depression

May 14, 2023

Of Love, Hate and the Love-filled Joy of Children

My grandson got married, but I wasn’t invited.

Amazing, isn’t it? All I did was show him love and buy him things. OK, he just turned four years old, and his parents weren’t invited either. Nor, from what I hear, were the parents of the bride.

I’ve seen photos of him holding hands with his “wife,” even in preschool.

Shameless!

Who knows what they do when no one is around?

But if this is how love starts, I approve. Fill your hearts full, children, because life will drain them, too — then, with luck, refill them again. Kind of like going to the gas or petrol station.

As to anger, let me say a little about that.

Anger is like a multi-blade knife with blades sharpened to a keen edge, mindless of who it cuts and capable of slicing both ways.

Where does such intense dislike come from?

First comes love, then rejection, then reaction to the dismissal from the life of another. A whisper saying you’re fired, no matter how delicate the voice.

Or, perhaps the starting point of antagonism is a failure to win respect, approval, and acknowledgment. Loathing can grow from the absence of caring parents or the simple difficulty of achieving success, however you define it.

Therapists have all heard the conventional wisdom that depression is anger turned inward. Don’t forget, however, that anger can result from disappointment in life turned outward.

We live in a competitive world, including competition for mates. Someday these two kids will seek consolation for a broken heart.

Someone will say, “Oh, you are better off without him,” or “He isn’t right for you,” but such statements rarely console.

Neither do they provide solace when the words are, “Oh, you are better off without that job — it wasn’t right for you.” Of course, both the young ones are far from the job market.

As we witness a world with more than its share of anger beyond romantic and professional disappointment, many of us are triggered by something less tender than lost love.

Some feel displaced from their spot in the world, their previous role as a worthy breadwinner, or as a person known for giving good advice and helping a neighbor fix his car.

Populist politicians and their allies play on this sense of injury, fomenting anger upon anger like a giant test tube full of bile with daily inflammatory statements, addictive but strangely validating.

Yeah! He gets it. It’s not my fault. I’ve been screwed! It’s THOSE people. They don’t look like us, don’t believe in our god, and steal our birthright.

My grandson and the love of his life don’t know about any of this. They only know about respect, affection, friends, and toys. Maybe an occasional “enemy,” meaning a minor league bully or two, but nothing serious.

We all want love, don’t we? We all hope for applause, a job that pays well enough, status, and an appreciative mate. We all hope to be well thought of, praised, and admired by those to whom we are close. 

In a different world perhaps this wouldn’t be much to ask for, but these days we are too often replacement parts that have been replaced.

Confronting a sense of disappointment in life, too many hunger to pay back those they think are responsible. They only need a model and some encouragement. When all the guys are whining, somehow whining is OK, not as shameful as it used to be.

Still, we search for someone loveable. If politics enters that pursuit, it can be contaminated by opinions that tend to be unloving.

We are not as companionable as we were a few years back. Now we grind our teeth or laugh at the ones “ruining” our country, whoever they are, however preposterous the claim.

We lack the innocence of my grandson and his companion. Indeed, when she was ill and away from school for a week, he missed her and worried about her, dear boy.

Lucky for them, they are not on the internet, an occasionally monstrous place. Many of our interactions with fellow humans come electronically, where plenty of anonymous hatred can be found.

Despite all its wonders, metaphorical bombs are easily thrown by those who are literally out of sight.

If one imbibes the toxic message of anger now widely distributed, I doubt one will become more tender or charming. The four-year-olds have innate wisdom and sweetness, qualities not characteristic of those addicted to TV’s political anger-fests.

Nor will the Rageaholics have much reason to approach those of different races, nationalities, ethnicities, or religions, perhaps even those who pray to no god.

Trust me — one of them might be “the one.” Or, at least, a friend not so different from you as you thought.

We live in a time of loneliness, the anonymity of cities, and the solitary pursuit of “being your own person,” however worthwhile that may be.

