31 yo. To 34 yo Psychiatry Residency, University of Manitoba

Psychiatry was very hard.  Surgery was tiring. It was athletic. Late nights, long hours, so many patients, so many people.  But almost like a mechanics shop with a whole lotof cars and trying to fix them with the engines running.

I remember a lung surgeon saying to me, “I do rounds before the patients are awake because I don’t want to talk to them. I don’t really want to know them as people. I’m a technician. I’m there to fix their lungs. Often I have to take them out. You’ve got great hands and will make a great surgeon one day. The trouble is you like people too much. You like to talk to them, listen to them, get to know them. If you want to be a great surgeon you won’t have time for that.”

 General medicine was a lot of memorization. Community medicine was looking at the bigger picture, public health and population considerations. 

Psychiatry was hard.  Everything I believed had another side to it.  

“Psychological mindedness is the ability to tolerate the ‘tension of opposities’.  

The mind and heart must twist and torque and spiral.  The soul is pulled.

 I would spend time with women who killed all their children. I’d spend hours with pedophiles. I’d be with victims of every heinous crime imaginable. I’d talk to people who believed they were the devil. I’ve met Satan dozens of times. I’ve met fewer Jesus Christs. Patients would be in communication with aliens. I’d have people who were the richest and most powerful in the land and yet they had a kink. The multi millionaire international banker who liked to dress in diapers. Every sexual flavour was represented. And all of them were selling.  

I was reading everything I could get my hands on in psychiatry too. I devoured the text books. But where the real gold was was in the journals and writings of the greats.  There’s a marvelous book called the ‘Discovery of the Unconscious.”  It’s hard for people looking back to understand the importance of Freud and his colleagues.  In the age of Rationalism everything was mental and up front. No wonder the soldiers dressed in bright colours and stood opposite each other lobbing lead at one another without ducking. Meanwhile the Indians of North America were hiding behind trees and shooting the solders in the back.

Psychiatry was total warfare. The ‘coping mechaniS ms’ and ‘defence mechanisms’ people learned and used, were guerilla warfare at it’s finest. I’d meet boys and girls who were sold into sex slavery by their mothers. I’d meet incest victims and talk to fathers who didn’t want a stranger to hurt their children so he said that’s why he introduced them to sex so young. I’d talk to hundreds of escorts and prostitutes. The doctors who paid their way through college doing tricks and the men who’d been criminals and buried bodies and now told me about it.

I’d learn so much about guilt and shame and covert and overt aggression. I’d learn that another system would control the behaviour of the group, relative influence upon relative influence.  I’d chart out the mind as Freud did. I’d begin to see the transactional analysis in groups as I once learned ion exchange in kidneys.  

My mind would expand and twist.

I’d walk a mile in the shoes of the psychotic patient. I’d enter their reality. I’d share spines with patients. I’d sit in locked quiet rooms. I’d be attacked again and again.  It was all so dangerous but not the physical attacks, the being held hostage, the black eyes, the wards gone crazy. The dangerously insane women’s ward where the women tore off their clothes and violently attacked the guards while older women were shoving me out the door while the young naked women were keening.  The men would throw shit at the walls.  They’d paint their cells with equations in shit. 

I’d come home and Maureen would complain.  She was always depressed. Her mother was always depressed. They were always tired. They had this mother daughter contest.

My own parents were simple , straight shooters, kind.  I was surprised at how uncomplicated they were. I learned to love to spend time with my father. My admiration for my brother and sister in law grew.

I had friends like Frank who were amazing individuals. I felt so inadequate. I really felt such shame and guilt. All that I believed and did made so much more sense in a different way. I saw my courage as reaction formation. Everything I believed was the cause of some other force I hadn’t considered.

I was writing.  I was reading. I was loving the adventures of Dr. Carl Jung, R. D. Lang, Karen Horney, Scott Peck. They all may as well have been 19th century explorers because they found continents. They mapped this whole other world.  People had killed them in the past. My patients who were seers and clairvoyants. My manic patients really did know what was going on. There were no unidimensional explanations for their psychic behaviour.  Walking onto a ward day after day and having a stranger tell you what you ate for breakfast and all manner of things of your past that they shouldn’t  know and telling you about your wife and her conversations and bouncing off the walls.  I’d try to package everything in the ‘right’ way. It must be a ‘heightened’ awareness. They saw food on your beard. That’s how she knew. 

But even in psychiatry we didn’t talk about the uncanny.  I’d eventually ask spiritual leaders to assess my patients whose psychosis was other than textbook with a great religious flavour. One in ten were not psychotic but having a spiritual experience according to the priest or rabbi or minister. I would talk with these holy men and discuss their understanding of my patients visions. Some would be discharged to monasteries rather than home.

I was working with a French Canadian psychiatrist who would take me to the catholic monastery and I’d see the priests with melancholia, the most depressed people I’d ever seen, who could not eat or sleep but never wanted to suicide. I’d see the miracle of medications in the brain injured and see that the worst cases of schizophrenia had no apparent injury. Word salad speech and hebephrenia and nothing physically wrong. 

I’d learned to hypnotize people to do therapy and now was doing hypnotherapy., I was trained in ‘Amytal interviews’ and over and over again learned the tricks of the psychopaths and sociopaths. All the lies. I’d lived in a tiny villlage now my world was opened to the universe. I was doing psychodrama in groups. I was learning systems theory in family therapy.  I studied “prisoner’s dilemma “.

I studied anthropology. Reading books about culture written by the psychiatrists and psychologists who came from those cultures. I was studying the ways families and communities adapted. I was still flying into the north and seeing natives from mostly Cree, Ojibway and Inuit community. I was learning how Cree were as different from Ojibway as Chinese from Japanese. I was also seeing the incredible ignorance and grandiosity in the system. I had individual teachers who were genius.

I ‘d spoken to Dr. Harry Prosen, this brilliant man with incredible vision and insight. He could be so wise and he so kind.  I’d ask him how I could be the best. I told him I wanted what I saw in Dr. Mark Prober and himself. I said I wanted to be a psychoanalyst but we had no psychoanalyst training in Winnipeg. There were two psychoanalysts and I had one as my mentor for a year. It was difficult and even more difficult dealing with his narcissism. The analysts had each bought a house in the city and immediately had to buy bigger houses when the other bought a bigger house. It really was that ridiculous. But while they had their eccentricities their insights into others and themselves were profound. I was so moved by ‘focal’ psychoanalytic psychotherapy.It was always like looking for the one log in the log jam that stops  the energy flowing. I’d find that log and watch the whole being heal.  

Psychosomatic medicine was the most mystical and uncanny. Literally people who could not walk walked.  I was daily ‘blown away’ by what I saw in psychiatry. It was a whole mystical magical world with patients in a circus in this part of the hospital attached to this ‘real’ world by corridors. Once  you’d step through the doors you were on a different planet.

I entered psychoanalytic training myself. I arranged for a much admired psychiatric psychotherapist, ‘don’t get one who is working in the university. There are a number of people who are outside the system. The university is too incestuous and political. These are people who I’d recommend.” 

There was one name that Dr. Nady El Guebaly, Harry Prosen and Dr. Bebchuck all recommended. I approached him and explained my desire to become a psychoanalytic therapist. I wanted to be his patient. For the next 2-3 years I’d go once a week, sometimes more. It was as profoundly disturbing as a heart surgeon watching his heart removed and another one put in to replace it.  I was not who I thought I was.

I began to change. I was changing. Psychiatry training changes you to the core. We had a group which met and discussed this. We had the brilliant and handsome  Dr. Pierre Leichner to guide us. I was against him for his obvious political connection to the staff but personally he really was a big hearted character, his wife and he, shining lights in the community, their flare for fashion ahead of it’s time in Winnipeg.  

We’d get to know our teachers and staff people intimately. We’d dine with them and talk with them. The conversations to all hours in their offices were deeply moving. What Oxford had been. The sharing of ideas , the discussion of Adler and Reike and considerations of Beck and Rogers. I loved the Milan school of psychotherapy. I’d become fascinated with Dr. Falconer’s Structural Family therapy and even more moved by the work of Dr. Milton Erickson and Jay Haley and their strategic interventions.

We’d work behind two way mirrors. We’d ‘predict’ and ‘prophecy’ what our questions would lead too. Our staff men and women would ask us to enter into the room and ‘ask him why he hit the children’.   

