Holiday Greetings: What if Jesus was Gay?

"What if Jesus was gay? Would you still be afraid? Would you torture and tease? Would you open your mind? Would you make him cry? Would you beat him the alley? Would you tell him to burn and rot?"

This little gem of a song, by Bryan McPherson, was recorded at Club Passim in Cambridge around the time same-sex marriage became legal in the Commonwealth on May 17, 2004. It's worth a listen this holiday season.

In listening to Bryan's song, I can't help but to think about how so many people make the conscious effort to bring hate and sorrow into the world. The choice of how are you are in this world is totally up to you.

Everything can be taken from a man or a woman but one thing: the last of human freedoms to choose one's attitude in any given set of circumstances, to choose one's own way. 

-- Viktor Frankl

Choose wisely.

Happy Holidays.

Bauhaus, More than a Band: Gropius House

Not too far away from my undisclosed location in the Merrimack Valley is the Gropius House. Built in 1937 by Walter Gropius, he and his family lived in the Lincoln Massachusetts home while he was on faculty at Harvard. Mrs. Gropius lived in the Bauhaus style home until her death in 1983. Two years later the house, now a national landmark, is open for public tours.

For more about the The Bauhaus, click here or here.

For more about the band Bauhaus (totally unrelated to Gropius), click here. 

Interested in visiting? Open year round, tour times vary by season. Visit Historic New England for more information.

Gropius House Peephole

Gropius House

Glass Block

Gropius House: Sky View

What Brand is Your Therapist: On Commodification of Change

Ever so often a rash of articles appears in popular media about the demise of psychotherapy. I generally treat those articles as just that: a rash that requires some sort of cream. Don't get me wrong, however, because I do think the field as a whole has a significant amount of work to do in remaining relevant, powerful, and important in the human growth, development, and change process. Articles like this aren't helping this nurturing of a strong and relevant field.  People who do "naked therapy" don't help either. I digress...

Illustration by Matt Dorfman. Photograph by Jens Mortensen for The New York Times.

This morning a piece in the New York Times has been making the rounds. What Brand Is Your Therapist: Psychotherapy's Image Problems Pushes Some Therapists to Become Brands is the latest in a history of these sorts of rashes. The author, Lori Gottlieb, bemoans the difficulty of starting a private psychotherapy practice. She writes, "after I completed six years of graduate school and internship training and was about to start my psychotherapy practice [I discovered that] nobody taught me in grad school that psychotherapy, a practice that had sustained itself for more than a century, is losing its customers."

Gottlieb continues on with very tired advice about branding, developing a marketing message, and selling a niche product that customers cannot do without. Bothered by troublesome ethical codes that prevent making promises and money back guarantees? Call yourself a coach and do whatever you please.

What Gottlieb walks away from is a long (and admittedly troubled) history of the psychotheraputic enterprise of human growth, development, and change within the context of a relationship. She encourages the marketing of quick fixes and soundbites that soothe the ego but do little to nurture more complete human beings.

All this is good fodder for future blog posts. What is important here comes from a close friend and colleague of mine. She emailed me the New York Times piece with some background information on Lori Gottlieb.

What Gottlieb doesn't point out in her article is that she is right out of school. She spent six long years earning a masters degree in marriage and family therapy (note: it is generally a two year degree). Gottlieb is, in fact, so right out of school that she is still collecting the post-graduation hours of supervised practice that she is required to have before she can be independently licensed.

IMF No. 64034, Employed & Supervised by Lori Grapes, Psy.D. License No. 29050

Of course she didn't have a thriving private practice. She is just starting out.

I don't know Gottlieb. I don't know her background, her skills, or her qualifications.What I do know is this: I am growing increasingly concerned about the commodification of psychotherapy. Slowly consultants and branding experts, out to make a buck, have been repackaging the psychotheraputic enterprise into a sexy sleek product that--similar to Twinkies--offers little actual value.

What do you think? What is the purpose of psychotherapy? Join in and have a dialogue here on my blog or on Twitter.

Autumn Updates: Magnolia Wigglesworth Edition

It's been awhile since I've connected my camera to my computer. I know this because I tried to shoot a few images yesterday and discovered the memory card was completely full.

Maggie, of course, got a significant amount of outdoor time. She finds the crunchy autumn leaves particularly wonderful. I think they hold the scent of whatever passed through them particularly well. She's been known to sniff each and every leaf in a pile--and of course leave a message of her own.

Of course there also was myriad opportunities for investigating wildlife in Cambridge. We attempted to visit out the urban chickens at least once a week and scout out a turkey daily.

The turkeys became very enticing. We caught this video outside in the grounds of the American Academy of Arts and Sciences. What didn't get filmed was the turkey sneaking up on Maggie while she wasn't looking. As soon as she noticed the results were rather predictable.

Maggie found the remnants of hurricane Sandy rather distressing. She elected to stay inside until conditions improved.



And of course there were the car rides. While it is terribly unsafe for a puppy to hang her head out the window, occasionally Maggie can't resist taking in the scents. We were coming back from a hike at an undisclosed location in the Merrimack River Valley in this shot.

Maggie also had ample opportunity to frolic around her favorite fields near our home in an undisclosed location in the Merrimack River Valley. Here she is engaged in the quintessential hound activity: sniffing.

...and her Maggie is nearly looking at the camera.

