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Author William Styron (Sophieâs Choice) talks about his struggles with depression, which he chronicled painfully and brilliantly in his 1990 memoir, Darkness Visible.Â
"Letâs face it. Weâre undone by each other. And if weâre not, weâre missing something. If this seems..."âLetâs face it. Weâre undone by each other. And if weâre not, weâre missing something. If this seems so clearly the case with grief, it is only because it was already the case with desire. One does not always stay intact.â
- Judith Butler, Precarious Life: The Powers of Mourning and Violence
"We need to accept our age. We need to accept many physical and mental illnesses and addictions. We..."âWe need to accept our age. We need to accept many physical and mental illnesses and addictions. We need to accept the past. We need to accept others as they are. This isnât to say we need to like it, or that we canât work to make the best of each of these entities, but we need to relinquish the idea that we have any power or responsibility to change them. Once people realize they can accept instead of fighting things beyond their control, they realize they have much more time and energy for things they can impact.â
- Ryan Howes, clinical psychologist A Marriage Counselor Tries to Heckle at a Knicks Game (The New Yorker):
(by Jesse Eisenberg, 4/25/13)
Letâs go Knicks!
But letâs also recognize the positive attributes of the opposing team!
Come on, Knicks! But please note that Iâm supporting the Knicks because I live in the same city as the teamâs arena, which is a distinction as arbitrary as what players are assigned to what team! That is, I could just as easily be supporting the other team were I to live in their arenaâs city!
Melo, you suck! And in some cultures you would be revered for such behavior! The Yanomami tribe, for example, will affect a sucking motion to indicate safe passage to a neighboring tribe!
Ref, are you blind? If so, it would be amazing that youâve been so accurately officiating up until this last play, which, for vantage reasons, appeared to me to be called incorrectly! Of course, Iâm judging this as a layman and you have a far more appropriate view to fully evaluate what just occurred! I honor your craft and insight and, in a way, I value your incorrect calls! It means youâre human, and thatâs healthy! Feel good about yourself and, in moments like this, remember how many calls you got right! The world is complicated!
DEFENSE! DEFENSE! But also, OFFENSE! OFFENSE! Lest we forget how quickly the offense becomes the defense! These frameworks are constantly in flux!
FOUL? Are you kidding me? If you are, I will say, simply, thank you! Laughter and joke-telling is healthy and can be used to convey messages that may otherwise be too difficult to express!
Get your head out of your ass, you must be the most flexible person Iâve ever seen!
Go for a three! I want to see this game go to overtime! I know itâs difficult to hear, but I believe there is a future for you both! Right now, youâre in the thick of it, youâre blinded by anger, which is normal and understandable! Frankly, Iâd be surprised if you werenât upset! The wounds havenât yet healed!
There were flagrant fouls, yes! And there were missed opportunities! But there were good moments as well! The national anthem! The jump ball! The halftime show! These were good and right and real! And to discount these good moments is as irresponsible as to count only the bad moments!
In fact, may you both win, regardless of the score! What is a âscoreâ anyway? An arbitrary number assigned in accordance with how many times a ball goes through a hoop? How silly compared to the amount of times youâve overcome adversity together! Why donât we count those times? Like when there was a loose ball, and everyone tried to pick it up, regardless of allegianceâthere were no âteamsâ then! There were no egos! There was just a ball that needed picking up!
If weâre going to count the score, why not count smiles? Or pats on the back? Or simple gestures that tell the other person, âHey, I get itâ?
Whatâs that? Iâm being kicked out of the game? Why? Whatâd I do?
Iâm talking too much? Iâm being too loud and ruining the experience for those around me?
Well, thatâs perfectly understandable! Here we are trying to enjoy a sporting event, and Iâm distracting everyone with my misguided enthusiasm, unending commentary, and meticulous analyses that conflict with the spirit of the game!
I can totally understand where you guys are coming from and I will leave on my own accord! In fact, I thank you for your blunt dismissal of me! I donât think I deserve to explain my position, as my actions have already indicated my lack of regard for the other fans, the teams, and, frankly, the sport at large!
O.K., O.K., Iâm leaving!
