Published ten years ago. slightly less true now, but still pretty good.
Oppositional treatment design is remarkably accurate in an acute
psychiatric setting. If you want to sleep, we want you to get up. If
you want to be up, we want you to sleep. If you want meds, you probably
shouldn’t have them, but if you don’t want them they are likely to be
exactly what you need. If you want to leave, we make you stay. If you
want to stay, we make you leave. If you’re blaming yourself, you should
stop that. If you’re blaming others, you should start blaming
yourself. It’s not as stupid or mean as it sounds. People usually
come to the hospital because of a particular point of contention with
the usual flow of life. That inability or refusal to change is usually
the central difficulty getting along in the world.
Monday, May 2, 2016
Different Holocaust Up Close
Visitors to Auschwitz and other Holocaust memorials are often moved to tears by the shoes, or other homely items of the victims. Perhaps because of advance preparation, such things don’t move me as much. What has tightened my throat and brought tears to my eyes are the things which took me by surprise: At
the Museum of Terror in Budapest, the focus was on the persecution that
was absorbed by Hungarians in general by the Germans and the Soviets. In most exhibits, the Jews were neither excluded nor singled out. But
in one film, a man was speaking about the horrors taking place in his
neighborhood, to his friends and own family and suddenly bursts into
tears “Why did they have to do that to the Jews? They took them away and killed them.” The word “Jews” was not an abstraction to this man. The word conjured up memories of actual individuals he had known and cared about.
Speaking with an elderly man in Romania, I asked where the synagogue had been. He couldn’t remember exactly, only that it had been on a side street. He remembered that a few Jews had come back after the war, but sold the synagogue because there were not enough of them. They left for parts unknown. It was bad for everyone, he thought. People wondered whether their families would be taken and killed. More of the Jews were killed, he believed. This struck me as a little distant and unsympathetic. In the West, we regard the Holocaust as one of the pivotal events of the 20th C, debating whether anything can be compared to it. We can afford to do that because we have some distance. To those up close, there is plenty to compare it to: the death of your own wife or son at the same hands. Seeing through this gentile's eyes made the Jewish loss suddenly larger, not smaller. I had now more fully understood the fear and loss of losing a tenth of one’s family to cruel men. From there I could better understand the loss of nine-tenths, which had been unreal before that.
When reading about the Ukrainian soldiers who were given the duty of executing many Jews -- how it was considered a bad job, a difficult job, a draining job, I held the soldiers’ difficulty of no account. They were victimizing, not victims. But in one account a man who had killed several hundred had a sudden apprehension of the next victim, a child, as a real human being, and it shattered him. Reading the story made the single child real for me as well. One death is a tragedy. A thousand deaths is a statistic
Speaking with an elderly man in Romania, I asked where the synagogue had been. He couldn’t remember exactly, only that it had been on a side street. He remembered that a few Jews had come back after the war, but sold the synagogue because there were not enough of them. They left for parts unknown. It was bad for everyone, he thought. People wondered whether their families would be taken and killed. More of the Jews were killed, he believed. This struck me as a little distant and unsympathetic. In the West, we regard the Holocaust as one of the pivotal events of the 20th C, debating whether anything can be compared to it. We can afford to do that because we have some distance. To those up close, there is plenty to compare it to: the death of your own wife or son at the same hands. Seeing through this gentile's eyes made the Jewish loss suddenly larger, not smaller. I had now more fully understood the fear and loss of losing a tenth of one’s family to cruel men. From there I could better understand the loss of nine-tenths, which had been unreal before that.
When reading about the Ukrainian soldiers who were given the duty of executing many Jews -- how it was considered a bad job, a difficult job, a draining job, I held the soldiers’ difficulty of no account. They were victimizing, not victims. But in one account a man who had killed several hundred had a sudden apprehension of the next victim, a child, as a real human being, and it shattered him. Reading the story made the single child real for me as well. One death is a tragedy. A thousand deaths is a statistic
Underground DSM-IV (Not) Going to Rehab
Published ten years ago. Still valid.
It is not a good sign for someone to use the words "whatever it takes," when describing their readiness to stop using. You would think that is precisely the attitude you would want a user to take, but somehow that particular phrase is a red flag. It will be replaced in 24-48 hours by some hedging about how this rehab thing is going to play out in practical reality.
There is the Goldilocks version of this growing avoidance: That rehab is too far. That rehab is too near. No rehab is just right.
For 80"s rockers, there is the Meatloaf version: "I would do anything for rehab," said with firmness and intensity on Monday morning. "But I won't do that," said Tuesday afternoon. It would be one thing if these were people who were suspicious whether rehab does much good, as I am. But this is from the rehab-immersed culture, with spouses, siblings, and friends all familiar with the various advantages and disadvantages of each program.
Believe it or not, wearing clothing with a beer logo on it to your rehab interview is often interpreted by others as an indication that you're not serious. Imagine that.
If someone claims to be clean but has a positive blood or urine sample, multiply the amount they eventually acknowledge using times six to get a more accurate picture.
Ask specifically about marijuana, as many users pretend that's not really a drug.
Heavy drinkers tend not to wear their seat belts when sober, but might wear them when drunk. I don't fully understand this, but there may be some balance of risk involved. Notice that other people's risk does not factor into the equation.
It is not a good sign for someone to use the words "whatever it takes," when describing their readiness to stop using. You would think that is precisely the attitude you would want a user to take, but somehow that particular phrase is a red flag. It will be replaced in 24-48 hours by some hedging about how this rehab thing is going to play out in practical reality.
There is the Goldilocks version of this growing avoidance: That rehab is too far. That rehab is too near. No rehab is just right.
For 80"s rockers, there is the Meatloaf version: "I would do anything for rehab," said with firmness and intensity on Monday morning. "But I won't do that," said Tuesday afternoon. It would be one thing if these were people who were suspicious whether rehab does much good, as I am. But this is from the rehab-immersed culture, with spouses, siblings, and friends all familiar with the various advantages and disadvantages of each program.
Believe it or not, wearing clothing with a beer logo on it to your rehab interview is often interpreted by others as an indication that you're not serious. Imagine that.
If someone claims to be clean but has a positive blood or urine sample, multiply the amount they eventually acknowledge using times six to get a more accurate picture.
Ask specifically about marijuana, as many users pretend that's not really a drug.
Heavy drinkers tend not to wear their seat belts when sober, but might wear them when drunk. I don't fully understand this, but there may be some balance of risk involved. Notice that other people's risk does not factor into the equation.
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