Pecking order and the Rules of engagement:

A 15 year old aspergers female was brought to me for lashing out at school, being impulsive and aggressive. She was getting lots of detentions. Mom expected me to medicate her to fix her problems.

On inquiring I learned she was being bullied in school and constantly being made fun of. She in return would retaliate over the top and it just kept escalating. This was not a medication issue but normal human behaviors.

I had a long discussion with both of them about how humans are territorial animals and that we have pecking order behaviors. I.e. we compete for status, who is better than who and we compare and contrast and point out what is different about each other. This is normal and no amount of anti bullying federal programming is ever going to change these behaviors. But that being said we have choice on how we approach the pecking order.

If we approach the pecking order form the standpoint of a victim we will always be on the bottom. Directly engaging and fighting back to bullying is the lowest level of pecking order behaviors as displayed by our 15 year old now. Over time one can become very successful in these behaviors as did the New England Patriot player Aaron Hernandez. But despite being successful in his career and earning millions of dollars as an adult he still plays the victim and engages via direct retaliation on the lowest level of pecking order behaviors. When confronted poorly he shot someone in the face!

This is in contrast to Sam Berns (life according to Sam) who suffered from Progeria. His disorder turned him as a kid into a wizened looking old man. Instead of being a victim he became an advocate for himself and his disorder. He educated, taught and role modeled to where he became his schools mascot. He raised money for his cause and did ted talks and had a HBO movie made about him. His struggle became an inspiration to others.

The same is seen in the true story “Front of the Class” when afflicted with tourettes Brad Cohen has to advocate for himself eventually gaining his dream, respect, admiration, and teacher of the year award. His struggle became an inspiration to others.

Instead of engaging at the bottom of the pecking order in direct conflict these people went to the top advocating for themselves and role modeling for others.

Our 15 year old is playing a victim. She wants both to fit in , be invisible, and be like everyone else but that can never happen. At the same time she wants recognition, attention and to be special -the conflict of every young teen. In leaning to advocate for herself, maybe have her school play these movies, talk about asperger’s to her school she will be like Sam and Brad, an inspiration.

In medicating her into complacency we would just be enabling her and delaying the inevitable. She would still need to learn to advocate for herself but would less likely do so. She would take this lack of skills into adult hood and eventually suffer for it just as Aaron Hernandez did.

Posted in Uncategorized | Leave a comment

It is all adhd:

There is a cultural trend currently that just drives me nutz. Everyone thinks all their problems are because they have adhd. Doctors reinforce this notion because the DSM5 is based solely on symptomology. If people have 5 symptoms of such and such then they have a disorder. No one asks why or what’s going on in their life. This is silly as common sense would often dictate another explanation besides having a psychiatric disorder but there is no common sense to our culture.

Perfect examples are when we make little kids sit still and pay attention for 6 hrs which is developmentally an incorrect thing to do. Schools adopting multiple recesses (about every 2 hrs) are finding no one meets the criteria for adhd anymore where before it was up to 1 in 4.

Another example is a woman I saw diagnosed with adhd by her family doctor and sent to me for treatment. When you listened to her life’s story it was obvious her meeting ADHD symptoms on the check list was absolutely meaningless. In other words if anyone given the same situation would have the same symptoms then it isn’t a disorder but something called being HUMAN!

Her story:

She is a 56 year old Hispanic woman who came to the USA as a toddler with parents whom could not speak English and would never learn English. By the time she was 6 she was their main translator for all social interactions outside the family and by 12 she was in charge of the family finances, billing, all mail correspondence to the outside world and anything else requiring English communications. Meanwhile she maintained b/c grades at school but complains she was a bit distracted. She remained throughout life her parent’s caretaker to their deaths from cancer a few years back. She also was caretaker for many years to an alcoholic husband while also working and bringing up 3 successful children and still taking care of increasingly ill parents.

