| Neurotics build castles in the sky. Psychotics live in them. Psychiatrists collect the rent. -------------------------------------------------------------------------------- A psychotic thinks that two and two are five. A neurotic knows two and two are four -- but he hates it. -------------------------------------------------------------------------------- Welcome to the Psychiatric Hotline. If you are obsessive-compulsive, please press 1 repeatedly. If you are co-dependent, please ask someone to press 2. If you have multiple personalities, please press 3, 4, 5, and 6. If you are paranoid-delusional, we know who you are and what you want. Just stay on the line so we can trace the call. If you are schizophrenic, listen carefully and a little voice will tell you which number to press. If you are depressed, it doesn't matter which number you press. No one will answer. If you are delusional and occasionally hallucinate, please be aware that the thing you are holding on the side of your head is alive and about to bite off your ear. -------------------------------------------------------------------------------- A man goes to a Psychologist and says, "Doc I got a real problem, I can't stop thinking about sex." The Psychologist says, "Well let's see what we can find out", and pulls out his ink blots. "What is this a picture of?" he asks. The man turns the picture upside down then turns it around and states, "That's a man and a woman on a bed making love." The Psychologist says, "very interesting," and shows the next picture. "And what is this a picture of?" The man looks and turns it in different directions and says, "That's a man and a woman on a bed making love." The Psychologists tries again with the third ink blot, and asks the same question, "What is this a picture of?" The patient again turns it in all directions and replies, "That's a man and a woman on a bed making love." The Psychologist states, "Well, yes, you do seem to be obsessed with sex." "Me!?" demands the patient. "You're the one who keeps showing me the dirty pictures!" A very shy guy goes into a bar and sees a beautiful woman sitting at the bar. After an hour of gathering up his courage, he finally goes over to her and asks, tentatively, "Um, would you mind if I chatted with you for a while?" She responds by yelling, at the top of her lungs, "NO! I won't sleep with you tonight!" Everyone in the bar is now staring at them. Naturally, the guy is hopelessly and completely embarrassed and he slinks back to his table. After a few minutes, the woman walks over to him and apologizes. She smiles at him and says, "I'm sorry if I embarrassed you. You see, I'm a graduate student in psychology, and I'm studying how people respond to embarrassing situations." To which he responds, at the top of his lungs, "What do you mean $200?!" -------------------------------------------------------------------------------- What happens when a psychiatrist and a hooker spend the night together? In the morning each of them says: "120 dollars, please." -------------------------------------------------------------------------------- A young woman took her troubles to a psychiatrist. "Doctor, you must help me," she pleaded. "It's gotten so that every time I date a nice guy, I end up in bed with him. And then afterward, I feel guilty and depressed for a week." "I see," nodded the psychiatrist. "And you, no doubt, want me to strengthen your will power and resolve in this matter." "For God's sake, NO!" exclaimed the woman. "I want you to fix it so I won't feel guilty and depressed afterward." -------------------------------------------------------------------------------- Two elderly couples were enjoying friendly conversation when one of the men asked the other, "Fred, how was the memory clinic you went to last month?" "Outstanding," Fred replied. "They taught us all the latest psychological techiniques - visualization, association - it made a huge difference for me." "That's great! What was the name of the clinic?" Fred went blank. He thought and thought, but couldn't remember. Then a smile broke across his face and he asked, "What do you call that red flower with the long stem and thorns?" "You mean a rose?" "Yes, that's it!" He turned to his wife. . ."Rose, what was the name of that clinic?" -------------------------------------------------------------------------------- What is the difference between a psychiatrist and a psychologist? If you say to a psychiatrist "I hate my mother," he will ask "Why do you say that?" while a psychologist will say "Thank you for sharing that with us." -------------------------------------------------------------------------------- What's the difference between a psychologist and a magician? A psychologist pulls habits out of rats! -------------------------------------------------------------------------------- Once I had multiple personalities, but now we are feeling well. I don't suffer from insanity, I enjoy every minute. I used to be indecisive. Now I'm not sure. The best thing about being schizophrenic is that I'm never alone. Hypochondria is the only illness that I don't have. I've always been a hypochondriac. As a little boy, I'd eat my M&M's one by one with a glass of water. -------------------------------------------------------------------------------- Psychiatrist to his nurse: "Just say we're very busy. Don't keep saying 'It's a madhouse.'" -------------------------------------------------------------------------------- Why is psychoanalysis a lot quicker for a man then for a women? Because when it's time to go back to childhood, a man is already there. -------------------------------------------------------------------------------- A psychologist returned from a confrence in Aspen lodge, where all the psychologists were permited to ski for free. Her husband asked