An Old Sibling Issue That Still Hurts

Dr. E, guest blogger

Sibling rivalry I have one sibling, a brother three years older than I am.  As kids, we really had very little to do with each other.  Just being different genders was one reason, but there were others.

We had to change schools every three years because each school housed only three grades, so every time I entered a school, my brother exited, on his way to the next school.  And we had very different interests: my brother loved ham radio stuff, and I was into tropical fish and children's theatre.

So it's hard to say whether or not we got along, since we really didn't have much of a relationship at all until we got older.  My parents, however, created a problem that angered me to no end, while my brother seemed hardly aware of it.

At one point, our Dad, who loved new cars, got one just about the same time my brother got his driver's license, so instead of trading in the older car, our Dad kept it.  Before I got my license, my brother had exclusive use of the older car, of course, but when I got my license, I thought we would share the older car.  I was so wrong.

My brother considered the car his property and did not want me driving it, and my otherwise good parents, agreed.  Their thinking, they said, was that as a teenage girl, my dates would pick me up in their cars, but as a boy, my brother would need the car to pick up his dates.  But why I was not allowed to drive the car when my brother didn't need it for a date was a question my parents never answered.

I feel hurt and angry as I write this even though it was decades ago.  Call it boy over girl favoritism; call it older child favoritism; call it our parents deciding it was easier to argue with me than with him;  call it the erroneous sociological and parenting ideas of the decade (the 1950's); or just call it what it was...totally unfair. 

What could my otherwise good parents have been thinking!

I'm Dr. E, guest blogger.   For more information, click on the following resources:

 Studies in Sibling Rivalry

The Everything Parent's Guide to Raising Siblings:Tips to Eliminate Rivalry,Avoid Favoritism,and Keep the Peace  

Siblings Without Rivalry:How to Help Your Children Live Together So You Can Live Too 

Keep the Siblings,Lose the Rivalry 

Brothers:26 Stories of Love and Rivalry 

The Importance of Sibling Relationships in Psychoanalysis 

Making Brothers and Sisters Best Friends 

Brothers and Sisters:Developmental,Dynamic,and Technical Aspects of the Sibling Relationship  

Amy Bishop:Should She Get Away With Murder?

Dr. Amy Bishop In 1986, when Amy Bishop was 20-years-old, she shot her brother after she had a fight  with her father as he was leaving their Massachhusetts home.  Her mother, the only witness, said her son's death was an accident.  Amy went on to marry, earn a Ph.D. at Harvard, have children and work.

People remember her as being quite a menace in their quiet Massachusetts neighborhood.  It is said that she tried to get her child's teacher fired and also successfully barred an ice cream truck from coming to her street because, she said, her children were lactose intolerant.  In 1993, she and her husband were suspects in an attempted pipe bombing of a doctor she had worked for at Boston Children's Hospital.  And in 2002, she punched a woman in a House of Pancakes and then fled with her family.  The manager wrote  down her license plate, though, so she was brought to court and convicted of assault.

Astonishingly and unfortunately, the administration at  the University of Alabama did not have any of this information when they hired Amy Bishop, but they denied her tenure recently.  Her research and publications did not meet high enough standards for tenure, and students criticized her for  being disorganized, not making eye contact, simply reading from a textbook and too often expressing her extreme political views with unsettling passion. Several weeks ago, during a department meeting at the university, Amy Bishop pulled out a loaded gun and killed three colleagues and wounded others.

It appears she was psychotic, most likely suffering from paranoid schizophrenia.  Having this mental illness, however, should not necessarily exonerate her from being convicted of murder and serving her sentence.  She planned the attack; she got a gun; she trained with it at a local shooting range; she brought the loaded gun with her to the department meeting; and she calmly got up and started systematically shooting her colleagues in their heads.

