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Ask Dr. Frank

Presents the responses of a family therapist to questions on gender
in children, symptoms without meaning, how to spot a man-eater, the
trouble with turning day into night, and the longest-running
stomachache.

Family therapist Frank Pittman, M.D., imparts his wit and his wisdom ontending to gender in children, symptoms without meaning, how to spot a man-eater, the trouble with turning day into night, and the longest-running stomachache.

DEAR DR. FRANK: MY 3-YEAR-OLD SON IS A DELIGHT--SMART, GOOD-NATURED, ADORABLE. BUT HIS NONCOMPETITIVE NATURE IS SOMETIMES SEEN BY OTHERS AS A SIGN OF EFFEMINACY. WHAT'S MORE, STRANGERS, RESPONDING TO HIS CHERUBIC FACE AND HALO OF BLOND HAIR, OFTEN ASSUME HE IS A GIRL. I DON'T KNOW WHETHER THEIR CONFUSION WILL CAUSE HIM CONFUSION. SOMETIMES IT CAUSES ME CONFUSION. I DON'T KNOW WHETHER TO BE WORRIED OR NOT.

Dear Mother of a Cherub: Congratulations! It sounds as if you have a wonderful son. Don't worry about your son's gender: There are only two genders, and I'm sure your son has discovered which one he belongs to and is preparing to enjoy it if no one makes too big a fuss over it. But it would help if it were more obvious to others.

I've always thought that if I couldn't tell whether someone was male or female, it couldn't possibly matter to me or to them. But a lot of people go around classifying things according to gender, and they get upset when they can't decide which slot to drop someone into. To avoid upsetting people, it might be helpful to display your son's gender, not by exposing his genitals but by dressing him up in a way that clearly identifies him as male. That way people won't be obsessed with trying to figure out which he is and thereby making more of gender than necessary. Once that issue is settled, people won't get confused, and they can respond to his many virtues.

Your other question, though, involves your concern over whether there is something wrong with a boy being sweet and good-natured--which is what I assume you mean by effeminate. Absolutely not! I hope these days we are all trying to raise full-scale human beings with the virtues associated traditionally with both males and females, all of which will be useful. There is no danger from your son (or daughter) having the traditional female virtues, as long as your son (or daughter) has the traditional male virtues, too.

Don't let either the feminist or the masculinist literature scare you into believing that men are, by nature, assholes and women saints. Men can have redeeming qualities, too, and if you are raising a son, it helps to know that sweetness, noncompetitiveness, good-naturedness, adorableness, beauty, and even "cherubism" are quite compatible with Y chromosomes.

Dear Dr. Frank: Recently I've been losing sleep. I keep having these recurring thoughts, you could almost say flashbacks. At these times I often feel that I am unable to breathe. They seem to occur in the evening and every time I am in an elevator. I feel very flushed and uncomfortable when they occur. I've also noticed that I become very irritable toward my older brother. This problem really scares me. Please help.

Dear Flushed: I have no idea why you are developing anxiety symptoms. It could possibly be a brain tumor or a faulty thyroid gland, so you should get a physical exam. It is more likely something simple and benign. When I'm restless, flushed, irritable, and sleeping fitfully, it is usually from drinking too much caffeine.

You say you're having flashbacks, but I'm not sure I understand what you mean. Flashbacks to what? Unpleasant experiences of the day? Unpleasant experiences from your past? Scary movies you have seen? When I am overcaffeinated, I experience all three.

Obviously, I know nothing about your relationship with either your brother or elevators, but if your brother used to close you up in elevators when you were a baby, ask him not to do that anymore. Otherwise, don't jump to the conclusion that these symptoms have any hidden meaning that you have forgotten. The reality we remember is quite sufficient to keep us busy for a lifetime, without having to speculate on adventures or traumas we may have experienced and forgotten.

If you are uncomfortable with elevators, I would recommend that you spend some time riding up and down in them until the experience becomes boring and a waste of time. If you are irritable with your brother, I would recommend that you lovingly discuss with him your problem of irritability, and apologetically mention the things you think he could do to make you more comfortable with him.

Meanwhile, exercise is probably the best anxiety reliever, so after you get comfortable riding up and down in the elevator, try walking up and down the stairs.

Dear Dr. Frank: I am in love with Veronica and she seems to need me. But every man in her family has been a disappointment in one way or another. Her father was abusive, as were her stepfathers. Her three sisters have all divorced their abusive husbands. Veronica's first husband couldn't hold a job, her second husband never took her anywhere, and her current husband is so jealous he doesn't like for her to go out and drink with us guys from work. I am a gentle, loving man and my friends are worried about me. They call Veronica a "man-eater." But I see her as just hungry for love. What do you think?

Dear Meat: You are a courageous man to go into territory from which no man has emerged intact. However, you are foolhardy to believe that you are so different from other men that you will be spared the fate that awaits any of us who enters hostile territory. I read of a tiger who recently ate a zookeeper who had wandered haplessly into the tiger's cage. The superintendant of the zoo said something like, "If the tiger had not eaten the man, I would have questioned whether she was a real tiger. The nature of a tiger is to devour any man who gets in her cage."

Whatever your merit badges, you are still merely meat to carnivores--and to women who have been attack-trained by the men who have gone before you. In George Bernard Shaw's play Androcles and the Lion, a tailor in ancient Rome pulled a thorn from the paw of a suffering lion. Androcles was later thrown to the lions, but was spared when his maned friend recognized him. Great fantasy, but I wouldn't risk my life on it. If you want to know what is in store for you when you enter the lair of a dangerous creature, find out what happened to the guys who went in before you.

