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Best psychiatrist” OR “Good enough psychiatrist” in Greenville SC

“Good enough mother”
The best bet against mental illness

I am spinning a pun on the famous pediatrician Winicott’s “ good enough mother” but not really!

What did he mean by that concept? Let’s explore because this has a very direct bearing on the subject matter

Winnicott thought that the “good enough mother” early on, tunes in completely with the infant because the later has no way of communicating except “crying”. She has to be like an “empath” who can read her infants mind and feel perhaps the same emotions what her child is experiencing.She is entirely devoted to the baby and tries to take care of its needs. As time goes by, however, the mother allows the infant to experience small amounts of frustration.

We can continue what else goes on in the mother – child duo but we are using this concept as a yardstick to measure “psychiatric care”.

Let’s refocus on the “patient- psychiatrist” first encounter- I need to qualify that I would be using the word “newborn/infant/toddler” to signify the “patienthood” and not the patient as a person and also psychiatrist as a “provider” and not as an individual.

Patienthood is born when a patient meets “the good enough” psychiatrist. Coming to see a psychiatrist is a “big step” in willingness to accept one’s helplessness in not being able to cope with the conflicting demands of life both within and without.

If the patient “feels” being held by the psychiatrist’s presence – it’s a good start. The way a “good enough “ psychiatrist is able to do that, is by giving an undivided attention to the patient. This kind of attention is not available outside a “loving relationship”. There is a “catch-22” here , because psychiatric illnesses attack the “ capacity to form loving intimate relationships “. This “capacity” is contingent upon the ability to accept one’s vulnerabilities to hurts and pain which is unavoidable in the struggle to develop intimacy. “A good enough” psychiatrist can at the very least provide with a “sample of this much needed relationship”to satisfy that need” to give some hope to the patient, that intimacy is possible.This simple explanation does run the risk of ridicule,by the likes of William Schofield, who writes in his critique of our profession “Psychotherapy- the purchase for friendship”, that, psychotherapist not trained as a specialist in therapeutic conversation, can fall unwittingly into the role of moral counselor or morale coach, and can be seduced into the chronic role of “best friend.

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Myths-Stories-and Mental health

Why we love stories? 

Let’s first define what’s the anatomy of a story –  – it has a beginning- a middle  and an end –

How about our life – we know the beginning- the middle is how our life is unfolding -(which one could know if one is able to stand outside the trappings of life) but the “end”- we won’t know – only the “others” would know that once we are gone.

Before I venture into the philosophy of this question I would like to tell few stories- which are really the lives of few persons I found entertaining and want to fictionalize a bit so as to make create a smooth flow.

The plan is to tell a story and go back to the question of our life’s story. 

Story #1

“Living an Oedipal fantasy”

Urvashi worked in my office. I have known her for last 22 years when I started my practice of psychiatry. I met her when I used to go to a church not that I am a Christian or religious at but or just to have some social interaction since I was marooned in this godforsaken Backwaters of Alabama.One could ask how did I endup there. The simple answer is that I was given a choice either to go back to my country of origin which was India or come to this underserved area and put in three years before I could get my green card. I wanted to explore the “underserved Alabama” because the underserved India was pretty familiar and mundane”.

I had just finished my residency in Psychiatry at an inner cityhospital in Brooklyn NY. The turn of the century- year 2000. My flight was supposed to be at 12 noon and I reached well within time but come to find out America’s day light saving had ended and “I was not informed” lol! Bottom line, I missed the flight and it happened to be April 1st. America had made a perfect April fool out of me!

I met Urvashi, few days after I landed in Birmingham,AL. She was a social worker and had just started working there. She was a member of the local Presbyterian church. One of my other colleaguealso went to the same church and invited me for the Sunday service. I first met her in the church. We hit it off well because she was interested in Eastern thought – influenced by Carl Gustav Jung. We often bumped into each other in the cafeteria and at times would exchange ideas. I was learning the southern culture and in the bargain I would share whatever little I knew about eastern philosophy.

