A LOVING FAMILY..NOT AN ORPHANAGE OR FOSTER HOME

Toward a System That Doesn't Punish Orphans; Nurturing Needed

By Helen Borel, R.N.,Ph.D.             Published: November 14, 1988    

[I sent this letter to The New York Times in response to an article

 therein lauding "orphanages" as appropriate places to raise children.]

Opinion

 To the Editor:

Although I emphathize with B. H. Taylor's painful odyssey through ''foster'' care (letter, Oct. 21), which amply illustrates the destruction of a child's life by uncaring adults, I disagree that orphanage care is a viable alternative.

What infants and children miss that causes arrested intrapsychic development is emotional nurturance - either by abuse as in B. H. Taylor's case or by neglect or abandonment without ''apparent'' abuse. Simple human nurturance costs nothing and is administered by touching, kissing, hugging, holding, listening to, smiling at, approval and consistent discipline of the child, and allowing a child to express his or her needs, talents and feelings. These normal human actions are as much the food for healthy emotional growth as the food the child is given for physical growth. Without these daily, emotional growth is stunted.

Long enough ago, the psychoanalyst Rene Spitz demonstrated that infants raised in hospitals or other institutions developed a serious depressive condition, marasmus, similar to adult grief, in the absence of their mothers. Many of these infants failed to thrive, and they died. They didn't eat because they were emotionally wounded. It was found that infants need to be held to feel that life is worth living (as if a study were needed to confirm this for the average feeling and thinking adult). These results can be extrapolated to the toddler and older child. Every child needs holding and kissing. Every child needs to be special to someone.

It is sad that such a simple, common-sense condition for happy, healthy living, which everyone realizes he or she needs as an adult and which every adult knows his or her own children need, is such a hard concept to grasp and apply to the care of infants and children unfortunate enough not to have their own parents to look after them.

These caring manifestations may be largely absent in the foster care system, but they are also sadly absent in orphanages. I know! I grew up in two orphanages between the ages of 2 and 17 1/2. And I don't remember one instance of being hugged, kissed, sat on someone's lap for a story or any other normal parental behavior toward a developing child. No one was cruel in the usual sense. But the abuse was massive in the effect it had on my emotional development, by virtue of what was absent, all the more insidious because a child who has known nothing else, or vaguely remembers warmer care, can't grasp what is wrong and can't articulate it. And even if she could, the compassionate human response wouldn't be there.

Some of the people who took care of us went home to their own families after their shifts. Did they hug or show appreciation to their own children for being alive? How come they couldn't give this natural, inexpensive gift to us orphans?

Institutions aren't the answer to anything. Social consciousness and individual concern and caring for one another as valuable human beings deserving of love is a start. Translating this into loving parental homes for children bereft of their own mothers and fathers is the goal for the individual child. The benefit to society will be psychologically mature adults able to love their own children and give back to the community out of their own talents. 

HELEN BOREL New York, Oct. 22, 1988.  The writer is a psychoanalyst.

© Copyright 1988-2015 Dr. Helen Borel. All rights reserved.
For permissions and rights, email me: medical-healthalerts@earthlink.net
For Interactive, Interventional, Creative PsychoTherapy - by this author of 
Journey Into Self: Holistic Interactive Integrative Psychoanalysis - that 
gets your life, your career, and your love relationship away from suffering 
and on to fulfillment, contact me: emotional_health@earthlink.net
...and You can call me Dr. Helen

DOES SEXUALITY AFFECT CREATIVITY?

By Helen Borel, R.N.,Ph.D.

I take the word “sex” to connote “life force.”  In other words, our sexual being encompasses
considerably more than attraction to another, intimacy with that other, and the sex act.  Instead  I view the Sexual Self as an undiscovered infiniteness yearning to be found.  As the life force of the individual which is sadly hidden, suppressed by the taboos of society, parents, teachers, peers and the individual him- or herself.

The Sexual Self is the fullness of being; it is the complete Self.  When an awareness of this totalness is blocked, mental distress ensues in the various forms of psychiatric illnesses.  Depression, for example, is generally accepted as the norm of daily life without the masses of depressed individuals being aware they are depressed.  They believe they are simply normally subdued and well-mannered.  It is the price people pay  for the widely-conditioned massive shut-down of enthusiasm, curiosity, self-esteem, enjoyment of work, creativity, and empathy for others.  So the crushed life force, the diluted Sexual Self, is deluded by false beliefs into disappearing from consciousness.  Which absence produces anger, anxiety, insomnia and depression.

