anxiety

April 23, 2023

How Much Do You Think You Will Change in Ten Years?

Ask a 28-year-old if he is mature; he will likely say yes. At a certain point in life, we believe we have learned most of the essential lessons. One can imagine our personalities are formed, and our values are secure. They will endure.

Nope.

Three psychologists published an important paper (describing six experimental studies employing psychological tests) focusing on our illusions regarding the degree to which time will reshape us.

For example, they asked 28-year-olds how much they believed they would change in the next ten years. In contrast, they asked a group aged 38 how much they had changed in the last decade. The groups were similar but for their ages.

When they compared the two, the first bunch predicted they would alter a modest amount. However, the older segment recognized they’d shifted more than expected in the identical period.

The experimenters looked at individuals between 18 and 68, obtaining the same results. The study included over 19,000 subjects.

Quidbach, Gilbert, and Wilson claimed this is an illusion to which humanity is subject. Indeed, they called their paper “The End of History Illusion.” We think of ourselves as fixed in place as we are, a more or less permanent version of the one who goes by our name. The big transformations in our life exist as a remembered past, so we think.

What does this tell us?

The strawberry ice cream you love today might be cast aside down the road.

More seriously, we can tap memory to capture the extent of previous modifications to our nature but ignore or forget such knowledge when considering the rest of the journey.

Given that the findings point to underestimating the metamorphosis over the horizon, they may result from not wishing to consider what the unknowable tomorrow might bring.

Fear of change applies to a segment of life experience for many of us.

Consider this as well. If you make unexpected changes in values, preferences, or personality, the same might be true of friends, lovers, or others. Such an idea anticipates a precarious existence without a clear path to make oneself ready for it.

If one expects the coming incarnation of each of us to be like the present (except for minor personal shifts), our plans shall be off the mark. But how can we do better when we lack a crystal ball?

Every human soul can try to control his behavior, education, and decisions for now, but not for the person he will become. The bucket list items of today need to be fulfilled while they still matter.

By the time you retire, you could be someone whose interests and tastes have traded places with those of the new guy, whoever he is.

Even so, humans are adaptable. They adjust to the prevailing conditions and move toward a set point — a built-in grade of life satisfaction. At a practical level, life’s ups diminish after their moment of buoyancy, while the downs hit the floor, and we usually bounce back to some approximation of where we started.

Though we underestimate the manner and scope of our change, we are created to last through whatever those differences amount to.

Since the image in the mirror, inside and out, won’t be the same for long, perhaps the best advice is this:

We are all in transit. Use the time to improve, repair the world, enjoy the moment, and make the most of it.

———-

The authors of the paper mentioned in this essay were Jordi Quoidbach, Daniel T. Gilbert, and Timothy D. Wilson. It was published in the January 4, 2013 edition of Science, Volume 339, Issue 6115.

Both of the above images are the work of Laura Hedien, with her kind permission: Laura Hedien Official Website. The first is the Chicago River, from the end of December 2022. The second is an Antarctic Sunset, photographed in November 2022.

January 15, 2023

What to Do When You Don’t Know What to Say

Some people talk too soon, some too late, some too much, and some too little. Others pile up the sentences so fast you’d think they have to catch a train. Some talk too loud, soft, or close (in your face).

One of the most common regrets I heard in my clinical practice was from patients who believed they lacked the right word at the right time. Something had happened. Perhaps an offensive comment had been made, and they didn’t know how to respond.

The right words arrived by United Parcel Service (UPS) about three hours later. Others couldn’t imagine a good repost even after three weeks.

There are too many ways to go wrong in everyday conversation and even more in a public presentation if you don’t have much to contribute. Adlai Stevenson II told the following story.

It seems that a young and none-too-impressive new member of the British House of Commons approached his party leader and Prime Minister, Benjamin Disraeli:

“Now, Mr. Prime Minister, I’ve just come to the House; do you think it would be well if I participated in debate?” And the Prime Minister looked at him appraisingly for a moment and said, “No, I think it would be better if you did not. I think it would be better if the House wondered why you didn’t speak rather than why you did!”

Even though we don’t have the benefit of Disraeli’s advice, many of us have thought of ourselves as Disraeli did of the young member of Parliament: that we’d cause embarrassment by opening our mouths.

Well, sometimes we will, and indeed, all of us have done it before. Few will remember our blunders, however, and there is no chance of making an impression that is clever, thoughtful, kind, or enlightened without moving our lips.

No amount of potential eloquence does us any good if we forever have the mute button on.

Discussão.png

I’ve made some unfortunate comments myself.

In my teens, I visited a cousin whose mother had died after a long and grueling struggle with cancer. I extended my condolences, and, as often happens during such visits, we discussed other things.

Indeed, I forgot the sad occasion for a moment and mentioned a recent minor mishap, characterizing it as a “fate worse than death.”

Oops.

Too late to suck it back in. No way to un-ring the bell.

I apologized, of course, and my kind relative forgave my mistake. She was dealing with the real thing, death itself, not something trivial and stupid such as my comment. Years later, she couldn’t recall it.

Tactless remarks arise, as uncomfortable as they are. As I said earlier, we often wonder why we didn’t know what to say.

For a lucky few, their command of language comes as a genetic gift. They also have the confidence to deliver a line that others might keep to themselves.

While I can’t give you natural eloquence, I have a few suggestions to increase the possibility of saying the right thing and avoiding the wrong one:

  1. Make a recording of yourself as if you were chatting. There is nothing like hearing how you sound to discover what might be imperfect about how you converse. Yes, it could fuel your self-consciousness temporarily. But the project of self-improvement rarely comes without courage and pain.
  2. Have at l least one joke in hand that isn’t dirty or politically incorrect.
  3. Cut out “stance adverbs” and participles when beginning to talk or as interjections. I’m speaking of “uh,” “um,” “like,” “so,” and “you know.” Limit how often you say “awesome.” And never put these words altogether: “So, uh, you know, like, um, it was awesome!” Don’t say “fail” when you mean “failure” and “reveal” when you should use “revelation.” You will sound 20% more intelligent once all this is accomplished.
  4. Wait a bit before answering, at least sometimes, to create the opportunity to formulate what you have to say. The conversation isn’t a race to hit the buzzer on a TV game show.
  5. Part of the reason for waiting is to grasp what your partner means, display respect, and understand his point of view. Repeating what has been said to you can be helpful. Identifying and acknowledging his ideas is essential if you wish to have friends and loving companions. Fewer disagreements will be one of the benefits.
  6. If you expect a wise guy to put you down (because of your history or his), prepare some comebacks in advance. There are books on this sort of thing, so you don’t have to be original. Don’t forget, however, that sometimes the best put down is to ignore the barb, and ending the relationship occasionally is necessary.
  7. Try to sound au courant (a French expression meaning “up to date” or “fully informed”). A good start would be to read something other than an internet story on the life of the Kardashians.
  8. Discover some new words. Thirty Days to a More Powerful Vocabulary has been around since 1942 and is a worthy place to begin.
  9. Don’t circumambulate (circle the idea you are trying to express). Get to the point so as not to lose your listeners.
  10. If you are in the habit of employing lots of pronouns, be sure the pronoun comes right after the formal name of whoever the “he” or “she” you are referring to is. If you don’t, the listener might think you are talking about someone else.
  11. In general, especially in public utterances, wait until you have the attention of others. Trying to talk over people is frustrating, and those who specialize in preventing you from completing your thought are rude.
  12. Asking dinner partners to stop texting should happen much more often than it does. It is not impolite to tell them you will wait until they are finished.
  13. Most people who are nervous tend to rush what they have to say. Instead, think of your oral communication as a landscape painting, where the words become the foreground, and the silence becomes the background. It will help if you allow seconds of quiet to put your words into relief.
  14. Consider going to Toastmasters. It is an organization whose meetings (also online) are “learn-by-doing” workshops “in which participants hone their speaking and leadership skills in a no-pressure atmosphere.” And they’ve been doing it since 1924.
  15. Unless you are gifted in delivering an unrehearsed speech in front of an audience, try to memorize your address or at least bring an outline.
  16. One last piece of advice comes from an anonymous author:

Be careful of the words you say,

Keep them short and sweet.

You never know, from day to day,

Which ones you’ll have to eat.

========

The revised edition of Thirty Days to a More Powerful Vocabulary was published in 2022.

The second image is a 1630 self-portrait of Rembrandt, sourced from the National Gallery of Art. The cartoon is called Conversation by Richard Melo da Silva, sourced from Wikimedia Commons.

December 11, 2022

Our Difficulty with Quiet

Spending time alone with our thoughts sounds easy, but isn’t. In my therapy practice, it wasn’t unusual for patients to leave a session — especially early in our relationship — and have difficulty recalling what had been discussed. Once by themselves, the mist of forgetting gripped them.

Many of us use our brains like a piece of white bread on top of a sandwich, covering the indigestible meat of pain. At least, it distracts from the crunching, too-chewy, weighty thing underneath. We don’t want to contemplate but rather cancel ideas, memories, and dystopian futures.

The remarkable author David Foster Wallace (DFW) mentioned the potential anxiety of being alone without switching off the brain. Perhaps we imagine missing out on what friends deem worthwhile activities (so they’d like us to believe). We assume our chums have the favor of other buddies that the stay-at-home souls (you and me) might not possess.

Thinking is difficult, as DFW and others have noted. No one is well-trained in how to do it, instead assuming it flows as a natural gift.

Thinking through, peering into — not over or above the storm — that’s what people don’t want to talk about or wrestle with if those twin ponderings can be avoided.

The Hebrew Bible speaks of such useful wrestling as happened between Jacob and an angel:

The same night he arose and took his two wives, his two female servants, and his eleven children, and crossed the ford of the Jabbok. He took them and sent them across the stream, and everything else that he had.

And Jacob was left alone.

And a man wrestled with him until the breaking of the day. When the man saw that he did not prevail against Jacob, he touched his hip socket, and Jacob’s hip was put out of joint as he wrestled with him.

Then he said, “Let me go, for the day has broken.”

But Jacob said, “I will not let you go unless you bless me.”

And he said to him, “What is your name?”

And he said, “Jacob.” Then he said, “Your name shall no longer be called Jacob, but Israel, for you have striven with God and with men, and have prevailed.” Genesis 32: 22-32*

Perhaps our angel waits to be found, hoping we will wrestle with the difficulties we try to set beyond our reach. Is deep reading in silence an invitation to such matters? Jacob, after all, sent his family away before the angel appeared.

One of the less elevating uses of visual entertainment occurs when it becomes a stand-in for thoughtfulness and reveals a passive passageway to escape. We dread boredom for its vulnerability to gloom and look for a way to block it out. When added to self-doubt and fears of our future, many of us take flight from ourselves, preferring TV or movies and a focus on the lives of others.

The crowd we belong to tells us what is of value. Without independent ideas, our role becomes one of receiving their borrowed thoughts, like a postal delivery of a puzzle. We open the box and find a large, ill-shaped puzzle piece to fit into ourselves and pretend all is well.

Nor do we believe our episodic sourness is acceptable to the group. They, too, want to persuade themselves their dark times and places are few. The laughter and pleasantness they display are taken by us as the entirety of their lives, suggesting they have mastered human existence as we have not.

We are ambivalent about where we went wrong. We want to find the answer but are afraid to get near it. When did our lives turn? How did we get where we are? Better not to ponder such things.

If the silence of these private ideas cannot be escaped, the lack of satisfying answers screams at us. 

Too many people sprint into the night away from the sound when walking toward it might calm the terror. The scream is ours, inescapable until we listen and understand the messages.

Greta Garbo might have been a similarly troubled individual. Her dialogue in the 1932 movie Grand Hotel, “I want to be alone,” told much about her-offscreen existence. Garbo retired early and led a life of astonishing solitude and self-willed isolation. Just before her 60th birthday, she told a friend:

In a few days, it will be the anniversary of the sorrow that never leaves me, that will never leave me for the rest of my life.”

Some of the brightest people avoid serious and lengthy books. True, we have more possible activities available to us than ever. Lives can be swept away by an infinity of choices, all leading to fog and forgetting. 

Can avoidance of an 800-page masterpiece be due to its soul-searching challenge beyond the lack of time we claim is the barrier? Does such immensity threaten to overwhelm our capacity and inform us what we are not and what we must do to improve?

