Finding the Balance between Effort and Surrender

Wisdom turns up in unexpected places. Who said, “Life exists somewhere between effort and surrender”?

The legendary and still active 44-year-old quarterback in the National Football League, Tom Brady, might be the most recent.

Many discovered this before him, including Danielle Orner:

Life is a balance between what we can control and what we cannot. I am learning to live between effort and surrender.
I imagine the Buddhists came up with something similar long ago.

How does this apply to therapy?
 


The most distressed of my patients — the joyless ones — inhabited one end or the other. Those who took the effort to an extreme sometimes achieved material or professional success but almost always encountered repeated frustration to obtain it.

Their singular focus also entailed costs for marriage and family.

A number of these, usually men, tackled life as if on the playing field where the domination of the opposition demanded mastery. They viewed problems as a series of obstacles to be overcome to the point of relentlessness. Such individuals were formidable but not easy to live with.

Openness, they believed, revealed weakness.
 
Serenity lay beyond their reach, leading to treatment.
The ones who specialized in surrender gave in to fear out of a lack of confidence and a punishing history. The human beings they encountered fell into the category of potential deliverers of harm, a kind of enemy army. Intimacy and emotional risk lived in the same category.

The safest way of surviving, as they believed, was to trust no one. Pets frequently provided warmth people didn’t.
 
In each of these cases, the counselor’s job is to ask the patient the cost of their favored strategy. If they identify the price, treatment goes forward. A bumpier path lies ahead if the individual has not reflected on the downside.

More than a few continue to defend their preferred choice. They will, perhaps, encounter more emotional pain or disappointment before choosing to make necessary alterations in their style of living. They might require reflection upon why they decided to be the person they are. However, a clear decision might not have occurred since none of us know our motives in every detail.

Many of my clients found their approach to life as children or teens. The solution appeared as the best available choice for the circumstances of the time, place, and people who surrounded them. I’m speaking of parents, relatives, schoolmates, and teachers. Keeping your head down and avoiding attention developed into a necessity for survival.

Time and experience reveal less satisfaction in the course of their lives. To the extent they become aware of the limitations growing out of their existing style, a search begins to remedy their discontent.

The world had changed around them, and the behavioral choices of decades past came to provide less profit and more loss. It was as if the new tires they put on their human vehicle years ago became threadbare.

With enough pain, the motivation to seek a better way ahead emerges.
 
 
But what of the balance between effort and surrender? That idyllic place is a moving target. Always.

I once asked Rick Taft, who managed investments for a living, whether he believed the stock market would rise or fall. “It will fluctuate,” he said.
 
This is true for stocks and most everything else. Just as the weather changes, we retain no promise of health, happiness, wealth, or much else. But if we can stop depending on a smooth life course, we have taken the first step toward emotional balance.
 
Without a single, permanent, satisfying spot between effort and surrender, what then? Here are ten suggestions:
  • Take opportunities where and when they arise. Doors open, but not always more than once.
  • Recognize the only unchanging experience in life is change. You cannot freeze the planet or our bodies in place, as the climate reminds us. Learn to become a tightrope walker on a windy day.
  • You do not have to take every opportunity, but take more than are comfortable if your nature is hesitant. Pull back instead if those instincts tend to push you to jump without looking.
  • Life will unsettle you, as it does to all of us. Resolve to reach for joy in small things, lest the inevitable unfairness of some days wrecks your disposition.
  • No one thinks about you as much as you believe. Others spend too much time with a miniature version of themselves buzzing around their brains. The focus outside of themselves emerges less often, except in moments of outsized feelings like love, hate, and fear. Therefore, don’t worry endlessly about looking foolish and making mistakes, lest you recall embarrassment long after the crowd has moved on.
  • You’ll grow more if you do more and find some exhilaration in daunting moments, balanced or not.
  • Learn to meditate, beginning in a calm and quiet circumstance when possible. Daily practice centered on your breath (as the top video suggests) reduces your chance of being swept away by a stiff breeze or worse.
  • No one figures out their life. Few of us fully display our pain and confusion. Do not be fooled by appearances.
  • If you can find a tender and consoling hand, reach for it. If you see a needy soul, extend your own to them.
  • Smile and laugh. Most of our worries don’t become a reality, and among those that turn out as we feared, a remedy might be found with time and effort.

We live in transit — in a perpetual transition, no matter its static appearance. A man in a train moving at a steady pace has no sense of forward motion except when he looks out the window. An observer outside the train, however, wouldn’t be in doubt about the fellow’s progress.

