Becoming a Traitor to Yourself

All my life I had been looking for something, and everywhere I turned someone tried to tell me what it was. I accepted their answers too, though they were often in contradiction and even self-contradictory. I was naive. I was looking for myself and asking everyone except myself questions which I, and only I, could answer.

So begins Ralph Ellison’s Invisible Man. But these words apply to more of us than the black protagonist of his novel. A careful reader will recognize how many psychotherapy bloggers are quick to condemn themselves. They define themselves as terrible human beings, inconsiderate and selfish. They believe their resentments should neither be felt nor displayed. A “better” person would be kinder, forgiving, more generous. Their unhappiness is taken as a commentary on their value, a failing grade in the class of life.

You will see them marching voluntarily to the world’s slag heap of unnecessary and misshapen things, beyond repair or redemption. They say, in effect, “If you wish to find me you must dig deep in a landfill, where I belong.” I asked one, in light of her self-assignment to the discard pile of life, how then she might describe herself if she were a spouse abuser or terrorist. These are far worse human behaviors than she’d reported and, it seemed to me, her self-condemnation went too far.

Here was a lady who sprinted to the local lumber yard, bought some wood, constructed a cross, and nailed herself to her destiny. To my mind, the bowels of hell (if such exist) are occupied by a group to which she doesn’t belong. They’d laugh if she requested admission.

I might have said, “Get off the cross, we need the wood.”

We can, in just this type of self-punishment, turn traitor to ourselves. I’m not suggesting anyone is perfect. But few of us are so unworthy that we must become our own dartboard. We bleed enough at the hands of fate without offering ourselves as a pin cushion. Some of us have been assigned a shape not our own. Life seems inauthentic. We must reform ourselves, shed the shape assigned, and work to improve it.

First, however, we must buy a new flashlight, stand in a new place, and look with new eyes.

Ellison’s fictional young man sought answers about a path forward. He wished to know who he was. The earnest fellow thought it best to ask others wiser and older. No flashlights for him.

Asked or not, those others give us our first sense of self by what they say and do. Their kindness suggests we are worthy. If they blame us we might think we are not. If they offer false gods, we get a counterfeit sense of what life is or “should” be. We are in the dark.

Ellison’s protagonist tells us he was indoctrinated for 20 years and needed another 20 to achieve self-awareness: to throw-off the self-destructive beliefs he had about himself and the nature of the world. Where can you go to find out whether you are as awful as you think, assuming you don’t like yourself?

Some begin by questioning the most basic assumptions they have. These include whether authority figures are usually right. Which authority figures?

All of them: your parents, government officials, best friends, clergy, and spouse are not exempt. The ones in power and the ones who want it. The pretenders and their defenders. The crowd and the solitary man. The critics and the critics’ critics, the know-nothings and the do-nothings, the show horses and the work horses. Include your therapist, too.

Even your God.

What do I mean? If you have been shamed and demeaned or neglected, especially in your early life, such treatment came from those on this list. If you accept their judgment then you internalize the guilty verdict on your character and talent. You will judge yourself as they have, carrying their voice, now your own, inside you. Indeed, if even a house of God is the source of repeated reminders of the indelible blackness in your heart, a religious book can become a cudgel to beat you with.

Worse still, believing them, you will continue to seek their “wisdom” and approval; desiring a possible reconsideration of your character since their magnetic attraction remains powerful. Or, you may search for others like them, those who claim they are only doing this (injury to you) “for your own good;” in effect, redefining harm as “caring.”

Here is the first bit of “fake news” we receive in life, making us vulnerable to those who offer us — their sheep — a caring hand that will instead shear us of the goods we own and the belief in our own goodness. These “wrong choices” of association with “wrong” people depend on the magnetism they share with those who began our “wrong” indoctrination.

Their magic only disappears when you recognize who they really are; and, who you really are.

Some authority figures deserve to pass the test. Others do not, nor should you return to them. You may be scared to be without their shoddy shelter. The security you believe they offer, however, is an illusion. You can only get out and get away.

All my life I had been looking for something, and everywhere I turned someone tried to tell me what it was. I accepted their answers too, though they were often in contradiction and even self-contradictory. I was naive. I was looking for myself and asking everyone except myself questions which I, and only I, could answer.

The first painting is George Hooker’s The Subway (1950). The second is the work of Tetsya Ishida: The Servitude and Deforming of the Salary Man.

