Looking Through Another’s Eyes: More on How Things End

The death of a parent compels attention. Last week I described how my mother’s end allowed me an enduring and touching memory after a difficult history. But I’m not her only son, and my brothers hold different images, early and late. You should know of one I witnessed. To set the stage, I’ll say more about the Stein household we all grew up in, all with our particular vantage points.

Imagine Milton Stein forever working one of his multiple jobs and Jeanette Stein overmatched by raising all of us on her own. Sibling rivalry became inevitable. We all wanted more time and attention and a different kind of time and attention.

From dad, a focus on us as individuals and our specific interests and talents would have been welcome, instead of the distracted and generic love of a man in motion: about to leave for work, at work, back from work, or worried about making a living. He designed his life to prevent a “Second Coming” of the economic hardship he’d endured in the 1930s.

Mom’s life had no such organizing principle to supply ballast. Perhaps as a result, her internal turmoil wasn’t contained. Relating to her was a tightrope walk.

The challenge of dad’s early life was exceeded by mom’s catastrophic upbringing. Her father Leo: a charming, alcoholic bon vivant. Her mother Esther: a suspicious, hard of hearing woman who cycled between vicious criticism of her children and a claustrophobic, suffocating love of them. Perhaps worst of all, the family’s frank poverty allowed my mother only enough money for a candy bar at high school lunch. Malnutrition made her an easy target for tuberculosis, while the clan’s economic desperation and social chaos stole any sense of value other than her physical beauty.

Her papa and mine abandoned her, each in their own way. To grandpa, drunken outings grabbed him; for dad the need to work. The turmoil of a childhood household with lots of little kids left an ill-equipped mother at the helm; exactly where my mother found herself again, this time assigned the role her mom played years before.

The frustration and anger boiled over at us rather than her parents or her husband. Routine comparisons occurred. “Why aren’t you more like ______.” We all heard this and sometimes thought ourselves the least favorite child because we didn’t know the game permitted no winners. What you did well didn’t count for nearly so much as what you didn’t or did wrong.

Jealousy grew, each boy short-changed. But our mother could also be extraordinarily warm, your fiercest defender against the outside world, and heartbreakingly sad, as she struggled with her own parental and sibling relationships. Only later did I realize I got the best of both of my folks, their adored only child for most of my preschool years.

Maturity was required of me as the oldest. Job #1: take some pressure off my parents and be a protector of Ed and Jack.

Eddie was an active, eager, smart little guy, while Jack as huggable as could be. Like all younger brothers (Ed is four years my junior and one year older than Jack), Eddie wanted my time and companionship; more perhaps because of dad’s absences and Ed’s quick displacement by Jack as the youngest. But, of course, big brothers don’t have the time or want to give it. I’m sure my rejection hurt.

Our temperamental differences made things harder. I was scholarly and reserved, carrying the family banner through academia. He was active and devilish, the kid who rushed in and sometimes made a mess. We didn’t always get along.

Yet there were moments when I did the right thing. Though I was no fighter, I took on our next door neighbor when the older boy pushed Ed around. I didn’t win, but the point was made. My mother said my opponent now had a hard time combing his hair at the place on the side of his head where I landed my most forceful blow. Later an older kid from the local parochial school harassed Eddie. This time I wound up on my back. I am not in the Boxing Hall of Fame.

Superman, starring George Reeves, was one of the most popular American TV shows of our youth. Reeves (not the late Christopher Reeve) starred as the handsome, muscular hero who every little boy emulated. He fought for “truth, justice, and the American way” as the idea was understood in the 1950s. Thus, TV provided an iconic image even more potent than the comic books we read, while the alley behind the house gave you a playing field to enact whatever heroism might come to mind.

Eddie showed some particular compassion for me in the alley. I was in the seventh grade. The sport was a two vs. two touch football contest. In trying to elude a tag I dodged to the right – and slammed into a jutting garage abutment. The right side of my head made the crunching contact. I knew the contest was now no game.

Eight-year-old Ed saw me – saw what I’d done to my ballooning forehead and my blood-filling, closing eye – and wept.

When Ed and Jack got older we played in summer softball leagues in Chicago and Evanston. Ed became a fine first baseman and a power hitter who once hit three homers in a single contest. Jack, the best athlete among us, was a gifted, strong-armed, left-handed outfielder; fleet afoot and capable of slashing line-drives to all fields. He went on to become an award-winning amateur body builder and a successful business man. These were the guys you wanted on your side.

Not everything in Ed’s life came as easily as hitting a long ball. School was a hard place despite Ed’s intellectual gifts. The rules chaffed. Trouble beckoned. The wrong friends, the kind your folks tell you to avoid, weren’t helpful. Some of them would later die of their own recklessness. Accidents, suicide, murder, drugs? In a wild crowd everything is possible. The coin of a life – the heads or tails of it – turned in the air.

Finding your way is rarely easy. Ed managed – through intellect, hard work, and courage – to shed the bad influences and create a wonderful business as a home remodeler of artistic sensibility and refined craft. He is a devoted husband and father; a smart, generous, and decent man who you still want on your side.

Somehow, though full-up with sadness, the death of our parents meant an escape from the adult version of the crazy-making sibling animosity my mom never stopped fomenting. Such losses don’t always result in closer sibling relationships, what with fighting over estates and bequests. But in our family everyone played fair and reconciliation came in its wake.

Ed, Jack, and I figured out that being friends, not only brothers, was desperately important. That grudges, regardless of the cause, needed setting aside. Love, after all, matters more than just about anything. The things binding us – our memories of the folks, the time together growing up, and a desire to live by the Golden Rule – became more important than our differences.