..and finally we get a look at the camera. Of course she is in motion so it's blurry. I call this area we are at "tick city" because, well, it's infested with ticks. It's off limits to me and Maggie from spring until the first frost because neither of us get out without at least a few ticks on us. All year long she looks longingly at the path that leads up to tick city. This was her first visit to the area since last spring.

What does one do while at tick city? Wiggle, of course. There is a reason why she is called Magnolia Wigglesworth. This image to the right suggestions one reason for her name.

Dear Republican Friends

Dear Republican Friends:

 I have been reading your Facebook updates, tweets, and blogs post-election. I have considered responding sometimes. It seems much more efficient to say this once.

Mitt Romney didn't lose the election because he ran a bad campaign, or because there were not enough young republicans who voted, or because of voter fraud. Romney lost because he offered too many losing ideas. The GOP ran a campaign of with a narrative of being against people. They ran an election with small minded candidates with small ideas.

What does this mean?

The GOP offered a losing world view, a losing platform that positioned itself against people rather than for people. Against gay and lesbian people. Against women. Against sexuality. Against Muslims. Against immigrants. Against science. Against knowledge. Against our environment. Against.

Against me.

A political party cannot win without coalitions of people. How many groups do the GOP have to run against before there is no one left?

I read some of your comments and am deeply saddened that you cannot see how much of the world the GOP has excluded. I am deeply saddened to see how many you have excluded and walked away from people who are different than you. While you might not overtly be doing this, your support of a platform that alienates and is against anything different is a rejection of the majority of your community.

You've rejected me.

Americans are not all Evangelical Christians. Americans are not all Christian. It disturbs me to see that some think we all share an Evangelical belief--and some think that is the only faith that there should be.

I know. The Bible says to spread the good news. I don't believe there is any instructions to spread that good news by being hateful and exclusionary. I believe the good news is supposed to be spread by embracing the other with love & compassion.

Engage me here, if you'd like. Defriend me or block me if you'd like. Whatever you do, I hope you spend some time thinking about how you might fight for people more, rather than fight against them.

e pluribus unum

The Opal: Alpina

From Shorpy

Yesterday I read a blurb about annual festivals at the Utica Asylum in Janet Miron's book Prisons, Asylums, and the Public: Institutional Visiting in the Nineteenth Century. I wanted to learn a little bit more about those festivals. That's how I found this image which dates from the 1890s. From there, one click followed another and before I knew it I had entered into the Google rabbit hole. I came back up with The Opal. 

The Opal was published in the 1850s by the New York Lunatic Asylum in Utica. Only two of the ten volumes appear to be available online. The others are locked up in various libraries. I've unleashed my irreverent librarian network to see if I might acquire access to these other volumes. 

Benjamin Reiss writes that the patients at the asylum were given "unusual, but not unprecedented, platform to address the public. The Opal, the patients’ literary journal, grew out of a school for patients run by the doctors; its first issue in 1850 was pen-printed and distributed only within the asylum. The next issues were sold at an asylum fair, and by 1851, the journal was published on the asylum’s printing press" 

The journal, of course, doesn't present a complete view of patient life at the asylum. Reiss points out that the journal "was an outlet only for those patients whose voices were deemed appropriate; even then, those voices only partially captured the experiences and thoughts of the authors, who always had to self-censor in order to find their way into print."

So let's take a peek inside volume II of The Opal. First published in 1852, my digitized copy is 382 pages and comprises of twelve monthly installments. The periodical, as described on the opening page to the right, is "Devoted to Usefulness" and "Edited By The Patients." 

I wonder what use the volume has 160 years later? I'm more than a little excited to read through the text and see who reaches out from the past and tells us something interesting about ourselves today.

As I read along I'm going to track themes that I'm thinking about. They'll appear in my commentary in bold. See a theme that I miss or think I've got something wrong? Leave a comment--this might turn into something larger than an occasional blog post. Your help is appreciated.

First up is Alpina: A Tale of Switzerland. Our anonymous author writes seven pages of prose that takes us on a journey from her home in Switzerland, to her passage to America by sea, to her eventual marriage and settlement in Indiana. 

I've selected a few passages that stand out to me. 

"Alpina herself entered her Father's and Mother's apartment, with a fresh unction on her soul, and kneeling at the bed-side of her inebriated parent, poured fourth in convulsive sobs, half stifled ejaculations, for his restoration to reason and duty." 

The facts of the author of Alpina are undoubtedly lost to history. We'll assume the author wrote some sort of fiction that was inspired by lived experience. There are two things that stand out to me in this particular passage: (1) the author makes mention of childhood complications that have an effect on later life development and (2) the theme of restoration to a state of sanity (described as reason and duty).

"Refinement of manners is always agreeable, and this young and only daughter was the idol of a fond parent. She never told her grief for his debasement, but let concealment, like a worm in the bad, feed on her damask cheek  and unlike the custom of the world, she never intimated that her Father was an inebriate, or told him how wretched he was."

Our author again speaks to childhood complications and adds a new dimension to their experience: silence. I wonder why the author decided, unlike the custom of the world, to keep silent about the alcoholism and wretchedness of Alpina's father.

"Educated as she was to prefer others, to bring herself to the wishes of others, and to seek their best good and usefulness, she lent her ear to sorrow in its every form, and gave her heart to sympathies, and her actions to engagements that tend to woo. No reproof, nor innuendoes, let a suspicion in those whom she sought to ameliorate, but with every look of love, and every smile of sweetness  and each embrace she gave her parent it seemed as if an angel girded him around--and her kisses and tears (a lady's most powerful battery,) divested him of that rudeness he had acquired by associations with the reckless and the unprincipled."