her, "How it went?". She replied, "Fine, but I've never seen so many Freudians slips." -------------------------------------------------------------------------------- Two psychologists meet at their twentieth college reunion. One of them looks like he just graduated, while the other psychologist looks old, worried and withered. The older looking one asks the other, "What's your secret? Listening to other people's problems every day, all day long, for years on end, has made an old man of me." The younger looking one replies, "Who listens?" -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Patient: Doctor, my wife thinks I'm crazy because I like sausages. Psychiatrist: Nonsense! I like sausages too. Patient: Good, you should come and see my collection. I've got hundreds of them. -------------------------------------------------------------------------------- When the new patient was settled comfortably on the couch, the physiatrist began his therapy session, "I'm not aware of your problem," the doctor said. "So perhaps, you should start at the very beginning." "Of course." replied the patient. "In the beginning, I created the Heavens and the Earth..." -------------------------------------------------------------------------------- In a psychiatrist's waiting room two patients are having a conversation. One says to the other, "Why are you here?" The second answers, "I'm Napoleon, so the doctor told me to come here." The first is curious and asks, "How do you know that you're Napoleon?" The second responds, "God told me I was." At this point, a patient on the other side of the room shouts, "NO I DIDN'T!" -------------------------------------------------------------------------------- A man who thinks he's George Washington has been seeing a psychiatrist. He finishes up one session by telling him, "Tomorrow, we'll cross the Delaware and surprise them when they least expect it." As soon as he's gone, the psychiatrist picks up the phone and says, "King George, this is Benedict Arnold. I have the plans." -------------------------------------------------------------------------------- Joe has been seeing a psychoanalyst for four years for treatment of the fear that he had monsters under his bed. It had been years since he had gotten a good night's sleep. Furthermore, his progress was very poor, and he knew it. So, one day he stops seeing the psychoanalyst and decides to try something different. A few weeks later, Joe's former psychoanalyst meets his old client in the supermarket, and is surprised to find him looking well-rested, energetic, and cheerful. "Doc!" Joe says, "It's amazing! I'm cured!" "That's great news!" the psychoanalyst says. "you seem to be doing much better. How?" "I went to see another doctor," Joe says enthusiastically, "and he cured me in just ONE session!" "One?!" the psychoanalyst asks incredulously. "Yeah," continues Joe, "my new doctor is a behaviorist." "A behaviorist?" the psychoanalyst asks. "How did he cure you in one session?" "Oh, easy," says Joe. "He told me to cut the legs off of my bed." -------------------------------------------------------------------------------- A psychologist was walking along a Hawaiian beach when he kicked a bottle poking up through the sand. Opening it, he was astonished to see a cloud of smoke and a genie smiling at him. "For your kindness," the genie said, "I will grant you one wish!" The psychologist paused, laughed, and replied, "I have always wanted a road from Hawaii to California." The genie grimaced, thought for a few minutes and said, "Listen, I'm sorry, but I can't do that! Think of all the pilings needed to hold up the highway and how long they'd have to be to reach the bottom of the ocean. Think of all the pavement. That's too much to ask." "OK," the psychologist said, not wanting to be unreasonable. "I'm a psychologist. Make me understand my patients. What makes them laugh and cry, why are they temperamental, why are they so difficult to get along with, what do they really want? Basically, teach me to understand what makes them tick!" The genie paused, and then sighed, "Did you want two lanes or four?" -------------------------------------------------------------------------------- One behaviorist to another after lovemaking: "Darling, that was wonderful for you. How was it for me?" How do you tell the difference between the staff and the inmates at a psychiatric hospital? The patients get better and leave. Not everyone of the patients thinks he is God. The staff have the keys! -------------------------------------------------------------------------------- Doctor, doctor, I keep thinking I am a set of curtains! Pull yourself together, man! Doctor, doctor, I keep thinking I'm a bell. Well, just go home and if the feeling persists, give me a ring. Doctor, doctor, people tell me I'm a wheelbarrow. Don't let people push you around. Doctor, doctor, I've only got 59 seconds to live. Wait a minute please. Doctor, doctor, I keep thinking I'm invisible. Who said that?! Doctor, doctor, nobody understands me. What do you mean by that? Doctor, doctor, People keep ignoring me! Next! Doctor, doctor, No one believes a word I say. Tell me the truth now, what's your REAL problem? Doctor, doctor, I feel like a pack of cards. I'll deal with you later. Doctor, Doctor, I can't stop stealing things. Take these pills for a week; if that doesn't work I'll have a color TV! Doctor, doctor, I keep thinking I'm a spoon. Sit there and don't stir. Doctor, doctor, I'm manic-depressive. Calm down. Cheer up. Clam down. Cheer up. Calm... Doctor, doctor, I keep trying to get into fights. And how long have you had this complaint? Who wants to know? Doctor, doctor, I can't concentrate, one minute I'm ok, and the next minute, I'm blank! And how long have you had this complaint? What