“I predict he will say this’ but in fact if you wait ‘he will tell you this.’  From his family history you see the relationship with the mother and father, he’ll somehow re reenact this. Watch for the tone of voice. Watch for the body language”. 

“Watch for when she dissociates. The clues are so subtle. Watch for the little girl. It will just be a flash. That’s where the angry is. It’s not what he says but what he feels.”

Sure enough we’d go in and interview and do therapy and all thes magicians and holy men and women who were our staff persons would unfold with uncanny routine. Nothing was sacred. There were no surprises. It was like everything people said and did had a neon light explanation. There were endless cues and we’d have them pointed out individully and in group,.

I’d do therapy and record the hour weekly, sometimes twice weekly then meet with my supervisor and go through the recorded tape minute by minute for as many hours the supervisor asking what I though, what I felt. Everything was transference and counter transference.  It was total immersion.

Meanwhile in my therapy, I’d be saying.

“She’s always talking about her mother. Her mother this. Her mother that.”

“How do you feel about her mother?”  

“I hate her.”

‘Why.”

“She’s sucking the life blood out of my wife.  Whenever she’s with her mother she returns hating me and has horrible headaches.It’s blatant but she refuses to acknowledge the association.”

“How doesn’t that make you feel?”

‘Frustrated.”

“Hold that feeling. Our time is up. I’d like to know about other times you’ve felt just like that in your life, in your childhood, in your family, in your school.”

I’d spent months talking without any comment and then my psychoanalytic therapist would have these little spurts of discussion. It was called technically something.  Mostly he’d listen. I’d learned to ‘free associate’.  Counselling isn’t anything like psychoanalytic psychotherapy. Years of free association later I’d try to explain to those who were ‘counsellors’ how they differed but they didn’t understand. 

Counselling is like massage compared to surgery.

As I began to sit with my own patients and let them free associate and learn to free associate I’d have that feeling like I’d have meditating with a monk. There was this great ocean we’d join in and sometimes I’d feel like I was drowning when the patient was drowning. I’d be the child with them, the adult with them and let go of the control and director and the parental role of the ‘counselling’ mode. 

I’d learn to trust the ‘process’. I’d come away often and want to kill myself as my patients did. I’d spend days reflecting on why I shouldn’t . I”d understand their views from their view. I’d become one. I’d meld. I’d do the borderline thing in therapy and join like some kind of Spock mind meld and then I’d find the knot that Laing described as needing untying. Then I’d ask the question that would lead to the ‘aha’ for the patient and overnight the behaviour changed with ‘insight’. Insight psychotherapy was profoundly rewarding but the most difficult and needing the greatest level of training.  It was fine surgery and fine needle work.

I’d learn that some many counsellors just retraumatized patients. I’d learn from the greats how not to bludgeon patients.  Doing hypnosis they’d know what they needed to know but it was all in the ‘timing’ . They were not ready for the insight. They had to be ready. I was studying zen at the time and so much was zen.  

“So he was raped by his father and that’s why he raped his daughter.” As Emerson wrote, “the red slayer thinks he slays and the slain thinks they ar slain, they know not well the ways I keep and turn and toss again.”

There were no black and white and all was grey and the victimizer had been the victim. The reason everyone likes counselling and cop shows and the courts because they have their villains. They’re into tribal revenge. They’re ancient history. The court is about primitives and barbarians. There’s no science. There’s nothing like the therapy sessions where two kids are lost in a sandbox trying to find the way out together. My way is never their way .  

Insight therapy doens’t work with addiction.  Kernberg and Kohut studied the field and found that individual diagnosis required individual therapy. The counsellors like the original therapists want to have one hammer and call everything a nail. I’d later train in ‘brief therapy’, ‘grief therapy’, ‘relationship therapy. ‘Supportive therapy’. ‘motivation therapy’, and 12 step facilitation therapy .I did former CBT. Still to I meet people who thinks it’s the ‘latest and the greatest.’ Just the other day I heard someone talking about B.F. Skinner. We’d be trained in all this and every week observed for hours and have hours to explain and discuss what we were doing.

Psychiatry is like surgery.  

It’s so far removed from general practice that it’s alien.  

I felt alien a lot in psychiatry. I felt like I walked out of this psychedelic world back into the suburbs when I left the psychiatry wards. It was core city.  What was tomorrows fashion was todays disease.

I had the greatest teachers.  Many of my teachers got the Order of Canada despite having me as their most inquisitive and challenging student.  

17 yo and Shame, Gays, So so Gay, spirituality, psychoanalysis and meditation.

Later there were years of celibacy cycling back to promiscuity.  It was like I could turn it off and then if I smiled young girls came and threw themselves at me. I’d find women in my bed when I came home. I’d be blamed for being charming.I was accused of seducing women. I was told I was irrisistable.  I spent years in therapy.  I didn’t masturbate. I sat cross legged for hours. I prayed. I joined with a Benedictine for meditation.  It was always like something out of Spock.  I’d mind meld with holy men and holy women. We’d watch sun rises and sun sets. Alone together in friendship.

Breathe in breathe out.

 Om mani padme sum.  

I am He. I am He. Blessed Spirit I am He. No birth ,no death ,caste have I, father mother have I none, I am He. I am he. »

Lord Jesus Christ, Son of God, have mercy on me, a sinner.

The psychoanalysis was different. I spoke with Dr. White, the Christian psychiatrist and we talked over 6 months when he was my mentor. 

« I didn’t find it helped much. My colleague found it exciting. But then there’s always something exciting in confessional for the listener. A kind of voyeurism.  But counselors like this. With little training. Hearing people speak of their inner secrets.  But I didn’t have any secrecy’s. I share everything with Jesus. I have a wife and church and pastor and Christian friends.  We talk openly among one another. We really are a community of God. I know people talk of that. But I found it.  I’d recommend you do too. I’ve heard you talk about your church and you seem to accept a kind of anemic Christianity.  There’s much more.  Not for all but for some. I guess that’s why psychoanalysis didn’t amount to much for me.  I still think he got more out of it. But then we were more interested in technique back then. »

At times the shame was overwhelming. Shame separates one from others, from God.  They say shame means ‘you’re no good’ but that guilt is’ I did something that was no good.’  It’s really nit picking. In the tribe hundreds of thousands of years ago you did something wrong and you were told it was wrong. Any deviation from what was done was wrong. People lived by repetition of right behaviour. Don’t eat the red plant. Eat the green one.  

I loved reading « The World Until Yesterday; What We Can Learn from Traditional Societies. » by Jared Diamond. His first book Guns, Germ’s and Steel had been such a watershed book for me helping me understand the Polynesian people I was working with at the time.  Traditional Societies weren’t the myth of Hollywood and liberal politicians.  The Horror. The Horror. That famous line from Joseph’s Conrad’s Heart of Darkness would come to mind. Everyone and everything was taboo.  The stranger was shunned and killed because that’s how people survived, safely, in the familiar.  

« Freud was afraid of the unconscious.  I thought it a much more reliable and trustworthy thing.  When I fell my body would automatically attempt to save me. Freud was an intellectual in that rationalist tradition that lead to so many hundreds of thousands of men killing themselves in trench warfare  WW1. «  

I was in Phoenix at an Ericksonian Foundation conference for the second time. I was learning hypnosis from the man who did hypnosis for heart and lung surgery. 

« Some people are allergic to anaesthetics. That’s when I come in.  In the old days everyone had surgery and was just held down by their friends and family.  Now they call me. I induce a trance. It’s often days of training and preparation. Then the person is distracted really. That’s what so much of hypnosis is, distraction.  They’re focussed here and the pain is over there. It works extremely well for acute surgery, brief periods. The dentists have caught on and like it. Of course locals and blocks work just as well. There’s the control factor to. The more you use drugs and procedures the more you rely on power.  Erickson liked to let things grow, trusting the process. Describing how plants didn’t need to be told. He believed that life was an inherent pattern in a person.  He thought Freud was afraid of the unconscious.  He didn’t like children much either.  I like children.  There’s that feminine and masculine aspect of nature. Jung talked of this, anima and animus.  We all begin as female and some of us transform into men biologically. »

I’d love reading Jung and how he saw Freud as frightened of the unconscious and needing control. Jung was more interested in the mapping the unconscious.  Freud was satisfied with his seeing that there was the Superego, Ego and Id. Later Erik Erickson, not Milton, would call these the Parent, Adult and Child.  Jung expanded this map as it were to the Shadow and Face. Then the animus (masculine) and anima (feminine).  He’d go on to study the archetypes and the « collective unconscious » those spiritual moments of ‘synchronicity’ and that sense of wonder.  HE was the son of a minister and his psychology spanned the whole of the myth and theology of the Europe of his day.  Freud by contrast seemed to be presenting an idea of the universe straight out of the Jewish history, limited to that, but with God removed.  They both were so interested in science and all the learning of the day.  Freud would write about anthropology.