To do that requires change and the endurance of strange expressions. The faces offer the wordless attempts of friends to discover why we are reading that. An unsettled feeling follows inside, telling us of the possible loss of our tenuous hold on our spot in the social network.

Part of the difficulty of understanding the best books is that they require courage. Many of us read them and make an inward and automatic declaration that the story’s characters made the kinds of mistakes we’d never make. 

Some bravery is needed to realize we are no better, no wiser, and have no more forethought than those characters, real or imagined.

As Kafka said,

A book is like an ax to break the frozen sea within us.

If we are to surpass our current life and the troubles it brings, we can do worse than follow Abraham Lincoln’s words:

The occasion is piled high with difficulty, and we must rise — with the occasion. As our case is new, so we must think anew, and act anew. We must disenthrall ourselves …

Are we prepared to unmake and recreate the person we are? 

If we do, one day, for the first time, it’s possible we’d look into the mirror, say hello to whoever has always been there, and smile.

==========

*The painting after David Foster Wallace’s brief comments is Gustav Dore’s Jacob Wrestling with the Angel, sourced from Wikimedia Commons. Is the creature an angel or God? Scholars of different religions are invited to inform me.

It is followed by The Pensive Reader by Mary Cassatt, 1896, sourced from Wikiart.org/

Next comes a 1925 photo by Arnold Genthe of Greta Garbo from History Daily.

The last image is a sculpture of Abraham Lincoln by George Gray Barnard from the Metropolitan Museum of Art. It is sourced from Wikimedia.com/

The Lincoln quotation was part of an annual speech made to the assembled Congress on December 1, 1862. His reference is to the ongoing Civil War.

November 20, 2022

Do You Believe? Your Answer May Surprise You

You’ve listened to people ask, “Are you a believer?” 

Some answer, “I trust in Him. I believe.”

The word belief is often attached to religious faith. Those who do not have such convictions are called agnostics or atheists. But the word has a broader scope.

Those who deny faith continue to believe differently.

Allow me to explain.

Perhaps unaware of it, they appear to rely on others in a manner similar to how religious people depend on a deity. This is not to say true believers lack the same everyday bolstering backstop found in non-believers.

Consider the pedestal occupied by physicians, especially those doctors we appreciate through long familiarity. They earn our trust if they are confident, knowledgeable, and kind. We turn to them for the maintenance of our lives and health. We entrust them with the well-being of our children.

Their role is godlike, without the ritual, ancient scripture, prayer, and attendance at a house of worship.

Such women and men provide confidence and strength, the ability to persist, the knowledge we are not alone, and, often, that all will be well. Healing us is their business, and sometimes we consider our survival miraculous.

Ah, but perhaps you recall times when a physician did not save you from disability or someone you love from dire illness.

Then you may have a crisis of faith in him, not unlike the intrusion of doubts about God. You might reject one or both, but not everyone does. Many recognize the medical profession’s limitations and continue to hold on to their confidence in a doctor’s value. Or, they might search for another practitioner to take his place.

The human response to tragedy is not so different in those who are religious. Blaming your God or yourself is common. Uncertainty frequently arises about why the misfortune was permitted by an all-good and all-powerful being.

“What did I do to deserve this?” can be followed by self-incrimination or pointing the finger at a deity. Just as the atheist might seek another doctor, the believer may seek another sect — or none.

Yet many — perhaps more — recover their belief and reliance, and the shaken trust regrows. The New Testament provides consolation and an alternative view of adversity:

And we know that all things work together for good to them that love God, to them who are the called according to his purpose. Romans 8:28

Regardless of the particular religion, the sufferer might accept the limitations of a superior being alongside the strengths attributed to him.

The need for assurance provided by a cosmic entity or influential person on our side is vital. To be without faith in anyone, mortal or immortal, is a lonely and terrifying human experience. 

We desire others we can trust with parts, if not the whole, of our well-being. They come to recapitulate our parents’ role as protectors in our early lives, if not to the same extreme.

Unfortunately, the urge to lean on someone or something more substantial can also be misplaced.

Some are vulnerable to the allure of charismatic, persuasive political leaders who disguise their corruption with smoke and mirrors. They offer much the same sense of caring about us, defending us from real or imaginary enemies as our mom and dad did, and offering the belief in a better future. To an extent, these individuals might be perceived as the agents of the actual deity, doing HIS work on Earth.

If officeholders are unscrupulous, sound evidence of their iniquity is sometimes shrugged off. More than a few followers find the need to believe is more essential than being alone without a worldly savior. The tricksters can appear as necessary as a God in the heavens and reinforce the thought HE has willed the anointed one’s presence.

Facts fail to defeat our reliance on a dynamic and persuasive duplicitous leader if his departure would leave us with no substitute champion to fill his role. This woman or man stands unique and extraordinary, occupying a position reminiscent of the physician or loved caretaker.

We live in hope and belief.

In their search for someone or something more extraordinary than themselves, the faithful and the faithless are not as different as they sometimes think.

In a world of uncertainty, we are thereby sustained.

=========

Both of the photographs were provided with the kind permission of Laura Hedien: Laura Hedien Official Website. Both date from this year. The first captures a Sunrise in the Italian Dolomites in early September. The second offers the Dolomites in the Clouds.

October 20, 2022

When We Stop Thinking

Something has happened, and few are thinking about it.

We live in a time of more books, movies, and accumulated knowledge than ever. The world should be ripe for thoughtful discussion, yet nuanced ideas are in short supply, if not dangerous. 

Not necessarily a danger of physical harm, but sleepless nights, depression, and anxiety. Lost personal connections, too.

We don’t want to look outside after dark. I’m not speaking of the time when the sun goes down. Instead, differences among friends and relatives who we believe have gone over the edge.

It doesn’t matter what side. Neither tribe (and maybe more than two) takes enough time to move beyond surfaces.

When a statement conflicts with our beliefs in conversation or public debate, friction starts and sometimes stops in two seconds. Our brains turn on the mute.

Better not to think about it, some would say. Better to search for distractions. Better to rely on authorities we believe in, news outlets who echo only what pleases us, and topics unlikely to cause trouble at work or home.

The current remedy is to grasp simple answers acceptable to the folks we live near, attend our church, and like our spouse.

Of course, there are other things to think about. Getting the groceries, raising the kids, saving money, and looking forward to a Saturday night date.