It’s true that there are various causes of depression.  And that a good many depressive illnesses are  known to arise  genetically - such as the depression of bipolar disorder.  While a good many others can be attributed to, possibly reversible, biochemical imbalances; upsets in our biochemistry which affect our immune system functioning and our brain chemical activity.  And these alterations affect our mood states.
So very many variables can upset the delicate balance of our neuroimmune system.  And one or more of these will directly impact our physiologic feeling states and will produce unpleasant moods.  These can include family and work stresses; chronic health problems; nutritional deficits; inhaled and ingested pollutants and pesticides in our air, water and food; ingrained negative belief systems; learned hatreds; physical abuse; emotional abuse; and alcohol and other substance abuse.  I would add to these causative factors for depression Unexpressed Creativity.

Sexuality, thus, encompasses lifeforceness.  It is Selfness fully expanded and expressed, thoroughly permeating one’s existence and infusing the very Self and the world beyond the Self with the full awareness of expansive, vibrant energy.  It is creativity expressed by the Expressor, the creative one, you.

Unfortunately, most people think of their Sexual selves through the narrowest of definitions, which seem to pivot around the quantity and quality of orgasm.

I  postulate, however, that orgiastic capacity includes those experiences not usually thought of as genital or erotically titillating.  For example, the ecstasy of creative work, scientific investigation, and social activism that achieve exciting results.  In other words, what
Abraham Maslow called “self-actualization.”

We know, of course, that the psychoneuroimmune system of neuroimmune transmitters (chemical messengers) is replete with signals that bring us either distress or satisfaction.  We know that activity, like running, can relieve some levels of depression.  And, I have learned that action binds anxiety.  These alleviations resulting from behaviors are undoubtedly due to cerebral enkephalins and specifically the brain’s own opioids,  the endorphins.  So too with self-actualization, the reaching for the fullest of one’s being, for the widest expression of one’s sensient Sexual Self.

Self-actualization is actually Self-growth, Self-expansion to one’s fullest possibilities.
Therefore, genital sexualness can only be a small smidgeon of that vastness of being.

The creative process unexpressed or dampened down injures a person and progressively traumatizes the individual to the point of shrinking the active psyche, crushing inventive thought, and probably damaging love and genital sex in the process.  This is because a fully engaged artist is happy, content and therefore more capable of sharing positive emotions with loved ones. 
While a covert or wannabe artist is slouching toward grief and depression due to the buriedness of the true Sexual Self.

So, the process of creativity liberates one’s life force...or Sexual Self...progressively
pressing that Self toward further liberation, further creativity, further total sexual beingness.  This process, and the higher and higher levels of self-achievement with its ultimate
capture of one’s Real Self moves far beyond ordinary genital sexual needs. The resulting ever-expanding life force and ripples of creative evolution thereby generate an ecstasy that lasts much
longer and is much more dependable for steady human satisfaction than are a few minutes of genital orgasm.

© Copyright 2008-2015 Dr. Helen Borel. All rights reserved.

For permissions and rights, email me: medical-healthalerts@earthlink.net

For Interactive, Interventional, Creative PsychoTherapy - by this author of Journey Into Self: Holistic Interactive Integrative Psychoanalysis - that gets your life, your career, and your love relationship away from suffering and on to fulfillment, write to me at emotional_health@earthlink.net

You can call me Dr. Helen

AMERICAN AGEISM CAUSES LONELINESS, DEPRESSION AND SUICIDE

By Helen Borel, R.N.,Ph.D. 

I wrote this commentary in response to an online discussion lauding the fact that 
"loneliness is alleviated by animals, gadgets and spiritual beliefs, not 
just people".

The fact that "lonely" people find various ways to ameliorate their loneliness is 
not a startling fact. Why wouldn't they? 

A People-Saturated Society that Ostracizes Many
Also, the fact that "lonely" people tend to "anthropomorphize" nonhuman 
surrogates should not be so surprising either. Humans need connection 
to other humans. Lacking the latter, voices on the radio, music, television, 
reading, "socializing" on the internet, petting one's pet, working at one's 
hobbies, etc. and so forth all are healthy ways of coping with so-called 
"loneliness" in a people-saturated society that nevertheless ostracizes 
many groups. 

Most vulnerable to the "loneliness" of social isolation are single mothers, 
the de-institutionalized mentally ill, those who've been raised in foster care or 
orphanages, creative/artistic person-alities, and mature women and men
either never-married, divorced or widowed. 

A more interesting subject for research would be: Why is our society set up in 
such a way so that many people are isolated from valued human contact 
and, therefore, become lonely, depressed and suicidal? How does this happen? 