Here our author gives some suggestions on their views of the roles of women. That role was one of limited power. Alpinia appears to have few tools of agency at her disposal: tears and kisses.

Alpina's father emigrated to the United States first and settled on a homestead in Indiana  "So soon as possible after he had made his home in order, he sent to the Counsel at Basle to convey with all despatch (sic) his wife and daughter to his adopted country.... Being the worst sailors in the world, they suffered very much from the illness generally attendant to ship board novices. Alpina and the little children recovered from their serious illness, but the mother sickened and died. Here was the outbreaking of Alpina's mental aberrations, for her gentle spirit could not broke so many sorrows, and she bent and snapped--a tender plant,--which the winds and storms had visited too roughly. As Alpina gazed at the form of her lifeless Mother, she was mute, her grief was too deep, she could not realize her loss. So powerful was her attachment, that all she heard or saw was only a part of the loved object that was motionless in death."

Themes here of grief and etiology of mental illness. The author also hints that emotions (grief, in this passage) can cause a loss of agency.

"Painful indeed it was, to see her approach the dear one in her grave dress  and that grave to be the bottomless Sea. But she did come up to the last kiss, embrace and farewell--and old salt, all bathed in tears, caught her up in his arms, and let her kiss the clay-cold lips of her Mother. Poor Alphina!--Poor Alpina! She was dumb with emotion, and loneliness -and felt the luxury of grief oozing out of her living soul--awhile after the sad ceremonials."

Here our author touches on themes about emotions (grief) and death.

"On arriving at their destined port, Alpina was placed in one of those blessings to mankind, named Asylums, where under the care of its Physician, she became soothed and restored."

Here we have our first mention of an asylum. The author suggests that an asylum is a place for caring for ones emotions (soothing) as well as restoration. I wonder if our author really found restoration at the asylum? Perhaps so, or, perhaps the author was trying to curry favor with a physician and was saying what needed to be said to be released.

"Would that all were as grateful as Alpina Swartz, for that restoration to health, induced by the skill, science and humanity of an Asylum, and as she glided over the splendid "high ways and by ways," to her new home in the far west, her countenance, manner and intelligence bespoke an interest in her behalf that words could not express."

Now the author here had not yet been released from the asylum. This passage perhaps represents a hope for the future--being released from the asylum, traveling far away, and being reunited with their family. Note here the reference to agency--here described as a self-interest.

"The hour of grief is the hour for love, and Alpina was deeply sympathized with by a kind young hoosier who had entered Justice Swartz's office to become a lawyer. And he won upon her affections; always together, their union was inseparable, and they were permitted to join hearts and hands--and live as members of the same family on Earth,--hoping to meet a dear departed mother in Heaven."

The story of Alpina ends with marriage. A hope to be cared for someone in the future in a loving way, and a hope to be reconnected once again with her dead mother in heaven. Also more reference here to the theme of emotions.

That's it for the Opal for now. Come back later for more.

If Your Colors Were Like My Dreams

My mother likes email. It's almost a condition.

Seriously. It appears that she spends several hours each and every day carefully curating her collection of incoming e-mail. Mom crafts mailing lists of people with similar interests and sends out a daily dispatch of information that people might like to know. I even have my own category: of interest to you.

So the other day in my daily dispatch I received this petition.

My son Ryan has been a Boy Scout since he was 6 years old, and now, a few days before his 18th birthday, he has fulfilled all the requirements to be an Eagle Scout. But because Ryan recently came out to his friends and family as gay, leaders from our local Boy Scout troop say they won't approve Ryan's Eagle award.

None of this is surprising as the Boy Scouts have reaffirmed their anti-gay policies over and over and over and over and over and over and over and over and over and over again. Preventing Ryan from becoming an Eagle Scout is consistent with their stated policy. It shouldn't come as a surprise to both Ryan and his mother that this has happened.

This blog post, however, isn't really about the Boy Scouts or Ryan Andersen. The email from my mother transported me back to Zellers Elementary School. 

In either fifth or sixth grade music class we had to research a band we liked and give a presentation about that band. Classmates picked the popular bands of the time. Unbeknownst to me, it was important to pick the right kind of popular bands. Liking certain kinds of music in my school allowed you to fit in with the crowd and be considered likable. I recall presentations about Quiet Riot, Journey, and Def Leppard. That's what the in-crowed liked (or at least pretended to like).

Being a young iconoclast and being totally unlike the other boys, I took the road less traveled. I never picked the things that were popular in school. It was like everyone except me received a popularity decoder ring.

I was enthralled with British and Euro-Pop music in grade school. This was not a "cool kid" approved preference. As you might imagine, I took some flack for my presentation on Boy George in my rather conservative suburban elementary school in Strongsville Ohio. I even took flack from my teachers.

Mr. Smith sporting some short-shorts.

At some point in sixth grade, my classroom teacher Joe Smith and music teacher Eric Richardson, called my parents in for a special conference. They were concerned that I wasn't like the other boys. Too sensitive, they said. When pressed by my parents about what too sensitive means, they explained they were concerned that I might be gay. "When he gets to middle school he will be eaten alive by the other boys."


"Have him join the Boy Scouts," they implored my parents. "It'll toughen him up."