Are the Chicago Cubs a lousy baseball outfit? At least, that is something about which we can agree.

But the questions don’t go away because we don’t want to enter the dark space inside or outside ourselves.

My take is that while some of the “other guys” are opportunistic and deceitful or worse, not all are, and not everyone on our team is pure. Nor am I always a paragon of virtue.

The talking heads have mostly made up their minds and ours along with theirs.

I like to learn more than what a closed mind offers.

It won’t take you very far to think that the other party or clan is full of stupid or evil people. Better to ask why they take the positions they do and what is important to them and read books that tell us things we don’t know.

In other words, get past comfortable explanations to those that might enlighten us.

And, once we’ve thought through the present and learned the unsettling lessons of human history and experience, to take responsibility.

Consider action intended to make the world better for everybody, not just your team, club, party, religion, race, country, gender, or tribe. That’s where the best possible future is to be found.

But first, you must focus, ask questions beyond what you are told, and move past the madness of the crowd.

============

The late 19th-century painting by José Ferraz de Almeida Júnior is Girl with a Book. The bottom image is Pieter Bruegel the Elder’s Tower of Babble. Both are sourced from Wikimedia Commons.

February 13, 2022

What Psychologists Know: the Unspoken Reasons for Our Current Anger

The news tells us why we are unhappy. Political media encourage outrage, aiming their daily rants at the “others.”

For many, the big-mouthed assertions “make sense.”

We are missing something bigger than the big-mouths. They are not the entire story.

Granted, in a time of pandemic, discrimination, and outsized electoral hatred, it’s easy to think such conditions are the source of all our rage.

Let’s try a thought experiment. What would life be like if the pandemic ended today, inclusivity improved, everyone made a decent salary, and politics returned to something more civil? I mean, once the euphoria diminished.

We’d still compete for jobs paying more and permitting time with our kids. We’d persist in comparing our happiness to neighbors who want us to believe they “have it together” when they don’t. We’d desire objects we don’t have, vacations for which we have no time, money to dine at exclusive restaurants, or just a tolerable living space.

Mistakes would be made, like marrying “the one” who, at 31 or 51, is one crazy piece of work.

Bosses would still fire and hire us. Our lives would include winning and losing, worrying about what others think of us, and watching our bodies head south for something other than keeping warm for the winter.

We’d lose old friends and win some new ones. Like a dance, the music would fade, but doctor visits increase. The insistence on finding balance, living in the moment, trying yoga, reading the Stoic philosophers, or faithfully executing the newest “five steps to a wonderful life” would define almost everyone as a slacker.

What did I miss?

Death, for one. It’s the world forgetting we were here, which it already accomplishes without breaking a sweat. The peopled planet forgets we laughed and suffered and helped and hurt.

The thrill of reaching the mountain top, assuming we get there, would still require a return to earth to take care of the laundry.

Someone must be blamed, so we displace our anger on others.

——-

As children, some of us heard, “Anyone can be President of the United States” or the Cristiano Ronaldo/Michael Jordan/Babe Ruth of our chosen sport.

The crowd added, “Try hard enough, and it will happen. Never give up. The result is up to you. Every knock is a boost. That which doesn’t kill you makes you stronger.”

When small towns, farmland, and cattle ranching described the landscape, you could be “a big fish in a small pond.” Everyone knew your name, and everyone had a place. All the folks worshiped in one or two buildings.

Now we are nameless, anonymous, stressed people passing through time on a bullet train. Often a terrific time, I’ll grant you.

But, too many feel invisible and without their version of fairness and respect. They try to “man up” because admitting episodic sadness doesn’t receive much applause. Alcohol and drugs don’t erase discontent.

Who created these conditions? Man did, yes, in response to his attempt to make his way. But we remain overmatched by a world we didn’t ask to enter. Life is quite a challenge.

The famous politician is right. “The game is rigged,” but rigged by the unavoidable circumstances of human life and mortality.

The thought, “no one gets out alive,” is set aside or prayed about by those who hope for a proper afterlife.

You can’t rage much at the Creator without considerable pushback from almost everybody. We lack permission to talk about the ultimate demise until the reaper sharpens his scythe within earshot.

If you do, you become “Debbie Downer,” the young lady who is a buzz kill and rains on otherwise joyous celebrations.

Yes, there is a lot of unfairness. Yes, lots of cheating, at least more than I noticed growing up. Yes, one must attempt to repair the world.

Along the long or short path to the end, consider taking time to deal with what it means to be fully human. I mean a creature in motion on a bumpy treadmill in a direction not on the map.

Learn to dance on the moving stairway, for sure. You might want to deny or distract yourself, and those defenses are necessary. But recognize your frustration is about more than your crappy neighbor who belongs to the opposite political party and plays loud music besides.

Bruises, bumps, and boulders are part of the world into which we’re thrown. You were in a safe, warm spot suspended in a perfect pool, protected from everything, and then mom’s body got unzipped. You didn’t volunteer for the jump, and the nurse didn’t strap on a parachute.

If you accept that, realize the guy next door is terrified and wants to drown out the sound of eternity’s eventual announcement, “It’s time!” No matter that his bucket list is not yet empty, the man becomes a drop in the bucket.

This stopping point and our fundamental aloneness are the most significant things we share. Might it be nicer if we consoled ourselves a bit? We arrived here as soloists without an instrument to play.

A conversation about this imperfect condition might provide relief.

Is a diagnosis always the answer? Is it possible the standard advice about dark thoughts misses something important?

Perhaps we should acknowledge our membership in a class from which we can’t be dismissed until the days are all over.

Maybe anxiety over environmental destruction will wake a few up to face the event, enjoy and save the wonders of the earth, pursue what is worthwhile, and search for love, not weapons: Climate Change Enters the Therapy Room/

Death is baked into our birthday cake. We might do well to accept the inevitable, as the ancient Stoics did, and use the time well. Some exceptional people reminded themselves of that message.

Mozart thought of death every day. Carl Sagan, the legendary scientist, kept a reminder on his bathroom mirror, but shame on you if you mention the “D” word. How many others, including your friends, see the shadow, too?

“Death smiles at us all. All a man can do is smile back.” — Marcus Aurelius, Roman emperor.

Among 1000 other things, we need a group hug — one extending across the globe.

