avoidance

March 5, 2023

Overcoming Suffering and Our Fear of Change

Suffering, both physical and psychological, cannot be escaped. We can, however, minimize it by not adding to our discomfort.

For Buddhists, much suffering comes from our desire for permanence. In the West, we often refer to this as difficulty adapting to change.

It is hard to think of anything that doesn’t change. The weather, our relationships, and life itself are all temporary. We age and die. Our children grow, create their own families, and become independent — a double-edged modification necessary for their well-being and requiring an adjustment that, at times, is painful for us.

One’s effort to establish a vice-like grip over all the “temporaries” we hold dear can only fail. Our attempts to freeze-dry and maintain ideal moments of perfection are fruitless.

Those who believe in an afterlife often imagine the best parts of this one and hope the future will contain some glorious, magnified, blissful version of these moments. Many believe there will be permanence, for example, in their joyous reunion with departed loved ones.

Others run from thoughts of inevitable loss or nightmare difficulties ahead of them in this life. They seek TV, music, alcohol, drug abuse, or other distractions from such possibilities.

What if we could become impervious to suffering using a magic potion? Imagine further that the rest of the world stayed as it is.

Without any sense of loss, we would become indifferent to the misfortune of others. We would lose ourselves, become unrecognizable, and be unable to understand anyone else’s hardships.

Without the capacity to sustain personal injuries, our lives might be described as robotic, wooden, and hardened — indeed unchangeable. No new learning would be possible.

Doesn’t love require compassion and understanding, put out of reach by the magical drink? Would we even wish for love, be moved by a tender film, beautiful music, or art? Why might such an individual read fiction without caring what happened to the characters? Nor could he capably raise children to become decent human beings.

Given that the suffering connected with an impermanent human state is inescapable, we must come to terms with our lack of control and inability to achieve more than a temporary evasion of external stressors. 

A worthwhile alternative is the transformation of ourselves into creatures who, recognizing life’s inevitable difficulties, hold our knowledge of human transitoriness gently.

Rather than gnashing our teeth over the uncountable unfairnesses befalling the human race, there are alternatives. One might do better to recognize that we pay for love, the appreciation of beauty, and the blissful moments of exhilaration with the suffering and change that make up the other side of the coin of existence.

We can learn to give up the struggle for control of everything except that which is in our power. We can accept the pain and the shortness of our lives and learn how to live with them.

One step is to recognize we will not achieve permanent happiness in an ongoing process of craving much of what we believe will make us happy. We tend to react to purchasing a dream home or finding a desirable mate as if they are Christmas toys: short-lived sources of joy. We take them for granted before long, at least to some degree. As the English author Wordsworth reminds us, “Getting and spending we lay waste our powers.”

Homo sapiens do better to shift their focus from the complexity and lack of ease in any life by focusing on self-care, kindness, gratitude, displaying compassion, and listening to and recognizing the true nature of our friends and acquaintances.

We can ask those we care about whether they believe we understand them. And if they say no, tell them we want to do better. An essential feature of such attempts to improve relationships involves working on ourselves and diminishing whatever anger might lead us to hurt them.

Self-knowledge and meditation may lead us along this path. The latter also allows us to live more often in moments of tranquility.

The Buddha told a story about “the second arrow.” The arrows he described referred to the pain from events outside us. Of course, when the first arrow strikes, we feel anguish. We are advised, however, not to wrestle with it. Instead, begin by recognizing it.

One can come to an acceptance of the harm by releasing the tension and embracing our distress. Gentleness with ourselves, meditation, and ensuring not to enlarge our suffering allows the injury to heal to the extent possible.

The agony will grow if we keep struggling with the wound and remain preoccupied with the affliction and how it occurred. As the Buddha tells us, worrying over our pain is like a second arrow we shoot at ourselves.

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Both of the images come from Wikimedia Commons. The first is Meditation at Empty Cloud by Rikki. The second is the Buddha.

December 11, 2022

Our Difficulty with Quiet

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

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

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

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

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

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

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

And Jacob was left alone.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

As Kafka said,

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

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

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

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

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

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

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

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

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

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

May 3, 2020

Who Was That Masked Man? Psychological Self-protection in an Age of Masking

Stepping out of my home early Tuesday morning, I stepped into a strange world. Nature wore a mask of fog. Not me, mask free. Well, unless you believe I am a man of false faces.

We outfit ourselves with disguises. One mask fits atop another. Some use different camouflage depending on the set of friends nearby.

For the dress conscious, clothing plays its part in the costume, hiding that which we don’t want revealed. Rather like an actor’s stage makeup or Halloween for the kiddies.

The coverups take many forms. First, there are the ideas we don’t share. Next come the beliefs we don’t believe, but repeat to get-along.

Feelings and weaknesses are on display without trickery, the ones of which we are aware and those too crushing to accept.

Sometimes the concealing tarp drapes over our opinions, while secrecy extends to our plans. For example, the-intention to rob a bank.

Our face covers save us from relationship troubles, too. Remember four-months-ago when you recognized someone at a distance, a character you wished to avoid? Now you can cross to the other side of the street without hesitation or worry.

Time and circumstance have transformed the meaning of our action, changed it from a dis to distancing.

