SHRINK TALK, THE DOCTOR IS IN

 Ego integrity versus despair is the eighth and final stage of Erik Erikson's stage theory of psychosocial development. This stage begins at approximately age 65 and ends at death. ... Individuals who reflect on their life and regret not achieving their goals will experience feelings of bitterness and despair.

According to Erikson,achieving a sense of integrity means fully accepting oneself and coming to terms with death. Accepting responsibility for your life and being able to undo the past and achieve satisfaction with one’s self is essential. The inability to do this results in a feeling of despair.

It is with this in  mind that I talk about the following. I was 26 years old, starting my psychiatric residency. I always wanted to know about people. I was fascinated by it. Psychiatry was not a job for me, it was a love and a passion. I had started my psychotherapy training, where we were assigned therapy patients, and a supervisor. I was always to tape our therapy sessions and every week, go through the session, with my supervisor. 

I had a patient, that was in the Vietnam war, and since coming back to the states, had trouble re connecting with life, friends, relatives and others. It turned out that he had lost his entire platoon, and was the only survivor of his company. (I have changed all the names, so no one can identify him)  And I must state, i discussed this fully with my supervisor, before i even attempted any of this, and we went through different options and variations and scenarios, before I even attempted any of this.  But i was still very nervous and anxious. My supervisor, was a tough taskmaster, who demanded perfection. She was very passionate about our Vets, and not only demanded perfection, but expected this of herself. 

So Ben, my patient came on his regularly scheduled therapy day, entered the room. I immediately said, “quite, get down, enemy at .....and i stated the coordinates of  their position, as Ben had explained all this to me in many previous sessions. I had turned a VA desk, an old heavy metal desk on its side, and was behind it. I pushed Ben down on the floor, behind the desk, and told him, the coordinates, where we had taken enemy fire. I had already turned down the lights. This was an attack at night. Ben sat down with me, and for the next 45 or 50 min, we took turns saying good bye to all of his group. We discussed in detail, all of his friends, and i knew, where all of his company was, during the attack. Each one, we said, our good byes too. There were many tears that day. It was one of the most emotional experiences I have ever had. But I didn’t realize this at the time. I was young, naive, and very inexperienced. I remember i went through that session, always trying to separate the emotion, from the actual facts of the experience. Because thats what psychotherapy is, separating the emotion from the experience, in hope that one may resolve an unresolved emotional conflict.  I so desperately wanted this for Ben.

Afterwards, I reviewed this session with my supervisor, and we went through it. I will always remember the smile, Dr. V gave me when we were done. 

I never saw Ben again. I often think about Ben and what he has accomplished since that time. I always felt he was destined for greatness. With integrity versus despair, this one is for you, Ben. 

I have always loved the Olympics. I love the competition, and seeing these young athletes compete against the best of the best. And i love hearing the stories behind the scenes too. For example, Michael Phelps, the most famous American swimmer ever , in his last race to take  home the gold medal, when he entered the water, his glasses flogged up so badly, he was unable to see, so he swam by rote, by memory. He had done this so so many times, he counted his strokes and then did his under water turn, not knowing where he was, and swam home to victory. Now if that isn’t greatness, i dont know what is. Credit to him and his coach, and his family for support!

Well Japan is getting set to host the Olympics on July 23, 2021. During this horrific pandemic. With covid rates surging in the world, (India and people still dying of this infectious disease).  However, Japan has a number of things going to them. They have contained Covid 19 far better than most other large countries. In fact, an amazing statistic, Japan’s over all death rate has decreased, thats right, decreased for the year 2020, even with the Covid pandemic. That’s amazing.  They are a nation, that is used to wearing of masks, and the Government closed their borders very early on. However, to balance that,  currently only 2% of the population has received the vaccine. And they are wanting everyone age 65 and over to be fully vaccinated by July 23, 2021. I dont know if that will happen. 

Even if that happens, though, Japan will not be free of risk. After months of allowing few international visitors, the country will be letting in tens of thousands of people. They will then interact with nearly 80,000 local Olympic volunteers, who will drive athletes and officials around Tokyo, serve as interpreters and do other tasks. A Covid-free Olympics seems unlikely. The question will be whether Japan can quickly identify, isolate and treat people who get the virus.
In this way, the Games may present a particularly intense version of the balance that many countries will be trying to achieve in 2021 — moving back to normal life while avoiding a new wave of a deadly virus.

GOOD LUCK TO ALL OF THE ATHLETES 

I wanted to add more and give you the latest definition of DSM-5 with regards to PTSD. DSM-5 is the latest classification, and how psychiatry defines mental health conditions. 

The condition lasts at least 1 month and result from experiencing actual or threatened death, serious injury, or sexual violence as manifested by at least one of the following: 

*directly experiencing or witnessing a traumatic event(s)

*becoming aware of close friends or family members suffering a traumatic events)

*repeated exposure to aversive aspects of traumatic events

INTRUSION SYMPTOMS:

Presence of at least one of the following after experiencing traumatic event(s):

*recurring distressing memories of the event

*frequent nightmares involving the traumatic event(s)

*flashback that may be accompanied by dissociative reactions as if the individual were reliving the traumatic event(s)

*intense reactive distress when in the presence of cues that serve as reminders of the traumatic event(s).

