Ever wonder what we owe to our children?

As a doctor of psychology, married to an oral surgeon, my wife and I have certainly been able to give our daughter a great deal. Furthermore, just having one child, we have been afforded the opportunity to give her even more. However, would giving her whatever she wanted really have been prudent?

When our daughter was growing up, my wife and I instilled in her the importance of working for what you truly want. If we had just handed things over to her, I don't believe she would have developed a work ethic.

I notice in my practice, that at times parents are so willing to give their children everything -- to the point where they negate the motivation in their youngsters to have a sense of working for what it is they desire.

I have never been the type of person, or for that matter psychologist, who points his finger at others and chastises them for what they did or didn't do. Life, after all, is a journey designed to learn as we move through it. Nor do I believe that it is ever too late to change the way one proceeds.

I believe we owe it to our children to help them to help themselves to navigate through life and learn from their struggles. Life is such an exciting adventure to embark on.

I remember when I was a boy, I wanted a gas propelled model airplane. My father could have given me the money, but where was the lesson in that? Instead, he said if I was able to earn half the cost, he would match me dollar for dollar. I had a goal! I quickly lined up some neighborhood jobs: mowing lawns, dog walking, etc. By the time I had
enough for half of the plane, I was so excited and most of the excitement, I can assure you, came from the fact that I had earned the plane.

My dad had made my goal obtainable with his offer to pay for half if I earned the other half. He was wise enough to take the opportunity to turn my "dream" into a realistic goal that quickly became one of life's lessons: If you want something badly enough, you can achieve your goal through hard work.

That lesson has stayed with me right up to my current age. I am always willing to work hard, because it offers me the opportunity to be able to play hard. This lesson generalized to many other lessons. I quickly learned that if I had to work for things, I could not afford to be a "slacker." I needed to be a sober, clear-minded kid who was able to get up on time and not be late for my work obligations. This carried through to my schoolwork as well. I did my assignments on time so that I had the time to work for what I
wanted. After awhile, I actually can remember that I consciously said to myself, "If I have to do my schoolwork, then I might as well learn what it is I'm studying." After awhile this really paid off, too. I knew the material, and studying for examinations became less time-consuming and almost seemed like a review process.

I am not here to tell you that my childhood was immersed in a "utopia." - I certainly had my moments of laziness and desire to "act out." But I was always able to remember that when I was in the "zone," I could accomplish things.

Parents often believe that if they were not afforded something as a child, they have an obligation to get it for their kids. This all-or-nothing notion is simply not healthy.

We owe our children the knowledge that they are only limited by their own motivation or lack thereof; that they can, indeed, accomplish anything and everything. Youngsters must have the knowledge that it is their life and that they can make the most of it. Parents must model this for their children; stop handing over everything your child's heart desires, and do the right thing. Help your kids to be motivated to live healthy, productive, purposeful lives.

It may sound like corny dribble, but I can assure you it works.

The ego has always been referred to as the "executive of the personality." It facilitates the id to delay its need for immediate gratification (think of the id as that part of the personality that "wants what it wants when it wants it"), like the need to quell a craving.

The ego puts some reality in the personality game and says: "Well id, you must come up with a plan that is reality-based before your needs can be met."

To accomplish this executive function, the ego utilizes what is referred to as the reality principle. All those instinctual aspects of the id are powerful forces that can result in an individual  disregarding the reality that we live in a law-abiding society, and cannot simply do as we please!

So, the ego takes on important decisions by using intelligence to learn -- in other words, it has the capacity to utilize cognitive functioning, unlike the id which can be thought of as the "big baby" and cannot think logically for itself in an effort to protect us.

In the aforementioned paragraphs, you can see how the ego could play an important role in controlling id-oriented desires to use drugs and alcohol, leading to addiction. (The reader is reminded that this blog is dealing with theoretical constructs first postulated by Freud to understand the personality. Of course, there are biochemical explanations that explain addiction in more tangible terms, but that is for another blog.)

The ego also is referred to as the "self." When people abuse drugs and alcohol, they allow themself to be given over to their id-oriented drives and don't enable the self to take the time to think the drink or the drug through -- to deal with the reality of the situation.

Time and time again, I have parents who come to my offices who are in recovery and cannot understand why their youngster does not yield the genetic reality that they must be careful with alcohol and drugs because of a predisposition to the disease of addiction.

It would seem that tweens and teens have egos that don't want to think the drink or the drug through; that don't want to weigh the variables that would inform them that experimental use of drugs and alcohol is a dangerous street to go down, particularly given a familial history.

Instead, their id gets the best of their ego and the reality principle seems to be placed in the background, in favor of what they perceive as the need for immediate pleasure, what Freud termed the "pleasure principle."

These youngsters lack the self-control to deal with peer pressure and have poor "ego-strength," succumbing to the same errors in judgment that their parents made, only to result in their moms and dads wondering just what it was they were thinking.

The problem is that the youngster believes he or she is immortal and simply is not engaged in thinking! Instead, he or she is caught up in the immediacy of the moment, on an existential journey to try and find themselves. How ironic!

As part of a peer group, each teen yields to and at the same time influences the other to make the wrong decisions. AA refers to this type of cognitive process as "stinking thinking" and encourages testing reality by attending meetings where individuals can hear others over and over again, in an attempt to appeal to their logic; to bore a hole into their psyches and reinforce the reality principle.

Another aspect of the ego, is "self-efficacy" -- one's belief in their ability to accomplish a task. Teenagers, percolating with biological, psychological, and social changes, lack a great deal of self-efficacy. This only makes it harder to resist id-oriented urges for experimenting with marijuana, MDMA, opiates, alcohol, etc.

Ok, so what is the answer? I believe the answer lies in responsible parenting from a very early age. One is born with an id in tact, and then goes on to develop an ego. So the sooner parents set boundaries and teach rules and regulations, the basic dos and don'ts, avoid acting like their child's friend instead of their parent,  the better the chance that the youngster will build up an armormentarium that leads to strong ego defenses that can fight the relentless forces associated with the need for immediate gratification. You would not allow a young child to touch a hot stove; why not attempt to disallow the teen from smoking a joint?

Things like zero tolerance for drugs and alcohol may seem unrealistic, but they must be firmly entrenched in core family values.

Yes, experimentation may still take place, but consistent messages make for a stronger sense of self-worth, which in turn gives the youngster the self-esteem and self-efficacy to stand up to peer pressure.

Perhaps old Sigmund  could still teach us a thing or two -- even this cognitive behaviorist!

I recently appeared on the television program, "Inside Edition," to discuss the new drug concoction "sizzurp."