I hope you all enjoy the rest of the game! May the home team prevail! Or the visiting team! Or, if possible, may they both prevail by transcending the false notion of prevailing!
Marvin Tolkin was 83 when he decided that the unexamined life wasnât worth living. Until then, it had never occurred to him that there might be emotional âissuesâ he wanted to explore with a counselor.
âI donât think I ever needed therapy,â said Mr. Tolkin, a retired manufacturer of womenâs undergarments who lives in Manhattan and Hewlett Harbor, N.Y.
Though he wasnât clinically depressed, Mr. Tolkin did suffer from migraines and âstruggled through a lot of things in my lifeâ â the demise of a long-term business partnership, the sudden death of his first wife 18 years ago. He worried about his children and grandchildren, and his relationship with his current wife, Carole.
âWhen I hit my 80s I thought, âThe hell with this.â I donât know how long Iâm going to live, I want to make it easier,â said Mr. Tolkin, now 86. âEverybody needs help, and everybody makes mistakes. I needed to reach outside my own capabilities.â
So Mr. Tolkin began seeing Dr. Robert C. Abrams, a professor of clinical psychiatry at Weill Cornell Medical College in Manhattan. They meet once a month for 45 minutes, exploring the problems that were weighing on Mr. Tolkin. âDr. Abrams is giving me a perspective that I didnât think about,â he said. âItâs been making the transition of living at this age in relation to my family very doable and very livable.â
Mr. Tolkin is one of many seniors who are seeking psychological help late in life. Most never set foot near an analystâs couch in their younger years. But now, as people are living longer, and the stigma of psychological counseling has diminished, they are recognizing that their golden years might be easier if they alleviate the problems they have been carrying around for decades. It also helps that Medicare pays for psychiatric assessments and therapy.
âWeâve been seeing more people in their 80s and older over the past five years, many who have never done therapy before,â said Dolores Gallagher-Thompson, a professor of research in the department of psychiatry at Stanford. âUsually, theyâve tried other resources like their church, or talked to family. Theyâre realizing that theyâre living longer, and if youâve got another 10 or 15 years, why be miserable if thereâs something that can help you?â
Some of these older patients are clinically depressed. The National Alliance on Mental Illness reports that more than 6.5 million Americans over age 65 suffer from depression. But many are grappling with mental health issues unaddressed for decades, as well as contemporary concerns about new living arrangements, finances, chronic health problems, the loss of loved ones and their own mortality.
âItâs never too late, if someone has never dealt with issues,â said Judith Repetur, a clinical social worker in New York who works almost exclusively with older patients, many of whom are seeking help for the first time. âA combination of stresses late in life can bring up problems that werenât resolved.â
That members of the Greatest Generation would feel comfortable talking to a therapist, or acknowledging psychological distress, is a significant change. Many grew up in an era when only âcrazyâ people sought psychiatric help. They would never admit to themselves â and certainly not others â that anything might be wrong.
âFor people in their 80s and 90s now, depression was considered almost a moral weakness,â said Dr. Gallagher-Thompson. âFifty years ago, when they were in their 20s and 30s, people were locked up and someone threw away the key. They had a terrible fear that if they said they were depressed, they were going to end up in an institution. So they learned to look good and cover their problems as best they could.â
But those attitudes have shifted over time, along with the medical communityâs understanding of mental illness among seniors. In the past, the assumption was that if older people were acting strangely or having problems, it was probably dementia. But now, âthe awareness of depression, anxiety disorders and substance abuse as possible problems has grown,â said Bob G. Knight, a professor of gerontology and psychology at the University of Southern California, and the author of âPsychotherapy With Older Adults.â
A report by the Substance Abuse and Mental Health Services Administration found that about half of all Americans ages 50 to 70 will be at high risk for alcohol and marijuana abuse by 2020, compared with less than 9 percent in 1999.
In years past, too, there was a sense among medical professionals that a patient often could not be helped after a certain age unless he had received treatment earlier in life. Freud noted that around age 50, âthe elasticity of the mental process on which treatment depends is, as a rule, lacking,â adding, âOld people are no longer educable.â (Never mind that he continued working until he died at 83.)