The Therapeutic Journey and Our Problematic Concern with Destinations

We are an impatient race. Tasks don’t get done fast enough, the wait in line is too long, the computer too slow. Our destination looms like a slave-driver of our own creation, craving full speed to the end of our journey and the imagined prize awaiting us there.

What are we missing?

Many of those in long-term therapy are ambivalent about the inevitable end of the journey. They correctly recognize that accomplishment of one’s therapeutic goals means the terminus of the walk through the mine field of the psyche, the regular sessions, and the severing of the therapeutic relationship.

The mine field traipse is the only one they hope to dispense with. Indeed, most would say removal of unexploded emotional bombs caused their enlistment in treatment in the first place. By contrast, the absence of session-bound, intimate time with the therapist is dreaded, like ejection from a cocoon.

The story is even more complex, however; both for those who fear the loss of their road-trip, therapist-guide/companion and those who believe the journey’s end will bring nirvana, the permanent release from all suffering.

Consider: more than a relationship is forged in treatment. There is a process of struggle, self-reflection, honesty, learning. Perhaps nothing before — nothing the patient has tried or accomplished — has been so hard, but so rewarding. Each step in each session is enriching or intense — alive — even if fraught with portent and overlaid with tears. The furniture in the office stays the same, but the mental furniture gets rearranged, replaced, knocked-over, tested, taken apart, and put together. All this is “process,” not product. All this is overlooked when clients reflect on their ambivalence about the end of counseling and loss of the therapist.

In part, the problem is our instinctive goal-directedness. Often, however, the target — whatever it might be — is not as special as anticipated. Heaven does not exist on earth. We get used to even a transformed life, no matter how worthy. We become accustomed to our new, higher cruising altitude of emotional stability. The background activities — the daily maintenance of clothes, body, and living surroundings — still must be done. As the Zen proverb goes, “After enlightenment, the laundry.”

Therapy becomes a road traveled-well only if we try to notice everything, absorb everything along the way. It is not like pursuing a diploma: trudging through courses in philosophy or calculus that are endured, not enjoyed. The treatment isn’t like having an ice cream cone in its pleasure, but absorbs our entire being as a fount of learning. The engagement is total, the preoccupation remains in mind even after the session ends, the effort is important, the risks great. You are reaching for the next handhold on the mountain. Yes, you are doing so to reach the top, but you will be on summit for just a few minutes, a static place no one can live. You soon must move below. Life is in the movement. What you took away was the experience, the incremental achievement of all the concentration and self-surpassing courage you could muster.

Cervantes’s Don Quixote reminds us, “The road is always better than the inn.”

The post-war circumstances of military veterans add to the discussion. None of them want to relive the horror. Yet, some will say it was the most intense experience of their lives. Moreover, the intensity is missed, if not what created it. Thus, the therapy journey brings not only pain, but something of value in its dedicated, focused, life-on-the-line process. Not a deadened, dull, inert state of being.

Elite athletes, similarly, don’t enjoy every moment of their competition. The combination of actions and emotions includes strain, focus, effort, and fear of failure, as well as elation. We tend to think of goals and the pleasure associated with their achievement without full recognition of the other experiences they live while in motion, in process, and in the moment. Yet this is what any journey worth taking entails.

If you are currently in long-term treatment and agree with my description of the journey’s value, you might say: “Well, then. Now I’m not just fearful of losing my therapist, but the journey, too!”

Fear not.

If the treatment has been successful, a wider world has gradually opened to you outside the counselor’s consulting room. Many journeys beckon, inward and outward, outside your comfort zone, where all journeys live: more and different friendships, travel, new vocations and hobbies, increased openness to art or music, spiritual awakenings, returning to school; and, too, “thoughts that do often lie too deep for tears.”*

You will embrace some of what once frightened you or found you closed off. Not all things, but some things. Even from the defacing hand of age, a man of thieving heart, will you wrest unexpected gifts.

You never become indestructible, but you can move along in life more confident in the ability to manage most of the hurts; accepting that, they too are a part of the human experience, the beautiful/terrible richness of life.

You will not become everything you could be. No one does. But you will be alive to the world.

You cannot ask for more.

* The last words of Wordsworth’s poem, Ode: Intimations of Immortality from Recollections of Early Childhood.

The top photo includes Remains of the Via Appia in Rome, ner Quarto Miglio, by Kleuske. The second image is called Roma, via Appia Antica: Arco di Druso e Porta San Sebastian by Lalupa. Both are sourced from Wikimedia Commons.

What Does Your Therapist Dream About?

