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The Stress Doc Letter
Cybernotes from the Online Psychohumorist (tm)

October 1998

Dear Readers,

Here is your free Stress Doc Newsletter. Twice a month I include original or favorite essays and articles from my various online and offline writings, including my weekly Humor From the Edge <A HREF="http://members.aol.com/hfte/">HUMOR FROM THE EDGE HomePage</A> and AOL/Online Psych <A HREF="aol://4344:972.doc.1264535.556723207">The Stress Doc @ Online Psych</A> columns.

Please forward this letter to interested friends, colleagues and family members, or send along their email addresses. (Also, if you don't wish to receive the newsletter, email me - stressdoc@aol.com .)

SPECIAL ANNOUNCEMENT: The Stress Doc and Digital City- Washington Go National: Shrink Rap and Group Chat, the Stress Doc's popular dynamic chat group, moves to a weekly format -- Tuesdays, from 9-10:30pm EDT. Here are links & announcements: <A HREF="aol://4344:1097.tuechat.25384394.563747919"> Tuesday Chats</A> and <A HREF="aol://4344:363.gorkin.5732839.568857121">Dig City Promo - Stress Doc</A> . Hope to see you on Tuesdays.

`````````````````````````````````````````````````````````````````````````````` ``````````` Last edition, based on reader inquiry and with it being National Depression Awarness Month, I shared the first half of a six-part series on my experience with depression and medication. Here are the concluding essays. If you missed Part I, email me.

Recently, a number of reader inquiries have surfaced about the nature of clinical depression and the effectiveness of medication. Not being a physician, I can't provide general information in psychopharmacology. What I can share is my personal depression path -- from long-term denial to more recent discovery and recovery.

Also, scroll past the essays to find information on my speaking and training schedule, the library of articles on my award-winning website -- www.stressdoc.com <A HREF="www.stressdoc.com">STRESSDOC HOMEPAGE</A> - and any fastbreaking developments. And here's my AOL/Online Psych Page <A HREF="aol://4344:972.doc.1264535.556723207">The Stress Doc @ Online Psych </A> and special AOL/Workplace Series <A HREF="aol://4344:972.docwork.1255066.562088752">The Stress Doc Interview @ Online Psych</A>.

Click on these links if you'd like free subscriptions to Humor From the Edge <A HREF="http://members.aol.com/hfte/">HUMOR FROM THE EDGE HomePage</A> and/or to The Death and Dying Newsletter <A HREF="http://www.death-dying.com/"> Welcome To Death & Dying...Where Life Surroun...</A> (See, this newsletter will make you die laughing ;-)

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Trial By Prozac

Well folks, after several steps out of the depression closet, we're into the homesketch. As outlined previously, five years ago, an acutely depressing period of my life - intense pressure as a Postal Service stress consultant, loss of a major consulting contract, the sudden death of a beloved uncle - finally compelled me to face my chronic low (and, occasionally, not so low) grade depression. Recently, I noted contributing factors for my resistance to an antidepressant meds trial - from psychiatric family history and misguided, neurotic false pride to fear of a psychotic reaction along with the loss of my primal pain and passion.

The Prozac Plunge

In my mid-40s, I had hit bottom; I couldn't willpower my way out of the latest black hole. Maybe a lifetime of creating and combating stress really does take a toll. I stopped fighting my resident psychiatrist's recommendation. Of course, this was also a sign of therapeutic progress. I was less defensive about the issues of depression and medication. Anyway, with prescription in hand, I then nervously passed it to a pharmacist, carried home the mysterious green and beige capsules...and popped my first 20mgs of Prozac. (Prozac enables serotonin to linger longer between brain cells, improving the chemical's efficacy. Serotonin plays a role in sleep, apetite, self-control, aggression and anxiety, in addition to effecting mood states. Prozac and its clinical chemical cousins - Zoloft, Paxil - have been likened to anti- inflammatories for emotional pain.)

Twenty milligrams is the basic starting clinical dosage. Typically, one is told that it can take two or three weeks before the antidepressant effects kick in. Within a couple of hours I knew I had ingested something unprecedented. Sort of like Alice's "eat me" encounters while falling down the hole in her early, madcap adventures through Wonderland. Things were getting "curiouser and curiouser." First, there was kind of a buzz. Then, after a day or two, I realized I was not having such pronounced sleepiness after eating. I had always attributed this to low blood sugar. Hmm, maybe there was a serotonin-related chemical deficiency after all?

