Dr. Mike is a licensed clinical social worker (USA and Israel) in private practice in Ra'anana. He recently wrote a column called "Psych-Talk with Dr. Mike" in which the feedback from readers was excellent. He has decided to shift gears and invite readers to submit their questions concerning a wide range of topics: child development, adult problems, addictions, ADHD, adjustment problems, crises and transitions, trauma, phobia, mental disorders such as anxiety, depression, and bi-polar.
He also welcomes questions concerning your marital or couple relationship, family issues, parenting, problems at work, self-confidence, shyness and much more.
"I take pleasure having the opportunity to answer your questions in what I hope will be an informative and exciting weekly column in the Jerusalem Post-online edition. Look forward to hearing from you soon."
Dr. Mike Gropper, DSW
Send your questions for Dr. Mike.
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This column is intended solely to educate and is not a substitute for personal diagnosis or treatment. If you have a difficult problem, please seek advice from your own doctor or mental-health professional.
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Q: Dear Dr. Mike, someone I know well who made Aliyah, converted to Catholicism. He was suffering from a major depressive episode and I wonder if this was a rational decision. Also, what are the implications of this step and, this may sound funny, but can they be 'reversed'? I feel he regrets his decision. He has a very strong Jewish identity and I really believe that he was psychologically vulnerable when he took this step. Thank you for your answer.
A: You mention that you feel that your friend regretted converting to Catholicism. First of all, you can tell your friend that he doesn't have to worry about barriers returning to Judaism since according to Jewish Law, a person born Jewish really can't leave the faith. I quote Rabbi Stewart Weiss of Ra'anana who says "Once a Jew, always a Jew".
Nevertheless, people do strange and sometimes irrational things if they are depressed. Major depression is a serious medical illness affecting approximately 5 to 8 percent of the adult population in a given year. Unlike normal emotional experiences of sadness, loss, or passing mood states, major depression is persistent, lasting at least two weeks, and can significantly interfere with an individual's thoughts, behavior, mood, activity, and physical health. Things that can trigger a major depression include having a major loss like the death of a parent or friend, ending of a relationship, and/ or loss of a job. Research has also found that some people may be biologically vulnerable to depression and may get depressed without identifiable psychosocial triggers. Other symptoms of major depression include depressed mood, loss of interest or pleasure in most activities, loss or gain of weight of 5% or more in a month when not dieting, difficulty falling asleep (insomnia) or sleeping more than usual (hypersomnia), fatigue, behavior that is agitated or slowed down, difficulty concentrating, thoughts of worthlessness and/or thoughts of suicide.
You do not mention anything about this person's age or circumstances surrounding his depression. Nevertheless, a person suffering from depression may be so desperate to escape his pain, that changing aspects of his identity may represent an attempt to escape from his suffering. Perhaps this person, during his depression, ran away from his Judaism in order to distance himself from things that were associated with his religion and were the real source of his pain. Maybe, he had a very painful childhood in a Jewish home, so once depressed he threw away the "baby with the bathwater" as the expression goes.
You certainly see this a lot in younger people going through an identity crisis because of a need to get away from emotional triggers of one's childhood that bring up bad memories.
I once worked in a psychiatric hospital where a young man in his twenties was hospitalized and presented himself as a Hassidic Jew. In fact, the man was actually a member of the Protestant faith. He actually knew quite allot about Judaism. He wasn't psychotic, but was experiencing a multiple personality disorder in which he took on the pseudo-identity of a Hassidic Jew to suppress his real self which had undergone a lot of trauma during his childhood. Eventually, he was helped to reintegrate his split off self and with that gave up the guise of being a Jew.
