Sunday, April 27, 2014

H. Michael Zal, DO, draws full house - Poem on Anxiety by Ed Quinn

Psychiatrist H. Michael Zal, DO, relaxes before his presentation. In practice for 45 years, he just retired in October.

His book sold out at the lecture. He didn't realize we'd have such a large turnout.

About 40 people.

Karl Rickels, MD, "wrote the beautiful forward." We had Karl speak at one of our Tuesday evening meetings a couple of years ago. Fantastic!

Rickels, a native of Germany, fought with Rommel "The Desert Fox" as a young man. Read about it here.

Read Dr Zal's impressive bio here. Scroll down to see all his books

Dancing with Medusa, written in 2010, sounds really interesting. Dr Zal - pronounced Zoll - was a first-year psych resident who met 20-yo Bella in the throes of severe psychosis.

"Everyone was diagnosed as schizophrenic back then," he told us. But he realized Bella had a better outcome than most people w/schizophrenia.

Talisman -Vayou -Vaslav Nijinsky -1909.JPG

Russian ballet dancer/ choreographer Vaslav Nijinsky, considered the finest dancer of the early 20th century, had his career cut short by schizophrenia. Read discussion by his "analyst," the famous Alfred Adler here.   

Altho Nijinsky died at age 61, he was actually cured by Dr Adler of his schizophrenia.

For his book, Ten Steps, Dr Zal asked 25 to 30 of his patients who suffer from anxiety to answer two questions:

- Describe your anxiety

- What helps your anxiety

He told the patients' stories in his book.

Dr Zal stressed that anxiety has a genetic component.

During his years in practice, Dr Zal prescribed meds for anxiety if appropriate, and also did psychotherapy.

This, as we all know, is the best way to treat a mental illness, but is rarely done anymore.

"We all have anxiety," said Dr Zal, "from a single mom taking care of her children" to men and women with busy careers.

Anxiety disorders - including post-traumatic stress disorder, social phobia, OCD, and panic disorder - affect 40 million people in the U.S.

GAD or Generalized Anxiety Disorder affects nearly 7 million.

"I'm honest with my patients," said Dr Zal. "I tell them I can't cure you but there's so much we can do."

In his initial interview with patients, he listens for CLUES that a patient is anxious. He hears statements like "I've been anxious my whole life." Some patients have a "startle response."

When my BF Scott comes over - he lives next door - he knows that no matter how quiet he is, I'm gonna "jump" when he comes through the door.

Dr Zal listens for "excessive worrying." And also recognizes "avoidance behavior." You're afraid of doing something - like driving somewhere or meeting other people or going on job interviews - so you avoid that activity.

"Take a risk and avoid avoidance," he tells his patients.

Anxiety disorders may overlap with other psychiatric conditions like depression or bipolar d/o.

Many individuals - including myself - suffered from extreme anxiety before their first psychosis. In 1984, I had no idea what anxiety was, but I sure had it. Then I found out after I landed in the hospital.

Here are some tips to help cope with anxiety:

STOP. Anxious people, said Dr Zal, move around a lot. Sit quietly. Meditate. Listen to music. You have the power to stop your anxious pacing. Give yourself permission to do so.

BREATHE. In and out, yes, but it's the "breathing out" that's especially helpful. S-L-O-W-L-Y.  One of Dr Zal's patients was so stressed out while driving he would get hives.

Dr Zal told him to exercise.

As you can see, his patient was a new man when he came for his follow-up appointment.

TAKE ACTION. Many anxious people are afraid to call someone on the phone for fear of getting rejected.

Now, I feared rejection and was worried that no one would show up for our program. This is always true with every Giant Supermarket program I run.

So I took action and you heard my call and we had a bigger audience than I ever expected. I put Noam in charge of getting more chairs.

TAKE THINGS AS THEY ARE.  People don't generally change, he said. Learn to like the positive and not-so-positive things about yourself.

EXPRESS MORE POSITIVE FEELINGS. "Mr. No" was one of his patients. He was forced to retire early as an attorney b/c of a chronic condition - a personality disorder. He had an inferiority complex but Zal told him, Look, you'll always be an attorney, feel good about yourself.

