Dr. Stanley Goldstein - Author and Psychologist

Thirty-years ago I was asked to treat an eight-year-old child who, stricken with leukemia, had been discharged from the hospital to die at home. Though fearing the emotional turmoil, I felt unable to refuse the request, feeling that he needed someone.

The boy looked terrible at our first meeting, holding a white enamel tray lest he vomit. I introduced him to "our friends," the stuffed animals in my office (Bertram Bear and Darrell Dog and Barry Bird and Gregory Gorilla) while we played a board game. He looked healthy at the following sessions, not bringing a tray, and playing and interacting with our friends comparably to my other young patients. He seemed so normal that I embraced the frequent delusion that his doctors were wrong and he wasn't dying. Then one day, when he became too ill to travel, I went to his home and spoke with his parents in the kitchen while he lay in bed.

Despite my heavy work schedule and preoccupation with him since we met, I felt nothing when he died but my body reacted differently. Though continually healthy, I immediately developed an unpredictable explosive diarrhea which made me unable to perform my duty as expert witness in court. Medical tests found nothing wrong and when the diarrhea ended two months later, I sensed it was gone forever and it never returned. Had my body tried to expel the poisoning stress through diarrhea? I wondered. A primitive reaction explained by psychosomatic medicine which holds that what cannot be spoken will be expressed through the body.

Twenty-six-years later I was referred for treatment an adult who, after extensive surgery, was being heavily medicated by his doctor for pain and self-medicating himself with forbidden alcohol and cigarettes. Having become a troublesome hanger-out in her office, she referred him to me "for therapy." A first glance told me he was dying. He had no interest in therapy, I didn't see him for long, and my increased blood pressure lasted as briefly. A week later, without conscious intent, I spontaneously spoke of the boy who departed life too soon, leaving his parents and me and our friends to grieve. Then I did cry.

In a semi-rural Community Mental Health Center where I once worked, a social worker, without telling anyone, brought in a caged rooster to give to another worker at the end of the working day, parking it in a closet in the women's bathroom. When one entered the bathroom and turned on the light, the rooster crowed, mistakenly believing that it was dawn. Women leaving the bathroom and reporting having heard a rooster crow were considered crazy by the staff ("probably their time of the month").

During my first job as a psychologist at a psychiatric hospital, I told my psychoanalyst/supervisor my adolescent patient's statement. "That's psychotic," the doctor replied. Though able to define "psychotic," until that moment I hadn't grasped the power of this condition.

Similarly, when mass murder horrors become public, the perpetrators are often viewed with surprise for these men had seemed so normal. They lacked the twisted features of horror film characters and spoke coherently though of bogus beliefs. Columnists asked the usual question of "why," and provide their usual answer that "no one knows." But this is not true!

While predicting violence cannot be certain, it correlates highly with several factors: failure in life; substance abuse; the ego capacities governing thinking and behavior being inadequately developed; and having a fragmented "sense of self," sense of who they are. The killer's frequent decision, to suicide in "glory," is considered preferable to their continued painful existence.

Though their act was horrendous, these individuals are not often considered "insane." The legal definition of insanity is determined by state statute, most usually whether a person can distinguish "right" from "wrong," and rarely succeeds as a defense. But to describe them as sane does not imply that they possessed "normal" control over their behavior though, except for those with extreme limitations, this should not influence their punishment. There is evil in the world and some succumb to its temptation. Yet even for the rest of us, the unconscious is very powerful and one must respect its power.

The Disastrous Estrogen-Replacement Saga's Cautionary Research Lesson: "How easy it is to be misled in medicine by correlational and retrospective studies, and how when it comes to proving the merit of any drug or procedure, nothing short of a large, controlled, double-blind clinical trial will do." In Natalie Anger's, Woman - An Intimate Geography

Emergency Room workers are being swamped by medically healthy people who are frantically seeking testing for coronavirus. Though the present national period time is exceptional, their behavior is no different from anytime when anxiety escalates and panic overwhelms.