I am not suggesting that your friend had a multiple personality disorder, but I am trying to show how extreme stress, and in your friend's case, severe depression, could cause a desire to distance himself from the things that were associated with his state of mind while he was suffering, and by transforming his identity, ie "I will convert to Catholicism", he may have been desperately trying to help himself cope with his emotional pain. Subsequently, It would be likely that as his depression subsided, he would come to his senses, and as you state, his Jewish identity was always secure, and he would perhaps want to return to his Jewish faith. I would encourage your friend to seek out some professional counseling and also consult with a psychiatrist to get his current mental state evaluated. Good luck.
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Q: Dear Dr. Mike: I went into therapy because my marital situation was very, very bad. My wife suffers from borderline syndrome and she thinks the world around her is crazy. She was abusive to the children and that was for me the final point to seek help.
This "help" turned into a drama! The therapist lied to me and at a certain point in time she could not be supportive after a tragic event at our home, involving one of our lovely children. To avoid that our children would be taken away by the child care, we "fled" the country, leaving all our belongings behind and leaving us with tremendous costs. And the worst case is that the children were taken away from their friends, school and way of life.
Is there a fair and trustworthy way this "therapist" can be held accountable for her dysfunction? Is there a way to complain and how can we ever come back to Israel without being afraid that our children will be taken away? I am looking forward for an answer on this topic.
A: The question that you sent me is loaded with some very complex issues. If I read between the lines, it sounds to me like the therapist notified child welfare officials because of an abusive incident involving your wife and one of the children. If the abuse was severe enough, the therapist is in fact required by law to actually violate the therapist-patient confidentiality and notify social service child welfare officials. Letting the parents know this ahead of time is a decision that the therapist has the responsibility to make. If the therapist believed that the situation was so dangerous to the child's welfare that telling the couple ahead of time would compromise the child's welfare, then the therapist has a right and even a responsibility to just simply notify the proper authorities. It sounds like once you and your wife became aware of the notification and an investigation was started, you decided to run "out of the country" because you felt betrayed ie 'lied to' and feared that your child or children would be taken away.
Now, you want to blame the therapist. I am not sure on the basis of the information in the question that there is anything to blame the therapist about in this matter. There may be, but this doesn't come through in my reading of the question. Therapists can be sued, and they do have malpractice insurance, or at least should, but, this sounds like a situation where the therapist may have been acting responsibly and in fact within the framework of the law. A therapist who knows about child abuse in a home has to handle this very delicately since not reporting child abuse to the authorities can be grounds for a lawsuit by state officials against the therapist.
Experienced therapists trained in family therapy usually try to avoid contacting officials by trying to treat the family dysfunction that led to the mother abusing the child. Again, it depends on what the particular therapist's judgment was concerning the danger facing the child. Getting up and leaving the country was probably a knee-jerk panic response. It would have been better to have faced the authorities, answered their questions, and then have gotten what ever help they would have recommended.
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Q: Dear Dr. Mike, What do you say to a person who needs psychotherapy who expresses reservations and a very negative attitude about
psychotherapy because "they don't really care and they are only doing it for the money". Also "they are a stranger and I don't want to talk to a complete stranger".
A: I recently saw a cartoon that shows a male patient lying on the analysts couch and the patient's first opening words in therapy were: "I trusted my mom and dad; they got divorcedâ€¦I trusted my teacherâ€¦.he was a pedophileâ€¦I opened a college account with a broker; he was a scam artistâ€¦.why should I trust you?"
First of all, you are not alone. Most potential clients often feel some degree of mistrust when they decide to seek counseling from a professional psychotherapist. This is normal. Perhaps, a previous therapist wasn't emotionally available and the individual just formed the belief that all therapists are the same and all they want is your money. There are other sources of mistrust that come to mind.
In psychotherapy, there is an emotional experience called 'transference' whereas the client projects and/or thinks, feels, and/or behaves towards the therapist like he or she did from some important figure from the past. This could be a significant other like one's mother or father, a brother or sister, or some other family member or caretaker. Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, parentification, extreme dependence, or even placing the therapist in a god-like or guru status.