CYCLE OF FEAR. People "catastrophize," thinking something terrible will happen to them. He tells his patients, "Your mind is speaking to you in Greek. Say, 'I'm feeling anxious.' You can break that cycle." 

EXPRESS NEGATIVE FEELINGS. "It's the way you say them, that's important."

If you're going to get married, you need to share negative thoughts with your partner. Talk to a clergyman. Meet a friend for lunch to talk. Write your thoughts down. You can also write a letter to someone but don't mail it.

MEDS:  Must take a full psychiatric history before prescribing. Can't prescribe some meds - like benzoes - if the person has a substance abuse problem. Dr Zal prescribes benzodiazepines, antidepressants including SSRIs, atypical antipsychotics and antihistomines such as Benedryl. Also propanolol.

"The best part of the book," he said, "is the last chapter: The Road to Contentment."

People who having caring people in their lives are more content. We also must learn to live with our good points and our bad points.

In his book he quotes Leo Buscaglia, PhD, who used to appear on PBS

Read Leo's account of when he taught at USC and a student took his own life. This inspired him to contemplate human disconnectedness and the meaning of life.

Dr Zal quotes him, stating how important "the sense of touch is" and doing small kind things for others.

Have you done something kind for anyone today, Dear Reader?

 Here's Alice Zal before our meeting began.
 Here she is with the chrysanthemums we presented them as a gift for coming out from Lansdale.
 In her retirement years, Alice has taken up oil painting. I kid you not that her paintings are unusual and truly wonderful, worthy of being in both her home - her daughter's home - and in an art gallery - and a museum!

I was so pleased that my daughter and kidney donor Sarah stayed for the lecture. She's in town for my sister Donna's 65th birthday celebration which lasts two or three days.

When Sarah and I are together we walk arm in arm, tell each other "I love you" and are so grateful for the wonderful lives both she and I have.

Sarah got friendly with Alicia, a peer specialist at Lenape Valley. Her boss, Donna Giordano, suggested we give out Certificates of Attendance, so I gave out two of them, designed by one of our members.

After lingering awhile at the Giant, talking to various people, Sarah checked the SEPTA train schedule.

"Mom," she said. "A train leaves in seven minutes from Willow Grove." She wanted to be home tonite to hear husband Ethan and The Bad Plus play in NYC. 

Now, a funny thing happened when I went to the Giant this morning to set up our room.

I brought a carton of materials - The Compass, brochures, donation basket - and set it aside in the flower department while I chose the mums for Dr Zal.

When I returned to where I'd parked my cart it was nowhere to be found.

I asked Joe at the Courtesy Counter what to do. He made an announcement, asking people to come forward if they took the wrong cart.

Meantime, I'm thinking, "You're always so trusting, Ruth. This should be a lesson to you." BTW, I always keep my money and credit card in my backpack, never leaving it - ever! - in my cart.

Went back home, preparing to recopy the Certificate of Attendance and recreate my box of materials.

Meantime, Elyse Bonner from the Giant called and said they'd found the cart and were bringing it up to our Classroom.

When we were leaving to go home, I asked Joe, "Where did you find it?"

"Outside," he said.

Ed Quinn on Right

 ANXIETY by Ed Quinn

There's someone in my head but it's not me.
Not the me I used to be.
I yearn for the old me frequently.
My mind complies only occasionally.

Such is the world of anxiety.
I want remediation constantly;
so I go to therapy
with a healthy dose of pharmacology.

I have read the literature religiously,
to rid myself of pathology.
Nature or nurture, what could it be?
Could this be caused by family?
Or the law school that cost too much money.

Sometimes I think I can clearly see
that I'm Einstein's definition of insanity.
While I'm busy living so painfully,
"experts" get grants and other fees.

Will we always exist simultaneously,
co-habituating in perpetuity?

Anhedonia looms; not the least bit funny,
when I don't see a sunny day as sunny.
Some say it's just negativity
that prevents me from going forth happily.

If I would just think positively,
things wouldn't seem so scary.



  1. Good sounding program! Glad you found your things. I can relate to being anxious about a possible poor turnout. Whenever I held agency events I would worry and they always turned out great, except maybe for one in 30 yrs and that was a fluke.

  2. I love people like you who can relate!!!