Smart thinking, eh? He might be gay. Change who he is. That'll work. Not once did it occur to these men that I might need to be nurtured and protected. Not once did it occur to them I might need to be equipped with skills at managing bullying. Nope. Just change him. That'll fix the problem.

I wasn't at the meeting. My parents, as I am told, unleashed their own particular brand of wrath upon these teachers. There was always one thing that was clear with my parents: there was always space to be exactly who I was. Getting in the way of my process of self-discovery wasn't a wise thing for an educator to do. My parents ate those sorts of educators alive.

To this day, I think those two men trying to impose a certain way of being a young man upon me was the most heinous and grievous act of violence that educators have ever perpetrated upon me. Rather than support me, encourage me, and protect me in my own process of growth and discovery, they attempted to shame and guilt me into being someone other than who I was.

Of course, they didn't really know who I was. They just had a feeling that whoever I was, wasn't the right kind of boy to be.

They wanted to give me that popularity decoder ring. Be like the other boys. Fit in. Conform.

In a way, Smith and Richardson were right. I was eaten alive in junior high. Those three years were some of the most unpleasant years of my life. I also wouldn't have had it any other way. In the midst of the horror show known as junior high, I found some real educators who nurtured, encouraged, and protected me. I can think of three teachers who helped give me another kind of decoder ring: the kind that eventually helped me discover who I am.

There is nothing more powerful than dreaming and living in the colors of  my own dreams. I needed Smith and Richardson to see me, give me the tools to be me, and create a protected place so I could grow into that man. I didn't need them to tell me who to be.

If they could see me now they'd probably still want me to be someone other than who I am. Rather than eat them alive, I think I might like to put on a top hat and sing this:

Extraordinary Escapes of a Lunatic

Sunday March 4, 1860 -- "This day, a lunatic, named Wheedon, was caught and taken back to the Northern Ohio lunatic Asylum from which he had escaped. The Cleveland (Ohio) "Herald" gives the following strange account of him and his escapes. it says:--

Among the inmates of the Northern Ohio Lunatic-Asylum is a person named Wheedon, once a highly-respectable citizen in good circumstances, and said to have been a member of the former coal-firm of I.C. Pendleton & Co. He has been in the asylum for some time.

For some time past he has manifested a strong disposition to escape, and the utmost care and vigilance have been exercised to frustrate his designs, but not always with success. Before being places in his sleeping-room at night, he has always been stripped and carefully examined, to prevent the secreting of any instrument, and all his clothes, but his shirt, pantaloons, and stockings, taken away In spite of these precautions, he has succeeded three times within a few days in escaping from his room.

About two weeks since, he took a set of false teeth out of his mouth, and, by constant work, contrived with them to saw a hole through the floor of his chamber, sufficient to admit of his dropping through into another part of the house, and then escaping. He was traced and caught at the house of Mr. Pendleton, on Euclid Street.

A few days since he secreted a pin, and with that exceedingly unlikely instrument managed to pick the lock of his door and escaped into the hall, where he was fortunately arrested. He then stated that a pin was of more value than ten thousand dollars when he wished to escape from a room.

Last Saturday night he was carefully examined, as usual, before being placed in his room, but succeeded in secreting a small brass ring, split at one part, in his hair. On being locked up for the night, he set to work, and, with the ring, he cut through the window-sash and shutter, so as to enable him to remove them from the window. He then took the coverlet of the bed and tore it into strips, with which he made a rope reaching nearly to the ground,--a distance of some twenty-five or thirty feet. Some of the cotton batting with which the coverlet was wadded, he placed in his stockings, to protect his feet, as he had no shoes. Then, dressing himself in shirt trousers , and stockings, he slid down the rope and escaped.

Striking across the country to Eight Mile Lock, he then took a two-path of the canal and walked to University Heights, where he arrived yesterday afternoon. The officers of the asylum on his track came on him yesterday (Sunday) afternoon. he was very quiet when arrested and spoke freely of his escape, and made no resistance to being taken back to the asylum. We question whether this series of extraordinary escapes can be well matched."

I find it interesting that poor Wheedon, a former employee of  I.C. Pendleton & Company, was so desperate to escape from the Northern Ohio Lunatic Asylum. Even more interesting, why did Wheedon escape the asylum and head to Mr Pendleton's house? Was this the owner of his former company? Was Wheedon's ingenuity based in some paranoid or delusional process about Mr. Pendleton? Was he tossed into the asylum to hide some sort of wrong doing and an irate Wheedon kept trying to escape to find justice?

Give a moment of your time to Wheedon and wonder what the nature of his stay at the asylum was all about. While the facts of the story are likely forever lost, the people who lived and died within the walls of America's asylums are important. There voices help us understand who we were, where where were, and where we are going.

For more about the Northern Ohio Lunatic Asylum click here.

Everything Goes Black: Then Comes Hope

The New Asylums

Some time ago I wrote a blog post about my first trip to an asylum. A regular reader of my blog posted a comment. In part, she wrote:

This is tragically unfortunate because instead of creating a healing environment hospitals create a feeling within patients that they are merely being housed until released. At least this has been my experience with crisis stabilization units. I was literally dumped out into a side parking lot after one release because the tech didn't have time to walk me up to the front of the building!

Many of us would like to think we've come a long way from the abuses of the past. I remain unconvinced. There are myriad experiences like my blog reader shared. Mental health care can be excellent with those with significant financial resources. It can be horrific and neglectful for the middle class and the poor.