One afternoon in our childhood, while I played in the backyard, Ed was indoors watching Superman. When the program ended, he decided the day begged for a solo flight. A white towel mom must have tied around his neck made a makeshift cape. He pushed open the window facing the backyard and got out on a ledge perhaps 12-feet off the ground, preparing for launch.

By the time I noticed him, Ed knees flexed like Superman preparing for take-off. I yelled for him to stop. He hesitated. But how to turn him around and back into the house? Before I could get upstairs Ed might crash.

A sewer manhole cover lay below the window, the place where Eddie would land, not the more forgiving grass. Mom didn’t answer my frenzied shouts.

I got underneath the ledge, braced myself, and asked Ed to jump into my arms. He didn’t take much persuasion. We both survived.

Fast forward now.

My mother lay unconscious in the hospital. She had a living will, with Ed assigned the power of attorney for healthcare. She’d told us she wanted no extraordinary measures. Mom told us all, over and over after the death of our father, she wished to die.

My brothers and I visited the hospital daily. Ed arrived first on the day in question. Mom’s physician entered her room. He wanted to perform an invasive, long shot procedure. No matter what mom might have asked for, the M.D. knew Ed had control. A conversation ensued. The doc tried to persuade Ed, then talked of Ed’s responsibility to the woman who raised him, guilted him and guilted him and guilted him. At last the “healer” ended his assault and threw up his hands, the indictment now delivered, the verdict of “bad, ungrateful son” rendered. The unstated implication was that mom’s money was more important to Eddie than her life.

Eddie walked out of the room. I’d entered the building minutes before and was strolling toward him down the hospital corridor. At a distance he was still my brother Ed; still a handsome, put-together man’s man with a steel core of toughness that could withstand anything. Wrong. He broke down in my arms.

Most of us could have rationalized conceding to the medical man. Jeanette Stein was now silent, the M.D. was not. Ed put her first, not himself.

I’ve had the privilege of knowing lots of courageous people, folks I met in my practice and elsewhere. Still, there are never enough.

When I think about Ed’s story, Ed’s last stand in defense of our dying mother, I recall his effort to be Superman at the backyard window.

I wonder, did I have to break his fall? In the last moment, Ed Stein – the real Superman who sacrificed a piece of himself in a hospital room – might have been able to fly. Yeah, compared to that, flying was easy.

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For the most part, the images should be readily identifiable: two of my parents, Ed Stein in a photo I took of him hitting a double in a softball game, a cartoon of Superman, Jack Stein, the entire family around 1960 (with Jack, Gerry, and Ed from left to right), and Ed and the author in our backyard. Unfortunately, you can’t see the area of the intercepted Superman flight, which we are facing. Our garage, behind us, stands between us and the alley separating Talman Avenue from Washtenaw Avenue.

Why Therapists Leave

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Any beginning predicts an ending. Permanent relationships can become impermanent with time’s passage. That knowledge unsettles those in long-term treatment. Abandoned before, they wonder not “if,” but “When?”

Why do therapists leave?

An example: the man and woman had been married for six years. In mid-life, however, he was afflicted with a rapid and permanent hearing loss. In the midst of the crisis, his mother-in-law was diagnosed with cancer. She lived 1000 miles away. What was the wife to do? She chose to spend the last six weeks of her mother’s life with mom. She’d have done the same thing if she’d been your therapist.

Granted the departure was temporary, but such disruptions happen and are sometimes more lasting. A lovely psychologist of my acquaintance, a being so calming as to make quiet moments with her almost holy, fought illness off and on for years. Her resilience seemed infinite. In her ninth decade she banged against infinity’s wall and retired abruptly, having met physical problems even she could not shake off.

The choice is usually not so harrowing. My own retirement was the consequence of the increasing depletion I felt from doing my work. The weight of the problems of others pressed heavily, even though my clients were less troubled as a group than they’d been earlier in my career. Then too, books called out to be read, courses of study beckoned, and new wonders of the world awaited.

Therapists are notorious for burning out, though not all do. Unfamiliar places trigger our wanderlust. Everyone seems to believe California or some warm spot would be nicer, at least if you live in the Midwest. Grandchildren need attention while they are small. You cannot place their youth in a safe deposit box for later use any more than you can your own.

Life intervenes in unexpected ways. I do not mean to minimize the pain when a therapist departs before a patient expects the end of the relationship. I helped clients grieve such losses when they came to me afterwards. I also caused unhappiness myself by deciding to leave practice. Unexpected finishes, however, cannot be allowed to finish us off.

When I was about to embark on the capstone or giant-killer to a graduate education, the dissertation, my advisor disappeared, vanished. I found out he was going through a messy divorce. Fair enough, but to another state? Without telling me? I adjusted. I lined up a new dissertation committee chairman and was ready to proceed when my initial advisor returned, as unexpectedly as he departed. Granted, he was not my therapist, but still …

Therapists also, on occasion, change as people. Funny, one wants a transformative counselor, not a transforming one. The patient expects to be the only person to make substantial self-alterations, setting aside any desire for a reduction in boundaries allowing more intimacy with the doctor.

A young therapist/colleague became a carpenter in his ’30s. I met a lawyer with a towering income who opted out of his partnership to opt into a seminary. Charles Krauthammer, a syndicated conservative columnist, was a psychiatrist. Granted, not many established counselors change careers, but an occasional dropout happens.

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Close to the end of my career I’d hear the question from a patient, “Do you expect to retire soon.” I think I answered, “I have no plans.” Until, of course, I eventually did and then announced my future unprompted.

We (and by “we” I mean you and me) have no crystal ball, no bewitched mirror on the wall. We don’t expect to divorce when we marry, don’t enter careers anticipating they will end soon, don’t fall into friendship with a vision of its erosion or collapse. I can only tell you — only tell myself — the things I know for sure. And sometimes what we think we know we don’t know. Fate’s hand spins the top of our lives in directions never imagined and, when the spinning stops, a new idea forms and informs us.

