I LOVE THAT BERNIE SANDERS IS NOT A PUPPET TO ORGANIZED RELIGION, by Art Smukler, author & psychiatrist

Recently, Bernie Sanders was asked whether he is religious. He said, “Yes, I am religious. When a child is hungry, it really bothers me. When a child can’t get the medication he needs because his parents don’t have insurance, it bothers me. When people are oppressed and discriminated against, it bothers me.”

Years ago, when I decided to become a physician, I was asked by a medical school interviewer why I wanted to become a doctor. I answered, “I want to help people.” The interviewer, a research chemist, then spent the next hour telling me how research chemists also help people. One month later, one of the most important, happiest experiences in my life (ranking up there with marriage and the births of my children) occurred. I was accepted to medical school.

Helping others is really what religion and being a good person is all about. It’s not about pandering to the religious right who HATE everyone who doesn’t agree with them and donates huge amounts of money to the candidates who can hate along with them.

Wouldn’t it be a relief to truly separate church and state, as our constitution espouses, and focus on making our country a place where we once again can spend our energy taking care of each other?

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DONALD TRUMP AND THE BATTERED WIFE SYNDROME, by Art Smukler MD, author & psychiatrist

Everyone has an opinion about why Donald Trump is still the Republicans’ #1 candidate.

His politically incorrect stance on immigration, foreign policy, trade, Muslims, and even on beating up people who disrupt his speeches, is a combination of appalling, intriguing, and flat out entertaining.

Many of his supporters don’t seem a bit bothered by his bullying style. He has stated that if fellow Republicans say anything that is not accurate or a lie it will be his pleasure to sue them. Geez. Maybe if I say the wrong thing he’ll sue me and the notoriety will make me famous enough to sell my books. On the other hand, I don’t know any psychiatrists with an eight billion dollar war chest. Maybe it’s better he doesn’t sue me…

But, back to, Why is this man who has been identified as grandiose, narcissistic, brilliant, a fool, and dozens of other colorful adjectives, still the front-runner and gaining every week in the polls?

There’s a concept in psychiatric thinking that seems to answer the question. It’s called Identification with the Aggressor. Another way to look at it is that the weak find solace and strength in the powerful.

Think about the battered wife who goes out of her way to hide her bruised body and protect the man who regularly harms her. Her perverse logic is that he’s really a good man who can’t help himself. The truth, if she ever has the strength to face her real feelings, is that she believes she desperately needs him. He is the strength that she doesn’t have and without him she believes she will surely fail. She identifies with the bully’s strength and can function better because his strength is now her strength.

So are The Donald’s supporters all like battered wives?

Maybe…

For years we have helplessly endured a pathetic, weak congress who have led our country into a dysfunctional mess. Then along comes a billionaire who couldn’t care less what he says or who he offends. It’s exciting and heady being able to tell the establishment to go to hell. It’s fun watching and listening to someone tell all these professional politicians that they are incompetent fools.

On the other hand, letting a bully loose in the world schoolyard is very dangerous. Just like the battered wife loses her identity as a human being, we risk losing who we are as a democracy and a country that thrives and encourages diversity.

So what’s the answer? Let our current politicos abuse us or let The Donald abuse us?

We don’t have to let anyone abuse us! We are not battered wives or husbands or need to be a battered electorate. Vote for the people you believe in. Forget what party they belong to! Focus on what they can do to solve our current dilemmas. We don’t have to identify with a man we don’t believe in just because he’s not afraid to say whatever thought passes through his mind.

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

Posted in Bullying, CHASING BACKWARDS, a psychological murder mystery, Psychiatry, Self Examination, Skin Dance, a mystery, The Man with a Microphone in his Ear, World events, a psychological view | Tagged , , , | 11 Comments

DONALD TRUMP, POTUS? IS IT POSSIBLE? WHY IS HE SO POPULAR? By Art Smukler, author & psychiatrist

Donald Trump doesn’t care who he offends. Whether you agree or disagree with his political statements, he’s making them without any consideration for the far right Republican Tea Party, the far left Democrats; or the holy grail military. Even the middle-of-the-roaders are standing around with their jaws agape.

