artsmuklermd

Author: artsmuklermd

Art Smukler, MD was born and raised in Philadelphia, went to college and medical school in Pennsylvania, and completed his psychiatric training at UCLA. He is a board-certified psychiatrist, specializing in the treatment of adults with a subspecialty in adolescents. As a member of the UCLA faculty, he ran an award-winning psychotherapy conference for psychiatric residents and received the coveted “Golden Ear” award. He has published in psychiatric journals, and won the award for excellence in creative writing at The Santa Barbara Writers Conference. Now a full-time author, he applies his deep understanding of the human psyche to the motivations of his fictional characters.

Paranoia, a feeling that someone is trying to harm you, get you, follow you, or send messages to you via TV, radio, cell phone, or some other unearthly means is a common psychiatric symptom. It is an example of delusional thinking and occurs in patients who have lost touch with reality.

One characteristic of being paranoid is that you suspect everyone of potential mayhem — the paranoid’s “danger antennae” is always on full alert. No one is immune to being a suspect.

Since the psychiatrist is always a major suspect, it makes treating patients with paranoid disorders extremely difficult — not impossible, but as you can imagine, very time intensive, sometimes dangerous, and often frustrating. Here’s an example from Skin Dance, a mystery. Jake Robb, a psychiatrist, is called to the Emergency Room to treat Sean Murphy, a paranoid sixteen-year-old boy.

Lying face-up on a gurney, wrists and ankles in leather restraints, was a huge man-beast — untrimmed beard, greasy-hair down to his shoulders, a look in his eyes somewhere between murder and Mars. Paranoia crossed all boundaries — age, religion, sex, social position. It was truly an egalitarian disorder.

“Sean?” Jake said softly, closing the door. “I’m Doctor Robb, a psychiatrist. Your dad is very worried about you. He wants–”

“Get me the fuck out of here!” Sean yelled, pulling on the restraints and arching his back. “You’re one of them!” He glared at Jake, nostrils dilated, eyes wide, teeth clenched.

“How am I one of them?” Jake asked, voice calm and gentle.

Sean pulled harder on the leather straps, the whole gurney shaking.

“Sean, your blood studies show you’ve been drinking and using speed and pot.”

“Get away from me or I’ll rip you a new asshole!” Sean jerked hard on the straps, fixing Jake with another hate-filled look.

“Who’s trying to hurt you?”

Sean glared, continuing to pull hard, straining, sweat glistening on his forehead.

“Sean, do you know where you are?”

Sean strained even harder, the desperation building.

“I’m not going to hurt you, I’m a doctor, a psychiatrist. I just want to help you feel better.” Jake reached down and put his hand on Sean’s shoulder.

“You fucker!” Sean wrenched his face around, his teeth bared and his jaw snapping together hard. Jake jerked his hand back.

“Sean, no one’s going to hurt you.” Jake’s voice sounded calm even though his heart was pounding. The crazy kid was less than an inch away from chomping off his finger.

After fifteen fruitless minutes, Jake left the examining room and walked quickly to the nursing station. “Mary, please give Sean twenty milligrams of Geodon IM. Let’s get him upstairs to the eighth floor, back on the closed unit. Be very careful. The Grizzly bites.”

Paranoia can also be viewed positively. It is a powerful tool for our fictional heroes and heroines to possess. Jack Reacher, Lee Child’s hero, always seems to know when the bad guys are ready to pounce. Without “healthy paranoia” Jack wouldn’t have survived his first novel.

Even “normal” people who are placed in difficult and life threatening situations can use this magical trait. If psychotic people can be paranoid, why can’t a healthy person develop the trait and use it to his own advantage? When our characters are battling vicious sociopaths they need all the psychological help they can get.

Dr. Art Smukler is the award-winning writer 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.

General Mills recently had 2 Cheerios ads, one on the Super Bowl, that featured a mixed-race little girl, a white mom and a black dad. When bigots and the religious right attacked General Mills because the ad polluted family values, General Mills stated that they believed in all kinds of families and held firm.

When CVS decided to stop selling cigarettes, no one, except maybe two-pack-a-day addicts, complained. They didn’t have the lung power to walk an extra block to a competitor.

We should all cheer when Captain Corporate America battles bigotry and hypocrisy (What’s more hypocritic than a drug store selling cigarettes?).

The public was bilked out of billions of dollars and thousands of lives when Toyota, GM, RJ Reynolds, Phillip Morris, and various banks and drug companies covered-up lies so we’d keep buying cars, tobacco, mortgages and flawed drugs.

In psychiatry, cover-ups are common. Facing early wounds, abandonment and early trauma are painful. In therapy, repression and denial are common and patients enter long battles to unravel their feelings, actions and dreams; so they can feel better and eliminate their symptoms.

On the other hand, corporations have no excuse. They don’t behave like bandits and killers because they are repressing unconscious ideas. They repress and deny because for years they’ve been able to get away with it. Sociopaths hide behind the corporate mantel and manipulate to get more power and money. Their symptoms occur when they’re caught and have to suffer for their sins — fines and/or jail.

What do General Mills and CVS risk losing? Well, bigots can certainly choose to not eat Cheerios and smokers can choose to get lung cancer and obstructive lung disease from any number of other drug stores.

Personally, I’m going to CVS to buy my next box of cereal.