Manic Moments

Within a week, a couple of dramatic symptoms appeared. I was recalling very vivid, violent dreams. One involved stabbing a father-like figure. (My father, as many readers know, has his own history of clinical depression.) Yet, I didn't feel malevolent or enraged. More like a psychic part needed to be killed off for me to explore fully new possibilities and paths. As the artistic genius Pablo Picasso observed: "Every act of creation is first of all an act of destruction."

Then, a couple of weeks later, on my yearly retreat to see the Fall colors in the mountains of West Virginia, I had a momentary scare. My thoughts were flyng. I was probably a bit hypomanic. In fact, a friend had commented around this time that he thought I was more aggressive than usual. I knew I was feeling a bit more energetic. What was his problem? Why was he uncomfortable with my more animated, dynamic self?

Fortunately, my retreat was in a remote bed and breakfast known for its mountain view and clean, crisp air. Gum drop trees on sloping sides as far as the eye could see. Out my window, ducks paddling in a babbling stream. Sheep enclosed in a pasture. A quaint wooden bridge connecting the rooms to the smoke curling out of the chimney Beekeeper Inn. The enclave in Helvetia certainly lived up to its mountain moniker -- "Little Switzerland." Being embraced by this pastoral panorama, I realized racing thoughts were likely jump started by the Prozac. I reassured myself that this was a mind-body system adaptation to a biochemical changing of the guard. My little alpine- like eco-cradle gently rocked away the mania while nurturing my newfound energy.

Lasting Side Effects Trinity

However, there were some ongoing side effects. Let me itemize:

1. Sleep. Many people when depressed have difficulty getting up in the morning. Sometimes this is due to staying up late at night or an inability to sleep through the night. (Do you know all the best buys at 3am on the QVC home shopping channel?) But for someone like myself, with a long-standing "agitated depression," getting up in the morning wasn't the problem. I would get up at six or seven am and be at my desk writing two minutes later. I never understood why people needed coffee as a catalyst. Of course, anxiety- propelled fuel would burn off pretty fast and I might feel sleepy or exhausted before the morning was out. (Who would have imagined that this was an aspect of a depressive cycle? I just thought the shutdown was a brainstrain by- product of creative "sturm und drang" or aerobic brainstorming. Ah, once a narcissist...)

With the Prozac, however, my sleep cycle was turned upside down. No longer was I sleeping through the night. I was waking, though just one time, usually in a REM cycle. So that was a positive - greater access to my dreams. And getting back to sleep was pretty effortless. I could live with these developments.

However, the most disorienting and disturbing change in sleep pattern was actually related to my waking pattern. For the first time in years, I was having difficulty getting up in the morning. Of course, I could recall years where high anxiety about school - from grade school to grad school - had me cowering under the covers. Now it seemed I was doing an Alfred E. Neuman, "what me worry" imitation: the Prozac had me feeling less agitated and obsessed; I lingered in bed enveloped in a drowsy, languid, "manana" haze. But once the haze lifted, I hated the fact that I was no longer hitting the floor running. My Type A New Yorker survival instincts were being chemically manipulated and suppressed. There was less depression but new frustration. This effect could not just be pushed to the side.

2. Sex. It's true. Prozac does diminish one's libido. Even occasional masturbation was losing it's attraction. However, this phenomenon evoked a meaningful insight. For years, I had been compulsively engaged in aerobic exercise (for the endorphins), high risk-takig career pursuits - the mass media, public speaking, violence prevention (for the adrenalin) and the romantic chase and sexual fantasy (for the testosterone and dopamine). Shoot...if I was working this hard to alter my body chemistry, was I unconsciously trying to self-medicate? Maybe there was a message: perhaps I was starting with (or had evolved) an abnormally low resting hormonal level, at least as it effected my mood state.

Returning to sex, I must say, even with medication, when engaged in the real thing, everything was just fine, thank you. (If Viagra, the new male potency drug, had been around back then, I wouldn't have been a candidate.) In fact, I remember saying to a partner in regard to my anatomical functioning: "Stronger than Prozac!" And while ejaculation time was a bit delayed during my 20mg phase, I don't recall any complaints. ;-)

I can't resist one final musing. What about a scenario where Prozac and Viagra, are on the same playing field, as it were? Is this a case of an "immovable object" vs. the "irrisistible urge," I mean "force." Or, is it an "irrisistible object"? That male ego never rests! And will a reluctant, yet opportunistic, spouse demand a pharmaceutical quid pro quo: "I'll let you take Viagra if you finally get on the Prozac"?