It consists of a combination of a rather old antihistamine drug known as promethazine in combination with  codeine syrup, which is a rather potent opiate.

Fruit flavored soda (usually Sprite or Mountain Dew) is then added as well, and (if you can believe it) Jolly Rancher candies!

It is all placed in a  styrofoam cup and because of the codeine syrup usually appears purple in color.

Between the codeine and the promethazine one experiences a sense of euphoria with impairment of motor skills.

If one consumes enough sizzurpp, he or she can experience seizures, as well as a drastic suppression of lung and heart function - which can lead to death. If you're lucky, perhaps you will only stumble and break an arm instead of causing a concussion!

Here is what troubles me: Why can't tweens and teens learn to "live life on life's terms?" Are the games offered on computers making their virtual world so wild, that an in vivo experience just seems empty, dull and drab?

Whatever happened to the excitement a youngster feels smelling the spring air, having a first crush, going swimming and diving and skiing, and skating, or smelling the nutty roasted smell of popcorn at the movies?

Perhaps I am missing something, but I'd much rather be hiking through the woods than doing something like sizzurp! I'd rather fly a kite, or body surf the ocean waves! I'd rather read a book and use this thing called an imagination, rather than risk a seizure!

But that's me: What about you?

Alcohol, boozy, tingling ice, smokey seduction.
Not sexist, racist, anti-semetic, age-bound, or prejudice in any way.
A friend on a lonely night that grabs a life and strangles it until you can't breathe.
Many friends -- liver disease, pancreatitis, colon cancer, breast cancer, heart disease, dementia, and many others, too many to mention.
A grip that builds to crescendo and then depletes to weakness, tears ripping apart families, breaking apart love, misdirecting, misleading, misadjusting, misaligning, misbalanced, misbecoming, misbegotten,misbehaving, misbelieved, misbranding, misbuilding, misclaiming, misconceiving, misconducting, misdemeanor, misdescribe, misdevelop, misdiagnose, misdirected, miseducated, misfortune!

In the 30 some odd years I have been in the field of psychology - specializing in co-occurring disorders, it is inevitable that at some conference I am always asked about psychiatric illness predating addiction, or addiction predating psychiatric illness.

As I point out in my book: "The PDR Drug Guide on Pediatric and Adolescent
Mental Health," which I co-authored with Michael Behar, MD, (Thomson Reuters, 2008), addiction is classified according to the "DSM IV," (American Psychiatric Association, 1994), as a mental disorder.

Certainly anyone who is actively drinking alcoholically, or using licit or illicit drugs to their detriment, is not in their right state of mind. We accept this as fact; however, we still get caught up in the "chicken and the egg" scenario.

Perhaps, this has to do with self-medicating behavior (do psychiatrically ill individuals self- medicate with alcohol and/or drugs, or do some individuals use alcohol and/or drugs to the point where they poison organs such as the liver and brain, developing various psychiatric conditions).

Any time a doctor of psychology, psychiatry, or any qualified mental health/addiction specialist conducts a psychiatric anamnesis,
they must ensure that they look at the identified patient's matriarchal and patriarchal genetics - is there any evidence of psychiatric or substance abuse history on either side of their family. This might seem rather obvious, but I can assure you it is often overlooked.

A good history must clearly attempt to reveal whether the individual had psychiatric issues prior to using substances, or perhaps only developed such symptoms from using substances.

I like to reinforce among my psychiatric addiction fellows to take their time. Unless an individual is truly suffering from psychiatric symptomatology, don't rush to prescribing something, and if you must, make sure it is nothing addictive such as a benzodiazipine. Once again, one might think this is rather obvious, but I cannot tell you how many times I have seen an alcoholic individual with anxiety and depression given a benzodiazipine - an addictive substance that is classified as a central nervous system depressant.

There is an old saying in medicine: "When you hear the sound of hoof beats look for horses not zebras." The truth is clinicians need to be orderly, careful, and deliberate, and the obvious will reveal itself!

As I write this, it’s New Year’s Eve in Connecticut where it has snowed about 4 to 6 inches. I decided to shovel the stairs so our guests would not fall. As I shoveled, I slipped and felt a pop in my back. It seemed OK at the time, like no big deal—at least that was what I thought.

Later that evening as the clock struck midnight, everyone toasted each other. There were many wishes for a "prosperous year," wishes for a "peaceful year," and also wishes for a "healthy year."

Of course, it is nice to have money and certainly we need peace, but the next morning when I awoke and discovered I had the worst pain in my back and could  not walk, I realized a "healthy year" was the most important!

By midweek I was in such pain I had to have an MRI, and discovered I had a "bulging disc." This led to an epidural, and let's just say the new year has been filled with unbearable pain.

I truly am not a pill taker—and no, although I am an addiction specialist, I am not in recovery. I just like to feel my feelings and never was one to go for altering my consciousness. So, opiates were out.

The pain I have endured has been, well, frightening. It’s hard to walk, sleep, work, etc. While I was assured that I will be OK and things will get better over the next week or so, it has really been tough. 

We know addiction is a disease involving the brain and certainly affecting the liver and eventually every organ in the body. My fall was an accident that I believe I could not see coming, and therefore could not prevent. Addiction, however, is preventable. It can cost someone their life in so many ways — health, family, friendships, self-respect, education, employment opportunities, and the list goes on.

How about for the new year, those of you fighting with this truly devastating disease, double your efforts to do everything in your power to get and stay sober. After all, good health is truly is the best wish of all for the new year!

Once upon a time there was a six-year-old little girl named Alexandra. Alexandra had huge hazel green eyes and always had her hair up like Audrey Hepburn. Many wondered how such a little girl born in the late 1980s knew of Audrey Hepburn, but I can assure you she did.

Alexandra always liked to follow her father around the house and yard. She would enter her father's study while he was writing a paper and gab away at him until his mind was full of the thoughts of a six-year-old and he could no longer write the latest study he was engaged in working on.

One day in the winter's chill, Alexandra's father went out in the yard to fetch some wood for the fireplace. Alexandra always was attached at the hip to her father so he really did not notice her when he gathered a piece of wood and as he went to place it on the cloth carrier accidentally hit Alexandra in the eye with one log!

The father was so sorry as he had not realized she was behind him. (Perhaps his mind was preoccupied with one of his studies.)

Let’s get back to the story.

The father gathered Alexandra in his arms and ran to the house to fetch some ice for her quickly blackening eye. Alexandra had so many tears and the father and mother felt so bad as they explained to Alexandra that it was an accident.