She had just earned her graduate degree with a major in social work in-spite of being a single mother of a 5 years old daughter. She lived with her parents. Few months into our association, she met someone got married and moved out of her parental home. Her husband worked in construction and made good money. After three years of the commitment to the “underserved place” I moved to Atlanta,GAand lost touch with Urvashi.

Fast forward, 20yrs and our ways crossed again. We filled each other with some details of our lives in the interim. I had married during this time and we had three children. She had three children as well but was divorced from her husband and was dating someone. We met occasionally during the monthly grand rounds or sometimes over a cup of coffee. As the time went by our relationship evolved from acquaintance to more of a friendship. 

Few days back,  she sought me out,saying she wanted to discuss some pressing issue. That evening we met for a drink. She told me that her son is very angry with her because she is dating his friend. I knew her son was around 18yrs of age and was a senior in high school. I couldn’t help not  ask her about this guy’s age. Lo and behold!he happens to be the same age as her son. Urvashi is around 35. She is in love with this guy- heads over heal. Uravshi’s parents are distraught and so are her friends. Of course, her son is outraged by this situation. Both his friend and he are still living under the same roof. This is just a very brief and very circumscribed view of her “life”. 

If this were to be a “story” it would have an end but “her life” is still unfolding. One could only speculate an end of this affair or not. We are left wanting,because it doesn’t have an end whereas in a story there would be an end. This is the only difference. 

Quoting, Tom Clancy

The difference between fiction and

reality? Fiction must make sense.

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Depression and Learned Helplessness

To study a “ new antidepressant” , researchers have to conduct “animal studies”. Since, we are testing a drug which is supposed to lift depression- the question is “how to demonstrate its effectiveness in animals. Quandary is, that except for dogs, who perhaps because of “being man’s best friends” for eons , other creatures are not afflicted by this malady to the best of my knowledge.
So the problem becomes of “inoculating them with the virus of depression”.
This feat is accomplished by coming up what the scientists call an animal model.
One such model is “learned helplessness”. What they do that they create a situation for the animal say a mouse where in it feels helpless and to conserve its energy, which is a biological advantage, it simply gives up. To explain more clearly they would put a mouse in a big container of water from which it cannot escape however hard it tries ,so it keeps swimming but after sometime it just floats realizing it’s futile to swim , thus conserving energy .
A parallel human situation would be someone in a shipwreck swim for a little bit but finding the land is not reachable gives up swimming and just floats.
Coming back to the animal model they repeat the experiment after injecting the animal, in this case a mouse with the new test chemical “purported-to be new antidepressant”. If the antidepressant is effective the animal would swim for a longer time before giving up.
So what an anti-depressant is doing is “buying time” and hoping help is on the way to address what is causing depression -myriad of causes, ranging from socioeconomic to psychological ,unfolding within the genetic makeup.
More of this next time, as for now,I want to focus on how could one address this learned helplessness by other means say for example exercise and biofeedback. One of the common symptoms of depression is that a person does not have much energy left and he’s lethargic.
I will start off with exercise since that’s easy to understand and to practice. There are twofold effects of exercise -one is causing neuro-chemical changes and the other is an indirect communication to the mind that one is not helpless. The helplessness in a “shipwreck” situation is a biological advantage but otherwise it’s like “ barking at the wrong tree”
The mind may start “ retuning to this “normal”level of activity and may in turn feel “better”. In other words if body sends the message “I am not giving up” mind recalibrate into thinking “the situation doesn’t demand “giving up” or in other words be in the “helpless mode”. The neurochemical changes caused by exercise also mitigate depression.


Of course if it doesn’t work the medication’s are available to break this vicious cycle of depression.