Therapists leave and it’s not personal, except it is. When you don’t think you are “enough,” a therapist’s departure (at least not one caused by a lightening-strike) says “You’re not enough to cause my staying at the job.” I get it and I also get the absence of an intention to harm.

So yes, your therapist might leave you, but your departure is more probable. The latter is best, for sure, if you’ve gotten what you came for. The good news is we have encouraging career-longevity data on doctoral level psychologists. The American Psychological Association’s Center for Workshop Studies reports that among those already “retired” in 2013, 42% were still working. The median age of retirement was 61, meaning half retired before 61 and half after. The sample included all doctoral level psychologists in the year of the study, not only clinical or counseling psychologists in practice.

Therapists, like most of the rest of us, are living longer and need to make a living. They have multiple incentives to continue. The satisfaction of meaningful work, the intimate contact with good people, and the words of thanks are enriching. The work is interesting and research offers us new tools. It’s an exciting time to be in the field, in the lab, and in the office.

We cannot guarantee our lives, any of us. The retirement or side-lining of a therapist probably won’t happen while you are in treatment. The answer to the “What will I do if it does?” question is that you will do what is required. In the meantime, avoid living the infinite variety of doom-laden scenarios available to imagination: a “thought-error” called catastrophization which can be treated with cognitive-behavior therapy (CBT).

Good advice comes from John Steinbeck’s The Grapes of Wrath and his character “Ma” Joad, the rock of a migrant family almost out of chances. She is the lady responsible for their emotional and physical sustenance, including cooking the salt-pork packed for the clan’s trip to an uncertain life in California. Her 16-year-old son Al asks:

Ain’t you thinkin’ what it’s gonna be like when we get there? Ain’t you scared it won’t be nice like we thought?

No. No I ain’t. You can’t do that. I can’t do that. It’s too much — livin’ too many lives. Up ahead they’s a thousan’ lives we might live, but when it comes, it’ll ony’ be one. If I go ahead on all of ’em it’s too much. … An’ (what I concentrate on is) jus’ how soon (the family) gonna wanta eat some more pork bones. That’s all I can do. I can’t do no more. All the rest’d get upset if I done any more’n that. They all depen’ on me jus’ thinkin’ about that.

The top photo is entitled Goodbye Grenada, Goodbye Karabik by giggle. The cover art for the sheet music for Long Boy (I imagine this means “So Long, Boy”) was drawn by Gar Williams. Both images are sourced from Wikimedia Commons.

My Seven Fathers

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This comes late. Late because Father’s Day was last month and late because this essay was appropriate 50 years ago.

I read several “Father’s Day” blogs this past June. Only then did I realize I had multiple dads. To discover this in my seventh decade was quite a surprise.

When I say I had more than one, I don’t mean official stepfathers. Nor did my dad die young, followed by others trying to fill his spot. Yet, the truth is, others did, with his knowledge. I bear no grudges about this. My father was, as the trite saying goes, “doing the best he could,” working as many as four jobs at a time, providing for us all. I never doubted his love. I never doubted his pride in me. Still, he was not present a lot. Not for me, not for my brothers Ed and Jack, and not for my mother.

Not there physically. Elsewhere. Away.

Part of a parent’s job is to be home, but that’s not always possible or easy. It wasn’t for him, a child of the Great Depression, claimed by the necessity of making a living. Every other consideration came after the long shadow of a scary time.

There we were, Milton Stein’s family, with him in the lead, racing hard to escape his shadow. My mom ran to catch up, pursued by her own shadow, holding hands with me and my brothers. All of us were in a dash for dad and his time. To the good, dad won the race with the specter of financial ruin, in reality if not psychologically. Ed, Jack, and I settled in the second shadow behind mom, a darker place than the first: a mixture of her personal insecurity, teenaged malnutrition and tuberculosis, poverty, her alcoholic dad and paranoid mother.

I like to say I came upon my interest in psychology honestly. Including the extended family, living examples of text-book emotional problems could be studied every day.

Other father figures embraced me. Did they recognize what I needed? I’ll never know. What follows is a tribute to these men and all the nameless adults who fill-in for a biological parent. They are rarely acknowledged. It took me much time to realize they should be.

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One was a portly, white-haired, candy store owner named Mr. Sharon, who talked with me about our favorite team, the Cubs, and called me “son.” A neighbor — movie-star-handsome Mr. Maddock — sometimes played catch with me. Add to the list Mr. Hanel, a tall man with a small dog. On his walks down the alley behind my house he let me play with his pet, something my brothers and I didn’t have. The roster includes a fifth-grade teacher, Mr. Friedman, who believed in me enough to give me a double-promotion. Nor should I forget Jim Bryan, my adviser in graduate school. His letter from Northwestern, informing me I’d be his teaching assistant, said he would “work with me and on me.” He did, to my benefit.

By far the most important father substitute was my Uncle Sam, mom’s only brother. As the first Fabian grandchild I received lots of attention, the most from Sam. My parents, Sam, and his wife purchased a two-flat building together in West Rogers Park, Chicago, when I was six. Sam and Charlene Fabian lived upstairs and the Steins lived downstairs. Until Sam had a male child (Marty) I was almost his adoptive son. My cousin calls us brothers of a different mother.

Uncle Sam took me bowling, to baseball games, and introduced me to famous bowlers. My dad didn’t know anybody famous, so you can imagine the thrill of meeting the keglers I witnessed on TV. I met Carmen Salvino, Don Ellis, and even received bowling tips from an older bowler, Joe Wilman, who’d once been named Bowler of the Year in the 1940s.

