Dr. Dabneys Blog

Dr. Dabney’s Blog
Dr. Dabney’s Blog


Analyzing Robin Williams

Everyone is asking me about it.  One person offered to pay me for it. 
I’ve never seen this much interest in any one topic.  Not 9-11.  Not the death of megastar Prince.  Not the election of the first African American president of the U.S.
So, here it is:  My analysis of Robin Williams’s suicide.

Suicide is a tangle of many strands. 
But let’s start with sad.  It’s the first and most obvious strand.  Ironically, suicide involves the inability to express sad.
It’s not a stretch to say Mr. Williams was manic. One part of mania is relentless humor.  Funny is a defense against sad.  Truism: you can’t be happy and sad at the same time. 
Busy-ness is another part of mania.  If your brain is crammed with facts (scripts?), there is no room for feeling.  Another truism: your brain can’t process facts and feeling at the same time.  (This is why successful meditation depends on chanting words devoid of feeling such as om). 
Williams numbed his mind with drugs and alcohol.  And yet another truism: you can’t be numb and feel at the same time. 
Robin Williams had all these defenses in spades. You could say Mr. Williams was sprinting from sadness.
And not just sadness. The second strand, less obviously, is anger.  But like sadness, the suicidal person has difficulty expressing anger.
So what’s so bad about expressing anger and sadness?  The reasons usually involve a sense that sadness is weak.  Maybe babyish or childish.  And excessive guilt causes people to stuff anger.  Some people fear that if they let the sadness and anger out, ­­­they will be seen as a negative (or bad) person and drive loved ones away. 
Suicide involves a lack of control which is the third strand.  Many more people think of suicide than do it.  The difference: impaired impulse control.  In Mr. William’s case this is evident in his overuse of alcohol and drugs, relentless chatter and prolificacy.
The fourth strand is self-punishment.  The suicidal person sees sadness, anger and poor impulse control = negative, mean and dangerous and concludes they deserve to be punished.

Four strands make the rope.
Why didn’t he get help?  Getting help means facing and expressing the “forbidden” emotions.
Why did he wait until he was in his 60’s?  Suicide is most common in the elderly.  In Mr. William’s case, he had been sober, had an impending infirmity (Parkinson’s) and work was harder to come by.   Life may have been intolerable without his primary defenses:  alcohol, busy-ness and scripts to memorize.
Why didn’t any of his friends or family help?  The suicidal person’s defenses disguise their distress from themselves and, typically, everyone. 
Of course, this is all conjecture; I have never met Robin Williams.  I wish I had. I have simply applied the common suicide dynamics to the public facts.  A sad exercise.  But one that might help generate awareness.  And perhaps save a life.  I fantasize about approval from John Keating, my favorite William’s character.
 
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Topics : Social Issues
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People : John KeatingPrinceRobin Williams




 

The Five Rs to Take You from Stepmonster to Stepmom (or Dad!) Plus One C to A

Summer.  No school, less work, more family time.  In today’s world that often means dealing with ex’s and step’s and all that blended families have to offer.  Step-parents frequently complain of difficulty connecting with their new charges.  Rightfully so.  Giving birth to and caring for a baby gives you years of closeness and trust that help the relationship survive the disciplining years.  It’s an annuity step-parents don’t have. So what can you do when your new husband’s sixteen year old darling shows up on your doorstep for a summer stay?  Before you lay down the law, follow these steps: 

1. Relate to the kid.  You don’t have a history with your stepchild, so make one.  Do your best to take an interest in something they like.  Does your stepson glue himself to Chopped and Triple D?  Sign both of you up for cooking classes.  Does your stepdaughter read book after book on marine life?  It may be time to try that new zip line at the Virginia Beach Aquarium. Try to have some empathy.  They’re probably as uncomfortable as you are.