And after the hug, the laughter, and tears? Throw off the restraints on your freedom.

Reconsider all the words that bind you. The unconscious voices that make life harder — the assertions we heard from teachers and preachers, parents, and false prophets.

Then embrace the best of them and a few of your own to shape a life so beautiful and true, so generous and brave, it would be worth remembering even if the memory vanishes.

That much is in your hands.

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The bottom photo, Sunset in Texas, Late May 2021, is the work of Laura Hedien with her permission: Laura Hedien Official Website. 

January 16, 2022

When a Therapist Changes His Mind

Some people consider changing their minds as a sign of weakness. It provokes the fear of being criticized, looking stupid, and needing to apologize or ask forgiveness.

Yet every therapist and non-therapist needs modification of himself and his outlook. We must try to learn what we don’t know of the human world and reform our previous beliefs. Bullet-proof ideas, unchangeable in every detail, lead to unchanging actions. As the old saying goes, “If you always do what you’ve always done, you always get what you’ve always gotten.“*

More than a few times during my career, I realized my patient and I were stuck. My part included a failed treatment plan and a misunderstanding of my client’s essential qualities, how he thought or felt, and the universe of his suffering.

I established a way of approaching this situation. Of course, researching and discussing the dilemma with experienced and wise clinicians was the first step.

If that failed, however, the fix required more.

I tried for a new conceptualization of my patient.

Imagine a blackboard full of every word or picture available to describe you. Now visualize your counselor. He is responsible for all you see before you, everything he chalked on the white-on-black wall.

He included the way you dress, move, and express yourself. Your history is recorded in the way he heard it. Your own self-reflections and self-knowledge are present, too, as you described them in the office.

The hard surface before you hides the contribution of an invisible sense, as well. The words and pictures sprang from the lens of the healer.

The counselor’s professional and personal life colored his attempt to recognize you for who you are. Add any psychological test results or elements from your medical history. The representation in front of you, no matter how close to capturing the whole of you, is imperfect and incomplete.

I have been this imaginary clinical psychologist. Looking at the blackboard, I thought about the product of my work and erased everything so I might begin the therapeutic project again.

This approach didn’t help everyone, but the piece I missed revealed itself in many cases where I tried to reimagine what I’d overlooked.

Abraham Lincoln said it better during the Civil War when he applied similar thoughts to the job of saving the broken union of individual states:

The occasion is piled high with difficulty, and we must rise — with the occasion. As our case is new, so we must think anew, and act anew. We must disenthrall ourselves, and then we shall save our country.

This way of approaching the world extends elsewhere on a much-reduced scale.

Take reading. Assume you are poring over the pages casually. Instead, engage in a conversation in your head with the book’s author.

Most of us reflexively respond to the characters or ideas we like and the ones we don’t. This manner of proceeding demands little thought. We judge the people, their behavior, and views from the perspective of beliefs we held before we began.

Here is an alternative, the one that grew from my professional frustrations. Begin by wiping your mind free of ingrained opinions and trying to figure out what the author wishes to express. No, you needn’t read his biography to discover this. Understand his message through his words without a leap to judgment.

When done regularly, the practice becomes automatic. Moreover, you will become less prone to immediate acceptance or rejection emerging from the deep freeze of your prior convictions. Perhaps reading will come to enlighten you through a growing capacity to read “closely,” with active searching and questioning as you dig into the material.

Little of this is easy, nor is it the work of a few days. None of us can make himself a whitewashed blank slate or scrape the blackboard of our every thought and feeling. Yet, to my way of thinking, we must try to be open, not constrained by comforting ourselves with unwarranted certainty.

We travel a road to stagnation when we insist our rightness is godlike and beyond reconsideration. To the extent we accept assertions based on questionable evidence handed down from a single person or group of like-minded people, we walk into invisible imprisonment by the false gods of our choosing. The more we convince ourselves of our rationality, closing our minds along the way, the farther we throw off our intellectual apparatus.

Doing so may make us feel wise or justify our anger but at the price of misunderstanding the world as it is.

As Ludwig Wittgenstein said in the preface to his Philosophical Investigations:

I should not like my writing to spare other people the trouble of thinking. But if possible, to stimulate someone to thoughts of his own.

A few of the most delightful and provocative books I’ve encountered so fascinate me, I return to rereadings. The new thoughts they spur sometimes modify my conceptions over time. This approach continues to transform me. I am humbled by recognizing I must change my ideas, redefine the unstable world, and modify what is in my control. That includes changing myself while recognizing what is unchangeable about me.

I know there will never be enough time to learn all that is worth remembering, do all that is worth doing, and repair more than a few bits of our planetary life together.

Still, I must try to hold my arms wide and embrace as much of the world as I can — with love.

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All of the photographs come from History Daily. The first University of Pennsylvania Football Player Frank Yablonski Wearing a New Style Helmet in 1932. Next is an image of Bedouin Tents in Morocco. The card game following includes Billy the Kid  (the Young Man in the Top Hat) with His Accomplices in 1877. Finally, Broadway and 53rd Street in New York City in 1928.

July 25, 2021

Talking to Your Doctor: A Guide for Patients

Imagine I ask myself the question: which doctor do I see this week?

Witchdoctor or which doctor? Genius, God, or man?

I have no fatal conditions, so don’t worry. But since I’ve known quite a few MDs as a colleague, friend, or patient, here is some advice about how to ready yourself for your next medical visit.

This applies in particular if you will be meeting a specialist. These suggestions are also the product of the numerous comments from my own clients about their experience with the healing arts.

PREPARE: Make a list of your symptoms and medications; consult reputable websites like Mayo Clinic, but do not make yourself crazy with conspiracies or every worst-case possibility. Think about questions you’d like answered.

YOU ARE NOT A HOSTAGE: Don’t be intimidated. God neither wears a white coat nor uses a stethoscope. The MD is a human being. Use your session efficiently, but you are entitled to time. You (or your insurer) will pay for the service.

TAKE NOTES:  Perhaps bring someone along who can verify what you heard, ask questions you don’t think of, and offer his impression of the expert.  

COLLABORATION: Choose a primary care physician (also called an internist) if you are without one. He should come to know you better than a specialist, possess a wide knowledge of the field, and provide insight into advice from fellow MDs. If you see this person yearly, a collaborative relationship should develop.