Some might think the most horrific images of neglect and abuse may mostly be a thing of the past in psychiatric institutions. They really aren't in the past. We have, as society, just managed to find another way to neglect those who are most vulnerable. Several years back the PBS program Frontline did an excellent documentary on prisoners with mental illness. They suggested--both in images and words--that prisons have become the new asylums.

There are nearly 500,000 mentally ill being held in jails and prisons throughout America. That's ten times the 50,000 that remain in psychiatric hospitals. 

If you don't have time to watch all these clips, just make sure you fast forward to the group therapy scene that starts at 6:25 in clip one. The horrors for those of our neighbors with mental illness have just moved to a new venue: prisons.

For more about asylums click here, here, here, here, here, here, here, here, here, here, or here.

Our Universe Gets Smaller

The Kepler Project, launched in 2009, has discovered 2,299 planets (and counting). I love this graphic view of what has been found. We have started to learn how to look at our vast universe to discover just how much is still out there to discover.

Click here for more. For more about the creator of the video, check out Alex Harrison Parker.

Worlds: The Kepler Planet Candidates from Alex Parker on Vimeo.

In the House of Dementia Love and Compassion

Northern Ohio Lunatic Asylum

Hawthornden State Hospital

A couple of years ago I wrote a blog entry about my first visit to a state run psychiatric facility. It was a harrowing experience that continues to influence my work as a psychologist in complex ways.

Recently someone left a comment on my original blog post. Shuko raised some interesting questions that I want to answer in more detail. That will have to wait for a future blog post since I've managed to get distracted (imagine that!). While you are waiting, check out Shuko's blog here. She has a great way of exploring the history around us in both images and words.

I visited Western Reserve Psychiatric Hospital every two weeks when I was a 23 year old case manager. The hospital has gone by several different names including Hawthornden State Hospital, Western Reserve Psychiatric Habilitation Center, and currently operates under the name Northcoast Behavioral Healthcare.

That's a whole lot of names. What surprises me is that there isn't a lot of information available on the internet about this hospital. It's especially surprising that the hospital hasn't been subject to any significant historical research. It seems that one of the precursors to Northcoast Behavioral Health Care found its way into a national magazine. The article was called Bedlam, 1946 and discussed the Northern Ohio Lunatic Asylum. We'll explore the Bedlam of Cleveland in a minute.

Here is an aerial view of Northcoast Behavioral Health (aka Hawthronden, aka Western Reserve Psychiatric Center) as it looks now.

Google Maps

Let's go back in time. The Ohio Department of Mental Health makes a single reference to the Hawthornden State Hospital. They write:

Hawthornden State Hospital, later known as Western Reserve Psychiatric Habilitation Center, operated as a farm for Cleveland State Hospital from 1922 until 1938. It was established as a separate facility in 1941. 

That's not a lot of information. The blurb however gives me an important clue. The property got its start as a farm for the Cleveland State Hospital. This means our first stop in exploring the history is a field trip.

Fenn College field trip, Special Collections, Cleveland State University Library 

It just so happens that in researching the Cleveland State Hospital, the first image I came across was an abnormal psychology class taking a field trip in 1946. Look at those eager young faces peering into a model of the brain and marveling at it's structure--and perhaps wondering what separated them from the patients in the asylum. Do you think as part of their field trip that they got to meet actual patients? I wonder what these young students thought about as they encountered those who were removed from society and kept for treatment in an asylum.

I also wonder if any of them were aware of the abuses that were going on at the hospital they were visiting. This class visited the same year that Life magazine published the article Bedlam, 1946. Look at the pictures in the article. The broken and abused people being "cared" for by the hospital in 1946 are far removed from the fresh faced college students pictured above.

The View From Here: Welcome to the Almshouse Edition

Can't you just imagine horse drawn carriages and early cars dropping off future inmates, patients, and residents of the Tewksbury Almshouse?

Pictured to the left is the Old Administration Building. Built in 1894, this building first accepted inmates to the Tewksbury Almshouse. The Public Health Museum notes that the name of the hospital changes over the years reflecting a change in mission as well as a change in how people were cared for. The facility was renamed Tewksbury State Hospital in 1909 and Tewksbury State Hospital and Infirmary in 1938. It has cared for paupers, pauper insane, alcoholics, and people with illnesses such as tuberculosis, smallpox, sexually transmitted illnesses, and typhoid. Currently, the facility goes by the name of Tewksbury Hospital. It provides acute and chronic hospital level of care for medical patients with Huntington's Disease, HIV/AIDS, and those in need of neurological rehabilitation. Additionally, the facility also provides psychiatric  treatment for adults over the age of 19 with serious mental illnesses that require the security of a locked unit.

Something I'm currently investigating: other institutions of the time include: State Colony for the Insane, Industrial School and Home for Crippled and Deformed Children; and North Reading State Sanatorium, and the Medfield Insane Asylum. It was a different era and the way we talked about and named conditions that people had were very different than our customs today. It seems incongruent that Tewksbury would be named a hospital while other institutions of the era were asylums and colonies for the insane. I suspect somewhere along the line some well-meaning local historians have altered the names of the institution to make it sound 'nicer'.

For more of my explorations of the Tewksbury Almshouse see here, here, and here. For more about my trips to the Medfield Asylum click here, here, here, and here. If you'd like to read about my very first trip to an asylum click here.

