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The Stress Doc Letter
Cybernotes from the Online Psychohumorist ™

JUL 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: Stress Doc's Best Medicine; AOL/Digital City Chat and Online Psych Shrink Rap: Out of Control: Losing Your Self & Finding Your Soul: Part I Shrink Rap: Out of Control: Losing Your Self & Finding Your Soul: Part II Sect 2: Main Essay: Excessive Arousal - Activation: Phobia-Panic Readers' Submissions: New Age Proverbs

Heads Up:

1. Media Exposure:

A delightful interview by freelancer Andrea Poe appeared in the airport magazine, The Washington Flyer. I've pasted the text below; check out the accompanying pic by Steve Barrett; it's even more outrageous. (Me with my "Shrink Rap" paraphernalia.) Here's the link: Washington Flyer Magazine-Insider


The StressDoc's Best Medicine By Andrea Poe

Laughing at patients might be considered a no-no by most therapists, but not Mark Gorkin. Actually, this D.C.-based doc doesn't so much laugh at patients as laugh with them. Each week, people from around the country gather in AOL's cyber-community and ask Gorkin, a self-proclaimed "psychohumorist," about a range of life- and work-related issues—including on-the-job stress. Gorkin likens his popular online chat (Tuesdays from 9: 30 to 11 p.m.) as "an exhilarating, exhausting, 90-minute workout" in which he serves as a "virtual Dear Abby." This gig has been so successful that it has led to several other "Shrink Rap and Group Chat" gatherings on Digital City and WebMD. [Editor's Note: The Tuesday night chat is with AOL/Digital City: <A HREF="aol://2719:3-4759-DC%20Support%20Chat">DC Support Chat</A> .]

Growing up in New York, Gorkin never planned to carve out a career with his wit. "I can't say I was a natural-born comedian, but I was a natural-born neurotic," he laughs. "That runs in the family, my Jewish Tennessee Williams family." Funniness found him, he claims, when "life's absurdities" hit. Gorkin was penning his doctoral dissertation in social work at Tulane University in New Orleans when he switched gears from social work to psychotherapy. In the late 1980s, he moved to D.C., opened a therapy practice and began calling himself the StressDoc. Asked why he chose Washington, he explains, "If New York City and New Orleans had a love child, it would look like Washington, D.C."

The city's mercurial climate also jibed with Gorkin's services. "Because of the political nature of the area, there's a lot of change and reorganization, which breeds uncertainty and anxiety," he says. Not surprisingly, his workshops and seminars on stress, violence and team building are in demand at government agencies. But it's not just government that needs help with burnout prevention. Gorkin travels around the country working with corporations, teaching things like conflict resolution and stress management techniques that use-you guessed it—humor.

Despite the laughs, therapy is serious business to Gorkin. "Laughter can break down the fear," he says. "By safely blowing off steam, you can really tackle problems." What are Gorkin's parting words on how to live a sane and stress-free life? "May the farce be with you." Rimshot, please.

Gorkin and his monthly newsletter, StressDoc Newsletter, can be found at www.stressdoc.com. His book, Practice Safe Stress With the StressDoc, will be published by D.C.-based AdviceZone.com this summer.

2. Chat Groups: a) Stop by my AOL/Digital City "Shrink Rap (TM) and Group Chat," Tuesdays, 9:30-11pm EDT <A HREF="aol://2719:3-4759-DC%20Support%20Chat">DC Support Chat< /A> . 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 on AOL/iVillage's Online Psych

The Stress Doc leads his lively, monthly mutually supportive one hour "Practice Safe Stress" Support Group for Online Psych on the first Thursday of the month, 10-11pm EDT <A HREF="aol://4344:972.chatmain.1267092.521492389"> OLP Chat</A> .

Shrink Rap (TM):

Out of Control: From Losing Self to Finding Your Soul

What images or emotions come to mind when you read the phrase, "Out of control?" Do you picture someone screaming violently or hysterically or, perhaps, someone coming unglued in a panic state? Or maybe you work in a field office and out of touch HQ policies and procedures (or lack thereof) evoke that sense of vulnerability and helplessness. Yet, what about the idea of "letting go," trusting in a different and, hopefully, higher and wiser authority? Also, can you envision being "out of control" as a momentary escape from a habituated, addicted or compulsive state? Here your mind is no longer trapped in a rigid cast; it’s more like wet clay capable of being sensorially and sensually shaped and sculpted with novel fluidity and elegant simplicity. Of course, your hands are an essential part of this potentially synergistic redesign process.