3. Chocolate. Believe it or not, upon taking Prozac for the first time, I found myself salivating over real chocolate. Previously, I was clueless regarding the existence of "chocoholics" or why people would mail greeting cards, "Things are desperate. Send chocolate." Though I had experienced faux chococolate cravings. About a dozen years earlier, a girlfriend created a surprise birthday confection. She made white chocolate truffles, with almond liqueur and bits of maraschino cherry....Wow! Turned on by the impostor and not the real thing...I should have known my biochemistry was all screwed up.

In summary, while Prozac startup had it's challenging moments, anything that has some liberating effects upon sleeping, sex and chocolate eating patterns can't be all bad. In fact, it can be pretty miraculous. Nonetheless, the right chemical, psychological and social balance may still need to be discovered. And next time, I will conclude with personal and professional insights gleaned from my supervised, yet adventurous, experimentation regarding the appropriate dosage, use and value of antidepressant medication. Until then, of course...Practice Safe Stress!

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The Prozac Paradigm Shift

In the last depression series column, I surveyed some startup side effects of my trial on Prozac - from short-lived violently liberating dreams and manic moments to ongoing effects related to sleeping, sex and chocolate eating patterns. The Prozac, by increasing the shelf-life and functionality of that brain chemistry catalyst, serotonin, was sparking a rejuvenation. The changes were provocative and mind opening. And then, at the three month mark, I had a revelation.

The Crying Scene

The revelation occurred in a movie theatre watching, "Uncle Vanya On 42nd Street," a film about the making and performing of the angst-ridden Checkov play. In a closing soliloquy, one of the main characters, a young woman and daughter of the family, makes an impassioned plea about the painful nature of life, loss and love. Intently listening to the monologue, a profound awareness suddenly strikes: I'm not crying. I always get tearful during poignant movie scenes...and this one is just about off the Emotional Richter Scale! I'm moved, just not watery-eyed. How is this possible?

Let me place my capacity for copious tears in context. I have always been "the sensitive one" in my family. At clan gatherings, while others were dry- eyed listening to the trials and tribulations of immigrant relatives and the first generation, my cheeks were invariably tear-stained from softly sobbing. And not just in my family. For example, as a young adolescent my sensitivity and lack of integrity - meaning significantly underdeveloped self-awareness, self-affirmation and assertive interpersonal skills - made me an easy target. Attacking a wounded psyche was blood sport for piranha peers. As I once penned in "The Poetic Scream":

The vacuum shrieks, the hours weeks The wail of solitaire. A wall leaks, piranha beaks Affixed the meat of prayer.

The last line is a metaphor for desperate, mind numbing, adolescent masturbation. Surely, overt and underlying issues of abandonment and rejection, raw fear and learned helplessness absolutely reverberated in my psyche and soul...or so I thought.

Clearly, various stressors and traumas of childhood primed my sensitivity well. But my capacity for emotional discrimination that night at the movies - being moved, not flooded - could only mean one thing: the Prozac was impacting the deepest parts of my primal pool of pain. Some of my sensitivity went beyond "personality" and family history and surely sprung from my current biochemistry and, perhaps, a long-standing predisposition toward depression.

Coming Clean, Getting Current

Five years ago, with the help of my resident psychiatrist and a friend who was already taking Prozac, acknowledging my clinical depression and need for medication had finally been possible...and a true relief. In addition to increased energy, now I could more objectively survey and review jarring and eroding life experiences and memories without feeling like such a wimp or a failure. There was a definite genetic and biochemical component; my depressive adaptation was not simply a by-product of an intractably deficient moral character and motivational nature. Ultimately, I was still personally responsible for my life choices but, fortunately, not existentially culpable for my genes.

Especially when the depressive condition is not so blatant or when a pathological process is slow building, it's hard to know what is normal. (Though with hindsight, the psychological eruptions and tremors seem hard to miss. Denial can range wide as well as run silent and deep.) Gradually, one begins to perceive and respond to life through a depressive lens and dark filter. Sort of like wearing sunglasses all the time, indoors or out, rain or shine. The depressed person can lose much of life's color and shading - things are either black or gray. Equally sad, outer shades and inner shadows block access to the windows of a melancholy soul.

Of course, a person laboring under a clinical depression rarely wants to get genuinely close to others. He or she anticipates with dread (though sometimes, alas, with relief) the possibility of being fatally swallowed in one's own emotional abyss. Then, again, depending on the depth of despair and dysfunction, the depressive may want to cling for sheer survival. Or he may need others for distraction if not as an addiction.