complaint? -------------------------------------------------------------------------------- Patient: Doctor, you must help me. I'm under such a lot of stress, I keep losing my temper with people. Doctor: Tell me about your problem. Patient: I JUST DID, DIDN'T I, YOU STUPID BASTARD!!! -------------------------------------------------------------------------------- Doctor, Doctor, I think I'm a bridge. What's come over you? Oh, two cars, a large truck and a coach. -------------------------------------------------------------------------------- Doctor, Doctor, I think I'm a cat. How long has this been going on? Oh, since I was a kitten! -------------------------------------------------------------------------------- Doctor, doctor, I keep thinking I'm a dog. Lie down on the couch and I'll examine you. I can't, I'm not allowed on the furniture. -------------------------------------------------------------------------------- How many psychologists does it take to change a light bulb? None. The light bulb will change itself when it's ready. Just one, but the light bulb really has to want to change. Just one, but it takes nine visits. How many psychiatrists does it take to change a light bulb? "How long have you been having this phantasy?" One, but he must consult the DSM-IV. How many psychoanalysts does it take to change a light bulb? "How many do you think it takes?" ------------------------------------------------------------------------------- GRADUATE TRAINING You just might be a graduate student if... ...you spend more on books than on tuition. ...you actually hope your professor assigns homework. ...you get a 3-hour final with 5 questions or less. ...the words "free time" are unfamiliar to you. ...you spend Saturday morning waiting for the library to open. ...you've memorized your professors' home phone numbers. ...your professors know your home phone number. ...more than 25% of your textbook is "left as an exercise for the reader." ...you are on a first-name basis with everyone on the library staff. ...you can analyze the significance of appliances you cannot operate. ...your carrel is better decorated than your apartment. ...you have ever, as a folklore project, attempted to track the progress of your own joke across the Internet. ...you are startled to meet people who neither need nor want to read. ...you have ever brought a scholarly article to a bar. ...you rate coffee shops by the availability of outlets for your laptop. ...everything reminds you of something in your discipline. ...you have ever discussed academic matters at a sporting event. ...you have ever spent more than $50 on photocopying while researching a single paper. ...there is a microfilm reader in the library that you consider "yours." ...you actually have a preference between microfilm and microfiche. ...you can tell the time of day by looking at the traffic flow at the library. ...you look forward to summers because you're more productive without the distraction of classes. ...you regard ibuprofen as a vitamin. ...you consider all papers to be works in progress. ...professors don't really care when you turn in work anymore. ...you find the bibliographies of books more interesting than the actual text. ...you have given up trying to keep your books organized and are now just trying to keep them all in the same general area. ...you have accepted guilt as an inherent feature of relaxation. ...you reflexively start analyzing those greek letters before you realize that it's a sorority sweatshirt, not an equation. ...you find yourself explaining to children that you are in "20th grade". ...you start refering to stories like "Snow White et al." ...you frequently wonder how long you can live on pasta without getting scurvy. ...you look forward to taking some time off to do laundry. ...you have more photocopy cards than credit cards. ...you wonder if APA style allows you to cite talking to yourself as "personal communication". The Top Ten Lies Told by Graduate Students (taken from the Harvard Crimson) 10. It doesn't bother me at all that my college roommate is making $80,000 a year on Wall Street. 9. I'd be delighted to proofread your book/chapter/article. 8. My work has a lot of practical importance. 7. I would never date an undergraduate. 6. Your latest article was so inspiring. 5. I turned down a lot of great job offers to come here. 4. I just have one more book to read and then I'll start writing. 3. The department is giving me so much support. 2. My job prospects look really good. 1. No really, I'll be out of here in only two more years. Top Five Lies Told by Teaching Fellows: 5. I'm not going to grant any extensions. 4. Call me any time. I'm always available. 3. It doesn't matter what I think; write what you believe. 2. Think of the midterm as a diagnostic tool. 1. My other section is much better prepared than you guys. Ask and ye shall receive (to the tune of "If I only had a brain"): If I only had a thesis Then they wouldn't call me specious. They would not reject my claim. Do Do Doot Da Doot Da Dum I would write it and defend it I would leave and that would end it. I'd be off to win my fame. Why God never received a PhD: 1. He had only one major publication. 2. It was in Hebrew. 3. It had no references. 4. It wasn't published in a refereed journal. 5. Some even doubt he wrote it by himself. 6. It may be true that he created the world, but what has he done since then? 7. His cooperative efforts have been quite limited. 8. The scientific community has had a hard time replicating his results. 9. He never applied to the ethics board for permission to use human subjects. 10. When one experiment went awry he tried to cover it by drowning his subjects. 11. When subjects didn't behave as predicted, he deleted them from the sample. 12. He rarely came to class, just told students to read the book. 13. Some say he had his son teach the class. 