Sam secured autographed pictures inscribed with my name from Hall-of-Fame baseball player Luis Aparicio and Billy Pierce. We watched Mickey Mantle, the Yankee slugger, hit two home runs (one batting right-handed and the other left-handed) from box seats on a May evening in 1956. Mom’s brother built a table-top basketball game we played, carving the “shooters” and the baskets out of wood with his own hands.

Best of all, my uncle talked about his view of life. Sam offered guidance in how to live — how to “make it” in the world. My youthful home provided little wise parental advice. The house was a place where I often had to figure out how to proceed by my own inexperienced wits.

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Most of the adults I knew reacted to the world. Unlike them, my uncle took charge, created a business, displayed leadership. Sam was 6’4,” outgoing, generous, and unafraid of voicing strong opinions — a person with a large presence in every sense. His fatherly embrace and powerful hands offered a tangible understanding of what it meant to be a “man.” His interest in me conferred a feeling of worth almost by osmosis.

Things changed between us when his son, Marty, was born. I became yesterday’s news and, in retrospect, I can’t imagine how it could have been any other way. At 16, I worked a regular after-school job for Sam, but my employment loaded the relationship with unbearable emotional weight. We occupied the dual roles of uncle/boss and nephew/employee at a time when even one role was too much.

The growing psychological distance became a physical one, too. My folks purchased Sam’s portion of their two-flat at his request and the Fabians moved from Chicago to the suburbs. With the end of high school I saw relatively little of him. Sam died of a heart attack at age 49, leaving a wife and three children with an emotional vacuum impossible to fill.

Perhaps we expect too much of relationships: that they should be forever fulfilling, at least as long as both parties live. Experience tells us most serve for a time, not more. We change, the other changes, the times change. Life goes on with new people and fresh concerns. Accepting this reality is difficult. Sam served more than well in his fatherly role and, perhaps, I was what he wanted for a time: a son borrowed, not yet born. As Marty says, we are “brothers of a different mother,” and therefore sons of the same father, in tandem.

Still, when I think of Sam it is with a sense of wistfulness. I regret few things in my life, but wish we had been closer at the end. Given a magic wand, I’d like to spend a few more minutes with him, knowing all I know now. I’d give him a big hug and say thanks.

Seven fathers. A lucky number. I could have done much worse.

Much worse.

The top photo displays four generations of the Hebert family, three of whom are (or are about to be) dads. From the rear, Tom, David, Keith (my son-in-law), and ______? The fourth generation is shown in an ultrasound image. The compilation was created by my daughter  — Keith’s wife, Carly.

The second photo was taken at my Uncle Sam’s wedding. Left to right: Aunt Charlene, me, Uncle Sam, and Aunt Florence Fabian. The final image is of my father and mother.

Managing the Dread of a Therapist’s Vacation

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Vacations should be care free. I suspect they were in the days before therapists and portable phones. Now, if you want some freedom from responsibility, limits must be set on how much of your “work” you take with you. Therapy patients, however, have little choice in the matter. After many years of hearing my clients’ concerns about my departures, I realize to some of them my farewells sounded as if I were saying, “Goodbye and good luck.” Today I shall address the problem of vacations from the therapist’s side of the treatment process.

I saw those interruptions as both essential to my well being and as an opportunity for therapeutic growth in my clientele. You might not agree with how I approached the issue while I was in practice, but I hope you understand my reasons.

The blogger What It Takes To Be Me, explains the client’s dilemma in this excerpt from her post, Reconnecting:

Regular readers of this blog will know that psychotherapy breaks is a topic I have written about a lot over the years, because it brings to the fore all of my fears about being abandoned and forgotten. It is also one of those things that people who haven’t been in therapy never seem to fully understand or appreciate. And, to me, that is also part of what makes breaks in therapy difficult; the sense that others don’t understand how hard they really are. Whenever I mention to ‘non-therapy’ friends that I feel really anxious about an upcoming break, I always get the feeling that they are thinking that I am worrying over nothing. And if I, during the actual break, say something along the lines of finding it hard that my therapist is away, the immediate response is invariably ‘When will she be back?’ followed by an equally predictable ‘Well, it’s only X weeks left’. This, of course, feels terribly invalidating, since a therapy break isn’t really about length of time at all, but about strength of emotions and how to cope with them in the absence of a safe place to explore them.

I was “forgotten” on the first day of kindergarten at Avondale School. I recall all my classmates being picked up by their moms. I was alone but for the teachers. Indeed, the school janitor, push broom in hand, was already making his rounds before my mother showed up. She misunderstood when school ended. The event did nothing to cement my own sense of security!

Much more serious and repeated abandonment issues fuel counseling sessions. Trust builds gradually, if (a big if) the therapist is sensitive to the kinds of feeling so well described by What It Takes To Be Me. Nonetheless, vacations are tricky.

The issue of credibility is near the heart of the problem. The people you treat are asking themselves an essential question: will this guy do what he says he will do? To fulfill the implicit or explicit promise of therapy, you must listen carefully to what people say to you, remember what they report from week to week, show up on time, be available by phone to a limited extent, and not be overwhelmed by the harrowing, heartbreaking stories you hear. Judging is not permitted either. Regardless of whether the client is aware of his motives, a part of him is testing you. Given his history, this kind of appraisal is more than fair. The vacation is one of the bigger tests.

I always tried to prepare clients by announcing my vacation schedule weeks in advance. Those who were in therapy for a considerable time knew when I predictably took off. Not all holidays, of course, were predictable. When I began outpatient practice I usually took four weeks vacation. Closer to retirement, respites from work were at least double the time, with roughly thirty years in between. Indeed, the need for more breaks signaled work-caused depletion and aging. Retirement beckoned.

The need for refueling is one of the funny things about doing therapy. The psychologist or other “provider” (as the insurance companies like to call all healthcare professionals) just sits, listens, and talks. A pretty soft life, eh?