Related topics of interest in this regard are: How does AGEISM impact the lives 
of our valued elder Americans? How does AGEISM impact the capacity to 
"connect" with others?

I have a few ideas that are ripe for "research," 

or better yet, for common sense social policy: 

1) Since the general populace and the government neither have the funds 
nor the interest to support elder Americans, why is rampant ageism allowed to 
flourish so that folks older than their late fifties -- who are healthy and are searching 
for work -- cannot get jobs, even when highly skilled and well-educated in the 
America of today? 

2) Unable to find work to pay their bills, what do psychologists and 
psychiatrists expect the mental state of financially desperate 
people to be? 

3) How can one connect to others in a callous society that 
excludes you when you pass a certain age criterion? 
~ Excludes you from financial independence by refusing to hire you
~ Excludes you from meaningful work and the human contact that a 
challenging job would offer
~ Excludes you from social functions because 
a) there is no money to pay for these 
b) you're "too old" for x, y or z activity
c) your hair is grey
... and 
d) just who do you think you are trying to live your life fully at your age? 

Therefore, I believe a great deal of so-called "loneliness" is involuntary, 
affecting people excluded from inclusion in normal life activities due to no fault 
of their own. Abandoned by a complex societal network of institutionalized
discriminatory practices that, despite legislation against such practices,
are blatantly, openly allowed to proceed unchecked. 

Correct these insults to our elders -- 

on whose backs American progress and

individual successes are being achieved today 

-- and we'll have a much less "lonely" society. 

As a New York City psychotherapist, I am concerned that the true psychosocial 
needs of too many Americans fall "between the cracks" when it comes to the so-called 
"helping professions." For example, relative to elder citizens, bleak "senior centers" are 
set up to low-cost feed and congregate the relatively helpless, poorly educated and sick 
or disabled adult. They do not assist able-bodied, skilled, educated mature adults in job-
acquistion and in socializing with educated peers. This kind of inequity in social policy 
planning excludes an entire group of elders who, lacking individual resources, can be 
expected to descend into "loneliness," depression and ultimate despair.

© Copyright 2008-2015 Dr. Helen Borel. All rights reserved.

For permissions and rights, email me at: medical-healthalerts@earthlink.net

For Interactive, Interventional, Creative PsychoTherapy - by this author of 
Journey Into Self: Holistic Interactive Integrative Psychoanalysis - that 
gets your life, your career, and your love relationship away from suffering 
and on to fulfillment, contact me at: emotional_health@earthlink.net


...and You can call me Dr. Helen

The BORDERLINE PERSONALITY: Unique Psychiatric Challenges

Number 1, in The Personality Series, Examines Borderlines

By Helen Borel, R.N.,Ph.D.

In my experience, during over two decades as a psychotherapist - providing successful therapeutic
outcomes for a wide spectrum of personality types and psychiatric disorders with a broad range of
life-disabling symptoms - Borderline Personalities are often the most challenging and most difficult
to treat.  This is because, not only are such patients largely defenseless - not in the ordinary
meaning of that word -   instead, lacking boundaries for the development of normal emotional
defenses, they’re unable to separate themselves from others. A Borderline hasn’t a clue where her
psychological boundary is (let alone where it ends in relation to others) so she can’t distinguish the
difference between her Self and your Self.

Borderlines are Secretly Hostile, Even When Appearing Compliant
So, since she can’t sense where your boundary begins, she crosses it time and time again -
usually in a fulminatingly hostile manner.  (Or obsequiously,  fake-smilingly, false-amiably yet
ready to pounce angrily, even though unprovoked.)

This type of person tries to do and say everything to engage his or her therapist in battle, and
verbally attempts loud brow-beating in sessions by misdirected harangues and severe over-
reactions, often to something said in an empathic or praising manner.  Such paradoxical
behavior is a difficult hurdle for any experienced mental health professional to deal with, not
to mention the widespread distress this kind of personality inflicts on family members,
co-workers and people trying to be their friends.

Disruptive, Self-Sabotaging Behaviors are Common
The frequency of the Borderline’s disruptive, counterproductive behaviors includes the afore-
mentioned loud and verbally vicious browbeating which any good therapist must curtail or put
an immediate stop to.  That,  at the risk of course of the Borderline storming out of therapy
and losing a good opportunity to get the emotional support she needs.   As well as the oppor-
tunity for some psychological growth which could have strengthened her coping capacities
and helped her regulate her fleeting and fluctuating emotions and positively modify her deep
reservoir of anger.