14. He expelled his first two students for learning. 15. Although there were only 10 requirements, most of his students failed his tests. 16. His office hours were infrequent and usually held on a mountain top. 17. No record of working well with colleagues. This letter was first written by a graduate student in Europe in 1954 and has traveled around the world at least 16 times. At first I wouldn't believe that it would work, but after trying it, I am now a believer in its mystical and magical power. This letter was received by a graduate student in Chicago, IL in 1973 and within two weeks, he had completed a 5600 page doctoral dissertation and began a career which lead to a Nobel Prize. A few years later, another graduate student received this letter and sent it to 5 of her friends, and she too completed a 3100 page paper which is continues to grow to this day! Simply write five pages of text on the given subjects for each person on this list. Than place your name in slot #1 and move everyone else's name down one space. Send this letter to ten of your colleagues, and within a month, you too will have a thesis or disertation which your advisor can choke on if he or she doesn't go blind or break his or her back first. Bernard T. Donovan, M.S. student in biochemistry EPR spectroscopy of crud from my refrigerator James C. Messier, PhD. student in political science The Cuban Missile Crisis: What if Nixon were president? Frances K. Allen, M.A. student in music theory Development of polyphonic forms from Gregorian Chant Penny S. Jordan, PhD student in computer science Is Windows 95 merely Mac 84? Thomas J. Quinn, MBA student Bears and Bulls in the stock market, but what about Sox and Cubs? The last person who received this letter and did not respond was tormented by receiving 100-level teaching assignments until he was 40 years old. Today he works as a clerk for the Little-Plastic-Pizza-Table Museum in Cleveland, OH, making minimum wage and regretting his terrible decision not to perpetuate this letter. A grad student, a post-doc, and a professor are walking through a city park and they find an antique oil lamp. They rub it and a Genie comes out in a puff of smoke. The Genie says, "I usually only grant three wishes, so I'll give each of you just one." "Me first! Me first!" says the grad student. "I want to be in the Bahamas, driving a speedboat with a gorgeous woman who sunbathes topless." Poof! He's gone. "Me next! Me next!" says the post-doc. "I want to be in Hawaii, relaxing on the beach with a professional hula dancer on one side and a Mai Tai on the other." Poof! He's gone. "You're next," the Genie says to the professor. The professor says, "I want those guys back in the lab after lunch." An MIT student spent an entire summer going to the Harvard football field every day wearing a black and white striped shirt, walking up and down the field for ten or fifteen minutes throwing birdseed all over the field, blowing a whistle and then walking off the field. At the end of the summer, it came time for the first Harvard home football game, the referee walked onto the field and blew the whistle, and the game had to be delayed for a half hour to wait for the birds to get off of the field. The guy wrote his thesis on this, and graduated. Graduate Admissions Committee Department of Psychology Big Deal University Collegeville, USA Dear Committee Members: Thanks for your letter of March 30. After careful consideration, I regret to inform you that I am unable to accept your rejection at this time. This year I have been particularly fortunate in receiving an unusually large number of rejection letters. With such a varied and promising field of schools, it is impossible for me to accept all refusals. Despite your outstanding record and previous experience in rejecting applicants, I find that your rejection does not meet my current career needs. Consequently, I will begin taking classes as a graduate student in your department this August. I look forward to seeing you then. Best of luck in rejecting future applicants. Sincerely Yours, [Name Withheld] Deep Thought by Jack Handy: Instead of studying for finals, what about just going to the Bahamas and catching some rays? Maybe you'll flunk, but you might have flunked anyway; that's my point. Top Ten things that suck MORE than writing a psych thesis: Getting hit by a truck Being stranded in the Sahara without water Falling in a pool of alligators Discovering that your house was built on top of a graveyard Hearing voices in your head Being eaten by turtles Getting a package from the Unabomber Studying thermodyamic engineering Writing a dissertation And the number one thing that sucks more than writing a thesis: Not graduating So I guess I'll get back to work. -------------------------------------------------------------------------------------- CLINICAL There are three guys going through an exit interview at a mental hospital. The doctor says he can release them if they can answer the simple mathematical problem: What is 8 times 5? The first patient says, "139." The second one says, "Wednesday." The third says, "What a stupid question. It's obvious: The answer is 40." The doctor is delighted. He gives the guy his release. As the man is leaving, the doctor asks how he came up with the correct answer so quickly. "It was easy, Doc. I just divided Wednesday into 139." Stress Management From Mental Health Net Picture yourself near a stream. Birds are singing in the crisp, cool mountain air. Nothing can bother you here. No one knows this secret place. You are in total seclusion from that place called the world. The soothing sound of a gentle waterfall fills the air with a cascade of serenity. he water is clear. You can easily make out the face of the person whose head you're holding under the water. There