If, however, you take it seriously, it is not. You must listen with intensity: hear, understand, and interpret the words; the tone of voice, watch the facial expressions and body language. To find out more about what is going through a therapist’s mind during the session, read What is Your Therapist Thinking?

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I have written the above to enable you to understand what I am about to say, even though many of you already know: therapy is hard work and vacations are necessary if you are to perform a desperately important task without burning out, becoming resentful of clients, and using yourself up so as to be of no value to yourself, them, or your family. I was privileged to do therapy, permitted access to secrets never told, and to know some amazing and courageous people almost as well as they could be known.

The practitioner must also present a model of self-care, an ability many of his clients lack. A counselor who is overwhelmed, preoccupied, or exhausted, benefits no one.  Your offer of yourself as a human sacrifice is a well-intentioned mistake. A portion of the good people you treat have lived in the same self-effacing style for years and are searching for another way. You are exhibiting all the wrong things about how to lead a life. Such a therapist is not a rock to hold on to in a torrent, but himself adrift.

Just so, you are giving an unfortunate impression if you do not take enough time or interest in your own family. This is complex. You do not wish patients, about whom you care, to experience guilt because you are taking time from your spouse or children. Some clients want as much of your presence as you can give, but you will almost always be respected more if you are good to yourself and your family. Your behavior, more than words, demonstrates sincerity and balance in the way you manage and (usually) do justice to the competing interests.

That said, by the time I was taking eight or more weeks off, I had accepted as patients only those people who could withstand my absences. Remember what What It Takes To Be Me wrote, “…since a therapy break isn’t really about length of time at all, but about strength of emotions and how to cope with them in the absence of a safe place to explore them.”

A therapist needs to put off very sensitive issues in the few weeks before his vacation. Just as a surgeon does not want to leave an operation before suturing the incision, a counselor shouldn’t leave anyone wide-open emotionally as he heads out the door for a holiday. Consultation with the client about what is safe to discuss is essential.

Part of a healer’s job is to factor in every conceivable variable in approaching his client, including his own mental and physical health. As Hippocrates wrote, “First do no harm” and he might have added, “to anyone, you and your family included.” I tried to be as thoughtful as possible. Young therapists, in particular, need to experiment to find an approach honoring their ethical responsibilities to others and their private needs.

I found out what worked best for me and my patients was not what I did early in my career when I took less vacation or, in a certain sense (as I will soon describe), none at all. A practitioner risks becoming too responsible as much as he risks being careless of others’ needs. One does not want to assume everyone you see requires access to you at every moment, thus stealing the initiative needed for them to grow. This is similar to an overprotective parent’s hovering over a child.

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I recall one patient in particular to whom I gave my private phone number with the instruction to call if she were in crisis while I was taking time off. She did, although I can’t remember how often. What I do recall is the effect on me: I was unable to unwind because I anticipated the possibility she might call. As a consequence of my decision, at vacation’s end, I felt as though I had not been away from my normal work routine. I soon ended this permission and discovered that she and others survived my absences and eventually grew from them.

That left the problem of how to best create the circumstances for such growth. I needed to stay bonded to those individuals who feared I would forget them or never return, or believed I was refraining from scheduling only them and not my entire clientele.

Therapists have many ways to approach this. The patient and I worked on my upcoming time away and how he might find support elsewhere. We talked, too, of the “transference” of his abandonment fears: parental figures who had been undependable, indifferent, or who disappeared during childhood create expectations of similar behavior by the healer.

Who was “covering” for me in emergencies was another important topic. If the colleague was in the building, I sometimes made sure there was a meeting between my client and this stranger before leaving.

I also used what are called “transitional objects.” Just as children will hold fast to a doll or a blanket to mediate the time until a parent returns, so do therapists offer tangible items for patients to take home while he is away. I sometimes employed a stuffed bear to maintain the connection between me and the person who was afraid of being abandoned again. A recording of my voice was another such device.

Ideally the client discovers, over many therapy breaks and an equal number of reunions, the healer is not identical to whomever abandoned him previously. In this way, the patient can begin to prevent his past from recreating a sense of anxiety in the present. Eventually, he sees the relationship-portion of the life project from a more hopeful perspective. In therapy and out, parting is inevitable. Treatment will end one day. A vacation by the therapist is a step in preparation for such a time.

Healthcare professionals are notorious for taking off during the holiday season. I was guilty of this, as well. These periods are often a temporal reminder of many of the worst experiences in a client’s life. The healer must help develop an adequate plan to get beyond the holidays. If the patient has supportive relationships outside of counseling he is well-positioned. Finding these is easier said than done, but with time it can be done. Without such people, activities (for example, working at soup kitchens for the down-and-out) are crucial to avoid the despair of a season that contributes to the unhappiness of many. The joyful images of TV programs and commercials are not a commonplace reality. Inevitable comparisons with idealized lives make us less than thrilled about our workaday existence.

There you have it. I do not mean to suggest I discovered the secret to perfecting a challenging part of being a clinical psychologist, and the potentially frightening and dangerous aspect of trusting a person like me. I am friendly with at least one psychiatrist who takes calls from his patients while on vacation. He is a conscientious man, but also one who doesn’t treat the phone as a burden to himself or his family. My hat is off to him. I did not have his magic formula within me, much as I searched early in my practice. Yet I believe I served my clients honorably and well within my limitations.

Remember, the Temple of Apollo at Delphi was inscribed with the Greek aphorism, “Know thyself.”

The top photo is a Surfer at the Beach of Costa da Caprarica, Portugal by Alvesgaspar. Next comes a Beach Sunset, Newport  Coast by Axion23. Finally, more of Axion23’s work: Crystal Cove Beach Sunset. All are sourced from Wikimedia Commons.