Though the small ones don’t know it yet, the time of our lives walks and whistles quickly past the clock, especially if one desires to be loved.

Companionship begins with a decision to pursue it, knowing armorless vulnerability places the heart at risk. The kids haven’t learned that yet, either.

Bless them.

The second decision is this one, made by a wise man over 2500 years ago:

I don’t have time to hate people who hate me because I am too busy loving people who love me.*

An ancient Chinese man said this, but the kids I’m talking about live it.

————-

*Laozi, also known as Lau Tzu (the “Old Master”) born in 604 B.C.

The first image is a 1957 photo of Two Children Holding Hands by Irvin Peithman, sourced from Wikiart.com. 

February 12, 2023

Michael Gerson: Fighting Depression with Hope, Faith, and Love

On the day before the Super Bowl, I’m guessing the short supply of serious newspaper readers is smaller than usual.

Still, the mention of Michael Gerson in today’s New York Times demands attention, though he can no longer know that anyone cares. He was a good man and perhaps a great one who died in December. Fifty-eight is too young for the departure of a person whose presence on the earth made it a better place.

Funny, I should say that. I didn’t always agree with his politics and didn’t vote for the President for whom he wrote speeches.

But in my book, I don’t have to agree with you to admire you, as I did him. I envied his gift of language, his principled stance on matters of importance, and a heroic battle that found him outlasted by death: a bigger-than-life opponent with an undefeated record.

Gerson fought a chemically-based depression severe enough for hospitalization, serious heart disease, and cancer that killed him. Outnumbered, you might say, but not out of hope, faith, and love.

I don’t have to believe in your faith to praise the way you go beyond the weekly attendance at a house of worship to live it. Gerson lived his own beliefs in deep consideration and helping the unfortunate. President Biden just hailed the 20th anniversary of the “President’s Emergency Plan for Aids Relief” created by President George W. Bush and Mr. Gerson. In today’s Times, Peter Baker said their effort saved more than 25 million lives.

Since my words pale to Michael Gerson’s, I hope you watch and listen to him in the video above, an invited Sunday sermon given three years ago. He will tell you enough about his troubles, his concern for the disadvantaged, and his belief in something transcendent to regret his early passing.

The Super Bowl can’t do that, though I hope you enjoy it.

A few seconds at halftime won’t be wasted to remember a humble, wounded, and wise man beyond describing with anyone’s words but his own.

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.

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.

September 18, 2022

How to Find the Type of Therapy You Need

Medical “house calls” were not unusual in the 1950s when I was a boy. I had the good fortune of receiving assistance from physicians who came to my family home once or twice.

Times have changed. No more house calls, but we often choose MDs and therapists as we did 65 years ago.

If you ask a close friend about their counselor, the answer will often lead you to your companion’s practitioner. You can also consult your primary care physician, but their knowledge of colleagues outside their specialty is not always as complete as you might hope.

The unspoken assumption many counseling shoppers make is that all “therapists” are equally capable of treating whatever psychological or emotional distress ails you. However, the actual talents and education of psychologists, psychiatric social workers, marriage and family therapists, and psychiatrists can be a mystery.

Think about it. If you look at a hospital’s list of medical departments, for example, you find many disciplines, some of which you might not be able to define. Similarly, if you consult a list of different therapies and medications, you could spend an impossible amount of time figuring out who to call and what to do.

I am not advising you to ignore the suggestions of your dear friend or physician. Nonetheless, I encourage you to consider the kind of therapy best designed to fit your condition. An essential factor will be to find out if it is effective.

If this is your choice, one website to look at is the Society of Clinical Psychology: Division 12 of the American Psychological Association. Its introductory statement is this, in part:

The field of Clinical Psychology involves … the applications of principles, methods, and procedures for … alleviating intellectual, emotional, biological, psychological, social and behavioral maladjustment, disability and discomfort, applied to a wide range of client populations.

