Monday, December 30, 2013

Back from vacation

Sorry I haven't posted anything for the past couple of weeks; I took some time off of work (and responsibility).  I thought about posting on several occasions over the past two weeks but I couldn't seem to muster enough motivation.  This was the longest consecutive period of time I've had off of work since the end of 2008.  It was actually a bit disorienting.  I found myself forgetting to do little things that I typically incorporate into my daily routine.  Without the routine they simply slipped my mind.  There was no damage done; I eventually got around to doing everything I needed to do.  It just made me realize that work has become the structure for my life around which everything else is organized.  Without work, I sleep in every day.  The earliest I start to become productive is around 10:00 AM.  If I have the option to be lazy - even if it's for five minutes - I almost always seize the opportunity.  I waste hours and hours doing things with absolutely no productive value whatsoever.   Because my regular sleep cycle is thrown off my body is confused; I feel lethargic when I need energy and have energy when it's time to go to bed.  

I do a little better when I have things planned.  If I know I have to be somewhere at a certain time I can structure my day around it.  I know what I want to get done that day so I have to give myself enough time to do it before I have to be wherever it is I have obligated myself to be. 

I initially felt a bit guilty about how little I accomplished during my two week vacation.  Then I decided not to worry about it.  It was, after all, a vacation.  You're supposed to spend your time relaxing.  While I can live with a little chaos for a couple of weeks I could not live my life this way.  At first I thought it was about work.  I thought to myself, "I can never quit working.  I would be a complete mess!"  Later I realized it isn't about work at all; it's about structure.  I need structure in my life in order to thrive.  Without it I become lazy, disorganized, and unproductive.  I feel lost. 

This isn't really a novel realization; I long ago embraced the comfort of a good routine.  It's just that being without structure for a couple of weeks really reiterated this point for me.  I sometimes wish I could be the kind of person who "goes with the flow."  I'd love to be more fluid and flexible.  I know I'm too rigid - I'm just not sure how to be another way. 

Wednesday, December 11, 2013

"Baby Bust"

In case you haven't heard, the United States is currently in the midst of a "Baby Bust."  The birth rate in America has been declining for more than a decade.  According to Stewart Friedman, author of "Baby Bust: New Choices for Men and Women in Work and Family," the national birth rate in 2011 fell below "replacement" level.  This means Americans are not reproducing fast enough to maintain our current population level. 

People are concerned about this trend.  There are, of course, existential worries about the survival of our species.  However, with 6 billion people on our planet homo sapiens are probably in little danger of extinction, at least for the foreseeable future. 

Dr. Stuart Bramhall ( thinks interest in the so called "Baby Bust" is driven by something nearer and dearer to our hearts: money.  Capitalism, he explains, relies on growth.  Success in a capitalist society requires perpetual economic growth.  Economic growth is fueled by population growth.  If the population stops growing so does the economy. 

While Dr. Bramhall makes an interesting argument, I'm not convinced there's a vast capitalist conspiracy to keep American women having babies.  If that were the case, both the private and public sector would adopt policies and practices that make it easier for people to work while raising a family.  Instead, we have extremely expensive child care, schools that let out at 2 or 3 PM - in the middle of a typical nine to five workday - forcing parents to figure out what to do with their children for the two or three hourse after school lets out, and outrageously expensive health care (which is costly at the individual level and becomes financially burdensome at the family level).  Paid maternity or paternity leave is practically unheard of.   For these reasons and others it has become increasingly difficult to balance the demands of career and family.  If people think it impossible to have children and a successful career they feel forced to choose only one of these options.  Many choose career over children.  So while capitalism may need perpetual growth to sustain itself - as Dr. Bramhall points out - concern about population decline is not yet pressing enough to be a priority. 

And then there are those who simply don't want to have children.  This was unthinkable in past generations.  Not having children wasn't an option.  Today, people are far less constrained by cultural norms and societal prescriptions.  Having children is no longer a prerequisite for leading a meaningful and fulfilling life. 

