By Mike McMahan, LPC
 
Chanel and the surviving Chanels are back for another season of Scream Queens. The campy and humor is still the show’s primary feature and Emma Roberts is still killing it (figuratively?) as Chanel Oberlin, the queen of the most self-absorbed and least self-aware TV trio in quite some time. The humor is still pitch black and in very questionable taste. My favorite thing about this show the huge amount dialogue. This style of dialogue, which I also enjoyed in the similarly rapid-fire Gilmore Girls and reflective speak of Northern Exposure, allows a lot of information to be packed into a small amount of time and provides the actors and actresses some room to show their stuff. On the opposite side of the coin in my professional life, this way of speaking can be challenging in clients, though, as it can be difficult for me to process everything and keep up with the words the client is using to relate their tale. On a purely practical level, one of my most challenging cases was working with a woman who had to be the fastest speaker I’ve ever known. During our first session, I realized I had learned more about her than I usually do in several sessions and we had only been talking 15 minutes!
 
Scream Queens season two moves the action to a seemingly distant locale: a specialty hospital opened by Dean Kathy Munsch (Jamie Lee Curtis), who has parlayed the events of the first season into a book and motivational speaking empire. The survivors from the first year are drawn into events after newly minted doctor Zayday Williams (Keke Palmer), notes the lack of female staff. We also learn that the Chanels have been cleared from the events of last year due, conveniently to a Netflix documentary, which, I’m sure, bears no resemblance to Making A Murderer. Naturally “Dr.” Munsch brings in the Chanels and the story takes off, the first episode, unsurprisingly, ending with a murder (no spoilers here on the identity, though!).
 
Very few (if any) of us have the opportunity to move our friends and support network to an entirely new locale. This might happen if a group of high school friends went off to college together or, perhaps, in the case of a mass transfer at your place of employment. But, usually, if we move to a new city we have to start over from square one with a new social network. Of course, if you’re married with children, they’re likely going with you, but we’re talking about a larger circle of people for this exercise.
 
Which makes this a perfect question for the make-believe machine. Think about somewhere you would move if you could go anywhere. San Francisco? Seattle? Hell, Michigan? Somewhere else?

• If you could move to a new city and take, say, four people (non-immediate family) with you, who would you choose?
• Why would you choose these particular people?
• What support are they currently providing you and how do they do it?
• If you could ask them, how would they say they are supporting you?
• How, in turn, do you support them?
• What would be better about your life if you all moved away together?

 
Now, consider the things that would be better about your new life in the place you chose; perhaps the sprawling mecca Truth or Consequences, New Mexico.

• How would your life be better with the change of a move?
• What is it about your new location that would make it better?
• What would you be doing to support your friends?

• And, more importantly, what would you and your sidekicks be doing to make it better?

 
I am skeptical that simply moving to a new place would markedly improve your life, so if things are going better, I believe that you and your “Chanels” must be doing to something to make it better. And, finally, the key question: what keeps you from doing those things here in your current city?
 
Of course, most of us will never make such a fantasy move. But it’s fun to think about and a good way to consider what is currently working for us and how can better appreciate and benefit from the kindness and support of our friends here, as well as better support the other members of our social network.
 
 
Mike McMahan, LPC is a psychotherapist based in San Antonio, Texas.

By Mike McMahan, LPC
 
Kudos to legendary rock ‘n’ roller Bruce Springsteen for opening up about his struggles with depression. Springsteen spoke candidly about the challenges he’s faced regarding the illness, which he has struggled with since entering his 60s. As we age, depression can be linked with facing later-in-life challenges such as medical conditions and the passing of friends and family members.
 
Springsteen stated that his depression symptoms “lasted for more than a year, and then it (the depression) would slip away. Then it would come back for a year-and-a-half. It sneaks up on you. I got to where I didn’t want to get out of bed, you know? And you’re not behaving well at home and you’re tough on everybody. Hopefully, not the kids. I always try to hide it from the kids. But, you know, Patti really had to work with me through it … her strength and the love she had was very important.”
 
Having a strong support system can be a key way to battle depression, as the disease itself tends to make one feel isolated and alone. This is part of the importance of someone like Springsteen speaking out. As Springsteen has been successful by literally any standard, it’s a reminder that depression can affect anyone of any age, successful or not.
 
The symptoms of depression can vary. They include: lack of energy; loss of appetite or excessive appetite and accompanying weight loss or weight gain; loss of interest in hobbies or activities you used to enjoy. A general feeling of sadness that goes on for over two weeks accompanied by some or all of the symptoms listed above may be a sign that you should speak to a doctor or mental health professional.
 
