November 24, 2012

Last Words: Be Sure to Choose Wisely

The elderly Lady Nancy Astor, the first female member of the British House of Commons, awoke during her last illness to find that her family was assembled around her bed. Clever to the end, she said, “Am I dying or is this my birthday?”

Most of us associate the idea of last words with the solemn and quotable pronouncements of great men and women, not the sassy commentary of the once beautiful English politician pictured above. Here is something more typical: John Adams, our second President, alternately rival and friend of Thomas Jefferson, found some relief and gratitude in uttering “Thomas Jefferson still survives” as he (Adams) lay dying.

What he did not know in the pre-electronic year of 1826, was that Jefferson had predeceased him by a few hours. Nor did either of them appear to reflect on the irony that these founding fathers both expired on July 4th, precisely 50 years after the Declaration of Independence that they both signed and Jefferson wrote.

On a less ironic note, those of us in Chicago might have heard of Giuseppe Zangara, an anarchist, who took aim at President-elect Franklin D. Roosevelt as he and the Mayor of Chicago shook hands in Miami’s Bayfront Park on February 15, 1933. The bullet hit Mayor Anton Cermak, who reportedly said to FDR, “I’m glad it was me instead of you.” Cermak died soon after and is memorialized to this day by a Chicago street that bears his name.

There are other kinds of last words, of course. And though most of us probably won’t plan out what to say in advance, I think you will agree that you could do worse than follow the example of Ernesto Giulini, an Italian timber salesman born in the 19th century. He gathered his family around his death-bed, including musician-son Carlo Maria, to remind them that the word “love” — “amore” — should guide their thought and conduct throughout their lives. And one can only imagine how many times the words “love” and “I love you,” have been on the lips of both the dying and their survivors at the very end of earthly things. The religiously faithful have been heard to add, “See you on the other side.”

A rather more wry approach to imminent mortality is attributed to Voltaire. Asked by a priest to renounce Satan, he reportedly uttered: “Now, now my good man — this is not the time for making enemies.”

As Voltaire’s comments suggest, timing is everything and it is best to consider carefully what you want to be remembered for — and by whom. Last words from or to our parents tend to linger in the memory of those who survive, sometimes because of what was said, sometimes because of what wasn’t. Too many people — including some of my ex-patients — lament never having heard the words “I love you” from a parent at the time of his death or any time before.

We are often cautioned to part from loved ones on a high note, not a dissonant one, lest someone be left with the recollection and pain of a final disagreement, or the regret of causing an injury in what proves to be the last possible moment. Nearly all of us would avoid cruelty if we only knew when that would be. Usually we don’t. The dead may not care, but those surviving surely do.

Two unfortunate examples from my clinical practice come to mind in this regard. One woman, whose mother had died many years before, had difficulty in shaking her mom’s last minute assertion, “You’re an ass, Jenny (not her real name).” It is not the only such example I can recall hearing from one or another of my patients. But the all-time cake-taker, the grand prize winner in an imaginary “Hall of Shame” of ill-timed and venomously expressed invective, are the words of a rebellious teenager to his severely taxed father.

A long history of mutual destructiveness typified their relationship. It seems that the pater familias was inept and self-interested in raising his son, and the son repaid his parent’s cruelty and clumsiness with as much drug use and petty crime as he could muster. Nor did it help that the family was under financial pressure and that the two adults of the home were a badly matched, fractious pair.

The father had only recently sustained a heart attack when the school reported to him and his wife that the son had once again been suspended. The “mother-of-all” shouting matches ensued between the middle-aged man and his first-born disappointment. And then, the last words: “You’re going to kill me.” And the reply, “I don’t care.”

Not 24 hours later the words were realized. Deserved or not, the father was dead of a second cardiac arrest. And despite the fact that one could easily make a convincing argument that his death would have happened very soon even without the argument as a trigger, it is easy to imagine a lasting sense of guilt in the son.

That said, I’m not opposed to standing up to people who have injured you, including parents, well before they check out of this mortal coil. Choosing to say, “I know what you did (even if you deny it or justify it) and I won’t let you do it any more” is sometimes perfectly appropriate. That act of self-assertion can be therapeutic, even though it is usually not essential.

You can also recover from childhood mistreatment without confronting the offender. Witness those individuals who do so when their abusive parents are already dead and therefore unavailable for real-life discussion. What is essential, however, is to make certain that any continuing mistreatment stops. This usually means that you, the by-now adult child, have to stop it: walk away, say “no,” or hang up the phone — whatever is required.