Alcohol has long been a tool like a self-protective armor plate. “Take a drink, you needn’t think,” says the bottle. “Dispense with your memories and feelings. I am your magic potion. I’ll erase your internal maelstrom – for a little while.”

Denial pursues this end, too, shrouding all our mirrors so we can’t recognize who we are, what we do. Others admit themselves to themselves but rationalize the necessity of being so.

Remember Salome? The girlish teen was Herod’s step-daughter, the child of his wife in the age of Jesus. The regent wanted the erotic young woman to dance. She did so with seven veils at the start and none at the finish.

The temptress then accepted payment for her star-turn: the head of John the Baptist on a silver platter, the better to kiss a decapitated man. The watchful Herod found the latter so disturbing he had her killed.

Removing veils can be a risky business.

Back to the present, our century encourages coverups via computer technology.

Are you uncomfortable on the phone? Want to dump someone? Turn away and send a text.

Are you bursting with unexpressed electoral anger or racism? A fake name and an itchy Twitter finger will fire the ballot bullet.

How about flirting or infidelity? The online world offers a digital dodge and a new name to hide behind.

A therapist is challenged by those patients who have never been unmasked. The sun never reaches their pale faces.

Take one mask off and you’d find another, masks on masks, layers piled up. The wearers have never seen themselves. The person underneath is a mystery.

And yet there is hope. Here is an example, a fellow I’d treated for some time.

Q: What price do you pay for the psychological protective equipment you employ?

The gentle soul lowered his head. His shoulders trembled as he wept.

A: Everything I want in life, friendship and love. I act like I’m a spy, in the shadows, on duty 24/7.

The door to recovery thus opened.

Like Tuesday’s lifting fog, a new day in my client’s life took a peek at possibility. The more we depend on masks, the less we own the joy of recognition and acceptance by another.

He discovered his disguises hid the best of him.

My advice? The next time you remove a cloth mask from your face, ask yourself this: Am I still wearing a mask?

—

Until then, donate what you can to a food bank.

The top image is Paul Hartland Carnival. Composition with Two Masks, 1934, by Lazlo Moholy-Nagy. Next comes Mask, 1919, by Marcel Janco. Finally, Lady Taking Off a Mask, 1906, by Konstantin Somov.

December 15, 2019

Hurdles to Healing: Dissociation, Self-Distraction, and Forgetting the Therapeutic Conversation

I noticed something surprising as a young clinical psychologist. A few of my patients forgot the most significant topics discussed in the previous visit. The client’s memory had been wiped clean as soon as he took a sidewalk step outside.

Let’s break the experience down. We are dealing with various methods of avoidance:

In behavioral avoidance, we stay away from or delay something. Not attending a party, not making a phone call, and side-stepping confrontation all fit the category.

Now think of the failure to recall segments of a penetrating conversation, a separate class of dodging. It is a kind of return to the state of ignorance we inhabited before the talk with the doctor, with an emphasis on the word ignore. This type of avoidance is a more internal, mental event.

Here are examples of the latter:

Dissociation:

One of the signs of dissociation is the fracturing of recollection. Parts of an individual’s lived-experience are compartmentalized, detached, put into a psychic safety deposit box. The mind drifts from ugliness, anxiety, or grief. In effect, the person walks for a while in daylight darkness. “Losing” the feelings and ideas raised in-session is an illustration of the phenomenon.

The occurrence doesn’t signify intention. The “disappearance” is automatic and unconscious: daydreaming, for example, to the point of losing awareness of time passing.

We all “space out” on occasion, but the recurrent loss of the therapeutic thread between sessions is noteworthy. A treatment obstacle exists.

Self-distraction:

Those who take on the unbuffered fury of every problematic life episode become like an unbending tree in a gale, lacking the flexibility to endure its impact. Self-distraction can be a way of moving aside from the indomitable force, at least for a while. Imagine it as akin to taking a breath, gaining strength, and coming back prepared to manage whatever taxes you.

Even so, because psychotherapy must unsettle the client’s internal climate enough to help him change, he mustn’t distract himself most of the time. If after-session contemplation of the therapeutic issues passes in a breeze of internet surfing, work, or socialization, so will the chance for progress.

However much these psychological defenses might be needed, they can also enact a cost. The fraction of the world we evade or forget leaves a smaller world for us to inhabit. Moreover, our acceptance of a miniaturized comfort zone implies a fear that we lack the abilities, resilience, and toughness to stand up to the larger cosmos.

The individual thus shrinks from all the glorious, dazzling, and frightening complexity of the real world. The universe of what is possible contracts: all the foods, adventures, types of people, behaviors, and opportunities for learning vanish. Existence is narrowed and diminished. Walls are built.

Here is an example. I treated many men who didn’t want annual physical examinations. They avoided physicians because they wished to block bad news (illness).

Quite a few of these men demonstrated bravery elsewhere in their lives. In this situation, nonetheless, they escaped reminders to lose weight, stop smoking, exercise, restrict their diet, and reduce drinking. They ignored troublesome coughs and chest pains. Any real malady was no less present, but the fantasy of make-believe health was maintained.