Additional disruptive actions on the part of the Borderline Personality include: (1) frequently
missing appointments without calling the therapist in advance, then without concern for the
other’s time, not even bothering to apologize; (2) usually blaming others, from childhood on,
for everything unpleasant in her life as well as for unpleasant happenings and relationship
disruptions she herself manages to create; and, finally (3) blaming her therapist for everything
and anything that impulsively comes to her mind at any given dysregulated emotional moment.

A Probable Brain-Chemical Imbalance May be Causative
In other words, the Borderline blames her therapist and others for her own internal distressing
feelings that normally arise in everyone.  But, because of the Borderline’s core inability to
modulate her uncomfortable feelings (which are neurochemically based), her approach to
family, friends and co-workers is generally from a hostile and judgmental perspective - albeit
usually masked by a phony smile or by the servile, obsequious behavior mentioned above.

This mask of   “fake amiableness” toward others is a weak attempt to appear to comply with
others’ needs while, just below the surface, despising the other and not really accepting that
other people have needs and feelings too.

But, when the Borderline patient does manage to develop some closeness to another person,
she invariably does or says something to destroy, sabotage, obliterate - anything to eliminate
this positive realtionship.  Often these behaviors grow from nothing, no incident,  to become
out-of-the-blue rages that have no basis in reality.  Meaning: Nothing is apparent in the
Borderline’s current life or work situation, or in the patient-therapist alliance that could
account for such an enormous and rageful reaction.  It is a matter of  lability of feeling states,
poorly modulated by the patient’s neurotransmitter (brain chemical) system - plus the
Borderline’s frequent disinclination to control behaviors despite feeling uncomfortable, as
normal people usually manage to do.

Intensive Psychotherapy, Both Individual and Group, Can Help
One of the goals of psychotherapy, if the Borderline sticks around long enough and regularly
enough to obtain the benefits of it, is to teach and guide and assist the Borderline patient in
certain thought-management techniques and in how to develop actions and new habits that
can pacify uncomfortable feelings when they arise seemingly uncontrolably.   So it’s possible,
in time, for the Borderline person to achieve some measure of control, while minimizing her
characteristic impulsivity and hostility.

Risks of Suicide and Other Causes for Hospitalization of Borderlines
Sadly, sometimes Borderlines hurt themselves, like making dramatic, call-for-help suicide
attempts or cutting themselves.  These behaviors require psychiatric hospitalization.  Worse
yet, sometimes Borderlines complete the suicide, so they account for a certain number of
suicide statistics nationwide.

These personalities are fragile types with high trait-levels of envy, jealously, sabotaging of
Self and others, sabotaging of their own therapists’ best efforts.  Efforts intended to improve
their emotional lives by breaking the negative feedback between neurochemical imbalance,
poor feeling control and poor coping mechanisms that produce the life-destructive behaviors.

Cause Unknown: You Might Say the Borderline Never Grew Up
This is a very difficult personality for family and friends to interact with.  In many ways, you
might say, Borderlines never grew up.  Importantly, no one yet knows the cause of this
emotionally weakened personality.

I believe, whatever happened to the person to contribute to it must have happened very,
very early in life.  Undoubtedly in infancy - between newborn and maybe two years of age -
because these are the stages of cerebral (brain) and psychological (mind) growth when
personal boundaries (defenses, for example) are being formed.  When the infant comes to
learn there is a “you” and an “I.”  That we are separate beings and somewhat safe within
our own physiologic and psychological skin.  But, I hypothesize that something happened to
intercept, indeed interrupt, that normal process to produce the Borderline Personality.

On the horizon, recent research is honing in on the probability of a cerebral defect
that may have early unbalanced brain chemical homeostasis, leading to the emotional lability
and excessive anger boiling inside Borderlines.  If such a defect can be definitively isolated
and understood behaviorally and neurochemically, I predict pharmaceutical industry scientists
will have a field day researching and developing prescription psychotropic medications in an
attempt to precisely target this purported defect and modulate the Borderline’s neurotransmitter
 imbalance.  Ultimately, such research and drug development could one day help the Borderline
benefit more cooperatively from psychotherapy, and live more comfortably, with more mature
behavior, in the world.

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ASPECTS OF LOVE - Part One

By Helen Borel, R.N.,Ph.D.

Distancing: Barrier to Love  
The Illusion of Love...The Elusiveness of Love
Do you want a man or a woman in your life you can connect with on many levels? Are you
feeling left out when your friends or colleagues excitedly relate aspects of their love relation-
ships? Wondering if love will ever happen to you?

