From a standard textbook of psychiatry*:
Patients with erotomania [a delusional conviction that another person, usually of higher status, is in love with him or her] frequently show certain characteristics: They are generally unattractive women in low-level jobs who lead withdrawn, lonely lives; they are single and have few sexual contacts. They select secret lovers who differ substantially from them. They exhibit what has been called paradoxical conduct, the delusional phenomenon of interpreting all denials of love, no matter how clear, as secret affirmations of love. The course may be chronic, recurrent, or brief. Separation from the love object may be the only satisfactory intervention.
Emphasis mine—and what a painful emphasis that is! Can that get any more pejorative? Not only are these women delusional, but they are also ugly, work crappy jobs, and hide away in tiny apartments all by their lonesome selves.
Good heavens. So much for warmth and empathy.
* Kaplan and Sadock’s Synopsis of Psychiatry, 10th ed. Published in 2007!
The back story behind the previous entry, “Therapeutic“:
- Yes, the account is entirely fictional. (Any resemblance to any person, alive or fictional, is purely coincidental, blah blah blah….)
- I shared brunch with some good friends and colleagues this weekend. One of them mentioned that Dr. Phil (of Oprah and Britney fame) previously engaged in sexual misconduct with a patient and subsequently lost his psychology license. I did not know this. Wikipedia suggests that this may be true.
- I finished Psychoanalytic Diagnosis last year and, upon hearing about Dr. Phil’s alleged escapade, I recalled the chapter on hysterical patients. According to the text, patients with a diagnosis of hysteria behave “seductively” and, in the 1970s, some male therapists fervently believed that sexual intercourse was therapeutic for these patients. Reading this made me recoil with anger. When anger is dressed as a story, it looks better.
- The “long, slender fingers” rotating the coffee cup came from Mr. Burns from The Simpsons. Both are smarmy men.
- The general lack of subject words in the first paragraph reflects a letter I received from another medblogger this weekend: There were absolutely no subject words in his three-sentence e-mail. (To be clear, there is no further parallel between this medblogger and the character. I was just stealing linguistic cadence, that’s all.)
11 Feb 2008 | 5 comments.
Therapeutic.
“She’s twenty-eight years old, unmarried, had an abortion two or three years ago. Feels a lot of guilt about it,” he said, watching the milk create light swirls in his cup of black coffee. “Doesn’t feel like she’s attractive; thinks that men now view her with disdain.”
His colleague lazily loosened the knot of his necktie and unbuttoned the first button of his shirt. “Yeah, go on,” he said.
“Came to therapy looking for improvement in her self-esteem, to not feel so dirty, to feel more confident, regardless of who she is around,” he continued. After taking a sip from the cup, he murmured with satisfaction. “I’ve seen her… I don’t know, maybe for ten sessions. Got a lot of conflict about her identity; on the one hand, she is an adult woman: She’s a copy editor for a well-known magazine. Paid off all of her student loans from college. Lives independently and supports herself. She’s physiologically an adult, you know? And, on the other hand, she believes she’s still an adolescent: She punishes herself for impulsively having sex with this guy and getting pregnant… and then beats herself up for getting that abortion when she was an adult. As if only teenagers get abortions.”
The other fellow, looking out the window, snorted quietly in cynical amusement.
“And so she has doubts that she can handle adult responsibilities—never mind she helps edit this magazine and functions well in her life! She’s not thrilled with her relationships, though, because of this conflict: Is she a girl or is she a woman? Do men expect too much if they believe her to be a woman, when she is really a girl? And if they believe her to be a girl, aren’t they disrespecting her because she is actually a woman? Her sexuality is in a precarious balance,” he continued, slowly rotating the cup with his long, slender fingers.
“So, the work is strengthening her ego so that she can embrace adult responsibilities and fully integrate this abortion experience into her life?” the other fellow asked.
“Part of it, yeah,” the therapist said. “She really doesn’t believe that men find her attractive, even though she is a beautiful woman.” He took another sip of coffee and, after pulling the cup away from his mouth, licked his lips. “She’s gotten some benefit from concrete evidence that men appreciate her adult sexuality. It’s been therapeutic.”
His colleague, perplexed, looked at him. “What do you mean, ‘concrete evidence’?”
“She needs to know that she is an adult woman who can attract adult men because she is an adult. She needs to learn to accept—and tolerate—the responsibility that comes with the power she can have over men. This power is frightening to a little girl and our time together demonstrates to her that, one, she can handle this power and two, she can use it responsibly.”
The other fellow blinked. He opened his mouth to say something, then closed it again.
The two men looked at each other.
“So… you’re sleeping with her in session?” the other fellow finally asked.