In particular, pay attention to the Society’s guide to diagnostic categories and other treatment targets.

The names of the conditions you find there are relatively common, including  Anorexia Nervosa, Chronic Headache, Depression, Mixed Anxiety Conditions, and 25 others: https://div12.org/diagnoses/.

When you click on one of the named maladies, it will provide further information about specific treatments subjected to scientifically rigorous evaluation to verify effectiveness.

There are numerous lists of practitioners on this website and elsewhere on the web who typically describe the conditions they treat and, less often, the types of methods they use.

If you contact those individuals, it will be helpful to know their skill level and experience in using such “evidence-based” remedies as the ones found by clicking one of the 29 links listed by Division 12 (above).

Your friend’s counselor might even be one of them.

Good luck!

==

The two photos above display the recent work of the outstanding photographer Laura Hedien, with her permission: Laura Hedien Official Website. Both date from this year. The first was taken in the Italian Dolomites, while the second is from Burano, Veneto, Italy.

I should also disclose that I receive no compensation for promoting the American Psychological Association or Division 12. As noted elsewhere on this site, however, I am a retired Clinical Psychologist and member of the APA. My conviction about the value of scientifically established, evidence-based treatment is my own.

September 26, 2021

Prolonged Grief Disorder

The permanent absence of a loved one can seem endless. The mornings are full of mourning and emptiness no amount of OJ or coffee or alcohol can fill.

If the sadness appears to extend to infinity, therapists have a less poetic task. They must determine whether your extreme unhappiness fits the criteria for Prolonged Grief Disorder (PGD). This diagnostic category is new, but the ailment is as old as human history.

To start, here are some of the symptoms of PGD in the American Psychiatric Association’s September 23, 2021 press release describing the soon-to-be-published complete formulation. A prior draft indicated that at least three of the eight must be present for the diagnosis to apply:

  • Identity disruption (e.g., feeling as though part of oneself has died).
  • Marked sense of disbelief about the death.
  • Avoidance of reminders that the person is dead.
  • Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death.
  • Difficulty moving on with life (e.g., problems engaging with friends, pursuing interests, planning for the future).
  • Emotional numbness.
  • Feeling that life is meaningless.
  • Intense loneliness (i.e., feeling alone or detached from others).

They also state the following:

The bereaved individual may experience intense longings for the deceased or preoccupation with thoughts of the deceased, or in children and adolescents, with the circumstances around the death.

These grief reactions occur most of the day, nearly every day for at least a month. The individual experiences clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Moreover, the length of the condition goes beyond cultural norms.

Experienced therapists know people are not so easy to categorize as labels suggest. Many times counselors encounter individuals with more than one psychological concern. For example, depression might be coupled with substance abuse or PTSD.

In the case of forms of bereavement, many have questioned the appropriateness of putting an identifying sticker on an almost inevitable experience in life. Our time by itself has created nearly five million deaths from COVID-19 and a much larger number of their loving survivors.

However, the APA emphasizes that Prolonged Grief Disorder goes farther than the normal grieving observed within one’s community. To the good, the health care field will help you take on your heartache and impairment, whatever name is given to it.

The APA’s announcement and a publicly available 2020 draft do not mention causes of extended lamentation other than death. A few come to mind.

We might include those who become caretakers to their radically changed lifelong partners, parents, or children. Transforming accidents, dementia, or lasting vegetative afflictions often create a world of joylessness in those who take on a job for which they did not apply.

Calamity takes too many faces. Mortals needn’t die to cause dear ones the realization they are no longer interacting with the “same person.”

While discussions about lengthy sorrows have been ongoing, the APA’s decision to recognize and define PGD can be expected to produce more words and productive research.

Even now, if you find yourself among those suffering from unrelenting adversity of the kind suggested here, professional consultation is recommended to discover if you fall into the new category.

