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Even If Talk Is Cheap, Drugs Alone Won’t Work

If a recent story in The New York Times is to be believed, psychiatrists are ditching talk therapy in favor of quick-to-the-draw prescription solutions because insurance companies won’t pay them enough for the broader treatment.

As someone who benefited greatly from both therapy and medication, I find this disturbing.

Mood music:

[spotify:track:40T969H60rqt5v1tWZDEMS]

From the article, written by Gardiner Harris:

Like many of the nation’s 48,000psychiatrists, Dr. Levin, in large part because of changes in how much insurance will pay, no longer provides talk therapy, the form of psychiatry popularized by Sigmund Freud that dominated the profession for decades. Instead, he prescribes medication, usually after a brief consultation with each patient. So Dr. Levin sent the man away with a referral to a less costly therapist and a personal crisis unexplored and unresolved.

Medicine is rapidly changing in the United States from a cottage industry to one dominated by large hospital groups and corporations, but the new efficiencies can be accompanied by a telling loss of intimacy between doctors and patients. And no specialty has suffered this loss more profoundly than psychiatry.

Trained as a traditional psychiatrist at Michael Reese Hospital, a sprawling Chicago medical center that has since closed, Dr. Levin, 68, first established a private practice in 1972, when talk therapy was in its heyday.

Then, like many psychiatrists, he treated 50 to 60 patients in once- or twice-weekly talk-therapy sessions of 45 minutes each. Now, like many of his peers, he treats 1,200 people in mostly 15-minute visits for prescription adjustments that are sometimes months apart. Then, he knew his patients’ inner lives better than he knew his wife’s; now, he often cannot remember their names. Then, his goal was to help his patients become happy and fulfilled; now, it is just to keep them functional.

Dr. Levin has found the transition difficult. He now resists helping patients to manage their lives better. “I had to train myself not to get too interested in their problems,” he said, “and not to get sidetracked trying to be a semi-therapist.”

This is tragic on so many levels.

I’ve said it before: Medication (Prozac) has been a critical part of my OCD management. It put my defective brain chemistry into balance and greatly reduced the moments where my brain would pulsate out of control with worry and obsessions until it incapacitated me.

But had I gone on the drug without doing the brutally hard therapy first, I would not be doing anywhere near as well as I am today. I can promise you that.

Mental health is like physical health. There is no magic bullet — or magic pill — fix.  You need a combination of diet, rest and exercise to maintain health as well as any medicine that you may need.

Talk therapy helps you build your coping tools from scratch. They become your lifeline to sanity, especially if the drugs stop working, which can happen in a variety of circumstances.

This is just one more example of the health insurance industry putting the bottom line before wellness. I don’t want to beat on the insurance providers just for the hell of it. The industry does face the genuine problem where treatments are becoming more expensive, especially in a population where many refuse to take care of themselves.

Now that I’ve gotten that out of the way…

There are things one can do to cut costs. But when you cut into the muscle of the treatment — in this case talk therapy — the treatment will bleed to the point of near-death.

Now I know what they’re thinking: People can go to a therapist for talking and the other guy for medication, but now we have another problem. Not everyone can afford both.

In my case, I go to a therapist to talk things out, and a nurse on his staff is authorized and in charge of writing my prescription.

Psychiatry and therapy are not exactly the same beast.

But a good psychiatrist includes the talking part and uses it to maximum effect.

Force them to stop doing that and many people will fall through the cracks.

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Fear and Self-Loathing in San Francisco

Just got to my hotel in Santa, Clara, Calif., with a few random memories shifting around in my head — memories that illustrate who I was and who I am now.

Mood music:

It was July 1991 and I was with Sean Marley on my first trip to the west coast. I didn’t really want to go because I was afraid of everything and everyone. But Sean was red h0t about the idea, and back then I was always out to impress the man.

So off we went, on a 10-day California trip that would take us as far north as Eureka and as far south as Los Angeles. We lived in the rental car the whole time except for L.A., where we stayed in a friend’s apartment.

I remember the plane going in for a landing. I looked out the window and saw the Bay Bridge below. It was a gorgeous sight from that height, with the bay glistening in the summer sun. I saw the same view this morning and felt warm and energized. Back then was different. I thought of the Bay Area earthquake two years before, with TV coverage that included a live shot of a piece of the bridge collapsing and a car driving off the newly created edge into the abyss.

I knew we’d be driving over that bridge at least twice.

Terror.

