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Psychopharmacology
A Letter from Santa’s Therapist
A medication review will be the first order of business.
Posted December 5, 2017
Dear Santa,
Thank you for the opportunity to work with you this year. I hope you’ll agree that you’ve made terrific progress on the issues we addressed in therapy.
Also, as expected, some issues have yet to be resolved.
When you first came in last January, your presenting problem was depression.
You described a “post-holiday slump” in which your “ho-ho-ho’s had turned into boo-hoo-hoo’s.”
You were experiencing weight loss, trouble sleeping, and an irrational urge to scream at idle elves.
You showed me the anti-depressants you were taking, and they turned out to be peppermint candies. It’s no wonder you were struggling.
It took a little time for us to hit our stride together. I was unprepared for your entrance through the chimney that first session, and you confided that the lack of cookies and milk left you wondering whether I might be “too naughty” to be your therapist. I’m glad we were able to iron things out.
As we got down to work together, it became clear that there was much more than a sack of toys to unpack.
We uncovered your grief, for example, over losing the bright red hair and slim figure of your youth. You told me you spent an entire, silent night processing your transition from “young and sexy” to “fat and jolly.”
The social anxiety that sometimes causes your cheeks to turn red appears to both contribute to, and be perpetuated by, your 364-day-a-year seclusion. As discussed, group therapy would be ideal.
While there are currently no social anxiety groups meeting in the North Pole area, there is one that meets in northern Poland. I’m afraid it’s the closest I could find.
Besides the anxiety, you realized other reasons for living in an Arctic wasteland inhabited only by reindeer and elves.
You came to understand your voluntary isolation as a valid response to the annual trauma of sticky-handed pawing and general rough treatment by children in malls. No one should have to be peed on while obtaining job-related information.
Over the course of the year you dug deep in therapy, asking yourself the hard questions:
Why did I marry a woman who looks exactly like me?
Why did I choose a profession that doesn’t pay anything?
Why don’t I have any clothes besides pajamas and my uniform?
You eventually made peace with the fact that those questions may simply have no answers.
As summer turned into autumn, your mood noticeably improved.
Your stomach often moved like a bowlful of jelly as you recounted amusing incidents from your workshop. (I trust the elf who wanted to be a dentist has made a successful career change by now.)
With the first snowfall, you became elated. You spoke of how “fun and easy” it’s going to be, carrying three billion presents on a sleigh and delivering them in just eight hours.
I told you then that I was concerned you might be having a manic episode; I wanted to discuss medication. You laughed joyfully and told me you already had some and pulled out a bag of gumdrops.
You refused further treatment against my recommendation, stating that everything is now “merry and bright,” and that you have work to do.
Please know that I will be glad to make myself available again, should you decide to come back in. A medication review will be the first order of business.
Wishing you a productive and happy holiday season,
Your Therapist
PS. I hope it won’t be an imposition if I ask for a new mug for Christmas? The tea stains on my old one seem to be permanent.
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