Thinking Outloud

I find it interesting to notice that sometimes my conversations in therapy, with vastly different people and circumstances, seem to circle around themes on occasion. This week, I've noticed two topics that I am repeatedly seeing in session: 1. Men who have become "awake" to their own conflicts, problem behaviors and thinking and have made radical steps to be fuller, more peaceful people. Some have partners that are whole enough people themselves who rejoice in the change, and despite years of distance, hurt and resentments, fight along with their men to restore and renew their partnership. Others have partners who are too fragile, conflicted or hurt that the reversal appears like an "act" and feel the need to flee. Whatever the result, their is great Joy in the awakening, and it's a pleasure to keep giving these new men feedback on their personal discoveries. 2. Narcissistic Personality Disorder. If there is a personality style that kills a marriage slow

As the roar of reaction begins to quiet following the horror in Newtown, many media comments I have read express a demand for better "access to mental health services." I'm not sure what that means in this case. The biggest gap in mental health care in our country, as I have come to know it, is in in-patient hospital care. After Congress passed laws in the 1980's that down-sized state hospitals, hundreds of people were released from care. States and communities were expected to provide needed services, but in many places, such care never materialized. The numbers of homeless, mentally ill and/or addicted persons swelled, and state and federal dollars for the seriously and/or persistently mentally ill dwindled and has stayed low. We have now have a chronic shortage of psychiatric hospital beds, and an even more critical shortage of child and adolescent psychiatrists. The cost of in-patient care is close to $1000 a day in some cities like Minneapolis. We have a sh