I was afraid of talking to strangers.  I was afraid to go to clubs at night for fear we might get mugged so far from home.

In L.A., we hooked up with a guy who used to live in the Point of Pines in Revere. I didn’t remember him, but he and Sean were tight as kids. Michael was his name. Michael took us to visit a couple of his friends who were living the stereotypical Hollywood lifestyle. They had a band, but sat in their cramped bungalow all day, surrounded by towers of empty beer cans and cigarette boxes, watching all the bad daytime TV they could feast their eyes on.

One of them asked me where we were from. The Boston area, I told him.

“Dude,” he said through the cloud of cigarette smoke encircling his head. “That’s a pretty long way from here.”

The statement filled me with more terror.

A pretty long way from here. From my safe place in the basement apartment at 22 Lynnway, Revere, Mass.

Terror.

That’s pretty much what the trip was. Sean ate it all up and had the time of his life, despite me.

I didn’t know back then that I suffered from OCD-induced fear and anxiety. I was still many years away from the therapy, medication and spiritual conversion. I had no idea what the 12 steps were when I was 21. Too bad, too, because I SHOULD have had the time of my life on that trip, too.

But that’s what fear does. It robs you blind. Robs you of everything that should make life worthwhile.

Thank God I’m done with that shit.

I’ve made this flight many times since then, always on business. But I’ve gotten the chance to enjoy the surroundings and experience the culture along the way.

In small steps, I’ve tried hard to make up for lost time. That gets me in trouble sometimes, because I forget to pace myself. That happened last time I was here in February, and my family paid the price.

Let’s see if I can do better this time.

And maybe one of these days, instead of coming here for work, I can come here for fun. Maybe Erin will live out of a rental car with me for 10 days.

What do you say, honey?

OCD Diaries

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The Problem With ‘One Day At A Time’

“One day at a time? You wouldn’t believe the crap that swirls around my head one day at a time.” –Anonymous

Recovering addicts have a saying burned into their brains: “One Day at a Time.” It’s important wisdom to live by. But when the recovering addict has OCD, there’s a big problem.

Mood music:

Let’s look at the meaning of “One Day at a Time.” In the world of 12-step recovery programs, the idea is not to be overwhelmed. Instead of trying to get your arms around everything necessary for recovery a week into the future or a month or year, we subscribe to the idea of just focusing on what we have to do today. Doing this a day at a time makes the clean-up tasks seem a lot less overwhelming.

The problem with an OCD case is that the disorder forces you to do nothing BUT stew over the future. You look at the next week or month and relentlessly play out the potential outcomes of that space of time.

The first time someone told me to take it a day at a time, my first instinct was to punch him in the face.

I had a business trip three weeks away to worry about.

I had a medical test planned for the following month and had all kinds of potentially grim outcomes to worry about.

That’s how guys like me roll.

So how have I managed to keep my addictions largely at bay for well over two years? Simple: I remembered another 12-Step saying (OA saying, more specifically): Fail to plan, plan to fail.”

The Powerfully Recovered website, based on the book of the same title by Anne Wayman, explains it better than I could, so let me share:

One day at a time doesn’t mean we shouldn’t plan

I imagine that this is the very first slogan that found it’s way into the original Alcoholics Anonymous meetings. Can’t you just picture a frantic newcomer talking about how difficult he (and yes, it was only men in the beginning – and the men didn’t think women could be real alcoholics, which is another story…) he was finding sobriety?

I can almost imagine the conversation:

Newcomer: What am I going to do? Next week I have to go to the office Christmas party – how will I ever stay sober there!

Oldtimer (early on, he might have been sober only a week): Slow down, it’s not next week yet. Take it One Day at a Time!

And a slogan is born – because it’s got some real wisdom in it. For in truth, each one of us has only one day at a time – or one hour or one moment. 

Abstaining a moment at a time

In the first few rocky days of recovery, just abstaining for that moment, hour, etc. is truly all we can do. If we can’t do that, there’s no point in worrying about tomorrow, or next week, or whenever. 

The One Day at a Time philosophy has benefits far beyond the early days in recovery. It can keep us grounded in the present – that Holy Instant that is so easy to miss in a busy and productive life.

Planning is okay

Unfortunately, some in 12 Step Groups have taken the philosophy to mean we shouldn’t plan. This is patently false. A major promise of the Program is torestore us to sanity, and that includes the very human blessing and curse – planning. We need to set goals, to make appointments, to design our lives.