Control has been on my mind big time. I was returning to my family of origin roots – New York City. While American novelist, Thomas Wolfe, may have been right – "You Can’t Go Home Again" – two recent episodes (with Type A personalities – what do you expect it’s the Big "A" for Apple) highlighted that you can go home and feel out of control again. Or, at least, you may have to deal with some powerful dynamics. This two part Shrink Rap Essay is an attempt to better understand the dangers and opportunities for "losing self" or "recovering some soul" when dealing with "out of control" issues regarding: a) an aging parent’s inexorable mind-body deterioration (Part I) and b) highly cerebral, cynical and controlling research analysts before and during a corporate workshop (Part II).

Individual/Family Perspective -- Part I: Can "The Last Angry Man" Last?

A classic aggressive (and likely manic-depressive) personality, my father survived over thirty years as a salesman in the heart and heat of the jungle – New York City’s garment center. Eventually, all that pressure and angry flamethrowing seemed to culminate in a serious case of burnout and premature retirement. Walking (or perhaps crawling) away from work had its ups and downs. Some of the former aggression (and need for achievement) got productively exercised and exorcised on a tennis court; some tension would be released by competitive and confrontative jousting between two fairly hyperreactive adults…my parents. And like Old Faithful, boiling steam would build and, at some point, culminate in an eruption.

More specifically, when feeling endangered, my father would use raw aggression to frighten and push people away. (My mother once shared a dream of being streamrolled, literally, by dad.) My mother’s arsenal involved intellectual condescension along with insisting on the last word. If she couldn’t sufficiently release her anxiety, then a high pitched verbal explosion ensued. This aggressive system of give and take, and make up, mostly worked because these two often exasperating yet mostly lovable oddballs, despite some personality frictions and communicational dysfunctions, were genuinely fond of each other. (The saving grace occurred about fifteen years before my father retired. He slugged out some hard-earned understanding and emotional release through a dozen years of group therapy. For a man of his generation, this was pretty damn heroic!)

However, these last few years, aging and a life of fighting depression and just fighting have exacted a toll, especially on my old man. In his mid-70s, prostate cancer and a series of strokes, a fairly serious one preceded by Bell’s Palsy, for a while definitely compromised memory and motor control. (And whether his memory had previously been weakened by years of shock therapy is a debatable point; though I can readily imagine a burning desire to forget the ECT trauma itself.)

Still, his considerable recovery from these physical and psychic blows has been nigh miraculous. All the hours of tennis over the last thirty years, being in basically good physical condition (though with a cholesterol problem) were likely the prophylactic, if not lifesaving, factors. My father finally had a mission as important as his former career – his recovery: a) he started a low fat, high fruit and high fiber diet; he sticks to grilled salmon in restaurants, b) he’s now taking cholesterol-lowering medication, c) he continues with a less intense tennis regimen, and d) he’s added daily walks on a tread mill. Dad has had to learn to not overexert and to pace himself. (This being no small accomplishment for an honorary member of the Type A Hall of Fame.)

However, despite these adaptive adjustments, he still harbors a Type A Achilles heel: rapidly going on anger alert if not an openly enraged state, when feeling endangered by a perceived adversary. And, of course, the world is still populated by "goniffs’ or thieves and crooks; not to mention a spouse who can quickly trigger his over reactive hot buttons.

The Red Flag

A very recent explosive encounter may have brought them both to a critical – more literal than figurative – turning point. My folks were planning a theater outing. When presented a list of potential plays, my father mentally ruled one out because of the complexity of the background subject matter – the field of physics and Heisenberg’s "Uncertainty Principle." (Please don’t ask…I’m my father’s son. ;-) However, he neglected to share this mental edit with my mother, though initially he was convinced he had. In the play’s aftermath, my father kept aggressively questioning why she had made the selection. My mother increasingly exasperated by his badgering and disbelieving, finally exploded. Suddenly, my father started losing his balance, facial muscles tightened and his mind processing slowed as if unexpectedly enveloped in a disorienting fog. If he wasn’t having a mini-stroke, he sure was on the edge.

