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A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

Becoming A Published Author

The process of gaining a book contract is different for every author and luck plays a role. I had just left a long-term hospital job and was at loose ends. My first thought was to write a research paper, then to write a book though the only thing I had written to that point was an essay on love which was published in my college's newspaper and a two-hundred-fifty page doctoral dissertation. But being completely ignorant of the publishing industry I trudged on, writing a one-page outline of my proposed book and its first three pages. Which I sent to the marketing director of Simon and Schuster or Doubleday, I no longer remember which, gaining their name from the phone directory (remember those?).


A month later I received an apologetic reply from him, stating that he had been traveling across the country and so been delayed in responding. He said they weren't interested in publishing my proposed book since they wouldn't know how to market it but if I wanted to write more stories like the one I enclosed they would be interested.


Feeling insulted by his delay in responding (like I said, I knew nothing about publishing) I ignored his letter. Two weeks later I was walking with a girl-friend in a Manhattan park where we met a couple she knew. The man had a degree in English from Columbia College and wrote travel articles and small pamphlets like those found in supermarkets ("Do You Know Your Wife?" etc). The only thing I knew about publishing is that one needed a lawyer to negotiate a contract, which I optimistically assumed I would get. I asked him if he knew one, he gave me her name and she who turned out to be a major figure in the publishing industry, partner in a large law firm, the past lawyer of a historic Hollywood screenwriter/novelist, and (I later read) is mentioned in the last volume of William Shirer's autobiography.


I phoned her, she asked to see the three pages I wrote, I sent it to her, she became my agent, and within two weeks I had an agent, a publisher, an editor, and a contract that required me to complete the book in a year. Terrified of failure, I completed the book in six months, it was published a year later ("Troubled Children/Troubled Parents: The Way Out") and my agent sent me the rave reviews including one from Publishers Weekly ("outstanding").

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Bats In The Hospital

A sad article in The Wall Street Journal ("A Bat Infestation, Postponed Surgeries and Unpaid Bills: A Hospital Chain in Crisis - March 20, 2024) sounds like the script for a horror movie for which my following scene is suggested. Doctor tells patient: "That bite on your neck is NOT from a vampire bat but from one of our common hospital bats. The FDA-approved Garlic Wreath pinned to your gown provides 94% protection against mortal or immortal wounding so do not fret. You and your husband will become accustomed to its odor and may even find it erotic. This is why its commercial name is 'Ordasm.'"

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The Annual Medical Exam

An article in The Wall Street Journal ("The Case Against an Annual Physical"/Feb. 19, 2024) aroused several thoughts.

The basic problem is that many illness are caused by lifestyle issues that doctors are loathe to address and patients are loathe to hear and usually ignore. A nurse told me that 90% of the patients in her hospital were over 300lbs. and ignored medical advice about diet. Another basic problem is that doctors are paid by procedure and not giving advice so which do you expect gains priority?


Having fortunately been healthy, I once told a physician that I didn't think I could get a chronic illness and she responded, "That's a good delusion. Keep it," which is true. But invasive unneeded tests can be dangerous. Read, "Should I Be Tested For Cancer? Maybe Not And Here's Why" by H. Gilbert Welch, M.D., M.P.H. A noted book that I bought five copies for relatives.


The skill of a doctor is critical too. I've Twittered that Americans are in far greater danger of being killed by their family doctor than a terrorist. One more thing: drug companies tend to exaggerate the purported benefits and downplay the potential side-effects of their wares. Nuff said.

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A Very Christmas Tale

In the era before cellphones, driving in a St. Louis suburb, my car got stuck on a road's divider while making a left turn. It was in early morning with no help or cars to be seen. A car finally appeared and stopped opposite mine. It held four huge guys and I regretted leaving my pistol at home. The driver came over and asked what happened. "My car's stuck," I said fearfully. After briefly speaking to his companions they came to my car, picked it up, and moved it back onto the road. I wanted to pay the driver but he refused. "There's a revival meeting at St. Louis Field tomorrow night. Come," he said. Then, without another word, my four angels drove off, vanishing into the night.