These people willed themselves “blind” rather than taking responsibility for their well-being.

Such individuals evaded conversations reminding them of their mortality and bodily vulnerability. By making a decision not to submit to medical evaluation, they reduced the freedom to know whether they were ill, defeat illness, and display courage in confronting the limitations and hardships connected with disease.

Excuses hid the truth of their existence, the truth of their avoidance of truth:

  • “I’m too busy to go to the doctor.”
  • “He’s just going to tell me X, and I already know it.”
  • “Doctors only want your money.”
  • “My insurance won’t cover the appointment.”
  • “Yeah, I’ll go, but not until next month.”

Whenever we duck taking responsibility for our welfare, we give up a portion of the capacity to shape the world to a different and more pleasing form. Whether alert to what we are doing or not, a choice occurs: to claim as our own the disturbing recognition of our inner and outer world or to bury it.

New knowledge, once aquired, always offers us a question: what are you going to do now and in the future in light of what you know?

As the existential philosopher, Jean-Paul Sartre wrote, “If you want x, you will have to (do) y.”

These awarenesses and choices are disagreeable. Otherwise, everyone would make them with ease. They are thrust upon us by the condition of being human. If we keep recognition of our current and past evasions underground, we thereby enlarge the risk of unseen catastrophes, as we do if we walk across the street without looking both ways.

Then, with our eyes ignorant of danger, we are inclined to consider these calamities a matter of hard luck or destiny. External forces appear to have destroyed our dreams. We tell ourselves we couldn’t have changed the outcome.

Maybe, but maybe not.

No one escapes trouble, but some number of calamities are preventable given enough time to prepare. That is, if one chooses to see and accept the freedom to push the boundaries of our knowledge of our psychological world to something closer to full size.

Therapists are wise to take sensitive issues slowly, lest they overwhelm the client, and trigger the tendency to “put away” enlightenment (insight) revealed in the office. Even so, no healer believes he can instill fortitude in another person to face his dilemmas where sprouts of courage don’t exist to be nurtured.

If buds are present, however, the counselor becomes something like the gardener who tends to his plants. His job is to enrich the soil and shelter them from part of the wind and cold.

Then, in the best case, the developed vegetable life — now independent — uproots itself, discovers it has legs and walks into a fuller animal life on his own.

In the end, freedom — the path to growth — is not free.

Whatever our life is to be, whatever it was, whatever historical harm we suffered, the life now and ahead is ours.

We must forever choose to make it.

———

The first image is Papagenato, imported by Archive Team. Next comes Gaze -3, an oil painting by Rajeskharen Parameswaran. The bulldog is called Barlow in Hiding by Andrew Smith. Finally, a Hide Pose by Peter Trimming. All were sourced from Wikimedia Commons.

September 4, 2017

The Need for Escape

The sense of being trapped may be a universal experience. Think of the small child who tries to wrestle out of his parent’s protective arms. The teen who hates curfew. The high school grad who can’t wait to leave home.

Other examples come to mind:

  • The suffocating boyfriend from whom you must free yourself.
  • The hated boss.
  • The stifling career.
  • The moribund marriage.
  • A restrictive religion and its too many rules.

Why are we so offended by the stickiness of things, of being like a fly on flypaper? Why do fences shout “Jump”? What is it about walls that beg us to climb, even as recreation?

  • Our ancient ancestors, the hunters and gatherers, needed to keep moving to find food and shelter. They profited by sensing and staying away from those animals and humans who menaced them. We inherited their survival tendencies. The complacent and trusting souls who acted otherwise and perished didn’t pass on their genes.
  • The instinctive man inside of us habituates quickly: he gets used to things, becomes restless, gets bored. Dissatisfaction is built into our nature, the better to thrive and survive. Were we satisfied by a single meal, with no recurring hunger, we’d starve. If sex so “blissed-out” cave-dwellers after one or two couplings, you and I would not exist.
  • The passage of time creates urgency. We don’t lead infinite lives. Want to be an Olympic star? Don’t wait until 30 to start practicing. The desire for love, too, means you must dive into the swim while your sparkle still can catch the eye of another aquatic creature.

The grass always being greener, where to? When? The five-year-old doesn’t run away because he can’t make a life on his own. The abused spouse with the ground-to-bits self-image holds her hopeless spot for fear worse awaits her elsewhere. The dissatisfied employee stays put in an economic depression. We all know out-of-love couples who remain married for the children, the worry of being vilified by co-religionists, and the thought of owning one dollar, where they used to count two.