If he really wants to become president, why is he making such dramatic politically incorrect statements?

Maybe it’s the fact that he has somewhere between 4 and 8 billion dollars (definitely enough to be considered F U money) and can say whatever he wants. Maybe he’s a narcissist and believes that whatever he thinks or says is verbal gold? Maybe he’s a political Howard Stern and just likes to shock people? Whatever his underlying motivation, his rhetoric is shockingly honest and unique.

He’s actually #1 in the Republican polls. Why is he so popular?

I think the american people are sick and tired of being afraid. Anti-immigration and devaluing of prisoner-of-war John McCain are statements that no one trying to get votes would publicly say, but there are many americans who obviously agree with Trump. Also, maybe it’s not his specific statements that are attracting so many supporters, but the fact that he is actually saying these things aloud rather than spouting all the veiled, politically correct statements that the other candidates bandy about. 

So what does it all mean?

What it means is very scary. He’s actually gaining traction. His outlandish style is attracting millions of followers.

Yet, this man, for all the wrong reasons, can change the political scene. What if all of the candidates took heed and stopped lying and manipulating, and really spoke their hearts? We could actually choose a candidate who had values that could help our country. As a country we need politics to change. We need honest people who aren’t afraid to state their beliefs, and not just a fearless self-serving billionaire. I wish a great leader would emerge. One that says, “You’re hired,” and takes pride in caring for others rather than pompously putting them down. Trump likes people who weren’t captured, yet he never served in the military. How would he tolerate years of abuse? Would he still have a grandiose, all-knowing attitude?

Our broken system needs fixing. And, even though I don’t like or agree with Donald Trump’s politics, I like his style of not being afraid to say what’s on his mind. That’s what the United States is all about.

Picture this very grim scene.

It’s a cold January in 2017 and Donald is standing in front of the White House being sworn in by our Chief Justice. The wind rustles the barren limbs of the trees, thousands of watchers pull up the collars of their heavy coats, and Mr. Trump’s comb-over shimmers over his face as he takes his presidential vow.

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COURAGE? WHAT DOES IT TAKE TO HAVE IT? THOUGHTS ON BRUCE JENNER, by Art Smukler author & psychiatrist

Being first is a national pastime. The World Cup, the World Series, the Super Bowl, and now being the first celebrity to announce being transgender has taken society to a new and more inclusive level. 

To be different used to be a curse. The goal was to fit in and be part of the group. Even dating outside of one’s religion was considered “dangerous” and wrong. As a teenager, I remember the angst and confusion I experienced when I wanted to date a girl who wasn’t Jewish.

With a lot of anxiety I brought up the issue to my uncle, the goto adult when a troublesome issue plagued me. 

“So Uncle Bill, I kind of have a problem,” I said, during a slow time at the auto accessory store where I worked for him.

“What kind of problem?”

“I want to take out this girl. She’s really nice…, but she’s not Jewish.”

He nodded and said, “So what’s the problem?”

“She’s not Jewish.”

He nodded again and said, “So what’s the problem?”

I just stared at him, comprehension and relief overtaking me. “Thanks,” I said. “Thanks a lot”.

Validation and permission were and often are important. Uncle Bill’s reaction to a young Bruce Jenner asking what he should do about feeling like a girl, even though he is a boy, might have required a lot more thought and exploration. But, if the Uncle I so fondly remember stays true to my memory, he would have eventually hugged Bruce and supported his decision.

To support someone whose ideas and life seem not only “out of the box” but on a different planet, is not easy. It calls on us to ACCEPT what we instinctively feel to be wrong. To really hear and respect the right for an individual to be different from what “everyone” says he should be.