But planning doesn’t mean we have to leave One Day at a Time behind – the trick is to watch for expectations. 

It’s one thing to plan and quite another to demand that the plan work out the way we require it too – in that we have no control at all. When our plans bring unintended results – and the often do – all we need do is reevaluate, accept where we are in this moment, and start anew. 

There are a lot of contradictions when you put the sayings “One day at a time” and “Fail to plan, plan to fail” together. It’s like a warm front running into a cold front. You get thunder, lightening and worse. Cars are picked up and wrapped around trees.

But in the end, life is unfair like that. We have to learn to deal.

So even when the OCD in me is planning, planning, planning, I do remember to take my recovery — especially the food plan that helped me break the binging spell — one day at a time.

I can digest life much more fully when the pieces are broken up.

But the push and pull still makes for plenty of confusion.

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Fear and Resentment. Resentment and Fear

For mental defects like me, a lot of what goes wrong is driven by fear. One thing I’ve learned in a 12-Step program for addiction is that the root of many fears is resentment.

Mood music:

You don’t have to be an addict to have resentments, of course. Most typical families, work environments and fellowships come packed with people you’re inevitably going to clash with. The more you disagree with someone, the more you’ll resent them.

Then, whenever you face situations where the one or more people you resent are present, you’ll be filled with fear: Fear about potential arguments, fear over whether you’ll look “normal” enough to avoid their ridicule, fear over how you’ll perform in public.

I have plenty of my own examples.

–Fear of arguments when dealing with my mother got so bad I had to put the relationship on ice for the sake of my sanity.

–Fear of Erin leaving me kept me from saying what I needed to say when we’d have the arguments that are part of every marriage.

–Fear of getting jumped and kicked around kept me from continuing my walks along Revere Beach in my early 20s, after the October 1991 incident.

–Though I’ve gotten very close to my stepmom in recent years, we used to clash all the time, which gave me a fear of any family event that required me to be in her presence.

Those fears filled me with all kinds of resentment toward those people and situations. In response, I plunged into addictive behavior with ultra-reckless abandon.

Fear and resentment are what keeps the hole in your soul from closing up. Until you deal with it at the roots, you will never truly be free or sane. That’s why as part of working the 12 steps, we’re supposed to write down all our resentments and work to make amends whenever and wherever possible.

Chapter 5 of the AA big book covers this extensively. Here’s an excerpt, along with an illustration about resentments:

—————-

Resentment is the “number one” offender. It destroys more alcoholics than anything else. From it stem all forms of spiritual disease, for we have been not only mentally and physically ill, we have been spiritually sick. When the spiritual malady is overcome, we straighten out mentally and physically. In dealing with resentments, we set them on paper. We listed people, institutions or principle with who we were angry. We asked ourselves why we were angry. In most cases it was found that our self- esteem, our pocketbooks, our ambitions, our personal relationships, (including sex) were hurt or threatened. So we were sore. We were “burned up.” On our grudge list we set opposite each name our injuries. Was it our self-esteem, our security, our ambi tions, our personal, or sex relations, which had been interfered with? We were usually as definite as this example:

I’m resentful at: The Cause Affects my:
Mr. Brown His attention to my wife.Told my wife of my mistress.Brown may get my job at the office. Sex relations
Self-esteem (fear)
Sex-relations
Self-esteem (fear)
Security
Self-Esteem (fear)
Mrs Jones She’s a nut – she snubbed me.
She committed her husband for drinking.
He’s my friend.
She’s a gossip.		 Personal relationship.
Self-esteem (fear)
My employer Unreasonable – Unjust – Overbearing –
Threatens to fire me for drinking and padding my expense account.		 Self-esteem (fear)
Security.
My wife Misunderstands and nags.
Likes Brown.
Wants house put in her name.		 Pride – personal sex relations – Security (fear)

We went back through our lives. Nothing counted but thoroughness and honesty. When we were finished we considered it carefully. The first thing apparent was that this world and its people were often quite wrong. To conclude that others were wrong w as as far as most of us ever got. The usual outcome was that people continued to wrong us and we stayed sore. Sometimes it was remorse and then we were sore at ourselves. But the more we fought and tried to have our own way, the worse matters got. As i n war, the victor only seemed to win. Our moments of triumph were short-lived.