Anxiety is the normal, healthy experience when the mind senses danger. It can produce symptoms that mimic virtually any medical disorder: pain in the head or back; nausea or dry mouth; scarily heightened blood pressure; skin eruption; lack of appetite. All instantly vanishing when the fear that aroused them disappears. During normal times, forty to sixty percent of the people arriving at an Emergency Room who fear that they're having a heart attack are really suffering a Panic Disorder. This is the condition when the normal symptoms of anxiety are misinterpreted as a deadly medical event.

More public education about the human mind is sorely needed.

I told the following to an Irish person: As frightening as things are, they're about to get much worse. A high-level government contact told me that several thousand space ships containing carnivorous alien creatures are speeding from Venus headed for Earth, having exhausted their planet's food supply. NSA communication decrypts revealed that their favored food is IRISH STEW.

The present extreme public anxiety caused by the coronavirus may reflect its difference from past national crises. Those, like in the immediate aftermath of the 9/11 terror attack and President Kennedy's assassination, were better capable of being grasped, being more "conventional" and having a presumed brief time frame to experience whereas the present crisis may be experienced more like that of the seemingly endless and inexplicable Great Depression.

There are few more painful experiences than an agitated depression: the combination of pervading anxiety and deep depression. Which can result following such common trauma as divorce or unemployment. Or even apparently nothing since, as I never tire of saying, the unconscious is very powerful and one must respect its power.

Because feelings reflect both mind and body, they cannot be separated. Thus does remaining in bed make depression worse and incoherent flight increase panic. So when altering the body through constructive activity, as by involving oneself in a work or household chore, the agitated depression lifts and, sometime later, its unconscious cause (if one exists) may surface.

Some months ago, I met an interesting man on an Acela train. The former soldier of an allied nation and early volunteer in the Afghanistan war, he had joined his nation's military at sixteen, later earning a science doctorate and currently traveling to Washington for conferences. While keyboarding, I accidentally bumped his arm and he quickly said, "Excuse me." I said, "Boy, you're really polite," and he responded, "Yes, my wife trained me."

Whether his gentility reflected the influence of his wife or his background I couldn't say but it began my thinking about courtesy. Yesterday, while in a drive-in banking line, I waited for minutes while the driver in front of me, whose business had apparently been completed, remained unmoving, doing whatever. Finally giving up, I drove around him and walked into the bank with my deposit and complaint, asking why the teller couldn't suggest that tardy customers move on. "We can't do that," came her reply. I suggested that a warning beep sound after one minute of the completion of business, which will never happen.

Another pervasive discourtesy is the seat-reclining problem on trains and planes. Which I never do, just as I'm careful about driving courteously (avoiding other cars is safest too). But many people aren't, arousing the crazed rage of people who feel "disrespected," an increasingly used adjective which will hopefully soon disappear.

Some of this behavior may be cultural. Americans, as opposed to Europeans, are more sensitive to what they consider their "personal space." Thus on a three-seater train row in Europe, the newcomer will sit beside the seated passenger, leaving the outside seat free for another passenger, while in America the new passenger will leave the middle seat empty to preserve their "space."

One wonders about the early life parenting of those engaging in unneeded social battles or perhaps it is simply what a teenager recently told me, "Some people got their head up their ass."

Physical illness involves feeling different, disconnected from the usual experience of possessing control over oneself, having the ability to reason, and considering oneself omnipotent in the world. While unrealistic, feeling all-powerful is needed for it enables one to function in the world, to engage in needed routines without anxiety. Yet this critical sense can be disrupted by physical change, even one so insignificant as suffering a conventional cold or stomach upset for these deny the person the feeling of intactness and affect reasoning.

Suffering a severe illness can be far worse as thinking processes change and helplessness ensue, the latter being the scariest of all feelings: when the ill person becomes passive, and his body no longer respects his commands.