With the above in mind, think of life as a series of alternatives. The midpoint between them should not always be your target:

    • Sleeping — waking.
    • Seriousness — laughter.
    • Learning — teaching.
    • Following — leading.
    • Being for yourself — being for others.
    • Head — heart.
    • Action — contemplation.
    • With people — alone.
    • Reading — writing.
    • Contemplation — spontaneity.
    • Being in the moment — being conscious of yourself.
    • Looking back — looking forward.
    • Listening — speaking.
    • Getting — spending.
    • Indoors — outdoors.
    • Accumulation of material things — reaching for experiences.
    • Assertion — passivity.
    • Diving in — waiting.

Are you disappointed I have not offered you a simple answer to this puzzle?

Sorry, I am too busy working it out for myself, searching for each day’s new balance!

———-

Beneath the top video are the following images, in order:

  1. An 1891 poster from Wikimedia Commons of Félicia Mallet by Jules Chéret.
  2. Tears of Blood  by Oswaldo Guayasami.
  3. An incredible view of Lake Misurina, Italy, from History Daily.
  4. The Example of One Choice Question, a screenshot simulation from the TV show Are You Smarter Than the Primary School Students? Taiwanese version. The picture’s author is 竹筍弟弟 (talk) from Wikimedia Commons.

    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.

    Making Experience New: On Recapturing First Times

    The first time something happens is almost always extraordinary. At least, that is how we remember many early events. History is written upon our innocent, blank canvas with bold, colorful strokes.

    The young one unwraps the world of initial impressions with every sense he owns, but many of these encounters become familiar before the brain inks them into long-term memory.

    Thus, in a sense, some “first times” have already become routine by the time we are a bit older. We can’t remember the fullness of their original impact unless they carried drama, good or bad.

    These thoughts occur in response to a new “first time.” My astonishment is not uncommon among those who, like me, have just had cataract surgery.

    The operation has freshened my capacity to see color, its richness, clarity, depth, and glory.

    I feel as though I lived for years in Plato’s allegorical cave, a man who took shadows for reality. Turning toward the light I’ve missed, the rainbowed world carries enchantment.

    Cataracts created the gradual clouding of vision — a kind of dimness and a blurring of the visual world.

    Like most, my case progressed slowly, without a noticeable change at first, creeping along undercover. Only when the dulling of the sense of sight brought growing practical challenges did it necessitate surgery.

    The next several weeks of recovery should offer additional positive news about my perception. Were you in front of me, I might paraphrase the Big Bad Wolf’s comment to Red Riding Hood: “Ah, how much better it is to see you now, my dear.”

    Of course, this change demands lots of second looks at the world. Not even my wardrobe appears the same!

    Every artwork, natural and human beauty, flower, and aspect of the sun or moon provides either a fresh experience or a second chance at an old one as if it were the first. The opportunity to recreate a series of “beginnings” bowls me over.

    I must emphasize the word “create.” To a degree, each of us creates the view ahead, along with our personal expectation of safety, friendliness, or opportunity in our human encounters. What we glimpse and how we interpret it depends on us, at least in part.

    I do not know how long my amazement will last, but once the surgeon finishes another of these procedures, I will surrender to every sight my hazel orbs permit. Indeed, I’ve begun.

    Since we tend to get used to conditions, lasting impact is never guaranteed. Think of food. You might remember particular unrepeatable restaurant meals.

    The delight in a new taste or marvelous  preparation is hard to recapture. We recall first loves with the same difficulty of finding another similar emotional and sensory wallop.

    I am eager to fill the space between my eyelids with my children and grandkids — their skin tone, complexion, hue, and glowing smiles. Museums await me, as well. Mark Rothko’s work will be a priority destination.

    As the late comedian Norm McDonald said, “The only thing an old man can tell a young man is that it goes fast, real fast, and if you’re not careful, it’s too late.”

    His words remind you and me to recreate ourselves, erase a part of our canvas and renew our eager receptivity to the palette of natural and human brush strokes. To let the world impress itself on us as children do. To become, as Carlo Maria Giulini, the gifted conductor, described himself, “an enemy of routine.”

    If life represents a search, taking in the fullness of the road and its surroundings becomes essential to the journey.

    I am not too late to widen my scope. Indeed, the previous darkness of my eyes and the metaphorical evening of our present moment join to enlarge my gratitude and amazement.

    One caution, though. The next time I meet you, I might make you self-conscious for a second, no matter your gender or age.