If, instead, you aim to change the offender, be prepared to be disappointed. Most won’t change or even admit that they did anything wrong. But if you wish to overcome your fear and master the situation, that mastery, at least, is possible. Nor should you usually hesitate for fear of “killing” your parent, as in the example I’ve given, especially if health issues aren’t present. That is the only story of its kind I’ve ever been told.

Better, though — so much better — to live among friends and relatives who live as Giulini’s family lived, with love at the center of their being. That way, even if there is no time for a formal goodbye, nothing will have been left unsaid: respect and affection will be well-known long before the end because of the way each treated the other. I’m told that the old Italian expression for this is “volersi bene” or “voler bene:” an untranslatable sentiment indicating that you cannot be happy without the happiness of the other. Yes, much better this way.

Perhaps it is no mistake that in English and German the words for life and love are so close. Change the word “live” by one letter and you have “love.” In German, change the word “leben” (to live) by adding one letter and you have “lieben” (to love). Not just last words or Ernesto Giulini’s last words, but words to live (and love) by.

—

Lady Astor (1909) by John Singer Sargent, is sourced from Wikipedia Commons. The photo of Carlo Maria Giulini comes from the front cover of the superb biography by Thomas Saler, published by University of Illinois Press. The present essay is a revised version of an earlier blog post from 2009: “Last Words: Be Careful What You Say.”

July 23, 2011

Too Many Balls in the Air: The Frustrated and Frustrating Life of ADHD

He was dynamic, outgoing, and enormously entertaining.

He was creative, full of ideas, and energetic.

And he was one of the most frustrating people you would ever care to be around.

About whom do I speak? A bright, charming man with Attention Deficit Hyperactivity Disorder.

ADHD is more complicated than you might think. Although there is much written about it, I want to cover a few of the things that can be missed about the condition. But first, let me explain the name and define it.

There are three types of ADHD (Attention Deficit Hyperactivity Disorder):

1. ADHD, Predominantly Inattentive Type. This used to be called ADD, but technically speaking, sufficient inattentiveness is considered a category of ADHD, even though little hyperactivity may be present. These are the folks who seem to be listening, but are lost in space; easily taken away by a tune, a sound, or an idea; the people who miss the details and forget the assignments.

2. ADHD, Predominantly Hyperactive-impulsive Type. This is what most people think of when they hear or read the four letter acronym ADHD. People with this diagnosis are characteristically talkative, active, intrusive; a bundle of unmanaged, impulsive activity.

3. ADHD, Combined Type (meaning it includes the symptoms typical of the first two categories); too many balls in the air, for sure.

What about the man I mentioned at the top; a person who had the “combined type” of ADHD?

He had lots of energy and ideas, so people found him engaging. But it wasn’t a very productive sort of energy. He would begin things, but not complete them. He was disorganized — losing keys and papers, and forgetting appointments. He promised to do things, but couldn’t be relied upon to do them as quickly or as well as expected, if at all.

This man (let’s call him A.T.) went nowhere fast; very fast. A.T. looked liked the “Energizer Bunny,” but mostly traveled in circles.

He tended to over commit himself, taking on more tasks than he could handle effectively, chronically underestimating what he could accomplish in the time available. A.T. was routinely late for appointments, and made decisions quickly, without fully considering the longer term consequences of his actions. Bored easily, distracted more easily, and prone to procrastination, he knew that he wasn’t what others hoped for and expected. Although he was full of promise, his reputation was that of someone who was a thoughtless, irresponsible underachiever — an individual who needed minding.

Employers were disappointed, co-workers were frustrated by A.T., and his spouse was driven just a little crazy, feeling that she couldn’t depend on her partner. She’d married someone who was exciting, only to find that the excitement he produced was more of the “Oh, no!” kind that made her sweat when she discovered he was late to pay a bill or pick up the kids. Not surprisingly, she started to see him as just another one of the kids, as their partnership turned into more of a “disapproving mother/resentful child” relationship than either of them wanted.

Before I tell you about A.T.’s treatment, let me say a few things that might not automatically come to mind about the condition and its consequences:

1. Hyperactive/impulsive ADHD individuals can sometimes look like they are world beaters, but mostly beat themselves; indeed, they are often chronic underachievers. If you are planning on forming a working group or partnership with such a person, don’t be fooled by a positive first impression of excitement and energy. You will almost certainly be disappointed down the road.