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Psychology's Absence In Discussion of The Sam Bankman-Fried Case

An article in The Wall Street Journal ("Why Are We So Obsessed with Sam Bankman-Fried's Parents?"/November 10, 2023) aroused several thoughts since, like many articles concerning him, it ignored the emotional problems involved. Apparently Sam had serious psychological issues during childhood which were treated with drugs rather than psychotherapy following his (widely reported) diagnosis with the long popular but unsophisticated notion of Attention-Deficit/Hyperactivity Disorder (ADHD). The early twentieth-century precursor of this diagnosis in America was "Minimal Brain Dysfunction" (MBD) of which a Harvard psychiatrist then remarked that only a doctor with a minimal brain dysfunction would use it. The symptoms of ADHD are identical to anxiety and depression which are present in virtually all medical and psychological disturbances. Thus it tells you nothing about the underlying cause of a chlld's suffering.

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The Child Mental Health Crisis in Hospitals

A November 8, 2023 article in The Wall Street Journal ("Children in Mental-Health Crisis Surge Into Hospital E.R.s") aroused several thoughts on why the crisis in child mental health treatment exists: the lack of public and doctor knowledge of child psychological development; psychiatry's false biological/genetic bias rather than the critical role played by parent-child interaction during early life when the basic ego capacities governing control of thinking and behavior, modulation of mood, and others develop; and the emphasis on psychotropic drugs with exaggerated benefits and downplayed side-effects. All leading to inaccurate and potentially harmful Emergency Room decisions and excess hospitalizations.

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Cannabis, Anxiety, and You

An October 26, 2023 article in The Wall Street Journal ("The Cannabis That People Are Using for Anxiety Is Probably Making It Worse") described the dangers of cannabis use despite its current widespread marketing as a benign treatment for anxiety and other ills. Living in a culture where rapid change is expected, it should not be surprising that many turn to the alleged benefits of drugs, legal and otherwise. This, despite historical awareness that the benefits of drugs tend to be vastly exaggerated and their side-effects downplayed.

Anxiety is a greatly treatable condition with drug-free psychotherapy since it is an identical normal healthy reaction to actual external and unconscious internal threats. Thus an adult whose parents discouraged feelings will feel threatened when experiencing love, and with the same pain as when a thug with murderous intent approaches. Similarly, Panic Disorder is the misinterpretation of normal anxiety symptoms with the same physiological reaction as the deadly medical danger it is believed to be.

The unconscious is very powerful and one must respect its power. Sadly, many psychiatrists and other medical practitioners have become mere pill-pushers rather than thoughtful assessors.

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Missing Appointments During Psychotherapy

Central to psychotherapy is the concept that behaviors can have symbolic, often unconscious motives. For example, a potentially dangerous road rage action can indicate both annoyance at another's driving but also anger from another situation: a workplace happening, an interaction in a relationship, or a lingering emotion from childhood.
Thus, missing several psychotherapy sessions without reasonable cause (illness, hazardous driving weather, death in the family), especially if the therapist isn't notified but left waiting, can reflect diminished interest in treatment, be an indirect expression of anger, or indicate excessive narcissism, the feeling that the world revolves about them.
 The therapist then has two choices: to accept that, in their patient's current level of emotional development, they cannot behave differently; or, if excessive, to end treatment. It is not unreasonable to expect simple courtesy from all.

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The Limits of Adult Personality Change Through Psychotherapy

Even with the best medical treatment the survivor of a serious medical condition is rarely as healthy as before their affliction overcame them. Similarly, while psychotherapy can effect profound improvement of behavior and capacities, a patient will never be as well developed emotionally as if they had experienced a "good-enough" parenting during their formative years.
Their healing can never be total since early life experience is the bedrock of the adult personality and the unconscious is powerful. Yet there are healing events outside therapy too: nurturance from a loving spouse; and helping others and identifying with them, as can happen with parents and health workers, creating interactions which foster the emotional growth of both
Having regrets, feeling guilt for past mistakes is part of the human experience and cannot be avoided when living a thoughtful life.

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Autism is Vastly Misdiagnosed

An August 31, 2023 article in The Wall Street Journal ("My Son Sam Doesn't Need Special Ed - His autism demanded it, experts said.") aroused several thoughts. My first book, Troubled Children/Troubled Parents, the first chapter can be read on my website, included my lengthy treatment of an accurately diagnosed autistic child. The current frequent misdiagnoses are caused by widespread inadequate understanding of child psychological problems by school personnel and doctors. To treat an autistic child the therapist must enter their personal world, which is their protective shell but can be relinquished with proper treatment. The belief they are uncommunicative is false and as erroneous as relating to them with behavioral modification (reward-punishment) methods. These children do communicate but in their way. With rare exception, schools do a poor to disastrous job of interacting with or advising parents about their troubled children.


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