Often agreeing with “Everyone” is just another way of being safe and not taking the time and risk to evaluate what you really believe. Standing up against the majority always takes courage and the intellectual strength and curiosity to pose the question, “What do I really think?” And,”Do I have the courage to back up my idea with action?”

Bruce Jenner is a brave man. His courage will surely help other men and women have a better life. 

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.
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Posted in Childhood Trauma, Psychiatry, Raising Children, Self Examination, Uncle Bill's Place, World events, a psychological view | Tagged , , , | 7 Comments

EVEN WITHOUT THE “L” IT’S ME! Art Smukler, author & psychiatrist

April 16
Author Talk with Art Smuker
6 p.m.
Westwood Branch Library
1246 Glendon Ave., Los Angeles

Arthur Smukler, an award-winning novelist and Torrance-based psychiatrist, comes to the Westwood Branch Library to discuss his blog, “Inside the Mind of a Psychiatrist, Harnessing Obsessions to Write Books and Stories” and read from his mystery novel, “Skin Dance.” This event is free to the public and designed with adults and seniors in mind.

310-474-1739
http://www.lapl.org

Posted in CHASING BACKWARDS, a psychological murder mystery, Psychiatry, Self Examination, Skin Dance, a mystery, The Man with a Microphone in his Ear, Writing | Tagged , , , , , , , , | 6 Comments

ANGER, THE MAGIC ELIXIR THAT CURES DEPRESSION, by Art Smukler MD, author & psychiatrist

In the late eighties, managed care became an intrinsic part of our healthcare system.

The goal of saving patients money and still providing excellent care was a blatant lie. Psychiatrists were penalized for doing psychotherapy by receiving lower reimbursement fees. Only if they focused their efforts on psychopharmacological management of the patient’s treatment could they make a decent living. It even influenced the way psychiatrists were trained. Many programs reduced the emphasis on learning intensive psychotherapy, focusing mainly on diagnosis and the treatment of disorders like schizophrenia, major depressions and bipolar disorders. Learning how to tease out the clues that would allow a patient to change the way he was behaving and cure his depression and miserable life were no longer seen as an essential part of the training programs.

Because drugs like Prozac, Paxil, Zoloft, Celexa, Lexapro, Wellbutrin, Effexor, Cymbalta, Pristiq etc. were such effective blockbuster money makers, drug reps would not only detail psychiatrists, but also family practice doctors, internists, gynecologists and any doctor who might have the opportunity to treat issues like depression and anxiety. If a patient came in to see his doctor for depression, he might very well be given a prescription for Prozac and told to make an appointment for a follow-up in a month. Often, the thought of referring someone to a psychiatrist would only occur after a suicide attempt or overt psychotic break.

BUT, no-matter how often the power of psychopharmacology was touted, it became clear that managed care, big pharm, and the change in training programs couldn’t alter the fact that in many, many cases, MEDS ALONE DIDN’T HELP CURE DEPRESSION.

Those of us who understand and use psychotherapy (and meds) to treat depression, know that often the real drug (the magic elixir) that cures depression, is expressing unconscious underlying anger. These angry feelings often date back to early childhood, when the fear of confronting an angry parent was foolish. How can a child conquer a giant ten times his size who has ALL the power?

So, if anger is unconscious, how can you express what feels like it doesn’t exist?

If you are depressed and the medication you’ve been given isn’t really helping, don’t despair. Not all things that are new and wonderful are correct. Sometimes, it’s the simple, logical things that are the real answer. Find a skilled therapist who really knows what he’s doing. The magic of uncovering unconscious demons really works and can make you feel a lot better.

Do you agree? Disagree? Any personal experiences?

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

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THE TALIBAN HAS A PSYCHIATRIST? ARE YOU KIDDING ME? by Art Smukler, author & psychiatrist

In the late 1990s until 2001, when the Taliban controlled Afghanistan, Doctor Nader Alemi, the only Pashto speaking psychiatrist in the area, actually treated thousands of militant fighters. Since many of them were struggling with the psychological effects of war — anxiety, PTSD, depression, psychosis etc., they were desperate for help. Even some commanders sought his care.