2. ADHD, even today, is sometimes not detected in schools. There are several reasons:

The inattentive form of this condition may well produce school failure, but not misbehavior. Inattentive children are often quiet and relatively well-behaved, unlike their hyperactive-impulsive counterparts.
School personnel may incorrectly attribute ADHD-like behavior to laziness or oppositionality. Moreover, school systems, even when they do formal evaluations, are frequently reluctant to identify problems that require additional resources and personnel, which they are hard-pressed to provide given their limited funds.
An ADHD child who is bright can compensate (to some extent) for his attentional problems by relying on his excellent intellectual abilities, at least for a while. Eventually, however, many of these children (as they age and school begins to demand more of them) find out that advanced intelligence is no longer sufficient to permit success.
There is no single standard measure that reliably identifies ADHD. Evaluators commonly use some combination of paper and pencil tests, clinical judgment, and attentional measurements. Intelligence (IQ) and neuropsychological tests can easily miss some of the most clinically obvious cases of this condition.

3. The fact that ADHD children are able to become “hyperfocused” on things like computer games or other tasks that they find especially interesting, does not invalidate the diagnosis of ADHD. Indeed, this sort of selective attention is seen fairly often.

Some researchers believe that those games provide rewarding stimulation in the form of frequently changing images, sounds, and challenges; as well as the success of achieving points or increasing levels of success, thus “capturing” the attention and imagination of the ADHD youngster. By comparison, the real world school room seems boring. Recommendation? Limit your child’s screen time, even in front of regular TV shows.

4. Although many people are hesitant to take medication, ADHD is a diagnostic category that is especially responsive to psychotropic medication. Hundreds of studies support the effectiveness of such treatment for about 85% of children with this condition according to Russell Barkley’s authoritative 2006 book Attention-Deficit Hyperactivity Disorder. In a 2007 paper by Elliot and Kelly — “ADHD medications: an overview” published in the journal Attention — the authors state that “No medicine available to psychiatrists produces a more rapid and dramatic effect more safely than the proper dose of a stimulant to a patient with ADHD.”

5. If medication does work, it will likely be needed on a continuing basis, not as a temporary fix. The irony is that stimulant medication, which will cause internal agitation in those who are not suffering from ADHD, actually permits the person with the condition to focus more and become less prone to the hyperactivity/impulsivity that had been a problem.

6. ADHD is correlated with a greater risk of developing a Conduct Disorder, typically characterized by antisocial misbehavior and defiance of authority. Not surprisingly, such individuals often abuse alcohol or drugs (not only as an act of rebellion, but also as a self-medication designed to calm their hyperactive state). Adolescents and adults who have ADHD are thought to make up at least 25% of the population of prisons according to Barkley.

In all these examples, the impulsive, ill-considered behavior that is typical of ADHD takes a fearful toll. Such individuals are easily bored, requiring intense and novel reinforcement (rewards) to motivate them, and are prone to “sensation-seeking” — looking for extreme excitement that their condition seems to make them crave. Indeed, one patient of mine reported driving at speeds approaching 100 MPH on city streets simply for the feeling it produced in him. Nor did he think he was at much risk (or putting others at much risk) in doing so, thus demonstrating the poor judgment characteristic of those with the hyperactive-impulsive form of ADHD, as well as their tendency to disregard rules and authority figures.

7. While many general medical practitioners (GPs) can prescribe medication for ADHD quite well, some are hesitant to do so, sometimes due to lack of training or inexperience with this particular diagnosis. Cautious GPs will prescribe psychotropic medication, but are prone to giving doses that are too small. It is generally best to see a psychiatrist in such cases; that is, someone who specializes in the prescription of medication for psychiatric disorders.

8. The frustration that ADHD produces in school children can make them give up (and eventually drop out), believing that nothing they can do will make any difference in their performance. Some of them will become avoidant of academic or other work tasks because they believe that they will fail, thus producing a self-fulfilling prophecy. Many will get angry at the teachers, bosses, and parents who so often are reminding them of their inadequacies. Thus, ADHD fuels other behaviors that make a good life difficult.

What happened to our friend A.T?

You’d think it was simply a matter of telling him of the benefits of medication, wouldn’t you?

Not so fast.

He was one of those folks who was uncomfortable with the “idea” of having to be reliant on medicine. He told me that he didn’t “believe” in medication, as if it was a matter of religious faith.