Finding the best treatment options for PGD — something distinct from conditions like Major Depressive Disorder or Dysthymia — is a first step in the direction of recovery.

Click here for an infographic on Prolonged Grief Disorder

==========

The first of two works by the Ecuadorian artist Oswaldo Guayasamin is called Spring. The second is Project for a Poster. Both of these date from 1956.

May 31, 2021

An Unusual Way to Think About Life When in Despair

Here is something you probably haven’t encountered in the self-help realm. The therapeutic aid applies in a world where trust is challenged 24/7, as it now is.

A story is required to explain it. No religious belief is needed, though the lesson can be found in sacred writing.

The Genesis tale of Sodom and Gomorrah, places of exceptional immorality, tells of God’s decision to destroy those cities and every person within them.

The Master of the Universe talks with Abraham before the destruction, a man honored by Judaism, Christianity, and Islam. He respectfully pushes back on the Almighty’s sweeping judgment to punish everyone, the decent along with the evil.

This worthy individual reminds God of his role as “the Judge of all the earth.” He asks the Lord whether the wicked and the righteous should share the same fate.

Might the Creator be willing, the Jewish patriarch asks, to spare the planned eradication if 50 upright souls reside within the doomed cities?

God agrees: he will save the entirety of those evil places if 50 exist.

The conversation with the Lord continues. Each time Abraham pleads for the Deity to lower the requirement. The discussion concludes with an agreement to spare Sodom and Gomorrah for the sake of 10 honorable souls.

In the end, only Abraham’s nephew Lot and his small family are deemed virtuous by angels who search for 10 upstanding citizens. Short of the number required for the towns to escape God’s wrath, they alone are permitted to flee.

Many themes are present in this biblical tale. Its emphasis on the value of each individual prompted this essay. God is prepared to spare all the guilty for the sake of a few who are good. He allows a family below the promised number to depart.

What advice might grow from this?

When in despair over your life or the state of the world, perhaps consider something else. Yes, we live in a troubled time in which much harm occurs each day. We have all been hurt or afraid in this challenging moment.

Yet, you might pause to evaluate whether anyone you know or are aware of is decent?

I imagine someone will occur to you. Does the presence of even one such individual encourage you to continue to recognize your life, too, has value?

Now think of someone who might also be facing challenges. They may be thinking of you as someone whose existence lightens their burden. You make their life better simply by being here.

Maybe you do things for them for which they are grateful. Your benign presence or characteristic kindness allows them to take heart. Your laughter or cleverness brings joy, distraction, and their gladness they are alive to hear it.

The world needs many things: wisdom, courage, and generosity come to mind, in addition to those qualities mentioned above. But just as Abraham argued that a handful would justify God’s leniency, I will argue one needn’t be a superhero to uphold the human race despite the messes we humans make.

The kind heart found in a single neighbor, friend, and even within you adds to the conversation about the value of life and living. I hope you can find yourself on the list of those with at least one good quality. Earth is a place where other admirable souls you know or have heard of also reside.

—–

The Descent Towards Sodom by Marc Chagall, 1931. Abraham is surrounded by three angels. The image is sourced from Wikiart.org.

February 28, 2021

“What Am I Without It?” When Opportunities Follow Loss

 

They say we don’t know the value of a thing until it’s gone. If so, everyone on the planet has learned something during the pandemic.

Do you remember your last kiss or hug or handshake? We aren’t often told, “Hey, I wanted to mention, this is the last time, at least for a while.” How rude of Mr. Covid not to announce us.

For a portion of our fellow men, having a job and a place to live is newly uncertain. The future of recess on the playground and the source of the next meal leave question marks.

We miss smiles not blurred behind an electronic scrim on Zoom, the twinkle of another eye, a hand on a friend’s shoulder, and a meeting with his eyes.

The bottom half of faces, too.

If the deprivation we suffer illuminates our values, perhaps we will live a rearranged, reimagined life just ahead. One hopes the knowledge of “what is important” sticks with us.