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Algorithmic Life

I admit that it’s little “tacky” to view life vis a vis algorithms but it’s my effort to take into cognizance “the ever evolving technology” and the impact it’s having on our life.
In “non algorithmic” life the “dictates of religion” the challenges posed by nature determined how we lived.
However, nature having been contained in a small conclave and the “religion” to the places of worship we need to come up with our own “unique dictates sans algorithms to feel connected to “what life is about”.
For the starter- let’s see how the simple algorithms are generated? Since, I have no background in programming I could share only a broad sweeping statement that it involves giving the computer “ binary instructions” ( that’s the only language computer understands – “0”s and “1”s- a zillion permutations and combinations) – around a problem and then instructions around the “ answers to the problem” computer comes up with.
It’s very boring and tedious job for the computer but it doesn’t get bored or frustrated with the wrong answers.
To this I want to add a little anecdote or it may even be a legend about Thomas Edison . As the story goes – he failed 600 times with his experiment to make a “light bulb” and everyone counseled him to give up this “expensive” mission. But his response was “ hey those failed experiments tell me that those 600 ways of dealing with the problem were wrong and we should be very close to “the right” answer since there could be only limited solutions to a problem. Believe me or not,this is how the algorithms are generated – these machines are generating random solutions hoping to “slay the right one” not unlike the hope, that there exist a possibility-doesn’t matter how small -of writing a work of Shakespeare if a bunch of monkeys are given typewriters who could f* their brain out punching the keys zillion of times.
But… we are not monkeys and we don’t have zillions of failed strokes available to us and furthermore we all are not striving to be Shakespeare.
So, rule number one -before we start on a path of failures which, if we have enough time ,but we don’t since we all are mortals, is to really know who we are and what and why we want something.
This comes forth only if we become “aware”
It’s the awareness which comes when we “meditate” on our desires, fears, fantasies, and so on. All of this is inside of us. We are not yet talking about outside of us- which is the world of science, money, politics, power and so on.
In my next blog, like a monkey on the typewriter NOT!, I hope to come up with the next rule.

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Anxiety Medications- Xanax, Klonopin, Ativan and beyond

Lorazepam belongs to a group of medications which are called benzodiazepines. The first one ever to be invented was Librium more than 50 years back soon followed by Valium. It was just like any other new drug was promoted as “ A wonder drug” i’m sure it was those people who are truly truly anxious they were using alcohol or barbiturates would much more side effects and toxicity unlike benzodiazepines it was safer and more effective for anxiety. Over the years they have added many benzodiazepines.
Let’s try to understand how are they acting in our body. They act through GABA which is primarily a neurotransmitter in our brain who’s function is to inhibit the nervous excitement and hence usefulness in anxiety and many other conditions were such dampening of excitement is required such as in epilepsy muscle spasm and so on
If you’re taking such medications it would be useful for you to understand what are the pros and cons
There is a lot of information available on the Internet so I am not going to go into that
My main purpose this post is to help you understand those effects on your mind which you may not like in the long run such as loss of memory disordered sleep especially REM sleep which, is very vital for our brain,to be able to process our experiences.
If you want to use these medications in a smart way the best bet would be use them for very short duration, and buy time,to be able to either get help with your anxiety through other medications or making changes in your living,in dealing with the underlying issues which might be causing these anxieties.
The public perception,as well as the authorities,take on these medications oscillates like a pendulum ,wherein, initially these were good drugs and now they are bad drugs. Because of this skewed

perception some of the patients really need these medications suffer. I need to stress that there are no good drugs or bad drugs and that would hammer home if you try to remember all medications in high doses are poisons and some of the poisons in small doses could be medications. Also if someone tells you that this particular medication doesn’t have any side effects I would urge you not to take it because probably it’s not a medicine at all In nutshell all medications do have side effects so the question is to weigh the desired effects with the undesired effects and if you find the desired effects outweigh the undesired effect that’s on medication you should take. Different individuals would have different expectations from a medication and if their expectations are not being met by that particular medication‘s and the undesired effects are unacceptable that is not the medication for that particular individual. Sometime it is difficult to figure out which one particular medication would work for who even though those medications may be similar and that’s where the genetic testing for how your body processes these medication‘s could be useful.

Why do we watch Crime Shows?

Recently, I started watching investigative police video, on You Tube. I was interested in learning how investigators gradually chip away the lies and expose the “criminal”in a crime. I stand guilty of enjoying them. Some of us, love to watch crime shows, and I started to become curious to understand the nature of this “pleasure”.

