The Stress Doc Letter
Cybernotes from the Online Psychohumorist
SEP 2000, No. 1, Sect. 1
Fight when you can
Take flight when you must
Flow like a dream
In the Phoenix we trust!
Table of Contents
Heads Up: Media Exposure, AOL/Digital City and Online Psych Chats
Q & A: N/A
Shrink Rap: The Illusion of Intimacy: Identity, Continuity and Change (with
uncommon lyric -- "The Alchemy of Miss P"
Main Essay: Designing a Receptive and Reflective Incubation Vacation: The
Stress Docs Five Prescriptive Interventions
Main Essay: Designing a Receptive and Reflective Incubation Vacation (cond.)
Readers' Submissions: Kids and Marriage and Jack and Jill
1. Media Exposure:
a) Some European exposure this month; quoted in a thoughtful and
comprehensive essay by David Gahagan on, "Surviving Stress," European
Cleaning Journal, SEP 2000 and
b) A first... Two of my articles appeared in Opportunity World: The Ultimate
Survival Magazine for Start-Up Entrepreneurs, SEP 2000 -- "Declaring Your
Emancipation Procrastination" and in the Stress Bustes Forum:
"Building Natural SPEED: Part II. For info about the magazine, call
212-785-9080 or email OppWorld@aol.com .
2. Chat Groups:
a) Stop by my AOL/Digital City "Shrink Rap (TM) and Group Chat,"
Tuesdays, 9:30-11pm EDT DC Support Chat . It's a dynamic, lively, at times witty
and always warm, thoughtful and supportive problem-solving group. We raise
questions and share our ideas, hopes and experiences with each other.
b) The Stress Doc Teams with AOL/Online Psych. The Stress Doc leads his
lively, monthly mutually supportive one hour "Practice Safe Stress"
chat the first and third Thursdays of the month, 10-11pm EDT: OLP Chat
Shrink Rap: The Illusion of Intimacy: Identity, Continuity and Change
Lately, I've been contemplating intimate relationships, especially the
transition that occurs over time, whether by volition and/or attrition. And
invariably questions arise concerning autonomy and dependency, reality or
illusion along with the security of constancy and the risk of change. Hmm, or is
it the risk of constancy and the security of change? Then add the gnawing
generated by a self-imposed, potentially creative quandary and a challenging
Muse. Well I finally ventured forth, not without trepidation, into the lyrical
lion's den. (Wheres Russel Crowe when you need him?)
So heres an overdue tribute to a longtime partner that also grapples with
complementary personal conflicts at the commitment crossroads:
a) the fear of entropy or "death fear" pioneering
Psychoanalyst, Otto Ranks fear of being consumed, controlled or overtaken by
b) the fear of exploration or "life fear" the fear of being
overwhelmed or disoriented by emptiness, isolation and alienation.
Consider the uncertain dangers and transformational opportunities in
The Alchemy of Miss P
It was chemistry at first sight
More precisely, first bite
Between you and me.
How you muted the pain
Redesigning my brain
It's a mystery.
Such a shape sleek and slender
Can one befriend her
If I trust you my Muse
To seduce those old blues
Will I still refuse
The valley and shadows of intimacy?
My eyes close and we're close
But where is your heart pulse?
Poof...Are you that real ghost
Yet, dearest Miss P
When tears couldn't stop
With fear over the top
When I felt like a flop
About ready to drop...
You then rescued me
From that lonely black hole
You unearthed my true soul
Now is there self-control
Or more fantasy?
No, you mirror my eye
Look, sweet tears when I do cry
As you ground my sky high
At least let us fly high
When rage couldn't stop
With fear over the top
When I felt like a flop
About ready to drop.
Oh my dearest Miss P
Despite all of the flack
From my manic attack
On your white or black track...Still
If I should wander
Angst-ridden and ponder
Just don't let us crack...up
Oh please take me back...up.
With your magical sauce
Is it you and me, boss?
My crown and my cross
Is there no going back?
Once making a pact
With that alchemical genie
A lily so dreamy
Will you ever wean me
Miss Lady Prozac?
(c) Mark Gorkin 2000
Shrink Rap Productions (TM)
A Biochemical Sea Change
Okay, now let me come clean. On Prozac for six years, Ive periodically
raised and lowered the dosage as needed, to a current level of 10mgs once/day.