Having gotten away with so much all her life, she might have started to believe that she was invincible and that when all the facts were presented, she would be exonerated.  She may think that her powers of persuasion are so great and her genius so valuable, that she will go free.  She most likely convinced herself that she had been wronged and that the people she killed deserved it.  She probably believes that somehow, once again, she won't have to pay for the consequences of her actions.

What is certain, however, is that Amy Bishop should not get away with assault and murder this time. She knew what she was doing and knew right from wrong when she fired her loaded gun and killed and injured her innocent colleagues.

I'm  Dr. Blokar.  For more information, click on the following resources: 

Schizophrenia for Dummies

Surviving Schizophrenia:A Manual for Families,Patients,and Providers 

The Complete Family Guide to Schizophrenia:Helping Your Loved Ones Getting the Most Out of Life 

When Someone You Love Has a Mental Illness 

Schizophrenia,Causes,Symptoms,Signs,Diagnosis and Treatments  

Tiger Woods and So-Called Sexual Addiction

Tiger Woods People of power and privilege, both men and women,  historically have engaged in extramarital affairs.  Having money and time on their hands, they indulge in all of life's pleasures, including extramarital sex.  A big difference today, however, is that journalists and the internet make it certain that eventually they will be caught.

"I thought I could get away with whatever I wanted to.  I felt that I had worked hard my entire life and deserved to enjoy all the temptations around me.  I felt I was entitled.  Thanks to money and fame, I didn't have to go far to find them," Woods said in his recent press conference.

Talented Tiger Woods, through hard work and discipline, rose to the pinnacle of success in the world of golf, and fame and riches followed.  In his private life, married to a beautiful woman and the father of two adorable children, he seemed centered, modest, and generous, funding important programs to benefit underprivileged children.  

But once the sordid truth about Tiger's multiple extramarital affairs were exposed, he needed cover, so he signed himself into a kind of "sanitarium" where people rich enough to engage in excessive sexual activity also can afford the treatment.   When he made his first public statements a few days ago, I was glad he never used the phrase "sexual addiction," because personally I do not see excessive sex, excessive eating, excessive gambling, excessive exercising or excessive working as "addictions."  One can use sex, like all of these activities, to deal with anxiety, loneliness and feelings of emptiness, and all of these activities help people avoid addressing their deeper and more painful issues.   In my opinion these are neurotic compulsive behaviors that can be successfully addressed in insight oriented therapies. 

It is possible that Tiger Woods's issues are more banal.  Prior to being caught, he was disciplined in keeping his game topnotch and keeping in top physical shape.  He was very focused and able to maintain his image.  Perhaps he is just another rich and famous man with strong narcissistic traits and an extraordinary sexual appetite and simply wanted to satisfy it while it lasted.

Based on some of his public statements a few days ago, however, and his plan to go back into therapy at the treatment center where he had been, he may indeed suffer from neurotic compulsive behaviors that can be treated with insight oriented analysis. 

"My real apology to [Elin] will not come in the form of words; it will come from my behavior over time," Woods said.  Only time will tell his wife and the rest of us whether Tiger Woods can keep his resolve to never engage in extramarital behavior again.

I'm Dr. Blokar.  For more information, click on the following resources:  

Healing the Hurt Behind Addictions and Compulsive Behaviors 

No Stones:Women Redeemed From Sexual Addiction  

Deceived:Facing Sexual Betrayal, Lies, and Secrets 

The Psychophysiology of Sex 

Addicted?:Recognizing Destructive Behaviors Before It's Too Late 

Facing the Shadow:Starting Sexual and Relationship Recovery  


The Search for Meaning in Our Lives

The meaning of When women in their twenties and thirties seek help from a therapist, the primary goal is to get help in finding and keeping the right mate.  For men in their twenties and thirties, the primary goal in seeing a therapist is to get guidance on career issues.

But when people seek the help of a therapist in their forties and older, no matter what the presenting symptoms may be, the underlying issue commonly involves the existential meaning of one's life.  Humans question why they are here and why our lives can be so easily replaced and forgotten after we're gone.  And no matter what our beliefs are, we are all frightened by the thought of what happens to us after death.  There are some literary works that explore the existential question of the human condition that are helpful.