Ours is to search for the joy we so miss, the balance stolen by the virus, the buoyant activities and interactions that made previous hard times endurable; the reliance, worship, and community encounters broken up and swept away like browned leaves in the wind.

At other times some decided to volunteer for losses. Peter Serkin, the recently deceased pianist, set music aside in his early 20s to travel. He ceased both practicing and performing to “find out who I am without it.” The artist returned to concert life and an extraordinary career informed by what he discovered during his self-imposed separation from his instrument.

Religions ask us to give something up, a loss imposed if you are a doctrinaire believer. Certain foods become forbidden. Your self-denial tells you how much your faith means to you, or perhaps how much you fear divine judgment.

Your devotion and comfort in the Deity grow from saying “no.” Saying “yes” to a moral code outside of church gives its own meaning, as well.

Time is a commodity we all lose all the time. Some careers stand frozen in place. Athletes don’t get their physical prime back. Young people need formative social experiences and pleasures that cannot be retrieved with ease from behind.

The philosopher Heraclitus said, “No man ever steps into the same river twice, for it’s not the same river, and he is not the same man.” The speeding passage of the seasons always requires our choice of one activity over another, one person over another. We might ask, how much time will I trade for how much money?

We are forever deciding where to focus attention, enduring stress to find the next job, risking a question in the hope of a particular answer, daily saying hello and goodbye. No wonder the Hebrew word “shalom” signifies both of those common words.

We are, if we are self-aware, frequently finding ourselves. A person who recognizes himself as changing and changeable knows he must remodel himself. Even without awareness of this necessity, he will be altered by time and events.

The first of the Ancient Greek Delphic maxims was “Know Thyself.” Most don’t, but even if they do, they ought to ask later, “Am I still the man I was? Who am I now? Do I want to be a different person living a different life differently?”

As the planet reopens, we will discover a new world, one with fresh dangers and novel opportunities. Indeed, our place in it, the place for us before COVID-19, may not be suitable after. To the good, we are still capable of becoming.

What you lose changes you. Though we come to expect it, the ache from the departure of a loved one remains tender for as long as it takes for the breeze to wear it away. Hearts are full of irreplaceable people, some alive in “a world elsewhere,” others muted shadows.*

Perchance a grand adventure awaits in the recovered and recovering times. Think of yourself as a sculptor or a portrait painter creating your own likeness.

Yours is the only hand that shapes and shades what is essential, knowing what you alone comprehend. Chance or fortune will fiddle with you, but you needn’t accept every bit of the fate they deliver.

You have a part to play if you can locate it. You haven’t, you say? Keep looking for the role to which you aspire. Life can break you, but it also carries surprise and wonder.

Late in his life, my dad often studied the cement a few steps beyond as he walked, perhaps reviving a habit begun in the Great Depression. He found pocket change, paper currency, and once a fancy watch. I’d not recommend the practice, but you won’t find anything unless you seek it.

First, tape over the hurt spots and find the hunter within.

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

*The three quoted words come from Shakespeare’s play “Coriolanus,” Act III, Scene III.

The top painting is “With an Umbrella,” 1939, by Paul Klee. The final photograph is “Arizona Sunset,” late July, 2020, S. of Tucson by Laura Hedien, with the kind permission of Ms. Hedien: https://laura-hedien.pixels.com/

February 7, 2021

When a Therapy Patient Dies

She died last year. This lovely woman might be called a survivor, but her story deserves something more personal than slotting her in a category, no matter how fitting.

Call her Cassie. I met her in a psychiatric hospital. Not her first hospitalization, far from her last. A suicide attempt brought us together. The lady already owned a long and troubled history, one as middle-aged as she was. I’m talking about 35 years ago.

Once an amateur gymnast, as a youth she was fit, flexible, and energetic. Early photos captured an innocent Nordic beauty, as well. Just by her presence, Cassie must have been as fair and welcoming as the first birdsong in springtime.

