Stress: Out Of Control?

What is even more interesting is that several factors may be considered environmental antecedents common to many different countries. One common source of stress, Dr. Costa e Silva mentioned, is the prevalence of violence in society. This often leads to posttraumatic stress, which "affects people when they in one way or another have been in a life-endangering situation. During the day they manifest insecurity in relation to everything. At night they have nightmares in which the episode that put their lives in danger is relived."

Now Everyone's A Psychologist ...

Have you ever been in a conversation where someone, perhaps even yourself, has told another that he or she needs help or should seek counseling? Have you witnessed laypersons attempting to make obtuse clinical-sounding diagnosis? Maybe it's all in fun. Maybe it's just part of the banter. Yet, is there a hidden meaning here?

It is no secret that our world has become very impersonal, and hence, very cynical. Trust has become a hazy term. As trust becomes suspect, we find that we have no one to turn to. And, without a support group of any kind, we find that we have only one alternative. Like anything else in a consumerist society, we must pay for "helping" services. Those who cannot afford the exorbitant fees of endless therapy are reduced to choose a more economical version: self-help books. All-in-all, we are bombarded by jargon and rhetoric (read "psychobabble"). As cynical as we are, we gradually find ourselves believing and spewing forth the same jargon. We relieve ourselves of any further responsibility by appending disclaimers for our use of psychobabble.

A lot of talk show audience members fall in this category. In talking with "normal" people, most have expressed a distinct dichotomy in intellect between talk show audience members and themselves. Yet, Dr. Psycho has observed that in the course of mundane conversations, the so-called "normal" people were found to be expounding the same kind of quasi-clinical diatribe. Clinical definition serves a purpose within the mental health care professions. It provides a vehicle to make a diagnosis as a precursor to alternative interventions. It is also a means of maintaining statistical data on the occurrences of distinct behavioral aberrations across a general population. And, most important, it is the means by which HMOs determine what can and cannot be paid for. That, sadly, is the bottom line.

As far as the clinical glossary permeating into the more mundane arena of society, this can serve no real purpose. The ability to recognize and categorize any of our associates vis-a-vis a DSM-IV classification does little to help those individuals. Unlike people who feign computer literacy, those that spew out clinical terms with an air of authority can only do more harm than good. Similarly, telling others that they should "seek counseling" or to "go find a good therapist" may seem altruistic at first. But, upon closer scrutiny, it is easy to see the injustice that had been done to that individual. Any of these conversations makes the implication that the speaker has adequate knowledge to come to the conclusion that someone needs help. By indicating a true diagnostic classification or a pseudo-classification (yes, many people make up new terms) to an individual, we wreak havoc on that person's psyche.

The impromptu referrals to seek professional help may seem honorable, but in many cases is it justifiable? At times, it is not because we are worried of causing more harm than good. It is a sad epitaph to a dying society. We equate daily problems with crippling dysfunctions. In an attempt to always put on a happy face, we find that we can no longer deal with what's underneath. Our interactions are then just small talk. We all need someone to turn to at times, not because we need a diagnosis, or we need some Prozac. We need friends, people to talk to, people who care. This is what gives all of us the strength to tackle our daily problems and obstacles. We have just forgotten how to do that. There is no magic in true caring. We do not need a doctorate to qualify.

Sensitivity, compassion and caring are the qualities we need to develop. None of these require the use of a mental status examination or diagnostic criteria. When we shirk others off to the "professionals," we have initiated the debilitation process. As this process continues, the persons will eventually become truly diagnosable in one of those DSM classifications. Just another statistic, though. One doesn't just catch a mental illness like a cold. It is a fairly long process with some notable features. How many chronic depressions could have been avoided? How many suicides could have been circumvented? There are other complex issues at play, some of which are out of the control of any individual. However, this is a good starting point for all of us to evaluate our role within the frame of human existence itself, devoid of ethnicity, gender, and status.

