Criminals Bank on Heroin Withdrawal?

Recently, I went to a bank robbery at a movie theater – well, sort of. Actually, this robbery played out in a movie called, “Hell or High Water,” destined to become one of the best movies of the year. It is the story of two brothers in Texas who decide that financial recovery from plummeting oil prices can be found by holding-up banks. I would soon discover that life imitates art.

Days later I received a call from an employee assistance program vendor asking if I would respond to a Texas bank robbery. I am trained in critical incident stress management, which means I am sent to workplaces or communities rocked by man-made or natural disasters. I use either one-on-one or group psychological interventions to help stabilize a specific population, provide them education and discuss how they can recover from the trauma. My last large scale response was a mass casualty shooting in Washington, D.C. in 2013 where 12 people were gunned down at the Navy Yard. What were the chances that I would see this movie, and then be sent to my first bank robbery?

Like the movie, this seemed to be your typical hold-up – man with a gun walks in, demands cash, and then leaves. Research reveals many bank tellers suffer through multiple robberies in their careers, some feeling the cold barrel of a hand gun pressed against their temples as they are threatened with death. In spite of FBI statistics that say robbery injuries or fatal shootings are rare, what is often stolen and injured is the teller’s sense of safety.

After a hold-up, bank workers can be challenged by typical responses to trauma such as shock, anxiety, fear, and anger. Many bank workers have nightmares and other sleep disturbances and are haunted by “what if” questions that can include: “what if I was shot, what if one of my co-workers was killed, what if I never see my kids again?” Many face hypervigilance in the form of scrutinizing every person who enters the bank. Each time that door opens and a customer walks-in, some tellers might experience a shudder moving through them like the ripples a pebble makes when dropped in water. Others may have trouble focusing and keeping their cash difference discrepancies (settle out amount at end of day) to a minimum.

Two weeks after doing the psychological intervention, I was called out on another Texas bank robbery. It was the same financial institution but another location, hit the Friday before Labor Day. That’s two robberies in about fourteen days in the same city. I quickly learned that most robberies take place on Fridays (9 to 11a.m), many on the Friday before a three-day holiday and last just mintues (FBI, 2015).

FBI statistics say bank robberies in the U.S. increased from 3879 in 2014 to 4030 in 2015. Why? There are some suggestions that it started with relaxed U.S. marijuana laws. Legalization has taken a bite of Mexican drug cartel profits (Miroff, 2015) and the business disruption has caused drug kingpins to turn away from THC and toward heroin trafficking. The influx of heroin, which in many cases is less expensive than opioid pain killers, has sparked an epidemic of overdoses. In a number of states including Massachusetts (Henrich, 2016), Michigan (Waterman, 2016), and New York (Schram, 2016) there are reports of robbers hitting banks for quick cash followed by a quick score at the end of a needle. Can the intersection of falling oil prices and the rising use of heroin be found at the end of a gun at your local bank?

I pondered this question as I exited the bank after this most recent critical incident response. I had a newly found admiration for the bank worker. The teller that has one eye on the presidents, one eye on the front door and a smile thanking me for my business, has a psychological sense of resilience that I now appreciate as I look through the bullet proof glass. Some of that world was captured in that movie- a work of fiction that might be closer to the truth.


FBI. (2015). Bank Crime Statistics. Washington, D.C. : U.S. Department of Justice.

Henrich, M. (2016, May 10). Retrieved from Fox 25.

Miroff, N. (2015, January 11). The Americas. Retrieved from The Washington Post: Losing marijuana business, Mexican cartels push heroin and meth

Schram, J. (2016, August 15). Metro. Retrieved from New York Post: Hat-loving serial bank robber used cash to fuel heroin habit

Waterman, C. (2016, July 12). Retrieved from Michigan Live: Heroin addict turned bank robber gets up to 20 years in prison

Posted in Stress Management

Bill Prasad Joins Bellaire Medical Clinic!

The door is now open to my new practice with Contemporary Medicine Associates (CMA) in Bellaire, Texas. CMA brings a whole person approach and 30 years of expertise to family medicine and psychiatric care. This team of doctors and psychotherapists has earned the respect of the Houston medical community for its high quality patient care and its work with hospitals, treatment facilities, pain management specialists, and other private organizations. The practice has been recognized for its accomplishments in Family Medicine, the field of addiction recovery and other therapeutic approaches to the overall health of its patients.

From their offices I will be treating those challenged by trauma, anxiety, depression and addiction. Working with this team offers my patients comprehensive psychiatric and medical services in one location making medication management and physician consultation effortless. I am proud to be part of their team.