There are numerous treatments for depression. One technique I have used with clients is channeling the negative feelings of depression into art. If you look at artists, writers and musicians, many struggle with low self-esteem or other negative self-feelings. Many also struggle with mental illness, diagnosed or not. The need to “fight the fight” is at the heart of many artists’ drive to succeed in my opinion, which may be one of the reasons that painting, writing or composing can be therapeutic for those that have never expressed themselves in that fashion. Art can be a powerful way of releasing negative energy.
 
Springsteen will release his memoir, Born To Run, on September 27. If his promotional interviews are any indication, it promises to be a good read.
 
 
Mike McMahan, LPC, is a psychotherapist based in San Antonio, Tx.

By Mike McMahan. LPC

Perhaps it was just belated recognition for “Lock and Key” from the underrated Hold Your Fire album, but Geddy Lee and Alex Lifeson, of legendary prog rockers Rush, will receive a key to the city of their hometown, Toronto. While safe to say it won’t be unlocking anything, a key to the city has endured as a symbol of achievement for the ages and not something generally handed out of rock ‘n’ roll bands.
 
Rush has never taken the obvious path, and this creative integrity has paid off handsomely. They are undoubtedly the most popular Canadian rock band of all time, and have been hugely successful in the United States as well; once they graduated to arenas they were never forced back to smaller venues, a feat few acts can claim. Many bands reach a level of success and attempt to maintain this success by catering to what fans want; Rush has done the opposite, challenging listeners and staying true to their personal ideals of creativity. Their full story is told in one of the best music documentaries of all time, Beyond The Lighted Stage.
 
Rush began their life as a heavily Led Zeppelin-inspired power trio. Their first single, “Working Man,” was so based in this guitar/bass/drums with high-pitched vocals approach that when radio stations played it, listeners called in asking “when is the new Led Zep album coming out?”
 
Rush’s third album, Caress of Steel, was a complete flop. This was the first album in which they really embraced the long-form progress rock style that would launch them to success—and it had bombed. So, naturally, they defied the record company’s request to reign it in and roared back with 2112, which opened with the side-long title track and launched them on the path to success. They continued to mine this vein for two more albums, before beginning to de-emphasize long songs and taking small steps to embrace the synthesizer sound that would define their 80s output and 80s rock, in general. This approach yielded two of their biggest hits—“The Spirit of Radio” from Permanent Waves and “Tom Sawyer” from Moving Pictures. Likely their most well-known album, Moving Pictures contains two inarguably keyboard-driven numbers, the aforementioned “Tom Sawyer” and “The Camera Eye,” the latter of which marked the last time to date that Rush wrote a song that stretched past ten minutes. By the time the distinctive synth intro of “Subdivisions” from the album Signals hit radio airwaves, they had fully embraced a keyboard-driven sound that bore almost no resemblance to the way they sounded on their debut. Some fans objected, but they remained popular, and continued tinkering with their sound (though never again as drastically) for years. However, now that drummer Neil Peart has announced his retirement from touring, their future is uncertain.
 
So why did this career trajectory work so well for Rush? Most bands would not be able to make this kind of changes in their core sound and successfully maintain a huge fanbase. One possible reason could be that they adhered to a principle that is very important to consider in psychotherapy: change should be gradual and sustainable. In the case of Rush, they added the synthesizer sound and expanded it for several albums. Many speak of Signals as a complete departure, though that is not really the case, as keyboards figure prominently on Moving Pictures and made at least a cameo on Permanent Waves. So they made what would eventually be a huge change, but they started small and expanded on that success.
 
Consider how this might work in psychotherapy. When I have worked with couples, they often come into the office at the end of their rope: they are fighting all the time and often considering divorce. Maybe one partner has had an affair or there has been a separation. Whatever is going on, they want change and they want change now. But, as we learned from Rush, you can’t change from guitars to synthesizers overnight.
 
Like Rush's sound, good therapy relies on using available tools well. A homework assignment that I have often used with couples encourages a change in perspective, as well as gradual change. The game works like this: each couple chooses two days in the coming week in which they will be “extra nice” to their spouse or partner. I tell them they can’t tell their partner what days they’ve chosen and I ask them each to write their days down, secretly, and give the paper. Then each partner is instructed to watch the other partner and, during the next session, guess what two days their partner was being extra nice. This works in two ways: one, it encourages a change of perspective, specifically a way to look for positive behavior from the partner, as opposed to the negative behaviors that they have likely been focusing on; and two, it introduces an element of change to the relationship. But it’s fairly small. After all, it’s only two days, and they can feel free to fight like cats and dogs the other five days if they choose to.
 