THE DOCTOR’S STAFF: Take a measure of the people employed by the individual in charge. Their listening skills, competence, thoroughness, and kindness often reflect the qualities of their superior.

TREATMENT CHOICES: At some point in the visit, the doc should indicate what comes next. He might order tests or a consultation with a colleague. Perhaps medication will be prescribed or a procedure involving the examination of an internal organ. Maybe surgery.

If he does not mention alternatives (say, watchful waiting, drugs, or another approach), ask what else might be done. Speak if you wish to hear more about each method. Request printed literature, as well. These days, previously extreme interventions sometimes involve only small incisions, minimal time in a clinical setting, and rapid recovery.

COMMUNICATION ISSUES: If you don’t understand some of the words or names the authority uses, tell him so and ask for language easier for someone not trained in his field. Feel free to slow him down.

The doc might recommend a more than ordinary therapeutic approach. Some will offer possibilities and take a collaborative attitude, wishing not to impose a decision. The following question can be useful: if you were making a recommendation to a loved one, what would you suggest?

Short of an emergency, not everything needs to be determined the same day. Doing your own homework, obtaining a second opinion, and finding time to catch your breath don’t necessitate anyone’s permission.

SURGERY: The expert could say something like, “The two surgeries I perform are X and Y.” Inquire whether there are others and create a conversation about pros and cons.

Seek details. Become informed about potential side effects and their likelihood in percentages, the necessity of hospitalization, and possible rehabilitation afterward (knee replacement often demands this).

Ask how many times the doc has performed the procedure. Consider his age. Not everyone retains undiminished fine motor skills forever. Find out how many such surgeries are done at the hospital where he practices compared to other healthcare centers. The more, the better. Investigate institutional rankings for the particular intervention or treatment you will receive.

If your surgery requires fasting beginning on the evening before, that fact might influence what time you prefer the appointment — probably early if you can get it.

Take a look at any record of legal action claiming malpractice by the MD or the hospital and its employees. Such information should be available on state websites.

PERSONALITIES AND SURGEONS. Doctors need confidence, with surgeons at the top of the list of those needy of the characteristic. You don’t want an uncertain person guiding the manipulation or invasion of your body. Don’t be surprised at the absence of a tender bedside manner.

Why? Even psychotherapists maintain a therapeutic distance from their patients. Surgeons often go further in this direction. They mustn’t feel the full weight or dread of what they are engaged in while in a surgical theater. My encounters with this gifted group have included both the cold and the more approachable variety of humanity.


LEGAL FORMS: Your signature will be desired in many places. The documents detail risks, your rights, who can receive information about your condition, etc.

Medical facilities often employ physicians in training. Ask yourself the degree to which you desire care from these (typically bright and talented) younger people. Doctors must gain this experience to become skilled. For you, however, the question is, do you want the lady or man who performed 2000 procedures or 10?

Make sure the doctor knows what decision you make and your autograph doesn’t contradict your spoken wishes. Don’t assume someone else will tell the doc unless you do.

GUARANTEES: There are none. When asked about surgical side-effects, more than one doc told me, “Well, you could die.” You might have noticed I’m not dead. Ask yourself about your own risk tolerance.

Not everyone reacts to medication in the same way.

Doing nothing can also have physical consequences, as does pretending you are fine despite your physician or relative’s belief you are not.

Too many men avoid doctors in the belief “He cares about my money, nothing else” or “I don’t need an examination.”

Good luck, fellas.

THE HISTORY OF MEDICINE: Because of the lengthy period when the field offered a primitive level of expertise (if any), the discipline’s scientific basis doesn’t have a long past.

Strep throat killed people in the absence of any antibacterial medication. The initial successful use of penicillin in the USA, the first such drug, occurred in 1942.

There was no polio vaccine in the first years of my childhood (the late 1940s and ’50s). During the US Civil War and after, amputations were done with saws.

Years-long gaps exist between fresh knowledge and the point at which the practice of healing changes. The profession requires both learning what is new and unlearning what is no longer considered best and might be harmful in light of recent data.

Remember what I said about the initial employment of penicillin? The first use in the UK was in 1930, 12 years before.

MEDICAL SPECIALIZATION: The dramatic expansion and creation of techniques and other discoveries tax every doctor to keep up. These fine women and men are often lifesavers. They’ve earned our gratitude and more than a decent living.

Understand, however, no one masters every other discipline within the helping professions. Moreover, physicians do not always have easy access to other specialists, nor the infinite time to sit down with them for in-depth discussions.

If you are being treated by multiple professionals, the ability to integrate each of them increases the challenge for them and for you.

When you are consulting more doctors than you can manage, think about going to a place like the Mayo or Cleveland Clinics, where a team approach can be found.

PHYSICIANS WORK MIRACLES: I’ve highlighted some pitfalls because nobody wants to fall into the pit.

Remember this: All doctors are bound by ethical guidance derived from the ancient Hippocratic Oath. They mean you well.

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Another excellent list of Questions to Ask Before Surgery comes from Johns Hopkins Medicine.

Here is the full text of the Hippocratic Oath. It offers the first written ethical guidelines for physicians.

All of the paintings are the work of German Expressionist artist Gabriele Munter. They include Flowers on White (Cyclamen and Hyacinth), Still Life with Poppies, Interior with Christmas Tree, and Morning Shadow. All but the second image was sourced from Wikiart.org.

May 16, 2021

Confused by Friends, Family, and Neighbors? Why is the World so Messy?

When I think back to my Chicago Public School education, only two answers existed for the many questions presented to us. One was right, the other wrong.

No, I suppose it wasn’t quite so simple. I had to find the one right answer. All the rest were wrong.

It is evident today that even my five-year-old grandson has opinions, and an astonishing number of us choose to believe a select group of those who deliver opinions. Unlike my elementary school, our country doesn’t agree on the question of what’s right and what’s wrong.

What shall we do with this condition of our equally human lives together? We are assailed by so many who offer a certainty not shared by other voices. They and we live in unshared tents of true belief.

First, dear reader, I don’t want you to accept automatically what I’m about to offer you. I don’t want you to receive my ideas without asking yourself about them. If you don’t step back and consider whether I’m wrong, I shall become another of those supposed authorities who might mislead you by accident or the intention to deceive.