    My eyes don’t intend this, nor do they wish to evaluate your appearance. Instead, to drink you in. Don’t worry. My soul-searching career is behind me.

    Like Humphrey Bogart in Casablanca, I may suggest we share a glass of wine and this toast: “Here’s looking at you, kid.” The person I embrace will be another first time, no matter how long I’ve known you.

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

    The top image is A Sunset in North Dakota captured this June by the magnificent Laura Hedien, with her kind permission: Laura Hedien Official Website.

    Next is A Woman in a Room by Pierre Bonnard from Wikiart.org/

    This is followed by Hot Air Balloon and Moon, © Tomas Castelazo,  www.tomascastelazo.com / Wikimedia Commons / CC BY-SA 3.0/

    The final artwork is Mark Rothko’s No. 3/No. 13, Magenta, Black, Green on Orange, also from Wikiart.org/

    A clip from the end of Casablanca with Ingrid Bergman and Humphrey Bogart completes the exhibition.

    On Adult Attachment to Children

    There is nothing like the wordless sadness of a beautiful face dear to you. I’m referring to the small, huggable, wide-eyed ones when overtaken by uncertain illness.

    “Mine!” is one of his favorite words, claiming property his bigger brother shows an interest in. The malady, however, offered nothing he wanted to keep.

    The upbeat mood of the smiling, sweet-as-chocolate cherub melts in a few minutes. Energy departs, spirit evaporates, words transmute into inexpressable discomfort. The flush of heat rises, but the body descends.

    The sick two-year-old loses his chatter.

    My youngest grandson does not reach for a hand — doesn’t lead you to a toy, or a place, or try to have you for himself instead of sharing you with his six-year-old brother.

    It must be tough to be a little fellow, hard to make your imperfect utterances understood.

    Now he wants the hugs only a mom and dad can supply — seeks their comfort and embrace, the safety he can’t describe.

    You watch this happen. COVID fertilizes your fear, growing like Jack’s speedy beanstalk. The concern is new, though other epochs had their own dangers — smallpox, polio, plague …

    The moppet slumps into slumber. You depart, but the precious person grips your heart, now shadowed by a cloud.

    The day passes. Your wife’s sleep is fitful.

    The golden boy holds the sorrowful power to instill worry.

    Daughter #2, his mother, sends a message early the next day.

    A long nap, his parents’ knowing, double-duty attention, food, and more sleep sweep the danger away. The tentative all-clear sounds.

    The news makes the sun shine brighter today. The superpowers of small children extend to the stars.

    Sir Francis Bacon wrote, “He that hath wife and children hath given hostages to fortune; for they are impediments to great enterprises, either of virtue or mischief.”

    What the writer didn’t say might have also been spoken about love. We are held fast by our loves, the closest friends, our offspring, and our grandkids, too.

    Those attachments can do far worse to us than the bit of concern we had that day. Much, much worse. Many near misses and joys await. Best not to borrow trouble.

    But this two-year-old deserves credit. His bounce-back brought the sky’s warmest blue. Only the dearest hearts inside you do this. He sprinkles fairy dust and doesn’t even know it.

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

    The first photo dates from 1934 and was published in Modern Screen magazine in 1950. The two-year-old girl is Elizabeth Taylor, with her mother Sara Sothern and brother Howard.

    The second image was taken by Rita Martin and shows an unnamed child in 1912. Both of the photographs were sourced from Wikimedia Commons.

    What Family Photos Tell Us

    I’d known since childhood. Mom told me her dad had been hospitalized with the Spanish Flu during World War I. Millions perished worldwide, 675,00 in the USA, not just the old but young adults in their prime.

    Like Leo Fabian.

    Grandpa.

    I didn’t think much about the averted calamity. The event hid behind my eyes while I focused on the world in front of them. Too bad I buried the idea of his medical confinement. I could have asked granddad before his much later, real burial rites.

    Eventually, a new thought pushed up for my consideration. If he’d died, my birth vanished with him. Jeanette Stein emerged in late 1918. Without Leo Fabian, no mom, no marriage between her and Milton Stein, no baby psychologist Gerry, no superman Eddie and champion bodybuilder Jack, my brothers.

    No Sam Fabian, either — my uncle and his three kids. No grandchildren at all.

    Long before my folks passed on, they gave me three large photo portraits. One of them showed Leo and Esther Fabian (my grandmother) with their first child, Aunt Nettie. Like all such images of the time, the posed picture was undated and formal — a no-smiles-permitted, dress-up occasion. These staged likenesses displayed dignity, pride, and status, along with severity.