This is generally at least a relative success if actually completed, though obviously nothing works every time. When it is successful, the partners often feel better about their relationship and it’s not uncommon for them to come in and say “we’re going to just do this every day.” On one level that seems great. They’re getting along, right? Case closed. But this new approach may not be sustainable, as it is a lot of pressure to behave differently every day in instant perpetuity. I encourage couples to stick to the two days for at least a few more weeks, so that new behaviors can take hold and, subsequently, be reinforced by therapy sessions. Then once they feel comfortable, of course the assignment can be expanded to three days and so forth, until, hopefully, it becomes unnecessary. They have made a gradual and sustainable change, which is more likely to take a deeper hold in the long run.
 
Rush took a slow, measured approach to change, and were able to harness new technology to their advantage. Some would argue that they took their experiments with synthesizers too far, and that albums such as Hold Your Fire were watered down as a result. While some might say that—you won’t catch me agreeing. I think each of their records are honest and reflect where they were currently in their journey. One of lyricist’s Neil Peart’s most famous lines is from “Freewill”: “If you choose not to decide, you still have made a choice.” Though the song is generally political in nature, it can apply to our personal lives as well. Feel free to make a change or not, but doing nothing is the default choice. We all have the power to change our own lives, but using that power is a choice and must be knowingly embraced and effort must be expended. You can only bring keyboards into your life's sound gradually!
 
 
Mike McMahan, LPC is a psychotherapist based in San Antonio, Tx.

By Mike McMahan, LPC
 
Kudos to ABC News anchor Elizabeth Vargas for speaking openly about alcoholism. It is a very difficult disease to cope with affects millions of people. A special will air tomorrow night, Friday September 8, 2016, but excerpts are already making the rounds. In addition, Vargas will publish a memoir, Between Breaths: A Memoir of Panic and Addiction, next week.
 
In the clip available in the E! Online story above, Vargas discusses the challenges that anxiety posed in her life and how she initially drank socially to deal with it. This is not an uncommon reason for people to start drinking. In fact, drug and alcohol use are a complicating factor when it comes to diagnosing things like anxiety; as a clinician, you have to ask yourself “are these symptoms due to substance use?” This is especially complicated in trying to figure out what, if anything, underlies the substance use. It can very easily become the classic “chicken or egg?” dilemma. Did the client start using to cope with something (anxiety, depression) or is the substance use creating the symptoms? For example, as alcoholism progresses, people can begin having withdrawal effects when they aren’t drinking. So if they come to you for help, how can you, as the therapist, be sure that the anxiety they are feeling at that moment isn’t due to not having a drink? This is why many times, clinicians recommend that a person get sober before looking at other issues. However, this in and of itself poses obvious challenges, as becoming sober is no easy task for people with long-standing drug or alcohol addictions.
 
The most striking element of the clip above was, to me, the moments when Vargas talked about her anxiety during the opening of the ABC Nightly News during her anchor spot. As she points out, she is gripping the table with fear, something that would not have been noticeable had she not called attention to it, but is painfully obvious once she points it out.
 
Vargas seemed to be in a place where total sobriety was the only solution. However, for substance users who have not reached the level of problems she described, there may be an alternative approach. I have had success with people who likely don’t meet the clinical criteria for full-blown alcoholism, and whose goal is to reduce drinking before it becomes a problem. This approach, part of Solution Focused Brief Therapy, involves a gradual reduction in alcohol usage. The client may say that they are drinking “3 or 4 beers a night” and want to “have a couple of beers on the weekend with friends.” This is an achievable goal, though is quite likely unrealistic for someone who is drinking 18 beers a night and blacking out. The treatment involves writing down the number of beers consumed each night, and gradually reducing the consumption. For example, a goal for one week might be to drink one less beer a night. Another week it might be to only drink on three nights. This client will hopefully learn coping skills on the nights with reduced or no drinking, and apply these skills to achieving their goal. These new skills can be highlighted and reinforced by the therapist during weekly sessions. I do want to say that I don’t recommend this approach without the assistance of a mental health professional or a doctor. While this is a rough outline of the approach, it is not intended as an instruction manual and any sort of alcohol or substance use (or the cessation of) can potentially be dangerous.
 
It's great that Elizabeth Vargas has made such a great turnaround. I hope she continues her success, as the fight against alcoholism and efforts to stay sober can be a daily challenge.
 
 
Mike McMahan, LPC, is a psychotherapist based in San Antonio, Tx.