Maybe some care-taking figure let the individual down or worse yet, was emotionally and/or physically abusive. These previous experiences leave the individual quite insecure or even paranoid, thereby lacking 'basic trust' in any potential caretaker. We can see that how the psychotherapist in this context can be viewed as someone who just wants your money and really doesn't care.
What I would recommend to you is to tell this individual that perhaps a part of his or her problem stems from the fact that he or she has difficulty trusting people and this may in fact be a big part of the individual's problem, that is, it is part of the reason for seeking help in the first place. I would also tell this person that many people have some mistrust going to a professional therapist and opening up about their personal problems, but if help is badly needed, then the individual should be encouraged to still give it a try and to tell the therapist about his or her reluctance and mistrust of psychotherapist. This then can become the beginning focus of the emotional work that needs to be addressed in the therapy.
In choosing a therapist, tell the person to get recommendations of names of therapists that friends know about and have had good experiences with and that the therapist is warm and supportive. My own recommendation would be for this individual to find a cognitive therapist, some one trained to help the individual look at his or her beliefs that may be interfering with the individual feeling good. Cognitive therapy could help this individual to check his or her beliefs out-in this case, not trusting therapists and I suspect this extends to lack of trust in many individuals-- and help the individual to develop a more balanced and healthier view around issues of trust vs. distrust in people. Good luck.
Q: Dear Dr. Mike, How can I help my alcoholic husband and save my marriage?
A: First of all, help is available and it is of utmost importance that you in fact seek help. You did not give very much information in your question so I will try to limit my response by giving you some data and resources as to where you can get help. First of all, while Israel does not have a very large alcoholism problem compared to many Western and European countries; nevertheless, we do have a problem that is slowly but steadily growing. Today, there are about 60,000 alcoholics in Israel, ninety percent of which are men.
The following information was given to me by Nachum Michaely, director of "EFSHAR" Unit for Treatment of Victims of Alcohol, National Center for Alcohol Treatment located at 1 Arlozorov Street in Ramat Gan.
Mr. Michaely explained that their main approach to treatment is a community reinforcement method that integrates individual along with couple and family treatment at many locations throughout Israel. EFSHAR requires that each alcoholic applicant bring his or her family into treatment. Family and couple counseling is an integral part of the approach that is used by EFSHAR.
Mr. Michaely explained that 5 out of 6 alcoholics that turn to EFSHAR for help can be treated as outpatients, but 1 out of 6, due to the severity of their addiction, may require some type of hospitalization or residential care at the beginning of the treatment.
Mr. Michaely added that 6-7 per of EFSHAR's clients are spouses, usually the wife, who are in treatment themselves because the alcoholic husband doesn't want to get treatment. The nonalcoholic spouse is given guidance as to how to motivate her husband to go to treatment, but if the alcoholic refuses, the spouse still needs solid counseling to take care of her needs and to make sure that she is not doing anything that would enable the alcoholic's drinking addiction or put her or the children in harm's way.
EFSHAR has incorporated into its treatment model, Alcoholics Anonymous meetings. A.A. is the traditional 12 step programs that help groups of alcoholics remain sober a day at a time by sharing their stories with other recovering alcoholics. It is a method that has been around for over 65 years and has a track record of proven success.
Two other programs available to family members are AL-Anon and Alateen. Membership in Al-Anon is open to families, friends, and employers of alcoholics. Alateen is a program designed for young people under the age of 21. The basic principle of both groups is that alcoholism is a family disease; those closely involved with alcoholics may suffer psychologically and spiritually and often physically. Both programs offer comfort, hope, and understanding to those who have lived in confusion and despair.
To contact EFSHAR's national telephone help line, call 03 673-3228 and they can refer you to a clinic that is closest to where you live. You may also want to check out the website for Alcoholics Anonymous in Israel which can be found at http://www.aa-israel.org/ and lists all of the meetings and times and locations in Israel.
It's important to remember that you are not alone. Get as much support as you can from friends and family and good luck.
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