Therapists tell you little about themselves, especially their dreams. Why would they? The woolly, wild world of the unconscious might suggest the counselor is a rapist, murderer, or thief.

Looking at him through the lens of the dream makes the treatment about the practitioner, not about the patient. It cripples the client’s ability to project his own long-standing issues onto this person: react to the counselor as if he were a father or mother identical to the real dad or mom.

A crucial part of classical psychodynamic treatment relies on the client playing-out his long-standing relationship problems and historically driven expectations of trauma or rejection within the session. The patient is unaware, at first, of the “mistaken identity” going on, where his reactions are more about his own past than the practitioner. If the therapist reveals too much about himself, he risks becoming the man of his chaotic dreams to the patient, not a benign, but blank canvas upon which his client throws the paint of his own internal life.

Dream interpretation is an art, not a science. Its value is difficult to demonstrate, though some therapists swear by it. Too many possible interpretations, no way to validate them. Yet they can be helpful. Certainly they may enlighten. Regardless, dreams are hard for the patient to resist discussing. An open therapist needs to take in all the uncensored data provided, the better to serve him.

Though I claim no specialty in dream interpretation, what I offer here is a partial explanation to those who wonder about the kinds of dreams therapists have.

The simple answer is, I doubt they are much different from those of people of similar upbringing, temperament, and overall life experience. I might add two exceptions:

  • Certain kinds of dreams are recognized as symptoms within the diagnostic framework developed by the American Psychiatric Association. For example, one possible symptom of Post Traumatic Stress Disorder is: “Recurrent distressing dreams in which the content and/or affect (emotion) of the dream are related to the traumatic event(s).”
  • Conventional wisdom tells us that high achievers have recurring dreams dealing with things like being late or unready for tests. Since people with advanced degrees prepared well for examinations (and took so many of them), the unconscious disquiet of discovering you are not ready or present for a test, a crucial appointment, or a presentation requires no leap of insight. Many of us were either driven to succeed, afraid of failure, or both.

Ah, but this discussion is rather impersonal, so I will offer an actual dream of one person I know well and present you with two interpretations. Moreover, I invite you to take the interpreter’s role yourself: be the therapist.

Whose dream shall I speak of?

My own.

Get ready. Prepare yourself for the unexpected nature of the story. The partially unclothed aspect, too.

I was sitting in the smallest room of my old office suite. Yes, the washroom. Some vulnerability here, don’t you think?

The door to the W/C led to the waiting room, the lobby of the office suite. I shared the workplace with other therapists. Unexpectedly, one of those counselors opens the door to the washroom. A man. He walks through a side entrance I hadn’t noticed and was never there before. I pushed him out and spoke with him soon after.

The extra door was installed without my knowledge, he informed me. Even though all the other counselors rented the space from me, they somehow did this unilaterally, without discussion with me, and with no warning.

Several of them were in a meeting which I joined. I talked to them. I spoke of the danger to our patients, our duty to protect, and our professional liability. Since our clients all used this facility, I stated this unlockable entrance would constitute malpractice. The head of the group argued back, though I can’t recall the details of her rejoinder. The assembly of counselors was mostly docile and unpersuaded by my logic. In the end I went off, saw my next patient, and did my job.

What should be made of this, if anything? Well, I can recall failed attempts at rational persuasion dating back to my childhood. Mom ran the roost, like the female leader of the other therapists. My mother was a tough cookie and dad worshipped her. No amount of logic or effort were enough to effect changes in the family dynamic. Should I leave the interpretation at that or try another tack?

Let’s visit recent events as possible triggers of the sleepytime return to my professional practice. I read two disturbing books in the days before the dream. As Dr. Michael Breus notes, some believe dreams are “a means by which the mind works through difficult, complicated, unsettling thoughts, emotions, and experiences, to achieve psychological and emotional balance.”

The Souls of Black Folk by W.E.B. Du Bois and The Revolt of the Masses by José Ortega y Gasset both carry profound messages about the dark side of humanity. The first deals with American slavery, the second with the growth of a naïve, destructive, anti-intellectual “mass man” who may destroy the pillars of Western civilization. Du Bois led me to watch Slavery by Another Name, a superb, but equally unsettling documentary on the color-line that existed in the South even after the emancipation of blacks. Their forced-labor and imprisonment by legal and extra-legal means was new to me.

I was powerfully affected, but not, I thought, to the point of emotional distress. Still, these books and the movie offered a larger vista on what happens when reason fails and men know only rights and not duties to something virtuous and greater than themselves.