It is plain that a life which includes deep resentment leads only to futility and unhappiness. To the precise extent that we permit these, do we squander the hours that might have been worth while. But with the alcoholic, whose hope is the maintenanc e and growth of a spiritual experience, this business of resentment is infinitely grave. We found that it is fatal. For when harboring such feeling we shut ourselves off from the sunlight of the Spirit. The insanity of alcohol returns and we drink again. And with us, to drink is to die.

If we were to live, we had to be free of anger. The grouch and the brainstorm were not for us. They may be the dubious luxury of normal men, but for alcoholics these things are poison.

We turned back to the list, for it held the key to the future. We were prepared to look for it from an entirely different angle. We began to see that the world and its people really dominated us. In that state, the wrong-doing of others, fancied or real, had power to actually kill. How could we escape? We saw that these resentments must be mastered, but how? We could not wish them away any more than alcohol.

This was our course: We realized that the people who wronged us were perhaps spiritually sick. Though we did not like their symptoms and the way these disturbed us, they, like ourselves, were sick too. We asked God to help us show them the same tole rance, pity, and patience that we would cheerfully grant a sick friend. When a person offended we said to ourselves, “This is a sick man. How can I be helpful to him? God save me from being angry. Thy will be done.”

We avoid retaliation or argument. We wouldn’t treat sick people that way. If we do, we destroy our chance of being helpful. We cannot be helpful to all people, but at least God will show us how to take a kindly and tolerant view of each and every one.

Referring to our list again. Putting out of our minds the wrongs others had done, we resolutely looked for our own mistakes. Where had we been selfish, dishonest, self-seeking and frightened? Though a situation had not been entirely our fault, we tr ied to disregard the other person involved entirely. Where were we to blame? The inventory was ours, not the other man’s. When we saw our faults we listed them. We placed them before us in black and white. We admitted our wrongs honestly and were willing to set these matters straight.

———————

I’ve done a lot of work to overcome my resentments and, at the very least, keeping those resentments from destroying me.

I’ve been able to path up a lot of relationships with old friends I had lost touch with after one petty falling out or another. I’ve worked at being a better arguer with my wife, though she’ll tell you — and I know — that i still have a lot of work to do. And I’ve done specific things to overcome fear: Getting on planes, walking alone in areas I had feared.

You know the saying: Face your fears.

The issue with my mother is one of the few left unresolved at this point.

Fear hasn’t left me. But it no longer controls me.

I owe much of that to strong support from my wife and children, friends and that 12 step program.

OCD Diaries

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Fear and Duct Tape

I was an anxious, jumpy, panicky little bastard when I was younger. Fear made me do the damnedest things. My sister Stacey loves to repeat the story of one of my more embarrassing moments. It used to piss me off. Now I can sit back and laugh with everyone else.

So fuck it. Let’s review the morning a hurricane was coming and I went bat-shit crazy.

Mood music:

[spotify:track:6KfzBFMXEOs7LgBcG4ZxyT]

First, some history. I’ve explained this before, so no need to stick around if you’ve heard it:

Before I got my OCD under control, I was always full of fear and anxiety. It robbed me of a life that could have been better lived. I hid indoors a lot. I favored the fantasy land of TV over the real, scary world. And when the weather got hairy, I over-reacted in ways that are more amusing in hindsight.

I blame the Blizzard of 1978 for that. When you watch the Atlantic Ocean rip apart a beach wall like it’s melted ice cream and head straight for your house, bad things go through your mind when you’re 8 years old. In later years, when comparisons of that blizzard go hand in hand with every new storm warning, the fear flames over everything else in life until your sanity is reduced to a pile of ashes.

So there we were, in August 1991. The news was already full of reports about a military coup in Russia, which was scary because that meant the overthrow of Mikhail Gorbachev. He would be back in power before the week was out, but take the early hours of that crisis and mix it with reports that a hurricane called Bob is coming straight at us, and here’s what you get:

Me running around the house with duct tape, slathering reams of it on every window I could find.

I ran into Stacey’s basement bedroom and proceeded to tape her window. One of her friends was sleeping over, and got to see me in all my crazy glory.

“Get up, a hurricane is coming!” I bellowed. Stacey and her friend remained in the bed, not a care in the world.

“Come on, you idiots!” I yelled. “This aint no fucking Hurricane Gloria.”

Hurricane Gloria was a storm that hit Massachusetts in 1985. It was supposed to be a devastating event, but it passed over us with more of a whimper than a bang. Hurricane Bob was going to be much worse, the weather people were telling us.