    My imagination didn’t go far with the story of a family cut short. The brain inside me allowed minimal consideration of the image or its implications.

    Decades ago, I hung the thick wooden frame in my home office and became accustomed to the threesome watching me over my left shoulder. They look at me from 103 years of distance now.

    They were patient from the start, you might say. Waiting for me to discover their undivulged secret.

    At some point, I observed the front of my grandmother’s black skirt rising over her white blouse into a baby bump just below her diaphragm. Seen but not interpreted, not realized as carrying a contradiction in addition to a new life.

    Then it struck home.

    Leo Fabian, the surviving target of the pandemic, fathered a second child before his illness. Esther was pregnant. My mother’s appearance in the family play didn’t depend on her father’s survival.

    The perception of my history swiveled at the knowledge. What would have happened to Esther if she became a widowed mother in 1918 with two preschool children? A woman with limited English and no trade or training to make a living for herself and those young ones?

    Would she have found a way to cross the ocean back to Lithuania? How would the overseas clan have accommodated newcomers amidst the turmoil of the just-ended WWI? If they survived, would all of them then die in the Holocaust some 20 years ahead?

    Might one of her sisters, who also came to America with her, permitted the three to move in? Wait. One of them died young and left her own three children. The widower husband, Harry Kraft, married the remaining unmarried sibling. No guarantees of a safe harbor there.

    Might an orphanage have been the little girls’ fated destiny?

    Or maybe Esther, Nettie, and little Jeanette would have lucked out in an unimagined way.

    None of this is knowable. You might ask, though, why it took me so long to recognize the photographic evidence for what it was.

    In any case, from my perspective, Leo Fabian’s recovery from his illness was essential for mom’s romance with dad, probably even her meeting with him.

    Of course, some of you may believe fortuitous relationships are “meant to be.” It is comforting if life works out as you wish it; more disturbing if a guiding hand sends you in an unwanted direction.

    Many others, the author among them, believe chance plays a big factor in every past, present, and future.

    Or perhaps, along with some quantum physicists, you’ve decided that infinite versions of our lives are being lived at this moment, all simultaneously, all different. No less than Stephen Hawking thought so.

    In the end, no matter what you do with such thoughts, you are immersed in the one world we inhabit (even if it is a dream).

    Best to concentrate on staying afloat.

    A full-time job, for sure.

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

    The first image is my mother, probably not long after her marriage to my dad in 1940.  Then, in succession, my Aunt Nettie when she was still the only child of Leo and Esther, Esther’s baby bump, Esther, and Leo. Other than the top photo, they all come from the early family portrait of the Fabians mentioned in this essay.

    Love and Where We Find It, Including the Therapist’s Office

    Our feelings are attached to places and dates, dates in both senses of the term. People with a good memory can even tell you the room or moment when particular words were spoken — when the mood or lighting altered because a relationship changed.

    First meetings, last meetings, and relational drama become almost like a portion of the architecture and appearance of the place where they happened. The spot takes on an emotional resonance out of proportion to what a stranger would notice.

    No wonder the counselor’s office becomes part of your alliance with him. Even your time slot in his schedule organizes your life and attaches to the experience of therapy. His consulting room is not just a place where memories are uncovered but where they are made.

    If you’ve ever owned a home or lived anywhere for a long while, you may have returned soon after you left. Maybe your route from work put you on the old path without thinking.

    Others go back consciously, though not sure what draws them. Some want to revisit an unforgotten ineffable quality associated with this material segment of their history. Or perhaps they still search for the events that happened there or the one or ones with whom they occurred.

    The evoked sentiments loom larger than the manufactured creation. They make the edifice small by comparison.

    —–

    An older woman I know, someone I am close to, visited Chicago decades after leaving for the suburbs, then California, and finally Nebraska. When arriving her first time back, she wanted to see the old neighborhood we both inhabited and the “other house” where her teenage years transpired.

    This charming lady’s youth and home life were troubled, but not so for the earliest years near my family. Her parents wished to rise in the world, motivating their departure from the north side of the “Windy City.”

    The dad, in particular, had been marked by poverty. Adult ambition took them all to a posh Chicago suburb, where parental conflict, poor parenting, debt, and the father’s illness and early death damaged everyone. The best part of her life remained back in the old dwelling on Talman Avenue, the street where I knew her.

    The status-driven designer house was supposed to make all their lives better, but when our tour stopped in front of it, the recollections embedded in the place bubbled up. A flood of tears followed. Once she caught her breath, she said, “For this.”