One more feature of my dream was a lack of control. Being interrupted in the washroom by a stranger is profoundly threatening. One is literally caught “with his pants down,” though I felt more surprised and angry in the dream than in danger.

The books also might have amplified my personal concerns about the current state of Western democracy: another possible precipitant of the strange story. If this is so, then perhaps I should alter my life: dip a toe into the ocean of earthly woe, not bathe in it. Rather ironic, in light of what I did during my career, which on some days was a daily if not hourly immersion.

Other interpretations are possible, of course, but I hope you get the idea.

Your own analysis might tell you about both yourself and me. Do remember, that the therapist must remove himself from his issues when doing therapy, including his investigation of dreams. Freud was a notable exception who performed a self-analysis.

So, you now get to be the psychologist. Complicated, isn’t it? Give it your best shot.

The first image is called Think Different by Neotex555. It includes within it a statue plus a portion of Kandinsky’s Fugue, the entirety of which makes up the painting that follows. Finally comes Sean Foster’s Cloud Frenzy. All are sourced from Wikimedia Commons. For more about the function of dreams, you might want to visit a very fine post by Dr. Michael Breus.

Do Therapists Only Care about Money? An Airplane Morality Tale

I will not persuade you.

No, I will not persuade you therapists are not in it for the money. If all you see are greenbacks in their eyes (🤑), I don’t imagine I can dislodge your thoughts. I can’t deny we work for a living. Indeed, some of us live well, go on vacations, have pricey things. No, I will not persuade you, but instead offer you a story about one noble and gifted therapist.

Perhaps then you will persuade yourself.

Three people make up our cast. Two participants, one observer. All occupied one side of an aisle on a commercial flight. Little identifying information about the 30ish man in the window seat will be mentioned.

I had the aisle seat. Call me the observer. A pretty lady with thick brown hair sat between the young man and me. Bald men, at least this one, notice luxuriant hair!

As we waited on the tarmac, I saw the window-seated gentleman fanning himself. True, the compartment was a bit stuffy before take-off, but I wondered why he hadn’t opened the nozzle above to create a cooling air flow. Perhaps he hasn’t traveled often, I thought. I reached over the napping woman and touched his arm, pointed up, and twisted the nozzle. He smiled and the fanning stopped. I went back to reading my book.

The sleepy woman’s eyes opened:

I became aware of some intense breathing from the gentleman to my right, turned to look at him, and noticed he was sweating profusely. I asked him if he was okay, and our interaction began …

He told me he ‘hates flying,’ especially, the take-offs and landings. I recognized the brief conversation helped him to regain control of his breathing, so decided to continue distracting him by engaging in some light discourse. I was also very, very relieved he wasn’t having a heart attack! He told me he was traveling to visit his girlfriend, and when I joked it would be her turn to visit him next time, he laughed, ‘Oh no, she’s moving (here); I’m not doing this again!’ He shared that he has a young daughter who loves to sing and so I invited him to tell me more about her. He seemed to appreciate the distraction and smiled when he spoke about her.

My focus was to remind him to take deep breaths, attending to the slow inhalation/exhalation of his breath. This gentleman seemed somewhat embarrassed, but also quite grateful, and certainly did not eschew my help.

After we reached cruising altitude, he seemed much calmer. From time to time his breathing turned faster and more shallow, which would prompt me to engage in conversation to provide a distraction. We spoke about his destination. I shared some of my favorite places there and he told me what his girlfriend had planned. I encouraged him to enjoy the weekend, fearing he would worry about the return flight instead. I also supported his willingness to fly, given his clear dislike of it!

When we began descending, our fellow-passenger was in distress again. I turned my head toward him, and thought I was directing my voice quietly just to him, never imagining you (on the opposite side) would be privy to the ‘therapy.’ I was focused intently upon him, as a counselor would be with a client.

I used ‘grounding’ mindfulness, and ‘present moment awareness’ strategies to help him control his breathing, and distract him from his fear. I coached him through some diaphragmatic breathing by instructing him to put his hands on top of his ‘belly’ (which sounds less serious than ‘diaphragm,’ and somehow always prompts a smile).

I asked him to attend to the rise and fall of his hands on his belly, and the feel of his hands against one another. When I noticed he was holding a soft velour hat, I encouraged him to pay attention to its texture. I coached him to pay attention to the muscles in his feet, legs, arms, shoulders, and neck, to experience each area relax, to wiggle his toes — anything to take his mind off the descending plane. I kept cycling through the breathing exercises. It seemed to help him, fortunately.  Of course, I also supported his positive progress.