A wondeful short and simple book is Viktor Frankl's Man's Search for Meaning.  Six decades after being published it is still in demand.

Leo Tolstoy's Anna Karenina is a great literary work in which the character Levin (basically Tolstoy himself) goes through a major crisis of meaning at the height of his career and the fulfillment of his personal dreams.  We can learn a lot from Levin's struggle.

Fyodor Dostoevsky"s Brothers Karamazov and Thomas Mann's Magic Mountain are also helpful. 

If you read these books in high school, it doesn't count.  You were too inexperienced, and these books require a mature and fertile mind in order to bear fruit.  These books are not easy literature, but life is not easy either.  Great literature, like life, is not clean-cut and linear.   It is messy and chaotic in spite of our best efforts to control it,  but life is intoxicating at times and even miraculous regardless of what we are feeling.

Do not be lazy.  After all, you have only one life to live, and in order to make it worthwhile, you need all the help you can get.

I'm Dr. Blokar.  For more information, click on the following resources: 

Finding Meaning in LIfe,At Midlife and Beyond:Wisdom and Spirit From Logotherapy

Passages:The Mystery of Death,Finding Meaning in Life 

Real Answers to the Meaning of Life and Finding Happiness 

Prisoners of Our Thoughts:Viktor Frankl's Principles for Discovering Meaning in Life 

Worldly Wisdom:Great Books and the Meaning of Life

Man's Search for Meaning 

Finding Meaning in the Second Half of Life:How to Finally,Really Grow Up 

Anna Karenina

The Brothers Karamazov

 Magic Mountain   


When Children Have a Chronic Illness

Children with chronic illness Chronic illness may have devastating effects not only on a child's physical development but also on a child's psychological development.

Ill children are often treated differently by their peers who see them as dissimilar and fragile.  Frequent absences from school can prevent a child from forming strong relationships and being an integral part of the school community. 

A chronically ill child is treated differently in the family, too.  Some parents may overindulge their sickly child trying to overcompensate for the unjust hardships and deprivation the child may face.  Parents may be understandably overprotective and unnecessarily shield the child from every challenge.  Puberty is a particularly difficult time.  It is the time when the child strives for independence and detachment from the family, but for a child with chronic illness that leap towards independence is often thwarted by the dependence on others that is necessasary because of the chronic illness.

There are also effects on other family members.  Parents can become overwhelmed by and resentful of the enormous demands their child's illness causes.  Siblings may be resentful because the sick child requires more time and care, invariably taking time and care away from them.  When family members feel angry and resentful while at the same time feeling guilty about their misplaced and inappropriate emotions, there is conflict.  These conflicting feelings are communicated to the ill child and influence the ill child's sense of self.

Children with or without chronic illness learn who they are from their parents and others closest to them.  Loved children feel lovable; abused children often believe they are bad and deserving of abuse; and children of depressed parents often feel inadequate because they fail to make a parent happy. 

Family therapy might be very useful in helping the family of a child with a chronic illness to develop  well, without maladaptive character traits or, worse, a character disorder.  Once that happens, treatment is much more difficult.

I'm Dr. Blokar.  For more information, click on the following resources: 

Helping Children and Adolescents with Chronic and Serious Medical Conditions:A Strengths-Based Approach 

Extreme Parenting:Parenting Your Child with A Chronic Illness 

Parenting Children with Health Issues 

Families Living with Chronic Illness and Disability:Interventions,Challenges, and Opportunities 

In Sickness and in Play:Children Coping with Chronic Illness  

Where Is the Confident and Courageous America I Love?

The american flag Coming from a totalitarian state with practically everything controlled by the government (your job, your apartment, your retirement age and your mobility), I had an image of America as a place in the sun. 