Not that you haven't tried to find "the right one." He or she, "the right one" that is, simply
eludes you.

Have you thought that maybe it's not about luck? Or about being in the right place at the right
time? Or about the shape of your body? Or your good looks? Or that scar on your cheek?

Could it be that there's something about you that - while wishing for a close relationship filled
with love in your life - paradoxically doesn't truly want that? Or is afraid of that? Or
unconsciously rejects that?

Could it be that no one you meet really never measures up? Measures up to whom? To
whose criteria? Yours? Or some faintly-recalled parental dictates?

Do you have any criteria by which you make choices for yourself - one way or the other? Or
are you relying on some other hidden rules, which you may or may not be distantly aware of,
that are running your life? Probably ruining your life?

Whose life rules are you following, anyway?

Feeling Alone, Lonely and At a Loss How to Become the Other Half of a Couple? 
You definitely deserve better in your life than to go through it all alone. But it seems so
hard to find someone you can comfortably relate to. Someone who you can trust and rely
on. Someone who won't disappoint you. Someone who won't take advantage of you and
then reject you.

On the other hand, do you sometimes think, "I enjoy being alone. It's not necessary to be
part of a couple to be a happy person"? This is a valid position for many, many people. But
is it really your true life perspective?

Your Psychotherapist Will Help You Sort Out Your Real Feelings and Needs 
You need to examine, in depth, your full needs and goals for your life to find your own
specific answers to these questions. This is most expeditiously done in psychotherapy
- where all your thought processes, feelings, childhood memories, and lifelong habitual
behaviors can be examined.

These are explored to discover how crucial elements of your personality and life
experiences contribute to your aloneness today.

How to Turn Your Life Around and Get the Love You Deserve And, then, your compassion-
ate psychotherapist will guide you in turning your life around to get you on target to obtain the
life results and love you want to connect with. Which is accomplished by countering your
Self-negating beliefs, by trying new behaviors, by feeling ALL your feelings, and by working
through the griefs of certain childhood happenings you were powerless to do anything about
when you were little.

What Gets in the Way of You Connecting with a Special Someone? 
Remember this cardinal rule: YOU CAN NEVER CONNECT WITH ANYONE ELSE 
UNTIL YOU CONNECT WITH YOUR SELF. And that's what quality psychotherapy
can accomplish for you. Self-connection!

By the way, that rule applies to ALL interactions in your life, to all lengthy or momentary
human contacts. If you don't know your Self and don't accept and love your Self, it's impos-
sible to honestly connect with others. Lack of empathy for your Self produces the inability to
sense where others are at and what they need from you and whether you are, basically,
comfortable with meeting them at the level of connection they may wish to have with you.

When you barely, if at all, know your Self and avoid coming to terms with your inner hurts and
wishes...fear, confusion, withdrawal from other people, and other Self-defeating feelings and
actions keep you in a distance mode. That is, to others you may appear haughty or snobbish
- while, in truth, you are living your life and experiencing others from a defensive position, a far
away emotional Bastille where you are protected from ever being hurt again.

But remember, this distance-armored place is a prison. A place away from social life
where real relationships would have to storm the defended barrier-walls to break through to
the Real You.

To Get What You Want, You Have to Change 
to New Thoughts and New Behaviors Thus, in order to experience
Real Life, Real People, and Real Relationships, you're going to have to break out of this
prison-of-your-own-making, usually easier done with the help of your psychotherapist.

Yes, sometimes people disappoint us - or even worse. But, be honest, sometimes you
disappoint others too - or even worse. That's because you're human too, just like them.

So, to get the relationships you want in your life, plus that special love relationship, you need
to let down your guard, accept your total Self, and let others in. Take a chance. Doing nothing
new gets you nowhere fast. Breaking down your distancing behaviors will feel like a wonderful BREAKTHROUGH for you. Why not start today?

(c) copyright 2008-2015 Dr. Helen Borel. All rights reserved.

For permissions and rights, email me:
medical-healthalerts@earthlink.net

For Interactive, Interventional, Creative PsychoTherapy - by this author of
Journey Into Self: Holistic Interactive Integrative Psychoanalysis - that
gets your life, your career, and your love relationship away from suffering
and on to fulfillment, contact me: emotional_health@earthlink.net


...and You can call me Dr. Helen

A MANHATTAN TALE: Remembering 911

By Helen Borel, R.N.,Ph.D.