now, feeling better? Patient: Doctor, my wife thinks I'm crazy because I like sausages. Psychiatrist: Nonsense! I like sausages too. Patient: Good, you should come and see my collection. I've got hundreds of them. A Stanford research group advertised for participants in a study of obsessive-compulsive disorder. They were looking for therapy clients who had been diagnosed with this disorder. The response was gratifying; they got 3,000 responses about three days after the ad came out. All from the same person. The head doctors in an insane asylum had a meeting and decided that one of their patients was potentially well. So they decide to test him and take him to the movies. When they get to the movie theater, there are signs of wet paint pointing to the benches. The doctors just sit down, but the patient puts a newspaper down first and then sits down. The doctors get all excited cause they think maybe he's in touch with reality now. So they ask him, " Why did you put the newspaper down first?" He answers, "So I'd be higher and have a better view." After just a few years of marriage, filled with constant arguments, a young man and his wife decided the only way to save their marriage was to try therapy. They had been at each others throats for some time and felt that this was their last straw. When they arrived at the therapist's office, the therapist jumped right in and opened the floor for discussion. "What seems to be the problem?" Immediately, the husband held his long face down without anything to say. On the other hand, the wife began talking 90 miles and hour describing all the wrongs within their marriage. After 5 - - 10 - - 15 minutes of listening to the wife, the therapist went over to her, picked her up by her shoulders, kissed her passionately for several minutes, and sat her back down. Afterwards, the wife sat there - speechless. He looked over at the husband who was staring in disbelief at what had happened. The therapist spoke to the husband, "Your wife NEEDS that at least twice a week!" The husband scratched his head and replied, "I can have her here on Tuesdays and Thursdays." 1-800-PSYCH Hello, Welcome to the Psychiatric Hotline. If you are obsessive-compulsive, please press 1 repeatedly. If you are co-dependent, please ask someone to press 2. If you have multiple personalities, please press 3, 4, 5 and 6. If you are paranoid-delusional, we know who you are and what you want. Just stay on the line so we can trace the call. If you are schizophrenic, listen carefully and a little voice will tell you which number to press. If you are depressed, it doesn't matter which number you press. No one will answer. Patient to Rogerian therapist: I'm really depressed. Therapist: I see. Yes. You are depressed. Patient: Nothing is going well. Therapist: Nothing well. Patient: I feel like killing myself. T: You're thinking of killing yourself. P: Yes, I'm going to do it NOW. T: You want to do it now. P: [Jumps out window.] T: Woosh. Splat. A young couple on the brink of divorce visit a marriage counselor. The counselor asks the wife what is the problem. She responds " My husband suffers from premature ejaculation." The couselor turns to her husband and inquires "Is that true?" The husband replies " Well not exactly, it's she that suffers not me." Two elderly couples were enjoying friendly conversation when one of the men asked the other, "Fred, how was the memory clinic you went to last month?" "Outstanding," Fred replied. "They taught us all the latest psychological techiniques - visualization, association - it made a huge difference for me." "That's great! What was the name of the clinic?" Fred went blank He thought and thought, but couldn't remember. Then a smile broke across his face and he asked, "What do you call that red flower with the long stem and thorns?" "You mean a rose?" "Yes, that's it!" He turned to his wife. . ."Rose, what was the name of that clinic?" One out of every four people is suffering from some form of mental illness. Check three friends. If they're OK, then it's you. Antidotes to Your Shrink's Falling Asleep During the Therapy Session: A Patient's Guide to Keeping the Therapist's Attention Insist that one of your other personalities already paid last month's therapy bill. Lie down under the couch. Express concern that you are not narcissistic enough. Bark. Shout "Eureka!" after your therapist makes an interpretation. Play dead. As your therapist hands you the therapy bill, put on a pair of latex rubber gloves to accept it. Copyright 1994 Wry-Bred Press, Inc. Excerpted from the Journal of Polymorphous Perversity by permission of the copyright holder. Announcement: the mental-disease-of-the-month club is being disbanded immediately. The reasons being: During dipsomania month, the club party spent 10 times its budget on refreshments. During kleptomania month, all of the club furnishings were removed, and (as aforementioned) the budget was already spent and gone. During megalomania month, the club organization broke down due to having sixteen claimants to being Club President, etc. During multiple personality month, our club roster roughly tripled in size with no increase in dues. During paranoia month, the inflated roster dropped to zero as each member changed his or her mailing address and left no forewarding address for the club. You members were obviously out to ruin us; it's all clear now. It took all our remaining personal savings to track you all down. Therefore, here is your last installment: clinical depression. Have a nice day." Top 10 Signs a Therapist is Approaching Burn-out by Storm A. King, 08/28/96 You think of the peaceful park you like as "your private therapeutic milieu." You realize that your floridly psychotic patient, who is picking invisible flowers out of mid air, is probably having more fun in life