It reminds me, of the book I read long back by the forensic psychiatrist Dr. Simon’s “Bad Men Do What Good Men Dream”. He proposes

that the only difference between Good Men and bad people is that a good person may just imagine or fantasize, about those so-called “criminals acts” or rather socially and legally unacceptable impulses but doesn’t cross over to the dark side of the crime. The criminal does make this transition by acting on those impulses.When I come across someone saying “oh my God! I can’t imagine someone could do that horrific crime”. If I happen to be an in an unforgiving mood, I end up blurting out “dude you have a very limited imagination”! I won’t deny that I haven’t gotten into trouble for saying that.

What happens generally is that we keep these thoughts “securely chained” in our “unconscious mind’s dungeons”.

Sometimes, they jailbreak by spilling over in the dream content and make their appearance as “nightmares”.

Going back the original question “why we love to watch crime shows” – is it possible, that act of watching it, absolves ourselves of any bad thoughts?

One of my friends – a psychotherapist-recently saw a young man,who had just returned from his deployment overseas. He witnessed a lot of bloodbath in bombing, explosions and as a matter of fact one bomb exploded right over his tent,killing many of his coworkers. Surely enough he suffered from PTSD. Strangely, he himself was a sniper, and took many lives without feeling traumatized. He shared with her, in confidence, that he misses not being a sniper because “I was very good at

that”obliquely referring to killing people without really saying it.

Was he committing a crime?Not legally, no,because the state condones it, but would it be pardoned on the day of reckoning? Who knows? Dostoevsky’s character Raskolnikov, a former student, lives in poverty and chaos in St. Petersburg .He decides—through contradictory theories, including utilitarian morality and the belief that extraordinary people have the “right to transgress”—to murder Alyona Ivanovna, an elderly pawnbroker in crime and punishment struggles with coming to terms with one such crime.

Franz Kafka’s Mr. K in his novel “the trial” wakes up one morning and finds he has been arrested right there in his bedroom for a “crime, he has no clue about” and throughout the novel he’s trying to figure it out. He even presents himself to “the court “, meets his lawyer and meets people of influence to get himself out of this “pickle “but to no avail and in the end he’s “executed like a dog” for some crime he had no knowledge of. The psychoanalytic take on the plot of this novel is that the “the court of law” represents unforgiving ruthless “unconscious”. What was his crime- ignorance about the workings of the “unconscious mind”. I see many people who have been “arrested by the unconscious” – the psychiatric diagnosis could be anything from garden variety depression to schizophrenia.

It also brings a question what would be considered a crime in the religious world. I’m not a clergyman, but whatever little I know about the Bible, I would say the first crime reported in the Bible was Cain killing Abel, and God became the first investigator. Cain committed one of the deadliest 7 sins – “jealousy” and that lead to the taboo of murdering his own brother. God asks Cain “where is your brother” and Cain retorts back “I’m not my brother’s keeper”. This answer was another crime he committed, because God opines “we are our brother’s keeper that means being responsible for others”. So, who are our brothers? Just the ones who share the same household, community, nation, or religion or could it be extended to all those who are sharing this planet. If we are all the bound by the bond of brotherhood, then killing someone dispassionately like that sharpshooter did, under to pretext of defending “our sovereignty” -should be a crime as well. But then again, “the poor guy was just following orders to make a living at the very least”. The character in Crime and Punishment – Raskolnikov provided a similar explanation for the murder. It is perhaps easy to demonize all the Nazi guards at the concentration camps for killing millions – in their own mind perhaps they were “just” following orders. More recently 9/11 terrorists killed thousands and were following “religious orders”.

A logical subquery of the subject question is –

Who decide what’s a crime? Should it be determined internally as Raskolnikov decided in the end; because under some strange circumstances, someone else was accused and found guilty. Raskolnikov, in the end decides to go to the police and confesses his crime.