2. Reach out to the biological parent.  If a behavior becomes a problem, don’t tackle it alone.  The father may have a unique perspective on the behavior.  Remember, the biological parent knows the child best.  Address any issues with the child together.  Better yet, have the biological parent do the talking.  Coming across as a team will boost your credibility and chances of getting heard. 
3. Reason behind the rule. Your stepchild doesn’t know you either. Make the extra effort to explain why their behavior is a problem for you. “When you come home at three in the morning, it wakes me up and then I’m tired and ineffective at my job the next day.”   This helps the stepchild understand you, but also invites him to solve the problem WITH you. 
4. Revisit. After explaining your position and before making a rule, see if the stepchild makes adjustments herself.  “If you can come in quietly, then maybe we don't have to set a curfew.” This helps build trust between you.
5. Rule. Keep in mind, no one likes rules.  The older the child, the more true this is.  But, if the disruptive behavior continues then, by all means, set a rule.  But also give a promise to revisit it if the behavior improves, “you’ve done a good job turning the TV off at 5:00 every day this week, so I’m going to lift the rule and see if you can monitor yourself from now on.”
6. Don’t Compare your stepchild with your own child.  All new relationships take time and communication to develop.  You wouldn’t expect a new friendship to be the same as a lifelong one so don’t set you and your stepchild up for a huge disappointment.  Your daughter might snap to when you ask her to do something.  Your stepchild might need to see you teamed with Dad along with more relating and reasoning before complying with a request to change.
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Locations : Virginia
People : Remember




 

Disabling the Enablers

Enablers aren’t just for alcoholics and drug addicts anymore.  Enablers are people who find ways for those with any bad habit to avoid the negative consequences of their actions. So for instance, someone who has difficulty getting out of bed may have a coworker cover for their lateness with the boss. This helps them keep their job for the moment, but at a cost.
Enablers tend to be nice people --to a fault.  They see their enabling as being a “good friend” or doing “a favor.”  But when the one being helped continues to act irresponsibly and avoid consequences, the difference between an honest favor and enabling becomes evident.
Enablers often continue to enable bad behavior again and again because they use a set of emotional beliefs instead of logic.  These beliefs include:
 “If I don’t ‘help,’ then I’m a bad person.”  Which is another way of saying guilt.  Certainly the one asking for the ‘favor’ often plays on and exploits the guilt. Most of us get enjoyment from helping others which can make it hard to say “no.”
“Something bad will happen, they might die!” Often, the one asking for help will paint a dire picture which can be far from reality. Of course, if the threat is truly life-or-death, then helping is just that: helping. But if dire crises seem to pop up for someone at every turn, then that’s a clue that enabling might be occurring.
“But I’ve already invested so much.”  Sometimes, when someone has helped someone once, twice, or several times, they may start catching on to the idea that the helping isn’t so helpful. Mere habit, or the false idea that this is a healthy relationship, can become the enemy. The enabler may start to believe “well, I’ve come this far; I can’t stop now,” or “how will it look if I stop now?”
“They can’t fix this without me.”  An exit strategy for an enabler is to realize that someone else might be better for the job. But what if the hapless friend really can’t meet their responsibilities? A good test to separate helping from enabling is for the enabler to ask himself, “is what I’m about to do helping someone become more competent, or is it preventing them from learning and growing?”

New beliefs to prevent enabling:

“They need to learn from their mistakes.”  Not all helping is truly helpful. Most people learn through consequences.  Negative consequences usually follow bad decisions. Forgetting to pay the water bill leads to empty taps. Taking away negative consequences robs people of the chance to learn that what they did is wrong which will then motivate and support change.

“There’s only so much one person can do.” If we’re honest with ourselves, and utilize humility, we are limited in our time and resources. Most of them are already spoken for. When we rescue someone it is often at the expense of ourselves.  Before pledging to help someone who may or may not deserve it, consider other commitments to avoid rushing into anything.

“Would other help be better?” Just because someone asks you for help does not automatically make it the best option. Depending on the type of crisis, perhaps a doctor, therapist, plumber or financial planner might be more suited to the problem.  Irresponsible people will try to pin you down with over-the-top pleas.  Don’t get sucked in. There’s a good chance they’re turning to you because others have seen through the ruse and have turned them down.