Not surprisingly, this sequence scared them both, and the retelling of this trial by ire was practically the first words each shared separately with me. My intuition told me to start with my father. Seeing him alone in the kitchen, I coolly announced, "Come with me into my office," and directed dad to the living room couch. We sat side by side. After reviewing some of the details, I asked, "Dad, how does it feel having an impaired memory and these periodic motor control attacks?" While the acute attacks are disturbing, he felt the loss of memory and having to slow down was not such a big deal.

I wasn’t convinced. I wondered if all that has gone on these last couple of years doesn’t have him feeling compromised, maybe sometimes feeling like damaged goods. He paused, eyed me thoughtfully and, then, for me a flash of insight or, at least, a hypothesis worth testing. I asked if some of the rage and shame associated with years of shock therapy wasn’t getting reawakened now. Both his past shock years and present stroke phase provoke a kindred and painful feeling of not being a full or complete man.

My father again disavowed awareness but conceded these feelings may be rumbling around his unconscious. I was persistent because feelings of humiliation and helplessness so often ignite defensive aggression. For my old man, this eruption can easily be a diversion away from his depressive history and potential; it may cover past and present feelings of being out of control.

Affirmations and Interventions

After affirming the importance of connecting to some of these feelings, of getting centered to lower the magnitude of his fiery reaction, dad countered with some humor: "I better get centered so I won’t lose my balance." We then went over some constructive "I" messages to use with mom when he senses mounting tension. The message, "I can’t handle this right now," dad thought would work.

Finally, my mother and I also had an exchange. She and I have a less consistent history of being able to openly discuss and emotionally battle tough issues without wounding each other. Certainly, I could empathize with her frustration. Two weeks before she had been venting about the challenges living with dad since his strokes. But in the same breath she clearly said, "I will bear with him…He was such a savior for me with mom (her mother had a variety of physical illnesses, leg amputations) and Rusty (an uncle in and out of mental hospitals the last ten years of his life). I owe him." With eyes starting to water, I touched her hand and nodded my head.

Now I encouraged her to set limits on her hot reactor tendencies (tactfully acknowledging this can be an issue for me as well). She initially countered, "Sometimes I just can’t hold it in any longer." I encouraged her to call a friend or to call me or Larry. (When they are in New York, my folks return to the Queens apartment, now inhabited full-time by my brother. However, when it comes to sharing feelings these three usually have a "Don’t Ask, Don’t Tell" policy.)

I could feel a beat of hesitancy upon volunteering for the family crisis hotline post. But my conscious outreach seems to be less anxious ambivalence and more a sign of having grappled with and having achieved fairly clear and healthy boundaries with my mother. Amen!

So here are some existential questions: 1) can his crisis challenge my father to confront past and present narcissistic injury while channeling shame, helplessness and anxiety into constructive assertion rather than self-destructive aggression? and 2) can my mother, historically uncomfortable with and ashamed of her emotional pain and vulnerabilities, reach out for help, acknowledge dependency needs and talk out her fear and anger without bottling up tension and then lashing out? (I always had a gnawing uneasiness and lurking sense of shame around a favorite pronouncement of hers: "God helps those who help themselves.")

If each can modify just enough habitual yet increasingly self-defeating ways of maintaining control perhaps these two heroic, embattled survivors can carve out more inner peace. At the same time, with such an "it’s never too late" learning curve, mom and dad just might give renewed meaning and life to the concept of soul mates. And I’d even bestow my highest honor: Here's to the future "Practice Safe Stress" poster couple!

Out of Control: From Losing Self to Finding Your Soul

Organizational Perspective – Part II: Even the Type A Can Learn to Play

My recent New York City adventure generated another "losing control to find your soul" experience: leading a workshop for a major Wall Street brokerage/mortgage banking house. Actually, this saga began to unfold about three weeks before. An Administrative Assistant or Associate (I believe) calls inquiring about my availability to lead a workshop for about 100 Research Analysts on an upcoming division retreat. A search engine led her to the Stress Doc Web Site; she senses my humorous and interactive approach will be just what these hard-driving Type A professionals need. (Useful to know that "A" in Type A can also stand for "Analyst," not just for "Attorney.") I email some promo material. Once again, "Hype Springs Eternal!"