Ivan Illich, the great French philosopher would write a book called Gender where he’d trace the domains of dominance by male or female of all aspects of life to the gender designation given them in language.  Le Auto meant that the ‘man’ had principal responsibility for this machine but ‘la maison’ designated this as principally the ‘mother or wife’s domain’

So much of the richness of existence and the sacred was lost to the bulldozing stupidity of Cultural Marxism, that Frankfurt school of intellectual nonsense that reduced everything to binary.  Marxism could be summed up as ‘rich and poor’, ‘bourgeoisie and proletariat’ and the rich oppress the poor. The exact same reasoning of the paranoid schizophrenic. There’s ‘them and me’ and I’m their ‘victim’. A very effective revolutionary design that served as the basis of aetheist war and murder of hundreds of millions of men women and children in a mere hundred years or more. No other religion had such a killing history.  Yet sadly Jews especially and all others refuse to let go of one of their own. As if Jewish intellectuals are a Navy Seal platoon of the mind that must keep bringing their fallen colleague back.

My famous colleague, a Jewish psychiatrist who survived Auschwitz would say with disdain, « Feminism is one of the maggots crawling of the dead body of Marx and Freud. »  

« A little girls religion, » she’d say. She was friends of Gloria Steinem and said her personal life was a train wreck.  « So many of the academics write and sound good until you know them up close. ». 

I’d meet the woman who lived beside my favourite gonzo journalist, Hunter S. Thompson.  

« He kept peacocks. Try sleeping when your neighbour has these bloody peacocks that wake at dawn and make all manner of racket. He’d be passed out after shooting his guns off in the early morning. The peacocks would shit everywhere. You know goose shit but peacock’s are a whole lot bigger. So the shits that’s much more.  Worst neighbour I ever had. All his neighbours hated him. Mostly the peacocks and the gun noinse in the middle of the night.  Otherwise he was fine. The peacocks were impossible. »

I cycle back to that night. Over and over again. Trauma does that. This is trauma.  Betrayal for sure.  Sexual so more subtle and worse in some ways than the blatant loss of a limb.  Sexual matters are like worms that burrow under the skin.  I suppose the loss of the limb is worse but the shame may be less. It’s hard to compare. I’ve not lost a limb but I have experienced what would be called rape. I agreed at first then changed my mind only to be held down and penetrated. A rapist might get off on the technicality. I’ve heard a lot of men describe that as ‘normal’. 

Indeed the sophisticated sexual older women of my youth would say ‘no’ as I penetrated them and this ‘pseudo rape’ fantasy loomed large. 

I stopped and she said,  ‘don’t stop. Don’t stop’....

« But you said’ no’ . 

« Ignore me’. »

« Just continue. Pound me. Pound me. I want you to fuck me. »   

«  But you said ‘no’. »  

« I didn’t mean it. ..  Do you want a discussion or do you want to get fucked. »

 I wanted  to fuck but I almost couldn’t because she’d said ‘get fucked’ . I found myself thinking about syntax and construction. Was she fucking me or I was I fucking her?

She was a few years older and had come on to me inviting me into the wealth and elegance she had. She was certainly more established.  She told me this was just sex. She didn’t want a relationship but wanted to fuck. Then she’d said ‘no’ and ‘yes’.  I didn’t go back after a while.  She was confusing. I was young and sex was always available but in bursts with dry periods in between.  Seasonal. With flurries. Women always told me they found me attractive.  They only got angry when I refused them or left. Then they’d be venomous. I loved Zorba the Greek. The « complete catastrophe’ he called it. « Never say no to a woman. »

But I was wondering if I was gay.  I had been that night. I’d had no food. I was hungry.  Never go out hungry if you can avoid it. I was without transportation. Boys don’t hear always have money to get a taxi home.The guys in the band had the car. They weren’t leaving. They were conspiring.  There was champagne and caviar. An exotic spread in an elegant penthouse. I loved the warmth and ambience. All the older guys. I was the youngest.  I was a poet.  I believed in diversity and learning. I didn’t want to. I said no over and over again. 

« I like girls’.  I don’t want to. I’ve never been interested. ». 

« Okay, but just come. You don’t have to do anything. He just said he liked young boys and would make the record if we brought young boys. He didn’t say you’d have to fuck. We said, we’d see. »

That was the conversation in the car. When Lonny took the gun from the glove compartment and slipped it into his pants. Meaningfully.  Manly. He did that when we went to a party. Part of his schtick. Having the pistol and showing us he had the pistol.  

We went up the elevator.  

There were others there. Mostly the old guy though. HE was very attentive. « More champagne’. « Another jay ».  

I drank and smoked.  And watched the movie he put on.

It was everything I’d never seen. I sat on the couch completely stoned.  Everyone said how powerful the dope was. Really good stuff. And the wine was so sweet. Bubbles. Went to my head.  And I saw there watching gorgeous men and naked women and orgies of men and women then the pictures would change to just women, all so beautiful, all mingling like a kaleidoscope of Kama sutra, then just men, and animals and children and I just sat and watched. Stoned. And frozen.  I was paralyzed and My brain a wet noodle.  I felt so good.

I looked down at my lap.  The old guy was down on his knees between my thighs was sucking my cock. I don’t remember him unzipping my fly. I don’t remember how long he’d been sucking my cock. All the band and the other men were standing by watch, sipping drinks, tasting jouer douerves. It felt  good then. He was taking my hand and walking me to the bed room. I was watching this happen to me.

He gave me a Playboy and I stared at a centre fold as he undressed us. Then we were naked and his hands were all over me as were his lips. Then he guided me into him but I kept going soft. 

« Look at the Playboy » he’d say  and I’d look at the Playboy centrefold on the pillow by his head. I’d stay hard then and finish.  He’d clean me up and dress me.  Then before I left I’d watch Lonny pulling out a contract and getting his signature. Lonny had been watching too. I thought that creepy.   My ‘friend’ was laughing and smiling.

« You took one for the team. Good on you. » He said, like we were in school and I’d held up the end. 

« I  wasn’t going to do it. I never could but you did. » he said and I hated him.  I knew I hated him. T.s. Elliott.s Hollow Men.

A while later an older friend at the university invited me to a faculty party her professor was throwing. I was the youngest there too.  Just out of high school. My friend was from Vincent Massey a year or two ahead of me and now studying poli sci and English.  

There were all these papers and every where bottles of wine.  A guy came in with two green garbage bags of marijuana and dumped them on newspapers  laid out in the centre of the room.  Rolling papers were thrown around.  My friend met another man and they began to kiss. I sat down with a glass of wine. She went up stairs with him .  A while later she came down. I was drinking more wine and just chain smoking dope. I was in heaven. Never had I seen so much dope.  I was l’église and everyone  was happy. I was drinking wine and smoking dope watching couples kiss then go up stairs. 

The professor had done it with students and his wife had done it with students. Old people, young people. Then she took my hand. It was so soft. Her face was so round and close. Her voice sounded miles away. The music was floating through the air like staffs. I was seeing it. I followed her  up the stairs. She showed me the babies in the crib in another the room. The professors and his wife’s. 

But then she took me into the extra bedroom. The bed was big and soft with huge mirrors on the ceilings and walls. I saw she had trouble getting my jeans off.  I couldn’t seem to help. I was in that drooling staring catatonic dope state. She’d walked out of her own clothes like they were designed for rapid exit.  She was naked before me stroking me and untangling my jeans from my stocking feet. She pushed me back onto the bed and straddled me.  I supposed I consented. I could say I was raped. No clothes so no deep pockets. No fowl. No thoughts like those in those days. Today a new game of rape history for profit. 

I hadn’t  hada volitional thought. I was like Garp. She was probably merciful. Practicing charity.  I was in the flow A silly dope grin on my face. My mind a loose noodle. My erection a mind of it’s own. The only place with blood I was all vegetable. She’d hardly mounted me when I came. Not quite premature ejaculation, at best a peri-mature. coming. She was upset. I was supposed to wait. But I wasn’t home. He had a mind of his home but she rolled her eyes at me. She brusquely dressed me like a child.  