Once we landed, he again seemed quite grateful but a bit embarrassed. I worried for him on the return flight, so tried to empower him, as we regularly do with our clients, by reminding him he managed the trip with the help of some newly-learned techniques which he could do for himself.

What did I feel during this exchange? I focused on calling up anything I could think of to help him, and keeping my voice calm and steady, as he was struggling a lot! I was pleased in a wondrous way, that I happened to be there and able to help. Such serendipity in the world!

I was also a little embarrassed to discover my ‘therapy session’ was overheard. (The gentleman behind us caught my eye when we stood up to de-plane, to acknowledge the ‘session,’ as did another person in that row). I hoped he and others were not distracted by the repetitive refrain, and that my struggling seatmate was not self-conscious about anyone overhearing. I felt a bit of the ‘therapist’s high’ that happens once in a while, when we have helped another person to find the ability to succeed, and we hope, empowered him to use the new tools to help themselves going forward. I was amazed that by some coincidence I was in that particular seat, at that time and I forgot all about the nap I had eagerly anticipated.

If anything, Catherine “Candy” Davies minimizes all she did, and the gift she displayed in doing it. A tour de force for sure. For over two-and-a-half hours Candy worked with the gentleman, sped through a sandwich, read a few magazine pages, but retained constant awareness of her ‘patient’s’ emotional state. I congratulated her when we landed and she introduced me to her husband waiting inside the airport. Later I found her online and asked if I could share her story. She kindly provided most of the details you’ve just read.

Candy was not always a therapist. She earned an MBA and worked for a large corporation, as well as a non-profit. She’s also been a teacher of college business courses:

My ‘midlife crisis’ led me to a career change, and a return to school to earn an MSW.  I have been working at SUNY, New Paltz (the State University of New York, New Paltz Campus) since 2007 and am happily married to husband Bill. We have two grown children of whom we are very proud.

When I shared the story with Bill, he commented it was yet another example my career change was the right decision.  I agreed with him, for it put me in a place to help this young man.

Legendary basketball coach, John Wooden, said: “The true test of a (person’s) character is what he does when no one is watching.” Even though a few of us listened-in (you can’t hear everything on an airplane and my book was engrossing), I would remind you Candy remained unaware of her audience until the end.

Maybe now you have persuaded yourself — by virtue of my seat-mate’s basic decency and therapeutic talent — that counselors are not the self-interested rascals you thought we were. Then again, maybe not.

But regardless of what you think, Candy will still be out there, giving her best, healing when possible, living her values.

Biased though I am and special though she is, in my experience she is not alone.

Below “Candy” Davies SUNY photo, is a High Contrast, Stylized Vector Image showing hands helping each other, the work of Phollox. The last image is A Helping Hand, by Jean-Paul Haag. All but the photo are sourced from Wikimedia Commons.

What No One Mentions about Health Insurance

I am always amused by questionnaires designed to reveal whether we have enough money to last a lifetime. They are intended to help us plan for retirement. Yes, many of you are too young to worry about this, but humor me. One of the questions is some version of “How long are you going to live.” Another asks, “How much money do you expect to spend each year (for the rest of your life)?” Those questions are often enough to make us stop trying to fill out the form. Why?

Because we don’t know and it’s too scary to think about.

Which brings up the problem of choosing a medical or health insurance policy. I will use the words “medical” and “health” interchangeably to describe this insurance. I intend to target only two aspects of making a choice of health coverage, each of which follows from the questions above.

Simply put:

  1. We can’t predict how much health insurance we will need because we lack a crystal ball about our future health.
  2. Both psychological and intellectual roadblocks make it difficult to choose a policy. Thinking about illness and death, hospitals and doctors, is scary.

Despite all the words spoken about health insurance in the USA, no one discusses these two points and how they complicate the debate over what should be the federal government’s role, if any, in providing medical insurance for citizens.

I am therefore taking on the job. Again, humor me. This is important.

Lots of adults in the USA still get medical insurance from an employer, who might also insure the spouse and children. Most of you in the rest of the Western World receive government sponsored evaluation and treatment. But, historically speaking (if you are not disabled or “low-income”), in my country there are three choices other than a plan for which the employer pays a big chunk:

  1. Decide you don’t need or can’t afford medical insurance.
  2. Buy a policy on your own, one sold by an association (for example, by your college’s alumni program), or one offered in your state-run online marketplace.
  3. If you are a senior, sign up for Medicare, which is the coverage you get if your employer deducted a portion of your salary to make you eligible once you were old enough.