After all these meanderings,I do want to come back to the original thought, “why do people indulge in their voyeurism vis a vis violence and crime”.And it is not only in the contemporary world, that people indulge in this pastime; Roman gladiators, and in medieval England, the public hangings served a similar purpose. The state would allow their subjects leisure time to participate in such activities.

Currently it’s not acceptable to watch even the cockfighting- it is a lot of blood- forget watching the execution or the blood bath in the “Roman colosseum “; so, the situations where people can have such gratification, is watching crime shows, playing violent video games and maybe watching violent sports like boxing.

It’s possible that, it gives a voice to their unacknowledged unconscious fantasies, fears and what not. In conclusion, my proposition that we love to watch crime shows, to absolve ourselves of “finding the same tendencies, within us, which has the potential to hijack our hard-earned bourgeois calm and peace”!

“Sound mind in a healthy body”

“We the living”

Even though an astronomical growth of mankind has reduced nature to an ever-shrinking corner*- we are a product of our environment and totally at its mercy – becomes very clear when some natural calamity happens.

We are becoming more and more insulated from the elements of nature because we have learnt to live in our own little safe “catacombs”. I am borrowing from the short story by EM Forster – “the machine stops “which was written almost one century ago -plot is set against uninhabitable earth- athleticism is scoffed upon and sedentary life is promoted. No one travels anymore because everything including medical care is provided to the subjects in their little cubicle by “the machine”. It eerily forebodes some such future for us all.

The reason I am bringing this up is to see if the definition of health and mental health is being redefined.

As a society we are less tolerant with any behavior which falls outside the narrowly defined normal behavior. Take for example- ADHD. Having worked with children over the years I have noticed that we dole out the diagnosis of ADHD much more than in the past. So, logically speaking either ADHD is becoming more prevalent, because of environmental, nutritional or some other influences OR maybe that, we are allowing “normal attention”, a very limited range. What I mean that their attention was good enough for working in their farms doing agriculture and all. There could be a psycho economic gain – there is more demand to stay focused in the binary world of computers than it was in the days when we counted with fingers.

Going back to the story “the machine stops” – the protagonist’s “athleticism” couldn’t be totally stomped out – and he started to explore the space outside his catacomb and at the surface of the earth and his dear mother warns him that “machine” would punish him harshly for these transgressions. He wants to meet his mother, who lives at the other end of the world. Mother is very astonished, saying “why do you have to come to see me, we can always talk and see each other on the screen”.!

Our mind, which is programmed to live in a tightly knit social rubric but instead must accept the make believe “social networks on the social media”. On this platform, the rules of communication are such, that we say something, which we would like to hear from others, and others say exactly something which we would like to hear. The personal opinions and the meaningful conversations are vanishing*.

Let me take the liberty of making a sweeping statement, by saying that biologically we have not evolved in terms of our body or mind, since we were hunter gatherers, but the demands are being made on us to do that. the burning questions is whether it is possible or not? Furthermore, is it redefining what is normal?

*The source is Umberto Galimberti’s philosophical assay, which I have made available        in one of my previous blogs.

Treatment for depression,anxiety,panic attacks, mood swings,explosive anger,OCD,bipolar, ADHD,schizophrenia,social media and other addictions -medications, therapy and beyond!

Psychiatric treatment   Can this  With that  Help?

Everyone reaches a point where they think: “we need help,” but if their healing processes are compromised, then they are unable to help themselves. Although our bodies and minds have the capacity to heal, sometimes the healthy part gets buried underneath the wounded self. For example, when a surgeon is treating a wound, he has to secure healthy margins of the wound, to put a suture to close the wound. Similarly, a psychiatrist assists with the mental wound; to secure those parts of the mind which are unaffected by the disease process. He appeals to those parts of your being, which are relatively healthy. Simply by giving medications, this is not a cure-all solution. Medications are like a surgeon’s knife, can cure, as well as injure. To become a psychiatrist, one has to graduate from a medical school – just like any other doctor and go through specialized training focused on brain and psyche.Though not required, but it’s useful to study psychology and sociology as well. He also has to know how the society functions, because the individual he is treating does not live in a vacuum. Under optimal conditions, he is required to understand his own mind; which is an important tool to understand others. In addition, he needs to know his own biases and develop some clarity to know what the patient’s problems are, and not to confuse his own issues with the patients. On HBO Max, there is a relevant TV show “in treatment,” which describes the hard work of the psychiatrist; to correct these processes and to be able to assist the patients.