Dear Dr. Frank: I have lost my natural ability to fall asleep. I am a chef and I work hard and long hours. When I leave work I'm tired, but when I go to bed my mind is cluttered with thoughts that only occur when I lay down to sleep. For the past eight years, I have been using marijuana and/or alcohol to sleep. I want to get away from this habit but, when I try to, I can't sleep.

In the morning, I have no trouble laying in bed snoozing. In a sentence, I hate to go to bed but I hate to get up. I desperately want to regain my ability to sleep without assistance. What can I do to sleep--naturally?

Dear Pseudo-sleeper: You'll sleep fine, just like everyone else, if you don't mess it up by trying to make it happen or by worrying about it.

There are some unusual, and often vague, conditions that interfere with sleep, but most of the causes for insomnia are pretty simple. The primary cause is the effect of sleeping pills and potions, which are addictive and bring about withdrawal hyperstimulation at bedtime. Sleeping pills like Valium and related drugs have been shown to help get people to sleep 15 or 20 minutes earlier for the first few days, but after that they do no good, and increasing amounts of harm. They are good muscle relaxants, and so they interfere with the exercise that is necessary for healthy sleeping. Steer clear of them. Alcohol is such an effective depressant, it is likely to let you sleep, and then wake you up four hours later in a state of gloom. I don't know how pot affects sleep since it is hard to tell whether chronic pot smokers are asleep or awake.

The second major cause of insomnia is caffeine, which people who haven't slept well drink to awake them after their restless night in bed. Caffeine is much longer acting than people appreciate, so it could be that the coffee you are drinking in the morning may be keeping you awake at night.

The third major cause of insomnia is anxiety about being able to go to sleep, and you might well feel that without your familiar going-to-sleep ritual, whether it be smoking pot, cleaning the kitchen, or sacrificing live chickens to voodoo gods, you'd be unable to sleep, and thus would get frantic at bedtime.

The fourth major cause of insomnia is depression, but that usually wakes you up during the night rather than keeping you from dozing off. If you are depressed, it is particularly crucial to avoid sleeping pills and alcohol, since both will worsen the depression. However, antidepressants may be in order if insomnia is a major symptom of even relatively mild chronic depressions.

If you really want to sleep naturally, live naturally.

Leave off alcohol, sleeping pills, and caffeine. Leave off the pot, too, though it will be months before you are completely clear of its effects. Without it you will gradually regain your will to do what is in your best interest, rather than what you think will make you feel good right that very minute.

Get some exercise daily--not right before bedtime, but earlier in the day. If you work late at night, exercise heavily in the morning or early afternoon, but get a little exercise--perhaps a short walk--to unwind you after work. That will relax you far better than either alcohol or pot.

Don't try to go to sleep immediately after leaving the stimulation of your work or your exercise. Arrange your sleeping time to fit your working time. You may have to reset your biological dock. Clearly, you are programmed to sleep in the morning rather than at night and that is inconvenient for your schedule. Choose a sensible and practical time to get up, and get up then. You may go through the day feeling sleep-deprived, but you will eventually go to sleep at a sensible hour. Once you are going to bed seven or eight hours before you are scheduled to get up, stick to both your bedtime and your wake-up time.

Make your bed cool and comfortable, dark and quiet. If possible, sleep with someone you like who is on the same schedule as you. Don't use bed for anything except sleep (and sex, which is wonderful for this purpose, whether you are alone or have company for the occasion; most men fall asleep instantly after sex, even when it is considered rude to do so).

There is music conducive to sleep. Bach's "Goldberg Variations" were written for that purpose, but Mozart's assorted serenades work just as well. There is apparently some New Age rainforest music that is guaranteed to put people to sleep, though as a home owner it sounds like termites and leaky faucets to me. Avoid anything you might be tempted to dance to or sing along with, or anything written to keep stoned people awake at concerts.

And, even as you're doing these things, don't think about them. Nobody ever died from insomnia. If you don't sleep for a while, the worst thing that could happen would be that you'd faint and achieve spontaneously the result you are working for so futilely.

Dear Dr. Frank: I've had a burning in my stomach for years. None of my doctors has ever found anything physically wrong; so I've been to psychotherapists three times over the years. The first one told me my problem was caused by too much closeness to my mother. He said I was "enmeshed." He encouraged me to be independent. I moved away from the town where I grew up and have never been back. I do send my mother a card on Mother's Day, but I don't call her, don't tell her anything about my life, and don't let my children see her very often. The pain, however, didn't go away.

I went to another therapist and we mostly talked about my marriage. She never met my husband but kept saying he sounded "just like a man." She told me I seemed to love him too much and was a victim of gender discrimination. I divorced him, and went through a terrible depression, but I was too busy with the problems of my teenaged children to worry about myself for a while.

When the children left home, the pain came back. My most recent therapist told me I must have been molested by my father when I was a baby, before he left my mother. I didn't remember it but something must have happened to explain this burning in my stomach. I sued my father, and he has refused to speak to me for the last few years.

I am alone now. The pain in my stomach is still there and my doctor tells me I should see a therapist. What do you think I should do?

Dear Pain in the Belly. Take Tums.

PHOTO: Dr. Frank Pittman