They started comparing the expected storm surge with that of the Blizzard of 1978. Panic.

That storm turned out to be almost as anti-climactic as Gloria.

That Halloween, a much more devastating storm hit, and flooded out the neighborhood almost as badly as in 1978. Ours was one of the only houses not to get flooded.

Go figure.

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The ‘Woe Is Me’ Disease

Funny thing about us OCD-addict types: When the going gets tough, we blame it on someone else. Call it the Woe Is Me Disease, where the sufferer is an eternal victim, forever screwed by everyone but his or her self.

Mood music:

http://youtu.be/-q-MorIES5I

It used to be that it was impossible for me to see the problems as my own. It was always the result of something someone else did to me or failed to do for me. Eventually my disease settled into a pattern where I blamed myself for everything, to the point where I just kept beating myself instead of doing what was necessary to move on with life.

My Mom, who passed many of her OCD tendencies on to me, is a textbook example of victim-based OCD. This isn’t meant as an insult or criticism. It’s simply the way the problem manifests itself in her.

She lacks the ability to see things she doesn’t like as the simple way of life. Nothing is ever her fault. It’s always someone else’s fault. She is the perfect victim. In her own mind, anyway.

Seeing yourself as a victim every time the going gets tough is probably one of the worst things you can do. It holds you back, keeps you from improving yourself and makes you look pathetic in the eyes of people who don’t understand where the emotion comes from.

I’m reminded of this after getting a message the other day from an old friend who has been fighting his own battle with OCD. I won’t tell you who he is, but I’ll share what he wrote to me, because he is choosing to do something about his problem:

I recently finished my PHP for my OCD. It was a great program and glad my wife recommended that I enroll. So many things helped me change my way of thinking. One of the most important things I learned was to find ways to be proactive and a problem solver (where before I would be reactive and put my head in the sand).

Additionally, I realized that I suffer from “victim” type of thinking (such as this is not fair, I can’t handle this, etc…) and I need to think more like a “survivor” (I can handle this). I could go on and on about what I learned. I still plan on writing a “guest” column about my experience. I haven’t had much time to put my thoughts down on paper and it’s really important to me to do justice to describing my PHP experience.

I have a huge folder of handouts that I need to organize. I do know that just because I went through the program doesn’t mean I’m miraculously cured. From here I on out, I have many “tools” in my toolbox to handle whatever life throws at me.

I’m looking forward to that guest column.

He’s also right that people like us are never miraculously cured. We simply gather up a series of coping tools and pull them out when we need the help.

As a result, we stop being victims and become, as he put it, survivors.

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Hospital Phobia

During visits to my father in the hospital, I find myself jittery and all-around uncomfortable. It’s not the sight of my father, who is starting the long road to recovery after a stroke. Sure, he’s looked better. But you could say that of anyone stuck in a hospital bed.

Mood music:

http://youtu.be/C6LCttYOO9Q

The discomfort, I’m starting to realize, has to do with the hospital itself.

He’s at one of the best hospitals in Boston, and the staff I’ve talked to are friendly and compassionate. He’s definitely in good hands.

But the sights and smells get to me. The machinery and the sounds they make unsettle me. I had forgotten these things.

It’s a phobia of sorts, the kind that always kept me from visiting my grandparents whenever they were in the hospital, which was a lot. I regret not visiting them as much as I should have, but there’s something about walking into those places that makes you take a hard stare at your own mortality.

I find it odd that I would have this problem, considering I was a frequent resident of Children’s Hospital as a kid.

I figure that should have desensitized me a long time ago. Yet here I am, confronting this reality.

I noticed my father had a swollen hand when I walked in his room. The sight would freak some people out, but I immediately knew what it was: The swelling you get when an IV needle has been in your vein for too long. It used to happen to me all the time. Could it be that it’s not really a phobia, but something even more unsettling — the discomfort of looking at the machines, beds and gray-beige walls and floors and feeling, in an odd sort of way, like I’m home?

Most of us feel the periodic pull of our old neighborhoods. We like to visit the places where we grew up. Even if we had a bad childhood, we feel the need to revisit the scene of the crime. I often do, and can never fully explain why. Maybe I should go visit my old floor at Children’s Hospital. Maybe it’ll break the spell.

Yeah, probably not.

Whatever is behind the uneasiness, I’m not staying away this time.

For one thing, I can’t let something so stupid keep me from doing the right thing.

Also, it’s what a good son should do.