Looking for my “self”

“How do I find my self?”

To answer this question-first we would have to define “self.”

Defining something has always been difficult for me, but that struggle has translated into developing a varied perspective.

Let’s start with a simple approach; is my “self” what I feel, what I think, what I experience or how I appear? Is it how others perceive me? Is it what others reveal to me or how I connect with others? There may be even more approaches to the “self.” Let’s think our way through each of these hypothetical approaches to the self.

If self is “what I feel”, then it is constantly changing, since we have a variety of feeling tones. So, we may have happy self, sad self, angry self and so on.

If it’s connected with what I think, then it could be: how my mind perceives, processes, and imagines ideas, putting them in language and symbols: The final product is what I say, do, or write.

If self is what I experience, then it could be pleasant, unpleasant, toxic, stifling, despondent, hopeful, hopeless, helpless or uplifting and so on.

If self is my body,then it could be tall, short, white, black, beautiful, ugly, young, old, sick or healthy.

Is self located within myself or outside myself? I think most of us believe it’s something internal—but what if it is external to us, when we encounter others? Could it be like a halo that envelops us , and where all things outside of us converge—people, things, trees, animals, earth, sky and beyond.

The question of defining “self” can be pretty destabilizing! Similar to what the fellow Christians might have felt, when Galileo Galilei denounced“the church’s unchangeable truth,that earth is at the center of the universe.” This is what the leading thinkers on this topic of “self” face!

We want to see ourselves as cohesive and stable at the “core” , much like the pit of a cherry- but maybe it’s more of a scattered concept. If that is so, then perhaps Jim Carrey in “Me, Myself and Irene” portrayed a universal struggle rather than that of a schizophrenic.

The quest for knowing our self is worthwhile and heroic if we are willing to risk our convictions and the security of feeling solid!

If you would like more resources on “self”and locating one’s self, leave a comment below and I can direct you to some interesting resources.

Embracing the absurd in life

It’s absurd” means “It’s impossible” but also “It’s contradictory.” If I see a man armed only with a sword attack a group of machine guns, I shall consider his act to be absurd.
There are absurd marriages, challenges, rancors, silences, wars, and even peace treaties.
Absurd is not in man (if such a metaphor could have a meaning) nor in the world, but in their presence together.— Myth of Sisyphus, Albert Camus.
No one has embraced “ the absurd” better than Franz Kafka – he makes it very apparent through his works- he introduces this in his short story“ metamorphosis”and develops further in the novellas “ the trial” and “ the castle”


Metamorphosis is a story about a traveling salesman who is going through the drudgery of his job because of assumed family responsibilities and to pay off family debt. One fine morning he wakes up and find himself turned into a “giant beetle” – what drives the absurdity home is his “ annoyance with this inconvenience because he is getting late for work”- in other words when his whole existence has changed he still is worried about “ catching a train in time”.
In a very concrete manner one could easily relate to this scenario when one is employed in a boring job so that one can “buy the latest gadget and be with jones and smiths” and is totally oblivious of the way it is “ transforming her life”.
This idea is developed further in his work “ the trial” wherein Mr K finds himself “arrested by three officials, “ as soon as he wakes up,clueless about the nature of his crime, and remains so, even after having navigated the “labyrinth of a convoluted legal system”.
Absurd is very succinctly examined by Albert Camus in the “myth of Sisyphus”
“What, then, is that incalculable feeling that deprives the mind of the sleep necessary to life? A world that can be explained even with bad reasons, is a familiar world. But, on the other hand, in a universe suddenly divested of illusions and lights, man feels an alien, a stranger. His exile is without remedy since he is deprived of the memory of a lost home or the hope of a promised land. This divorce between man and his life, the actor and his setting, is properly the feeling of absurdity”.
“ this feeling of absurdity causes extreme “nausea towards life” as taken up by Jean Paul Sartre in his work “ Nausea” – it causes despair and is excruciatingly painful.
The remedies, unfortunately, are not listed by these philosophers, but nonetheless, I would like to quote Camus again”We turn toward God only to obtain the impossible. As for the possible, men suffice.”