Now, in this land there was a shop called Bloomingdales, and as the father's guilt for giving Alexandra a black eye was growing by leaps and bounds (even though it was an accident), he took Alexandra and the mother to buy Alexandra a very expensive coat that was red, warm and comforting. Alexandra really had wanted this coat and hoped that the great Santa Claus would bring it to her, but the father insisted that the jolly old elf might not get around to it. He too might have been busy working on a paper like the father, and so it was wise that the father purchase it.

The sales lady at the great department store was grandmotherly and sweet to Alexandra—that is how most people were to Alexandra who appeared to be a great ballerina in a six-year-old's skin. The father thought to himself—was it Alexandra's charm that made the clerk so friendly or the commission on the expensive coat?

When the sales lady said to Alexandra: "You must be a wonderful little girl to have a mother and father love you so much to purchase you such an expensive gift," Alexandra replied: "It is because my daddy hit me in the eye with a piece of wood!" The father and mother quickly explained the accident that had occurred, as they saw the flush come upon her face and her mouth drop open.

This story is about a little girl of six, and the accident that happened and the love that made a father and mother purchase her a very expensive gift that would turn her tears into a smile. This is the type of story that we all have about our children when they were, are, or are about to turn six—a sweet tale about the things we remember and the happy but funny endings they have because of something the little one says or does.

This is the type of story that we tell for years on end that brings a smile to all our faces as we recall the sales woman's shock at the little girl innocently stating that her daddy hit her in the eye with a piece of wood— that is, until the mother and father were able to explain the accident and resultant father's guilt.

Until last Friday, this was my most frequent memory of the age of six— now that is all gone. For the people of Newtown, Conn., our country, and the world I close today's blog with the words of Tiny Tim: "God bless us, every one!"

I remember when I was growing up in the ‘60s and ‘70s. I would never dream of doing some of the things I see teens and even tweens doing today.

If I ever used foul language with my parents, or even during the drug laden "hippie" era, so brazenly used mood-altering chemicals without at least thoughts of serious consequences, I just would not have been properly in touch with reality, even when I was sober.

I don't want anyone to think I am in favor of hitting youngsters - it certainly sets the wrong example and has been clearly shown to result in the opposite outcome from the one a parent is trying to achieve; however, in the absence of corporal punishment, a parent can still teach responsibility.

Under my model of "carefrontation," one learns to treat people (including adolescents) with respect and dignity - never shaming or blaming them for having a problem. But the identified patient, let us say a 16-year-old, still must understand that they must meet certain responsibilities - whether for addressing their addiction or even seeking therapy or taking medication for a psychological issue.

When did parents become so soft - so enabling? Enabling one's children to continue to display deleterious behavior is simply a shirking of parental responsibility. As a baby boomer (one who is born between 1946 and 1964), I believe my generation has tried to give our children more than we had - most of us grew up with the Great Depression always in the background and our parents tended to not want to spoil us. Then we became parents, and reacted by wanting to give our kids everything. The result is a generation of youngsters feeling entitled and not truly understanding their responsibilities in the conjugal family.

If we can simply understand this as parents without becoming defensive, we can slowly correct the problem. It is not about punishment but dialogue that supports responsibility. Not a choice but a mandatory duty to deal with "life on life's terms" that we must begin to inculcate before (and I truly mean this) our society is doomed.

We often hear of “imperfections of character” in recovery. Some of them can include: being too serious; jealous; dishonest; prideful; arrogant; cynical; argumentative; lazy; conceited; judgmental; selfish; insecure; etc. I think at times we have all shown some of these “defects.”

Now, before you think you are a "flawed" person, I believe many of these characteristics are just part of the human condition. The key is to what degree you showcase these “inadequacies.”

I know in my own life, that despite being a psychologist, I too, can be conceited, judgmental, cynical,  argumentative, etc., and this is after many years of professional study and therapy – well again, I am human! I also believe I have a good sense of humor and this certainly helps in the process of forgiving myself, striving to improve.

Taking oneself too seriously is always a problem because if you do that, then it is nearly impossible to look at yourself.

First things first: relax and accept that every human being has “character flaws,” and that does not translate into a personality disorder (unless  it becomes so dysfunctional that it gets in the way of one's life.) I know that at times I am trying so hard to help my patients to feel accepted, that I may illustrate something utilizing myself, and it blows up in my face. But I always have to remind myself that my intentions were good. The vast majority of my patients, friends, and certainly my family, have taken the time to get to know me and realize that I am just being “Dr. Stratyner,” or “Harris,” and that I am the first person not to take myself too seriously.

We all have an ego – the self that attempts to defend against narcissistic injuries with myriad defense mechanisms. Aren’t many of the” flaws” I mention in essence types of defense mechanisms? They may not always be the highest order defenses that we can use, but they certainly have their place. Hard to believe that being too serious, jealous, dishonest, prideful, arrogant, cynical, argumentative, lazy, conceited, etc. can actually work in the service of one’s ego. Think for a moment how laziness, cynicism, or pride can actually protect us.

Let us say you have a sense of low self-efficacy (one’s belief in his or her ability to accomplish a task) around a particular endeavor – wouldn’t laziness serve a purpose? Or perhaps you are afraid to admit that your friend is right and you are wrong because of a feeling of cognitive dissonance (the feeling of discomfort when holding two or more conflicting thoughts), for example, your deep belief about something and your friend’s opposing belief which you find plausible – wouldn’t cynicism serve a purpose? Perhaps you make an embarrassing error and feel “less than” – doesn’t pride serve a purpose? A justification to allow you to not admit you were wrong?

Suddenly, we see that these so-called “character flaws” may simply be “techniques” to prevent a bruised ego – indeed, one usually goes about life without even having knowledge that they are utilizing such maneuvers.

And here enters therapy – cognitive or psychodynamic, role play or gestalt. It really doesn’t matter as long as it makes the individual aware of her or his tactics, which if go unchecked, become part of how others brand you.

The most important thing one can do to improve oneself is be open to feedback. Don’t forget to have a sense of humor (the highest order defense), don’t take it all so seriously, and finally, believe that as long as you are breathing you have the capacity to change. Now, that is an impressive character trait!

In all the years I have worked in the field of psychology — as Division Director of Addiction Services at New York Presbyterian Hospital, Weill Cornell Westchester, Director of Addiction at Mount Sinai School of Medicine where I continue to serve as a Clinical Associate Professor, or in my current role as a Vice President of Caron Treatment Center and New York Regional Clinical Director— I always run across colleagues who believe that relapse is a given.

Let’s be clear. It is not!