Nothing in the woman I met suggested any of this. Like other sexual abuse victims, pounds became a bubble wrap to discourage those who might otherwise desire or terrorize her in search of chest-beating rapture and savage control. Now gray, her hair lacked its youthful golden hue, and the innocence remembered by the photos had been forgotten by her lined, questioning face.

—–

The hospital stay progressed. Apparent roots of her clinical depression extended to a male-dominated childhood, a bad marriage, and a ne’er do well, alcoholic adult son often in trouble. Cassie’s husband displayed passivity and incomprehension. Divorce followed.

—–

My efforts continued for a year before I received a call from a hysterical woman en route to murder her offspring within the hour.

Cassie didn’t sound like herself. Her voice turned unearthly; her tone transformed into that of an avenger of outsized energy and purpose, not the beaten-down creature I knew. My patient’s memories were disjointed, recent conversations erased. Cassie’s child, who’d been jailed for murder, had been released on a technicality.

Cassie intended personal correction of the law’s failure.

I talked her down, but the episode brought home a diagnosis everyone missed: Multiple Personality Disorder (MPD), today called Dissociative Identity Disorder (DID). I’d long recognized this woman to be dissociative, but here was a new facet. From that day, treatment inched its way toward goals she would achieve many years later: integrating her system of alter-personalities and reaching depression’s end.

—–

In homes such as this courageous individual inhabited, families create a loving self-image. Parents cloak themselves in the garb of religiosity.

Cassie’s father died not long after her updated diagnosis. The news came during another hospital stay. A breakthrough followed when Cassie began to have nightmares of never reported sexual abuse. The death of her abuser freed her from enough of the fear of more violence to allow her to remember and speak of it.

—–

The mother denied any mistreatment. In her daughter’s presence, she met with us and declared her upstanding husband incapable of it. Yet Cassie recalled her mother seeing a glimpse of her father’s molestation and watched her turn away and depart instead of intervening.

The trauma ended after her tenth birthday. The family relocated to a new home in another state. Upon moving in, she immediately asked which room was hers and found a key in the door. She grabbed and hid the key. The world changed.

During one of her hospital stays, I walked with Cassie off-unit, on the facility’s ground floor for a reason lost to time. Nor do I recall what distracted me. By then, however, I trusted her enough to sit in the lobby while I talked with someone at the front desk. My back turned, she disappeared within a minute.

Rushing through the doors, I spotted her about a half-block away, running toward the main street ahead. The chase began.

Knee surgery was not yet in my foreseeable future, and Cassie’s vanished prime gave her no help. Calls to her went unheeded, but I caught the laboring woman by the arm. She put up no fight.

I’d never read the word “racing” on a psychologist’s job description. I’ve become a more careful reader since.

—–

Cassie’s troubled life left her without medical insurance on another occasion. By then, she’d had many visits to the hospital where I met her. I spoke with the facility’s administrator upon her admission. He agreed to forgive all charges for her stay, no matter its length. God bless you, Phil.

For a significant period of my patient’s lengthy treatment, I also worked with an insurance company nurse. She became like a visiting angel, helping to craft the therapy to include multiple weekly sessions beyond the company’s normal policy. Her employer gave permission. This enabled Cassie’s life to escape some of the disruptions caused by her hospital stays.

Hat’s off to those good samaritans, as well.

At some point, Cassie raised the question of God’s role. Once a faithful Catholic, she now accused an all-powerful, all-knowing Deity who witnessed her father forcing himself on her and who permitted this outrage to continue.

I suggested she speak with a priest, a wise and sensitive soul of my acquaintance. He offered her tenderness and asked her to consider the possibility her rage at God could also be understood as an act of prayer. My patient solidified her religious connection and held it until the end of her life.