than you are. A grateful client, who thinks you walk on water, brings you a small gift and you end up having to debrief your feelings of unworthiness with a colleague. You are watching a re-run of the Wizard of Oz and you start to categorize the types of delusions that Dorothy had. Your best friend comes to you with severe relationship troubles, and you start trying to remember which cognitive behavioral technique has the most empirical validly for treating this problem. You realize you actually have no friends, they have all become just one big case load. A co-worker asks how you are doing and you reply that you are a bit "internally preoccupied" and "not able to interact with peers" today. Your spouse asks you to set the table and you tell them that it would be "countertherapeutic to your current goals" to do that. You tell your teenage daughter she is not going to start dating boys because she is "in denial," "lacks insight." and her "emotions are not congruent with her chronological age." And, the number one reason a therapist may be burning out.... You are packing for a trip to a large family holiday reunion and you take the DSM-IV with you just in case. Case example: Dorothy, Scarecrow, Tin Man, Lion, Toto Rationale: This group of four individuals and a little dog is being denied in one paragraph since their reports were submitted together; we concluded that none have conditions requiring medical treatment, and that all of them would be considered prime examples of "worried well" individuals who are constantly in search of some kind of magical solution to their problems. While the little girl who ran away from her Aunty Em's home may have a conduct disorder (after all, she did kill the so-called wicked witch whose assertiveness she found threatening), we would point out that running away from home, singing and dancing, hanging around with peculiar, oddly attired friends with grandiose expectations, and occasionally indulging a fetish for fancy footwear are all normative among adolescents, just as among psychologists attending out-of-town meetings. ...Finally, we feel that the most cost-effective alternative for the little dog, Toto, is that he be put to sleep. Excerpted from articles appearing in the Journal of Polymorphous Perversity. Copyright 1986, 1988, 1994, 1997 by Wry-Bred Press, Inc. All rights reserved. Antidotes to Your Shrink's Falling Asleep During the Therapy Session: A Patient's Guide to Keeping the Therapist's Attention This paper presents concrete tactics that will ensure retaining the analyst's attention. Insist that one of your other personalities already paid last month's therapy bill. Lie down under the couch. Express concern that you are not narcissistic enough. Bark. Shout "Eureka!" after your therapist makes an interpretation. Play dead. As your therapist hands you the therapy bill, put on a pair of latex rubber gloves to accept it. The psychiatrist tells his patient: "Well I have good new and bad news..." The patient says "Lay it on me Doc. What's the bad news?" "You have Alzheimer's disease." "Good heavens! What's the good news?" "You can go home and forget about it!" "Great news, Mr. Oscarson," the psychiatrist reported. "After eighteen months of therapy, I can pronounce you finally and completely cured of your kleptomania. You'll never be trapped by the desire to steal again." "Gee, that's great, Doc," the patient replied. "And just to prove it, I want you to stop by Sears on the way home and walk the length of the store. You'll see - you'll feel no temptation to shoplift whatsoever." "Oh, Doctor, whatever can I do to thank you?" "Well," suggested the psychiatrist, "if you DO have a relapse, I could use a new microwave." A woman took her husband to the psychiatrists because he thought he was a dog. "Why don't you sit on the couch?" the psychiatrist said when they arrived. "Oh, no" said the woman. "He's not allowed on the furniture." A husband brought his wife to the psychiatrist. Husband: My wife thinks she’s a chicken. Psychiatrist: That’s terrible. How long has she been this way? Husband: For three years. Psychiatrist: Why didn’t you bring her to see me sooner? Husband: We needed the eggs. Patient: Doctor, I get the feeling that people don’t give a hoot about anything I say. Psychiatrist: So? --------------------------------------------------------------------------------------- Useful Research Phrases and what they Really Mean "It has long been known" . . . [I didn't look up the original reference.] "A definite trend is evident" . . . [These data are practically meaningless.] "Of great theoretical and practical importance" . . . [Interesting to me.] "While it has not been possible to provide definite answers to these questions" . . . [An unsuccessful experiment but I still have to get it published.] "Three of the samples were chosen for detailed study" . . . [The results of the others didn't make any sense.] "Typical results are shown" . . . [The best results are shown.] "These results will be shown in a subsequent report" . . . [I might get around to this sometime if I'm pushed.] "The most reliable results are those obtained by Jones" . . . [He was my graduate assistant.] "It is believed that" . . . [I think] "It is generally believed that" . . . [A couple of other guys think so, too.] "It is clear that much additional work will be required before a complete understanding occurs" . . . [I don't understand it.] "Correct within an order of magnitude" . . . [Wrong] "It is hoped that this study will stimulate further investigations in this field" . . . [This is a lousy paper, but so are all the others on this miserable topic.] "Thanks are due to Joe Blotz for assistance with the experiment and to George Frink for valuable assistance" . . . [Blotz did the work and Frink explained to me what it meant.] "A careful