There are individuals who enter recovery and continue in recovery—as Caron Treatment Center always stresses, it is important to be sober and not simply abstinent—which, in this clinician's mind is the pivotal variable that separates those individuals who are able to avoid relapse, from those individuals who find themselves relapsing time and time again.

Is it OK to relapse? Of course one must accept the notion that it is "OK" to relapse, but certainly, the general consensus is that it is better if one can avoid it.

We understand relapse to a much greater extent, and forewarned is forearmed—particularly in terms of knowing what one's triggers are.

Perhaps the most important thing to remember when it comes to preventing relapse is that one gets sober to make their life better, not worse. Otherwise, why would one focus on giving up a drink or a drug?

Be patient and realize with sobriety your life will certainly improve. Remember, anything worthwhile takes effort — simple advice, but important.

I cannot help but think of the parable of the man who felt sorry for himself because he lost his shoes— until he saw the man next to him who lost his feet.

In the recent Sandy storm, I lost a new Vespa and my classic sports car, which I spent years working on — it was my "baby." But compared to the devastation that many people went through, mine was just material.

Funny, I thought of a comparison to how peoples' lives were in shambles, and the disease of addiction— homeless, lost, at times without hope, grasping for something that resembles the familiar, the safe.

Perhaps individuals who have never really understood the disease of addiction should think of it as an "internal storm" — one that churns inside and destroys families in the wake of the identified patient. Yes, addiction is the hurricane within that leaves lives in tatters and is unforgiving as it ravages those innocent souls that perhaps never saw it coming.

Some of you may get angry at my analogy. After all, you may say, Storm Sandy hurt innocent victims who did nothing wrong. Well, if addiction is truly a disease, and as a clinician and researcher I know it truly is, then the lives it destroys in its wake are innocent as well.

Governor Chris Christie of New Jersey warned many to evacuate those regions that were most susceptible to the storm, and I now remind those with addiction in their families; heed the warning — save yourself by taking responsibility.

Ever think about poetry? Whether it is a simple rhyme, a more obscure verse or a lyric to a song, it is always a creative process.

The poet creates a story of sorts, which springs forth from his or her mind and places it on paper for other people to read or listen to when set to music. Indeed, it is a gift from one individual to be shared by many. In essence, one might say the poet has to "Give it away to keep it" — to have the thought behind the poem perpetuated.

Recovery is a poem. It is a gift that is given, whether by a professional teaching a class at a rehabilitation facility or a member of a Twelve Step group sharing his or her experiences, allowing someone else to benefit. One might even say it is a gift from a person to her or himself.

Life is such a diverse mystery of conceptualizations. Our reality is ultimately what the living perceives it to be. You see, psychologists know how important perception is — hearing, seeing, touching, smelling, experiencing our positional orientation in the world. It is important because we need to know if the individual is experiencing reality or has gone beyond reality. Yet, the ultimate reality is always unique in some way to the individual. Psychologists establish parameters to measure that reality, but again, ultimately it is very individualized.

Thus, when "the poem" of recovery is received as an offering — be it as a gift to oneself or in the form of one individual helping another — it is based on a parameter of perceptions as well as unique circumstances.

Nobody can truly know what an individual is feeling or thinking when it comes to her or his own recovery except the individual. Yet, "the poem" of recovery is offered in the context of a parameter of those experiences that one does indeed share with others — those threads of common experience when someone in the "rooms" has that "ah-hah" moment and is able to say, "I share a common bond." Even though my recovery is ultimately unique to me, it is within the context of others' perceptions.

Think of it this way: a patchwork-quilt can be made up of different squares that are designed by different individuals, but when they are sewn together to form the whole quilt, a new meaning is derived.

There really is nothing new here. The concept of the "gestalt" is defined as "the whole being different than the sum of its parts." And yet, without the individual "parts" being blended together, there would indeed be no whole.

Recovery, much in the same way, is a blending of unique, individualized, experiences together to form a common experience that leads to sobriety. The poetry of this process is almost like alchemy and we see that the individual is transformed into a "new being," like coal into diamonds. In essence, all those with the disease of addiction have the capacity to be sober. They simply (and it is not always so simple - but you will allow me poetic license here) must listen to their unique poetry within as well as the poetry of others and find that common thread.

Image courtesy of stock.xchng.com.

In the past two weeks, I have done interviews for various websites and TV regarding the growing interest in the newest designer drug, Smiles.

Smiles has most recently been implicated in actor Johnny Lewis’ violent death, which resulted in him allegedly murdering his landlady before falling to his death. Prior to the tragic news about Johnny Lewis' death, the drug was also implicated in the deaths of two teenagers from East Grand Forks, N.D.

So what do we know about Smiles? It is a type of psychedelic drug known as a phenethylamine called 2C-I.

2C drugs are not simply hallucinogenics but have a "twist" - they also have stimulant effects, which are not unlike ecstasy. So, one can envision LSD and amphetamines in a potentially deadly chemical compound.

Historically, 2C drugs were first discussed in a 1991 book by Alexander and Ann Shulgin entitled: "PiHKAL (Phenethylamines I Have Known And Loved): A Chemical Love Story." Some say Shulgin is the Timothy Leary of 2C drugs.

2C-I, like many of the 2C drugs, result in not only visual and auditory hallucinations, but due to their stimulant aspects, can cause elevation of heart rate and increases in body temperature. This obviously could lead an individual meeting a violent death, like walking off a building, on to train tracks, or experiencing a stroke, severe heat prostration, dehydration and imbalances of electrolytes. In terms of brain function, on a neurotransmitter level, dopamine receptors as well as serotonin receptors are affected - much of this is based on speculation from research with other synthetic compounds.

Just as we have started to try and relax about bath salts (a drug which is based upon a shrub-like plant that has a component in it called cathinone and can be synthesized for its hallucinogenic properties), and K-2 (a form of synthetic cannabis that is a blend of herbs and synthetic chemical compounds), along comes Smiles.

“Smiles” looks like powdered sugar, and can also be seen in pill form, but less often. As I said on WCBS-TV New York, “It’s a very, very, very dangerous drug that is being marketed through the
Internet. Teens mix the white powder form with chocolate or other confections, and they
eat it like candy."

The "roller-coaster high" is often accompanied by nausea, vomiting, anxiety and panic attacks. As I stated earlier, this drug has a strong potential for resulting in fatal dehydration, arrhythmia and stroke. Ironically, its victims have smiles on their faces.

The DEA has been quick to classify 2C-I as a Schedule 1 substance, making it illegal to manufacture, distribute or possess. Still, reports of teens using smiles across the U.S. are popping up rapidly, which can be largely attributed to teens' tendency to spread "misinformation" through chat rooms.