The View From Here: Almshouse Edition

This tower fascinates me. I'm convinced that there is a history waiting behind this shell of copper and glass. Perhaps a few scraps of paper telling a secret of a former inmate of the almshouse--or maybe some graffiti carved by a patient when this building housed an insane asylum?

As a side note, I've been somewhat obsessed by old graffiti since discovering a face drawn on a wall at Ellis Island by someone waiting to be processed for entry into the United States. By obsessed I mean I've thought about it from time to time and hope someone might point me to some historical graffiti since I'm not often wandering across it on my own.

Anyway.

I've not yet had a chance to venture into this building. Parts of it are open to the public on a limited basis for tours. This building, the old administration building of the Tewksbury Almshouse, now houses a Public Health Museum. Peeking in the windows I saw a veritable cornucopia of treasures to look at, think about, and use to illuminate how we have cared for those most in need in past eras.

For now, I'll have to settle for pictures. In the late 1890s, the Commonwealth went about building sturdier structures at the Tewksbury Almshouse. The main administration building, a Queen Anne style building, was completed in 1894.

For more images of the Almshouse check here and here. To see images of another asylum built in this same style during this era, see my blog posts about the Medfield Asylum here, here, here, and here.

Linen isn't Frivolous: A Lot of Materials Are

When is the last time you thought about where your clothes were grown? A few clicks this morning brought be to a blog that had this wonderful video from France about linen. The video is promotional material for flax--and linen fabric--made in Europe. It definitely made me want to go out and buy some of this fabric to have a little piece of nature with me and around me.

"I think that linen is rather like wood. There's a structure. It's a living material."

BE LINEN MOVIE IN ENGLISH from Linen and hemp community on Vimeo.

The View From Here: Patients Downstairs Edition

Earlier this summer I spent a couple of days wandering around the Tewksbury Almshouse. First opened on May 1, 1854, the almshouse offered care for those in society most likely to be ignored and thrown away--paupers, insane people with no financial resources, and people who were disabled. One of the more famous residents of the Tewksbury Almshouse was Annie Sullivan, the teacher of Helen Keller.

This sign, near the imposing front door of the main administration building, points potential patients down to a nondescript door. While I'm processing what I saw on my trips and doing more research, I'll be posting some of the images that I took.

Check out The Field of Dreams, which is the first of the images I posted from the Almshouse.

The View From Here: Morning Reflection Edition

The View From Here: Summer Sampler Edition

There is a veritable cornucopia of images captured this summer that are lurking in my computer. Here are some of my favorite. Enjoy the view! What have you seen this summer?

Harvard Square, Cambridge Massachusetts

Marblehead Massachusetts

Marblehead Massachusetts

Marblehead Massachusetts

Peabody Essex Museum, Salem Massachusetts

Peabody Essex Museum, Salem Massachusetts

Boston Commons, Boston Massachusetts

Public Gardens, Boston Massachusetts

Commonwealth Avenue, Boston Massachusetts

Public Gardens, Boston Massachusetts

The Potential Dog Poisoning Misanthrope of Cambridge

Some time ago Maggie the therapy dog and I were taking an afternoon walk through Cambridge. An elderly man, perhaps 80, was walking around in house slippers with black polyester socks on that were pulled up past the hem of his bathrobe. He shuffled down the sidewalk with a plastic bag in hand. The sight of him made me want to cross the street and get away. I felt uncomfortable at the sight of his decaying and disheveled appearance. I also wondered if he was naked under that bathrobe. I wasn't mentally prepared for a flasher.

I couldn't get away fast enough. He asked if he could give Maggie a treat. Hand coming out of his plastic shopping bag, he produced a large sized Milk-Bone. Maggie sat down, tail wagging and eyes making excited contact with the elderly gentleman. Maggie loves treats.

I had just read an article about dogs being poisoned by treats left out on a sidewalk. I was a worried pet-parent. What if he was a crazy deranged dog poisoning misanthrope? I said no thank you, tugged Maggie a bit, and kept on walking. Just as I was starting to feel smug in my self-empowered confident "no" skills I saw the man's face. 

He said to me "Really? It's just a bone." His face, formerly lit up by Maggie's excited eye contact, fell back into a decaying sadness.

My smug pride was tempered by sadness. Not by my actions, mind you, but by a world in which we have to worry about people poisoning dogs.

I ran into the man again just yesterday. He saw us and came shuffling down the sidewalk. While he didn't appear to remember us, I remembered him. He was wearing the same tattered robe. The same style of black polyester socks. The same house slippers. I was again caught off guard by the potential dog poisoning misanthrope of Cambridge.

Again he asked if he could give Maggie a Milk-Bone. I remembered the stories of dogs dead from poisoned treats. I also remembered how his face fell into a lonely distant sadness when I declined his treat the last time. 

Maggie and he locked into an eager gaze and time seemed to stop for a moment. 

A loving dog wagging her tail, an elderly decaying man brandishing a potentially poisoned Milk-Bone, and an anxious psychologist. For a moment I saw everything clearly. My own irrational fears about things that haven't happened. The ugly world we live in were acts of violence happen. My lack of control over those random acts of violence. My own revulsion at the sight of the decaying lonely man who reminded me of my own process of decay.

Perhaps at that very moment a Buddha, living on a dust mote, passed in front of my eyes. There was a moment of enlightenment (don't worry, it'll quickly pass). The thought occurred to me that I have an infinite number of choices that I can make in that moment. Some lead to more happiness, others lead to more misery.  

Great, dust mote Buddha. Give me the right choice. Time can't stand still for much longer.