Dr. Alemi disagreed with the Taliban’s ideology, but still treated them.

I used to treat the Taliban as human beings, same as I would treat my other patients…even though I knew they had caused all the problems in our society. Sometimes they would weep and I would comfort them.

Incredibly, while all this was going on, his wife Parvin Alemi ran an underground school for about a hundred girls. Under the Taliban, girls were not allowed to study.

This article by Tahir Qadiry in the BBC News intrigued me. I asked myself what I would have done under similar circumstances. Could I treat someone whose ideology I despised, a person who under other circumstances would have gladly killed me and my family — an ISIS fighter, a Nazi, a white supremacist, a racist?

Dr. Alemi is a remarkable man, a man who sees the human side of all people. But, is the Hippocratic Oath still in play with someone sworn to kill you and anyone who believes what you believe?

The Israelis treat Palestinians who are ill or wounded. Throughout history, captured soldiers are medically treated by their captors. Does compassion lead to mutual understanding and kindness?

Every day, I treat people with opinions and philosophies that differ from mine. It’s what I and other health professionals do.

So, would I treat someone whose ideology threatens the lives of all non-believers?

I don’t know… I really don’t.

What do you think?

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

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THE EVOLUTION OF GOD AND POPE FRANCIS, by Art Smukler, author & psychiatrist

For a moment, let’s assume that there is a God, a powerful force that created the world and all its inhabitants.

Strict Old Testament adherents will say that it took seven days for God to create the world.

Men of science will adhere to the Big Bang theory, an enormous explosion of energy that was the true beginning of the world.

Islamists will say that Mohammed was God’s prophet and what was written in the Koran is inviolate. What the Koran says is fact.

Pope Francis is a man of courage. Attempting to get Catholics to accept our changing world is an amazing step forward. To promote the idea that gays and divorced people are part of our society and should be treated with the same respect as non-gays and married people can change how millions of people treat others.

For me, it isn’t religion that’s important, it is doing everything possible to help our world be a better place. Strict religious zealots do exactly the opposite. ISIS will happily kill anyone who doesn’t agree with their strict brand of Islam. Right-wing religious fanatics in our country have killed physicians who perform abortions.

I applaud Pope Francis. I respect and admire men in power who stand up against the religious power structure that only adheres to dogma.

Psychiatry is a profession that honors the rights of people to have their own opinions and lives based on personal beliefs. It doesn’t honor the rights of people to kill or attack others who don’t agree with them. In the seventies, psychiatrists believed that homosexuality was a disease. Their belief was wrong and now we know better. WE CHANGED. Homosexuality is not considered a disease. It is an accepted sexual preference.

The pope is trying to get fellow Catholics to change. Maybe his thinking can influence millions of people who are not yet capable of thinking for themselves. Leaders have great power. Using that power to make our world a kinder, more loving place seems to me to be the essence of what religion should be all about.

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

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IS PSYCHIATRY DYING? A REPRISE, by Art Smukler, author & psychiatrist

Since publishing this post last October, and living through the tragedy of Robin Williams suicide, my thoughts seem even more immediate and important. We can’t just watch our wonderful profession sink into mediocrity. Too many people need our expertise…

Once upon a time, psychiatrists spent uncountable hours during their training learning how to do psychotherapy. They studied the vagaries of the unconscious, had intensive training presenting cases to highly trained supervisors, read volumes on how the psychiatric greats treated their patients, and helped train psychologists, social workers, MFTs and other therapists to do therapy.

Then Insurance companies sold the concept of managed care. The mantra was simple. Treat symptoms not people. Don’t take time to understand someone, just take the depression and anxiety away. Time is money. A good psychiatrist is one who doesn’t use time, but fixes things quickly. Medication is the cure. Psychotherapy? Leave it to the other therapists.