Let me clearly emphasize that parents need to sit down with their teens to educate them on the dangers of Smiles, and all of the synthetic drugs. Do it fast, because there is nothing funny about this drug.

When I was becoming a doctor of psychology, from the first course I took in school, the topic of nature versus nurture constantly came up. I never really framed it as one or the other.

I mean, we know we have genetic factors that affect our intelligence, and we interact with the environment, so to me, it was rather obvious that it was nature AND nurture.  (This is not what this specific blog is about - I will leave that to my research colleagues who focus on that area). But I wanted to raise nature and nurture as a "lead-in" to discuss book smarts versus street smarts.

I believe in today's world we need both.

If I want to learn reading, writing and arithmetic, I usually need some form of book smarts. I suppose I could learn quantum physics by interning with a quantum physicist, but I know I will be cracking a book for sure (and obviously that is putting it mildly). Similarly, I suppose I could read what it is like to live on the streets in a tough urban environment, but I know sooner or later I will need to do so if I fully want to appreciate the experience.

Books are something I love, and lord knows I have literally read hundreds and hundreds to become a psychologist, but I also needed to work for years and years in the trenches with patients to develop very specific clinical instincts - what I refer to in many of my writings as "clinical savvy."

I could read Irvin Yalom's classic, "The Theory and Practice of Group Psychotherapy"— and indeed, I have — and savor his 11 therapeutic factors to running a successful therapeutic group experience; yet, being in a group and running a  group really completed my education.

I come across a great deal of budding Bill Gates who want to drop out of "their" Harvard and start their own Microsoft, but I am not sure that without the university and graduate school experience, they will make it as big as Bill Gates. Let's be frank, even with higher education they probably will have a tough time - but many are looking for a shortcut and they rationalize taking that shortcut by pointing to Gates.

OK, so what am I saying? Well, you need common sense and experience (my operational definition, of "street smarts"), but you also have to pour over the books, take the classes, listen to the scores of lectures, if you want to increase your odds of success. So, it will always be vital to "jump in the pool." But first, perhaps you should take some swimming lessons — there is always the exception — but let's face it, what I am calling for is probably more the rule.

Image courtesy of shho/stock.xchng.com.

This week's blog is in the form of bullets - it gives you some of the latest facts about marijuana. You may not like them but they can be backed up with credible scientific studies too numerous to provide here without specific requests:

• Today's marijuana is not only psychologically addictive but capable of being physiologically addictive as well
• Marijuana does have carcinogenic properties that are as dangerous as cigarettes
• Marijuana can affect your ability to process information by impacting your memory
• Marijuana can affect your ability to process information by impacting your executive functioning
• Marijuana can make you paranoid
• Marijuana can lead to other drug use
• Marijuana can make you procrastinate
• Marijuana can lower your IQ

As they say in cartoons: "That's all folks!" Give it some thought the next time you rationalize that, "all the kids do it!"

Image courtesy of Salvatore Vuono/freedigitalphotos.net.

"The unexamined life is not worth living," so said Socrates - and perhaps truer words were never spoken! If one has an addiction, be it to a chemical or a process such as gambling, acting out sexually, spending, etc.— as I said in my last blog— it is not ever enough to simply abstain.

Why would someone not want to get sober? Be clear of mind and honest? Think about others instead of constantly engaging in a "narcissistic exercise?" Understand what makes him or her tick so that the individual is comfortable in their own skin?

I have always been a student of Lao Tzu (even before Wayne Dyer brought the great philosopher to the minds of millions as only Dr. Dyer can do.) Lao Tzu once said:

“Simplicity, patience, compassion. These three are your greatest treasures.

Simple in actions and thoughts, you return to the source of being.

Patient with both friends and enemies, you accord with the way things are. Compassionate toward yourself, you reconcile all beings in the world.”

It is only through the true examination of one's life that understanding can lead to a sober, simple and accepting peace of mind that allows all of us to be at one with the beings that surround us - even those we do not agree with. This sobriety is the gift we derive from the journey of abstaining from those things that lead us away from introspection - an introspection that derives from accepting that there are powers greater than ourselves that connect us to all of humanity.

Why would one want to abstain from an addiction if their life did not change for the better? If they could not develop a sense of love and compassion for all living things? A profound attempt at trying to be one with the universe? This may hit some as psychological or spiritual dribble - but those are the folks who stay "dry" instead of getting sober.

Acceptance is such a simple concept but much harder to achieve - yet if one tries to reach a state of acceptance they will find themselves so much happier, filled with positive thoughts that lead to a much less stressful state of mind. That is why therapy, be it individual, gestalt or cognitive, etc., should always be seen as a gift to oneself - not a sign of weakness but a harbinger of strength.

This is what this psychologist is expressing - to examine one's life is to go on an honest journey that logically will eventually lead to a deeper understanding of humanity.

Image courtesy of stock.xchng.com.

Often, individuals with addiction issues have a related psychiatric issue - particularly if you include personality disorders in the mix. According to the National Alliance on Mental Illness (NAMI), 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.

It is not enough to simply believe that if a person addresses his or her alcoholism or other drug addiction(s), that all their problems will be resolved.

For example, this clinician is a huge fan of Twelve Step programs and believes they are an integral part of a well rounded "treatment plan." However, it is equally important that the person seeking sobriety be in professional treatment in addition to working a self-help program - especially if the individual has mental health issues such as bipolar disorder, or perhaps a borderline personality disorder.

Treatments such as cognitive therapy, and when necessary utilizing psychopharmacology, are very important to folks with co-occurring disorders.

Any individual with an addiction should receive a professional assessment that includes looking at a potential family history of addiction and psychiatric illness.

Whether an addiction professional or mental health professional conducts this assessment, they must be trained in both addiction and mental health issues - don't just assume that they are!

It has only really been over the past 20 years or so that clinicians are starting to understand both of these specialties, and still you will find many counselors and clinicians, who lack expertise in one area or the other.

Don't be afraid to ask your treatment professional what their training is - this is your life or the life of a loved one we are talking about!

There are so many issues that the co-occurring individual faces: did the addiction lead to the mental illness or did the mental illness lead to the addiction?; as previously mentioned, is there a genetic history of one or more illnesses?; has the patient ever been on medication - such as a benzodiazepine (eg., xanax) - if so, did the person who prescribed these medications understand that any medications that are addictive should NEVER be prescribed; does the patient's family and friends, and especially their sponsor, understand that someone who has a debilitating, independent psychiatric condition, may benefit from medication? (For example, with endogenous depression, which is a type of depression caused by biological factors rather than reacting to something in the environment, therapy can be enhanced - even made possible, with the prescription of an SSRI or other non-addictive medication). The list of concerns goes on and on.