Let’s get back to what I learned early in life.

My sliver of religious education encountered authorities similar to the secular ones employed by the city, in this case having to do with alleged truth about our obligations to a creator and fellow mortals.

Depending on one’s religion, one received God’s all-knowing words, some etched into long-unavailable stone tablets. So the believers believed.

Friends told me about the Catholic churches of the time. Bible reading was discouraged. The priest would inform you of all you needed. Accepting his pronouncements was expected.

The various authorities delivered top-down stature and insistence. Don’t rock the boat. Don’t dare ask who or what is in the boat or where the vessel is docked.

You could ask questions in these centers of learning, but I didn’t ask many early on—most who did attempted to understand what the teacher or the text said, not challenge the instructor.

Parents also authored a version of the law: the rules of the home and how to behave outside. Again, follow the drill. If you don’t, no thrill.

If the city elders put a sign on the Chicago block containing Jamieson School — the gigantic mortar and brick edifice I attended through the eighth grade, it would have read:

WANT TO FAIL? ASK QUESTIONS!

Somehow I got a doctorate. I made a jump of several years here. Hope you are still with me.

What was going on then? What is going on today?

The average American has not been encouraged to ask queries of himself. Not well-considered, thoughtful ones, at least. For example, when the teacher told us about slavery, the telling including a few uncomplicated explanations of how and why.

Almost no instructor asked students, what else? Might there have been other causes, more or fewer?

We could have been asked, “What do you think was going on in the minds of the slaveholders? What motivated them? If you were a slave, how would you have felt?”

Many of the slaveholders claimed adherence to high-minded religious principles. How did these “masters” combine the vision of a loving God with their treatment of men they considered property?

What does this tell us about the ability of some folks to hold contradictions in their minds? Do you think the plantation owners resolved those contradictory beliefs and actions? How? Do such contradictions present themselves in today’s world? Do they live inside you?

What would you have done if you were the son of a mom and dad who kept slaves? Can you be sure without having lived in that moment, in an identical place and time?

Well, you can imagine. If I taught such a class to young people in certain places today, I’d be terminated along with this agenda.

To my benefit, I was a curious kid, one who led a one-person in-home questioning of my family’s life on Talman Avenue.

Whatever the cause, most of us should harbor lots of questions about the world we live in. An endless number. In particular, those without easy answers

Even before we start, however, we must begin by observing more of the world. Socrates, Martin Heidegger, and other philosophers said a typical person sleepwalks his way through life. We see without awareness. We hear without listening.

We peek at life through a tiny lens — as if through the small end of a funnel. We walk down the street peering into phones, examining texts, tweets, headlines, and emails fed to us by those opinionated others I mentioned before. Taking selfies along the way, as well. Everything gets blurry.

Meanwhile, if you challenge yourself to absorb everything else, you might see without a funnel. Notice the road. Why is it closed off? Perhaps you would wonder who decided this? Who benefits? Who doesn’t? How are the asphalt and labor paid for?
 
You’d see homeless people instead of walking past them as we tend to do with discarded furniture, recognizing the humanity in them described in Sabbath sermons. Do these creatures cause problems? How? What do they need? What is your responsibility? Where do they sleep?
 
Recognize the weathered skin of those too long in the sun. Were they born to other homeless people? Did medical bills lead to the loss of proper shelter? Was prescribed medication a stepping stone to addiction?
 
You’d see trees and insects. In some locals, few flies, bees, and butterflies live. Was it always this way? What explains their reduction in numbers? What happens when these beings are in short supply? Are there human consequences due to their diminished number?
 
Do you know population growth is slowing in many countries? This started before the pandemic. Is it a good thing or not? Why are people having fewer babies? How significant a factor is a living wage to the decision to have a child?
 
If you take another intellectual step, immigration policy enters your conversation with yourself. Pro or con? More newcomers would increase the number of inhabitants and produce more children. Helpful for business or not?

I hope you recognize how many issues like this are interconnected with other observations you might make as you widen your eyes to consume what is in front and around you. Prepare yourself for one question leading to another. The experience can be both unsettling and exciting.

We are interlinked to things, bugs, bridges, people, the folks harvesting our crops, the guy who collects our garbage, the environment, the people who build businesses, the men and women working three jobs of necessity, and the police.

We are attached to entities like us who toil in never heard of villages or cities, absent from dusty maps. Some are decent, some indecent, some would give you the shoes they use to walk, and others would steal yours and laugh about it.
 
Socrates, Parmenides, and Heraclitus all observed their neighbors’ failure to open themselves to the world, wonder about it, and raise internal inquiries instead of accepting the opinions of those thought to be more learned or wise. They believed this the natural state of humanity.
 
Why? Why do we hear but don’t listen? Why do we step forward through the day, the places, and the living things without “seeing” them?
 
Why don’t we reflect upon what we perceive of this magnificent, baffling, racing life and begin more questioning rather than reflexively buying into so-called authorities, assuming they are right?
 
The philosophers I mentioned suggested explanations like this one:

We want simple answers. Quick conclusions making us feel better are preferred, whether they help us feel secure, confident, and adequate or project blame for hard times on others instead of ourselves.

If a person admits he doesn’t understand something by asking a question, he risks self-doubt. If this man is unsure around associates, he may appear foolish.

Uncertainty experienced within our complicated lives provokes anxiety for many. Confused, shaky members of the group can be cast out or lose status. Rejecting the accepted ideas of the tribe breaches the unstated rules of membership.

The world is a demanding, competitive place, where few own the luxury of time. It is one where fairness and prosperity are not guaranteed. Making a living, finding a mate, achieving a safe place to live, and raising decent and healthy children can’t be assumed.
 
Better, many believe, not to overthink what others don’t ask about, thus avoiding worry. Last, we cannot escape the grim reaper: death. We will die, as will everyone we know or will know, those dearest to us included—another troublesome topic to be set aside instinctively.
 
Few have the courage to look at the most pressing conditions of existence in the face, nor the person seen in their mirror. Thus, only the strongest can take on the surroundings in one swallow that includes everything — the beautiful and the awful together.
 
Small bites of the least unsettling bits of it come naturally to the human condition. No, don’t ask too many troublesome questions without comforting, fortifying answers. When in doubt, trust your friends and maybe the people they trust. If you take a widemouthed gulp of the whole world, you might drown.
 