When her boss, the Director of Global Research returns my call, reality hits. He’s a bit antsy about too much interactive stuff. And he stresses how bright, cynical and impatient these analysts are: "You’ll have to grab them immediately or forget it." The analysts are forever tied to their wireless, yet nonetheless umbilical cell phones. I let him know my Type A-NYC pedigree (throwing in my elitist Stuyvesant High School status). I wanted to reassure this head honcho that I could be as pompous and ego-maniacal as any of his analysts.

The Director still wants to ponder the selection. The next day we agree to a temporary win/win. The company will pay $1,000 for a group interview at their Midtown headquarters. Next stop, "Stress Doc in the Lion’s Den."

The Group Interview

The players: two very cerebral, very analytical male analysts, a bright female administrative associate and a very sharp, very animated if not hypomanic, Research Director. (For example, I barely kept pace with this guy as we crisscrossed through the labyrinthine hallways and offices…And I’m a fast walker.)

The first question: What was my operational philosophy for this workshop? Huh??? I suddenly shifted into workshop performance mode. And after several minutes, the committee seemed impressed with my verbal skills and truth in advertising: "Have Stress? Will Travel: A Smart Mouth for Hire!"

But this talk of a discussion-drawing exercise on the sources of work stress and conflict…this is getting a bit too touchy-feely. And how would it work with 130 ("130?") in amphitheater-style seating? These folks aren’t likely to be keen on moving around to form small groups. And besides, "You’ll be lucky to get fifty minutes for your hour workshop." And for good measure: "When you’re time is up the curtain comes down…and on your head if need be!"

If I still haven’t gotten the subtle point, another example. The Director belabors that analysts may do four or five hours of research for a sales team presentation. He then asks and answers his own question: "Do you know how much time the analyst has for his pitch? Fifty-five seconds! These folks don’t like having their time wasted." Sans doute!

We were still grappling with the philosophy and the feasibility of the drawing exercise when a dealmaking flash occurred. I reminded the Director of the very positive program testimonial from the head of Human Resources of a major, international Washington, DC law firm. This legal Director had noted her initial reticence about using the drawing exercise with firm managers and administrators. These professionals were familiar with lecture-type presentations. She was, "amazed at how enthusiastic people were with the interactive exercise."

Mr. Wall Street Wizard calmly played a trump card, "Yes, I spoke with Ms. W (law firm HR Director). She was quite pleased. However, when I asked her if she would do this unconventional program with her attorneys…she quickly replied, ‘Of course not.’" Ugh…

I was bloodied but still standing. The Director, who earlier had announced needing to leave our meeting at a certain time (and, of course, left promptly) had a parting observation. Without tipping his hand, he observed: "You make your points clearly and succinctly and you don’t come across as an arrogant expert."

I was a bit taken aback by such a prescient remark. As it turned out, Mr. Global Research had been a Theater Director in a previous, pre-MBA/suit incarnation. He did have more personality than the others.

Anyway, with the remaining troika, I smoothly asked, "Shall we do the numbers?" (I could not resist.) And we basically divided up presentation and exercise segments into five minute intervals. If I happened to be especially hypomanic that day we just might be able to shrink an hour workshop (that really should be at least 75 minutes) into a fifty minute hour. Ugh, ugh.

I hung around for a final one-on-one with the Research Director. During the interim I chatted with the Administrative Assistant. She expressed confidence about the contract. During the closing encounter, the Director still wasn’t showing all his cards. We got as far as doing an invoice which broke out the $1000 fee for today’s interview from the fee for an actual workshop. This way he could pay me the grand even if we don’t collaborate on the workshop. Life on the edge.

Two days later, an email from the woman who had initiated the process: It’s a go!


The workshop ballroom is no lion’s den. With a power point display on a huge screen and 140 Research Analysts with cell phones and microphones that admit an eerie red light when clicked on (an electronic thumbs up or down?) this feels more like "The Stress Doc Does the Cyber Coliseum." (Then again, I did see the recent Gladiator film. Ah, "Grandiosity the name is Gorkin!") Actually, I’m sufficiently concerned about the cramped seating to ask an assistant if people might be willing to work on the floor for the drawing exercise. She says, "No way!"