We sometimes stay when we should escape and leave when we should hesitate. I’ve done both. How do you tell whether flight is best or portends even worse? A few things to consider:

  • Nobel Prize winning psychologist Daniel Kahneman states, “It is only a slight exaggeration to say that happiness is the experience of spending time with people you love and who love you.”
  • Psychologists remind us that experiences, not things, have more lasting value internally and are more positively remembered than buying one more material object.
  • We cannot escape ourselves entirely. One’s innate temperament makes a significant contribution to happiness.
  • What we choose to focus on and whether we set impossible goals also factor into our sense of satisfaction. These are within our control. The long-term practice of mindfulness meditation has been associated with happiness, as well.
  • Research suggests Midwesterners who believe life will be better in California simply because of the weather tend to discover fair weather, like almost everything else, gets absorbed into the background. Not only climate, of course, is subject to habituation: think money, a new car, and today’s Christmas toy – the new delight turned stale; closeted before the weather warms. In the absence of other factors that might sustain a sense of well-being, we return to our set point, a basic and more or less enduring emotional state.
  • A richer neighbor will always be a happiness-wrecker if $$ are the measure you crave. Above $75,000 per year, your moment-to-moment, experienced well-being doesn’t improve much.
  • On the other hand, more money does tend to increase life satisfaction: your opinion of your life when you stop and think about it. And, up to about $75,000 yearly income, moment-to-moment happiness does increase.
  • Ask yourself what is your default tendency. If you tend to change jobs quickly, for example, then the next question becomes, how is that working? If you are prone to stasis when dissatisfied, the same question must be answered.
  • Are other lives involved in your decision? Maybe moving to a new house is best for you, but will it work for the spouse and kids?
  • Try to predict how you will feel about your choice in five months or five years. We tend to be poor at “affective forecasting,” the ability to gauge the emotional consequences of our actions. Still, an attempt is required.
  • A 2017 paper by Blanchflower and Oswald suggests we reach a low point to our happiness in midlife (around the early 50s). Thereafter, in general, we rebound – major life change or not.
  • You will do better to know where you are going, than just the situation from which you flee.
  • Those prone to anxiety and worry tend to exaggerate the danger of taking a risk. Judgment is questionable when angry. If you can, wait for a cool moment to make a decision.
  • Who are you? What are your values? How do these translate into life as it is lived?
  • Is there more than one way to achieve the result you want?
  • You might ask yourself whether your internal life requires attention. The externals – other people, your job, your living conditions – are less in your control.
  • If you expect utter and permanent transformation following your leap from a stuck place – well – you could be expecting too much. Remember, though, nothing in life is permanent and one can do worse than reach for the beguiling flowers still in bloom.

One last thought: we get no free lunch. Staying and going – except in extreme circumstances where life depends on it – each have a cost. Sometimes the decision is easy, often we struggle. Some doors remain open a while, others close with a rush. None of us get this right every time. Indeed, even knowing whether there is a “right” road can be challenging, since we only know with certainty the chosen path, while the other avenue lives in an idealized state within our imagination.

We’ve all read stories about the courage of people real or imagined, and the fixedness and quiet desperation of others. Those lives may provide guidance, but making choices presents a challenge unless you are an inveterate risk-taker or so frozen in place that no heat wave can de-ice and free you.

We each have only this one life. Try not to die with too many regrets.

—

The top image is the Vatican Museum Staircase as photographed by Andreas Tille. Next is James Jowers’s L.E. Side. These were sourced from Wikimedia Commons. Finally comes a Space Escape Grunge Sign, created by Nicolas Raymond and available from: www.freestock.ca

July 16, 2017

What Comes after Grieving? The Challenge of Saying “Yes” to Life

A formal, sarcastic, middle-aged woman, she was not an especially promising therapy candidate. Though very bright, one of her problems was her penchant for closing doors. She needed escape from the confined space of her life, but when possibilities arose, “no” was her usual answer. Even if no joy resided within her narrow neighborhood of known places, the dismissed opportunities existed outside her psychological comfort zone. Instead, she went to work, dutifully visited her adult children, saw her siblings on holidays, and spent lots of time reading and doing crossword puzzles and Sudoku, at which she was adept. Her life was safe, her job secure, her unhappiness guaranteed.

The lady thought she had all the answers, but her sadness suggested otherwise. Widowed for some time, her muted grief could be traced to guilt over failing an abusive husband, not his absent kindness. Until the grieving was completed, however, no manner of persuasion convinced her she was now free. Her fortress against hurt from others – a shelter of  fixed routine, avoided chances, and minimized risk – was self-created.

A luxury room in hell is still in a place you won’t like.

Some therapy clients feel as though the past has stained them indelibly, made them unacceptable. Or that they are tainted, marked “beyond repair” soon after birth. They believe unacceptability pervades everything they are, everything they touch. My patient was such a one.

The therapist faces many challenges here. He must, of course, win the trust of someone untrusting, accept the sarcasm and negativity, understand the part “attitude” plays in defending the individual, and realize the presence of an injured soul under the porcupine spines. A grieving process will take the time it takes, until past losses recede and guilt is shed, the stain less visible. At some point the patient must begin to reenter the world or, perhaps, enter for the first time.

A scary thing.

Life is like a book we write in indelible ink. We can’t erase the past, even though some imagine the ink is still wet and marks everything they touch with words written far back: words like bad, selfish, mean, stupid, and unattractive. Those who think this way believe the pejoratives live inside of them. They attribute superhuman powers to new acquaintances. People will, they are sure, quickly read the words through the transparency of face and body.

The book, however, has many blank pages left. The virgin parchment remains to be filled in, as pristine for you as for another. What will you write? Yes, you possess a history, but how much of it must you endlessly reread and then repeat and recopy on the unfilled paper? How much of the book’s future story must tell the same tale only with different people?

