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July 2004

Bleachers, the book

John Grisham writes beach books. They are fast and fun to read. They usually deal with legal issues. His book, Bleachers, departs from his usual subject and deals with high school football.

"High school all-American Neely Crenshaw was probably the best quarterback ever to play for the legendary Messina Spartans. Fifteen years have gone by since those glory days, and Neely has come home to Messina to bury Coach Eddie Rake, the man who molded the Spartans into an unbeatable football dynasty." Now as Coach Rake's "boys" sit in the bleachers waiting for the dimming field lights to signal his passing, they replay the old games, relive the old glories, and try to decide once and for all whether they love Eddie Rake - or hate him. For Neely Crenshaw, a man who must finally forgive his coach - and himself - before he can get on with his life, the stakes are especially high.

I found the book trite and cliched, but hey it was fun to read. It doesn't require much concentration or effort.

The creative tension is derrived from football glory days gone awry for players as well as a hallowed coach. In spite of regrets and some awareness that the values that drove them during their winning football days were bogus, they still maintain, in the face of death, that what was done had a touch of greatness to it. It seems counterfeit and a stretch to me, but I am sure that football fans and people who get their sense of self esteem from identification with sports teams will resonate.

Good mental health is based as much on positive values as anything. The value of winning at all costs even to the extent of maiming one's opponent is sick. It is unhealthy for the players, the opponents, and the fans who revel in the lust of the win. There is something greedy, lustful, and obscene about winning as a result of exploiting others including oneself. Coach Rake exploited his players whom he claimed to love to the point of killing one of them inadvertently, and leaving many of the others hating him even as they question their loyalty (love) for him. It reminds me of abused children who still love their parents.

This abusive exploitation supposedly brings Coach Rake, as well as the players he exploited and the fans, to the brink of "greatness". It reminds me of the greatness and grandeur of the Third Reich. Evil and cruelty can appear "great" in the awe we feel as we view its power. There is a very thin line sometimes between awesome power used for constructive purposes to create and destructive purpose to destroy. It is this ambivalence between good and evil, creation and destruction, that leaves us confused about insanity and greatness. They sometimes look like the same thing.

As Coach Rake lies dying he has some regrets as well he should have. Too bad he didn't recognize the negative impact of his destructive values sooner. As people reflect on the passing of Coach Rake there is a depression that sets in not only about glory days past, but about maybe having chosen poorly and valued the wrong things. If this is one of Grisham's points in his story, he could have done a better job of making it.

I don't necessarily recommend this book, but if you have nothing better to do it will help pass the time, and it certainly is better than TV.

Barnes?&?Noble.com - Bleachers


Farenheit 9/11, the film

farenheit_911I loved Farenheit 9/11.

Michael Moore is one of the most courageous people in America today. He takes on the President, and his administration, and some of the richest people in the world. He shows how the rich exploit the poor to get richer. They do it by pandering to people's fear. They wage war and kill people for political power and money.

There is no good reason for the United States to be waging an immoral more in Iraq. The Pope and most of the world agrees.

The fact that so many good Americans could be duped into this fiasco on false pretenses as they grieved the loss of their fellow Americans in 9/11 is finally coming to light and it is making many people very uncomfortable. People don't like to admit that they have been played for fools and that they were wrong in supporting a misguided and immoral foreign policy. Meanwhile, the real trouble makers and criminals go their merry way.

The thing that inflames people against Michael Moore is their fundamentalist interpretation of patriotism. It reminds me of the Viet Nam era all over again when the protesters were told by the rabid chauvinists "to love it or leave it", and "better dead than red".

Turns out the whole domino theory of the world falling to communism was wrong and 58,000 of my fellow Americans died in that war. You would have thought that Bush and his buddies would have learned the lesson, but history is repeating itself and Moore has the guts to read between the lines and tell a story that leaves the open minded viewer with the idea that there is much more going on here with this war in Iraq than meets the eye.

Michael Moore says that he made this movie because he doesn't want to see Bush re-elected. I think our nation and the world would be much more mentally healthy without Bush in the White House.

The delusions that have fueled a disasterous policy such as the belief in WMD, nuclear weapons, links to Al Queda, and freeing the world for democracy have persisted in this administration. It is time for saner heads to take over. Hopefully, the American voters are sane enough to recognize craziness when they see it, and vote for change.

The technical definition of a delusion in psychiatry is a "fixed false belief". In other words the delusional person persists in their belief in spite of new information which contradicts the belief. President Bush and his administration continue to insist that the grounds they used for the basis of this war continue to be true in spite of the facts that contradict them. The world knows better and is furious with us as well they should be.The American people owe it to their brothers and sisters around the world to be honest with them even if their elected representatives won't. This administration has continually and persistently lied about why it has chosen to kill people for peace and freedom. As they say, "Ya either laugh or cry", and Michael Moore will have you doing a little of both.

I highly recommend this movie.


High co-morbidity between nictoine dependence and gambling

bingoWhile the prevalence rate for smoking in New York State is 23 %, there are studies which show that the rate of smoking for people with problems with alcohol is 80%, people with Schizoprhenia 85%, people with depressive disorders 65%, and now a study reported in the June 23, 2004 issue of WAGER, a weekly newletter dealing with gambling problems published by the Harvard Medical School suggests that there is a very high association between gambling and smoking.

This is interesting in light of a recent development in Genesee County, NY where a waiver was granted to a local volunteer fire department from having to comply with the New York State Expanded Indoor Clean Act Act so that they could have smoking at their bingo games. Apparently, attendance at bingo had dropped off significantly when smoking was not allowed.