Our politics is dominated by the question of who makes the choice. Are you free not to buy medical insurance? Are you free to choose the kind of policy you want? One that pays for nearly all medical/psychological conditions or only some? Are you free to assume you won’t need certain medical/psychological services?

Some of the voices in this argument imply this is a rational choice, much like deciding whether you want to buy a car or prefer public transportation; and, if you do want a car, what model might you enjoy and how much are you willing to pay.

In fact, however, the decision is more complicated and not fully rational. Philosophers such as Martin Heidegger, a sociologist named Ernest Becker, and psychologists Sheldon Solomon, Jeff Greenberg, and Tom Pyszczynski have raised the issue of our discomfort with even the idea of mortality, let alone facing the reality of serious disease. Moreover, those social scientists created a body of research demonstrating our unconscious flight from the terror of our own personal end. No wonder Ernest Becker called his Pulitzer Prize winning book, The Denial of Death. No wonder the three psychologists do research on Terror Management Theory: not about terrorism, but the terror of knowing you will someday die.

Are you still reading or have you thrown a sheet over your computer screen?

If we cannot frankly face death without a secret shiver and a turning away, how then can we make rational choices about what health care we need or will need?

Will you or your child get depressed, need psychotherapy, or psychotropic medication? Become addicted? Have an accident? Face an unplanned pregnancy and need maternity and pediatric care? Be taken to the ER? Require a vaccination? Encounter a chronic, expensive illness?

No crystal ball, eh?

Few people seek out these unwelcome thoughts. We put them out of our minds when our health is good. Indeed, we must surely have inherited the ability to distract ourselves from life’s dystopian downside. Had our ancestors, broadly speaking, not had such an attitude, they wouldn’t have survived and we wouldn’t be here. They needed to attend to all the immediate tasks of living. “What if I get sick?” was not the most helpful question when the crops needed planting and harvesting.

A certain bravery is to be found in this optimism toward life. The attitude must come from half of our species, the fair sex bearing our children; those who (to quote W.E.B. DuBois) risked their lives and bodies “to win a life, and won.”

Illness and mortality are prospects most of us compartmentalize unless we are battling them. We will acknowledge the concerns, but in an abstract, impersonal way. They are “out there,” or “might happen someday,” but not today. We give these inevitabilities their own separate room within our psychic space, building the structure with bricks and mortar, double thick, the more to keep our emotions and thoughts untroubled. We wall-off potential weaknesses of our psyche and flesh, put them in isolation where we cannot be turned to stone by the prospect of serious illness, as if we faced Medusa.

My office manager routinely checked insurance benefits for new patients when I was in practice. Why? Because they usually did not know about their coverage. Some, in fact, were saddened and surprised to discover they had no therapy benefits and their insurance paid only for physical issues; that is, until the law required attention to mental illness.

Understand, please, my patients were almost all of average or greater intelligence. Still, most lacked knowledge of potential holes in what they considered to be their healthcare safety net. They trusted they were “well-covered.” Perhaps an insurance salesman told them so or their employer did the same. Or, maybe, after the Affordable Care Act (Obamacare) became law, someone assured them therapy was among the “essential health benefits” in their insurance contract. In the latter case, they did, indeed, have counseling benefits. Again, however, they tended not to know the details.

We live, as humanity always has, in a world requiring a significant amount of faith in other people. What I’m getting at, however, is more than trusting whoever designed your insurance or whoever is offering the product. In order to make thoughtful decisions about medical insurance we must face the issue of illness and mortality squarely, without evasion or distraction; and with a level of experience, intellect, and even specialized knowledge to do the job. We must do this despite our tendency toward mental and emotional evasion of illness and death.

To quote the title of a Tom Stoppard play, what we have here is The Hard Problem.

The top image is a Saddlebred Stallion in Harness by Jean. Balloons in a Car Lot in Normal, Illinois, by ParentingPatch, is followed by Caravaggio’s The Head of Medusa. All are sourced from Wikimedia Commons.

How Vulnerable Can We Be? Emotional Openness in Therapists and Performers

We get to see public people expressing private emotions on TV. Allowing themselves to be vulnerable. Not only on dating shows. Politicians do it on occasion, including George W. Bush, whose voice cracked and eyes moistened more often than any U.S. President I can remember.