20mgs, my highest dosage, is considered the clinical baseline. Prozac increases
the effectiveness of the neurotransmitter Serotonin, a vital agent for mood
stability. And while the benefits have far outweighed the side effects,
gradually, dissatisfaction increased with the prolonged spacey state upon waking
and with periodic daytime drowsiness. And, sometimes there's just a time-limited
effectiveness or habituation point for folks and their meds.
Amidst this low level background static, reading a fairly recent article on
the use of antidepressant medication in the "Health" section of The
Washington Post disturbed my consciousness and complacency: For a number of
patients with depression, the most effective intervention (in addition to
psychotherapy) involves a medication regimen that targets some combination of
the three main neurotransmitters affecting the clinical mood state. The article
likened the optimal functioning of Serotonin, Dopamine and Norepinephrine as
creating biopsychic synergy and harmony among "The Three Tenors"
Lucianno Pavarotti, Placido Domingo and Josť Carreras. (I recall a friend,
years back, insisting that my "Shrink Rap" singing talk about an
oxymoron had dramatically improved on Prozac. Hmm, could I add a duet to my
workshop repertoire, allowing my bipolar personality to reach it's full musical
The functions of these psychopharmacological tenors: 1) Serotonin targets
anger and worry, 2) Dopamine stimulates initiative and pleasure and 3)
Norepinephrine primes energy and alertness.
As I mentioned, Prozac has been my Serotonin supplement for years. So I
definitely had some anxiety about rocking the biochemical boat. Still I began
wondering about a medication that could both: a) sustain the psychic calming and
massaging Serotonin presence and b) stimulate the neurotransmitter
Norepinephrines brain wiring and alertness enhancing functions. As a booster
of integrating hi-tech and hi-touch (I especially like the massaging part), as
well as a cautious ally of the upgrade philosophy, I was tilting toward change
yet ambivalent. And then a client of mine, in consultation with a psychiatrist,
started a trial with an antidepressant med that targets both of the above
neurotransmitters. The new post-Prozac generation drug is Effexor. And his
response seemed positive.
After conferring with my doctor, we set up a trial stopping the Prozac
and starting the Effexor combo. A month later, Ive had no Prozac withdrawal
effects and the drowsy drugged state appears to be gradually receding in
intensity and duration.
So this is some of the context for "The Alchemy of Miss P." And, of
course, Ill keep you posted on subsequent trials, tribulations and triumphs.
For now, a final moral: Sometimes its important to change "it --"
if not "fix it" -- even "if it aint broke." This approach
is a modus operandi for experimentation and psychological growth, not simply
biochemical survival. And surely, its also a strategy for helping us
Designing a Receptive and Reflective Incubation Vacation
The Stress Docs Five Prescriptive Interventions
When heading for an east of the Mississippi River mountain vacation, hiking
in lushly forested, stream-lined trails is a high priority. Such a setting
always provides a mental massage for my periodic case of the "brain
strain." However, on a recent escapade, the early eruption of fairly
serious lower back strain compelled a rethinking of vacation strategy and
itinerary. For the record, the body was an accident waiting to happen. So hiking
on a rocky trail was simply the proverbial straw for the Stress Docs back.
With hindsight, clearly Ive been both ergonomically and kinesthetically
incorrect working too many intense and uninterrupted hours with the
computer, insufficient lower back support when sitting, too few breaks and not
doing regular preventive stretching and muscle building exercises.
But in lifes paradoxical way, the vacation glass wasnt truly broken or,
even, just half empty. Being physically restricted, along with having to let go
of original plans, unexpectedly revealed unforeseen vistas and pathways. To
quote French philosopher and Nobel Prize-winning novelist, Albert Camus:
"Once we have accepted the fact of loss we understand that the loved one
(or, in this instance, the vacation ideal, the perceived healthy body)
obstructed a whole corner of the possible pure now as a sky washed by
And just what was this dark cloud clearing epiphany? Simply this: that
"R & R" can go beyond "Rest and Recreation." When open
to a slower, gentler and quieter pace, whether chosen or mandated, time off and
away can evolve into an "incubation vacation." R & R goes beyond
diversion and begins to morph into a process for contemplation. Think of it as
transitional space for discovering a magic lantern which when rubbed
unconsciously and tenderly, passionately and purposefully releases your
rejuvenative and meditative muse. Now R & R a "Receptive" and
"Reflective" mode combining relaxation and psychological
incubation yields the potential for sowing and cultivating unexpected mind-body
insights and problem-solving perspectives along with barrier transcending
bridges and new self-environmental action plans. (For those affiliated with East
and West Coast holistic institutes or Washington, DC "think tanks,"
novel paradigmatic possibilities abound.)