I awoke that day to a station on my TV showing a rerun of a downtown
disaster in Manhattan. Heavy, black smoke was issuing from the top section
of a skyscraper. Newstalkers were talking animatedly. Orange flame shot out.
I rubbed my still sleep-filled eyes. This was a rerun of the 1993 catastrophe
where hundreds of workers, forced to walked down endless stairs, escaped
the tall buildings, faces blank or contorted in fear, or flattened by shock.

All the fleeing faces with black ash lip-sticking their mouths. I had thought, then,
"If any of these people were asthmatic, they’d have died from the smoke inha-
lation. Their bronchi would have closed from the thick smoke triggering
brochospasm. Zero oxygen would have reached their lungs." A handful of people
had been murdered in this 1993 attack.

I wondered, "Why are they rerunning this footage? Is this the anniversary of
1993? But why have this TV show so early in the morning?" Still wondering, I
got myself some orange juice, then, remaining glued to the TV...I began clicking
around for the day’s news elsewhere. And there it was on all the other channels.
So it couldn’t be a rerun. What was it then?

A plane had accidentally hit a tall building this clear, sunny morning. This was in
real time. Conjecturing TV newspeople were theorizing about the awful air-
traffic-gone-awry accident. And my brain reran newspaper pictures from long
ago. I was remembering the day the Empire State Building was accidentally
crashed into by an airplane. (Like an eerie movie reminiscent of King Kong.)
The heaven-thrust skyscraper...wounded. Impregnable like the Titanic. But the
impossible had happened then. And, this morning, the impossible
had happened again.

Suddenly, speeding out of nowhere, came another plane and an inferno of
orange pluming out of a second tall building. All speculation ceased as I,
together with the TV reporters, realized this was an attack on New York City,
on the fabric of America.

The horrifying scenes enfolded one another. New Yorkers running as toxic
clouds and white ash surrounded and pursued them. My mental images of
those trapped who were perishing in their offices consumed my emotions.
Then visions of others dying flying out windows triggered the thought-flash:
"I’ll never again work in a building taller than two or three stories high."
Morning melted into late after. I’d been mesmerized. The unfolding disaster
nudged at me, reminding me that, "Here, I am safe, I’m alive. And I’m a nurse.

I grabbed my RN license, found a white uniform top in my closet and my
stethoscope, and ran to the Broadway 104 bus to Roosevelt Hospital on 59th
and Tenth Avenue. There I would volunteer to help the staff handle the myriad
victims of this tragedy who would be rushed to Roosevelt, I was sure, by
ambulances being triaged from downtown to every hospital in the city. The bus
driver refused to take any fares from riders. All public transportation was
suddenly free, he said.

A serene twilight began tenderly blanketing the West Side as halos of
soft-glowing street lamps lit our way, illuminating what felt like my spiritual
transportation to the hospital.

Arriving at the hospital Emergency Department I saw, parked nearby, NYPD
cars and fire trucks covered in that same thick, dry, white ash from hell. "They
must have transported some of the victims here," I thought. I told the front desk
person, "I’m an RN, here to volunteer because I know your evening and night
staff won’t be able to get here."

Immediately, after checking my credentials, the evening Nursing Supervisor
welcomed me and assigned me to the general ER triage area. There was a TV
high up on a ceiling shelf in the ER entrance lobby. And interns, residents,
nurses, firefighters and police kept coming by, standing around, watching for
updates on what was happening downtown. And NYPD had set up a satellite
police division in that ER area.

I took care of a crying 2-year-old brought in by his parents because he’d had
an allergic rash that was red and itching badly on his abdomen. And I triaged
police and firemen mostly suffering respiratory crises and fractured ankles and
feet from climbing atop brick, glass, wood; uneven, jutting debris of all kinds,
trying to rescue fellow New Yorkers. These who had witnessed the tragedy
close up, of leaping souls, feeling the grief of copelessness in the face of the
unthinkable, would often refuse to ride in a wheelchair to X-ray because they
wanted to be brave and walk there.

Most of the time, I and my colleagues, stood around hoping to hear fresh ambu-
lances arriving with patients we could save. But no disaster patients ever arrived.

Aware of my psych specialty, the nursing supervisor then reassigned me to the
ER’s psychiatric section. Soon, in came a victim of the disaster. Walking into
Roosevelt Hospital. An unlikely victim, but a true one nonetheless. For
confidentiality, I’ll call this 22-year-old Harry L. "How can I help you?" I asked
as he breathlessly told me he’d walked a very long distance to get here.

Harry L. added, "There’s no way I can get back to Brooklyn, where I live,
tonight. I work here in the city. I don’t have my 9 p.m. medicine with me.
It’s at home."