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Morning After The Twisters

This is one of those mornings where I wake up uneasy. Several tornadoes tore through our state yesterday, but that’s not it.

Mood music:

I used to panic at the sight of a yellow-green sky, because that’s usually a sign of imminent tornadoes and hurricanes. But as I looked out the window, all I could muster was a “meh.” I guess that’s progress.

But then I had other things on my mind.

Yesterday I visited my father in the hospital, where he’s been since Sunday night. He suffered a stroke, and looked like it. His mind was clear, but one eye was covered with gauze and the other was drifting off to the side.

I left the hospital to go back to work and drove right into an hour-long traffic jam. It turns out the Red Sox were playing. When that happens, the area around Fenway Park becomes a sea of humanity and a graveyard for drivers trying to get from points A to B.

On the plus side, I didn’t erupt into a white-hot temper tantrum like I used to when getting stuck in traffic. I wasn’t happy. The F-word escaped my mouth a half dozen times, but I didn’t beat on the steering wheel and scream like I used to. More progress.

Still, it left me in a bad mood for the rest of the day. My mood sunk even further when I learned that Dad has some breathing difficulties AFTER I left.

I’m still in a bad mood, but at the same time I have hope. This stuff always works itself out, because God sends us helpers.

I mentioned this in a recent post about Mister Rogers:

Mr. Rogers learned a powerful lesson from his mother. I wish I had it in my head to focus on the helpers growing up. In hindsight, they were always there:

–The doctors and nurses who saved me from brutal bouts of Crohn’s Disease.

–The therapists who guided me through a diagnosis of OCD and showed me how to manage it.

–My family, especially my wife, and also my father and even my mother. My relations with the latter are in mothballs right now, but I think she tried to do her best for me. The help Erin has been to me is way too big to be measured here.

–My friends, who have always helped me make sense of things, made me laugh and done all the other things a person needs to get through the day.

–Many of the people in my faith community, who showed me how to accept God’s Grace, even if I still suck at returning the favor.

Fast-forward to the present. I’m uneasy, but I know that in the end, somehow, things will be alright.

My prayers are with those in the state that lost property and people in the tornadoes.

My prayers are obviously with my father.

The helpers are always around us, and they will help us through it all.

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For Veterans, A Holiday Here and There Isn’t Enough

Funny thing about holidays where we honor veterans: Everyone puts those who have fought for our freedom on a pedestal for the day, then the next day some of us go back to treating the same people like garbage.

Mood music:

http://youtu.be/V-zqIS7vWbY

Flashback: September, 2010: I’m walking the streets of Brooklyn on a beautiful night, and a guy comes up to me. He has a hole in his head where his left eye used to be and burn scars up and down one arm.

I’m smoking a cigar, so he approaches me for a light. He tells me he was maimed in Afghanistan during military service and asks for some change so he can get a train to somewhere. He tells me he’s in New York looking for work and was stranded without money.

I give him the change from my pocket and then he’s gone.

Is he telling the truth? I have no idea, and I don’t really care. He just looked like a guy in pain who needed a few quarters to survive the next few hours, and that’s all that mattered at the time.

Flashback: Late April, 2011: I’m on Facebook one afternoon and I see a friend commenting that he’s disappointed that some of his friends have decided to “like” a page that makes fun of a fellow known in Haverhill, Mass., as Crazy Mike.

In any city there’s a guy like “Crazy Mike.” The stereotype is usually a long beard, ratty clothes and the fellow is usually living on the street. He talks aloud to no one in particular and falls asleep on playground equipment. People like to laugh at him.

A lot of these so-called crazy guys are homeless vets whose luck ran out somewhere between the battlefield and the hard re-entry into society.

After a few seconds of thinking this through (admittedly, a few seconds is never enough time to really think things through), my temper reaches full boil and I pound out a blog post called “Liking The Crazy Mike of Haverhill Page is Sad and Stupid.”

Discussion follows online, with a big question being if Crazy Mike was in Vietnam and, as a result, sick on the streets with Post-Traumatic Stress Disorder. One reader insists he is indeed a veteran, and that other homeless people keep stealing his medication. Someone else says she knew the family fairly well, and that Mike is not a veteran. He’s simply a guy who has a serious mental illness.

To me, it doesn’t matter if he was in Vietnam or not. Instead, two realities have my mind spinning like a top on fire.

One is that a lot of people assume he is a veteran, but treat him like shit anyway.