Well, the insurance companies did what they set out to do. All the money they were paying psychiatrists (and I can assure you that those fees were nowhere near what surgeons or other specialists made) now went to the middle managers who were paid to limit care. Big business defined what was good psychiatry and what was bad psychiatry.

So what does it all mean? Should psychiatrists be happy prescribing medication and just let other therapists do psychotherapy?

To me, psychiatry is a specialty that is a combination of medicine, psychology and poetry. Only psychiatrists go to medical school and have the opportunity to understand the complete person. The mind and the body always work together. One can’t exist without the other. To just prescribe meds is the equivalent of removing only the top of the iceberg. What about the main part of the person, the part that was formed back in childhood, the part that psychotherapy reaches.

In Brave New World, the dubious answer to human pain was the drug “soma”. We can’t let that happen in our society. Just using drugs because they are a cheaper way to calm the masses and save money is short-sighted and hurtful.

Psychiatrists used to be masters of the mind. They used their unique skills to help all psychological professionals understand what people were all about and how to help them combat the psychological torture that was ruining their lives.

Limiting a psychiatrist’s skills to prescribing medication starts at the top. If training programs let this happen, they are short-changing all of us. If psychiatrists just want to make more money and not learn how to be masters of psychotherapy they are no longer masters of their profession. Master carpenters, master electricians, master cardiologists and masters of anything are an important part of creating a society based on excellence. Excellence is what we should strive for.

Is psychiatry dying?

Not in my office…

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

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HARNESSING OBSESSIONS TO WRITE BOOKS & STORIES, by Art Smukler, author & psychiatrist

Experiences that play over and over in our minds are often the ones that authors can turn into books or stories. Like the lyrics or tunes from a catchy song that you just can’t stop humming, an event or encounter can also keep replaying.

Rather than tuning out the obsessive thought, consider doing everything possible to flesh it out and examine all aspects of the experience. Often, our mind latches on to something for a reason. If we force ourselves to look deeper, there can be a surprising array of explanations that clarify why the experience just won’t go away and leave us alone.

A number of years ago, a patient suffering from intense bouts of depression described how he was placed at bed-rest at the age of six in a pediatric hospital for one year. He was suffering from Legg Perthes Disease, a congenital hip dysplasia, which if not treated appropriately would have led to severe crippling.

I couldn’t get the image of this little boy, trapped in a bed and hooked up to weights and pulleys, out of my head. At first I tried ignoring the image, but it just kept reappearing. Eventually, I sat down and forced myself to examine why this image was haunting me.

The explanation was a lot closer to my conscious mind than I realized. My patient was hospitalized at the Children’s Seaside House in Atlantic City, New Jersey. I had spent my childhood summers not far from where the hospital was located and actually remembered seeing children playing on the hospital grounds. As a child, the sight of those crippled children horrified me. Obviously, even as an adult physician, the memory was still disturbing.

So, one thought led to another and my character, Joe Belmont, a tough Italian medical student, with a traumatic past, was born.

From multiple hiding places within the Philadelphia neighborhood where he grew up, to the Jersey shore hospital where he was placed at bed-rest for 12 nightmarish months, to the financial district of Zürich, Switzerland, Joe desperately tries to unlock the secrets that have marked him for death. Finally he realizes that his only hope of survival lies in the one place he has always avoided, the darkest corner of his own mind.

With a lot of research and work, my obsession with a helpless little boy trapped in a hospital bed, was turned into a novel.

Obsessions are intense feelings about a particular person, place, feeling, or way of life. Many authors follow their obsessions from one book to another. Pat Conroy is obsessed with Charleston and the South, John Grisham is obsessed with renegade lawyers who risk their lives fighting evil attorneys, Lee Childs, in the form of Jack Reacher, is obsessed with the freedom that comes from not being attached to any possessions, except his toothbrush.

Using obsessive thoughts and harnessing them as writers is a means of hooking into our passion and using it in a positive way. How else can a person sit down and spend months and years writing unless they really care about the subject and the person they are writing about?

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

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