The empty spaces ahead are untainted, pure. If you keep looking back, you will keep getting the wet ink on your fingers, your forearms, your future. The new leaves will be smudged. Thus, the lady with whom I began this story anticipated an unsatisfying, injurious path, closed the gate to it, and only accomplished a reliving of her past in places offering no novel possibilities.

She needed a change of clothes, a shower, even a fresh start at work or new friends; maybe without her siblings or with a changed attitude toward them.

If you are like this patient, too quick to say “that won’t work or “I can’t do that,” well, as the wry aphorism tells us, “If you do what you’ve done, you’ll get what you’ve gotten.”

The art of therapy is, in part, the art of managing the client’s transition from shedding the past to his trying out a new version of himself: a kind of gradual debut of a person partially transformed. Some of the transformation happens in the working through of past injuries, but much develops, too, in taking on the world again. There is danger if you ignore your history, but an equal amount if you don’t venture out.

Each of us carries some version of the book of our life’s saga. For those least fortunate, the incomplete autobiography is heavy, filled with the weight of tragedy. Others own a lighter volume, but not free of disappointments, mistakes, and the harm nature or fate or other people have inflicted.

The past is a place for reluctant therapeutic visits or fond memories. In the middle of life, however, many blank pages still need filling.

The patient I mentioned eventually ventured out of those phases – those pages – already read and reread, lived and relived. She entered the world of the living again, where history is made. She noticed anew a man she’d known for a few years, someone who admired her from a distance. My client took the risk of taking him seriously, instead of treating him with her standard defense: a witty, but sarcastic distancing.

If any of us are to find a pot of gold at the end of the rainbow, we must first leave the house in search of it. We remake ourselves, in part, by taking tentative steps, not by waiting until we are fully changed. Change is in the action. Change is never finished, always moving, forever incomplete.

Perhaps it is too much to say my client found her innocence again, but in a way she did, and the joy of a second first love. She and her admirer married.

Life does not always permit a happy ending, nor do we get to write our whole story free of fate jostling our hand as we move the stylus.

Still, the blank pages beckon.

—

The top photo is called, Afraid of Water, by Jaka Ostrovršnik

May 21, 2017

Dying to be Seen, but Afraid to be Seen: Where Insecurity and Invisibility Meet

The quiet ones envy those who are sociable. Not always, but often. They wish for an ease of contact which is not theirs. Too many hunger for understanding, for a kind person to recognize them, accept them; even love them. They are dying to be seen, but afraid to be seen.

Anonymity is the preferred choice. Many escape to the shadows, at least if they can.

Don’t raise your hand, says Mr. Anxiety, even if you have the right answer. Too risky. Your voice might quiver, your hand might shake, and there could be a follow-up question which leaves you speechless.

The insecure ones make a trade. They take the apparent safety of invisibility at the price of being ignored, misunderstood, or quickly forgotten. They leave no mark on the world, hoping to avoid criticism and ostracism. Better to take yourself out of the competition for attention than be told to go away. Of course, you wind up alone, but you persuade yourself this is better than rejection.

Instead of belittlement you opt for the shrubbery, hiding behind the bushes. True, sometimes you get wet when the lawn sprinklers go on. Occasionally a kid throws a ball that hits you or a dog sprays you, but you get used to it.

Group conversations are the worst. When might I jump in? My face will flush. They’ll think I’m an idiot, too boring. I’ll just sit tight or stand and nurse my drink.

Who would have thought a man could dive into his glass, hide behind its opacity? Or imbibe enough to shed his disguise and turn into a more outgoing, confident version of himself?

Once you sober up, you will still be like a person with a fire inside who is afraid of venting a smoke signal. The result? You are consumed from within and your glorious flame is unnoticed.

Mark Twain said, “The man who does not read has no advantage over the man who cannot read.” Change two words and the sentence becomes: the man who does not speak has no advantage over the man who cannot speak. Will you be thought of as the latter? Are you already?

Or have you become someone who is told what he thinks, afraid of challenging a rude or wrong idea? You will be outdone by those with half your intellect. They, the half-brained, are kings and queens in the land of the mute.

You remain unknown, even if others think they’ve sized you up. Many believe you are stuck-up because you avoid them. Some say you are kind, several imagine you lack “personality,” others reckon you stupid, a few timid: an easy mark to be pushed around. Most strangers form no opinion. Not one of them will be completely right, know the whole package. You won’t even be seen in full by yourself.

Your attempt to vanish is exhausting. The task is like running a race, trying to escape the eyes of others, but distancing yourself from yourself. If all escape routes close you will grab your throat and squeeze, stifle your emotions and ideas so as not to offend anyone.

Do you wish asphyxiation by your own hands?

I hear you gagging.

Do I know you? Not completely. But I’ve seen you and I might have been you a long time ago.

It wasn’t fun.

It’s not as if everyone else is completely visible. No one is. One might display an eyebrow or an ankle, even a heart: that most precious portion of ourselves when offered as a present. Such a one is trying, practicing, gathering momentum.

A gradual path toward self revelation can grow on you.

In the end, however, if you are seen but unseen, dying to be seen but afraid to be seen, you should realize something: you cannot be both.