Searching for Sanctuary and the Kindness of Strangers

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Sometimes it is the next door neighbor or the checkout lady at the store. Sometimes it is a friend’s mom or dad. Sometimes it is an aunt or an uncle, a grandparent or a teacher.

Their role is to provide a glimmer of hope, kindness, and a little bit of the love that by rights should come from the parent, but doesn’t; just enough to make life tolerable; just enough to get the child through the bitterness of life at home with some small sense of self-worth and the hope that the future might be better.

Benign and caring adults are remembered all your life, even if you passed through a less than dire childhood.

I can recall two men in my own life who showed kindness and an interest in me, whose connection felt good to me, who offered respect and seemed to enjoy the times that we talked. One would play catch with me on occasion, something I dearly treasured because my father was often at work. Mr. Maddock, our next door neighbor, was a handsome man with two sons of his own, but always had a good word and took the time to say it.

Another, Bob Hanel’s dad, a man tall and slender, talked baseball with me when he walked down the alley with his small dog. “Such a big man and such a small dog,” I remember thinking. He was blond, like his crew cut son. The younger Hanel, my older buddy Bob, became a dentist, I believe.

And, now that I think of it, there was the owner of a soda shop/candy store on Lincoln Avenue near Washtenaw, Mr. Sharon, who was loved by all the kids who frequented his establishment. A roundish and white-haired man with a warm and soothing manner, and a ready smile. He called me “son,” a common mode of address from a “stranger” to a male child in the ’50s and ’60s that implied a certain kind of protective relationship between a man and a boy.

A heart condition eventually laid Mr. Sharon low and he had to sell the store.

Ironic that his heart should have caused him trouble, because — for me at least  — his heart was the best part of him.

I’m sure that adults who fill this saving role in the lives of troubled kids think nothing of what they are doing. They probably don’t know how tough it is for the child.

Parents usually succeed in hiding these things from the public. The household ethic is to keep up appearances. And the warning is never to talk about what happens inside the house while out of the house. Most children keep to this admonition, honoring the parents’ concern for reputation over reality, not wishing to disappoint mom or dad by an act that would be considered disloyal.

So much can be achieved for kids like this, just by being stable, smiling, asking a question, offering a cookie or a soft drink.

It means the world:

My last name begins with the letter “M.” Jane’s begins with “N,” so she sat behind me in the first grade. We lived just a block from each other. We became friends.

The first time I was allowed to go to Jane’s house, I was amazed at how different it was from my home.

Janes’s mother was out of bed, dressed, made meals, did laundry, cleaned their home and took Jane and her siblings places outside their house. I felt terribly sorry for them. Everyone knew that moms were supposed to lay in bed all day and give orders!

Making meals, cleaning, laundry, etc. were what the maid did. They didn’t even have a maid!

As I later realized, my mom’s illnesses were the kind that no doctor could diagnose, nor persuade my mother that they did not exist.

My family had more money that Jane’s. In retrospect, it must have been a hardship to keep feeding me, year after year, yet Mrs. N never even hinted that I should go home. Not even once.

Jane’s father came home every evening and had dinner with the family. Very strange. I wondered why he wasn’t always at work like my dad.  Jane’s father wasn’t all that fond of my omnipresence, however.

I’m guessing Mrs. N never let him tell me to go away.

Over the years, Jane and I became inseparable. We spent almost every waking moment together. We  did this at Jane’s house, rarely at mine. My home was bigger — had more room and more quiet. Neither one of us wanted to be there, although it was never discussed, simply understood. We played at her house, we ate dinner at her house, every weekend I slept at her house. This went on from age seven to approximately age 16.

During all this time, I never realized what a gift Mrs. N was to me. It was only much later that I came to understand that this woman probably saved me. I had a safe place to go. I had a place where no one criticized me. Where people were alive, not constantly “dying.” It was a relief not to be in the tomb I called home.

My mother believed that if something was easy for her, it should automatically be easy for me. One day she wanted me to swallow a Coricidin capsule. I couldn’t. My usually “bed-ridden” mother chased me around the house trying to force me to swallow. At last I was backed into a corner in the kitchen and told that I was going to swallow that pill or “I am going to know the reason why!”

It wasn’t a pretty day. Pill swallowing was enormously difficult for me. I don’t remember if I ever got that pill down.

As soon as I could, I fled to Jane’s house. Mrs. N made no comment about the incident. I’m not sure if it was then or a little later she suggested that if I put a tablet in a little applesauce, it might make it easier to swallow. It worked and mother never gave me grief about pills again.

As a young adolescent, I would run away from home, usually leaving in the middle of the night. I’d walk the streets of our neighborhood. Eventually, I’d head for Jane’s house and climb in the front window.

The first time this happened, Mrs. N was up waiting for me. My mother had called her looking for me. Somehow Jane’s mom knew that I’d show up at her house. She immediately called my mother, who had called the police. Mrs. N then said she would put me to bed with Jane.

For a couple of years, I ran away a lot. The police told my mother not to call them anymore. Eventually, she stopped noticing that I was gone. So, when I was ready to come back, I’d just crawl in through the window in Jane’s house, not my own. Mrs. N let me.

No critical comments.

She never, ever told me I was a bad kid who should stay home.

She never told me not to do it.

She simply accepted me.

On rare occasions, she would very subtly say something that led me to believe she didn’t approve of the way my family treated me. However, she never put down anything my family did.

Twice a year my father would take me shopping for seasonal clothes, to up-scale stores like Marshall Fields and Saks Fifth Avenue.  I had nicer clothes and many more of them than Jane and her siblings.  When, on occasion, Mrs N would be taking Jane and her other children shopping for clothes, she took them to what we called “schlock shops.” Basically, these were the counterparts of today’s Loehmann’s.