She walked me quickly down the stairs and left me by my pile of marijuana and poured me another glass of wine, immediately taking the next  man upstairs. He looked as blotti as me. I rolled another joint, had another glass of wine and wonder if that had just happened.  There’d been so many going up and down the stairs before the night was through. I thought she was wonderful. I felt wonderful. I almost took off my clothes in the living room but somehow stopped myself that time. Taking off my clothes seemed to take up a lot of thought and time. Eventually she came for me and put my parka on. We went out in the cold. She never asked me out again. I know it wasn’t anything I said because I didn’t speak. 

I was passive. Passive was great. Over the years I’d move all over the passive active spectrum. I felt I had to be active. The more active the better.m Married  for years , years later ,I’d get kinks in my neck spending my life between her legs licking an eternity as she said that’s the only way she could orgasm. 

« I don’t orgasm with intercourse, » , ‘she said. She seemed to. Come to think of it she always had a contented smile on her face. After I divorced I suspected her of lying. She didn’t reciprocate. « Good girls don’t like that. » 

Reciprocation became a theme with money and sex when I was a marriage and sex therapist..

I would sit for hours and and years and listen to couples dicker ant trade. Then the courts would talk about money like they’d talked about sex. Everyone wanted to be served but no one wanted to serve.

« He just fucks me. Never once asked what I wanted. Just fucks me. I take care of myself. I never had an orgasm till my girlfriend introduced me to her vibrator.  Never had one with him even after. I just lay back. You know that mothers told their daughters to ‘lie back and think of England’. I don’t think of England but I just think of other things.

« So here’s the joke, doctor. «  a patient told me »What’s the difference between a mistress, a prostitute and a house wife.?’

« What? I humoured him. I was seeing so many men for sexual abuse. All these macho men, leaders in society, doctors, chiefs, colonels. Coaches. First it had been the residential schools Then it had been word of mouth. You should talk to Dr. Hay about that. The newspapers made it something men could talk about. I loved the psychologists who had begun the BC Society for Sexually Abused Men. I talked to them in early days met the doctor who’d been 20 years with a male lover and 20 years with a female lover. « I love the person not the  genitals’.he told me. 

« What? ».  He was laughing. Sexual jokes were manly.

« The prostitute says, are you finished yet. »

‘The mistress says ‘more, Cherie, more’

‘The housewife says ‘beige, I think I’ll paint the ceiling beige.’

He was one of hundreds of good men who married in good faith and their wives decided they didn’t want sex anymore. Not after the kids. A myriad of excuses. They were good church women. Upstanding citizens. Withholding bitches.  Cunning conniving insensitive takers.  Stupid cows. Controlling. There were a thousand words that had come down through the ages to describe the situation. Always she said, he said. But in the end if the man slept outside of the house then  he lost the house and he  children. The women came in too and told me of lovers who were gardeners and how they were having sex with the  father or brother or best friend.  All I heard especially when I worked with the country.  I was a psychiatrist and I flew from town to town and worked in a variety of cities and different countries. But every person was telling me a sexual story of horrible sadness.

« My other doctors didn’t ask if there was anything that was bothering me, My psychiatrist says he’s just there to give me pills. He didn’t discuss sex or marriage and especially didn’t want to hear about affairs.

« He brings home men from the office to use me. Says he likes to watch. »

« If I don’t sleep with the men he doesn’t sell another car. I like it really. They say women don’t like that sort of thing but I do. I’ve always had a healthy sexual appetite. I don’t think my husband could fulfill it alone . This works. He likes money more and I make him a lot of money. »

« He was my pimp and the father of my children. »

‘The judge told me about her love of sex and role play.’

« She was a Wiccan ,’ she said. She described the orgy with the other naked white witch women and the happy young man.  

« He was in his  twenties and we asked him if he’d help us in our ceremony. Nothing painful. No one would be hurt. There were six of us. That’s the number you know. We all had a go with him. He was a really healthy boy. »

« My husband doesn’t care what I do as long as he’s got his football games.’

« If married women had sex with their husbands there would be no prostitution. Almost all my customers are upstanding men who are married, bringing home the bacon and doing their part but married to these cold bitches who simply don’t care for them. I service them and they think of me like they think of the garbage man. I fulfill my role. The women here know what goes on .  They’re not stupid. A lot of women just see their husbands as dirty little boys they use. »

« I dont know if I’m gay, I told the psychiatrist. I’ve never looked at another man and been interested in him. I’ve never dreamt of sex with a man. I’ve sometimes thought back to that older guy and his friend who fuckd me.  It wasn’t pleasant. I was hungry. I wanted dope. It was only a couple of times. I never went back.  I met Nancy after that and one girl lead to another. I loved sex with women. I masturbated to images of sex with women. I wanted women . I loved women.  But they say if even you have one time with a man it’s just a matter of time.  You’re either / or. »

« Thats’ not true,’ he said.  He discussed the spectrum.  « You’re definitely heterosexual.  My gay patients never think of women. Some men switch like women. I ‘m seeing a woman now whose husband died after 35 years and three children. She has an older lady friend and they’ve become intimate. She doesn’t know what to make of it. But it’s easier for them because no one thinks of two older women living together. Not that a lot of them aren’t lesbian but that’s what they think of men living together. Especially young men. »

I thought a lot about this.  Everything was a default pattern to the sex I knew married.  Married sex in a loving relationship with a woman was unsurpassed in my experience. I’d known years and decades of it. The hierarchy rancher than binary. 

There are many reasons for breaking up. She lost interest in sex. I found that that was what did me in. She just stopped having sex. She might have been having an affair and she said she was always tired. She turned away. She said no. I was rejected another million times by women and now it was my wife. I kept thinking of that study that showed men had been told ‘no’ a thousand times to women being told ‘once’ and how rejection saddened men in the dating world but made women angry.  The psychologist out of California who did the sexual research said, « Feminism is dead. Women simply cannot shoulder the burden of sex that men do. So the species simply can’t perpetrate with women being in charge. They simply won’t take the risk of rejection and want everything their way in the bed room. »

« Did you hear the joke about the two girlfriends at the woman’s sexual palace,’ she said.

« No. »

Freud said jokes were veiled hostility but he wasn’t a very funny man and quite insecure according to his colleagues.  He did accept that humor was a as mature a ‘defence’ or ‘coping strategy’ as ‘altruism’ . His daughter, The brilliant child psychiatrist would go on to write about lines of development.  Some of the early group who worshipped Freud still speculated about what his developmental disorders were. 

« Sometimes the paranoids are right’, he’d say fleeing the Nazi’s. He’d get cancer from smoking his cigar. Horrible mouth and throat cancer. Surgery and pain. The later somatic psychiatrists would speak of Anger and Organ susceptibility.  Those were the years when breast feeding and bottles were an issue. Then there was Abraham who said depression was anger turned inward. The somatic doctors considered much of chronic illness repressed anger . That certainly jived with a lot of stress research.

« The women are dying of breast cancer because the men aren’t fondling them. The men are dying of prostate cancer because their wives aren’t havening sex with them. »  He and his wife were both psychologists and they taught ‘energy flow’.

The facts scientifically were that much of prostate cancer was the same as cervical cancer. Herpes Simplex II STD  virus and too many sexual partners. His argument though was for much more sex with just one partner. They were very much monogamomay proponents.

So many patients told me of their involvement with the Polyamory Society.  This was different from the ‘swinger set’.

By this time I’d seen dozens of transexual assisting them in their process getting tremendous support when I kept them going forward towards surgery and then getting tremendous backlash and stigmatisation when I pointed them the other way to the door.  There was so many politicals in medicine by then. Competing factions. The drug company celebrated the ‘influencer’ and ‘leaders’ who got the most drug sales. No clear association with correct diagnosis or the increasingly criticized ‘morbidity and mortality’ concepts.  The College bureaucrats suggested a paradigm more  like Walmart . 

« Doctors are the service personnel. ». « Remember the customer is always right.’ 

« Your job is to move product. » 

I was castigated when I wouldn’t agree with a child having a sex change. I was all for adults having freedom of choice, that modern technology gave us many options. Luddites continued to criticize everything but cherry picked the clean water and efficient transportation. I wore a dress then. I liked going to church in high heels with red painted nails. We were all part of a society where women dressed as men and men dressed as women and we went out for dinner.  I felt so vulnerable in heels, so unable to run. I couldn’t understand how women had ever allowed men to take away their right to carry a purse gun.  I wore this skirt and had these thin little panties and only thought about being available for sex with my butt pushed out by my heels. 