    For this?

    They’d moved from a location where she had friends and felt accepted and acceptable, where her parents got along with each other: a place where the idea of home meant safety.

    The exit from West Rogers Park leading to the family’s new chapter became a loss, not the betterment expected. The ensuing unhappiness tied itself to the new site.

    The finer set of walls, rooms, and a circular driveway brought no satisfaction, no lofty place in the world. This was the graveyard of hope, not its fulfillment.

    The therapist sometimes enables people to feel they are worthy of love after a lifetime of believing they are broken, ugly, or stupid — “too sensitive,” disturbed, or weak. The fact of being valued can cause outsized affection, transference, perhaps love of the one who assisted in the process.

    When the treatment ends, it isn’t uncommon for the client to wish to take something physical — a small piece of its contents, a “thing,” but one containing personal meaning.

    This desire is similar to small children holding on to their blanket or a stuffed animal to calm them when the parent isn’t available. But saying goodbye to the counselor is different.

    The article given by the clinician is a transitional object and also something more, intended to preserve indescribable emotions indefinitely. Mom and dad return, but from the healer, there is a parting.

    Momentos needn’t be beautiful to carry the significance of the people and moments we retrieve from those inanimate creations, the sentiment they offer. We also remember places, sometimes unremarkable, because of those beside us when we were there — the beloved parents, partners, and pals of our lives.

    —–

    When the Madison and Wabash elevated train platform underwent deconstruction and remodeling, I could not look at it without recalling my dad. He and I stood on the now-discarded wooden planks many times and at many different ages.

    I doubt I will ever see that station without thoughts of him, though the boards on which we trod have disappeared.

    I imagine there are such locations in your life. They become part of us.

    Are the things intended to catch lightning in a bottle — the electric charge of human contact?

    The best possible “bottle” evokes emotion in touch with the heart. Perhaps, too, “sessions of sweet silent thought,” as Shakespeare would say.

    When you are old and ridding yourself of worn-out objects and stuff of no value, I suspect you will keep those beyond price because they carry this special kind of magic.

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

    The photo of the old Madison and Wabash “L” (Elevated Train) Station is the work of David Wilson. The image was sourced from Wikimedia Commons.

    For those who don’t know the Chicago “Loop,” the term first referred to the area within the “L” train’s loop-like route around the city’s downtown center.

    Are You More like Your Parents than You Think?

    Judging how much you take after your parents becomes a question of whether you can bear reality, at least if they fell short. 

    Short of what?

    Benign attributes such as respectability, kindness, or caretaking.

    In that case, our forgiving brains tend to airbrush the reflected image shining back at us from the mirror, so we miss the resemblance.

    We’d rather observe a face we admire or tolerate than one with enough flaws to trigger the scream, “Oh, no!”

    Why?

    We are prone not to unsettle our self-evaluation or family relationships. Nor does society want to hear from “ungrateful” children.

    A human’s capacity to create a beam of insight into himself and the world always contends with his desire to sleepwalk through the undesirable parts.

    Experience suggests the majority choose the parent they like as the one who they most resemble. The adult child also may have acquired a blindspot for his own dark side, the part resembling one or the other guardian.

    Clinical psychologists, however, comment on the danger of becoming like the person you hate, as if you received a transfusion of his hot temper or critical nature. Therapists encounter patients with unresolved parental issues with regularity.

    Psychotherapists attribute the cause to continuing anger at the one who harmed them. As the top painting illustrates, such emotion gets displaced, whether at another or ourselves.

    We all possess the capacity for ire, a quality required for self-defense. If the fund of internal fury looms larger or smaller than conditions justify, it becomes a problem.

    Anger turned inward is a longstanding definition of clinical depression. An oversized storehouse of rage within a human receptacle is corrosive no matter where it is directed.

    To continue the topic of blindspots, we not only turn from recognition of lamentable similarities to a disliked parent, we often put the “good” one on a pedestal. This calls for a bit of a whitewash to disguise his shortcomings or invent excuses for him.

    The paint-over also ignores our favorite’s failure to acknowledge or prevent unfortunate actions by the one we identify as the principal contributor to our unhappiness.

    Our folks always require some slack, especially when they lack supportive social institutions, friends, or family to help with childrearing. Neither does single parenthood, and the necessity of moneymaking allow much room for attention to little ones. Inadequate housing, unsafe communities, and more compound the demands of bringing up offspring.

    No mom or dad manages the task without mistakes.