Learning to spot the difference between enabling and helping benefits the enabler, the one with the habit/problem and their relationship.
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Why Doesn't My Therapist Talk?


Why Doesn't My Therapist Talk?
 

A silent therapist can make even the toughest among us squirm.  This discomfort occurs when a patient expects a therapy session to follow the social norm.  That is, you talk and then I talk.  In fact, in a typical social setting, it is a faux pas to hog the conversation.  But therapy is NOT a social encounter.  In fact, there is nothing social about it.  It is a patient-doctor relationship. This means one person has a problem and one person has a solution.  The burden is on the patient to say whatever comes to mind about the problem while the doctor/therapist listens for clues on how to solve it.

A conversation going nowhere in a social setting can mean one party is preoccupied, disinterested or simply out of sync with the other person.  In therapy, silence means something else entirely. In short, it provides a wealth of information.

Silence gives a therapist just as much information as words.  When the silence occurs, how the patient breaks the silence, what the patient is thinking about during the silence and how the silence is broken all give the therapist a better understanding of the patient.

As stated earlier, most patients feel awkward when silence ensues. This awkwardness is another word for stress.  Zipping it, therefore, gives the therapist a ringside view as to how a patient handles stress. Does the patient rush to fill the silence, does he get angry with the therapist, does he become silent himself?  An astute therapist will watch this play out then put it together for the patient.  “I noticed you got anxious when there was a silence between us.”  The patient may respond, “Yeah.  Silence always reminds me of when my dad would take off in his car after an argument with my mother.” Now, we have a gem, a new piece of information to focus on that might never have been discovered had we filled the silence with banalities about the weather.

In a similar vein, silence allows a patient to recreate his relationships in the office. This isn’t possible if the therapist is a chatty-cathy.  Her silence allows the patient to make her into whatever character he unconsciously wishes.  The therapist becomes the withholding mother or the distant father or the dead grandparent.   Again, the astute therapist will point it out, pursue it and learn from it.

Further, if the therapist talks it breaks the patient’s train of thought.  Let’s say the patient is talking about a problem with his mother (yes, the stereotypical mother problem).  If the therapist were to chime in and change the course of the conversation, “hey, if you think your mom was bad listen to what my mom did!” The information the patient was trying to parlay would be lost.  Maybe he was going to reveal abuse or another trauma, the opportunity is lost, maybe, regrettably, forever.

So, when your therapist appears “too quiet” understand that she is thinking, watching and listening on your behalf.   He is not making out a grocery list, thinking about his fantasy football team or bored.  Inevitably, there are stories about the rare therapist who has somehow missed this lesson.  They treat the therapy session as a tea party or worse, a therapy session for themselves.  In one spectacularly unbelievable story a patient told me that, while crying about a painful experience, his therapist suddenly asked him where he’d bought his tie!  In a mind-numbing twist of events some therapists act as if they are the patient.  This would be like a surgeon handing a man with acute appendicitis the scalpel and saying “hey buddy, can you stop complaining for a minute and get that little mole off my back there like a good sport?”  What a horrible dilemma! Most patients want to oblige their doctors but they also have an underlying sense of how terribly wrong this is.   There may be a temporary relief that therapy is imitating the social situation but, most patients eventually see this for what it truly is, an abuse of power.

So, remember, silence in session can reveal valuable information.  It’s our equivalent of an xray or blood test.  We can now see what’s going on inside of you.  And, you deserve a therapist who can hold his tongue, is more interested in your problems than theirs and understands that treatment goes in only one direction.   If you want to chit-chat head to a happy hour.  If you want treatment, embrace the therapist who can embrace the awkward silence.

- See more at: http://drldabney.com/why-doesnt-my-therapist-talk-or-embracing-the-silence/#sthash.MRBL4P81.dpuf
A silent therapist can make even the toughest among us squirm.  This discomfort occurs when a patient expects a therapy session to follow the social norm.  That is, you talk and then I talk.  In fact, in a typical social setting, it is a faux pas to hog the conversation.  But therapy is NOT a social encounter.  In fact, there is nothing social about it.  It is a patient-doctor relationship. This means one person has a problem and one person has a solution.  The burden is on the patient to say whatever comes to mind about the problem while the doctor/therapist listens for clues on how to solve it.