Buddha of course didn't have a single damned answer for me. He blew away and time started moving again. Both Maggie and the decaying man looked at me. 

He asked "Can I?" 

Maggie gave me an expectant hungry look. The tip of her tail thumped on the sidewalk.

"She's sometimes a little anxious when strangers put their hands near her," I said. "This is very kind of you. Perhaps you can give it to me, and I can give it to her?"

I wanted to make a choice that lead to more happiness and less misery for all involved. Buddha still wasn't helping me out. Now I had a potentially poisoned Milk-Bone in my hand. Would I somehow instantly drop dead? This isn't what I had in mind with the less misery  more happiness thing.

I turned the Milk-Bone over in my hand looking at it. The decaying man said, "Well I've got to go. I just came out to wait for the mailman and saw you two. I wanted to say hi." With that he turned around and shuffled away from me. The potential poison dispenser was slipped into my pocket and we discreetly walked away from the elderly gentleman who was smiling and whistling.

It all worked out.

Thank you, Buddha of the dust mote, for giving me that moment to see clearly that I could choose more happiness or more misery. The first time I met the decaying man I brought violence into the world. I hurt him while trying to protect Maggie. Yesterday I made a different choice. 

I hope you come to see you have that choice too.

_____
Update 8/26/2012

This blog post received some interesting interactions on Twitter. I thought I'd post a three of them here.

I'm not particularly proud of the fact that my first reactions when encountering this elderly gentleman was fear and revulsion. However, this is my true reaction and I think when engaged in self-reflection being truthful is important. We all have parts of ourselves we don't like. I'm reminded today that when any of us engage in public self-reflection of our own shadow-selves we also provide a mirror for other people to see the reflections of their own shadow.

I'm curious if you all find this to be true. When you watch me--or someone else--look at their shadow do you see parts of yourself that are difficult to see? Do you look away? Do you push back and try to denigrate the person who is reflecting? What do you think?

The View From Here: Empowerment Edition

The View From Here: Farm Share Faces Edition

New Techniques in Psychotherapy: 1940s Edition

Well isn't this a precious video clip? Here we are, back in the 1940s, when humanity was discovering new ways to talk about our behavior that includes an understanding about how were once were effects  how we currently act.

We also get this fabulously delicious line: "Now tell me about your mother."

Confidentiality and the Unthinkable: Murder

Perhaps you've been in therapy at some point in your life. Your therapist--whether they be a psychologist, social worker, psychiatrist, mental health counselor, or marriage and family counselor--should have notified you about the nature and limits of your confidentiality.

I've been thinking about this a lot recently. The news report instantly got my attention. Anderson Cooper reported that a notebook that was mailed to a psychiatrist at the University of Colorado was handed over to the police. That notebook, made by the alleged killer James Holmes, detailed his plans for the murders in Aurora Colorado. More news has since come forward. The psychiatrist, Dr. Lynne Fenton, treated James Holmes for schizophrenia. He was at one point, her patient.

We don't know the nature of that treatment. We don't know how the journal was released to the authorities. Unnamed sources. That's what the news reports say. Unnamed sources leaked information that James Holmes was treated for schizophrenia and sent his psychiatrist a notebook that contained stick figure drawings of his plans for the massacre that left twelve dead and 58 wounded.

What is the nature and limits of confidentiality in psychotherapy? Here is what I tell each and every patient that walks into my office. I'm not a lawyer. Keep that in mind. This is my best understanding of the laws that govern my practice as a licensed psychologist in the Commonwealth of Massachusetts. The laws don't differ much from state to state.

What you say here, stays here. It is important to me that you know that this. As a licensed psychologist the things we talk about remain confidential except under very specific circumstances. I want to spend some time talking about this and I'd like you to spend some time asking me questions. Confidentiality means that I cannot and will not talk to other people about you and our work except under very specific circumstances that I will explain. This means your husband, wife, partner, friend, parents, or police can't call me up and ask about you. If they do, I say I cannot confirm or deny knowing you. As soon as I get a call like this, I will contact you and tell you. If you are under 18, your parents can ask about you, and have a right to know what we are talking about. If you are over 16 and under 18, you can tell me not to talk to your parents and I would have to respect your wishes. However, your parents still have the right to inspect your medical records.

That is the basics of confidentiality. I don't ever reveal information, except in certain special circumstances, about my patients. It is the beginning of a special relationship where a patient can talk about whatever they wish. Their fantasies, their fears, their hopes, their traumas, their crimes, and their crimes against others. I listen. I don't talk to other people about it. Without this basic trust no patient would ever feel safe exposing the contents of their minds, hearts, and souls.

Psychologists have a duty to protect people from abuse. This is what I say:

Here are the limits of confidentiality. It's important that you know them. I do not want you to find yourself in a situation where you talk about something and then have unexpected consequences because I have to take action. We can talk about this as much and as often as you'd like. You can ask me hypothetical questions should you want to know what I'd do in particular kinds of circumstances. If you talk about and identify a child under the age of 18 that is being abused, anyone over the age of 60 that is being abused, and anyone, of any age, that has a disability that  is being abused, I will have to break your confidentiality. It is important that you understand that if you identify the person being abused, or I can reasonably ascertain their identify from what I know about you, I will have to break your confidentiality and protect that person.