Well, despite some anxious moments, the brain kicks into starting gear. My opening remarks grab the room’s attention: "Having met with your organizing committee and having heard some of the earlier program discussion, I know time pressure is a great concern. We'll be hard-pressed to carve out a full hour. Yet, as a psychotherapist I understand time pressure quite well: my clients only get fifty minutes for their therapeutic hour. But now that the shoe’s on the other foot…I’m feeling stressed, especially as I want to do a couple of exercises. So let’s get down to work."

And a bit surprisingly, the troops fairly quickly clustered into groups of five and six and animatedly engaged my "Three ‘B" Stress Barometer" Exercise: How does your Brain, your Body and your Behavior let you know when you’re really STRESSED!" After some feedback from a few groups, nervous laughter broke out when I acknowledged that, "We have an audience of experts and it seems as if most of you belong here." And after my five minute, rapid-fire highlights of "The Four Stages of Burnout," everybody knew they belonged here!

Now the stage was set for the big test: the main discussion-drawing exercise. (Normally, I break the audience tension evoked by the vivid burnout stages with a "Shrink Rap" (TM) performed in Blues Brothers hat, black sunglasses and a black tambourine. However, in the pre-workshop planning battle, I reluctantly agreed to drop the "rap" to keep in the centerpiece exercise. My rapping has a role modeling effect; it gives an audience permission to engage in some playful and a bit outrageous behavior. (In fact, upon completing a "Shrink Rap," I inform the audience that my capacity for rapping means only one thing: "Absolutely no appropriate sense of shame.") These somewhat stuffed suits, however, have been deprived of this self-consciousness reducing jump start. Gulp!

Yet again, the troops rallied and in teams of four discussed and designed this twofold question: 1) How does stress influence your ability to be organized and productive and 2) How does your own degree of organization as well as the degree of organization within the company as a whole affect your stress levels? People moved out of seats to work more effectively; some groups even took to the carpet to draw. ;-) And throughout the exercise, there was an energetic buzz and background laughter. Despite the enthusiastic engagement, I remained conscious of the fifty-minute hour glass. I asked for a half-dozen (of the 30 +) teams who felt compelled to show off and briefly explain their designs. (I figured there had to be some Type A narcissists, not to mention some collegial rivalry.)

First one, then two…then, seemingly, two-dozen representatives with drawings eagerly poured out of the stands. So many folks, in fact, that I initially could not limit the spotlight to a handful. So another operational flash: we formed a Mardi Gras second line. (I knew those sixteen years in "The Big Easy" would come in handy.) And with a rousing rendition of "When the Saints Go Marching In," the drawings were proudly held aloft as the reps followed my playfully strutting and singing lead. Upon completion of the line display, I selected a few of the most outrageous and artistic pictures. Then the audience called out their preferences – from impossible monsters to impassable mountains.

Amidst the cacophony, I sided up to the Director and observed: "We don’t want to cut all this energy off prematurely." He gave me a non-nonsense stare, looked at his watch and stated, "You have eight minutes." Clearly this was an objective sign I had won over many of his "cynical" analysts along with this time-driven task master.

We wrapped up with some useful tips for developing "Psychological Hardiness" in times of change and my classic, "The Secret of Wisdom." (Email if you haven’t caught either one.) And while the closing applause and check stroked heart and pocketbook, this workshop also worked on a more soulful level.

To Control or Not to Control

Two parties appeared to garner real growth from this existential and interactive encounter – the Stress Doc and these stock analysts, both management and the research professionals. Here are some outcomes of grappling constructively with control issues from an individual and systems perspective.

A. Stress Doc Growth

1. Stand Up for Convictions, Consensus and Compromise. The key to the success of the pre-workshop planning meeting was holding fast to the critical role of the interactive discussion-drawing exercise. Even in the face of possibly not being selected by this firm, I was going with my exercise track record. The exercise had seemingly magical results with other "tough nuts to crack." Why not with Wall-nuts! ;-)

In addition, this management/selection committee learned that I would logically and passionately fight for a principle. At the same time, flexibility was demonstrated by dropping the Shrink Rap and agreeing to a very tight time frame.