She would take me also. I wonder if she knew how wonderful it was to have a woman’s point of view and a “family” experience?

Mrs N never said a word, really. There was just her unending acceptance. I actually thought it was normal, unremarkable. After all, Jane and I were best friends. She never let me believe that I was getting anything special.

Mrs. N allowed me to be in every part of her family life throughout my entire childhood. I never wondered, until this very minute, if she loved me.  Perhaps so. Perhaps not. I was not exactly a lovable child. Yet, she saved me. I don’t know if she did it consciously. Although I think she knew how desperately I needed her.

The years went by. Jane moved out-of-state. The only time I saw Mrs. N was when Jane came home for a visit with her husband, and later, their children. Once again, I fell back into Jane’s family. I hung-out at Mrs. N’s house whenever I could. She was still welcoming and accepting.

When I got married I asked Jane to be the matron of honor in our very small wedding. My husband and I had no plans after the ceremony. The next thing I knew, there was a luncheon following — given by Mrs. N at her home.

Mrs. N died a while ago. In adulthood, I often tried to tell her she saved me and how much I had come to appreciate her. She pooh-poohed me. Yet, she was always there for me, without my really knowing it.

That, I think, was the greatest gift of all.

The above image is I Wait, an 1872  photo of Rachel Gurney by Julia Margaret Cameron, sourced from Wikimedia Commons.

Do You Know Who You Are? A Meditation on Identity, Mid-life Crisis, and Change

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Who are you?

In times of war, men define themselves by three pieces of information only: name, rank, and serial number. I suppose that the peace-time equivalent is name, profession, and age; not social security number, which you are wise to keep to yourself for fear of identity theft. Stolen identities aside, the question of who you are is still an important one.

But let me formulate it differently.

How would you describe yourself? What human characteristics or traits or values are essential to you? What makes you different from any other person on earth?

Let’s start at the beginning of life. You are given a name. How does the name define you and influence the rest of your life? If you are A Boy Named Sue, as in the old song, you can be sure that your identity and life have been changed by your parents’ decision about appellation. Indeed, there is now research evidence that some names, those thought to be used predominantly by blacks, cause potential employers to discriminate against a job applicant’s resume when compared to individuals with the same qualifications who have names that are less racially-linked.

Name-changing has long been a way for white Americans to avoid discrimination based on ethnicity or religion. Others had their names compromised when reaching this country from Europe and were processed for entry to the USA on Ellis Island. Thus, a Paderewski became a Patterson and a Rifkin became a Riff, due to the simplifications created by the randomly assigned immigration official. And, from the start, the new arrival had to deal simultaneously with a change of name, a new nationality, a loss of homeland, and the now restricted opportunity to use his native language, all playing on the question of his identity. Meanwhile, his young offspring encountered the attitude of teachers (and, much later) potential employers or lovers to someone named Patterson rather than Paderewski, just as he saw himself as the former and not the latter.

For the immigrant, the “dislocation of place” both parallels and creates the dislocation of his sense of who he now is. The person has gone from being (perhaps) an unremarkable resident of his home country to someone “different,” who speaks (at best) with an accent, and who has a history that is at odds with the shared past of his new neighbors. The man has become, truly, a stranger, but he is not just strange to others—he is strange to himself.

Just as some people voluntarily attempt to hide their ethnicity, so too do some few work to hide their race. You might want to watch the 1959 movie, Imitation of Life, starring Lana Turner and John Gavin, for a cinematic take on this subject, the attempt to pass for white. More recently, Philip Roth’s year 2000 novel The Human Stain (and the movie of the same name) deals with a black University professor passing as a white man; and Bliss Broyard’s 2007 memoir One Drop: My Father’s Hidden Life—A Story of Race and Family Secrets describes her father Anatole Broyard’s self-transformation from black to white within the literary world.

And one must give at least brief mention of a condition called Gender Identity Disorder, in which children may be born anatomically of one sex, but of the opposite sex in terms of identity.

Religion also helps create one’s sense of self. As the European generation who survived World War II began to approach death, a number of adult Polish Catholics discovered, through these aging parents or other relatives, that they were born Jewish. The children had been rescued from the Holocaust by Polish gentiles. It was therefore often easier and safer to treat them as Catholic during the Nazi occupation than to try to persuade them to keep a secret of their religion. Once this identity alteration was performed, however, it proved to be hard or uncomfortable to undo, particularly in a nation with an antisemitic history. The revelation of the religion into which they were born surely transformed the identity of a number of these religiously recast people.

Revelations of another kind occurred in post-World War II Germany. The children of Nazi authorities and SS members did their best to keep their identities secret for fear of being prosecuted for crimes against humanity. Nonetheless, their children sometimes discovered (to their dismay)  the answer to the question “What did you do during the war, daddy?” This type of revelation can lead the child to wonder who he really is, and whether he has inherited some of the unfortunate qualities of his father.

The 1989 movie Music Box starring Jessica Lange and Armin Mueller-Stahl deals with a similar circumstance, but one transported to the Chicago area. It involves the question of a father’s activities in Hungary during the war and his daughter’s legal defense of him against the US government’s attempt to deport him.

If you have seen or read the Arthur Miller play All My Sons, you know still a different take on the same theme, this time without war crimes entering picture, at least as they are usually defined. The play takes place in post World War II America. Joe Keller ran a wartime factory with his former neighbor, Steve Deever. The men knowingly shipped defective airplane cylinder heads causing the death of 21 U.S. Air Force pilots. Steve goes to jail for this, although somehow Joe is exonerated of the crime. But when Joe’s pilot son Larry finds out what his father has done, his shame translates into suicide, so devastated is he by the identity-altering knowledge of who his father is and what his father has done.