As the reader begins to see, there are important issues which arise as we delve into the world of co-occurring disorders - I was just touching the tip of the proverbial iceberg!

Given that it is the 21st century, it is time that we realized treating an addiction may not be as simple as we once thought - it requires (in this clinician's over thirty years of experience), self-help, as well as professional help.

The good news is that people can get better regardless of their diagnosis or diagnoses, but we must open our eyes to comprehensive, inclusive approaches.

Image courtesy of Ambro/freedigitalphotos.net.

I can recall vividly, that as the summer would wind down I would begin to ponder about the fall—returning to school was always number one on my list.

Depending on what age I was, I would anticipate the social interactions that would take place—would I make friends easily? (I particularly can recall this anticipatory anxiety in the first grade.) Now, that's what psychologists refer to as a fairly regressed memory.

It is quite normal for a child and even an adolescent to have some anxiety about starting school for the first time—or even returning to school.

This is also particularly true for parents who are worried about their kindergarten student who is going "off into the real world," or the college student's parents who are experiencing separation anxiety.

Here are some tips to ease the process:

* Any time a youngster begins a new school year—be it kindergarten or college—it is a transition for both student and parent. Acknowledge the transition and dialogue around it with your child in an age-appropriate manner

* Recognize that one size does not fit all—it may seem obvious, but oftentimes parents do not take their children's age into account or other important variables like siblings who are older or younger, starting in a new school after moving, the child and the adolescent's personal problems such as ADHD or drug issues, or even something as basic as sleep habits

* Get the preparation out of the way—prepare clothes, purchase school supplies and make sure your child is part of the process. He or she must take ownership; even the kindergartener has a right to have a say about something they will wear (within reason)

* Don't be surprised if tears are displayed—by mothers and fathers who are sending sons and daughters off to college, or youngsters who are starting high school. Prepare for it by discussing feelings—again in an age-appropriate manner. Make sure there is no blaming or shaming by anyone including a sibling

* I even had parents have a multiple family support group—"misery loves company;" or perhaps a better way to put it is "share the joy."

* One last tip: Remember the saying: "This too shall pass." Along with the first tip, remember that life is indeed a series of transitions that can and usually are dealt with effectively, and then growth occurs and we move on to the next phase!

Now, all of you get to work!

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As many of us who work in the addiction as well as mental health world know, many patients experience shame around the stigma of what is perceived as a "moral failing" or psychological weakness – despite the fact that addiction, as well as mental illness, are diseases and are thus primary, progressive, chronic and if not treated can be fatal.

This shame often leads to patients who spend good money for psychological treatment to lie to their respective therapist. This is somewhat ironic because confidentiality laws are so stringent. The whole idea of seeing a professional is to be honest and seek the help one needs.

Yet, defense mechanisms such as denial, projection, rationalization and etc. result in therapeutic hours that are spent, at times, in falsehoods. It is the counselor's job to break through this resistance that comes in the form of lying so that real issues can be professionally addressed.

This process involves developing what is referred to as a "therapeutic alliance"— forming a bond that develops trust between counselor and client. It is the only way that hope is nurtured.

If you are going to see a therapist make sure you are comfortable with that individual. You can even "shop around" until you find the right fit. It sure beats wasting your time and hard-earned dollars when the professional simply wants to help.

Image courtesy of Ambro/freedigitalphotos.net.

From Kierkegaard to Dostoyevsky, to Nietzsche to Sartre, man has always been interested in "authentic" existence. This experience comes to my mind very strongly as I reflect on the Colorado movie massacre.

You wake up one day and decide to go to a picture premiere— a midnight showing of a movie series that dates back to a comic book that first appeared in the early ‘40s. You are excited about the mystery and fun that combine to create what was referred to in the ‘60s as "a happening" – an experience shared with friends and strangers that would unfold through some form of creativity. In this case, a film.

Then all hell breaks out — every single human being's existence changes, whether they were there or through the media. Something that was anticipated with a mysterious joy turns into a real life horror. This is life.

This is the experience of shear existence that the living walk through, that our senses are filled with. Our minds are filled with a curious sense of the unknown that slowly reveals itself and dances between eros and thanatos—the opposing drives of life and death that Freud (1856-1939) so eloquently discussed.

For this clinician, the only way for me to make sense of the recent events in Colorado is to recall the character John in Huxley's Brave New World, who was willing to face tragedy in order to feel! I, like John, would rather live in our "brave new world," with all of its unknowns than to spend whatever is left of my existence in a computer-controlled calculated farce.

I feel fortunate that I am alive and privileged to be able to share my thoughts, knowing that so many others are not.

I have always related to my adolescents’ parents that raising youngsters is indeed the most difficult job in the world. You have to maintain and teach boundaries, while at the same time being approachable. What a difficult task trying to let your tween or teen know that you are their parent not their buddy, but that you love them and that they can come to you with any problems they might be having. That does not mean they will not be corrected, but it does mean they will be treated with love and kindness — oh, understanding as well.

Parenting should start early by teaching your children responsibility. If you can inculcate responsibility then you won't have to get to consequences to correct behaviors that lead to trouble—acting out with alcohol, drugs, failing in school, shoplifting, texting while driving—well you get the idea, but it is never too late to start.

As a doctor of psychology, I practice what I preach. I make sure the young folks I work with know they can tell me anything. They know I will listen and discuss issues with them, and that unless they tell me something that is threatening to themselves or others, what we discuss will remain with me.

Therapy is an art and a science, and I suppose parenting is as well. If you are a parent, you can read many books and blogs, but you ultimately have to find what resonates with you. Again, the principle of instructing responsibility is vital—it is based on "trust," which the Pulitzer prize-winning author Erick Erickson wrote about more than sixty 60 years ago in,Childhood and Society. Erickson noted that without trust, a burgeoning youngster never develops hope. Truer words were never written.

Adolescence is such a time of change. The cerebral cortex is developing, hormones are percolating and curiosity is the outcome. Yet, youngsters actually want rules and regulations. Study after study demonstrate that effective parents know when to say “yes” and perhaps, more importantly, when to say no (refer to Townsend, 2006).

Adolescents are learning—they have no roadmap! They rely on friends who are just as lost as they are, as well as misleading Internet posts.

