AFFECT AND SCRIPT IN PRIMARY CARE - VIDEO

[drlynch]

This is a view of how affect theory can be applied to primary care:

http://www.brianlynchmd.org/SIXVIDEOS/A ... RT15MG.wmv

http://www.brianlynchmd.org/SIXVIDEOS/A ... RT25MG.wmv
http://www.brianlynchmd.org/SIXVIDEOS/A ... RT35MG.wmv

Dr. Lynch

[drlynch]

Short essay on therapy in primary care done some time ago.

As a urban Family Doctor I have, for many years, dreamed of a unified medical and social support system. What we have is the façade of one at that. The only place it works to any extent is in the hospital setting and then there is little communication between and amongst the professions.

I think Mr xxx does an excellent job of pointing to the services that are available no matter how fragmented and costly they might be right now.

Of course to create an integrated systems we need the will of the citizens and the funds to do the implementation.

I am, however, puzzled when I read, especially here, that only by being ‘responsible’ citizens will anything happen. Well, maybe that in itself is true but then psychotherapy and the political world are not very connected at this level.

I, for one, don’t think the world will change due to my skills as a psychotherapist and physician but that is what I do and it seems to help some. I also know that people that ask for help are, usually, in no condition to be ‘good’ citizens and to ask them to be is ‘putting the cart before the horse'. Granted we are all many selves and many people are able to function in the political world despite great handicaps, be they mental or physical. But then is that what we want necessarily?

More directly to Mr yyy: I think, and would hope, that those that practice the therapy we are trying to develop here go about it by not avoiding and acknowledging the real hardships in the world and demonstrate in some way or another that we are all in the same boat. Dr. Nathanson said something to that effect that ‘patient and therapist all are just trying to figure things out.’ If this is not the case then the danger is that the patient just might get the idea that the therapist knows what they are doing! Well, not exactly, better said the patient might get the idea that we have all the answers. That the world is never confusing to us and that we never Withdraw, Attack or Avoid. Unless someone out there has been raised perfectly, and I don’t know how that could begin to happen without some knowledge of Tomkins, then we are all, really, are in the same boat.

Tomkins just gives us a road map. We very much have to figure out the timing, rhythm and destination of the trip. Those of us who study it hopefully know the map and sign posts a bit more thoroughly then those that are going about other important business in the world but need some help. The truth of the matter is that we have all just begun to learn.

I don’t think the goal of this therapy is any different from instruction in meditation, good military or sports training or the martial arts. They are all trying, whether they realize it or not, to teach the student to tolerate and make something of the moment. None of them say that those that attack us, avoid us and withdraw from us are going to go away anytime soon. I often warn people when they start that yes we all want happiness and if you stay with me you might find some, but it will be much different then you thought and to get even that much happiness things might have to get much worse before they get better.

The reason, after all, that we started on the journey was that we where confused as we thought we knew what happiness was and we were not getting it. Often we even come to find out that hurting ourselves seemed like happiness. It also turns out that the more pain we where feeling the more expectation, with or without therapy; we had of a ‘heaven on earth.’ With time though we hopefully find out that, particularly due to our biology that dictates constant doses of fear, distress, shame, anger, disgust and dissmell and some not so good surprise, there can never be that ‘heaven’ we dreamed of.

I certainly think I understand, after all is said, that when we start to come out of our fog we can definitely suffer form surprise that the world is still very much as we knew all along but disavowed. But that does not mean it is, on average, a ‘bad’ place. On the contrary if the world, on average, where ‘bad’ it just seems to me nothing much would be here, even, now. The chore now is not only to be ready to respond to ‘the moment’ and ‘process’ the ‘bad’ quickly and move one, but to be open to many, many moments where we can, even if it be unilaterally, be empathetic and caring of others and also give others the gift of expressing our feelings, appropriately, whether they be negative or positive. I think the learning of what empathy is and how to ask for it ourselves is the best ‘plan’ there is. I know you want another answer but I don’t think there is one.

Finnally I guess there is something to serendipity. I opened an email just after writing the above and found, among others, these. We have all probably heard them and received them but all of them seem worth reading and to be about paying attention to ‘the moment.’



Happiness comes through doors you didn't even know you left open.

Most of us go to our grave with our music still inside of us.

You may be only one person in the world, but you may also be the world to one person.

Don't cry because it's over; smile because it happened.

A truly happy person is one who can enjoy the scenery on a detour.


Brain



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