So turn on your meditative mode and muse. Here are "The Stress Docs
Five Commandments for a Receptive and Reflective Incubation Vacation for Healing
and Rejuvenating Body and Brain Strain":
1. Listen to Your Body. Why is it so difficult for so many of us to
connect with our bodies in a knowing and healthy way? For many men theres a
tendency to deny or tune out physical conditions and conditioning. For women, I
suspect, theres an inverse problem. Pushed by the media and other
sociocultural forces the female mind-body is often pressured to inhibit or mask
the aging process. Obsession with the external surface reduces exploration of
the subterranean beauty. The womans body becomes the symbol, perhaps the
worshipped idol, of youth and of sensuous, if not carnal, desire.
Let me return to gender behavior with which I am more knowledgeable, that is,
the male tendency to ignore signs of medical complication or physical stress.
Some contributing factors:
a) Real Men Slogans. A favorite brainwashing one-liner from mom was,
"God helps those who help themselves" (with its subtle injunction
to suffer in silence or to ask for celestial rather than familial help.) This
aphorism was only topped by slogans modeled, if not verbalized, by my idealized
athletic uncle: "Play through the pain" or "No pain, no
gain." Black and blue marks from crashing on asphalt playing football or
basketball were proudly worn as urban purple hearts, further encouragement to
"suck it up" and quietly bear your burden. Today, of course, as a
back-strained baby boomer Im ready to edit "No pain, no gain" to
"No brain, no gain."
b) Beware Tuning Out Pain. In the mind-body system, for the pain-gain
connection pain must be seen as both a signal from the brain and a signal to the
brain. In hindsight, Ive been blocking out strained and tightened back muscle
feedback for months, more likely years. Periodically, muscle strain would flare
on a tennis court and the rationalization was, "I just overdid it."
This seemed plausible not playing tennis on a regular basis.
One belatedly grasps that aging means eventually having to be
"sorry" while elastic youth scoffs at the word. Yet, the
acknowledgment of physiological downgrading becomes a catalyst for mind-body
c) Nurturing Reality. A slowed down vacation, taxing neither psyche
nor corpus (other than adopting to a non-Type A, absence of adrenaline rush
pace) allows for reconnecting to the needs of the body. A consult with a
chiropractor yielded both helpful back and neck adjustments and, more important,
a series of exercises for strengthening lower back muscles and flexibility.
Placing a rolled towel between my lower back and the back of an already
ergonomically primed computer chair (a client calls it my "Star Trek"
chair) is, surprisingly, providing added support. Long live the pain-brain-gain
2. Quiet the Mind. If your brain could be hooked up to a psychic radar
screen, conscious and unconscious data patterns would likely be whizzing
helter-skelter across the monitor, whether awake or in a REM/dream state.
Sitting or lying quietly, practicing being a silent observer, allows us to tune
in to these overt and covert mental meandering and memory minefields. There are
past emotional depth charges - joyful and painful - attached to these
cognitions. Especially regarding past trauma, we often keep busy, distracted or
addicted as a way of numbing or sealing off this potential emotional feedback.)
Not allowing these cognitive-affective percepts to see the conscious light of
day or have a voice keeps them in a feverish state. Sometimes they briefly
escape into awareness through nightmares or dreams. During waking hours much
energy is often expended restricting mental and behavioral exploration and
decision-making for fear of being overwhelmed or consumed by this psychological
Of course, someone struggling with unresolved trauma abuse or abandonment
pain, with associated rage, panic and/or shame states, underlying clinical
depression or morbid, "black hole" grief may find the quiet
opening of the psychic Pandoras Box particularly frightening or disorienting.