Who, given her life’s situation, wouldn’t meet criteria for adhd ! Upon complaining to her family Dr. that couldn’t focus and that she was having trouble at work and home he gave her an adhd checklist and she had every symptom. He put her on stimulants to which at first she thought really helped but then made her increasingly irritable and aggressive. Of course they helped as would caffeine or any stimulant but not because she was mentally ill. She just hat a lot on her plate and being able to do more of it wasn’t really in actuality good for her. It enabled her to make her life even more complicated.

She didn’t set boundaries in her life, she never said no. Being able to do more just allowed her to agree more to things she could not in reality complete. She shouldn’t have been the only one doing everything in the first place. Enabling her to do more of the same just in the long run was making her situation worse! When this type of person finally reaches their limits they often completely crash. All or nothing. But nothing could take 56 years to reach and by then they interpret their life as a complete failure because they didn’t fix everything for everyone. Their life’s sacrifice didn’t in the long run change anything.

Medicating people but not looking at the big picture only allows us to enable people to continue to make the same mistakes they are already making longer.

Posted in Uncategorized | Leave a comment

The new norm:

A friend was explaining this weekend why a mutual other friend put up with her mentally ill husband for so long, 10 years before divorcing. I realized her “new norm” explanation generalizes to just about every relationship.

She basically attributed it to the frog in hot water story. If he just suddenly changed one day and became a total bastard out of the blue that would have been that. But that is not how relationships work. They always start off great or there would be no relationship in the first place. Then over time things deteriorate or change one way or the other. The water heats up slowly and just as the frog doesn’t notice the warmer water the couple doesn’t notice their increased dysfunction it just becomes the new norm.

Most of the time things can coast even with some dysfunction but this doesn’t work as well once children are thrown into the mixture. Children’s needs heat the water or stress the family system rapidly. Things get noticed. Sometimes the new norm is again adjusted to and the couple makes the mistake of adding another child once again heating the system. Any change from here can heat the water to much to bear. Everything is now noticed. A change for instance the loss of a job or the loss of an extended family member and the system boils, the frog jumps out, divorce.

Posted in Uncategorized | Leave a comment

Black sheep?

For the last few years Susan (made up name) has been justifying her bad decisions and self loathing by being the black sheep of her family. She compared herself to her successful sister in medical school where she dropped out of HS and worked menial service jobs. Her Uncle and brother she said also made good money as compared to her.

Turns out Susan is of a crime family steeped in drugs. Her uncle makes and diverts the product and her brother distributes it. The sister not Susan is actually the black sheep in the family as she is the only one consistent with cultural expectations as compared to family expectations. The medical student sister is like Marilyn Munster. The sister instead of being praised and supported by the family is just not understood and never affirmed. She in order to maintain her culturally consistent lifestyle has to have nothing to do with the family. Meanwhile Susan although not steeped in the illegal part of the family business makes poor self decisions that continually immerse her in crisis. She is 100% consistent with family values, expectations, and decisions. She is enmeshed and immersed with all the families’ poor boundary and codependent craziness. Susan also needs to become a black sheep.

If people knew objective truth they wouldn’t need counseling.

Posted in Uncategorized | Tagged , , , , , , , | Leave a comment

On this the last night of Hanukah, Don’t let the light go out.

On this the last night of Hanukah, Don’t let the light go out.

click on the link above for a Hanukah Davar ( exploration on a theme)

Posted in Uncategorized | Leave a comment

trump Trump

trump Trump

click on the link above to be taken to my post at

Posted in Uncategorized | Leave a comment

Barfing on your relatives:

Dear Dr. Brilliant Cliché,

How do you reverse an event that you had no control over but which had devastating consequences? Let me explain: the last time my family was invited to my in-law’s house was four years ago. It was a big deal- my grandfather-in-law’s eightieth birthday, as well as Thanksgiving. Their whole side of the family was there. They’d had a very expensive chocolate statue cake made for the occasion. At the moment of the toast, I suddenly gagged, spewing champagne all over the table, cake and party goers. I was mortified. They were disgusted… but they ate the cake!!! The family had gone to great expense and effort to get it. It was delicious despite the spew but I think their disgust was burned into their memory and “swallowed.” Their politeness sealed my fate and excommunication from all future events.