As I hope these examples make clear, the question of your identity also involves awareness of who your parents were or are. Adopted children often seek out their biological parents, as do those who have been abandoned and left with only one parent to raise them. They also lack the medical history that informs the lives of those of us who know our parents well. The difference can mean life or death. Am I at risk for heart disease or not? It depends, in part, on who your parents are or were, and that information can change your life.

Children who have lost a parent to disease or death-by-accident or in war-time have a similar problem, even if they don’t have to deal with the knowledge that a parent or parents gave them up, and the attendant implication that they were worthless to those parents. And, their identity is influenced by the fact that they are “different:” the ones who lack a parent, have no partner at the daddy-daughter dance, have no father to teach them to play ball and no male parent to root for them at the Little League game.

Shifting gears, our identities are surely influenced by physical and intellectual characteristics: short/tall, young/old, handsome/homely, smart/stupid and so forth. But not all such qualities are fixed. Witness the change in identity that happens as people age, especially if they were once beautiful or handsome, or once athletic and now infirm. For those who trade on superficial characteristics exclusively, the change that comes with the passage of time is more than troubling.

Gorgeous women, in particular, find that they no longer turn the heads of men so much, if at all. Instead, the male of the species looks to other, younger women. Germaine Greer talked about this in terms of becoming “invisible,” though she found freedom in it to be more herself, less concerned with how she looked. One way or the other, it is an identity changer. Similarly, those who are injured, scared, or lose a limb or a breast must redefine themselves, reconfigure who they are in their own minds just as they have been quite literally reconfigured physically.

On the other hand, if you receive an organ transplant, you face an unusual assault to your sense of self. You are no longer the physical entity of earlier days, but now have a part of another person inside of you.

Yet, sometimes external changes do not alter identity very much. I have counseled more than one naturally beautiful adult woman who was the fat kid or the ugly kid while growing up, or the child who was criticized and belittled by parents. Too often the early labels seem to adhere to the person’s self concept as if they were tattooed on their flesh. Thus, it is not a surprise that cosmetic surgery does not always achieve the sense of self-worth that the patient is looking for.

Other life events can also transform one’s self-image. Men are notoriously vulnerable to a loss of identity when they retire or lose a job and are no longer the CEO, breadwinner, “doctor/lawyer/Indian chief” of their working days. I recall hearing it said that for a time after his retirement from baseball, the great New York Yankee outfielder Mickey Mantle had a recurring dream about trying to reenter Yankee Stadium by crawling under the fence that surrounded the ball field and getting stuck there! This is a stereotypical example of a man who was suffering from his loss of identity as an athlete.

So too, women who defined themselves exclusively in terms of their job as mothers frequently seem bereft and without a sense of self when the children leave the nest. In addition, women historically are more likely than men to define themselves by their partner, and achieve a sense of who they are by who their partner is. Being, for example, “the doctor’s wife” might have some value until the day that you are the doctor’s ex-wife. But, it must be said that men do this, too, and take some measure of self-definition and pride in having a talented or beautiful or charming wife.

Before closing, one must certainly comment on the notorious mid-life crisis of identity usually associated with men. Some men begin to get the sense of time passing them by and of not having accomplished all that they wished for in life. Jean Améry has said that a young person “is not only who he is, but also who he will be.” In other words, his self concept is informed by the expectations he has for his future. For most men in middle age, however, “who he will be” is not all that promising.

As the (usually unconscious) sense of mortality and “doors closing” begins to encroach, males have been known to act foolishly in order to hold on to or recapture their youth. A fast, new model car will suffice on occasion, but the stereotyped search for a new model “trophy” love is certainly something I’ve encountered in my clinical practice. It has been known to take the form of a rekindled high school or college romance, as well, for those men less concerned about external appearances and more about “the road not taken.”

However the crisis manifests itself, the crisis-driven actions inevitably fail to find the “Fountain of Youth” that is their real goal. Grudgingly or not, one must accept one’s mortality and the accompanying aging process or make some big and painful mistakes, costly to yourself and to others around you, as the price of trying to hold onto an identity whose time has passed. Dylan Thomas wrote, “do not go gentle into that good night,” but, gentle or not, go we will.

A few years beyond the mid-life crisis stage, most men and women find themselves thinking about different things than they were in their youth. Thoughts related to sex diminish and thoughts about aches and pains increase. In both cases, the mind is reminded by the body of one and not the other. The only difference is that the body steals upon you with sexual thoughts and feelings while young and, as these diminish, perversely tries to make up for it with sensations that hurt more! If you are like me, the first change you notice is that you actually have knees. Now, for the first time, you are aware of the work they do, and the knowledge is not consoling. These thoughts and sensations make their own contribution to who you are.

Finally, Richard Posner, the public intellectual, scholar, and judge has asked an interesting question about identity. What if, Posner wonders, we send a young man to prison for a serious crime, but he reforms himself and becomes an admirable human being during his lifetime confinement? Are we still punishing the same man 40 years after the wrong has been done? Certainly his name is the same and his history marks him as the same man. But his personality might have been altered by rehabilitation, reflection, experience, study, faith, or any or all of the aforementioned.

I hope that it is clear that identity is not so simple a thing. It is made up of one’s history and those histories of one’s forebears. At least partially, it is a function of a name and a place and a time, whether friendly to a person or not, particularly if society is prejudiced. Physical characteristics, too, play their part, as do what we think and what we do; and, of course, whether we have much self-awareness or, instead, see ourselves as different from who we really are.

And, it is a thing that can change — that must change — as we age and take on new roles in our families and in our community; and as changes occur not just in our mind’s eye, but in the mirror.

It is worth some thought, I think, that question with which I began.

Who are you?

The image is called Pentaeagondodekaeder by Lokilech, sourced from Wikimedia Commons.