We talked about this. « « In my lumberjack shirt and jeans and boots I want to swing an axe and mount a woman....the clothes are so defining ».

« Ive said it for years women are transvestites in modern society and men are the ones who are restrained. The man’s suit jacket was developed by the British army as part of their uniform in the 18 hundreds. I’m dressed for daily war and you’re dressed for love making. It’s so unfair.’

We all laughed over dinner and talked of sex changes and hormones. Many of the wives were there.  We played games like seeing who won the fashion contest shopping at Thrift stores without spending more than  $20. I was a wreck.

« You have to come out, » he said. He was my priest and I shared with him my confusion and frustration. 

« What’s more coming out than wearing a dress, make up and high heels. »

« But you’re gay. « 

« I like women. »

‘But gay includes that. It’s us and them. They believe in this one heterosexual myth. Strictly binary. ». 

If that’s the definition then I’m gay but I don’t think that’s very scientific. Political, maybe but not at all scientific. I liked Dr. Bea’s work out of Berkeley. She has men who’d rather die than switch and the women who were the same and that opportunistic middle group which went with the flow. I’m there. I won’t die to be straight or gay. I remember my Christian friend liking that there were other men like him who’d die rather than let anything touch their behinds. What really angered him was when I told him that there were an equal percentage of gay men and gay women who felt the same towards heterosexuality.

« It’s sexual addiction. » he said.  What did God want? That seemed pretty straight forward when it came to procreation but the relational part of sex was not so clear. There was a very good evolutionary argument that sex was fun far before it was functional. Monkeys don’t associate sex with procreation and many not have figured that out till animal husbandry days. But men and women have been doing it since the beginning as well as looking for love in all the wrong places. But we tend to judge others who sin differently than ourselves. 

The monk Ispent time with rejected all attachment.  The Stoics did the same but my philosopher professor friend was an epicurean.  We debated the Greeks once again.

I thought my body didn’t care whose lips were on my penis, male or female, but my mind felt differently.

That’s when I considered all the men and women I’d seen at work who had been into  bestiality. That through another log into the fires of the long discussions of ethics, morality and psychiatry.  As primitive even barbaric cultures move into the scientific modern age almost yanked out of ancient centuries they are trying as hard to pull us back into the dark ages. It is alright to fuck a goat but only if the goat consents. 

« Doctors shouldn’t talk about sex with their patients especially male doctors with female patients. If they insist there may be a reason but it’s best then to refer the patient to the same sex doctor primarily someone who is trained only to deal with sex. It doesn’t matter that there is no such person. It doesn’t matter if the wait list are years. You just must act like a doctor. Nothing is real. You just act like you care. Like I act like I care. The  jaded didn’t know they were jaded, »

A speciality in sexual medicine might be a consideration. « But it’s better not to ask questions about sex. ». No one does anymore and the children are again sexually abused and the darkness descend because the elite don’t care. The kill by neglect, murder by covert aggression. And lies 

He was a pompous fool who brought in sharia trained people to teach the students the proper medical exams . He worked for pharmaceutical companies and governments who had been caught covering up corruption so thick that the stink reeked throughout the valley. He was impervious to change.  Superior in a way that made a human chuckle.  He knew nothing about psychiatry and even less about sex. The money laundering was all he cared about the billions and billions of dirty money and dirty people. He was such a disgusting dirty little boy. Leonard Cohen said he’d be the KY Jelly. 

« Women don’t lie about sex’ his colleague said with a straight face on another occasion. Her divorce from  another physician and her sexual perversity  was common knowledge. A train wreck but always wearing white cotton panties.  The look in her eyes was vacuous. 

« They recruited women who hated men and hated sex. Communists mostly. They have peculiar ideas about sex.  Honey pots and promiscuity.  Engles and Marx were against the family. They fooled around themselves. Like the UN committee on sexual equality chaired by the Saudi Muslims, with not a woman present , and they don’t see a problem with that. They called all of this ‘superego lacunae’ when i was doing analysis.’

I was at the World Congress of Psychiatry talking with the Head of Moscow Psychiatry.  I had painted my nails red.  Men and women psychoanalysts told me how much they liked the color. Bringing the painted nails to the centre of the conversation intrigued, hoping I’d share,  but I just said ‘thank you’ .We talked about what we thought the sexual proclivities were of the present leadership of men and women . 

« We always got together and talked of them as children. « Merkel’s still Stazi ».  « What’s with all the mommy’s boys ? «  « Macron «   

« I don’t know what to make of Trump. He loves women but does he like to get spanked in the bedroom like our British leaders.’ 

 We laughed and it was good to be home among adults away from the asylum of the government and the faculty where they ‘d hired all the perverts who covered up for them.

I’d feel the gay older guy took advantage of me. He certainly drugged me and had sex with me. Just like my female friend did. I didn’t put up much resistance with either of them once my body was in play. A bit like a dog humping furniture. Date rape might be the term today but back then everyone was ‘easy’.  We drank and did drugs and even guys ended up with guys and girls with girls. We joked that if you remembered the 60’s and 70’s you simply weren’t there.  The Kavanaugh public drama was such a lie.  False accusations now running 40%. The « me too » movement as much about Weinstein being Jewish as about his being an obvious pig.  

Ugly men got positions of power and women without money or power exchanged sex for power. It’s there in the Museum of Sex I visited in New York.  I went au femme and I went drab. We read the histories on the wall. The number of species who were ambivalent. The biological record and the record of cultural history. 

I remember defending the Little Sisters costly and painful long running legal battles over censorship. I’ve always been a libertarian, hated the communist dictatorships and other dictatorships. Loved freedom. I thought it wrong that some dirty little political biddy with no sex life of her own, culturally immature, would spend countless nights alone or with her select and special boy and girl friends, perhas her family, deciding what other adults could see. The arrogance. 

I  was  the Youth Representative to Parliament and gave a speech on freedom against communism. Now the slippery slope has begun with hate speech and Islamaphobia.  Homophobia was a lie , just the binary idea of the thing not that gays aren’t persecuted, and it just snowballed .Even antisemetism back fired. A whole new victim industry. The fall of society with half the population accountable while the other half are not and claim entitlement by aneient victimship. Years ago I wrote extensively about the war between the ‘whose up and whose down’ the « one upmanship’ competition of men and the ‘one downmanship competition of women. » male bullies and female bullies.

I have had sex with a woman hundreds of thousands of time and sex with a man a dozen perhaps.  I understood her dilemma when she told me that her lesbian friends were rejecting her saying she wasn’t a lesbian anymore because she hadn’t had a girlfriend in a couple of years. She told me how boring the lesbian commercial drive society had become with who slept with who and who had the youngest. And she just hadn’t found anyone she loved. Her last partner had died after a ten year romance. I remember the lovely lesbian nurses I adored who I worked up north with and had at my home when they came down to the city.  Now here was this patient. Not lesbian ‘enough’. 

The pendulum had swung from gay being illegal in 1968. I’d dressed in a hot mini skirt and made a pilgrimage to Stonewall one night to see the drag show. It was very conservative. I was more outlandish in my space age wig.  I’d had to put together a costume at one store for under a hundred, The American I had in cash.  The young black girl had had a hoot helping me dress for the occasion.  Faces of New York wanted to photograph me. How funny was that.

But then the shift occurred. The mixed result of the Aids epidemic. My San Franciscan Anglican priest friend told me he was at a religious conference as a speaker following his Baptish friend who’d just heard that thered’ been another earthquake in San Francisco.

‘He’d then gone on to blame this on the gays and insist that their sinful life style had caused their the earthquake like it caused their Aids.. »

Hearing this I thought of all the men I’d seen when I served in the aids epidemic who’d got their disease from tainted blood the BC government and Red Cross had given them. I thought too that Aids was a heterosexual disease in the rest of the world and mostly my patients got it sharing needles.  I thought of the babies. I’d gone to courses at the conservative Regent College and the Liberal Vancouver School of Theology specifically to study « how come bad things happen to good people’ . It was what Job, the least taught book of the Bible was about. 