    Part of our life’s work is to choose models for our behavior. Parents are the obvious and necessary candidates because of every youngster’s long period of dependency. Therefore, the default tendency is to view them as better than they are, lest we live in fear of having no adequate protectors.

    With the passage of time and the enlargement of independence, it is beneficial to recognize this pair represents only two versions of pursuing a satisfying life — two sets of values and choices.

    Moreover, because they are usually older than we are by a matter of decades, their perspective and guidance do not necessarily fit us.

    A wise parent remembers enough of his early years to be helpful. One with little recall of what it means to be young might not do his best.

    Nor do those who dismiss the unique difficulties of their children’s lives increase their chances of offering the young ones empathy.

    —-

    The ability to discover ourselves in our folks must overcome the age difference. The obstacles to seeing sameness are magnified by the physical and psychological differences that come with the passing years.

    Allow me to explain.

    A dad, say, 30 or more years your senior, later might no longer be the same person he was when governing his life and yours. Aging, personal growth, self-reflection, and experience cause revisions of his former state, though not every alteration enhances his being.

    On the other hand, you may begin to recognize similarities not before discernable when you get older. Growth into adulthood should increase psychological awareness, though not everyone becomes enlightened.

    Once the wellspring of your existence is dead, of course, he doesn’t run ahead of you in chronological progression, and you might perceive yourself in the later versions of who he was.

    Gender differences also hide qualities that would have been discerned had you shared the identical birth assignment of sex with the parent you believe to be less akin to you.

    The essential message here is to beware of mutating into a form of yourself you would advise others not to become.

    Consider taking an occasional moment to reflect on the characteristics describing those who gave you life. Time and experience sometimes alter the look back.

    While I cannot promise what visions then emerge, don’t rule out the possibility of surprise. By examining the contents of old luggage and saved correspondence, the opportunity exists to assume the role of historians of our families and ourselves.

    The task can be like reading an outstanding book for a second or third time, spaced years apart. The writing has not changed, but the reader has, thus remaking the words and their meaning.

    New discoveries and insights are possible when we revisit the memory of long-departed people, especially those who were once so important. Unrealized gifts can be uncovered even in the baggage they leave behind, including an unsuspected one: your forgiveness of them and its blessing to you.

    As I’ve implied, holding anger forever punishes the one who holds it regardless of whether the other ever receives his just deserts.

    ==========

    The top image is called Anger Transference by Richard Sargent, 1954. It was sourced from History Daily. The next one is Happy Parents and Baby by Sheldonl, from Wikimedia Commons.

    When Your Therapist Doesn’t Share Your Faith

    A few potential clients asked me this the first time we spoke on the phone:

    Are you Christian?

    Since I’m not, the call soon ended.

    I never tried to talk them out of their decision. Not that I could have.

    The choice of practitioner involves numerous factors, but one shouldn’t dismiss the importance of religion. For many, it represents a major pillar of their lives and a source of sustenance.

    Nor should the helping professional disregard it in a new client who never asked about whether he believed in a higher power.

    A counselor must respect your creed. The doctrine you hold offers guidance in morality. Therefore, you possess the right to expect the practitioner to be principled, even if not identical to yourself in his every value and code of conduct.

    From this retired clinician’s standpoint, a professional who adheres to a different faith requires two levels of acceptance of his new patient:

    First, she needs to remember the beliefs and motivations of the human race are dependent on a large component of instinct and emotion. Because we lack scientific proof of God’s existence, religious differences begin from a base of uncertainty.

    No wonder there are thousands of Christian denominations alone, all basing justification for their understanding of proper Christianity on the same book.

    No one in the mental health profession encounters a robot-like slice of humanity without a core of emotion. If such people existed anywhere, they would consult computer programmers for all their sadness and anxiety.

    Second, the practice of treatment with words includes the ability to accept homo sapien frailty. No healer has every answer.

    He must recognize his own limitations, his patient’s foibles and model for the client a generous, empathic embrace of the human condition despite the condition of humanity.

    Some of those in search of psychological help believe shared faith ensures security. Unfortunately, supposed identical beliefs may enhance a false sense of safety and enlarge the opportunity for the authority figure to harm one who comes for his aid.

    A therapist always starts by playing catch-up. He attempts to accumulate information about this woman or man with speed. The client’s belief system adds to his understanding.

    I treated adherents to multiple forms of many religions and of no religion. To understand Christians, I read historical volumes and enlarged my familiarity with the New Testament. I also began to educate myself about Buddhism when I worked with my first adherent to this Eastern way of living.

