Scratch whatever visual you have, and picture a tall, fastidious man in his mid 50s with a head of gray hair, a diamond stud earring and iron-creased jeans. On his last visit (a stuffed toilet), I mentioned that I was training for my first marathon: a fundraiser for the Leukemia and Lymphoma Society to honor my mother, who had died the year before of nonhodgkin's lymphoma. It turned out his father, too, had died of the disease a few years earlier. The following week I opened what I thought was Chris's bill and found a $50 check to the society with a note saying how much he admired my effort.

So aside from being reliable, neat and a damn good plumber, Chris is a mensche. After resolving the pipe fiasco that day, Chris inquired about my training and how I was doing. (It was a little past the first anniversary of Mom's death.) "Actually, Chris, not great," I replied, picking up one of the many living room photos of my mother. "I miss her, still everyday."

"She's a beautiful woman," he said. "Just beautiful. He paused. "You never get over it, " he said, "but after awhile, I promise, it stops hurting so much. You go on ... and even have happy days." Assuming he was talking about his Dad, I asked how old his father had been when he died. His expression was far away and melancholy.Our conversation had touched on something. Chris explained he'd experienced other losses. After a moment of silence, he replied, "My daughter."

I'd known Chris for about four years and he had mentioned a son in his early 30s but never a daughter. "How old?" I asked. "17 years old. Kate was 17." I waited for more, and when nothing came, I said. "I'd really like to hear about her. if you want to talk."

More than 10 years had passed since her death, but you could feel the heaviness of grief in the room. He spoke of her beauty and intelligence - how good and sweet she'd been - and then moved into the story of that day. It was Kate's senior year of high school. Chris had bought her a car, a used stick shift, which had stalled on her a couple of times. He had just brought the car back from a second visit to the mechanic with a clean bill of health the night she drove to a friend's house.

When she got ready to leave, the car wouldn't go into gear. Her friend came out to help but after no luck, she called her Dad. While he drove the five miles to get her, Kate decided to try the car one more time. She tinkered a bit and then walked a ways down the steep drive, just as the car began to roll, mowing her down before crashing into a tree. As Chris drove up the street he could hear sirens and see flashing lights. His daughter died in his arms before the ambulance ever came.

The conversation took place at 10 a.m. in my living room, but I had lost any sense of time; it felt as if I had emerged from a movie house into a stark, bright afternoon. Chris didn't say more about that night but spoke of its aftermath: about the what-ifs, the guilt, and the self-hatred, and how he and his wife had struggled. He told me he had wanted to die and that for weeks he couldn't get out of bed. Six months after Kate's death he was hospitalized for major depression – which, he said, runs in his family.

"My wife was my pillar. We went to therapy together,and she helped me fight the guilt," he said. "You hear about marriages falling apart after a child's death, but we were lucky. Ours became stronger."

I told him I, too, have battled depression and survivor's guilt – the latter, following a car accident in which a friend died - and have written and spoken publicly about these difficult times. The next thing I knew Chris and I had launched into a discussion about medications, comparing which antidepressants worked best. I told him I'd written a book about hypochondria in which I touch on my struggle with depression and an obsessive fear of death.

Chris became wide-eyed. "You're kidding. That has been my biggest problem. It still is: The fear that I will be struck down and die from something painful and awful. I've had every disease you can think of."

I reached on the shelf for a copy of my book, Phantom Illness. "The prologue and the epilogue tell my story; there are also stories of many others," I said. "Some of them might resonate with you." He took it and thumbed through its pages. "I cannot wait to read this," he said, and then realized that he'd better get to his next call. Our eyes met and, spontaneously, we hugged. An authentic, deep-felt hug. "I'll mail you the bill," he said, "though, on second thought, maybe you should send me one." And then we laughed, our eyes wet with tears.