«  I told  my friend that I thought his friends  description of the earthquake and disease science was pretty sketchy. »

He went on to tell me, « I’d called my parish because I’d been concerned and found out everyone was alright. But I simply don’t like this old blaming and shaming holier than thou theology. »

« When I got up right after him, I shared that I was really thankful for my learned friend’s analysis and observations and that I would go back to my parish in San Francisco and Check this out immediately because I’d just called to see if everyone was alright and found out the epicentre of the earthquake was in our convent  nunnery. You can be sure  I’ll be looking into finding out if all these women are really homosexual men fornicating and spreading Aids.  I thought they were really nice and kind chaste ladies and never knew. ‘ 

« The assembly of ministers and priests had collectively not been on the side of witch hunts and blame and shame but  laughed uproariously. Even my Baptistfriend acknowledged I had a point »

« So remember a decade or so ago when if you sucked one cock the heterosexuals kicked you out and the gays took you immediately. » I asked my authoritative gay friend.  He nodded.

« I’ve got this patient who thinks she’s not gay enough so I was wondering now that gay is very much « in » how many cocks does a person have to suck to be gay?’

« None, «  he said. 

« It’s where you shop. » 

Eclectic Therapy -2) Hypnotherapy

I am indeed an "Eclectic Therapist' simply because of all the training and experience in a variety of psychotherapies I've formally and informally learned and applied.  Maybe if I was ever really a great therapist I'd not have to continue learning as I've had  all these years. The fact is I'm fascinated by the human mind and behaviour and the more I actually learn the more I realize how little I actually know.
Having already learned "Counselling" and "Supportive Psychotherapy"  I next learned Hypnotherapy.  I was working as a country general practitioner in southern Manitoba at the time.  I was doing deliveries every couple of weeks and doing minor surgery. I had already learned how to anesthetize every part of the body with a long needle.  The one time I was forced by an emergency to do a high forceps delivery I was very thankful for this knowledge. Otherwise I'd have had to do a caesarian section with spinal block. I hadn't done a spinal block myself though witnessed enough. I'd done countless spinal taps and the block isn't that much more technically difficult, just potentially more lethal.  Anesthetists aren't well appreciated by the public but they are the unsung heros of surgery and obstetrics.  I have thanked my lucky stars many times when I've had the benefit of an anesthetist present.
Despite my basic surgical training and training in intensive care medicine I was  frankly often alone and scared in the backwoods. If I had a competent nurse things were much better. I have the greatest respect and love for some of the old battle axes that helped me in those early years.  In contrast I've had nurses green or incompetent nurses screaming at the sight of blood or fainting in the emergency room. I even had to ask one nurse to leave in a delivery because her fear of childbirth was getting the patient all worked up. When she and her 'textbook knowledge' left this lovely country woman delivered easily a rather big boy.
It was in this context that I learned about hyposis as a therapy for doing medical and dental procedures. I thought that as I was often doing home visits and working in places without an anaesthetist including the country hospital where I was principally located, this 'skill' could be very beneficial.  The Amercan Society of Hypnosis had a 2 level training program taking a matters of weeks to obtain. I read extensively and took the time off work to attend the hands on training workshop and attend the examinations. When I finally got my certification I was amused that I could use the acronym CASH after my name as I truly had obtained a Certificate of the American Society of Hypnosis.  Unfortunately hypnosis never made me any money but it certainly was an eye opener.
ndeed I think all my colleagues should be required to observe surgery done under hypnosis.  It's one thing to know that 90% of pain is processed mentally and another thing to witness something so revolutionary as to see a person being cut open without even local anesthesia.  The fact is I went on to do it when I got back to my practice, electively.  I cut out moles and warts using hypnosis and had a marvellous old time for a while until I found that just using xylocaine 1% took a tenth of the time and was more certain.  It had cost me roughly $10,000 in training and loss of income and then this further experience to have a skill which really was never compensated by the health care system despite it's proven benefit. Nonetheless it sure was fun. Talk about feeling like a wizard.  Gandolf Doctor Hay!
I'd become a certified yogi too with years of formal training, papers from a highly recognised International and American Institution, and even later a trip to India where I studied advanced meditation.  I've even a childhood friend Kirk who I thought at one time had overdosed on yoga and definitely must be a saint. Despite the scientific double blind evidence of the benefits of meditation therapy (see Herbert Benson MD and Relaxation Therapy) and today (Mindfulness Therapy) that too was never compensated or paid for. Another $20,000 to $30,000 training and experience which was never 'supported' by the institutions despite the overwhelming 'evidence' scientifically and otherwise of healing benefit.
I mention this because I can't get over patients expecting doctors to 'learn' alternative therapies and keep up with latest developments in medicine when to do so we have to put out the time and money ourselves and very little except the narrowest areas of study are supported financially.  The cost of all the alternative practitioners even the phd's is minute compared to the expenses we accept to be healers in the modern sense. The richest, most powerful and hence most influential physicians do their basic training and then the minimal level of training to keep up with their 'niche'.  Relatively, I made the most money I ever made as a country gp and lost all my income to do advanced specialist training and never have been compensated for the training or the skills. Indeed I've not even been able to use a third to a half of my most advanced training because there is no support network for the training 25 years later despite the evidence supporting those therapies.  I trained as a psychiatrist with the promise of having hospital beds for the elective admission of patients for therapeutic treatments.  Even when I was a member of a hospital all I was ever able to admit were emergency suicidal or psychotic patietns because of lack of resources.  I'm not alone. Many of my surgical colleagues are trained in advanced surgical approaches but can't get operating room time becasue of the politics of hospitals and most importantly so much of what is proven scientifically and advanced is simply not funded.
Many of my finest colleagues have left the so called 'mainstream' and moved into private areas, some have even left medicine altogether ,to go completely private.  Most of those I knew who went to the US didn't go for money alone but rather they went so they could do procedures which required MRI's.  Canadians simplyt don't know that while Canada was at the height of world medicine 20 years ago Canadians limitted to the public care system are often getting only third world medicine.  Europeans and sometimes even Cubans are appalled by how limited our health care system is. The amount of administration and regulation that has arisen in the last 20 years is eating away all of what was once 'medical' care and now has become 'health' care.  Millions of dollars in 'advertising' are called 'health care' funding and people don't realize that. .
But I was talking about Hypnotherapy.Ooops!
Milton Erickson, MD is the psychiatrist who is the father of hypnotherapy.  He was a midwest American. He said Freud was wrong about the ID.  Jung had said Freud was afraid of the  Id and the 'irrational' as well.  It might have had something to do with Freud's  relationship his wife's sister and the experience of genital mutilation as a child.  Maybe it was just the residual effects of his cocaine abuse.  That said, Freud is still to my mind, perhaps the world's greatest psychotherapist and certainly to psychiatry what Einstein was to Physics.  He was a true adventurer.  I accept that I stand on the shoulders of those who went before and with the knowledge they gave us we can advance but we'd not be where we are were it not for them.  I sail and I see this in navigation and maps without having to listen to the petty political criticism of Columbus mistaking North America for India. If Columbus were a psychologist, boy would he be pilloried today for that. Freud unfortunately went astray when politically he got into the business of empire building.  That said, I save 'reverence' for God and tend to irreverence with myself and my  fellows, a fault that no end of therapy has been unable to eradicate. I can't help but think that Jung and Erickson would have enjoyed Monty Python and Seinfeld more than Freud despite Freud's intellectual support of laughter.  Now Anna Freud on the other hand would have loved even George Castansa and the Canadian Air Farce.
Milton Erickson said that it was the 'unconscious processes' that caused us to 'automatically' protect ourselves when we fell.  We didn't think about putting up our arms to 'block a blow'.  Milton Erickson believed in the 'child' within and felt that we had to 'free' the natural healing process of the human.  Jay Haley wrote the classic "Uncommon Therapy' describing best the work with Milton Erickson.  Though I was fortunate to know and train with Jay Haley and his wife Bianca Jenks I missed meeting Milton Erickson by a year or two when I began training in hypnosis and later in Structural and Strategic Family Therapy and Strategic Therapies in general. I even studied with the original Palo Alto group whose research gave rise to the mind body therapies that produced EMDR for instance.  "Mind Body Therapy" and other "Psychosomatic' therapies were foundational to hypnotherapy.
"Frogs into Princes' by Grinder and Bandler is a marvellous text teaching the basics of inducing a trance. These students of Milton Erickson went on to develop Neurolinguistic Programming which makes alot of Erickson's work more accessible to the lay public.   Milton Erickson was famous for saying everyone could be hypnotised. What he didn't say is that some took seconds to minutes while others could take hours to days.
I feel terribly guilty for not remembering the name of my original hypnosis teacher. He was the most extraordinary doctor whose job it was to hypnotize people for major elective surgery who were allergic to anethesia.  He told amazing stories about hypnotizing people for heart surgery and lung surgery.  Despite having learned and done extensive work using local anesthesia I was still impressed when I met a Russian doctor who'd removed a lung in the Urals because he had no anesthesetist.  This doctor who taught me hypnosis and wrote a classic book about his work   trumped us all.  I witnessed him hypnotise people stick them with needles and their showing no physical or psychological changes.   Having learned hypnosis from him I too went home and cut people under hypnosis was amazed.
Thanks to hypnosis and yoga I even learned the party trick of slowing my heart to where medical students couldn't feel it beating.  Those were halcyon days for learning about the mind and body in the early years of training before learning that the 'powers that be' were simply not interested in anything that was not 'orthodox'. Indeed the medical legal crisis was such that doctors who tried anything new were at the greatest risk for being punished royally. Adding lawyers and administrators to the healing equation guarateed mediocrity would reign.  That said, there have been major gains for all in the development of ethical research policies and advances again can be made but usually only by committee and with large financial funding.  It didn't surprise me to hear of a recent potential cure of cancer going unnoticed in Alberta because there was no likely profit from the development.  Business medicine reigns and with it comes pros and cons.
There are many ways to induce a trance. Later I'd even use amytal to do amytal interviews, injecting what has been called 'truth serum' into the veins of patients and then doing interviews and hypnotherapy with them. Most people who belittle pharmacology do so because they haven't learned it themselves, can't do it and don't have a license to do it.  It's called "cutting the heads off others to make yourself taller."  The "holistic' doctors often would be left with nothing to say if all their criticism of traditional medicine was removed from their repetoire.  And here I'm doing the same.
So hypnosis doesn't require pharmacology.  Hypnosis is done by joining with a person at their unconscious level using ritual and repetition.  It's really easy with children.  I ask a person to stare at something and this wil cause their eyes to tire and their eye lids to droop.  It's classic.  So I begin by using that 'tarot talk' , 'hypnotherapy' ' "mesmer voice' low and slow saying "I am observing you breathing, you are breathing in and out, your eye lids are fluttering and growing tired, you are breathing more slowly now, your eyes are drooping and as I count backwards from 10 to 1 your breathing will grow slower your eyes more tired and you will enter deeper and deeper into a relaxing calming pleasant thoroughly satisfied trance like state where you will be able to hear my voice and respond to my requests or commands but you may not remember anything that we say and do thereafter, I'm beginning now as I observe you breathing in and out, in and out, your eyes more and more tired, 10, 9, you are going deeper and deeper into that semiconscious realm, 8, deeper down deeper into the trance, where you will hear me and we will be able to communicate but your body will be so relaxed that you won't be able to move without my voice helping you 7, deeper now, your breathing in and......out, ....in and out....6, you are getting sleepy but not like sleep going into that twilight state, where you can hear me and respond to me but only as I ask you to where you won't remember what we have said because we will be so tired, 6 5 4 3 2 1....you are hypnotised now and your eyes are closed but your are able to hear me, can you hear me ....etc.