As a young medical doctor, I first came to the USA while working on a ship that besides carrying cargo also carried 13 American tourists.  During my three week trip I discovered that America was also unexpectedly and exceptionally generous.  I met people  who looked very young for their age, who engaged in their second, even third, careers, and I, too, wanted to live and thrive in a country where you can be young at 50 and where your prospects seem endless.  That was 32 years ago. 

What I see now, though, worries me. The 1993 bombing of the World Trade Center, in spite of subsequent bombings of US targets abroad, was not taken seriously enough.  September 11, 2001, however, changed everything.  It finally focused the public's attention on the dangers of terrorism...for a while. 

 Many of my friends and patients express doubt about our government's ability to protect us from man-made disasters.  They're resigned to whatever fate awaits us, hopeless especially after the attempted downing of an international Detroit-bound Northwest Delta plane on Christmas Day.  The symbolism was not lost on those who wish us harm, and many lament the shortness of our collective memories.

The government appears to be complacent at times, if not unintentionally complicit.  The fear of making value judgements or offending particular groups appears to paralyze the authorities constrained by the straightjacket of political correctness.

If psychodynamic concepts are applied to a nation, then America is behaving like an abused, despised child who concluded that it must be deserving of the hate it encounters.  Once you incorporate the hatred of those who are attacking you, you stop fighting the attackers.  Instead, you exaggerate your imperfections in order to justify their behavior towards you.

Where is the bold and courageous America I once knew with people who are generous, but not in denial, and who are confident in the future?

I'm Dr. Blokar.  I wish all of you a very Happy New Year, and may God bless America.

Alexa Ray's Attempted Suicide

Alexa joel Alexa Ray, singer/songwriter Billy Joel's daughter, recently attempted suicide.  Reports about what ticked her off seem to center on a recent breakup with her boyfriend and her relationship with her mother, model Christie Brinkley.

According to reports, Alexa Ray had just returned from a Caribbean vacation with her mother and half siblings.  Apparently her mother, still stunning and trim at age 55, kept criticizing Alexa Ray about her lax attitude toward her weight.  Brinkley, who made a fortune on her good looks and fitness empire, is making the mistake that too many other parents make, that is projecting their personal preferences onto their children and pressuring their children to follow them.  Alexa Ray may need help to learn how to fully appreciate her own value and to find her own calling. 

Of course, Alexa Ray might have a genetic predisposition towards depression and mood swings.  In any case, judging by the number of pills she allegedly ingested, this incident was a cry for help.  Since many people who attempt suicide eventually succeed, though, any attempt or verbal threat of suicide should be taken seriously. 

I'm Dr. Blokar.  For more information, please click on the following resources:

Suicide and Attempted Suicide

Why People Die by Suicide 

Understanding and Preventing Suicide:the Development of Self-Destructive Patterns and Ways to Alter Them 

November of the Soul:The Enigma of Suicide 

Suicide and Attempted Suicide:Understanding the Cry of Pain 

Night Falls Fast:Understanding Suicide 

Depression and Attempted Suicide in Adolescents

Tiger Woods and the Sad "Marital Sex Was Bad" Excuse

Dr. B (M.D.) and guest blogger Dr. E (Ph.D)

041203_woods_vmed_7a_widec  Tiger Woods, who started to play golf at age 2 and appeared on ABC's "That's Incredible" at age 5, has achieved one of the greatest sustained periods of dominance in the history of men's golf.  He plays in fewer tournaments than most professional golfers, but when he does play, according to the findings of Jennifer Brown of the University of California, other golfers play worse than when he is not in the tournament.

His ethnic diversity (Tai,Chinese, African American, Dutch and American) and physical grace make him attractive and exotic and add to his appeal.  His measured, cautious and carefully controlled demeanor help him project an image of an elegant, reliable, cool, masculine, disciplined and trustworthy man.