By far the most interesting thing I read about the "Baby Bust" is an article by Joel Kotkin entitled "Why the Choice to be Childless is Bad for America" (  The "Baby Bust," Kotkin asserts, will have unintended consequences.  First, the population as a whole ages.  This is already happening as the baby boomers grow older and begin to retire.  According to Kotkin, retirees already receive $3 in government spending for every $1 spent on children under 18.  This trend will increase as our aging population retires, placing an increasing burden on younger workers (and ironically making them more likely to opt out of parenthood for economic reasons).

Beyond the economic impact, the Baby Bust could also have significant political implications.  Evangelical Christians, mormons, and similar conservative religious groups have much higher birthrates than other segments of the population.  If these children adopt their parents' politics the country as a whole will become drastically more conservative.  Whether or not this is a good thing depends on who you ask.

My husband and I have been considering having a child.  At one point, we'd decided to start trying in January with the hope of bringing a child into the world by the end of 2014 or the beginning of 2015.  My husband is extremely concerned about the financial impact of expanding our family.  This explains why I've taken an interest in why people choose to have or not to have children.  Just thought I'd share what's been on my mind lately...

Wednesday, December 4, 2013

Group therapy

The clinic I work in recently started a new two week therapy group for women who have had any kind of unwanted sexual experience.  Our medical director has talked about doing this for a while so I knew it was coming.  I was under the impression that we would start offering the group in January.  I was assigned two groups a few months back.  I was given discussion topics and encouraged to start thinking about content.  Apparently my boss decided at some point that the first two week session would begin December 2nd.  I somehow missed the memo.  (I appear to be the only one in the clinic who had no idea this was happening.  Logic suggests that we were all informed and I just wasn't paying attention).  Anyway, I had no idea until I got an email last week confirming the December 2nd start date.  I had given exactly zero thought as to the content of my assigned groups.  I printed out a few articles the day before Thanksgiving with the intention of coming up with something during the holiday.  Unfortunately, I went out of town and left the articles at home.

I spent a decent amount of time Monday coming up with a format for my group discussion.  Still, I was less than confident Tuesday morning when I introduced myself to the group members.  I was pleasantly surprised, then, when everything went smoothly.  I gave myself a pat on the back (okay, maybe two pats on the back) for a job well done.  It may be, however, that I just got lucky.  Sometimes you get a really good group of people who are extremely motivated and invested.  Everyone participates and members give each other feedback.  That makes my job easy.  I just throw out an idea, step back, and let the group do its own thing.

Tuesday's group was a good group.  Everybody contributed something and everyone was engaged.  So it could have been luck.  I guess time will tell...   

Monday, December 2, 2013

Feeling down

I usually start working on a new blog post at the beginning of the week.  This past Monday, though, I had a sinking feeling in the pit of my stomach.  I tried to start writing but I drew a blank.  I couldn't muster the motivation nor the focus to get started.  It was like this all day.  I lacked my usual easy way with my patients.  I had trouble making myself smile.  I usually laugh and joke but my sense of humor deserted me.  My voice was flat.  I could hear it but I couldn't change it.  It was strange.

Everyone has bad days so I didn't think much of it.  But Tuesday came and I felt the same.  And Wednesday too.  I've started to get nervous.  I know this feeling.  I'm surprised at how quickly I recognized it because it has been a while since I've felt it.  The giveaway for me is the sinking feeling in the pit of my stomach.  It weighs me down.  Something is wrong inside but it doesn't make sense because nothing is wrong outside.  Everything is fine.

But that's what depression is, if I remember correctly.  I work with depressed people all the time so I know what it looks like.  But it's been a long time since I've felt that way myself.  I guess seeing it and experiencing it yourself are different.

It hasn't settled in - the depression I mean - and it won't if I can help it.  It may just be that it's a certain time of month and all my hormones are conspiring against me.  In that case, I'll be myself again by Monday.   Let's hope for the best!

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