AVOIDANCE SYMPTOMS:  Chronic avoidance behaviors beginning after occurrence of traumatic events(s). As manifested by at least one of the following: attempts to avoid distressing thoughts, feelings or memories reminiscent of the traumatic event(s): avoidance of external stimuli that may serve as reminder of the traumatic event(s).

NEGATIVE MOOD :  Negative transformations of mood or thought related to the traumatic event(s), with onset after the event transpired, and manifested by at least two of the following:

*dissociative amnesia—inability to remember details of the traumatic event(s)

*chronic and exceedingly negative attitudes and expectations about oneself, others, or surroundings

*self blame, or blame others due to chronic inaccurate thoughts about the cause of effect of traumatic events)

*chronic negative feelings

*loss of interest in significant activities 

*Alienation from others 

*chronic inability to experience a positive emotion or feeling

AROUSAL SYMPTOMS. Significant changes in sensitivity to traumatic event(s) starting or worsening after the traumatic event(s) as indicated by at least two of the following:

*unprovoked irritability and temper tantrums 

*irresponsible self-destructive activities 

*hypervigilance 

*heightened startle reaction

*difficulty in focusing and concentrating 

*disrupted sleep patterns

Each person’s potential PTSD may be unique and different but you must have these signs and symptoms to be diagnosed with PTSD.

Hope this helps, a bit more.  Knowledge is power. 

• Rob 

Post Traumatic Stress Disorder (PTSD) is a mental disorder in which the person has difficulty recovering after experiencing or witnessing a terrifying event. This can be emotional, physical or sexual abuse, accidents, war and other natural disasters. The condition may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions. 

PTSD is very common. There are more than 3 million U.S. cases per year.  In general, people experience flashbacks , hyper vigilance(become super sensitive to their surroundings),  panic attacks and insomnia. Additionally many people with PTSD often develop other signs and symptoms of depression and/or anxiety.

 It is important to note, that not everyone who has experienced a traumatic event will develop symptoms of PTSD. Even if your immediate reaction and response was extreme, this does not necessarily lead to PTSD. It is perfectly normal to have an intense reaction to a potentially traumatic event and not develop PTSD. Research HAS NOT SHOWN which brains lead to PTSD and which brains do not, and why. Please go back and re read this last statement. There is nothing you could have done to prevent or cause this from happening. We do not know the reason. Please stop blaming yourself for this unfortunate occurrence. However, research has shown if one does experience a traumatic event, to keep them up. Do not allow them to fall asleep. Sleep, somehow, solidifies these intense events and emotions and “preserves” these emotions, allowing PTSD to possibly develop.

There is help and treatment. The combined use of psychotherapy and medication, (usually an SSRI) have been successful in alleviating many of the PTSD symptoms.  Please see your doctor for an evaluation. There are also some pretty good self assessment tests online. I do not have one in particular in mind, so i will just refer you to the internet. Pick one. 

Lastly, I want to mention, what i hear pretty frequently, masochistic women and perhaps others, often state, they enjoy the pain, because it calms the thoughts and feelings and anxieties. I have often wondered if these are PTSD symptoms. I am not here to judge, and the Cage is an accepting group of people, that I am proud to be a part of. I do not know. But I am here to help.  I am writing this blog to further educate and possible help anyone in distress. 

Happy kinking my friends

Rob

I want to tell you a true story.

This young man, wanted to go to medical school, so badly, but his grades were just fair. So he applied, was turned down, the first year, and he got another degree, i cant remember, what it was, a master in pharmacy, but something to do with medicine, he improved himself, and then he applied again, got turned down. It’s hard to get into medical school, so he improved himself again, got his masters in something else, then applied again, a 3rd time, got turned down, then got another masters degree in something, applied again, but this time, he went to the house of the Dean of Admissions, and sat at his door step the entire night. When the dean walked out, to go to work the next day, he found Joe sitting on his porch step. He asked joe , what he was doing? And joe said, “sir, with all due respect, i want to become a doctor and will do anything to get in, so please tell me , what i need to do to get in. I will do it. The dean shook his head,  and said, Joe, your grades are not good enough, and i dont know if you would be able to make it through medical school.”  Joe stood tall, and faced the Dean,  and looked him , right in to the eyes, and said, “i dont know either, but i want that chance to find out”.  The Dean shook his head, and and walked off to work. Joe applied again, and got in.

The moral of the story, follow your passion to wherever it takes you. 