It appears that there is a very high co-morbidity between smoking and addictive behaviors whether the addiction is to chemicals or behaviors like gambling.

The Wager 9(25): What’s Underneath? The Role of Negative Affect in the Tobacco/Gambling Link


People with Co-Occurring Disorders Overlook Treatment Needs

"A report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) finds that the majority of individuals with both serious mental illness and addictions don't realize that they need treatment for either or both conditions.

According to the "Adults with Co-Occurring Serious Mental Illness and a Substance Use Disorder" report, 52 percent of the four million adults with co-occurring disorders failed to receive mental health or addiction treatment during the past year. Only 12 percent received treatment for both problems, while 34 percent received treatment for mental disorders, and only 2 percent received addiction treatment.

The report showed that 61 percent of those diagnosed with mental illness and an addiction didn't go for treatment because they believed it wasn't needed."

I sometimes tell my clients, "You're not nuts if you know you're nuts. The problem is if you are nuts and don't know it."

People who are nuts and don't know it wind up usually arrested, visited by child protective services, fired from a job, shunned by neighbors, suspended from school, etc. Our society has ways of dealing with deviant behavior that falls outside the realm of health care services.

As our quote of the day today from Karl Menninger says, "Mental health is the ability to maintain an even tongue, an alert intelligence, socially considerate behavior, and a happy disposition." How many people do you know who would measure up to this standard? I know that I don't always, but when I don't measure up, I usually know it, or when others point it out, I listen to the feedback and consider it.

I don't know what it means when 61% of the four million people with mental illnesses and substance abuse disorders didn't go for treatment because they didn't think they needed it. Perhaps ignorance and/or denial is bliss until problems get you into trouble and then perhaps you would have wished you had known. In the substance abuse field this is called "hitting bottom."

Socrates said that an unexamined life is not worth living. How many people do you know that live examined lives?

I have a friend who was an assistance district attorney for a while in a rural county. He told me that he and the District Attorney had decided to revamp the penal code and instead of having violations, misdemeanors, and various levels of felonies, they would simplify the whole penal code and only have three categories: stupid one, stupid two, and stupid three. We laughed together as he told me this story, but as I have gone on with life and hear about the trouble people get themselves into, I think he and the DA had it right.
People with Co-Occurring Disorders Overlook Treatment Needs


The Fourth Step and Leadership

I was talking with a client yesterday about her doing her fourth step. For those of you who may not be familiar, Alcoholic Anonymous is what is called a 12 step program because people in recovery need to proceed through twelve steps according to AA. Many people abstinent from alcohol never do their twelve steps and they continue with the same nutty behavior even though they are abstinent. These folks are referred to as "dry drunks".

The fourth step is to do a "fearless moral inventory" of all the people who were harmed by the drinking. My client asked me what this is about and how she should do it. She is working on this with a friend.

As we discussed the reason for doing a fourth step, it dawned on me that people who don't do a fourth step are still in denial. The still have not recognized, let alone acknowledged, the harm that was done by the drinking. We call alcoholism a "family disease" because more people are effected than just the person doing the drinking. Every person that drinking person is in relationship with is effected in some way, and even people who are in relationship with a person who is in relationship with a person who is drinking can be effected such as children of a mother who is married to a husband who drinks. She is upset by her husband's drinking and so is in a bad mood in caring for her kids.

At any rate doing a fourth step can be a very powerful learning and transformative experience in one's life.

I have been wanting to write about leadership because I see things going on in politics and in life in other areas that can't be explained by surface facts. There are hidden dynamics that are influencing events and being a curious person I want to know about the hidden agendas and the hidden facts. That's probably why I enjoy being a therapist.

So as I was talking with this woman about doing her fourth step, I got to thinking about the President's and the Vice President's alcoholism. President Bush says he never got any treatment for his alcoholism or his drug problem, but rather found God, and took up jogging. Is it accurate to think he never did a fourth step? This would explain his denial of any mistakes or culpability at his last press conference where several reporters asked him repeatedly whether he had any regrets or felt he or his administration had made any mistakes on his foriegn policy. He said he couldn't think of any, which in my mind is a scary answer, and indicates to me a man either in denial or scared to face reality.

So I continue to wonder what behavioral health has to do with leadership? Is it possible for a person to be a good leader who is not mentally healthy? We have President Clinton who got involved sexually with an intern and then lied about it, and now President Bush who leads a nation to war on false pretenses. Both men have their demons: one a sexual addiction, and the other a chemical addiction. Perhaps we should only choose leaders who are in recovery who have done their fourth step.


DEAD BY SUNSET, the book

Probably no author writes better true crime books than Ann Rule. I am not a big fan of this genre, but every few years I read one of these type of books just to remind myself what some people are capable of. I first read Rule when I read her book Small Sacrifices which is a story about a woman who kills her children because she believes they are interferring with her relationship with her boyfriend.

In Dead by Sunset, Rule tells the story of Brad Cunningham, a psychopathic fellow, who kills his wife, Cheryl Keeton. If you would like to see what the mind and behavior of a psychopath look like this is a great example.

Brad was married five times, very successful Real Estate developer and banker, enjoyed a very hedonistic life style, was extremely charming and talked five women into falling in love and marrying him whom he then exploited financially, sexually, and emotionally.

As a therapist, I am still at a loss to understand what makes people like Brad Cunningham tick. Rule does a great job describing his functioning and the havoc he wreaks in the lives of others.

I recommend this book.

Amazon.com: Books: DEAD BY SUNSET : DEAD BY SUNSET