Perhaps the most important thing a parent can do is stay in touch with their tweens and teens—ask plenty of questions and set rules. You run your household. You would not let a 12 or 13 year old drive, so why would you trust them to tell you they are sleeping over at a friend’s house who you never met and, "their parents will be home."  Make phone calls, set rules and regulations, discuss your reasoning, but remember it is your reasoning and you will stick to your reasoning, your rules. Anger gets you nowhere, but boundaries get you everywhere.

Remember the old adage: "an ounce of prevention is worth a pound of cure." It became a cliché because it made good old-fashioned sense!

If you have any questions after you read this blog please write back and I will supply black and white, step-by-step responses. I am always happy to help parents raise adolescents that grow into well adjusted, effective, caring adults.

Image courtesy of photostock/freedigitalphotos.net.

I decided that I am going to talk about marriage this week. My wife and I have a 25-year wedding anniversary coming up in October. This blog is from a successfully married guy who just happens to be a doctor of psychology — but the "successfully married guy" thing is what I will lean on.

My wife and I are on vacation this Fourth of July week. So, if you cannot make an appointment, don't hear me live on my radio program, or see me on the TV news, that is the reason — word of my death simply is not true! 

OK, now that I got that out of the way, you should all know that besides two days spent with my daughter and her boyfriend, my wife and I spend our holiday alone (that's right, alone) with our dog, Gertrude, at our beach home. We read, we eat, we sail, we scooter, take in concerts and plays, watch TV and boy do we sleep. Oh, we also bicker!

I like the word "bicker." It seems to be just right. It is kind of a romantic, passionate way to go back-and-forth in terms of arguing until one of you gives in and decides, "Oh hell, let them have their way." I must admit, I believe that usually turns out to be me — me as in I let my wife have her way. Here are some of the stupid things my wife and I bicker about: television, politics, sex, the dog, my driving, her driving, my weight, restaurants, movies, who will make the bed, throwing out the garbage, families, our daughter, our daughter, our daughter, friends, religion (she is Irish Catholic and I am Jewish), and the list goes on and on and on.

I suppose the reason we have stayed together so long is that the bickering is vibrant — it's alive damn it— it's alive! Sometimes when you’re in your 50s, it can take the place of sex. Sometimes it is followed by sex, and sometimes it is followed by my sleeping in the den.

My wife and I trust each other enough to bicker with gusto. It never becomes physical and the police have never shown up, which is a very serious topic I will save for another blog (i.e., domestic violence).

In the meantime, I want to point out that our bickering has never turned into threats of separation or divorce — as I tell my patients, there really is not much out there, so quit while you’re ahead! Too many youngsters today, in my opinion, are too sensitive. They have an argument and all hell breaks out and the next thing you know someone is contacting an attorney. I have referred to young folks as the "microwave generation" – everything must be immediate; no time to work through things!

I love my wife — yes and I am also in love with my wife. She is smart, compassionate, not afraid to speak her mind, takes people on, tells the truth and never, in my opinion, admits when she is wrong. By the way, I am not showing her this blog, it's better that way!

Image courtesy of Salvatore Vuono/freedigitalphotos.net.

I heard last week that there is a town somewhere on the east coast that is considering giving out fines to folks when they use the "F" word in public.

Despite my being described as a great liberal (which has become a dirty word in this country unto itself), I believe this action may be reasonable — if only to make a statement.

Filthy language used on the street (in front of children, adults, etc.), makes for a more disrespectful society — it creates an atmosphere of rudeness. Dr. Douglas Fields, a scholar of brain science notes that rudeness literally produces neurotoxins in the brain, thus rudeness leads to rudeness and creates a milieu of tension and angst.

I personally find it distasteful when folks use inappropriate language in front of children who may be passing by on the street. Think of the impressionable minds, and perhaps the parents who are trying to shelter their youngsters from such things.

Additionally, I am from an era when one did not wear jeans to work or the theatre. (I am not that old, but let's just say old enough to remember). Now we see disrespectful words, sayings and pictures on T-shirts. I remember when the flag was pledged to and not worn on a T-shirt, and yet I would be the first to fight for free speech (but I guess I always believed in some "judgment.")

I think our society has changed and as I said a few weeks ago, there simply is no turning back.

Maybe I am too old after all, to accept car alarms, and doors being locked, lobbying for legalization of mood-altering chemicals which effect the cerebral cortex, TV "news" people with political agendas and a continuation of hate and violence.

Oh well, as my mother once said: "Growing older is not for the faint of heart!"

I am known for a form of addiction and co-occurring psychology know as "carefrontation." You see many years ago I found that "in your face" therapy does not work! People can have addictions or psychiatric disorders and addictions, but they still have a right to respect — both are diseases and accusations have no room in treatment, when trying to help people. It is called treatment not confrontation.

So "carefrontation" states that individuals must be treated with no shame or blame — treated with respect and dignity, but because they may have serious diseases, held responsible for dealing with them.

You see "in your face" therapy simply raises defense mechanisms – it makes individuals feel threatened and that does not allow for therapeutic alliance!

If one is gentle and caring and helps the patient become ready to change, safe enough to take the risk to change, and feel empowered – has a sense of what Rotter called "internal locus of control," then there is fertile ground for recovery.

Caring goes a long way. Try it. Oh, but remember then must come the individual's realization that they have responsibility over their disease! Don't let your angst over your patient's illness or illnesses result in raising their angst! We are all just human beings – whether there is a "Dr." In front of your name, initials after or neither!

My wife and I recently had dinner at an extremely pricey restaurant across the street from Yale — I was in New Haven on business, and felt we could afford the more than $100 a person. I mean we both work hard — she's an oral surgeon and I am a successful psychologist, so why not treat ourselves now that we are in our 50s?

Across from us sat two folks who were in their early- to mid-20s. They ordered an expensive bottle of wine, appetizers, several main courses (one for each of them and one to share, followed by aperitifs and soufflés and coffee.)

Besides our visual eavesdropping, my wife and I were for the most part minding our own business (why would we “begrudge" these youngsters who were not our children?)

However, then it happened. They both brought out their respective iPhones and completely ignored each other – no interaction between the two of them the entire dinner. Oh, I stand corrected, at one point they did discuss an iTune download, but that was about it.

What's happening to us folks? Are we raising the next generation to be completely devoid of direct contact? What happened to talking with eye contact (oh, that's right we have Skype for that, how silly of me). Are we or have we created a new addiction? Talk about angst! I felt truly sad for them — I remember going on a date (yes, we ascertained they were on a date), and being so nervous. Would I have gotten a good shave? Would I have dressed nicely?  Hair combed?  Breath minty fresh? Been up on the latest news and gossip? Would I have been able to keep the conversation going or gotten a word in edgewise?