âThatâs been totally turned around by what weâve learned about cognitive psychology and cognitive approach â changing the way you think about things, redirecting your emotions in more positive ways,â said Karl Pillemer, a gerontologist and professor of human development at Cornell, and author of â30 Lessons for Living.â
Treatment regimens can be difficult in this population. Antidepressants, for instance, can have unpleasant side effects and only add to the pile of pills many elderly patients take daily. Older patients may feel that they donât have the time necessary to explore psychotherapy, or that itâs too late to change.
But many eagerly embrace talk therapy, particularly cognitive behavioral techniques that focus on altering thought patterns and behaviors affecting their quality of life now. Experts say that seniors generally have a higher satisfaction rate in therapy than younger people because they are usually more serious about it. Time is critical, and their goals usually are well defined.
âOlder patients realize that time is limited and precious and not to be wasted,â said Dr. Abrams. âThey tend to be serious about the discussion and less tolerant of wasted time. They make great patients.â
- James Thurber
Babies wise up fast. By the time infants are 3 months old, their unfinished brains are laced with a trillion connections, and the collective weight of all those firing neurons triples in a year.
But the indecipherable babbling and maladroit wiggling so beloved by parents just leave scientists in baby labs scratching their heads. What do those little people know, and when do they know it?
A team of French neuroscientists who compared brain waves of adults and babies has come up with a tentative answer: At 5 months, infants appear to have the internal architecture in place to perceive objects in adult-like ways, even though they canât tell us.
âI think we have a pretty nice answer,â said Sid Kouider of the Ecole Normale Superieure in Paris, whose findings were published Friday in the journal Science. âBabies as early as 5 months, and probably earlier, are displaying the same neural aspects of consciousness as adults.â
The findings hint at an early shift from a largely passive biological process shared with other animals to the uniquely human ability to ponder ourselves and our surroundings in complex and abstract ways.
Researchers spent the better part of five years fiddling with fussy babies â at 5, 10 and 15 months of age â who had to sit still while wearing a cap with 128 electrodes and watching images flicker before them at eye-blink intervals.
âThis was heroic,â said UCLA developmental psychologist Scott Johnson, who was not involved in the study. âIt must have taken them forever.â
Said Kouider: âWe had to be very patient.â
Researchers have spent decades observing infantsâ eye movements, attempting to delve into such issues as memory, cognition and perception. But there is a limit to what they can infer.
âFour-month-olds can predict trajectories of objects, but do they have a conscious projection of a ball? Does she wonder âWhere is that thing?ââ Johnson said. âItâs a question we wrestle with.â
Kouider relied on studies of adult brain waves recorded while subjects were presented with images that flashed for milliseconds. Some images were recognizable, such as a numeral, while the rest were indecipherable. The study volunteers were asked if they had âseenâ anything.
In adults, the brain processes fleeting images â ones presented for less than 200 milliseconds â in a way that prevents us from consciously perceiving them. That finding that has broadened scientistsâ understanding of subliminal suggestion and priming of human behavior.
But when images flash for at least 300 milliseconds â roughly the duration of an eye blink â brain activity increases exponentially, like a seismometer needle responding to a tremor. Thatâs also when adults can report that they consciously perceived the image.
The French team recorded equivalent brain waves in the 80 infants who could sit still while wearing their electrode caps. While the adult-like wave forms were somewhat weaker and delayed in 5-month-olds, they were strong and sustained in the older babies, the researchers reported.
Charles Nelson, director of developmental medicine at Boston Childrenâs Hospital, cautioned that the French scientists may be over-interpreting data.
âThe study is well done,â said Nelson, who wasnât involved in the Science study but has done similar research. âThey just take the inference too far.â
Brain wave data and brain activity measured by functional MRI scans alone cannot infer a behavioral state, Nelson warned.
âIf that were true, I should be able to look at your [EEG and MRI] response and know what youâre thinking or feeling, and we know that is not the case,â he said.
Kouider acknowledged that the study describes brain function, not the content of the babiesâ thoughts.
Further research may unveil what babies actually know but just wonât tell us, he said.
- Abraham Maslow