Monday, December 2, 2013

Wishes from the little Silver Tree

So, she has awakened once again. You remember her, right? Our Christmas Tree, the Bearer of wishes?  the Reminder of Hope? Well, she awoke, stretched her arms and demanded to be adorned, dressed in glitter and light.

So, here she stands ready to receive new wishes, to bear more dreams.

Last year my own wish was that our shore would be rebuilt and stand once again beautiful and shinning in the summer sun. And my wish came true, not without a lot of work, but then again that's how all wishes come true.

This year I will let the tree talk, through the words of the poet, about her wishes. And I will hope that these words will touch every heart and resonate in every mind. And maybe one day... Maybe one day....

Man is ever in a struggle
    and he's oft misunderstood;
There are days the worst that's in him
     is the master of the good,
But at Christmas kindness rules him
     and he puts himself aside
And his petty hates are vanquished
     and his heart is opened wide.
Oh, I don't know how to say it,
     but somehow it seems to me
That at Christmas man is almost
     what God sent him here to be."
Edgar Guest

Thursday, November 28, 2013

Thanks Giving

It is  customary today to give thanks for all the opportunities this wonderful country affords us to be all that we can be. As a relatively new immigrant, I also bow my head in gratitude for having been allowed to fulfill some of my most cherished dreams.

I am grateful to all my teachers and mentors who along the way expanded my intellectual horizons, strengthened and galvanized my mind and soul and sent me off to a challenging and fulfilling career.

Most of all, I am grateful to my patients who through the years invited  me along their wonders-full journeys of self-discovery and trusted me with the most sacred  parts of their minds, their growth and healing are inextricably linked to mine. They have been my best teachers and to them I offer my heartfelt thanks.

Saturday, September 14, 2013


You told me that if you were granted  a little more time you would let the women in your life know how much their love and tenderness and kindness have meant to you. You said that if you had another chance you let the tears of gratitude and vulnerability and even fear flow in their presence. You promised that if you could take a few more breaths you would even dare speak these three little words that had always scared you so much: I love you.

But you did all that W.  and much more:  you taught  me that dignity does not have to fall victim of aging or illness.  You showed me that even with death a close step behind you can still dream and enjoy a glass of Remy  Martin and the best dark chocolates you could hunt down.  You saved some of those precious breaths to make me laugh with stories of your mother and to teach me Yiddish. Because who better to keep the language alive than your Greek therapist.

You did get your second chance W. and had the courage to use it right. So rest in peace, Shalom.

Tuesday, July 23, 2013

The rape of the Soul

I was raped by a monster who called himself my uncle and then I was "raped" again by my parents who told me to "forget it and move on". They told me that this kind of a thing would tear the fabric of our family apart,  that it would for sure kill my grandparents.

So, I locked this deadly secret deep in a dark place in my mind and I built thick walls around it to keep it inside and to keep out a world that had turned cruel and treacherous and duplicitous. As I grew older the Walls got thicker and higher and the light of my soul dimer and colder. Then I was told that I was cold and bitter and ungrateful and nobody would love me because I turn everyone away.  And you know they are right!

So, I told my patient the story of Medusa. And here it is for all who suffered and kept the secret.

There was once in a time beyond time a beautiful maiden with golden long hair and eyes the color of the dark blue sea.  She was so radiant that Poseidon, The Lord of the seas, was stricken by her beauty and when she rejected him he raped her right in the temple of Athena where she had gone to make her offerings. Athena who saw the whole thing got angry but being that Poseidon was her uncle and getting angry with him would had carried  no favors with the rest of the Olympians she instead got angry with the girl. She punished her by turning her into a monster and her beautiful hair into venomous snakes. Her face was so horrible to behold that turned anyone who looked at it directly into stone. She was finally decapitated by Perseus but here is the interesting twist of the story: out of the blood of her severed head was borne Pegasus, the white stallion of the Poets. In other words inspiration and creativity and beauty.

The anger of the hurt and the weight of the secrets turn the heart cold and vengeful not just with the people who hurt us but also with those who want to love us. It is not until we face our anger that we can find the courage and creativity necessary to love and be loved again.
In the words of May Sarton:

I turn your face around! It is my face.
That frozen rage is what I must explore.
Oh secret, self-enclosed, and ravaged place!
This is the gift I thank Medusa for.

Saturday, July 13, 2013

I am the captain of my soul

Therapy, I was telling a despondent patient the other day, is like someone holding a mirror up to our soul. Sometimes what we see in it is the youthful, ageless part of us that shines and sparkles bright . Other times what stares back at us is the wrinkled by time, scarred by pain, burdened by responsibility side of us which we want to disinherit and run away from in anger and disgust.