Gym "Owner" Goes Berserk

The gym "owner" has made it clear that the rules that pertain to all gym members do not apply to him. So, what he does blatantly in front of everyone should not serve as an example of acceptable conduct. The gym "owner" has often taken a few members under his wing, so to speak, but after gaining modest control over their person, he immediately begins to exercise cruel and sadistic methods to hurt the individuals. The gym "owner" repeats this with his employees, and there is speculation that he does this with his girlfriend. The gym "owner"'s raucous manner has gotten him into trouble before, but old ways die hard.

The gym "owner" also claims to own a construction company as he is proud to tell all that he is a general contractor. Yet, his gym is a dump and he is forever hiring other incompetent people to do the simplest things. In actuality, the gym "owner" does nothing. He lives off of someone else's money, which he spends freely on expensive toys to satisfy his whim. He has nothing else better to do, so he hangs around the gym, harasses the members, interferes with his own staff, countermands his management, and races the engine of his boat out in the parking lot.

Analysis: This case was forwarded by some members of a certain gym. The gym "owner" is typical of a man whose masculinity is in question. He knows that he is totally worthless and that he has no marketable skills. His only claim to fame, the ownership of the gym, is not even of his own doing. It really belongs to his girlfriend. He is a kept man, and his only worth is his penis. In a Freudian sense, he has reverted to the phallic stage, but his inability to prove his worth as a man has symbolically reduced the size of his penis, at least in his mind. He strikes out to try to protect the secret of his small penis, which results in his overbearing and controlling style. Increasingly, paranoia has become manifest in the symptomatology. He does not trust other men, and he trusts women even less (delusions of persecution). Further, his "kept man" status has further promoted his feelings of misogyny perhaps as a result of a fear of castration or inevitable shrinking of his penis to nothing. To rationalize his odd behavior, the gym "owner" has elevated his position (delusions of grandeur) in his own eyes, and is constantly trying to persuade others as well as himself of his self-importance. From all accounts, the gym owner has exhibited this behavior for several years, and has shown marked increases in symptomatology. Without a mental status exam (MSE), it will be difficult to make a real assessment, but it would seem that the gym "owner" is diagnosable with delusional disorder (grandiose and persecutory), sexual dysfunction (possibly impotence), and a multiplicity of personality disorders (paranoid, histrionic, sadistic, narcissistic and anti-social). Although the gym "owner" appears lucid, this may be a facade. The gym "owner" is the proverbial time bomb ready to go off, and he will take down as many as he can when he does go off. Certainly it is just a matter of time before this happens, but it will happen. The gym "owner" is on the borderline of functioning. The gym "owner" may benefit most from drug therapy, as it would seem unlikely that he would be open to talk therapy. Lopressor or Haldol, in conjunction with Xanax may reduce the more psychotic features exhibited by the gym "owner," and may lessen the chances of a violent episode. The gym "owner" should be considered a threat to himself and others, not because of his strength or power, but because of his incoherent state of mind.

Slowly I Turn, Step by Step ...

What could be at the root of this odd behavior? Is it boredom? Is it delirium from lack of sleep? Or is it anxiety as a result of babes (or lack thereof)? Loser never receives any phone calls, but he is always calling people up. The calls never seem to last long, on the average. From this, we can extrapolate that Loser is not very popular. He has nothing tangible to offer his associates. Loser did have a close associate named "stooge" for a while, although it seems that "stooge" was actually using Loser. The hyperactivity and psychomotor agitation that has manifested itself in the form of pacing or traversing is an extension of the apprehension that Loser is experiencing because his need for acceptance is not being met. Loser is also facing alienation and confusion about his sexual self-worth. Why? Notice that Loser had remained somewhat dormant after his return from Spring Break, but when the babe that lives above him had her boyfriend over for the weekend, Loser became anxious. The pacing was revived, and the need to call everyone and anyone surfaced. Loser is grasping at straws attempting to maintain his sanity. His back issues of ManDate are not cutting it. Also, remember how quickly Loser darted out onto the balcony when some babe was outside washing her car. Loser had to feign a need to straighten out that ugly blue tarp that covers his empty box collection so he could peruse the babe. Needless to say, those odds noises and thumping sounds emanating from his apartment (also referred to as the "palace") do tend to confirm that Loser was involved in some kind of unusual autoerotic activity.