Not surprisingly, the chronic low grade depressive, having constructed a lifetime of adaptation processes and compensations, some of which are "functional" if not successful, finds letting go of and recalibrating one's coping patterns profoundly disorienting. And it's not just in the person's head. The scenario is not unlike an individual who has gradually and steadily lost his eyesight or has only limited tunnel vision. And then, with successful surgery, he or she finds comprehensive sight and the adjustment to this new perspective and forgotten world, initially disturbing. With repetition, over time, our convincing take on "reality" is colored by psychophysiological blindness, fearful tunnels and/or by those ever present, indiscriminately shaded, if not jaded, sunglasses. The current challenge: how to unlearn depressive, repressive and habitual perceptions and belief systems; how to modify and transform self-defeating styles of thinking, feeling and reacting?

Reflecting and Reframing

Shortly after the three month revelation, my mind spun off vivid analogies illustrating the burden and danger of chronic depression and why Prozac was a necessary, though not a sufficient step, in recovery. (Maybe I should carry around a flashing yellow sign: Paradigm Shift in the Making -- Approach with Caution.) Anyway...One analogy involves the absence of a negative, the other the addition of a positive.

First, low grade (and not so low grade) depression is like having to run constantly both short races and marathons with a heavy weight around your ankles. Granted, you've got pretty impressive thigh muscles and a high capacity for empathy - you feel others' pain - but it's damn demoralizing and exhausting so often feeling shackled and empty. A constricted life is rarely a confident life or a life of emotional freedom and exploration. Why shouldn't you be able to run full speed for a change?

The next analogy requires imagining yourself as an automobile with a slow leak in your oil casing. You're also leaking power steering fluid. You can still drive yourself around but, slowly, inexorably these compromised conditions will take a toll on the engine, transmission and other operating systems. And the longer you put off fixing the leaks and getting a full complement of oil and other vital fluids, the greater the likelihood of secondary damage, major breakdown and lengthy, expensive repair. Why shouldn't you be able to cruise around fully serviced?

Over forty years of challenging life stress was wearing down my psycho- biochemical apparatus, especially with some of it's built in genetic vulnerability. Therapy had enabled me to carry on, sometimes quite productively, but always straining mightily to do so. With therapy and Prozac there was hope that I was out of the depression closet for good. And in the next series column, I'll examine sharing my startup experience with a family member, ongoing adaptations and experimentations with the medication and how I began using my hard-earned wisdom with clients. Until then, of course...Practice Safe Stress!

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In his closing segment, the Stress Doc steps outside and locks the door on his depression closet. From sharing his Prozac trial with a family member to stabilizing on a low dosage, the Doc documents why this has been, and continues to be, a life-changing, affirming and ongoing experiment.

Out of the Depression Closet

In the last installment of this depression series, I shared a revelation experience: after three months, I realized the Prozac was having a dramatic impact on my depression and, even, my deep-seated sensitivity. I also likened the medication's effects to a runner being freed of shackles or a car finally getting its full complement of oil and power steering fluid after being chronically low. My concrete example: while touched emotionally, on Prozac, tears did not automatically flow during a poignant movie scene.

Feeling better, I decided that Prozac had passed its three month probation period. Of course, I didn't expect to take the stuff that long. My psychiatrist had suggested a six to nine month trial before doing a thumb up or down on continuation. Ha! This Type A New Yorker wanted proof of results in four to six weeks. Lasting three months on meds was not just a clinical victory, but a triumph over cultural neurosis as well.

Confronting the Intimate FOE: Fear of Exposure

Flush with new found confidence and conviction in the experiment, I approached my younger brother (by five years, and only sibling). The family's tradition of secretiveness and shame around mental illness and my brother Larry's aversion to psychotherapy, despite being trained as a clinical psychologist, evoked some anticipation anxiety. But Larry was cool and basically understanding. A sometimes cutting or cover-up humor, especially when feeling uncomfortable, only poked through one time: he wanted reassurance that I wasn't going to be one of those, "Jews for Prozac." As much as it pains to admit it, that was a funny line. I did a counterpunchline, though. I reassured him that I would not proselytize Prozac over caffeine (his drug of choice).

Most important, being open with Larry helped reaffirm my identity as an individual who has struggled long and hard with chronic, if not major, depression. That despite my extensive training, personal therapy, my own practice, etc., even I had closed my mind to many of the subtly powerful and pervasive dynamics of depression. And now, finally, I had evolved a readiness to explore technological advances for treatment and recovery, to complement years of traditional psychotherapy.