Now his wife, the mother of his two children, along with the rest of the world, knows that what we all see is not what we get.  Tiger, like many married men, we now know is a womanizer, with one of his extramarital women saying that Tiger likes it rough by dominating her, spanking her and pulling her hair.  Others now argue that Tiger was unsatisfied with marital sex, an excuse many married men use, and that's why he went elsewhere for sex.

Tiger and his wife apparently find it easier to discuss money than their relationship (the elaborate prenuptial agreement and the alleged financial deal for her to stay married), and that makes us wonder why married men and women can't discuss sex.  Why do so many of them seem unable to tell each other what they need and want from sex?

In the movie "Analyze This," Robert DeNiro, a Mafia boss, has a beautiful wife and a mistress.  The psychiatrist, Billy Crystal, asks him why he can't make passionate love with his wife.  DeNiro, looking incredulously at Crystal, replies,"You mean doing IT with the mother of my children?"

How ironic that husbands love their wives, put them on a pedestal, and respect them as the mothers of their children so much that their wives become untouchable!  And wives may feel that since their husbands think of them as saintly, they have to inhibit their sexuality or their husbands won't love them as much.  Instead of talking about it and getting help if needed, husbands leave their wives sexually frustrated and unsatisfied, go off and have sex with women they have no attachment to or respect for, and when caught, rationalize that they went elsewhere for sex because they couldn't get it at home.  Extramarital affairs are free of the complexities of marriage, and men prefer things simple.

Ordinary men may not have the women groupies who surround famous athletes and entertainers, and they don't get to travel, making affairs easier, the way Tiger Woods does.  And they certainly don't have the resources to wine, dine and hide their extramarital women.

More important for all married couples is to examine why deeply loving someone may result in unfulfilling sex.  When did pure love mean love without passionate sex?  At one time pure love was a prerequisite for great sex. 

We're Drs. B and E.  For more information, click on the following resources:

Passionate Marriage:Keeping Love and Intimacy Alive in Committed Relationships

Dr. Ruth's Top Ten Secrets for Great Sex:How to Enjoy It, Share It, and Love It Each and Every Time 

Till Sex Do Us Part:Make Your Married Sex Irresistible 

Systemic Sex Therapy 

Is That All He Thinks About?:How to Enjoy Great Sex With Your Husband 

Getting the Sex You Want:Shed Your Inhibitions and Reach New Heights of Passion Together  

Multiple Personality Disorder (Dissociative Identity Disorder)

The-Three-Faces-of-Eve  Popularized years ago in the movie "The Three Faces of Eve," Multiple Personality Disorder (now known as Dissociative Identity Disorder) was recently back in the news.  A New York man who murdered his family claims he suffers from this ailment and that one of his other personalities committed the crime.

According to the Diagnostic and Statistical Manual of Mental Disorders, the main feature of this disorder is "the presence of two or more distinct identities or personality states."   The disorder is more prevalent in women than in men with the ratio often stated as 9 to 1 female to male.  People with this disorder test high in their  hypnotizability. Although the disorder tends to be chronic and recurring, it is less manifest beyond the late forties but can reemerge with trauma or alcohol or drug abuse; drugs and alcohol lower the defenses and barriers that the dominant personality has built. 

The dominant personality carries the person's given name and is passive, dependent, guilt-ridden and depressed.  The other personalities may have different names, different memories, and a different vocabulary and level of knowledge.  These personalities may deny knowledge of one another, may be critical of  each other or may even be in open conflict.

The alternate personalities are usually quite different from the dominant personality.  They are often aggressive, provocative and hostile. Their memories are often more complete than those of the dominant personality, which makes sense since the disorder usually develops from severe trauma, such as physical or sexual abuse that took place in the dominant personality's childhood.

The dominant personality developed survival strategies by becoming less visible and by burying her memories deep into her subconscious.  The trauma that the dominant personality was exposed to and which she pushes away and tries to forget reemerges in alternate personalities who dare to remember, even remembering the original trauma to which the dominant personality was exposed.  The alternate personalities may be highly critical of the dominant personality's squeamish, mousy and passive ways.