Psychiatric treatment

Psychiatric treatment


Can this

With that

Help?

Everyone reaches a point where they think: “we need help,” but if their healing processes are compromised, then they are unable to help themselves. Although our bodies and minds have the capacity to heal, sometimes the healthy part gets buried underneath the wounded self. For example, when a surgeon is treating a wound, he has to secure healthy margins of the wound, to put a suture to close the wound. Similarly, a psychiatrist assists with the mental wound; to secure those parts of the mind which are unaffected by the disease process. He appeals to those parts of your being, which are relatively healthy.  Simply by giving medications, this is not a cure-all solution. Medications are like a surgeon’s knife, can cure, as well as injure. To become a psychiatrist, one has to graduate from a medical school – just like any other doctor and go through specialized training focused on brain and psyche.Though not required, but it’s useful to study psychology and sociology as well. He also has to know how the society functions, because the individual he is treating does not live in a vacuum. Under optimal conditions, he is required to understand his own mind; which is an important tool to understand others. In addition, he needs to know his own biases and develop some clarity to know what the patient’s problems are, and not to confuse his own issues with the patients. On HBO Max, there is a relevant TV show “in treatment,” which describes the hard work of the psychiatrist; to correct these processes and to be able to assist the patients. 

Procrastination

The Latin root of ‘procrastination’ is ‘procrastinare’, which means “to put off or postpone until another day”.

In order to get an unbiased view of “this thief of time”, it is important, that we separate the construct of procrastination,from its presumed consequences.

So why do we procrastinate?

Simple answer “ to prevent mood dysregulation” meaning “keeping our good mood from taking a dip”.

After days of saying to yourself “I’ll do it tomorrow,” it is now the day before your report is due despite your intention to get it done a few weeks ago. However, instead of sitting down to finish it, you decide to get busy catching up answering email with the hope that you will soon feel more in the mood to work on the report. – does that sound familiar? I would like to be brutally honest and share that I have a deadline coming up reviewing some documents but currently, I am enjoying writing this “blog”! If I were to give up this activity and focus on the aversive task of reading the documents, I am going to be an “unhappy camper”. If I “procrastinate , I would be in a time crunch and perhaps end up being in worse mood but “tomorrow “.

Focusing on regulating mood and feeling states in the short term can lead to failure of self-control in other areas of our lives. When we are in a bad mood, we want to feel better, but many ways of feeling better involve indulging our appetites that we usually use self control to resist (e.g., eating sweet foods, shopping for items beyond our financial resources). In terms of procrastination, the argument is that aversive tasks lead to anxiety and worry, and that task avoidance is a strategy to avoid this negative mood.

There is a tremendous gain for “the you of today” but “what about the you of tomorrow“?

Yeah that’s the downside of procrastination- today’s gain is tomorrow’s loss.

Let’s admit we all procrastinate, and some researchers- such as Pannapacker, think moderate procrastination helps creative thinking, probably by problem restructuring, and the activation of new knowledge. Let me quote him”Anecdotally, Leonardo da Vinci is known to have been an inveterate procrastinator and there is evidence that Albert Einstein, Thomas Edison, and Frank Lloyd Wright engaged in procrastination.”

But, are there some of us who are chronic procrastinators? I guess there are. So, by using the previous logic of payoff why would they have such a need to regulate their mood by procrastinating. Applying common sense I could say “maybe they have chronic dysregulated mood” which in more technical nomenclature is called dysphoria

There has been some research done on that front,and some researchers connected chronic procrastination to generalized anxiety disorder. These folks can not afford to have more anxiety, lest they go into a complete panic mode. They are so precarious,mood wise and can not risk feeling worse, so they have increased need to postpone tasks.