A Piece of the Prozac Puzzle

While progress was clear, a frustrating side effect remained: emerging from a hazy, drowsy state was a daily morning chore. This was especially unnerving as pre-Prozac, two minutes after awakening, I would hit the desk writing...without coffee! When still having trouble awakening during a relaxing vacation, and exhaustion wasn't the issue, the culprit became transparent -- overmedication. And so did the pass in the impasse. My psychiatrist gave me the green light to halve the Prozac dosage. And within a couple of weeks, again, the difference was noticeable. I still was not jumping out of bed and becoming superwriter in response to anxious inner voices. However, now there was a dialogue about rising instead of a stuporously mellow state.

Lately, I've instituted a little game to ease the transition from bed to writing desk. I allow myself to read morning email for thirty minutes. Concentrating, first thing, on an early easy task has become my rising sun. It burns away early haze or fog.

And nine months later I reduced the prozac dosage to 3 mgs/twice a day, taken at breakfast and dinner. And with each decrease of dosage, getting up was easier, and not just in the morning. My libido was also getting stronger!

Forever Prozac?

At this point, the obvious question: why haven't I tried going off the Prozac? Here are some of my thoughts:

1) I feel like my healthiest, strongest self these days, and like the feeling. 2) Have heard too many stories of people eventually relapsing after stopping their antidepressant meds. (Though some are making a successful transition from the newer generation of antidepressants - Prozac, Zoloft, etc. - to St. Johns Wort, the natural herb which also impacts serotonin efficacy. I still would talk to a doctor, preferably a psychiatrist, about such a switch.) 3) Don't feel ashamed or less of a person taking my medications. Prozac is not a crutch. If anything, it allows me to throw away the compulsive crutches that I'd been using to compensate for depression - such as compulsive exercising and codependent romantasizing. I'm finally breaking out of the biochemical and behavioral shackles with which I've struggled for so many years. 4) There's a better balance between energy and focus (without the pronounced or prolonged swings of moodiness and agitation) while having access to my current emotions and past pain. I can still be a bit manic as an extroverted performer and obsessed as a introverted writer. But now, the recovery time from my psychophysiological peaks and valleys is much more manageable. There's a greater likelihood I will live and return to tell the tale. 5) And finally, and most important, an artist friend who knew me in my early days as a "Shrink Rapper" observed that my, "rap singing (okay, I concede, it's an oxymoron) on the Prozac has never been better!"

So I'm on medication for the long haul. Actually, I have come up with another rationalizing reframe. With a 3 mgs/twice a day regimen, I'm not so much taking antidepressant medication as a "Serotonin Supplement." (Isn't a mind a terrible thing to waste?)

So this has been my story out of the depression closet. Some talk about the trinity of mind-body-spirit. For me, I'll flesh out my m-b-s revelation: the Prozac-Psychotherapy-Passion Connection. And as always...Practice Safe Stress!

(c) Mark Gorkin 1998 Shrink Rap Productions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"The Stress Doc Letter" features and functions:

1. Psychohumor Writings. To provide you the best of my past and current online and offline writngs, including Humor From the Edge columns and America On Line/Online Psych special topical essays, e.g, <A HREF="aol://4344:972.docwork.1255066.562088752">The Stress Doc Interview @ Online Psych</A> and <A HREF="aol://4344:972.olpny3.1264502.565460680">Make Your Resolution A Habit With Help From Online Psych!</A>. For those not on AOL, if you'd like a copy of these popular series, just email - stressdoc@aol.com. Or check out my website - www.stressdoc.com - or my AOL/Online Psych Page - Keyword: Stress Doc, <A HREF="aol://4344:972.doc.1264535.556723207">The Stress Doc @ Online Psych </A>.

My writings now appear twice/month in Perspectives, the electronic magazine of Mental Health Net. MHN is a not-for-profit organization devoted to mental health information and education resources online. They are located at: www.cmhc.com/ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

2. Online/Special Projects. Online groups, conferences and new or special projects that are flying around or about to be (or have been) launched:

a) Come on by for my weekly"Shrink Rap and Group Chat" on AOL/Digital City - Washington, Tuesdays, from 9-10:30pm EDT. It's an online stress support group. It's a free wheeling discussion, with some Stress Doc direction about your personal concerns on stress and wellness, relationship and family issues, loss and grief, career transition, creativity and psychological growth, etc. Here's the link: <A HREF="aol://4344:363.gorkin.5732839.568857121">D</A>i <A HREF="aol://4344:363.gorkin.5732839.568857121">g City Promo - Stress Doc </A>

This group replaces the Frequent Sighers Club which never quite got off the ground. (I still like the name.)