The dominant personality, on the other hand, is not aware of the other personalities which sometimes can take years to discover.  People around the dominant personality may keep telling her that she behaved in an inappropriate way, atypical of her usual behavior and about which she has no recall.  The dominant personality may sometimes find pieces of provocative clothing that she not only cannot remember buying, but also says she would not be caught "dead" wearing!

Diagnosing this disorder seems to be on the rise.  In my opinion, it has been over-diagnosed.  It seems to me that many patients suffering from borderline personality disorder who are by nature highly suggestible and hypnotizable and whose personalities are ill-defined and fluid and who often abuse alcohol and drugs, may be coached by a therapist hunting for an exotic disease into believing they have multiple personality disorder. 

I'm Dr. Blokar.  For more information, click on the following resources:

Dissociative Identity Disorder:Diagnosis,Clinical Features, and Treatment of Multiple Personality

Jekyll on Trial:Multiple Personality Disorder and Criminal Law 

Breaking Free:My Life With Dissociative Identity Disorder  

Switching Time:A Doctor's Harrowing Story of Treating a Woman with 17 Personalities 

Bluebird:Deliberate Creation of Multiple Personality by Psychiatrists 

The Bifurcation of the Self:The History and Theory of Dissociation and Its Disorders 

Hoax and Reality:the Bizarre World of Multiple Personality Disorder 

The Dissociative Identity Disorder Sourcebook 

Mistakes Were Made (But Not By Me)  

What Causes The Holiday Blues and Can They Be Avoided?

Satisfied%20guests  In Western countries, the suicide rate is highest during this holiday season.  The reasons for this are many and complex.  The expectation of the season, which has lost a good part of its spiritual and religious meanings, is to have a jolly good time, but good times do not necessarily follow a predetermined time frame; they come and go regardless of our expectations.  And all the merry making around us when we feel blue just makes us feel worse.

The holiday season practically forces us to take note of our achievements and failures, including last year's resolutions which mostly went unfulfilled, just like the resolutions of the year before that.  It is hard to face the fact that we were not able to live up to the promises we made to ourselves and to others.

This is also the season of voracious consumerism. No matter how much we buy, instead of feeling fulfilled we feel emptiness and a growing longing for more things.  We may even feel sadness that we can't afford what we want and jealousy of those who have and can afford more.

In addition, the pressure of gift giving can add to our holiday sadness.  Some of us feel we must give the perfect gift, sometimes within a strict budget.  And even if cost is not a factor, it is hard to come up with that special meaningful present for everyone who needs to be gifted.

Going home for the holidays is suppossed to be joyful, warm, fulfilling and serene.  In too many families, though, the modus operandi is anything but.  One tends to regress in emotionally charged situations, so many of us respond as we did as children when parents and relatives push certain buttons.   But you are an adult now, and this is your life, so take possession of it and be proud.

Learn not to apologize or feel ashamed for your failures.  And don't feel you have to perform spectacularly.  Your best approach is to dare to be yourself.   Be tolerant of others for they, too, have their own struggles.

The expectations we put on ourselves, our families and our close friends this season are so high and the pressure is so great that it ultimately proves to be too much to bear.  A cetain amount of letdown is unavoidable.  Family gatherings, however, are not the place for dramatic and forced resolutions of the family dynamics.  Individual and group therapy, if warranted, is a much better place for venting your regrets and casting the blame.  The ensuing results are beneficial and lasting.

I'm Dr. Blokar.  For more information, click on the following resources: 

The Family Gathering Survival Plan

Happy Holidays:How to Beat the Holiday Blues 

Holiday Blues Rediscovering the Art of Celebration 

No More Holiday Blues:Uplifting Advice for Recapturing the True Spirit of Christmas, Hanukkah, and the New Year