I wonder when the first iPhone rehab program will open — I can see it now: God grant me the serenity to accept the things I cannot accurately Google, the courage to download the iTunes that are obscure and the wisdom to know that human, direct contact is so, so important!

On that note, let us pray!

Yes, yes, I know an apple is a fruit and that would make it a food. But if you throw it at someone’s head is it now a weapon. Is it a weapon but still a food? Or does it take on what it is, given its context?

As a cognitively oriented psychologist, I find this interesting. You see, we are our consciousness—the conscious experience of what we perceive. Now the trick is understanding that our behavior is not simply mediated by the stimuli we encounter but by the way we think about the stimuli we encounter.

This is so important because we can change the way we think about our experiences. There are positive as well as negative ways to think about life, and our presence in life.

Think of the possibilities: The things that might create angst can be viewed in a different “light.” We can actually become optimists if we choose to see things in an affirmative way instead of with a jaundiced eye.

Look folks, all we have is the moment so why not stay in it and think about it in a manner that brings us peace? Dare I say even joy and happiness? If you simply put your mind to it, you can actually live a pretty happy life and, as the song says, “accentuate the positive.”

Yes, I know this sounds like a great deal of bother—all that thinking and rethinking. However, after some practice the rethinking will become automatic and thus not rethinking at all but pure, unadulterated original thought.

Now, wouldn’t that be swell!

 

The phone rang late one night in the winter of 1992. I grabbed the receiver, fearing the worst. I knew the call must have something to do with my “godfather,” John Birks Gillepsie, who was dying of pancreatic cancer.

“Hey, man.” 

It was reassuring to hear Dizzy’s voice, which rumbled like a storm front.

“Hey, Diz.”

“Whatcha up to?”

“Aaach. Trying to work on my dissertation. But I’m doing more staring than writing. It all seems like so much bullshit.”

“It’s hard to compose … ,” he said, leaving the thought hanging, as he often did, presuming I’d figure out the best way to finish it.

“What’s up, Diz?” I asked.

“C’mon over, man.”

“Yeah? It’s two o’clock in the morning. The hospital staff may get pissed off.”

“Nah, it’s only me and the nurse. C’mon over. I want you to hear something.”

Dizzy, among his many larger-than-life traits, was utterly compelling.

“Okay, man. What the hell, give me a half hour.”

“That’s cool.”

This Time Was Different
Within minutes, I was in my car. I always felt excited as I crossed the George Washington Bridge to visit Dizzy because I knew that he’d say something—or suggest we do something—that I could not have imagined. I always had the feeling that something cool was going to happen—even the simplest thing, like shooting a game of pool, which Dizzy turned into an exquisite ritual. This time was different. I was apprehensive. He wasn’t at home; he was in a hospital room. Part of Dizzy’s pancreas had been removed and his liver was not metabolizing his pain medication properly. Sometimes his mind was cloudy.

I arrived at Englewood Hospital and rode up the elevator. My heart started beating fast. Being there brought me back to the day he’d had his surgery a few weeks before, and how scared I was waiting for the surgeon to deliver the prognosis. As I walked into his room, Dizzy was sitting up in bed, listening to music through a headset perched on his broad face. His famous cheeks sagged from infirmity. He looked at me and smiled.

“Oh, yeahhhhhhh …,” he said.

It was a familiar, catchall phrase of Dizzy’s. I couldn’t tell if he remembered that he’d summoned me.

“Hey, man,” I said. “What are you listening to?”

“A-Night-In-Tune-Ease-Ya,” he said, his eyes twinkling like they did when he was on stage.

Night in Tunisia was Dizzy’s signature song. I loved the way he’d introduce it in concerts toward the end of his career.

“We are going to play a tune that has been closely associated with me for more than forty years,” he’d say. “As a matter of fact, I wrote it.”

The audience would laugh politely.

“This par-tic-u-lar tune has withstood the vi-ciss-i-tudes of the con-tin-gent world,” he'd continue, standing back from the microphone with the smirk of a boy who has just aced the Spelling Bee, “and has MOSEYED” — he’d cock his head and suspend his thumbs upward as if he were snapping invisible suspenders —”into the realm of the meta-phys-i-cal.”

The hoots and hollers would steamroll into applause as Dizzy preened in the spotlight. Then came the kicker.

“Damn good for a South Carolina high school dropout, wasn’t it,” he’d say.
 

The Notes He Didn't Play
I looked at Dizzy with wide eyes.

“Man, you wrote that song. You’ve played that song probably hundreds of thousands of times,” I joshed, “and that’s what you’re listening to? A Night in Tunisia?”

“Well,” he replied, “I’m listening to the notes I didn’t play.”

“Diz, c’mon man, cheer up,” I blurted, feeling broken hearted. I had my therapist’s hat on. Dizzy was always the one making everybody else feel good, but here was this great man at the end stage of his life caught up in Erik Erikson’s concept of ego integrity versus despair. He seemed unable to appreciate one of his great accomplishments as the triumphant work of art that it was.

“You wrote a wonderful song,” I continued in a soothing voice. “You built a wonderful life. Why are you so remorseful?”

“Oh, mannnnnnnnnnnnnnnnnnn,” he replied, shaking his head slowly. It was a groan that seemed to come from the pit of his being. I’d heard it throughout the nearly forty years that Dizzy had been a major presence my life. “Didn’t I teach you anything?”

I stared back into his eyes, ready to absorb.

“No, man. I’m not listening to the notes I didn’t play because I’m bummed out,” he said, enunciating each word precisely. “I’m listening to the notes I didn’t play because they make the notes I chose to play that much sweeter.”

Dizzy reinforced a lesson that morning that he’d taught me many times before. As we improvise on the score that is our lives with every breath we take, the choices we don’t make are just as important as the ones we do. Dizzy’s overriding principle was that we should make our decisions based on one standard: What’s right? What’s decent? How would I like to be treated under similar circumstances?

It’s not that Dizzy didn’t suffer from angst like the rest of us. He certainly did. But when you hit the wrong note, as you certainly will from time to time, you’ve got to learn to leave it behind you.

Only problem is that sooner or later they wear off and the misery returns. Hemingway, Joplin, Dylan Thomas, Miles Davis, Pollack, Hunter Thompson, Getz, Faulkner, Clapton, etc., all discovered at some point that the pain returns. Even if in some cases the substance takes you out, the journey back to reality bites. Oh yeah, and then there is the addiction angle!

So why have I decided to write a blog and call it “Angst”? Because at least it is an affirmation of life.