A conversation going nowhere in a social setting can mean one party is preoccupied, disinterested or simply out of sync with the other person.  In therapy, silence means something else entirely. In short, it provides a wealth of information.

Silence gives a therapist just as much information as words.  When the silence occurs, how the patient breaks the silence, what the patient is thinking about during the silence and how the silence is broken all give the therapist a better understanding of the patient.

As stated earlier, most patients feel awkward when silence ensues. This awkwardness is another word for stress.  Zipping it, therefore, gives the therapist a ringside view as to how a patient handles stress. Does the patient rush to fill the silence, does he get angry with the therapist, does he become silent himself?  An astute therapist will watch this play out then put it together for the patient.  “I noticed you got anxious when there was a silence between us.”  The patient may respond, “Yeah.  Silence always reminds me of when my dad would take off in his car after an argument with my mother.” Now, we have a gem, a new piece of information to focus on that might never have been discovered had we filled the silence with banalities about the weather.

In a similar vein, silence allows a patient to recreate his relationships in the office. This isn’t possible if the therapist is a chatty-cathy.  Her silence allows the patient to make her into whatever character he unconsciously wishes.  The therapist becomes the withholding mother or the distant father or the dead grandparent.   Again, the astute therapist will point it out, pursue it and learn from it.

Further, if the therapist talks it breaks the patient’s train of thought.  Let’s say the patient is talking about a problem with his mother (yes, the stereotypical mother problem).  If the therapist were to chime in and change the course of the conversation, “hey, if you think your mom was bad listen to what my mom did!” The information the patient was trying to parlay would be lost.  Maybe he was going to reveal abuse or another trauma, the opportunity is lost, maybe, regrettably, forever.

So, when your therapist appears “too quiet” understand that she is thinking, watching and listening on your behalf.   He is not making out a grocery list, thinking about his fantasy football team or bored.  Inevitably, there are stories about the rare therapist who has somehow missed this lesson.  They treat the therapy session as a tea party or worse, a therapy session for themselves.  In one spectacularly unbelievable story a patient told me that, while crying about a painful experience, his therapist suddenly asked him where he’d bought his tie!  In a mind-numbing twist of events some therapists act as if they are the patient.  This would be like a surgeon handing a man with acute appendicitis the scalpel and saying “hey buddy, can you stop complaining for a minute and get that little mole off my back there like a good sport?”  What a horrible dilemma! Most patients want to oblige their doctors but they also have an underlying sense of how terribly wrong this is.   There may be a temporary relief that therapy is imitating the social situation but, most patients eventually see this for what it truly is, an abuse of power.

So, remember, silence in session can reveal valuable information.  It’s our equivalent of an xray or blood test.  We can now see what’s going on inside of you.  And, you deserve a therapist who can hold his tongue, is more interested in your problems than theirs and understands that treatment goes in only one direction.   If you want to chit-chat head to a happy hour.  If you want treatment, embrace the therapist who can embrace the awkward silence.
Why Doesn’t My Therapist Talk? (or Embracing the Silence)
- See more at: http://drldabney.com/why-doesnt-my-therapist-talk-or-embracing-the-silence/#sthash.MRBL4P81.dpuf
Why Doesn’t My Therapist Talk? (or Embracing the Silence)
- See more at: http://drldabney.com/why-doesnt-my-therapist-talk-or-embracing-the-silence/#sthash.MRBL4P81.dpuf
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Topics : Health_Medical_Pharma
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So Confused

"Chuck and WooWoo, Help! Me out I think this guy is really trying to play me but Im trying to give him a chance. I met him over twenty years ago and then we lost touch. Last year, we met up again and he told me that he had always been attracted to me but I was always dating other guys and wasnt into him. So we started talking on the phone. We never went on an actual date, but I did go to his home he cooked dinner once and then we started having a sexual relationship. After I figured out that all he wanted was sex, I stopped calling him and taking his calls. Now we are talking on the phone again and have made like 3 plans to go on real dates, but something always comes up and he cancels!! I dont get it. Its like he doesnt want an actual relationship with conversation and dinner dates and trips to the movies he just wants to get me in bed. Why do you think he keeps canceling? Should I just accept that he only wants sex and move on or should I try to figure out his issues?!? So confused."
 