Few words about the treatment part. Therapy of course- to help us see the downside of the mood advantage we get by procrastination and if it’s possible to develop better coping skills. Anti anxiety medications such as SSRI’s and benzodiazepines perhaps- even though none has been approved by FDA for the treatment of procrastination.

Parallel Worlds- Regrets

We can but live once and at a particular given moment can walk but one road. Even though regrets mostly pertain to misgivings about not having taken an alternate course of action, one could have regrets about future. Our thinking, takes us back and forth, and we almost live different life scenarios- like the heroine in the movie “sliding doors”- who found her new love, when she boards the train in scenario #1 and catches her boyfriend in bed with another woman when she reaches home; whereas in scenario #2 she misses the train, gets mugged and then meets her future love, but escapes the shock of catching them in the act. Both scenarios develop differently, though in a “parallel manner”in the movie. She gets pregnant, and has a miscarriage in both scenarios, however in scenario #1 she lives and #2 scenario she dies.

Psychologically, regrets are “counter factual” because cognitively we pursue “what didn’t happen “so it is “counter” to the “fact”.

Is it a futile activity which at best leads to pangs of emotional pain or is there a possibility of redemption and growth?

Let’s start with the assumption that it’s futile activity and collect evidence to prove it wrong just like researchers do using “null hypothesis “. Can we establish it as a constructive emotion? Wait a minute-is it just an emotion or is there a cognitive component. Many philosophers have a consensus on the hybrid nature of this “state of mind”

Opportunity breeds regret. In other words, those who are oppressed or live in a rigidly conventional society would rarely be regretful. They have little use for this activity.

There is some other set of people who are immune from regrets – deeply religious, because they have no other choice but, follow the dictates of “God”. On the other end of spectrum, there is some evidence, that psychopaths remain free of this tormenting emotion as are people with damaged frontal lobes of the brain.

But for the rest of us,it is inevitable- whether futile or constructive.”

It is a value laden activity- we can only regret not having acted in a certain way, if we value that course of action. At times, we are aware of this valency, as we are making decisions- we are really speculating how could we avoid “regrets in future”. Let me explain with an example. Nancy got pregnant- her first pregnancy- out of wedlock at a very inconvenient time in her life when she was still in college with no income and little possibility of support from the “one night stand” who she met in Hawaii and has no way to track him down for child support. Should she abort this unwanted pregnancy or go ahead and have the child? If she aborts her pregnancy-she is putting “value” on her career- thinking she can become pregnant again and if she goes ahead, it with it perhaps valuing “motherhood” – assuming career is secondary or something on the similar lines.

Whatever course of action she chooses, I think most of us would agree that she could have some regrets about the choice not made going forward, but then it also depends on what our values are.

So, we have established that futuristic regrets help us make a choice based on how we prioritize our values.

What’s the payoff for being regretful for some decision already taken? painful as it is.

To define the unique type of pain regret is, let me borrow from Ishiguro’s “remains of the day” and bring in the central character Steven – a butler, very devoted one to both his old master – an English Nobleman who was not that noble after all; and his new master – an American nouveau rich. His whole life was centered on doing a job well, with utmost professionalism, to the exclusion of any “romance at work”. After his new master, sends him out for a little vacation- Steven chances upon an opportunity to meet his old colleague Ms. Kenton and realizes that by keeping romance out of work he also threw an opportunity for a fulfilling life with Ms. Kenton who is rather unhappy but devoted wife, may have had feelings for Steven but were unrequited.

Unlike the heroine Helen in Sliding doors, Steven alas, cannot go back and fix it. When he comes back to the manor, he resolves to learn how to engage in “bantering” which he had been struggling to get a hang of .In some oblique way this resolve was a product of poignantly painful regret mentioned earlier.

Just like Steven, maybe we would factor the expression of regrets into our future decisions if come face to face with choosing one course of action over the other. It could help rearrange our value system.

I may have some “regrets” – pun very much intended, for not bringing more evidence but some of you might agree that the “null hypothesis” that regrets are futile, has been disproven.