When I was in my doctoral program we were expected to have therapy ourselves. We were asked by our professors to look into the same mirror that later on we will be holding up to our patients. So I, like the rest of us doctorate aspirants, complied with the request admittedly not without my reservations. As therapy progressed I named my therapist, half in zest half seriously, Freddy Krueger because many times after our session I felt that my heart was shredded as if I had spent the hour with the infamous soul-shredder. However, it was during those times that I learned the most. As if the oak tree of my life got taller and stronger with every emotional storm it weathered. I learned to look at my broken or bent branches, my scarred and carved bark as the emblems of my survival as the signs of my uniqueness. My therapist taught me what to trim, what to cut off and what to nurture and strengthen.

So, my dearest teacher and guide, in case I have not said it before, thank you for often "being cruel to be kind". Thank you for showing me that the future does not indeed lie in our stars or in the wounds of our past but rather in us, that the chapters of our lives lying ahead are for us to write because as Henley said:
It matters not how strait the gate,
How charged with punishments the scroll.
I am the master of my fate
I am the captain of my soul.

Sunday, June 30, 2013

Mother Nature is giving me a migraine

If you suffer from migraines you may have noticed that the frequency of attacks has increased this past year. But before you run to your neurologist in panic let me remind you that weather-related phenomena can cause a throbbing headache.Rapid changes in barometric pressure can change the charge concentration in the air and in turn flood the brain with serotonin which can cause head pain. The lightning from a thunderstorm may also cause a migraine. Actually it is 28% more likely that you will suffer a migraine during lighting.I think we can all agree that Mother Nature is having an angry fit this year across the Glob and those of us who suffer from migraines are keenly aware of her moods.

Other triggers for migraines include:
Emotional stress (good or bad stress)
Changes in schedule (weekends is often the time for an attack)
Traveling (especially airplanes)
Hormonal changes
Certain groups of food
Hunger (don't skip meals)
Strong smells like certain perfumes
Flashing lights
Noise and loud sounds

Tuesday, June 4, 2013

Depression makes us Bitter

No, really I mean it literally. A study published In May in the Annals of Family Medicine showed that in people with diabetes depression increases the risk of serious hypoglycemia by 40%. Hypoglycemia (dramatic drop in blood sugar) is a serious condition that sends a lot of people to the ER and can be fatal.

It is also the case that Depression is often (not always) accompanying diabetes. People with diabetes often take drugs that at this point work very well, sometimes too well in that they drop sugar levels too low. This being the case, depression can lower these levels even more sending the patient into a hypoglycemic episode. The lead researcher of the study, psychiatrist Wayne Katon, cautions people with diabetes to pay attention to symptoms of depression and seek treatment for it.   
Of course it is my strong opinion that there is no physical condition that if not caused by depression is not exacerbated by it. As I said in a previous blog, the tears the eyes will not shed the body will weep.

Sunday, May 19, 2013

A Real Life Faust

The world was my oyster she said. I started from the inner city slums and reached and touched the stars..

In her early 80s she was still a stunning woman with gorgeous blew eyes and a smile more brilliant than the huge stone on her finger.

I am dying she said. One moment I am traveling the world the next I am diagnosed with a rare and fatal illness. I am not ready to die especially not on this illness terms. I always got what I wanted but still there is an emptiness inside that power and money never filled. I want to feel whole before I die.

Her words carefully articulated and perfectly syntaxed painted a picture in my mind of a beautiful and powerful goddess issuing proclamations and receiving adulation from her throne set high up on a pedestal. I shared this image with her along with my feeling of how lonely and scary this throne can be at times. Her blew eyes pierced into mine searching for criticism or condemnation. What she saw instead brought a mist in her eyes which she quickly blinked away. There is no room for vulnerability in my world, she protested.

But vulnerability was exactly what this doctor had in mind for her healing. She had to come down from her icy throne and talk about her fear, ask for help from the people in her life, especially her loving husband whom she had always kept at an arm's length, most of all she had to find her own feelings of affection and get the courage to express them.

Reluctantly she started opening up, first to me about her fears of loosing her independence, of becoming a cripple, of putting her pride away and asking for help and finally of her dying. Then she started opening up to her husband and to her astonishment she felt closer to him than ever before and he became more loving. 

Months into the treatment she started for the first time in her life listening to the people in her family and friends and truly connecting with their problems and pains. The tears of joy in her niece's eyes when she paid her college tuition reawakened a feeling in her heart so intense that shook her very foundation. And just like that she discovered Faust's redemption : That her joy, her purpose, her wholeness, her very redemption was inextricably connected with that of those around her. Her tears were melting her icy pedestal and for the first time in a very long time she was feeling free and light, like a kid.