b) To promote my Coaching for Consultants and Entrepreneurs Program:

Special Announcement: I am starting a Multi-Media Coaching for Consultants Program:

** developing, delivering, marketing workshop programs online & offline ** humor/speech writing services and website design with the Cyber Doc ** online consultation and participation in chat group

For information on the products and instructional services, email me at Stress Doc@aol.com. With questions, call (202) 232-8662 or mail me at:

Mark Gorkin Stress Doc Enterprises 1616 18th Street, NW #312 Washington, DC 20009-2530 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

3. Upcoming Speaking/Training Programs.

a) On Becoming a Netrepreneur for DC Metro Chapter of the National Assn. of Social Workers and The National Network of Social Work Managers on October 15, 9-3:00pm. For more info, call Joyce Higashi, Executive Director, Metro-NASW, (202) 371-8282.

b) Stress Management for Human Resources Center, Naval Sea Systems Command on March 27, 8:30-3:30pm. For more info, call Chaprella Collins, Administrator, (703) 607-1828.

4. Ongoing Training and Consultation Programs.

a)Team Building Series for Aeronautical Charting and Cartography/Dept. of Commerce commenced on June 5th and continues in high gear. A number of peer facilitated groups have been launched. This follows two highly successful Stress and Conflict Management all day workshops. For more info, call Melissa Hartman, Special Projects Manager, (202) 482-3026.

b) Overcoming Stress, Loss and Change; Managing Anger and Conflict - continuing series for Fairfax County Government, VA, Metro-Area Re-employment Project: for Displaced Federal Employees. For more info, call: Marilyn Manno, (703) 324-7390.

c) Stress, Communication and Team Building Skills Training - series of programs for Food and Drug Administration, Center for Devices and Radiological Health (CDRH). For more info., call Michelle Hudson, Deputy Director, (301) 594-4585.

d) Work Environment Intervention and Team Building - ongoing consultation and training for a department in Naval Sea Systems Command, HQ. For more info., call Sally Johnston, Program Manager, Civilian EAP, (703) 413-0755. ------------------------------------------------------------------------------ -----------------------------------------

5. Award-Winning Website. To remind you that there is a lot more material on my award winning, USA Today Online "Hot Site" website. It's also just been acclaimed a 4 Star, top-rated site, by Mental Health Net, the largest review guide of mental health, psychology and psychiatry resources online today. Go to www.stressdoc.com or <A HREF="http://www.stressdoc.com/">STRESS DOC HOMEPAGE</A> . Also, check out my AOL/Online Psych Page, <A HREF="aol://4344:972.doc.1264535.556723207">The Stress Doc @ Online Psych </A> or Keyword: Stress Doc. Over 100 articles are arranged in 15 different categories:

Stress Doc Bio and Philosophy Stress and Burnout Managing Anger with Authority Power Struggles: Dyads-Systems Depression/Teens, Parents... Cyberaddicts Anonymous Good Grief Searching for Love Career Transition Humor: Art and Science Creativity Unbound Achieving Peak Performance Spiritual Exploration Readers' Submissions

6. Readers' Platform. Please submit questions, comments, criticisms, cutting edge information as well as stories about how you've used humor to help relieve a client's, family member's or your own stress. I will gladly print your offering and credit you completely. (And thank you for using your spellchecker.)

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Mark Gorkin, "The Stress Doc," Licensed Clinical Social Worker, is a nationally recognized speaker, workshop leader and author on stress, reorganizational change, anger, team building, creativity and humor. He is also the internet's and the nation's leading "Psychohumorist." The Stress Doc is a columnist for the popular cyber-newsletter, Humor From The Edge . Mark is also the "Online Psychohumorist" for the major AOL mental health resource network, Online Psych and Financial Services Journal Online -- http://fsc.fsonline.com/fsj . And he is an offline writer for two mental health/substance abuse publications -- Treatment Today and Paradigm Magazine. His motto: Have Stress? Will Travel: A Smart Mouth for Hire! Reach "The Doc" at (202) 232-8662, email: Stress Doc@aol.com, or check out his "Hot Site" website: http://www.stressdoc.com . (The site was selected as a USA Today Online "Hot Site" and designated a four-star, top-rated site by Mental Health Net.)

(c) Mark Gorkin 1998 Shrink Rap Productions