You must choose or remain in torment.

The therapist’s door is waiting, but even there you can try to be invisible.

A pity.

Counselors, you understand, don’t do their best work blindfolded.

—

The top image is a photo of the cover of The Invisible Man by H.G. Wells. The cover was illustrated by Ludvik Strimpl and the photo taken by Gallica/Sudoc. The image was sourced from Wikimedia Commons.

February 12, 2017

What You Can Do When Trauma Reminders Intrude

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Victims are easy to identify — or so we think. We see them on TV each day. We are inundated with injury. Too many terrified people, mistreated people, and survivors of war zones and privation carrying their children and belongings. The images arrive from displaced persons camps, airports, and highways.

Look in the shadows, however, and you will find even more. Those are the second-hand souls, the past sufferers, the ones reinjured at a distance.

The men and women to whom I refer are recovering from Post Traumatic Stress Disorder. Some of them are rebroken by watching or reading about the latest victims and the menacing public statements of elected officials. They shudder at the unpredictability in the air. According to the conservative columnist David Brooks, we are witnessing  “a rising tide of enmity” in the USA. Indeed, swastikas have appeared in the public library men’s room of my own suburban Chicago community.

Yesterday’s unfortunates are reminded of their imperfect healing by the incivility and xenophobia around them. Their bodies respond by saying “fight or flee.” A sense of being flooded, overwhelmed — even to the point of collapse — sometimes is not escaped for minutes or days.

Retraumatization of this kind can leave the individual disoriented and dissociated. He may undergo flashbacks of his past: a psychic reexperiencing of the event. At the extreme, there is the loss of awareness of where you are, in what circumstances you are, what age you are. You time-travel to a place you escaped, reinstalled into a mental chamber of prior misfortune. Perspiration, nausea, tearfulness, and intense fear are only a few of the possible sensations and emotions.

You are alone, even if others are nearby. The triggered individual is often unable to describe his internal world. He is awash in a fetid river of word-preventing feelings. The proper vocalizations do not come.

What is one to do?

Here is an example of a young man who dealt with a mild version of the problem, but still enough to put him in treatment. He was in his early teens. A bike accident — he was struck by a car — left him with a painful recovery. Even after the physical injuries healed, the newspaper account of the collision — one which blamed him — still felt like an attack. Moreover, the intersection where he had been hurt remained dangerous. He felt both unfairly targeted and helpless to do anything either to vindicate himself or prevent harm to others. He continued to avoid the location, but traffic reports of pedestrian injuries (regardless of where they occurred) darkened his mood and made for painful and repeated revisiting of his experience.

One aspect of his treatment was a turning point. We talked about what he might do to get a sense of control and counter the wrong and wronging newspaper account. This thoughtful adolescent wrote a letter to the reporter who covered the event. Two things followed: 1. His comments were published in the newspaper. 2. The reporter researched the statistics pertaining to accidents at the place of injury and wrote another article detailing the danger. The city council then investigated the matter and made the intersection safer.

Where does that leave you?

You can, of course, hold your hands over your eyes and plug your ears. The avoidance of TV and radio is a close equivalent, as is holding to an agoraphobia-like self-protective self-confinement. Though understandable, these strategies must eventually be set aside lest you continue to remain terror-prone.

Another patient of mine, long after her father died and mother denied (in my presence) that any sexual abuse happened, chose to return to her childhood home. This was the site where years of sexual abuse by dad occurred with mom’s knowledge. She traveled 500 miles to get there. As it happened, the house was being redecorated and the new owner permitted her to look around. My client left the spot with a sense of palpable triumph. She had faced-down the ghost of her demon in the place of his iniquity.

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If you are pained by news accounts in the aftermath of the President’s Executive Order of January 27, other actions commend themselves to your attention. The American Psychological Association offered a concerned Response to this Directive on February 1, 2017. It reads, in part:

‘Refugees, particularly those displaced from war zones, experience stress, trauma and other serious mental health problems,’ said APA President Antonio E. Puente, PhD. ‘Denying them entry to the United States, particularly those who have already been vetted, is inhumane and likely to worsen their suffering. This conclusion is based on extensive research and clinical experience … .’

Such policies can lead to a perception of reduced freedom, safety and social connection for those directly affected, as well as for society at large (my italics) … .

Research has documented serious mental health consequences for immigrant children and/or their parents who have been forced to leave the United States, which may magnify earlier trauma experienced in or upon fleeing their country of origin. Sudden and unexpected family separation is associated with negative outcomes on child well-being that can last well into adulthood.

If you have been retraumatized by the human consequences of your country’s immigration policy, your decision concerning any response may be more personal than most. Others, perhaps less impacted in this way, have marched, attended town hall meetings, written public letters to news organizations; and visited, called, or emailed their elected representatives.

In the end, those without trauma histories would be wise to refrain from judging whatever action you choose or do not choose. The world presents many chances to reinvent ourselves and repair the injuries it inflicted.

Remember, however, that you and your therapist aim to help you distinguish the present from the past, both intellectually and emotionally: to realize you can act today in an effective way not possible before. And to keep the past from recurring in any form by your self-affirming assertive actions.