Another thing is that there are a lot of homeless who ARE military veterans, and most days we don’t give them more than a few seconds of thought before we walk on by.

It’s almost as if we honor them on holidays to make ourselves feel better about being the assholes we often are.

I say this as a guy who is admittedly one of those assholes. I’ve made my share of fun of people like this, and in the rear-view mirror, looking back at my own struggle with mental illness, it makes me feel ashamed.  Back when fear, anxiety and addiction had me by the balls, I used to walk or drive the other way when these guys approached. It makes me the last guy on Earth who would be fit to judge others for poking fun at someone less fortunate.

It would be high-minded of me to say we need to do better for our veterans. But it’s been said so often it’s pretty much lost it’s meaning. We like to praise our veterans on Veterans Day, Memorial Day or July 4. But once the holiday is past, we go back to our normal behavior. Because they’re homeless and, as a result, they’re dirty, scary and unpleasant to those who have lived far more comfortable lives. And, don’t you know, we LOVE to judge people even though we know nothing about them.

Let’s face it, folks. We need more than the occasional holiday to treat these people the way they deserve to be treated.

And with that, we can all go back to our holiday cook-outs.

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Fear of Coming Clean At Work

No, not my fear. I came clean about my fight with OCD a long time ago and my work colleagues are nothing but supportive. At this point, my life is an open book. But for those who are at the other end of the spectrum, I came across an article that might help.

Mood music:

http://youtu.be/bWsYuW9ULdU

It’s an item on About.com from Dr.  called “OCD and Work: Dealing With Employers.” There was a time when I lived in dread over whether or not to come clean. For one thing, there was a time when my disease was impacting my workmanship. I was a control freak in an environment where I had no control. That period of my life is best captured in a post called “One Of My Biggest Regrets.”

But that was long before I got the treatment I needed. Through years of extensive therapy, medication and tackling other disorders, I’m at a point of no return. I may backslide from time to time. I do, in fact. But there’s no going back to the insanity of 2000-2006. I’ve simply learned too much.

But for those just beginning to deal with their demons, the question of what to do about work is a big one — maybe even the biggest. You want to get well and do so in an honest way, but how many times have we heard about workplace discrimination? I hear about it all the time.

Dr. Kelly’s article is an excellent first step in knowing what to do.

He writes:

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Choosing to disclose that you have OCD to a potential or current employer can be terrifying. People in this position often:

  • wonder if their potential or current employer will be supportive, reject them or even know or understand what OCD is
  • fear being passed over, fired or forced out through attrition
  • worry what people around the office will think
  • worry that they’ll regret their decision
  • fear being blacklisted within the industry they work
  • fear not being trusted with important tasks or responsibilities

It is important to know that if you are in this position, there is no right answer and that you need to weigh this decision for yourself.

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The best part of the article is when he gets into what you should do IF YOU DECIDE TO COME CLEAN.

He writes:

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If you decide that benefits outweigh the risks and you decide to disclose that you have OCD to a prospective or current employer, it will be up to you to make sure that your employer understands the nature and severity of your symptoms. This this doesn’t mean that you need to tell your boss everything — just what she needs to know and what accommodations you might need. If your employer does not fully understand the challenges associated with OCD, or doesn’t even know what it is, it may also be helpful to educate your employer about your illness. It may even be possible to enlist your health care provider to advocate for you.

Finally, check and see if your employer has retained the services of an employee assistance program or EAP. This service may be able to assist in or facilitate disclosure of your OCD to your employer.

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An important part of the article is near the beginning, and deals with your rights. Kelly notes that it’s illegal to discriminate against someone because of a medical condition, including OCD. A final excerpt:

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 if you are otherwise qualified for the position, you cannot be denied employment simply because you have OCD. Although the law is quite clear on this, the actual experience of prospective and current employees with OCD can unfortunately be quite different.

However unfair, there is actually quite a bit of incentive for employers to terminate or pass on hiring someone who they know has a chronic illness — mental or physical. On average, their health costs will be higher; they will be absent more days; and they may even have to go on long-term disability leave — all of which impacts the bottom line.

Although it is illegal to terminate someone on the basis of a medical condition, there are many ways that employers can accomplish this indirectly. For example, the employer can give the employee progressively more undesirable tasks until to the employee decides to leave.

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This article is something I wish I had back in the day. It’s probably the best direction I’ve seen anyone give people facing the question of disclosure.

I hope this helps. Good luck.