There is no question that Loser is already exhibiting some severe symptoms of psychopathology, although it is not clear whether he has progressed to higher level disorders. It is clear that Loser has babes and/or "stooge" on his mind. This suppressed sexuality and repressed carnal desire is building up to a fever pitch. When Loser is unable to dissipate this energy through his pacing and traversing, he will need to seek other means to release that pent-up energy. Loser is a time bomb ready to explode at any time. Loser needs help, but will he seek out that help? Dr. Psycho suggests that Loser purchase some over-the-counter medication, Benadryl, commonly used as an antihistamine or allergy remedy. He should up the dosage by two times to begin with, and if necessary increase the dosage to three times that prescribed on the package. This will only provide temporary relief, however, until he can be checked into an institution for isolated observation. Those who know Loser should encourage him to go in on his own recognizance immediately.

Psychopathology of Dating

Fear and anxiety are at the root of social breakdown. From AIDS to date rape, no stone has been left unturned in creating large scale panic and anxiety. This, in turn, has manifested itself into a general mistrust amongst the population at large. Dr. Psycho, himself, is immune from these effects because he (like the monks at The Monastery) is an eunuch. Nonetheless, dating, mating and courtship are the essential elements in procreation. Without any of these, the human race would become extinct.

However, this procreation process is initiated by a series of games. These games are far from fun, and are at the root of psychopathology. For example, Dr. Psycho was perusing one of the many articles that routinely get published which allegedly contribute the feminine perspective on the dating problem. The common plea was for some "good men" to step forward, because they knew that they are "somewhere out there." Where are those "good men"?

As it turns out, there is some need for interpretation here. Dr. Psycho had to reread these various articles several times to discover the paradox of the existence of "good men." "Good men" are few and far between because they have to be, at a minimum, somewhat handsome with a good build, have excellent financial resources, be a man's man, yet be gentle with the babes. In actuality, there are plenty of good men out there. Dr. Psycho personally knows quite a few of them, but they appear to be missing at least the first two qualifications of the babes' definition for a "good man." Herein lies the problem and the paradox. An unattractive, poor guy would be deemed undesirable. His attempts to woo a babe would naturally be interpreted as a nuisance and possibly a form of sexual harassment. He would be a "stalker." Of course, the desirable guy doing the same thing would be seen as "friendly" and engaged in "flirting." Now, where do you think, say a typical computer nerd, would fit in? Desirable or undesirable? Even Dr. Psycho can figure that out.

That is why asking babes out, dating babes and all that other mumbo-jumbo is useless. It is a stressor that can trigger pathological anxiety. Only a select few can play and win. Continued rejection or even incarceration can result in Schizotypal Personality Disorder and extreme chronic depression may set in, and there will be no recourse but to reach for the Prozac. Dr. Psycho can only recommend that losers should take the vow of celibacy, or perhaps consider joining a monastery. Take a good look at yourself. If you realize that you can't cut the mustard, then it is best to nip those fantasies in the bud, as it were. There is no need to worry about babes if the only result will be rejection and humiliation. Buying those "How to Pick Up ..." books is not going to help either. These kinds of so-called self-help books will only expedite your demise, as well as lighten your wallet. They don't even make good doorstops.

There will always be a few who will remain adamant in their pursuit of babes no matter how fruitless are the results of their feeble attempts. Dr. Psycho can only suggest that a person in this category must try to eliminate the external stimuli that can over-exaggerate those primal urges. This means no downloading of those XXX gif or jpeg files, no Baywatch, no hurdy gurdies, and total avoidance of places where babes hang out. This kind of stimuli will only lead to delusional thinking, which may ultimately develop into psychosis. After that, all one can do is reach for the Thorazine.

DOH!