2. Making Edits on the Fly. No matter how much rehearsal, a significantly streamlined version of "The Four Stages of Burnout" requires some improvisation: assessing the energy and attentiveness of the audience while delivering material, then making cuts and adjustments spontaneously. Talk about an element of being out of control! And yet, it worked. While definitely on the line, there was more mastery of the material than could be anticipated or imagined. (Some times there’s no way of really knowing how cold the water other than by jumping in.)

And when an audience member expressed confusion about an aspect of the drawing instructions, I successfully simplified the task instead of belaboring the original directives. So again, sometimes one must let go to discover the unexpected degree of control actually possessed.

3. Competing with the Big Boys. Maybe this Stress Doc Daniel is ready to enter more lions’ (or at least, more bears’ and bulls’) dens. I’m taking the recent achievement as a sign of being at the top of my public speaking/workshop leading game. Maybe now I can finally overcome a reluctance to set fees in line with a hard-earned evolutionary fitness.

Making money has never been my "modus operandi" (even though for years annual income has been a source of discontent regarding self-worth.) The driving force has been the challenge of evolving as a therapist, speaker, consultant and writer. Perhaps, finally, the two are not inherently incompatible.

B. Management/Organizational Growth

1. Challenging Diagnostic Assumptions. First and foremost, the workshop affirmed the Director’s risk-taking instincts despite his concerns and ambivalence about giving up significant control of the workshop agenda.

The workshop also raised some questions about his appraisal of analysts as being totally cynical and self-absorbed with Beavis & Butthead attention spans for things not directly work-related. Given the right learning context and orchestra leader, these analysts made some truly insightful, playful and harmonious music.

2. Rethinking the Lone Ranger Image. The analysts cooked up their own spicy interactive gumbo. Solitary researching would be hard-pressed to generate the group humor and creative problem-solving energy released through open discussion, free association and exaggerated design. There’s no way to be a Mardi Gras second liner as a lone ranger. And the recognition and appreciation from an audience of peers is a memorable moment that touches the heart as well as the ego. And all this occurred despite or, perhaps, because of the time limits built into the exercise.

Before my presentation, an analyst addressing the entire group, had dryly noted that group participation is extolled at retreats but not practiced in daily operations. The program certainly provided dramatic (and comedic) evidence for considering a paradigm shift. Shifting from individual control (often dysfunctional hoarding and territoriality) to an organizational process that rewards both professional autonomy and team coordination is definitely a maturational indicator.

3. Becoming 4 ‘C"-ing

Moving out of a comfort zone, helped many of these Type A’s relax and, for a change, earn some "C"s: "Compassion" and "Camaraderie" along with enhanced "Consciousness’ and "Creativity." To become more foreseeing and to discover a little secondline soul power all within a ‘therapeutic’ hour is the trade surplus for letting go of some control and exploring new learning/performing domains. In fact, this letting go process can evolve another "C" – "Courage!" As previously observed in the aftermath of a high anxiety and totally out of control television apprenticeship decades ago: "Errors of judgment or design rarely signify incompetence; they more likely reveal inexperience or immaturity, perhaps even boldness. Our so-called failures can be channeled as guiding streams (sometimes raging rivers) of danger and opportunity that often widen and deepen a risk-taking passage. If we can just immerse ourselves in these unpredictable yet, ultimately, rejuvenating waters." Definitely a philosophy that will help you…Practice Safe Stress!

Editor’s Note: In a follow-up phone call, the Director said while many thought it was great, there were a group that grumbled that my presentation was a waste of time. Initially taken aback, at first I agreed with his judgment: "Those cynical bastards!" His good news, bad news assessment triggered hard reflection. What I came up with is this: My fifty minutes was as dynamic and effective as humanly possible. I shared that there are people who are afraid of getting out of their box. These individuals try to control others and to rigidly protect their "Intimate FOE" ("Fear of Exposure") through a judgmental, cynical cover. Perhaps, if the organization can move into more team collaboration these folks will get on a successful bandwagon. If not, perhaps they need to find a more conventional working environment.

And another sign of maturational growth was being able to hear his message as feedback, not as criticism to be taken personally. And the final control lesson: You can't always please everyone, no matter how wonderful the message or the presentation!

(c) Mark Gorkin 2000 Shrink Rap™ Productions