    In cases involving sexual abuse, I occasionally consulted ministers or priests who were not among my clientele. Misfortunes challenging to the patient’s faith led me to encounter questions impossible to respond to from a position of religious authority. Among these was how a supposedly all-good and all-powerful Deity permitted such suffering.

    When one woman wondered how to manage her rage toward God. I encouraged her to meet with a sympathetic priest. He offered her a transformational change in viewpoint:

    If you choose to speak to the Lord about your anger, that too is a form of prayer.

    Her faith remained intact.

    On occasion, the helping professional walks an invisible line between supporting the client and undermining her credo. He takes care not to rob the sufferer of the spiritual reliance upon which she depends.

    Too often, a patient encounters co-religionists who shun her because of her alleged moral failure or absence of prompt forgiveness of devastating injuries.

    The same challenge occurs if she is told her emotional pain demonstrates a lack of commitment to the Almighty’s requirements. So-called righteous individuals have been known to blame unhappiness on insufficient prayer or shaky fidelity to dogma.

    The counselor needs to negotiate this tightrope-like pathway regardless of his own doctrinal attitudes or their absence. The personal bias of an atheist social worker is not necessarily less or more than the prejudice held by a therapist who belongs to the patient’s community of faith.

    Religion can connect the individual to something beyond himself. Our secular and isolated world of individualism leaves many without a sense of higher values. I needn’t explain the problems of too great a focus on the self, material success, or the tribe.

    While religious differences present unique challenges, other variables also impact the doctor-patient relationship. These include age, race, nationality, gender, background, politics, personality, sexual identity, therapeutic orientation, and more.

    Experienced and talented counselors work to create the human connection needed for healing. When such souls are suited to their vocation, they welcome the enlargement of their own humanity by encountering and assisting people unlike them.

    ========

    All three of the images are sourced from the Art Institute of Chicago. The first is The Battle between the Gods and the Giants, 1608, by Joachim Antonisz Wtewael. Next comes Sunset, 1930, by Paul Klee. Finally, Bodhisattva, from 8th century, Japan.

    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.

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

    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 PoppiesInterior with Christmas Tree, and Morning Shadow. All but the second image was sourced from Wikiart.org.

    Tests of Character and What We Make of Them

    Life is full of challenges. Not all demand courage.

    Moreover, sometimes what looks like bravery might be foolishness.

    Judge for yourself.

    Judge me if you wish.

    Before I began the independent practice of clinical psychology, I taught at two fine East Coast universities and then spent several more years working in a small private psychiatric hospital.

    The institution’s owner was a remarkable man, remarkable because of his strange combination of incompatible characteristics. Those qualities included generosity, thoughtfulness, arrogance, philanthropy,  and vindictiveness.

    Let’s call him SB.

    Play with the letters to see if you can come up with a nickname. Perhaps choose a vowel for his middle initial.

    This gentleman’s ego could have filled a large sports arena. I learned during my tenure to reason with him alone, not in public, a place where he might lose face. Confidential discussion often persuaded him to give up some of his dubious ideas.

    The boss recognized my worth and treated me well for a few years. Ah, but almost everyone found himself in his metaphorical crosshairs as time passed.

    One of SB’s brainchildren was the creation of a psychology internship program based at the hospital. The head man hired a part-time director, but the American Psychological Association accreditation team rejected his scheme — his baby. They cited the lack of a full-time chief as their biggest concern.

    SB was displeased.

    I was occupied with other activities within the facility, but SB wanted me as the savior of the program: its new high potentate. Some confidential conversations with the overseer offered hope he’d target someone else. I preferred my then-current work responsibilities. The request remained unresolved.

    The new interns arrived on an autumn day like any other, but not a day like any other in my life.


    At the time, I had a 19-month old daughter. My wife and I wanted our darling to benefit from a stay-at-home mom. Therefore, I was the sole financial support of my family, a fact known by SB.


    Unknown to me, “the man” used the morning and early afternoon to introduce the aforementioned three graduate students to various staff members. I later found out he pushed several people around as he walked the newbies through his domain. No one was immune. Not doctors, nurses, psychiatric aides, or housekeeping personnel.


    SB was a master of bending others to his will on the days he wasn’t smiling. The chieftain demonstrated to the twenty-something trainees his status as GOD relative to mortals.

    My office overlooked a river at the far end of the building, leaving me last on the trail of tears. The maestro announced himself, and the young people joined the two older ones (I was almost 34 and SB in his 50s).

    After introductions, the conversation sounded like this:

    Dr. Stein, what have you decided about the directorship of the internship program?