analysis of obtainable data" . . . [Three pages of notes were obliterated when I knocked over a glass of beer.] --------------------------------------------------------------------------------------- THE ETIOLOGY AND TREATMENT OF CHILDHOOD Jordan W. Smoller University of Pennsylvania Childhood is a syndrome which has only recently begun to receive serious attention from clinicians. The syndrome itself, however, is not at all recent. As early as the 8th century, the Persian historian Kidnom made references to "short, noisy creatures," who may well have been what we now call "children." The treatment of children, however, was unknown until this century, when so-called "child psychologists" and "child psychiatrists" became common. Despite this history of clinical neglect, it has been estimated that well over half of all Americans alive today have experienced childhood directly (Suess, 1983). In fact, the actual numbers are probably much higher, since these data are based on self-reports which may be subject to social desirability biases and retrospective distortion. The growing acceptance of childhood as a distinct phenomenon is reflected in the proposed inclusion of the syndrome in the upcoming Diagnostic and Statistical Manual of Mental Disorders, 4th edition, or DSM-IV, of the American Psychiatric Association (1990). Clinicians are still in disagreement about the significan clinical features of childhood, but the proposed DSM-IV will almost certainly include the following core features: Congenital onset Dwarfism Emotional lability and immaturity Knowledgy deficits Legume anorexia Clinical Features of Childhood Although the focus of this paper is on the efficacy of conventional treatment of childhood, the five clinical markers mentioned above merit further discussion for those unfamiliar with this patient population. CONGENITAL ONSET In one of the few existing literature reviews on childhood, Temple-Black (1982) has noted that childhood is almost always present at birth, although it may go undetected for years or even remain subclinical indefinitely. This observation has led some investigators to speculate on biological contribution to childhood. As one psychologist has put it, "we may soon be in a position to distinguish organic childhood from functional childhood" (Rogers, 1979). DWARFISM This is certainly the most familiar marker of childhood. It is widely known that children are physically short relative to the population at large. Indeed, common clinical wisdom suggests that the treatment of the so-called "small child" (or "tot") is particularly difficult. These children are known to exhibit infantile behavior and display a startling lack of insight (Tom and Jerry, 1967). EMOTIONAL LABILITY AND IMMATURITY This aspect of childhood is often the only basis for a clinician's diagnosis. As a result, many otherwise normal adults are misdiagnosed as children and must suffer the unnecessary social stigma of being labelled a "child" by professionals and friends alike. KNOWLEDGE DEFICITS While many children have IQs with or even above the norm, almost all will manifest knowledge deficits. Anyone who has known a real child has experienced the frustration of trying to discuss any topic that requires some general knowledge. Children seem to have little knowledge about the world they live in. Politics, art, and science--children are largely ignorant of these. Perhaps it is because of this ignorance, but the sad fact that most children have few friends who are not, themselves, children. LEGUME ANOREXIA This last identifying feature is perhaps the most unexpected. Folk wisdom is supported by empirical observation--children will rarely eat their vegetables (see Popeye, 1957, for review). Causes of Childhood Now that we know what it is, what can we say about the causes of childhood? Recent years have seen a flurry of theory and speculation from a number of perspectives. Some of the most prominent are reviewed below. Sociological Model Emile Durkind was perhaps the first to speculate about sociological causes of childhood. He points out two key observations about children: the vast majority of children are unemployed, and children represent one of the least educated segments of our society. In fact, it has been estimated that less than 20% of children have had more than fourth grad education. Clearly, children are an "out-group." Because of their intellectual handicap, children are even denied the right to vote. From the sociologist's perspective, treatment should be aimed at helping assimilate children into mainstream society. Unfortunately, some victims are so incapacitated by their childhood that they are simply not competent to work. One promising rehabilitaion program (Spanky and Alfalfa, 1978) has trained victims of severe childhood to sell lemonade. Biological Model The observation that childhood is usually present from birth has led some to speculate on a biological contribution. An early investigation by Flintstone and Jetson (1939) indicated that childhood runs in families. Their survey of over 8,000 American families revealed that over half contained more than one child. Further investigation revealed that even most non-child family members had experienced childhood at some point. Cross-cultural studies (e.g., Mowgli and Din, 1950) indicated that family childhood is even more prevalent in the Far East. For example, in Indian and Chinese families, as many as three out of four family members may have childhood. Impressive evidence of a genetic component of childhood comes from a large-scale twin study by Brady and Partridge (1972). These authors studied over 106 pairs of twins, looking at concordance rates for childhood. Among identical or monozygotic twins, concordance was unusually high (0.92), i.e., when one twin was diagnosed with childhood, the other