Psychologists have a duty to protect patients from committing suicide. This is part of what I say:

The second circumstance when I would have to break your confidentiality is if I have reason to believe you will kill yourself. This doesn't mean that I will immediately hospitalize you if you talk about having a dark night of the soul, or wonder what it would be like to not be alive. Many people talk about suicide and contemplate their own deaths. Many people are also chronically suicidal and do not require hospitalization. We can talk a lot about this, what this means and what it doesn't, and we'll work together to make sure you can talk openly about any feelings you have about suicide while also making sure you are safe.

Psychologists have a duty to warn and protect intended victims of homicide. This is what I say:

The last circumstance when I would have to break your confidentiality is if you are planning to kill someone. Often times people say "Oh my boss, I could just kill him." I understand that is a figure of speech. You wouldn't be hospitalized for that. However, should you have planned and and have intention to commit murder and you tell me about it, and you identify your intended victim or victims, I will have to take every action at my disposal to protect you from committing this crime and protect your intended victim. This likely means I will attempt to have you secured in a psychiatric hospital. If I cannot do this, I am required to warn your intended victims and am required to warn the police.

Think of what would have happened should that journal Holmes made was been found before the crime was committed. Lives could be saved. Traumas could be prevented. Dark Night Rising would be about Batman, not about murder. Our  movie theaters could feel safe.

None of this, of course, will ever happen. Nothing will undo the murder of twelve people and injuries of 58 others. Nothing can undo what has already happened.

Had Dr. Fenton had knowledge of the intended crime before it happened, she would have had an affirmative duty to protect and warn. We do not know what Dr. Fenton knew, and when she knew it. We only know that Holmes was in treatment at some point in time, and that a journal detailed the crimes arrived at the University of Colorado at some point in time.

What does a psychologist do when a patient has already murdered someone? What if the unthinkable happens and a patient of mine walks into my office, sits down on the couch, and confesses to a murder?

I cover this in my first session with patients.

If you murder someone, and then tell me about it, I believe that I cannot break your confidentiality. You need to understand that. I would have a lot of questions for you. We would talk about what you did, and how you want to move forward in making the right choices. This would be very difficult for me, however, your confidentiality would remain and it is my understanding that I would not be able to turn you in to the authorities. Any other crime you might be involved in, as long as it doesn't involve planning murder or the abuse of a child, person over 60, or a person with a disability, is not something that I can tell other people about. 

How could someone get my records? That's covered in the first appointment, too.

Your records are confidential, as is the contents of anything we talk about inside this room. If you give me permission to release information about you to someone, and we agree it is in your best interest, I will do that. I will release information without your permission if you are a risk to self, risk to others, disclose abuse that I am mandated to report, or if your decision making is impaired based on the symptoms of a mental illness. Short of that, I would need a court order from a judge to release information. Am not required to hand over medical records based on a warrant or a subpoena. 

I also share with patients how I break confidentiality in these circumstances. There is a specific and progressive order of steps that I take that escalate until I either am assured the individual is safe or I have progressively exhausted all means I have available to protect an individual.

So why am I writing about this? I believe I have no business, as a  member of the public, knowing that James Holmes was in treatment for schizophrenia. I believe I have no business knowing that he wrote a journal in which he detailed his plans for the murders.

As difficult and as unpopular as this might be, if I was his psychologist, I believe I would have the responsibility to hold onto this confidentiality and not release the journal or any information about his treatment until such time as I was served with a court order. 

Somewhere, somehow, Holmes lost his confidentiality. I think it was wrong that this happened. He had already committed the alleged crimes. There was no duty to warn or protect, therefore no ethical or legal reason to disclose the journal or information about his treatment.

There was every reason to protect his confidentiality. Not because of Holmes, mind you. We needed to do a better job of protecting Holmes' confidentiality because of everyone else that ever enters into a therapeutic relationship.

My work starts with a promise. I promise to keep your confidentiality and hold your secrets. I promise to do my best to keep you safe. I promise to keep those around you safe. This breach of confidentiality (whether a failure of the doctor, the university, a mail clerk, a student assistant at the health center...) makes every patient, everywhere, a little more afraid to reveal the contents of their minds, hearts, and souls to the professionals they entrust with their secrets. 

That promise, the most important promise of the therapeutic enterprise, was broken.

____
Updates

As I find specific information for licensed individuals in various jurisdictions I'll add them here.

Ohio 

(G) Divisions (A) and (D) of this section do not require disclosure of information, when any of the following applies:

(1) The information is privileged by reason of the relationship between attorney and client; doctor and patient; licensed psychologist or licensed school psychologist and client; member of the clergy, rabbi, minister, or priest and any person communicating information confidentially to the member of the clergy, rabbi, minister, or priest for a religious counseling purpose of a professional character; husband and wife; or a communications assistant and those who are a party to a telecommunications relay service call.

(5) Disclosure would amount to revealing information acquired by the actor in the course of the actor's duties in connection with a bona fide program of treatment or services for drug dependent persons or persons in danger of drug dependence, which program is maintained or conducted by a hospital, clinic, person, agency, or organization certified pursuant to section 3793.06 of the Revised Code.

(6) Disclosure would amount to revealing information acquired by the actor in the course of the actor's duties in connection with a bona fide program for providing counseling services to victims of crimes that are violations of section 2907.02 or 2907.05 of the Revised Code or to victims of felonious sexual penetration in violation of former section 2907.12 of the Revised Code. As used in this division, "counseling services" include services provided in an informal setting by a person who, by education or experience, is competent to provide those services.