Still, most of us try to stay in control. We hesitate to let down our guard for fear someone will reach into our chest and rip out our already wounded heart. In my experience, however, some of the most touching public situations occur when a self-possessed person displays the courage to live so much in the unselfconscious moment that the voice breaks or tears flow a bit. Before I tell you about my own challenge with this, I will relate two other public examples, as well as describing a therapist’s hesitancy to feel too much in session.

Fred Spector, a retired Chicago Symphony Orchestra violinist, told this story in 2001 about an event then three decades old:

We were doing the Verdi Requiem and we knew that the mother of Carlo Maria Giulini, the conductor, died (unexpectedly, while he was in Chicago). He walked on stage (to rehearse with us), starts to conduct the Requiem and stops. He was crying and he said ‘They want me to come home (to Italy). What good is that? My mother is dead. It is more important that I have this experience with you and the Verdi Requiem and think about my mother.’ And now he’s got us all crying, the whole orchestra in tears. ‘That’s more important because then I can experience and think about my mother in this marvelous Requiem. … and those were the greatest performances I’ve ever played of the Verdi Requiem, bar none. … We wanted to get that feeling he wanted for his mother.

Giulini was a private, ever-dignified, old world man (born in 1914) for whom this exposure was uncustomary if not unseemly. Indeed, the orchestra and chorus had been instructed by an administrator not to say anything to him about his loss. Such a direction could only have come from Giulini or his wife.

Of course, it’s one thing to be unguarded in an empty hall and another to “lose it” during performance. Indeed, among the greatest sins of public musical or theatrical presentation is to be so moved by the words you can’t do your job: enable the audience to experience emotion while you remain in control. I am aware of one instance alone when the rule was violated, but the artist succeeded anyway.

A 1947 Edinburgh Festival rendition of Gustav Mahler’s Das Lied von der Erde (The Song of the Earth) was the occasion. This hour-long song-symphony portrays the transient beauties of existence and concludes in a 30-minute Abschied (Farewell) to a friend and to life, based on ancient Chinese poetry.

The work’s last moments are a whisper of exquisite, heart-rending beauty as the singer reflects on the passing away of human life, while the world itself blooms anew every spring, “forever.” The last word — “forever” or “eternally” (“ewig” in German) — recurs several times, ever more muted against the fading, shimmering, ethereal consolation of the orchestra.

According to Neville Cardus, a critic for the Manchester Guardian, Kathleen Ferrier, the contralto soloist, was “unable to enunciate the closing words.” Moved by the music, she broke down.

Ferrier, a 35-year-old woman soon to become an international celebrity, was then new to this composition and in awe of Bruno Walter, the 70-year-old conductor who had been the composer’s disciple and given the work its world première in 1911. Cardus tells the story of his arrival backstage after the curtain calls:

I took courage and forced my way into the artists’ room, where I introduced myself to this beauteous (unselfconsciously beauteous) creature. As though she had known me all her life she said: ‘I have made a fool of myself, breaking down like that.’

When Walter came into the room she went to him, apologizing. He took her hands, saying: ‘My child, if we had all been artists like you, we should every one of us have broken down.’

For Cardus, it was one of the greatest, most life-changing performances he heard in a long career as a music critic.

Where does a therapist fit in our discussion? He is not a public performer, but must empathize with his patient. Unmoved by the human suffering he witnesses, he is of no value. But what if he is moved to the extreme? Were he to experience the same level of emotion as his client, he himself would become the patient. The room would be occupied by two people equally anguished, both needing support and relief with no one available to give it.

Someone must possess a therapeutic (but not unfeeling) distance from the suffering. The therapist must.

My own challenge with public vulnerability came in toasting my first child’s marriage. Tears interfere with an adoring parent’s speech at many such events. A guest’s attention is then drawn to the speaker’s unraveling, however sympathetic or touching, not his words about the newly married couple. I wanted the assembly to know what I had to say about my daughter and son-in-law, the better to appreciate them. The language, properly spoken, would externalize the internal, convey emotion, and move the audience.

The problem was, in practicing I could not get through the speech. Time after time I tried, time after time I failed, overwhelmed. Were I to tell you the number of rehearsals I attempted, starting months in advance, I suspect you would not believe me.

The day came — the moment came — and I still had not a single run-through without the internal tidal wave overwhelming my words. Once on stage, however, — finally, finally — the elusive control arrived and the toast went well. I was not as emotionally “present” as I could have been, but the cost of unconsciously distancing myself from my sentiments was the price for moving the audience by words and delivery, not becoming overwrought and a bit incoherent.