Sometimes a Cigar is Just a Cigar

The patient described other unusual experiences. He recently went to a shoe store some 30 miles from his home in an effort to obtain some shoes that were not "altered." However, he soon discovered that, like the rest of the shoes he bought, special nails had been put into the soles to annoy him. He was amazed that his decision about which shoe store to go to must have been known to his "harassers" before he himself knew it, so that they had time to get the altered shoes made especially for him. He realized that great effort and "millions of dollars" were involved in keeping him under surveillance. He sometimes thought that this was all part of an elaborate scheme to discover the secret of his superior intelligence.

Discussion. After further investigation, it was discovered that the patient's allegations were indeed correct. Dr. Psycho, himself, had observed some strange occurrences in his own neighborhood. The patient was released. This case substantiates Freud's observation that "sometimes a cigar is just a cigar."

Dr. Psycho Looks at Prozac

Life may be difficult, but the effective cure for life stressors is not as simple as an orally (PO) dispensed happy drug. Sooner or later, one is going to have to come to grips with the actual problem. That is where Dr. Psycho comes in. One office visit with Dr. Psycho is the equivalent of a whole week's supply of Prozac.

Sometimes things can get to be difficult to cope with, just like the way Dr. Psycho is always putting off his research. This can create anxiety, which only continues to grow with procrastination. Finally, overwhelmed and exhausted, one gives in to depression and reaches for the Prozac. It is better to forget the research and just "surf the net" (whoever came up with that term needs counseling). At least one can rationalize that there was some kind of educational enhancement involved.

And, what about those Prozac parties that Dr. Psycho has been hearing about (and invited to) lately? Should you go? That is up to you. Remember, though, that what goes up must come down, and whatever goes down may never come back up again.

Baboon Love

Why are the guys always doing bench press? And, why are they always trying to show each other up with how much they can bench? As it turns out, the need to build the chest is linked with the mating ritual. The "chest thrust" is a postural message by men to signal sexual interest in babes. When approaching a babe, a guy is apt to protrude his chest out. When engaged in trivial discussion in the flirting phase, the chest remains conspicuously protruded. What happens when your chest is concave like many of the guys whose only workout is logging in on the InterNet? Obviously, this is a rhetorical question because they would not be on the InterNet if they had babes, and thus, they must have concave chests.

The fixation with chest and pec development when left unchecked may indicate the onset of Obsessive Compulsive Personality Disorder (OCPD). The subject may be seen frequently engaged in discussion and comparison of chest size, or the subject may be seen scrutinizing himself in the mirror and running his hands along his pecs to insure desired firmness. In the severe phase, the subject is observed to be keeping comparative charts of chest measurements of himself and other associates.

Can this behavior be curtailed? With proper diagnosis and treatment, the fixation can be minimized and OCPD may go into remission. If not, OCPD may continue and the chest and pec fixation may be displaced by a secondary phenomenon, bicep fixation. Or, the diagnosis may be complicated by the addition of Narcissistic Personality Disorder symptomatology. Dr, Psycho can only conclude that being of the male gender is, in and of itself, a situation of chronic anxiety. The question of virility and masculinity as a function of attractiveness to women is at the root of the problem. Is it worth all the trouble? Dr. Psycho thinks not. In clinical study after clinical study, Dr Psycho has found that males with concave chests who have no babes and who are logged onto InterNet in excess of forty hours per week were found to be devoid of any psychopathology or personality disorder, probably because they were also devoid of personality.

Dr. Psycho's Babble

Anti-Social Personality Disorder. Anti-social personality disorder is characterized by continual anti-social or criminal acts, but it is not to be confused with criminality. The disorder is characterized by a history of conduct disorder, cruelty, lying, irresponsibility and a lack of remorse.

Anxiety. Anxiety can be considered a highly unpleasant form of apprehension. Whereas fear is a response to a threat that is known, anxiety is a response to a threat that is unknown or vague in nature.

Benadryl. Diphenhydramine (Benadryl) is often used for the treatment of extrapyramidal symptoms and also used as an hypnotic. Note that antihistamines such as Benadryl have not been proven to be effective as long term chronic anxiolytic treatment.

Dysthymia. Chronic, non-psychotic signs and symptoms of depression that do not meet the criteria for a major depressive episode characterize dysthymia. For example, thinking constantly about babes one can never have may produce dysthymic symptoms.