Ah, but the same philosophers also believed there is an upside here. If you are brave enough to perceive everything as it is and engage in questions on a large scale, you will become a more excellent person. You may then alter your life’s path and the history of those around you.

This kind of courage, curiosity, and wonder offers engagement with whatever exists ahead. The well-being you want for those you love and the world’s future requires people such as you shall thereby become.

The possibility of discovering the best possible version of yourself remains down this road. I hope you seek it.

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The first image is the Yukon River, Dalton Highway, Alaska by Laura Hedien, with her kind permission. Next comes Oswaldo Guayasamin’s Waiting. Finally, a Buddhist Lama, 1913, sourced from History Daily.

April 4, 2021

Does Love Die of Boredom? Some Unexpected Advice

As the stream of time moves us on, most of us hope to find a comfortable way to manage. Few beg for more of the turbulence of early years, a period fraught with insecurity and internal confusion. “Who am I — who do I want to be?” — is a question we’d rather not ask. Psychological and physical ease is the goal.

Yet, do we risk a life of deadening routine? Do we hold too fast to one version of our identity past the point our partner finds us dull? Even the beautiful and smart can be unlucky in love.

Who might we consult to make ourselves forever interesting to the one we care for?

How about someone who ended one of his most famous works with the words, “You must change your life.”

Rainer Maria Rilke died at 51 in 1926. In his half-century, he gained an unconventional perspective on love and keeping it fresh. He thirsted for experiences, wishing to absorb the world with new eyes as if he were seeing his surroundings — human and natural — for the first time.

The poet often praises those who make perception into an activity, not the automatic, passive accumulation of sights, sounds, and smells entering our awareness without effort. He wants it to be alive, not rendered invisible by his failure to recognize more than customary appearances.

In The Notebooks of Malte Laurids Brigge, insightful observation requires intention: an attempt to make the familiar unfamiliar, nor turn from what troubles us when we look and listen closely.

Here is an example from the title character Brigge:

There are many people, but even more faces, since everyone has several. There are people who wear a face for years, and of course it wears away, gets dirty, cracks in the creases, stretches like gloves you’ve worn whilst traveling.

Rilke’s words push us to take a new look at the next face we behold. He implies more exists behind faces than we thought. The portrayal of Brigge discloses a young man attentive to subtlety and nuance, the qualities arrayed before him available to his sight: the sensory world we find unremarkable without the effort to inspect it.

Now imagine yourself attached to someone like Rilke, woman or man, who transforms part of the experiences you take for granted.

At age 27, Rilke received a letter from a 19-year-old, with whom he continued a prolonged but occasional correspondence. The younger man, a military student named Franz Kappus, sought advice on his own literary efforts.

The compilation of Rainer Maria’s side of the exchange appears in his Letters to a Young Poet.

In the eighth of his 10 communications, dated August 12, 1904, Rilke addresses the reasons he believed sweethearts became boring.

For it is not only indolence that causes human relationships to be repeated from case to case with such unspeakable monotony and boredom; it is timidity before any new, inconceivable experience, which we don’t think we can deal with.

Note, Rilke doesn’t say one of the lovers is boring. He says tedium grows out of hesitation to take on new inward and outward adventures. He continues:

But only someone who is ready for everything, who doesn’t exclude any experience, even the most incomprehensible, will live the relationship with another person as something alive and will himself sound the depths of his own being.

For if we imagine this being of the individual as a larger or smaller room, it is obvious that most people come to know only one corner of their room, one spot near the window, one narrow strip on which they keep walking back and forth. In this way they have a certain security.

The above passage suggests courage is the inoculation preventing the death of intimacy. Moreover, Rilke believes it will foster not only closeness but also Kappus’s self-discovery. In eaves-dropping on a century-old private exchange, we are allowed to ask if we too remain in “a corner of (our) room” out of a desire for security and safety.

The older man’s message continues to explore this idea:

And yet how much more human is the dangerous insecurity that drives those prisoners in Poe’s stories to feel out the shapes of their horrible dungeons and not be strangers to the unspeakable terror of their cells.

We, however, are not prisoners.

Later, both Kappus and we are told why we ought to flee our self-imposed confinement and embrace the wider world.

If it has terrors, they are our terrors; if it has abysses, these abysses belong to us; if there are dangers, we must try to love them.

And if only we arrange our life in accordance with the principle which tells us that we must always trust in the difficult, then what now appears to us as the most alien will become our most intimate and trusted experience.

How could we forget those ancient myths that stand at the beginning of all races, the myths about dragons that at the last moment are transformed into princesses.

Perhaps all the dragons in our lives are princesses who are only waiting to see us act, just once, with beauty and courage. Perhaps everything that frightens us is, in its deepest essence, something helpless that wants our love.

The dragons might also be thought of as personal shortcomings hidden by the masks we wear — the truth we hide from others and ourselves. The writer suggests we take the role of a sculptor of our individual humanity, forever adapting, shaping, and experimenting with an identity which new circumstances, aging, and personal history demand we change.

Rilke asks us to begin self-examination, to stand erect and naked before the sunlit mirror, and declare, “This is who I am.” The static life, he might tell us, is a missed opportunity. He applauds those who wish to know more — endlessly.

The whole of humanity will never take Rilke’s advice. Not everyone accepts life’s unexpressed invitation to discover who they are and create who they strive to be. I suspect the man is speaking of rare creatures among us.

Perhaps they would be the metaphorical tightrope walkers and fire-eaters, and those to whom love or justice or freedom are worth everything they possess — everything they must endure for the chance to achieve them.

In our challenging mortal world, Rilke recommends we mull over unnecessary boundaries and barricades built for self-protection, some of which cost us the fulfillment we say we want.

Since the clock on our duration keeps its steady pace toward the ends of things, we do well to live with a tempered urgency to be more, notice more, and do more.

And if we are lucky and his suggestions are correct, win and maintain a lasting love.

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The quotations from Letters to a Young Poet are a part of one long paragraph. I’ve broken the sentences up to better clarify your understanding and my commentary.

The first painting is August Macke’s 1914 Tightrope Walker. The second is Tightrope Walkers,1944, by Remedios Varo. Finally comes Giorgio de Chirico’s 1926 The Two Masks. All of these come from Wikiart.org/