Posted in Employment

Putting Anxiety and Depression On the Spin Cycle

Houston health club members now pedal their way to a healthy heart and a healthy mind. Armed with a Schwinn Cycle instructor certification I have started teaching cycle classes several times a week. From the therapy chair to the cycle saddle, it is a tremendous opportunity to combine my skills as a counselor with those of a fitness instructor to help members reach the finish line when it comes to meeting goals. From our perches on the bike we work together to overcome life’s physical and emotional challenges while coming together as a cycle class community. Research shows exercise, in particular spin, is a key weapon in our fight to manage symptoms from:

Watch for me! I might be pedaling at a club near you!

Posted in Leadership


Psychological therapy is not for men. Unfortunately, many men believe this is true. As men we sometimes see sometimes refuse to ask for help for the following reasons:

  • It will make us look weak
  • We don’t want to feel the pain that comes with explaining a problem
  • We don’t want to admit that a problem exits and we don’t have a solution
  • Going to therapy means we will be blamed

A new web site, is taking a revolutionary approach to helping men seek help by inviting men to “Take the Head Inspection,” and to “Get a Few Things Off Your Hairy Chest.”
Mantherapy uses satire, wit and humor to diffuse a man’s feelings of shame and embarrassment that might come from reaching out, then links men to the information they need to function at a higher level. Many men that I work with in counseling yearn to become better fathers, husbands and sons. Often work related stress, dysfunctional choices or childhood psychological injuries get in the way. This web site helps them take the first step toward understanding how teaming-up with a male counselor can help them win psychological battles.

Posted in Care Giving

Caring for Your Elderly Parents

Darlene Nestor is on-call at all times. She isn’t a firefighter but the care and service she provides is just as important. Nestor, is an administrative assist for Fairfax County Fire and Rescue in Fairfax, Virginia. She is one of a large number of baby boomers who are parenting their parents. Her 90 year old mother, Marjorie, suffered a stroke about 9 years ago which leaves her mentally unable to care for herself. Her father, Warren, is 86. While he lives independently, his reluctance to accept help and his determination to be independent in spite of risks continue to place a great deal of stress on Nestor and her family. “Every time the phone rings I dread that the call will bring bad news about Mom or Dad,” says an exasperated Nestor. The fear can be seen in her face, the emotional exhaustion can be heard in her voice.

It is estimated that 80% of all care received by older Americans is provided by family members. The 85-and-older population is expected to more than triple between now and 2050 in the United States. Half of those older than 85 need weekly help. Thirty-five percent of working people also care for parents 35 or more hours per week. These staggering statistics show the growing need for elderly home care skills and the growing challenges of having to make some critical decisions for you and your senior loved ones. Elder care can be as simple as combing your aging mother’s hair, to something as complex as having to make decisions about rehabilitative therapies, choosing a doctor, or dealing with resistance from your loved one.

There is a complex and subtle shift in power as parents grow older. One day we find ourselves doing for them what they did for us. We drive them to doctor’s appointments, keep track of their eating habits, and make decisions based on their best interests. With that wave of responsibility can come feelings of fear, being overwhelmed and, at times, unprepared. “My sisters and I share the care of our mother,” says Nestor. “Mom is incontinent and needs us to dress her and prepare meals. Dad was one of the strongest and healthiest men I’ve ever known. It has been so difficult to watch him become so fragile.”

If you have siblings, Nestor prefers a team approach to include:

  • Developing a plan that will establish responsibilities
  • Sharing and seeking information
  • Keeping everyone informed including discussions about money and legal matters
  • Involving the elderly parent as much as you can. It gives them some sense of power in a world where they are wrestling with a loss of power

When choosing a physician, select a geriatrician. This is a doctor who specializes in the care of the elderly. Also, you should understand how your elder views the doctor-patient relationship. Does your senior loved one see the doctor as an unapproachable authority or will your mom or dad ask some important questions? Look for a doctor who is a good communicator and shows a willingness to understand the elder’s time period. Most of all, select a physician who sees the elder as a person, not a set of symptoms. Finally, I recommend that an Advance Directive be signed. This is a legal document that conveys one’s decisions about end-of-life care.

When encountering resistance from your senior try to understand why they are saying “no” to something. Seek the aid of another elderly person who might persuade your loved one to be open to changes or might explain your loved one’s recalcitrance.

Things you will want to avoid:

  • Don’t judge them
  • Don’t give unsolicited advice
  • Don’t believe that you can solve all their problems
  • Don’t tell them you know how they feel. This can breed anger and resentment

While this can be a challenging time, it can also be a rewarding time. A senior can bring the gifts of wisdom, love, and experience to a household. It can be an opportunity to take a relationship to a sudden and unexpected stage of growth. “I have no regrets as a daughter caring for my elderly parents- I feel very fortunate that my parents are still living and I have the opportunity to make such decisions,” says Nestor. Nestor’s love, patience, and understanding are on-call 24 hours a day and she wouldn’t have it any other way.

A one hour training on “Caring for Your Senior” is available for your business.

Posted in Care Giving Tagged , , ,