Time Management Problems

TimeI have a good friend, a woman close to my own age, who struggles with time management problems. She usually arrives late for social events and often fails to meet deadlines at work. In her free time, she sets time-related goals for projects that mean a great deal to her and consistently fails to achieve them. In general, I'd say she feels very unhappy about her troubled relation to time.

Many clients I've seen over the years have struggled with similar difficulties, most notably with procrastination. I'm sure many readers have difficulties in completing their work on time. Often, an underlying perfectionism lies at the heart of the problem. With a harsh superego finding fault with everything you do, you're often reluctant even to begin: nothing can ever be good enough. Safer to remain in the realm of infinite potential -- that ideal in your head -- than to suffer your own scorn and self-criticism for attempting to produce something real and inevitably imperfect.

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Self-Loathing

Self-Loathing AngerAbout 30 years ago during analytic training, my good friend Tom Grant was describing a difficult case in seminar -- a man in his mid-30s whom Tom had already been treating for quite some time. Tom's client came from a severely dysfunctional background that had restricted his ability to feel for and depend upon other people. He lived an emotionally isolated life; he was "schizoid," to use the psychoanalytic term for it -- "having a personality type characterized by emotional aloofness and solitary habits." After years of analysis with this client, Tom had helped him to develop a strong liking for other people; Tom believed that a profound sort of love was likely beyond this client because he had been too damaged, but he could nonetheless sustain relationships and even get married. Tom said he had no problem accepting the limitations of what their work together could accomplishment.

At that time, I had a great deal of trouble with what he said. I was convinced that with enough time and hard work, we could help our clients to transcend their past, to become just as "normal" as anyone who had come from an intact, loving and healthy family. Looking back, I can see I had a highly idealized view of psychoanalysis, largely because I wanted to believe that my own lengthy analysis had made me "normal." It took me many years to face and accept the ongoing nature of those emotional issues that had driven me into therapy at the age of 19, years to recognize the lasting effects of early damage. In my recent psychotherapy work, I've been focusing on similar idealized expectations held by my clients. Sometimes those expectations are conscious; often, they show up as self-loathing.

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Childhood ADHD: Over-Diagnosed or Under-Treated?

Ritalin2I was planning to write an overview of the recent controversy in this area concerning frequency of childhood ADHD diagnosis and treatment with stimulant medication.  This very lively exchange of expert and personal views was touched off by a New York Times article citing a Centers for Disease Control and Prevention telephone survey of many thousands of parents.  However the latest issue of one of my favorite magazines scooped me.  I can say it no better than the two-page article in Scientific American, Are doctors diagnosing too many kids with ADHD? by Editors Scott Lilienfeld and Hal Arkowitz.  It's the most comprehensive presentation of good science concerning the important issues.

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Lying to Our Clients


During several recent sessions, one of my clients has been struggling to make an important decision in her life that's causing her considerable anguish -- whether or not to leave her husband. I don't normally give advice in such cases, but based on my lengthy relationship with this client, I strongly believe that she ought to stay for the time being and have told her so. Her doubts about what to do have continued to resurface and I've repeated my point of view whenever I thought it appropriate and helpful.

Over the weekend, I received an email from this client; she acknowledged feeling somewhat "paranoid" and wanted to touch base with me about her thought process. Her intuition told her that, in truth, I thought she ought to leave her husband but felt it would be "unprofessional" for me to tell her so. She worried that her decision to stay was foolish, that she was closing her eyes to the depth of her husband's emotional difficulties; she feared that by staying, she was setting herself up for even greater heartbreak down the line. She felt certain that I believed the same thing but couldn't bring myself to tell her so.

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Early Memories

Given that the limbic system (responsible for encoding memory) hasn't fully matured until after the first two years of life, it suggests that any memories we might have from that time period are actually reconstructions based on later experience, or "implants" built upon stories other people have told us. I have two early memories, one of each type, I believe.

My earliest memory is simple: it's the kitchen in the house where we lived at that time, as seen from my perspective. Based on the vantage point, I would have been in some kind of infant seat set upon the counter and I'm looking upward. I am alone; there's no one else in the room. The walls are a muted green, somewhere between celery and avocado. Across the room, there's a bulky refrigerator with a horizontal handle. Near to it, light comes through a window, just above the kitchen sink. That's all I remember.

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