Delusional Disorder, Grandiose Type. A delusional disorder in which the predominant theme is one's perception of inflated worth, power, knowledge, identity or special relationship to a deity or famous person.

Delusional Disorder, Persecutory Type. A delusional disorder in which the predominant theme is that one is malevolently treated in some way.

Depression. Depression is characterized by depressed or irritable mood, diminished interest or pleasure in all or most activities, diminished ability to think or concentrate, fatigue, feelings of worthlessness, insomnia or hypersomnia, psychomotor agitation or retardation, and significant weight loss or gain.

Haldol. Haldol is in the butyrophenones family of dopamine receptor antagonists. It is an antipsychotic used in treating symptoms of schizophrenia and other idiopathic psychosis, and severe agitation or violent behavior.

Histrionic Personality Disorder. Histrionic Personality Disorder (HPD) includes a pervasive pattern of excessive emotionality and need for attention. The individual constantly seeks or demands reassurance or approval, is uncomfortable when not the center of attention, and has a style of speech that is excessively impressionistic and lacking in detail.

Lopressor. Lopressor is a beta-adrenergic antagonist (beta blocker) used effectively in the treatment of aggressiveness and violent behavior associated with schizophrenia.

Narcissistic Personality Disorder. Narcissistic Personality Disorder (NPD) includes a pervasive pattern of grandiosity in fantasy or behavior, lack of empathy, and extreme sensitivity to the evaluation from others. The individual has a grandiose sense of self-importance, and may be preoccupied with fantasies of unlimited success, brilliance, beauty, or ideal love. Sounds very familiar, does it not?

Obsessive Compulsive Disorder. Obsessive Compulsive Disorder (OCD) is an anxiety disorder marked by recurrent obsessions or compulsions sufficiently severe as to cause marked distress. An obsession may include intrusive thoughts, excessive concern for order, unwarranted fear or forbidden impulses. Compulsion includes ritualistic or unusually repetitive behavior that is uncontrollable such as pacing continuously for no reason at all.

Obsessive Compulsive Personality Disorder. Obsessive Compulsive Personality Disorder (OCPD) is characterized by a pervasive pattern of perfectionism and general inflexibility.

Paranoid personality Disorder. Individuals with Paranoid Personality Disorder (PPD) are characterized by long-standing suspiciousness and mistrust of people in general. Such individuals refuse to take responsibility for their own feelings and assign them to others. They are often hostile, irritable and angry.

Reticence. Reticence is sometimes used synonymously with the term shyness. However semantical as it may seem, reticence actually indicates a personality pattern of quietness, but not normally equated with the lack of self-confidence, whereas shyness is an avoidant behavior pattern that is a source of anxiety for the person in question. For example, Dr. Psycho is a very shy person. 

Sadistic Personality Disorder. Sadistic personality Disorder (SPD) includes a pervasive pattern of cruel, demeaning and aggressive behavior. The disorder is characterized by violence or cruelty, humiliation of others, intimidation and amusement derived from psychological or physical suffering of others.

Schizotypal Personality Disorder. Schizotypal Personality Disorder is characterized by excessive social anxiety, odd or eccentric behavior, odd beliefs or magical thinking, and suspiciousness. Some engineering types seem to fall in this category, eh?

Serotonin. The neurotransmitter, serotonin, has been indicated in mood disorders, anxiety disorders, violence and schizophrenia. Drugs like Prozac block the reuptake of serotonin by the transmitting neuron.

Stressor. Stress that is created by life events or the environment qualify as psychosocial stressors. Stressors can precipitate various forms of psychopathology. For example, thinking about babes all the time when one is a loser will result in chronic anxiety.

Thorazine. Thorazine is a trade name for the antipsychotic, chlorpromazine, a dopamine receptor antagonist. Primarily dispensed for schizophrenia, Thorazine is also indicated for psychotic symptomatology.

Xanax. Xanax is a benzodiazepine used primarily as an anxiolytic and sedative hypnotic.

© Copyright 1995, 1996 by Dr. Psycho, M.F.C.C.

MonasteryNet^tm