Psychiatry

Doing it on your own - facing daily life, that is - may become too much. An executive is foolish to push beyond a certain point without seeking help. A top management man worth his salt will have first-hand knowledge of tension, pressure, and anxiety. The question is, how well does he handle the stress? If he's in his 40s or 50s, and finds that his job and social responsibilities - and his sex life - add up to too much frustration, he might be wise to consider psychiatry.

There are important new trends in psychotherapy:

Sex problems faced by men over 40 are point one - and here there is new information, new understanding that wasn't available a few years ago.

Family therapy is coming into its own - and for the troubled 40- to 50-year-old executive a program that involves working with his wife, possibly his children, might well spell the difference.

Chemotherapy has advanced - for example, better nonaddictive drugs are available for the treatment of such symptoms as emotional depression, chronic irritability, and insomnia.

The profile of a candidate for this type of check-up is pretty clear. He's usually about 45 to 55, ambitious, hard-driving often the type who likes to be independent, doesn't want to seek help if he can avoid it. Typically, he faces this career dilemma: He must either push hard to reach the top - or force himself to face the fact that he isn't going to make it.

Specialists point out that signs of serious trouble appear when a man begins to feel he can't cope, when the zest is gone - and is replaced by nagging worry, unaccountable hostility toward others, depression, and maybe excessive drinking or eating. The executive, especially, is apt to feel a strange sense of boredom, and an unexplained inability to make sure decisions. He'll tend to consider dramatic solutions - changing careers, changing wives, fleeing to the Caribbean. These may be a symptom, not a solution. In any case, the experts say: A man with brains enough - and courage enough - to recognize his own symptoms has half the battle won.

If a man takes stock, and decides to consult a psychiatrist, then what? First, he should dismiss the notion that it inevitably means years of treatment. This simply isn't true. The initial checkup session, in some cases, may be enough to spark the needed self-understanding - and do the job. This, though, is rare. More likely, a series of consultations, lasting maybe three to six months (often twice a week), will be recommended by the doctor - though a psychiatrist won't be pinned down to a definition of the term of therapy.

In any case, if a man approaches his problem with an open mind, the time needed for helpful therapy can be far shorter than most people realize. Complete psychoanalysis - two years, or more, three or four times a week - rarely will be required.

Open-mindedness is vital, of course - and this means partly a man's ability to speak out without reserve on such subjects as sex relations. What about the business of "slowing down" sexually, so much feared by this age group? The experts say it comes to this: Many a man, starting usually in his middle or late 40s, begins to experience what he fears is a "natural" decline in sex drive and activity. The best opinion - based on new research - says that this isn't really inevitable. True, it's quite common. But it's more a mark of a general decline in physical health, brought on - not so much by age - but by too much sedentary living, overeating, too little relaxation and exercise.

The executive is especially prone to this cycle because he's at the highest-pitched point of his business life at the very time when he should be taking better care of himself.

What about the trend toward "family therapy"? In many cases today, both a man and his wife, possibly his teen-agers, will be called in by the psychiatrist for group and separate consultations. In effect, it becomes a highly sophisticated form of marriage counselling . If the parents have problems, these will, of course, be reflected in the children. And they may need help without your knowing it.


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Cigarettes

Tobacco isn't alcohol. But tobacco is deadly in its own right - and there is plenty of research to prove the deadly part. But the trouble with all the research is that while it dramatizes how dangerous the habit can be (at age 50, a pack-a-day man has almost five years cut from life expectancy), it doesn't tell you much about how to quit.

Still, there is some hard information on quitting - some of it solidly scientific, some of it simply inspirational. At the outset, keep in mind two main paints - one of them obvious. You must sit down with yourself and make a strong, all-out decision to quit. Anything less is a waste of time.

Then - and this is important - realize that how you... see: Cigarettes