"Don’t worry Mr. L," I reassured him, "we’ll find you a place to sleep overnight
and get you an emergency supply of your medicine from our pharmacy."
"Thank you," he sighed with relief, "I’m a paranoid schizophrenic and my
medicine helps me a lot."

In the midst of all this day’s chaos, abomination and grief, here was a touch of
sanity. I marvelled. It wasn’t too long ago that people cringed, branding every
mental illness and its sufferers with indelible stigmata, ostracizing them instead
of helping them to live to the best of their abilities in our communities, instead
of being sealed away in asylums.

Out of all the craziness of this day, and despite our overwhelming distress over
the lack of salvagable disaster victims, along comes a young man, sane enough
to know he had to get to an ER to get his medicine. Sane enough to remain
clear-headed enough to bravely name his affliction without flinching. Sane enough
to know he wanted live out in the world among us. Sane enough to hold his head
up high, despite the anguish and fear this day’s happenings should have caused
him in his mental fragility, and reach out for our help. Harry L. was a victim that
day. You just couldn’t see his wounds on the outside.

I do not believe, however, the 9/11 killers had any mental illness I know of.
Robotic, determined evil is what drove them into those buildings that morning.
And no amount of human rationality could have penetrated their inflated paranoia
and grandiosity. Where they were triaged that day, there was no ER to receive
them, there were no nurses to revive them. There was only obliteration.
Now that’s ultimate insanity.

(c) copyright 2001-2015 by Dr.Helen Borel. All rights reserved.

For permissions and rights, email me:
medical-healthalerts@earthlink.net
in the Subject line, type "Borel Medical Syndicate"

For Interactive, Interventional, Creative PsychoTherapy - by this author of
Journey Into Self: Holistic Interactive Integrative Psychoanalysis - that
gets your life, your career, and your love relationship away from suffering
and on to fulfillment, contact me: emotional_health@earthlink.net

...and You can call me Dr. Helen

DEPRESSION: SYMPTOMS AND TREATMENTS

By Helen Borel, R.N.,Ph.D.

Beyond the Blues: Sadness or Depression?
Depression, a worldwide challenge to psychiatrists, afflicts 15 to 19 million Americans. Untreated 
or undertreated, it accounts for the daily disability and suffering of these millions, but suicide is 
its major danger.

Common Sadness and Ordinary Grief are Not Depression 
Never confuse depression with common but fleeting down-moods like sadness due to loss of a 
job. Or like that "bad mood" caused by insomnia or hunger. And not even the pain of grief over 
a death. These latter are typically time-limited. Moreover, although the duration of grief varies in 
different people, in contrast to depression grief generally follows a four-stage course. These 4 
stages proceed, respectively, as Shock, Bargaining ("If I do so-and-so, the person will return to 
me"), Anger, and Letting Go. Depression does not include this very specific experiential quartet.

Actual Depression is Unbearable and Seems Never-Ending 
True depression is tenacious and prolonged; its symptoms, to the depressed person's life, 
devastating. So emotionally painful that the depressed person may feel that the only way out of 
the blackness is suicide. It is this danger, in addition to the joy-robbing symptoms, that makes 
the rapid diagnosis and immediate treatment of depression so essential.

Kinds of Depression 
Occurring on a continuum,depressive mood states can be relatively moderate,others prolonged 
and severe such as Major Depressive Disorder(MDD) and the depressive phases of Manic 
Depression (also known as Bipolar Disorder). It's important to note that Bipolar Disorder tends 
to run in families.

All too often, depression goes unrecognized since it can seem to be a physiologic illness, 
such as pain of unknown etiology (cause), or progressively deteriorating hygiene, or as a 
forced, painted-on smile in spite of marked internal suffering. These confounding symptoms 
and  family-upsetting behaviors are too often not viewed as typical depression.  Unfortunately, 
in such cases, essential therapies are delayed due to absence of a swift and accurate 
diagnosis of depression.

Swift Depression Diagnosis and Treatments 
Improve Mood and Can Prevent Suicide 
Biochemically, emotionally and psychosocially,depression is a serious disorder. To recover 
from it, or at least sustain a full remission, it requires long-term treatment - and sometimes a 
lifetime of treatments. The earlier a depression diagnosis is made, the better in order to lift the 
depressive's mood state and prevent suicide. Then, ideally, a prescription drug and/or 
psychotherapy begins immediately; upon prompt diagnosis, the optimal regimen for each 
particular patient is prescribed. This means that one or another antidepressant drug and/or 
psychotherapy will begin right away.