—

The top photo is a Syrian Refugee and Her Newborn in Ramtha, Jordan taken by Russell Watkins for the UK Department of International Development. The second image is a World War I propaganda poster called Every Girl Pulling for Victory by Edward Penfield, created in 1917. Both are sourced from Wikimedia Commons.

August 20, 2016

Treating Insecurity and Anxiety: Eight Roads to a Solution

512px-Anxiety_cloudImagine you are considering therapy for the first time. Or perhaps your treatment isn’t working. You stand at a crossroads, like the hub of a wheel where eight spokes beckon for attention. How should you choose among them?

Not all are good and you may even realize that as you decide. Here is a guide to thinking about what to do (and what not to do) with the weighty package of insecurities velcroed to your life. Click the link for a comprehensive list of the signs of insecurity.

ALCOHOL AND DRUGS. The issue of substance dependency should not be ignored. Recall the old Chinese proverb, “First the man takes the drink, then the drink takes the man.” Alcohol’s comforting relief and buoyancy is commonly replaced by longer term emotional darkness. Marijuana (cannabis) might mellow the smoker out but leaves underlying insecurity and anxiety untouched when sober. If you are attempting psychotherapy, best to tell the counselor the extent of your substance use straight away. The deepest wounds are slippery things. Grasping them is harder (if not impossible) when alcohol or drugs add to the excess lubrication.

WILLPOWER AND SELF-ANALYSIS. The old saying tells us, “When the going gets tough, the tough get going.” Yes, some few people manage their own psychotherapeutic project. Indeed, Freud analyzed himself. What is required? Although I know of no research on this, I suspect one needs a strong capacity for self-reflection, high intelligence, some degree of emotional openness, the courage to look in the mirror, tenacity, and knowledge gained through reading about treatment. Willpower is necessary because the self-analyst must inevitably get out of his head and leap the wall of fear to master behaviors blocked by insecurity: good eye contact, self-assertion, saying no, asking for things, making uncomfortable phone calls, inviting someone on a date, public speaking, etc.

THE SEARCH FOR A STRONGMAN. Some rely on a mate to perform avoided tasks. The significant other becomes a caretaker or body-guard, an individual who is sought to do the jobs the hesitant one believes he cannot: return a product to a store, accompany him to events otherwise avoided, and so forth. This is no solution to anxiety or insecurity, but a human crutch to sidestep the need to change. Another danger: too often the protector becomes an overlord, pushing you around or worse; the mister turned monster you hoped he would protect you against.

PSYCHOTROPIC MEDICATION. Medications, like other drugs, carry possible side-effects. Antidepressants can impair sexual performance, anti-anxiety tablets often have addictive properties. While a good psychiatrist will carefully watch for these, pharmaceuticals do not create a sense of security and confidence beyond the time you use them. Moreover, to the extent that the psychotropics help you feel better, your motivation to tackle underlying reasons for your symptoms may be reduced. That said, sometimes susceptibility to anxiety and depression is inherited and biologically-based, making the booster of drugs a necessary and permanent mode of treatment.

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AVOIDANCE AND THE INTERNET. Anticipation of discomfort, humiliation, or failure translates to turning down invitations — limiting chances for growth, accomplishment, and joy. The troubled soul is assaulted by hatchet-bearing ideas that have become permanent, non-rent-paying residents in the head. The data set of the insecure is based on an unfortunate history. The job of recovery translates to writing over your old history by gradually taking on social challenges and accumulating successes reinforcing your effort.

Beware the false god of the internet! The more time you worship at its alter and “let your fingers do the walking” on the keyboard, the less you have for direct human contact (involving actual walking out of the apartment). For all its marvels, this deux ex machina can become a screen behind which to hide the human face, trading yours for a virtual one. Yes, social media can be a stepping stone to a life beyond the keypad. For many, however, it’s another form of concealment and self-distraction. You can identify too fervent online social network disciples by the pain they will suffer for their god: a malady called text neck, the product of bending over their smartphone.

PSYCHODYNAMIC PSYCHOTHERAPY. Psychodynamic treatment, the traditional talking cure, can be a foundational part of counseling. It helps one clear the life-history undergrowth undermining a healthy self-image, planting  seeds of sturdiness to deflect the inevitable defeats we all encounter. Such counseling also lifts the weight of self-blame by recognizing the fingerprints of others on one’s problematic background story. It cannot stop there, of course. Grief and grieving demand attention.

Beyond relieving submerged pain, one must eventually take psychoanalytic insight for a test-drive: try new behaviors just as one would a new car before purchase. However much a “depth psychology” approach is needed, empirically based (research supported) interventions provide the practical impetus for emotional availability, symptom reduction, and behavioral change.

COGNITIVE-BEHAVIORAL THERAPY (CBT). Many of the well-researched and effective treatments just referred to fall into the category of CBT. Obsessive-Compulsive Disorder (OCD), for example, is among those problems amenable to this set of tools. Indeed, attempting a solution for OCD psychodynamically is, in contrast, a therapeutic cul-de-sac. CBT can often, however, be combined with more traditional talking therapy to join the best of both worlds.