“Look—this is her opportunity to develop confidence with me, an adult man. This is her opportunity to learn that she can attract men, that she can behave like an adult and not like a child, that she can move on with her life despite a past mistake. If she is able to engage in a sexual relationship with me, that increases the likelihood that she’ll be able to do the same thing outside of therapy. Her confidence will generalize,” he argued.
“Don’t you have another patient who’s got a similar story?” his colleague asked. “Isn’t she like in her fifties and believes she can’t attract men because she got maimed in a car accident and subsequently gained a lot of weight?”
He cocked his head to the side and impatiently replied, “Oh, no… no. That wouldn’t be therapeutic at all—that woman requires strict boundaries because she needs to learn how to construct her own identity without unnecessary contributions from external forces, such as the car accident.”
He took another sip of coffee.
“That woman absolutely would not benefit from this kind of clinical intervention,” he concluded.
10 Feb 2008 | 8 comments.
This isn’t a Political Blog.
The fervor of the pending Presidential election has reached Washington State. Yesterday, three major candidates (Barack Obama, Hillary Clinton, and John McCain) were in Seattle to court voters. At least one medblogger in the Pacific Northwest was able to get away to see a candidate. (And it clearly wasn’t me.) Today, the precinct caucuses convened. In Washington, the primary election apparently does not apportion delegates to candidates. Delegates are assigned to candidates from the results of the caucuses.
Thus, I attended a caucus today. I’ve never done this before.
Background information: Seattle is a liberal city. I live in one of the most liberal neighborhoods in the city (this area has been labelled “the gay mecca of the Pacific Northwest”; there are several communist bookstores; people just don’t look “conservative” here: lots of tattoos, piercings, hair dye, men in skirts, etc.).
A friend and I—we live one block away from each other and are thus in the same precinct—walked to the local (Democrat) caucus site. Outside were several tables, some plastered with Obama signs, some adorned with Clinton signs. A man was selling tee-shirts that read “Obama is black and I am proud” while he chanted pro-Obama phrases into a megaphone.
Inside the (large) caucus site were hundreds of people filing along the hallways, standing in lines, and crammed into rooms. There were probably a few thousand people there. Most of them were younger (twenties and thirties) and with the requisite ornate tattoos, wildly colored hair, multiple ear and face piercings, hipster messenger bags, boldly patterned scarves and hats, long sideburns, dangly earrings, baggy jeans, artsy buttons on their coats and bags, skinny pants, studded belts, and cups of coffee.
After signing in at the appropriate precinct and writing in the desired candidate, we were directed to a specific room for the purpose of discussion. I apparently also live in one of the biggest precincts… though it is clearly not the most youthful or punky.
The caucus was eventually called to order and the precinct caucus chief (a handsome young man with a dry sense of humor) solicited other people to become the precinct caucus chief (as this fellow apparently did not feel strongly about his job). After the candidates for the chief position identified themselves, the crowd (which probably numbered around 150 or so) voted for a chief… and the vote was indeterminate. In lieu of democracy, there was a coin toss (after a suggestion of “rock paper scissors” was shot down) and the original chief was named as the chief.
Bureaucracy.
The chief then read instructions to orient us to the purpose and mechanics of the caucus. Shortly thereafter, the floor was opened for discussion. The basic rule is that everyone in the room is allowed to speak once for, at most, 60 seconds. (”But you don’t have to,” the chief commented. “There are a lot of people here—you do the math.”)
Banter between Obama and Clinton supporters thus began. (There were no third-party offerings.)
It was cool. Most of the individuals who spoke offered thoughtful opinions about their candidate of choice. The general arguments that came up repeatedly:
People generally like both Obama and Clinton. Their policies do not differ significantly and people are hopeful that, should one become President, the direction of the country will change and circumstances (the war, the economy, etc.) will improve.
Should Clinton become the nominee, Republicans will unify and potentially win the Presidential office. One of the speakers stated that he worked as an intern in the Senate (for a Republican—”you can only work for a Republican Senator when you’re from Alaska”) and commented that the hatred that Senate Republicans have for Clinton is impressive. The conclusion from this argument is that voting for Obama will facilitate a Democratic win.
While I understand this argument, I don’t particularly like it. This is like believing in God simply to avoid the consequence of going to hell, not because of faith. Ideally, people should vote for who they want to be President.
Clinton has experience. The corollary is that Obama does not.
Obama generates enthusiasm and can mobilize people to facilitate change. The corollary is that Clinton, even if she has experience and fantastic policy ideas, lacks the capacity to unite people (”except for Republicans”). Without support, she cannot effect change.
The Obama supporters were clearly more vocal and energetic than the Clinton supporters. The Clinton supporters generally only spoke up to offer a counterpoint to a pro-Obama argument (i.e. more reactive than proactive in their statements). The Obama supporters were also, as a group, younger than the Clinton supporters.