This 'induction of trance' is done in a whole variety of ways. It's used in marketting and advertising and commonly most adults aren't even aware when they are being manipulated and hypnotised.  Everyone should read 1984 and the Animal Farm.  These are dangerous times.  Especially with corporations like Abercrombie and Fitch marketting padded bikinis bras to baby girls.
That said any party animal should be able to hypnotise his friends to be clowns at a party.  What separates the professionals from the amateurs is if the patient lets you cut them open with a knife or tells you in horrifying detail about some memory that is frankly unbecoming and surprising.
The trouble with hypnotherapy is that alot of what one can learn using techniques such as reqression of a patient back through the ages is that for the benefit to be gained this 'unconscious' material must be 'learned' in the conscious.
Freud was probably one of the world's greatest hypnotists and hypnotherapists. His development of the technique of 'free association' and use of a couch was indeed a means of establishing a' partial trance' that faciltated the development of 'insight'.
Many is the time that I learned things about paitent's pasts in hypnotherapy but it did no good for the patient until they were subsequently 'ready' to 'learn' and 'accept' the material.
As every psychoanalyst and every psychoanalytic psychotherapist knows it's all albout the 'timing'.  Of course I know I want to go back in the womb and I want to be on another planet but telling me this is of little value and importance than if you tell me at exactly the right time I need to hear it.
Zen teachers call that the 'aha' moment and frankly amateurs are 'impatient'. I was lucky to have surgical training prior to psychotherapy training because I'd already learned to wait for an abscess to be ripe before cutting it or squeezing it.
Hypnotherapy is also all about association.  Being a poet before  learned hypnotherapy I found it easy to use allegory and metaphors in my work with patients. This allowed me to bring patients to get around 'blocks' without having to address them directly.  A famous Erickson metaphor was when he talked to a woman about growing tomatoes and her fear of sex left her. He never mentioned sex but he did talk about stroking ripe red tomatoes and the tall green stalk.
I don't think I could do hypnotherapy in another culture or as a second language.  Maybe if I was Joseph Conrad I could do hypnotherapy with English speaking people but despite my little knowledge of spanish and french I simply can't imagine doing hypnotherapy outside of my primary language of English and my culture.. I certainly couldn't see myself doing it with a translator. I've not tried but it seems foreign.
I did hypnotherapy extensively for anxiety disorders and mood disorders. Ironically people would want me to do it for quitting smoking and I'd not see it as that effective in that regard. But then in addiction psychaitry I wasn't doing forrmal hypnosis and hypnotherapy.
What I found was that I had to have a therapeutic setting for doing psychoanayltic psychotherapy and especially hypnotherapy.  It's been over a decade since I've had a practice in which I can guarantee that my sessions won't be interrupted by an emergency or in which I can guarantee silence in the room. Indeed most male psychiatrists and female psychiatrists as part of the organized destruction of the therapeutic process hardly feel safe with their door closed. Most doctors would like a lawyer in their office for all patients. And most doctors simply won't discuss sex or ask about sexual matters because of the risk of false accusation, or as is more often the case down right 'extortion'.
More pateints also have a 'secondary gain' issue when they see the doctor in a public setting. Their insurance company needs a report and often my role is 'illness recorder'.  In the mental health teams the psychiatrist is often told they're only there to prescribe and indeed if a psychiatrist does anything more than prescribe he or she will make less money.  I am paid most for recording illness and I can face severe penalties if I 'confront' a patient.  Indeed whereas 'confronting' illness was what we were trained to do in medicine, telling a person they have cancer, I found increasingly I was told that patients shouldn't be told anything they don't want to hear or they can 'sue' you.  We used to mock 'feelgood' medicine likening the valium prescriber and hand holding counsellor to the pusher and masseuse.  Now here we are terribly afraid of saying anything that might upset a patient for fear they might complain. Family physicians actually sometimes refer patients to me rather than tell them an unsavoury diagnosis for fear of retaliation.
I heard one doctor afraid of telling his patient he had cancer because he was afraid this very 'litiginous' patient would blame them.  The stress that doctors work under just going to work and making diagnosis is such that many colleagues have taken to calling everything 'bipolar II" because it's a diagnosis which actually has no clear specificity and if anyone doubts it the doctor can say its because the patient 'rapidly cycled'.  Epidemiologically there's been epidemics of 'bipolar II " diagnosis breaking out everywhere without the World Health Organization even investigating it. It's terribly infectious to say the least.  The most cowardly of doctors and lowest of doctors flee the frontlines of patient contact and hide in administrative office or worse police doctors acting out their own unresolved 'identification with the aggressors'.
The only treatment I've read for Bipolar II is pharmacalogical.
A pharmacalogical psychiatrist can see 6 to 10 patients in an hour billing for visits every 5 to 10 minutes whereas a hypnotherapist takes usually an hour and a half.  The provincial plans pay at most for 50 minutes of therapy wiht any one patient but will pay ad infinitum for 5 minute visits weekly ad infinitum. The richest most relaxed and satisfied of pscyhiatrists are the pharmacological psychiatrists.  Their frequent trips to Hawaii  providing by drug companies revive them.
Psychotherapists don't make anyone any money and the payment for psychotherapy is the least that a doctor can receive despite the fact that psychoanylitic pscyhotherapy and hypnotherapies and couple and family therapies are the most intensive of work.
So I don't do much hypnotherapy.  As I've got older I've learned that I'm stupider than alot of my colleagues. Rather than criticize them for doing those things that are remunerated I've come to realize that the 'market system' repays those things that people want.  I get great satisfaction personally from alot of the successes that I've had as a result of my training and the exdellent teachers I've had. I use the lessons of  hypnotherapy in my day to day language and in the way I talk to patients and do therapy itself.
One of my favourite hypnotherapy techniques is to 'seed' conversations and by 'story telling'.  I talk about 'irrelevant' matters and 'seed' this material with whatever it is I'm 'selling " the patient.  So I may talk about my dog and comment on how the young are constantly exercising. It's no surprise that all my obese patients have heard these stories but none of my athletic patients would hear about my dogs constant exercise.  I tell a story about a patient who recoverd from cancer giving up smoking and indirectly I'm telling my patient who I've already told to stop smoking because of her cancer, to stop smoking in another way.  I never do 'nocebos'. I never undermine a person's work on their wellness or suggest they can't.
I've dozens of students in my practice whose grades have gone any where from failing to passing or from c's to A's and I take that as evidence of the effectiveness of therapy.  Naturally I have all manner of psychiatric disorders improve or get better but take even more pleasure in seein my patients with somatic illnesses and addictions get better because these have more obvious 'markers' for the success of the interventions I'm using.  Some of my patients are just living a lot longer than their doctors predicted and I like that too. I actually take great pleasure in my patients getting better and leaving practice where I had a locally famous pharmacological psychiatrist say his patients never got better and always had to see him. He didn't see any irony in this because frankly he's a fairly stupid rich thug and gives pharmacalogical psychiatry a bad name by his barbarianism.
These days I enjoy working with addicts and take every success to heart because the life expectance of a downtown eastside addict is maybe 30 years of age or so.  I love seeing alcoholics and addicts achieve sobriety or needle users get off needles.
Alot of my work with somatic illness is to get patients otherwise dying to adhere to their medical regimen. I work with some of the finest endocrinologists, cardiologists, neurologists, gastorenterologists and internists who every once in a while phone me and tell me that they realize that their patient is alive and following medical regimen since seeing me and that before that they didn't think they were going to live out the year. I am blessed to work with some of the finest of family physicians as well and so often together with a motley team of community resources manage the most difficult of patients watching them go from the dregs of life to whatever passes for normal living.
I had alot of fun working with a pediatric endocrinologist getting teen agers to accept their diabetes and take their insulin. She was great to work with and together we had tremendous succes with this really tough crowd.  Overdoses and diabetic catastrophes literally stopped the year we worked together.
Trauma interests me now. When I worked with the military and police what  I learned in hypnotherapy helped me walk people through the trauma that had given rise to often chronic ptsd.  It's one thing to remember but remembering can re traumatize. So how one does this is really tricky and I enjoyed honing my skills with these amazing heros of our society.  I loved having them tell me their nightmares were gone but mostly I had a great deal of fun working with a military captain and his secretary who truly loved the vets who had been in the front lines. Often these were the ones who were most stoic and least likely to talk about their experinces. This beautiful captain doctor would send these amazing men to me and over time they'd tell me stories that I was truly priviledged to hear, often stories that had never been told.  Not only would Veteran Affairs be able to help these individuals then but also we could get psychologists trained specifically in the treatment of ptds to help these folk regain their lost lives.
Oh well, that's about all I'm going to say about hypnotherapy.  I did regress a guy in hypnotherapy once by saying "I want you to go back to when you were happy' and he told me he was surrounded by blue and felt warm and there was this loud comforting drum beating.  He was back in the womb.  He had chronic depression and never had a happy day in his life as far as I could see so my task went from restoring a sick man to health to teaching a blind man to see. All the failed therapies he'd had hadn't taken into acount that he simply had nothing to build on.  Hypnotherapy certainly helped him.  His telling me he actually felt what he understood to be happy one day, really did make my day.