Behaviors and Feelings Pointing to Depression 
At its worst, depression is a shutting down of feelings and a retardation of physical motion. 
In the depressed state, a patient's activity is markedly slowed, eventually to a halt. So much 
so that the patient's appetite can vanish resulting in refusal of food and liquids, with dehydration 
an added risk. So too, such patients in such severe depression may remain in bed all day. But 
not only is over-sleeping common. In some cases, inability to sleep enough is paradoxically 
present and can result in irritability and agitation.

Look for the Following Indicators When You Suspect Depression: 
1) Feelings of Lethargy, Hollowness inside and Worthlessness
2) Feeling and exhibiting Irritability, Anxiety and Agitation 
3) Insomnia or Hypersomnia (Oversleeping)   4) Anorexia or Overeating 
5) Indecisiveness and Poor Concentration 
6) Anhedonia (unable to feel pleasure) or have interest in a sexual or social life 
7) Copelessness (can't cope due to lack of hope)  8) Unrelenting Sadness 
9) Physical Complaints unrelieved by medical interventions 
and finally A paramount risk in depression is 
10) Suicide. Suicide itself can proceed from thoughts of suicide to 
attempts to kill oneself, to completion of one's suicide.

Varied Therapies Decrease Depressive Suffering, Often Preventing Suicides 
PSYCHOTHERAPY is the first-line intervention for intransigent dark mood states and 
moderate levels of depression. Cognitive-Behavioral Therapy (CBT) is one approach that 
helps redirect a depressed person's negative beliefs toward positive thoughts and attainable 
goals. Thus, CBT teaches and helps the patient maintain personal behaviors and interactions 
that restore normal moods and awaken enthusiasm for life.

PSYCHOANALYTIC APPROACHES are useful, too, because these techniques help 
depressed individuals face and handle their critical problems arising from childhood events. 
Particularly those that are dysregulating current relationships and that can complicate 
recovery from depression.

ANTIDEPRESSANT DRUGS may be needed along with psychotherapy in some moderately 
affected patients. However, all severely depressed patients require antidepressant medication. 
Such prescription drugs include the chemical class known as the tricyclics, of which 
Elavil (R) (amitriptyline) is an example.

Or the depressed patient may be given one of the "newer generation" antidepressants called 
SSRIs (serotonin selective reuptake inhibitors). Examples of this chemical class include 
Prozac(R) (fluoxetine), Zoloft(R) (sertraline), and Paxil(R) (paroxetine). Somewhat more 
side-effect-free than the tricyclics of yesteryear, the SSRIs intervene in serotonin brain 
chemistry, thereby delivering their antidepressant effects.

Other prescription agents, particularly Lithium carbonate and anti-epileptic medications are 
also used to treat the episodic mania-depression cycles of bipolar disorder.

ELECTROCONVULSIVE THERAPY (ECT) is sometimes unavoidable to quickly reverse 
severe depression that is, too often, medication-resistant. ECT is necessary in such dire 
circumstances because this only minutes-long procedure - performed with the patient 
under anesthesia - is a safe and rapid way to resolve depressive symptoms unresponsive 
to antidepressant drugs.

ECT's one inconvenience of temporary memory loss 
is a small price to pay to get better and not end one's life.

To sum up, ECT is administered in unrelenting, drug-resistant depression because it is 
the surest method for quickly combatting depressive pain and obviating suicidal actions. 
It thus saves many lives.

A key fact is that ECT can more rapidly accomplish what drugs 
and psychotherapy take measurably longer to bring about
Basically, ECT shakes up the patient's neurotransmitters (brain chemical messengers), 
shifting them toward homeostasis and elevating mood states toward more optimistic 
frames of mind by effectively "balancing the brain."

Getting Help for Depression 
If you suspect you are (or a loved one is) depressed, get psychiatric help immediately. 
Remember that the earlier your diagnosis, the swifter your treatment regimen can begin. 
You don't have to suffer any longer now that you know depression is substantially 
treatable. You can feel better. You'll be able to get back your pleasure in life. 

Don't wait. Reach out for help right now!

(c) Copyright 2008-2015 Dr. Helen Borel. All rights reserved.

For permissions and rights, email me:
medical-healthalerts@earthlink.net

For Interactive, Interventional, Creative PsychoTherapy - by this author of
Journey Into Self: Holistic Interactive Integrative Psychoanalysis - that
gets your life, your career, and your love relationship away from suffering
and on to fulfillment, contact me: emotional_health@earthlink.net

...and You can call me Dr. Helen