I do not know what to do. It wasn’t my fault. I did not do it on purpose.

Al Full

Dear Al,

Disgust can be visceral and you have been linked with this awful sensation. Intellectually everyone knows it wasn’t your fault and they probably forgive you; yet the sight of you probably turns their stomach and makes them want to vomit. This is a classic conditioning response.

In order to change this you have to use Pavlov conditioning to your advantage. You need to invite them to something simple and pleasurable and not sneeze, vomit or fart on them! After a few times the old conditioned response will be broken. If they refuse to go you will need to get creative. You may need to arrange something elaborate at your own expense. I wouldn’t bring up the disastrous event for many years. Some day in time it will be funny. Embarrassments work that way.

Good luck, maybe Granny has some ideas for you to try?

Dr. Brilliant Cliché

Granny says: OMG. If it had been me at the table, I probably would feel the same way. For the first time in many years, Granny is almost at a loss for an answer, probably because she suffers from post traumatic stress disorder and she knows how relentless bad memories can be. However, perhaps I can give some practical advice from this very perspective. My first thought is- don’t provide them with any triggers! This would be anything that was present at the time of the incident. If you ever get these people in the same house with you again, don’t have it be for Thanksgiving, don’t have any similar decorations, and make sure nothing you are serving smells like anything they might remember from the fateful Spew Day, because smells can trigger buried responses and PTSD more than anything else. Above all DO NOT SERVE CAKE. In fact, you might want to arrange a get together at a basketball game or the beach…some sort of atmosphere that is the bipolar opposite of a Thanksgiving Day celebration.

But if these people resist all of your efforts, don’t push it. You’ve survived the last four years without being invited to the in-law’s. You can survive many more.

Posted in Uncategorized | Tagged , , , , , , , , | Leave a comment

keyboard Elitists

keyboard Elitists

Click on the link above to be taken to the Blog post.

Posted in Uncategorized | Leave a comment

Where am I?

Where am I?

click on above link to be taken to the essay…

Posted in Uncategorized | Leave a comment

Why an antidepressant for anxiety?

Dear Dr. Brilliant Cliché,

My brother is like crazy anxious but when he went to see a shrink he put him on an antidepressant? I don’t get it? He is not depressed?

His Sister

Dear Sister,

The volume control of human emotion is a chemical in the brain called serotonin. When its low emotions are “O-My God,” loud. When serotonin is high emotions are quieted down. There really is no such thing as an antidepressant as the medications that affect serotonin are not specific for sadness but as they increase serotonin they turn down emotion, all emotion. That’s why when people are on to much of a serotonin medication they complain of feeling numb or having no emotion.

Your brother received a serotonin antidepressant for anxiety. The antidepressant thing is just marketing because ‘Numbing Agent’ doesn’t sound as pleasant.

Serotonin antidepressants can help anxiety in a few other ways as well. Many people are anxious because they have heightened empathy. If you feel the pain of others to much you get too invested in it and it can make you feel worse than the person you believe is suffering feels themselves. Serotonin antidepressants block empathy so they help you to not get enmeshed in other peoples stuff. They help you from living in other people’s heads.

Serotonin antidepressants decrease obsessive thoughts and perfectionism which is a huge cause of anxiety for people. Again giving one distance from emotions you get a tad Zen from the pill, “Whatever.”

In rare cases people can have the opposite reaction from antidepressants. If a person has bipolar genetics serotonin can be like rocket fuel agitating them. Serotonin antidepressants in rare cases can also be disinhibiting. Disinhibition plus agitation can fuel the increased risk of suicide that you read so much about these days from taking serotonin antidepressants. Again this is rare but it is possible.

Hope your brother is feeling better,

Dr. Brilliant Cliché.

Posted in Uncategorized | Tagged , , , , , , , , , | Leave a comment