Couples Therapy 4

Marriage Enhancement is commonly a weekend workshop put on by churches or synagogues or temples. It wasn't developed as a 'religious' workshop but was picked up by the religious organizations because the premise of marriage enhancement is that marriages are best and that couples benefit from help keeping them together. The exact opposite of a marriage enhancement coordinator would be the divorce lawyer.  In these workshops, often a one day session though some go on in evenings over a few weeks,  newly married and long term married folk, mix and discuss issues,  share stories, and play some couple games.  By all accounts of those I've referred to these, the experience has been fun,  entertaining, inspirational and helped the couple improve their marriages. The cost of these workshops is kept low.  They are for the married people who want to stay married but would like to know how to do marriage better.
Virginia Satir was one of the earliest leaders in Couples Therapy. Indeed her name is often synonymous with Communication Therapy for Couples.Her writings are an excellent resource for training in the 'communication school' of therapy.  Her books  include actual written tracts of therapy with the words of Virginia indicating the therapists 'take' or response.  They are easily accessible and serve as excellent training manuals. I trained with Virginia Satir and love her work.  Unfortunately I have  found that most couples who come to see me in my referral psychiatric practice aren't  ready for "communication therapy'.  Couples who I've seen in the last few years have often consulted a divorce lawyer or are on the verge of breakup when I've been able to suggest alternatives.  I think it's best that there is  a 'ceasefire' in place for Virginia Satir's 'communication theory' to work.   Higher functioning couples do well with this approach and couples once they are no longer committed to killing their partner benefit greatly from this work. PD Seminars on Gabriola Island for many years held workshops for counsellors to learn the basic techniques which could help couples who were committed to relationships and wanted to learn resolution strategies.
"Structural Family Therapy" taught by the likes of Minuchin was a well established therapy for couples and families. There's a lot of scientific research and specific training for doing this advanced form of therapy which has a high likelihood of helping couples stay together when they are on the verge of separation.
Milton Erickson, MD, psychiatrist,  was the father of American Hypnosis.  He is the founder of the school of therapy called "Strategic Therapy".  This was studied by Cameron in Canada and found to be clearly an evidence based for of therapy which required fairly advanced training.  Jay Haley wrote the book "Uncommon Therapy" describing some of Erickson's cases and how he addressed couples with difficulties. The Ericksonian Foundation continues in Phoenix and every few years has an amazing workshop which looks at all the varieties of therapy used for couples and individuals which have derived from the 'interventionist' approach which originally was behind hypnotic therapies but has expanded to encompass the Palo Alto school and other 'change' therapies.  The idea isn't laissez faire but rather there is an agreed outcome and various forms of therapy and homework and exercises are given to achieve the desired outcome.  Paradoxical intervention, reframing, sympton suggestion, psychodrama techniques are all employed.
The Love Lab is a recent successful therapeutic approach for couples. The techniques utilized by therapists have resulted in 80% success rates for couples staying together after therapy is initiated. This evidence based approach and utilization of a variety of therapy approaches from previous schools of therapy is excellent. The weakness from a scientific point of view is that it is predominantly a 'business model' which markets it's work in a modern way with only limitted availability of the actual workshop content for general perusal.  In contrast Satir and Erickson shared their material fully without any issues of 'copywrite' so that those who are more inclined to 'share ware' approaches have objected to the cost of training and materials. On the other hand the outcome success of this model argues that commonly higher costs are associated with sometimes higher quality products.  What is available to review certainly supports the validity of this approach and I strongly recommend people go to the "Love Lab" site and read the material that is posted there as well as the books which are truly inspirational.
Alot of material is now available which can be said to optimize couples functioning.  Transactional Analysis, mediation therapies, communications couples therapies, Structural and strategic therapies, Ericksonian models, all have strong evidence based results.  The difficulty is finding adequately trained therapist.  To this end it's really useful to ask ahead and review the experience and training of the person doing the therapy.
Having a phd in Psychology might mean that a person is a specialist in mice behaviour. A clinical psychologist however is a person with a phd who has worked with patients.  A psychiatrist may have gone to a school which trained them predominantly in psychopharmacology whereas other psychiatrists are trained in both psychopharmacology and psychotherapy. However many psychiatric psychotherapists and psychological psychotherapists have never been formally trained in couples therapy. Social workers have had a major contribution to the field of couples therapy given that couples therapy is more a 'sociological' external phenomena than internal 'psychological' phenomena.  Clearly a social worker who has specialized in couples therapy would be more desirable than a counsellor with limitted experience. More and more too ministers and priests have recognised that their training in pastoral counselling can be coupled with formal couples therapy to result in a stronger basis for therapeutic intervention than might a person coming from an 'insight' based therapeutic background.