Still, even for folks not profoundly abused, existential angst is actually quite
"normal," when in a truly self-reflective and receptive state: a sense
of loneliness or emptiness, lost dreams, a disparity between an ideal and real
self, the balance in your life between security and vitality, passivity and
So attempting to calm the mind by observing and gently uncovering its overt
and covert manifestations with relaxed attention isnt just an awkward
meditation learning curve. This process for many individuals is an act of
3. Being with Nature. Getting out of the city scene and into natural
surroundings especially the height, breadth, expanse and contrasting
perspectives found among mountain peaks, ridges and valleys, meadows and
forests, rushing streams and dreamy clouds for me evokes a sense of the
spiritual and a sense of cosmic consciousness. One fleetingly grasps "the
the mother (nature) of all creations. Finally, theres
something more compelling than whatever trials and triumphs (real or imagined)
are swirling about me. A holistic, intuitive floodlight perspective is
reflexively triggered by this majestic panorama that inundates my categorizing,
analytical, logical left hemisphere.
Simultaneously, my senses are attuned and transfixed in a way not possible in
my obsessive workaday or static generating urban mindscape and landscape. I
revel in the nuance of the various birdcalls, the healing sounds of a gurgling
stream. This forest symphony has its woodwind section as the air whips through a
lush arboreal canopy accompanied by a percussion-like crunch of pine needles or
leaves under foot. One recalls the primal "tree top" lullaby as well
as a mysterious, ever lurking ebb and flow of stillness and sound. And when the
holistic, soft perspective mixes and marinates with an acute focus a
synergistic, poetic mindscape-landscape is born. Consider these lines from
Close your eyes for a journey, a deep breath to unwind
Now contemplate a mountain, the mountain of your mind.
Sculpted peaks, green valleys, the rush of ice blue streams
Sway to the cosmic ebb and flow, the rhythm of your dreams
We begin in the forest enchanted beyond time
Its dance of light and shadow primeval and sublime.
The forest as the artist, trees willowy and bold
The brushstrokes of the branches, leaves afire red and gold.
And then God-like fingers stream down from above
Solar rays caress you both a touch of natures love.
Have you found your Eden or have you lost your will?
To build a loving lasting bond you must go higher still.
So head upstream, the gentle stream, the babbling soothes your brain
A crystal clear reflection to find yourself again.
(Email firstname.lastname@example.org for the complete lyric.)
Engaging peacefully with nature fosters the temporary suspension of my Type A
ambition and achievement orientation. Human doing goes into hibernation;
my receptive and reflective human being nature comes to the fore. In the
survival of the fittest, Richard Hatch to the contrary, perhaps there is room
for the person capable of being quietly humbled. If not likely to win a million
dollars, this individual may inherit some priceless earthly and cosmic wisdom.
4. Seek Solitude in a Wired World. Todays passwords and mantras are
"24/7," "do more with less," "anytime, anywhere."
Email, FAX, laptops and palmtops continue to blur, if not obliterate, the
division between work life and home life. Everyone seemingly has access to
everyone else. And Im getting tired of being trapped in others wired nets.
Cell phones now routinely invade Teaism, my artistic hangout and safe haven.
Self-absorbed individuals throwing privacy and protected space to the ether,
covering their rudeness or justifying their loudness with cell phone
"urgent" (or, more likely, self-important) speech. Or maybe these
folks are simply oblivious. This Practice Safe Stress slogan may have potential
for reinforcing civility and social boundaries: "Idiocy or Cell-ibacy
Your Call!" (I like the policy in one playhouse. If an audience member
needs to be available for an urgent call, the theater manager will baby-sit the
individuals cell phone and, when necessary, retrieve the patron.) Laptops,
cell phones and the like have become such everyday mind-body extensions that
when we are disconnected for even a relatively limited period separation anxiety
With data, if not meaningful information, continuously flooding our conscious
and unconscious, with constant demand for our attention time and space for
percolating and playing with subterranean ideas and salient information is
becoming endangered. In a waking state, one hardly ever has to be truly alone
with oneself. The evolution of dysfunctional techno-dependency along with an
undeveloped capacity for self-awareness and psychological integrity seem
So in my proposed "R & R" schema, a key component of taking an
incubation vacation involves unplugging electronically and tuning in organically
to the ultimate hi-tech and hi-touch computer your own mind-body system.
(Ed note: The fifth and final commandment continues in Sect. 2.)
(c) Mark Gorkin 2000
Shrink Rap Productions