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WHY SELF HELP BOOKS DON’T HELP.

How long have you been reading self-help books? One year? Two? Five?!

And are you successful yet? Are you where you want to be in your life? Or are you still going around in circles unable to break away from the anxiety or depression that is ruining your life?

It’s frustrating isn’t it? The self-help books make it sound so easy. Simply smile, breathe, be in the moment.

You do these things while realizing how hard it is to do these things. Your husband is criticizing you again: SMILE. The doctor said your mother has Alzheimer’s: BREATHE. The ex-boyfriend is getting married to your former best friend: BE IN THE MOMENT.

Your own miserable reality keeps getting in the way. On some level you realize that if it were as easy as smile, breathe and be in the moment no one would ever feel depressed or anxious. It’s a vicious circle. The self-help books have to make curing anxiety and depression sound easy or they won’t sell books. Just as you’re realizing it’s not helping, you get lured into another author’s promise of an easy fix. Another version of smile, breathe, be in the moment. Which is simply code for: just forget about it.

As well-meaning as these authors might be, the technique of just forgetting about something like anxiety and depression is no use to the person so consumed by frustration, fear and anger that they can barely function on a daily basis. This comes down to the reality that anxiety and depression are not simple or easy to cure.

The people who most need help are often those in the most desperate circumstances. They feel closed off, entrenched, hemmed in, trapped, lost, scared, uncertain, hopeless, helpless. I’m going to go out on a limb and guess that they have already tried to forget about it. Telling anyone that the solution to their problems is to smile, breathe and be in the moment can actually be insulting.

The Disconnect

I suspect there are legions of people who feel disconnected from much of the self-development wisdom found in books and floating around the web. In order to sell an idea of eternal happiness, the authors have to make their ideas sound simple to adopt. But, in my experience, this is never the case.

Changing your mood is about changing the way you think. And that’s going to take a while. If you’ve spent thirty-five years as a pessimist or a worrier you cannot expect to become an optimist by the end of the book. Or the end of the week. Or the end of several months.

Ironically, packaging the self-help game as simple ideas that are simple to adopt can lead to more self-flagellation. I failed the self-help game! I often wonder how many people’s lives have been made worse because they read self-help books. It’s not your fault. Words on a page can’t help you because words on a page can’t understand you.

So what’s the answer?

The answer is exactly the opposite of what the self-help books peddle. Instead of covering up your feelings with a self-help chant, immerse yourself in the feeling. Depression and anxiety are like a smoke alarm. They are telling you something you need to know but are afraid to see.

This is where it gets tricky. In order to cure your depression and anxiety you have to understand it. But it’s painful to sit with depression or anxiety! That’s where a therapist comes in. A therapist gives you the space, attention and encouragement to examine those difficult emotions even when, and especially if, you don’t want to.

The key here is this: a problem can’t be resolved until it is understood. No architect would fix a building with a crack in the mortar until the painful truth about what went wrong was investigated. Airlines listen to the black box recordings not because it’s fun to hear those pilots’ last words, but in order to understand exactly what went wrong so it can be repaired. Surgeons don’t cut you open the moment you complain of a belly ache, they run tests, look at x-rays and consult with other experts to fully understand the problem before they attempt to fix it. And that’s the main failing of the self-help books. They can’t understand you because they can’t hear you.

It boils down to this.

Self-help books are a one way street. That can be great for encouragement, advice and cheer-leading. But to fix a problem like anxiety or depression it needs to be understood. And to be understood, one needs to be heard.
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