    I’d prefer to speak with you about it alone.

    I’d like to know your answer now.

    I’d prefer to speak with you alone.

    Tell me now.

    The exchange continued into infinity. The overlord tried to force the issue, and I repeated myself in the same words for about 10 years, psychologically speaking.

    OK, not a decade as told by the clock. Maybe a few minutes if you add the silences. Lots of time spent staring at each other.

    Another entity entered the room as soon as the confrontation began. No, not my past flashing before me, but my unlived future, towering like a gray shadow from a place just over my shoulder. Every person had a shadow but the fellow in charge.

    Weeks later, I asked the fledgling psychologists for their take on the episode and their estimate of its duration. They were petrified. Everyone’s sense of time stretched like taffy.

    Back to my office. Once SB realized he couldn’t make me talk in their presence, he ushered them out and told me I’d better say yes if I wanted to work at HIS facility. He gave me a couple of days to think it over.

    Sounds like fun, doesn’t it?

    The result: I took over as the new director and explored plans to exit the hospital. SB and I were soured on each other. No value would come in staying. I departed several months later, invited to become the junior member of small group practice, of which I became the head within a few years.

    What else was going on inside of me during the contest? I envisioned the event this way:

    One person tried to get over (on top of) the opposition, defeat the other — “put him in his proper (diminished) place.” SB intended to bend another human object to his will, bring him to his knees.

    The other resisted.

    For years I engaged in silent self-praise for holding to some unarticulated principle.

    Nope. No doctrine existed. My intransigence was about being a man. I wasn’t fighting for freedom, civil rights, saving the planet, world peace, better schools, racial equality, or any other noble pursuit.

    As you must recognize, I did give in to him later offstage, not in the drama he initiated. Indeed, I knew he owned the power to fire me from the start.

    Despite mindfulness of my jeopardy and awareness my wife and daughter depended on me, I didn’t roll over. The months between that day and my resignation were fraught. I put myself through a good deal of worry and unhappiness, my spouse as well.

    Not so smart, then? I might even agree with this determination.

    Here’s an additional complication: I felt I could not do otherwise than what I did. I reacted out of instinct. I’d have been ashamed for capitulating in front of the arriving trainees.

    I’d have defined myself as a coward even though my employer had every right to reassign me to a different niche in the organization.

    Both SB and I behaved with an awareness of our audience. It doubtless reduced the two antagonists’ willingness to act differently than we did.

    Though I did not realize it at the time, SB’s actions motivated me to leave his employment and begin a far more fulfilling role within my profession, a necessary step toward my professional independence.


    The insecurity of my status required me to be more creative, learn additional skills, reinvent myself from a vocational and personal standpoint, and enhance the economic security of my little family.

    From that perspective, SB did me a favor. My superior made me uncomfortable enough to alter my career path and take more risks. I became, in my judgment, less a person who allowed fate to carve the road I traveled and more a man who forged his own way.

    As I progressed, more opportunities came to me. Confidence grew, and my perception of myself evolved into that of an individual who could make a life rather than endure it or hide from it.

    SB meant me no favors, but if I met him today, I might thank him.

    One more thing, I was lucky, wasn’t I? A poorer outcome might have occurred.

    Until such challenges appear, we don’t know ourselves. Most of us imagine what we’d do in a variety of conditions we’ve never encountered.


    When we read news stories about the misfortunes of others, too many of us achieve a cheap self-satisfaction by claiming we’d have made a different choice. We assure ourselves of a wise departure before a disaster unrecognized by its soon-to-be victims.

    Unlike other weaker souls, our fantasy includes unfailing defense of our principles. The poor mass who suffered or died didn’t possess our foresight, intelligence, or hard work, so we think.

    On the other hand, self-awareness comes at the price of realizing the dream of heroic behavior in unlived circumstances is like a soothing massage of our self-image.

    I am no hero, and I do not claim the rank of a great man. I hope you extend yourself beyond whatever evaluation you make of me.

    What I’ve written has value only to the extent a single reader considers himself and reflects on whether the tale offers insight into his own life.

    That much is in his hands.

    =======

    Each one of these images is called Face-off.

    The first is by Aaron from Seattle. The Jack-o’ – lanterns Face-off is the work of William Warby.

    Next comes the Face-off Situation between Evan McGrath and Ken Olimb in Tegra Arena by Calle Eklund/V-wolf.

    Finally, NASA/JSC and Robert Markowitz created Face-off Robonaut. All were sourced from Wikimedia Commons.