I don't know how long I have, she said to me one day, and there is plenty of work left for me before I die. You have opened my eyes to a world I had not believed existed for me and for that I am immensely grateful . There is one more thing you can do for me: Tell my story. There are other ice queens out there waiting to be saved, maybe my story will help.

 Yes, I believe it would and I am grateful and deeply touched for entrusting it to me.

Sunday, May 12, 2013

The organs weep the tears that the eyes refuse to shed

Psychologist have for years now accepted the connection between depression and susceptibility to infections and gastrointestinal inflammation. Two recent studies at the University of Michigan found that depression and the use of certain antidepressants are both associated with increased risk for Clostridium difficile infection, C. diff, which causes diarrhea and in some cases death.

More specific the researchers found that the risk of C. diff infection among people with a history of depression or depressive symptoms was 36 to 47 percent greater than among people without depression.  Very interesting was also the finding that bereavement and living alone was also found to lower the ability to fight infections in older adults.  

A second study, involving patients, average age 58, found a similar relationship between infection and depression. The same study found an association of specific antidepressants — Remeron, Prozac and trazodone — with C. diff infection. There was no association with other antidepressants.
Although the connection between these antidepressants and the infection was not clear and more research is needed, it seems that at the very least patients on these meds that come down with serious infections should be talking to their doctors about the possibility of switching to different antidepressants.  
The ancient proverb comes to mind: "The organs weep the tears that the eyes refuse to shed"
Whether ongoing depression or the pain of bereavement sadness needs to be experienced and processed appropriately before the body suffers too.   


Sunday, May 5, 2013

The best Antidepressant/Anxiolitic

I have often told my anxious and depressed patients that one of the most effective medication is exercise.  Their response is often " but I don't have the desire to do it, it will not work".
It turns out that  a new U.S. study finds that exercise can help reduce anxiety and depression, even when you don't feel like working out.

Researchers at the University of Colorado Boulder found that being forced to exercise -- for instance by a doctor or gym instructor -- helps reduce stress, anxiety and depression just as well as exercising voluntarily does.

Ok then, here is what I suggest for all of you skeptics who struggle with anxiety and/or depression:  come on in, we will go for a nice bike ride on our newly reconstructed boardwalk!



Sunday, April 28, 2013

More about Stress and Healing

For those of you who found the pervious tips for stress reduction helpful here are some more:

1. Learn some yoga It improves flexibility, it also helps you cope with stress and lower inflammation. Inflammation is an immune response that can be beneficial, such as when your body is fighting off infection, but chronically high levels of inflammation have been tied to health problems such as cardiovascular disease, asthma.

2. Make sure you get enough sleep. Getting adequate sleep doesn't just make you look better, it also improves your health and helps you stress less, according to the Centers for Disease Control and Prevention (CDC). Unfortunately, poor sleep and stress can be a vicious cycle: feeling stressed out during the day can cause you to toss and turn at night, then feel tired and even more stressed the follow morning. If you suffer from insomnia talk to your MD or to a psychologist.

3. Learn some Meditation. Numerous studies have shown the positive benefits of meditation, which include soothing stress, decreasing blood pressure, easing feelings of pain and even preventing relapses in patients with depression. For example, a 2008 study from Emory University in Atlanta showed that Zen meditation, which encourages mental awareness and control of one's thoughts while focusing on breathing, could treat disorders marked by distracting thoughts, such as attention deficit and hyperactivity disorder. There are many different meditation techniques, so don't think that you're required to sit cross-legged and hum a mantra to de-stress. Some meditation styles focus on clearing one's mind, while others encourage visualizing healing or calming imagery or thinking kind thoughts towards oneself and others. Those with physical limitations can also meditate while sitting in a chair or even lying.

4. Venting has its limits. Complaining about what's stressing you out may seem like a good idea, but a study published in July showed that unloading about your problems to a friend may not always be helpful. The study, which was conducted by researchers from the University of Kent in England, found that when people with traits of perfectionism faced daily setbacks, venting made them feel worse . These study participants felt less satisfied with their circumstances than before they talked to a friend about what was stressing them out.

5. Instead Keep a journal. Keeping a journal can lessen stress in several ways, according to the National Institutes of Health (NIH). When you're feeling frazzled, writing down your feelings makes you feel more in control, and may help you better analyze the situation. It can even give you a new perceptive or ways to address the problem. And by looking over past journal entries, you may begin to see a pattern of what stresses you out, according to the NIH. You can then decide what needs to change to prevent those stress triggers from affecting you in the future.