twin was almost always a child as well. Psychological Models A considerable number of psychologically-based theories of the development of childhood exist. They are too numerous to review here. Among the more familiar models are Seligman's "learned childishness" model. According to this model, individuals who are treated like children eventually give up and become children. As a counterpoint to such theories, some experts have claimed that childhood does not really exist. Szasz (1980) has called "childhood" an expedient label. In seeking conformity, we handicap those whom we find unruly or too short to deal with by labelling them "children." Treatment of Childhood Efforts to treat childhood are as old as the syndrome itself. Only in modern times, however, have human and systematic treatment protocols been applied. In part, this increased attention to the problem may be due to the sheer number of individuals suffering from childhood. Government statistics (DHHS) reveal that there are more children alive today than at any time in our history. to paraphrase P.T. Barnum: "There's a child born every minute." The overwhelming number of children has made government intervention inevitable. The nineteenth century saw the institution of what remains the largest single program for the treatment of childhood-- so-called "public schools." Under this colossal program, individuals are placed into treatment groups based on the severity of their condition. For example, those most severely afflicted may be placed in a "kindergarten" program. Patients at this level are typically short, unruly, emotionally immature, and intellectually deficient. Given this type of individual, therapy is essentially one of patient management and of helping the child master basic skills (e.g. finger-painting). Unfortunately, the "school" system has been largely ineffective. Not only is the problem a massive tax burden, but it has failed even to slow down the rising incidence of childhood. Faced with this failure and the growing epidemic of childhood, mental health professionals are devoting increasing attention to the treatment of childhood. Given a theoretical framework by Freud's landmark treatises on childhood, child psychiatrists and psychologists claimed great successes in their clinical intervention. By the 1950's, however, the clinicians' optimism had waned. Even after years of costly analysis, many victims remained children. The following case (taken from Gumbie and Poke, 1957) is typical. Billy J., age 8, was brought to treatment by his parents. Billy's affliction was painfully obvious. He stood only 4'3" high and weighed a scant 70 lbs., despite the fact that he ate voraciously. Billy presented a variety of troubling symptoms. His voice was noticably high for a man. He displayed legume anorexia, and, according to his parents, often refused to bathe. His intellectual functioning was also below normal--he had little general knowledge and could barely write a structured sentence. Social skills were also deficient. He often spoke inappropriately and exhibited "whining behaviour." His sexual experience was non-existent. Indeed, Billy considered women "icky." His parents reported that his condition had been present from birth, improving gradually after he was placed in a school at age 5. The diagnosis was "primary childhood." After years of painstaking treatment, Billy improved gradually. At age 11, his height and weight have increased, his social skills are broader, and he is now functional enough to hold down a "paper route." After years of this kind of frustration, startling new evidence has come to light which suggests that the prognosis in cases of childhood may not be all gloom. A critical review by Fudd (1972) noted that studies of the childhood syndrome tend to lack careful follow-up. Acting on this observation, Moe, Larrie, and Kirly (1974) began a large-scale longitudinal study. These investigators studied two groups. The first group consisted of 34 children currently engaged in a long-term conventional treatment program. The second was a group of 42 children receiving no treatment. All subjects had been diagnosed as children at least 4 years previously, with a mean duration of childhood at 6.4 years. At the end of one year, the results confirmed the clinical wisdom that childhood is a refractory disorder--virtually all symptoms persisted and the treatment group was only slightly better off than the controls. The results, however, of a careful 10-year follow-up were startling. The investigators (Moe, Larrie, Kirly, & Shemp, 1984) assessed the original cohort on a variety of measures. General knowledge and emotional maturity were assessed with standard measures. Height was assess by the "metric system" (see Ruler, 1923), and legume appetite by the Vegetable Appetite Test (VAT) designed by Popeye (1968). Moe et al. found that subjects improved uniformly on all measures. Indeed, in most cases, the subjects appeared to be symptom-free. Moe et al. report a spontaneous remission rate of 95%, a finding which is certain to revolutionize the clinical approach to childhood. These recent results suggests that the prognosis for victims of childhood may not be so bad as we have feared. We must not, however, become too complacent. Despite its apparently high spontaneous remission rate, childhood remains one of the most serious and rapidly growing disorders facing mental health professionals today. And, beyond the psychological pain it brings, childhood has recently been linked to a number of physical disorders. Twenty years ago, Howdi, Doodi, and Beauzeau (1965) demonstrated a six-fold increased risk of chicken pox, measles, and mumps among children as compared with normal controls. Later, Barby ------------------------------------------------------------------------------------- |