Thank you for your service” is what i always say when meeting or talking to someone who has been in the service, and put his or her life on the line to defend our country. And now, i must add, an additional group of people who have defended our country currently along with the people of the armed services. They are all AMERICA’S HEROS, NOW AND FOREVER.   I am speaking of the many thousands of people who have help combat covid 19 during this pandemic. The front line of defense, the unsung hero’s, who have worked tirelessly , day after day, weekend after weekend. The many doctors, nurses and others who were sleeping in their cars after their shifts so they didn’t bring home to their families,  whatever this was. At the beginning, we didn’t know what this was, only that it was highly infectious, and very deadly. 

Now these heros are leaving medicine. It is a shame and a very sad thing indeed. The Washington Post reports, 

“An exodus from the medical profession is underway, as doctors, nurses and other health-care workers experience trauma, burnout and disillusionment. About 3 in 10 workers have considered leaving the profession, according to a new Washington Post-Kaiser Family Foundation poll, and more than half report burnout. 

“Most of us got into this to save lives. But when death is blowing around you like a tornado and you can’t make a dent in any of it, it makes you question whether you’re making any difference,” a night-shift nurse in Dallas told The Post.”

I hope and pray for time and patience. I hope these people can retain some sense of balance and structure and peace. I ask G-D for help with this. There is no second best in medicine, you must be at the top of your game, always, every minute of every waking hour.  I know their thoughts, i ask and pray for time to heal. My heart and gratitude goes out to these American Heros. This country owes you and our fighting men a debt of gratitude of which I will never be able to re pay.  I humbly salute you all!

I have heard this comment from so many submissives, that i want to write about it. It goes something like this, “i wont ever show you my littleness until there is complete trust” or “I am afraid of showing you who i really am, and who i want to be”.  Or, “I will never show my Dom these things because I know they are viewed as derogatory and people will judge me badly and poorly for it. My friends will leave me, if they knew the real me” 

   To that, I say , F. Them, if they knew the real you, and they judged you like that, and then left you. Good riddance. They are not the real friends that you need, want and crave. Make new ones, make real friends, who will love and care for you, no matter what. These people are what you need. And if you go about life, waiting for the trust to develop before you reveal to your significant people, who you really are, then you will be waiting forever. Waiting for Gadot.  It will never come,

Be yourself, be kind and caring,  and as long as you are not hurting anyone ,  then i dont see the harm in revealing your true self. It will set you free and give you such feelings of self confidence and love, and happiness.  Trust me, i am the doctor!!!!!

“Thank you for your service” is what i always say when meeting or talking to someone who has been in the service, and given his or her life to defend our country. And now, i must add, an additional group of people who have defended our country currently along with the people of the armed services. They are all AMERICA’S HEROS, NOW AND FOREVER.   I am speaking of the many thousands of people who have help combat covid 19 during this pandemic. The front line of defense, the unsung hero’s, who have worked tirelessly , day after day, weekend after weekend. The many doctors and nurses who were sleeping in their cars after their shifts so they didn’t bring home to their families,  whatever this was. At the beginning, we didn’t know what this was, only that it was highly infectious, and very deadly. 

Now these heros are leaving medicine. It is a shame and a very sad thing indeed. The Washington Post reports, 

“An exodus from the medical profession is underway, as doctors, nurses and other health-care workers experience trauma, burnout and disillusionment. About 3 in 10 workers have considered leaving the profession, according to a new Washington Post-Kaiser Family Foundation poll, and more than half report burnout. 

“Most of us got into this to save lives. But when death is blowing around you like a tornado and you can’t make a dent in any of it, it makes you question whether you’re making any difference,” a night-shift nurse in Dallas told The Post.”

i hope and pray for time and patience. I hope these people can retain some sense of balance and structure and peace. I ask G-D for help with this. There is no second best in medicine, you must be at the top of your game, always, every minute of every waking hour.  I know their thoughts, i ask and pray for time to heal. My heart and gratitude goes out to these American Heros. This country owes you and our fighting men a debt of gratitude of which I will never be able to re pay.  I humbly salute you all!

Crisis averted, in fact, there was no crisis, i cant believe she duped me.  Now, she just txted me, saying, guess what day it is today......April 1, April fool’s day, 

i cant believe i fell for this, my apologies my cage friends.  Now i need to go spank her, royally

i hang my head in shame.  

I want to add more information about Covid 19. My friend, who has been vaccinated twice, so she fully has been dosed, started having fever, chills, n/v,  and body aches on Monday. On Tuesday, she started losing her taste and tested positive for Covid. She is a nurse, so she is very familiar with procedures.

She is not doing well, her oxygen is down to 90% in her blood, normal is 97-98%, this is bad. This is an indication for hospitalization, which she is desperate to avoid. Oxygen has been ordered to her home. 

Apparently this has been happening around the nation, 102 people in Washington have contacted covid, even though they have been inoculated. PLEASE TAKE THIS SERIOUSLY, my cage friends. This is real, this is serious, and this is not going away, anytime soon. 

MASK UP, KEEP VIGILANT AND please pray for my friend.  I am asking for your prayers and support.

Many thanks,

Rob