ACT (ACCEPTANCE AND COMMITMENT THERAPY). ACT is described in the following way on its website: “Developed within a coherent theoretical and philosophical framework, Acceptance and Commitment Therapy (ACT) is a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behavior in the service of chosen values.”

Plowing through this technical language, ACT deals with the losses most patients have sustained, traveling from a grieving process toward acceptance of those life circumstances that can’t be changed, reduced avoidance, learning to live in the moment via meditation, deciding what is most important to you, and choosing behavior consistent with your stated values.

WE ALL TAKE TURNS at life’s crossroads. Sometimes the best advice is to make no movement, patiently waiting for the traffic to clear. Do remember, however, not choosing is also a choice. The clock is always ticking, even if, in the digital age, we must strain to hear it.

—

The top image by John Hain is called Anxiety Cloud sourced from Wikipedia Commons. The photo beneath it is Girl Suffering from Anxiety by Bablekahn at Kurdish Wikipedia.

August 30, 2015

Passive or Active? Choosing Your Life

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Simple words are not so simple. Rather, we forget their meaning. We forget how much they should provoke a reevaluation of our lives. Consider the words “take” and “make.” I’ll try to “make” something of their importance in describing the lives we choose.

Here is a common sentence: “I must make a decision.” It sounds more passive than it is. I have heard the same phrase from non-native English-speakers, slightly altered: “I must take a decision.” As in grab or capture. Even in “making” a decision, at least in its most active form, we “build” or “construct.”

Take stock. Take over. Take responsibility. Make a choice. Make something of yourself.

Do you see where I’m taking you? What kind of life do you want? One you take or one left over because you did not capture a place in line?

We all know not choosing is a choice. If you don’t make a decision someone else will; or, perhaps the opportunity to intervene on your own behalf will pass. Many times an active decision is right even when wrong. You grab hold of the wheel of your life and try to steer. Value resides in ownership of yourself: self possession.

Many of the newer therapeutic models are not as contemplative, reflective, and retrospective as Freudian therapy, but add conceptual, emotional, and behavioral change — action — in the present. True, Freud warned about making personal decisions early in the treatment process, when still burdened by unresolved issues. There is recklessness in acting without thought, but finally one must roll the dice of life or stay on the sidelines, part of the audience. Indeed, one persuasive therapy model goes by the name of ACT (the word, not the initials): Acceptance and Commitment Therapy. ACT leads you to a point of decision about what is important to you, commitment to those revealed values, and an eventual behavioral enactment of your commitment.

You have doubtless noticed women whose companions are men of action, whether thespians, builders, or “makers and shakers.” Indeed, a man pursuing a woman is described as “being on the make.” Some of those “gentlemen” are less than uniformly admirable, but their grasp of initiative is. Many other males (and females) lead lives of “quiet desperation.”

Please don’t misunderstand me. You needn’t be a leader to take charge of your life. Each of us has problems. Our inner life can be like a room filled with shelves of challenges we avoid. One must clear the shelves. We either sweep them clean or avert our eyes and lock the room wherein they reside. We then avoid any part of life reminding us of the courage we lack. Our failure might even be rationalized as good judgment — as an avoidance of danger.

How many people can’t eat out alone, try to make a new friend, or phone a stranger (choosing email instead)? How many of us can’t speak in a group or attend a class out of fear? How many adults can’t say no, ask for things, or look someone in the eye while uttering a necessary truth? If you are 16 and you don’t tackle such challenges, OK. At 56, if you still can’t, what then?

A graduating high school senior tells a younger, awe-struck young man why she couldn’t be with him:

“Charlie, I told you not to think of me that way nine months ago because of what I’m saying now. Not because of Craig (her then boyfriend). Not because I didn’t think you were great. It’s just that I didn’t want to be somebody’s crush. If somebody likes me, I want them to like the real me, not what they think I am. And I don’t want them to carry it around inside. I want them to show me, so I can feel it, too. I want them to be able to do whatever they want around me. And if they do something I don’t like, I’ll tell them.”*

Life in a fetal position is not a life in full. Trying always to please others is a life given away to people who won’t value you because you set your price tag too low. Such an existence is the opposite of “being a man,” a phrase that applies to any mature, confident adult, regardless of gender. Some of us persuade ourselves that the things we don’t do (because we don’t try) aren’t important. A kind of self-delusion. Others live in regret, consumed by “what might have been,” shadowed by the effort they did not “make.”

Regret is the only six-letter word equivalent of a four-letter swear. Unless you do an irreparable injury to another, perpetual regret is like a judge you have assigned the job of looking down on you, pointing an accusing finger eternally.

We all must stretch ourselves to our limit, especially in the first half of life, and learn to hold our head high always. Ironically, in the act of lengthening the spine by standing upright we feel better, and tend to overcome whatever sense of shame lives inside. Few of us, after all, wish to appear spineless.

Passivity isn’t the opposite of activity as much as it is the adversary of “living.”

Make the best of your life. You will die whether you do or not, so you might as well die trying.

—

*Chbosky, Stephen. The Perks of Being a Wallflower. New York: Pocket Books, 1999: 201.

The painting of The Archangel Michael Tramples Satan by Guido Reni is sourced from Wikimedia Commons.