The chief then stopped the discussion and provided opportunities for those undecided individuals to identify themselves. This then made them targets so that pro-Obama and pro-Clinton people could speak to them to influence (persuade, badger, coerce, buy off) their vote to help shift the balance of delegates.
At this point, my friend and I left as (1) no one identified themselves as undecided, (2) we had already submitted our votes when we signed in, and (3) we had already been there for nearly two hours.
So we kinda shirked the democratic process.
I’m glad I went—I enjoyed seeing and hearing people advocate for their candidate of choice, express their hopes and goals for the future, and respectfully demonstrate passion for their beliefs. Democracy on this level looks different (and more genuine) than the democracy that we read on the front pages of newspapers or hear on the radio (remember, I don’t own a television—and not because I’m a hippy socialist who believes entertainment should come only from reading pre-owned books, hugging trees, and eating organic, 100% pesticide free, soy products packaged in 100% recycled plastic… I just don’t own one).
This is an exciting and important Presidential election. Please exercise your civic duty and vote.
9 Feb 2008 | 2 comments.
Link-o-Rama (X).
>> Chinese New Year. Today marks the beginning of the Year of the Rat, which is the “first” animal in the Chinese zodiac (”first” points are difficult to identify in circles). To commemorate this Asian holiday (yellow power and whatnot), today I wore most of the red clothes I own (which doesn’t amount to much), as the color red both encourages good fortune/chases away bad fortune. Upon seeing me, one of my patients remarked, “Wow—you’re not wearing dark colors!” I didn’t realize that my wardrobe consistently absorbed so much light.
>> Nice and Normal Ringtones. Verizon Wireless, in my opinion, does not provide a great variety of ringtones. Sometimes, you just want a simple, unique ringtone that will distinguish your phone from the population of cell phones out in the world. I particularly appreciate the “text alert” ringtones (short and sweet—and thus serve as the standard ring to my phone).
>> United States Running Streak Association. “USRSA RUNNING STREAK DEFINITION: A running streak is defined by USRSA as running at least one continuous mile within each calendar day under one’s own body power (without the utilization of any type of health or mechanical aid other than prosthetic devices).” I do not qualify for the USRSA. However, I am trailing just behind a pace bunny and have run over 58 miles in 2008.
>> French Quarter Phantoms. I have the good fortune of going to New Orleans in March. I’ve never been to the South. I have also never eaten beignets or jambalaya, tasted coffee with chicory, or visited a mausoleum. In a city that is renowned for jazz music, there is indeed a lindy hop scene, though I am doubtful that I shall have the opportunity step onto a dance floor during my visit.
7 Feb 2008 | 3 comments.
Dancing and Falling.
I recently fell while dancing.
This is a rare occurrence for those of us who lindy hop without aerials (i.e. where someone is tossed into the air).
I’m not really sure what happened. It wasn’t the guy’s fault; he’s a reliable and skilled lead. We had generated a fair amount of angular momentum (…) and suddenly, I realized that my feet were no longer under me. I slid forward and felt my center of gravity approaching the floor. The lead had let go of my hand at that point and we both watched me land squarely on my butt.
We did not move…
… the other couples on the dance floor maneuvered around us…
… I looked up…
… I saw him looking down at me.
Realizing what had happened, I extended my arms up. He quickly grasped them both with his hands and helped me back onto my feet. He graciously led some stationary, low energy moves.
“Are you okay?” he asked a few bars later.
“Yes—I’m totally fine,” I honestly replied. Had my face not already been flushed from warmth, the blush of embarrassment would have colored my cheeks. We said nothing else for the remainder of the dance, though he was clearly leading with less exuberance and I was following with more caution. He still indulged in a dip at the conclusion of the song, which could have been a risky move—follows can “refuse” the dip (in varying degrees), particularly with leads they do not fully trust, for fears of being dropped.
(That’s happened to me, too.)
We all fall down at some point. Sometimes, we must claim responsibility ourselves; perhaps we knowingly wore slick-soled shoes on a notoriously slippery floor. Sometimes, our dancing partners erroneously think we are at Point A when we are actually at Point B, resulting in mismatched momentum. And sometimes, it has nothing to do with us and everything to do with the floor: An errant nail may be poking out of the floorboards and when one trips, the other follows.
When we fall, though, we do not simply slink off of the dance floor on our hands and knees. Nor do we abandon our dance partners for the remainder of the song. We get back up, find the rhythm, and continue to move together. Sometimes it takes time to reestablish a comfortable connection; sometimes both partners experience the event as awkward and both lead and follow are unsure of how to proceed; sometimes the fall only induces good-natured laughter and, building upon that experience, both dancers feel less inhibition in creating novel moves.
In dancing, there are the risks of falling, injury, and the resulting embarrassment.
In dancing, there are also the rewards of joy and trust that comes from creating and maintaining movement with another person.
Do you dance?
5 Feb 2008 | 9 comments.