6. Even better: Talk to a psychologist. It is more than venting. It is healing and enlightening.

Tuesday, April 23, 2013

Healing the Trauma

For the survivors of the Boston massacre and all of us surviving the blows of life.
I hope the words of the Poet are as soothing to you as they are to me.

A Psalm of Life

Tell me not in mournful numbers,
Life is but an empty dream!
For the soul is dead that slumbers,
And things are not what they seem.

Life is real! Life is earnest!
And the grave is not its goal;
Dust thou are, to dust thou returnest,
Was not spoken of the soul.

Not enjoyment, and not sorrow,
Is our destined end or way;
But to act, that each tomorrow
Find us farther than today.

Art is long, and Time is fleeting,
And our hearts, though stout and brave,
Still, like muffled drums, are beating
Funeral marches to the grave.

In the world's broad field of battle,
In the bivouac of Life,
Be not like dumb, driven cattle!
Be a hero in the strife!

Trust no Future, howe'er pleasant!
Let the dead Past bury its dead!
Act, - act in the living Present!
Heart within, and God o'erhead!

Lives of great men all remind us
We can make our lives sublime,
And, departing, leave behind us
Footprints on the sand of time;

Footprints, that perhaps another,
Sailing o'er life's solenm main,
A forlorn and shipwrecked brother,
Seeing, shall take heart again.

Let us then be up and doing,
With a heart for any fate;
Still achieving, still pursuing,
Learn to labor and to wait.
Henry Wadsworth Longfellow

Saturday, April 20, 2013

We will endure. Six ways to handle trauma

The grueling images from the Boston massacre tore at my heart and haunted my dreams.
Tearful people sat in my office and talked about their shredded sense of security:
" I am afraid to go to my classes, the movies, the Mall". I heard it many times over this past week.

The fact is that "evil" has always existed in the world and our abilities to predict or stop it leave much to be desired. What is magnificent ,however, is our species' ability to persevere and thrive in spite of it. So here is what I would suggest:

  1. Turn off the TV and turn on music. Repeated exposure to traumatic news is retraumatizing  and   sets off negative thinking patterns. Music calms the emotional brain centers.
  2. Go out with friends or family and have a fun time. Laughter is a natural antidepressant.
  3. Do some exercise: walking, bicycle, yoga... Endorphins is another natural antidepressant.
  4. Be with nature: the ocean, the parks, your garden. Nature heals.
  5. Pick a task, no matter how big or small, from your To Do List and finish it today.
  6. Spoil yourself. The iPad, new phone, the manicure you had wanted, GO for it. Terrorists want to reduce us to miserable recluses and destroy our way of living because they are losers and jealous of our successes. Fight back. Reaffirm life.
We can not totally avoid evil or crisis, but we can control how we handle them. We have and we will endure.

And of course if trauma symptoms continue see a psychologist. We are here to help.

Monday, March 25, 2013

I Rise

A mind fragmented by childhood abuse.  An adulthood in tatters because of prejudice and betrayal. Yet we put the fragments back together and out of the ashes of her past life was born someone beautiful to tell a story both heart breaking and inspiring.  When we bid each other goodbye I gave her her  "diploma" and never before Maya’s words sounded more true, more palpable, more heartfelt.  

Here is to S. and all of you who overcame obstacles and  Still Rise:
Still I Rise
You may write me down in history
With your bitter, twisted lies,
You may trod me in the very dirt
But still, like dust, I'll rise.

Does my sassiness upset you?
Why are you beset with gloom?
'Cause I walk like I've got oil wells
Pumping in my living room.

Just like moons and like suns,
With the certainty of tides,
Just like hopes springing high,
Still I'll rise.

Did you want to see me broken?
Bowed head and lowered eyes?
Shoulders falling down like teardrops.
Weakened by my soulful cries.

Does my haughtiness offend you?
Don't you take it awful hard
'Cause I laugh like I've got gold mines
Diggin' in my own back yard.

You may shoot me with your words,
You may cut me with your eyes,
You may kill me with your hatefulness,
But still, like air, I'll rise.

Does my sexiness upset you?
Does it come as a surprise
That I dance like I've got diamonds
At the meeting of my thighs?

Out of the huts of history's shame
I rise
Up from a past that's rooted in pain
I rise
I'm a black ocean, leaping and wide,
Welling and swelling I bear in the tide.
Leaving behind nights of terror and fear
I rise
Into a daybreak that's wondrously clear
I rise
Bringing the gifts that my ancestors gave,
I am the dream and the hope of the slave.
I rise
I rise
I rise.