—–

Though he never again murdered anyone, Cassie’s son continued a mischievous, substance abuser’s life. His mom told him she would cease contact until he’d been sober for a year. Much time passed, but he accomplished this, found steady and honorable employment, married, and produced a family. Cassie embraced this change and welcomed them all into her life with much gratitude.

—–

Cassie’s road to health never included interest in finding new love. She did have many dear friends, modest professional success, sustained work, and several outside interests. She once said perhaps the only way she could share her life with a man would be if he were both uninterested in sex and unable to be sexual. Psychotherapy often has its limits.

—–

This woman was the only person in my practice with whom I maintained contact from the end of treatment almost to her life’s completion. She would send me a holiday card once a year, and I would telephone her soon after. We both enjoyed the reconnection. The last time we spoke her memory was failing with speed. She died a few months later.

My heart was full at the news. This woman was a kind and determined person, not without an edge, but with an unexpected tenacity not evident when we met. All the memories I offer here pushed themselves to the top of my consciousness. It was my great good luck to have known this lady and others like her.

Adieux, Cassie. Here’s hoping you reside in a heaven made for the most remarkable among us.

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

The “Please Touch Gently” photo comes from Marduw Quigmire. The Paessaggio sculpture, “A Helping Hand,” was photographed by Safiyyah Scoggins –PVissions1111. Last are “Fungi Located on a Log Near the Forest Floor” by Mfoelk13. All were sourced from Wikimedia Commons.

January 10, 2021

Consolation and Hope in a Challenging Time

On most days, I wouldn’t be quoting President Abraham Lincoln. At a different time, this atheist might not be looking for solace in scripture, though I am often comforted when I do.

Today I’m doing both and offering their consolation to you.

Lincoln, this country’s Civil War President, authorized a day of “national prayer and humiliation” in the midst of that war. His proclamation reads, in part:

I do … designate and set apart Thursday, the 30th day of April, 1863, as a day of national humiliation, fasting and prayer. And I do hereby request all the People to abstain, on that day, from their ordinary secular pursuits, and to unite … in keeping the day holy to the Lord, and devoted to the humble discharge of the religious duties proper to that solemn occasion.

Humiliation fits for this time, too, just after the storming of the Capitol. Fasting fits, as is expected on the annual Jewish Day of Atonement, Yom Kippur. Self-reflection is necessary. Humility and prayer create the appropriate attitude and mood for the occasion.

People are dying. Loneliness overwhelms many, poverty and joblessness terrify, sadness covers the homes and the hearts. Then came the mob.

Humiliation, indeed.

Yet, there is hope.

Lincoln’s leadership continued under even more challenging circumstances.

As the Civil War neared its end, the President offered these lines in closing his Second Inaugural Address of March 4, 1865. His message was one of reconciliation between opposing sides:

With malice toward none with charity for all with firmness in the right as God gives us to see the right let us strive on to finish the work we are in to bind up the nation’s wounds, to care for him who shall have borne the battle and for his widow and his orphan ~ to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.

Abraham Lincoln knew our job is always to repair the world.

Reverend William Sloane Coffin, 100 years later, knew it, too. He offered this in prayer: 

Lord … Number us, we beseech Thee, in the ranks of those who went forth … longing only for those things for which Thee dost make us long, men for whom the complexity of issues only serves to renew their zeal to deal with them, men who allieviated pain by sharing it, and men who are always willing to risk something big for something good — so may we leave in the world a little more truth, a little more justice, and a little more beauty than would have been there had we not loved the world enough to quarrel with it for what it is not — but still could be. …

————

The top painting is called Woman at Prayer by Harry Wilson Watrous. Next comes The Morning Prayer by Ludwig Deutsch. The final image is the photo of a Nomad Prayer taken in an African desert, sometime between 1931 and 1936. The photographer was Kazimierz Nowak.

William Sloane Coffin’s prayer can be heard near the end of the award-winning radio collage/documentary created by Studs Terkel and Jim Unrath, Born to Live: https://beta.prx.org/stories/118275