Why am I reminded of all this? I just completed a course at the University of Chicago’s Graham School in which our instructor, near the class’s end, discovered her voice cracking with emotion. Sometimes this happens in intimate conversation, frequently in counseling, but not so often at the U of C, and not from this confident and expert guide to literature. She said (to someone else) after the session, she “didn’t know where that came from.”

But, you know what? It capped a great class discussion of a moving novel with a flourish. Sometimes one needs to go with the flow, even if the flow is both figurative and literal.

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The painting at the top of the page is called Tightrope Walker by Jean-Louis Forain(1885). The next image is Australian Artistic Gymnast, Lauren Mitchell at the 41st World Artistic Gymnastics Championship in London, UK, October 14, 2009. The photo was taken by Steven Rasmussen, Explorerdk. The following picture is Gymnast Feet on Beam, January 19, 2008, by Raphael Goetter. All are sourced from Wikimedia Commons. Finally comes Tightrope Walker by August Macke (1914), sourced from WikiArt.org/

Where Therapy Starts: Witnessing Another’s Suffering

I was reminded of a basic human need — a therapeutic need — in the middle of a boulevard. Recognizing another’s pain happens routinely in therapy, but this unfolded outside, in public, on a windy winter afternoon.

Imagine a wheelchair-bound, middle-aged black man. His clothing dark, his appearance unremarkable but for the machine he sat in. I hardly noticed him and he was not aware I was standing a few feet behind and to his right. We shared only the patience of waiting for the electronic sign to brighten and whiten — for the Michigan Avenue traffic to stop in Chicago’s downtown.

The walk signal came on and the red light turned green, permitting cars and pedestrians westward travel on Lake Street. Perhaps another second passed before a northbound SUV ran the red light in front of the chairbound man, within a few inches of the chairbound man. He’d just started to maneuver off the sidewalk. Had he owned a motorized device, a quick start would have put him in the SUV’s path. There was no hit and run, thank goodness.

Even from behind his upset was evident. The driver of the tall car must not have seen the artificially short man, diminished by his seated position. The near-victim of the near miss shouted something indistinct in a voice lacking force. He raised a left fist, impotent because it lacked a goal. The hand held only frustration and great sorrow. The vehicle was past him, the driver oblivious. People stepped into the street. No one recognized the close call, the tragedy averted, the remaining distress.

Not quite. My wife did and so did I.

I caught up to him in mid-Michigan Avenue, said I saw what happened. He described the event, needed to tell his story even though I gave my own report. The man related the brief tale twice. I mentioned I was glad he was safe and put my left hand on his right shoulder. He thanked me. The sitting soul needed to talk, needed someone to mark his words. All this in a few seconds, in the time required to cross the boulevard. The stranger wished me a pleasant weekend and again repeated thanks and his hope I’d have good fortune ahead. His speech carried some urgency and offered more gratitude than I expected.

What had I done? Nothing remarkable, but something necessary.

A man in a wheelchair is an easy target. Imagine his life. People are always passing by, speeding up, trying to get away. You have no stature. In a measuring world you are deficient. Your presence sets others to flight, instigates multiple small rejections. You are identified not by your human qualities but a machine; as an encumbrance, an obstacle to be negotiated, a thing. Does such a one feel helpless? This person appeared to. I could not climb down into his head, but I wondered later if the incident made him feel less of a man.

I deserve no special credit here. This is not about me. This is about humanity, our needs. On big city streets we are invisible or objectified, even the handsome and beautiful. But we are people, not furniture, not newspaper kiosks, not light poles. We suffer, we laugh. We create, we love. We live and die. All this is personal, treated as impersonal. In between the two sides of Michigan Avenue a man was witnessed. An anonymous individual became a person. Dignity returned to him in some small measure. At least that is what I imagine.

In giving the stranger my focus, perhaps I provided a bit of repair to someone who was otherwise not even an afterthought. Therapists do this in session. We validate and acknowledge; we listen, note the hurt and give it weight, meaning; extend a metaphorical helping hand, a meeting of the eyes, an affirmation.

Recovery often sounds complicated and often is. But remember too, life is full of simple things; simple but valuable things a therapist offers: everyday gestures that do not always happen every day.

We humans do not ask so very much.

The top photo is of Franklin Delano Roosevelt in a wheelchair. It is the work of jimbowen0306 and sourced from Wikimedia Commons.