A.T. was also quite narcissistic; in denial concerning his own responsibility for the things that went wrong in his life. Similarly, he had no trouble blaming others including bosses and wives. Not to mention that he drank too much and didn’t acknowledge that it was a problem. Indeed, he had only come into treatment at his spouse’s insistence.

One of the challenges of psychotherapy is the fact that few people fit “pure” diagnostic types. Instead, one must be aware of all the complicating factors that can make effective therapy difficult. This man’s narcissism, denial, and alcohol abuse certainly created just such complications.

Had A.T. been more motivated and self-aware, less prone to denying the misery he was creating around him, a cognitive-behavioral (CBT) approach to his ADHD could well have helped, even if he chose not to take medication.

CBT programs include formal guidance in planning and organizational skills, assistance in problem solving and decision-making, help in reducing the number of distractions in the environment, practice in new thinking skills, training in ways to reduce procrastination, and advice to help you cope with failure. Homework is required between sessions.

The program described by Steven Safren and his associates in the work book Mastering Your Adult ADHD, developed by psychologists at Massachusetts General Hospital and Harvard University, was able to produce significant improvement in about 50% of those patients who continued to have clear problems even after being treated with medication.

So, if you have ADHD, medication and CBT provide reasons for optimism that things can get better.

Just don’t drop the ball!

—

The top image is the Carbon Cycle created by the U.S. Government Department of the Interior. The one that follows is the Tux Crystal Linus Award by Nevit Dilmen. The next photo was created by Thomas Pusch and is called Scolded By Mama. The fourth picture is of Two Men Playing a Computer Game by Love Krittaya. Finally, a picture of a Geode by Whitsoft Development. All are sourced from Wikimedia Commons.

June 21, 2011

“I’m Still So in Love:” Why We Must Give Up the Ghost

Some patients haunt your memory.

I recall treating a teenager who had lost her father suddenly. It had actually been many years since he died, but she remained cut-off from the world and her family.

Friends were kept at a distance, her mother was pushed away, and her stepfather was never permitted to come close to her, try us he might.

Never ever.

Her mother and mom’s second husband worried about her self-isolation, so they brought her in to see me.

As the treatment progressed, I discovered that this young woman thought about her father a lot.

Every day.

She would review the memories that she still retained of his kindness and warmth.

Of course, I’d never met him, but I got the sense that she had idealized him — fashioned her memory so as to make him a vision of perfection that no flesh and blood mortal can hope to achieve.

And the recollected reproduction of her father, almost like a ghost, remained the most intimate connection of her life.

Not just historically, but even while I was treating her.

In fact, sometimes she would talk to him; one way, naturally, since she was not psychotic. And that provided her with a kind of closeness that was the best she could do to recreate the comfort that her dad had provided when this young woman was little.

As the protagonist states in Robert Anderson’s play I Never Sang For My Father, sometimes “death ends a life, but not a relationship.”

The people — the real people who reached out to my patient — found her unresponsive. They could not compare — could not compete — with the vanished flawlessness of her dad; an excellence that, after all, probably never existed in the first place, however dedicated and fine a man he might have been.

Moreover, her “relationship” with her father was safe: the dead cannot die on you; or reject you; or move away. They are utterly reliable and totally benign, unlike the rest of us.

As most of us do, my patient had been trying to protect herself from the injuries that life delivers from without, but left unguarded those equally tender places that are open to the wounds that come from within.

—

When a child loses a parent early on, she often loses the surviving parent, as well.

No, not to death, but to grief. Having lost a spouse, the surviving despondent parent (more often than not) is unavailable to aid the children. She is too bereft herself to be able to be the life-giving, supportive, attentive, omnipresent presence that children sometimes need a parent to be.

Worst of all, it is precisely at this time of loss that the child needs the surviving parent most desperately. And, it is at precisely this time that the remaining parent is least available and least capable of giving what he or she might wish to give, if only he or she could.

The result is a double-loss: one dead parent and another who is, for a time at least, a dead man walking, the half-alive state that we all know from the shock and privation and emptiness of a broken heart; a heart that one cannot imagine will ever heal.

It is no one’s fault, certainly not that of the grieving adult. Rather, this is just one of those dreadful ironies of the human condition: in the moment of loss and for some time after, the now-single parent has no capacity to do what must be done.

But the child needs that impossible thing, all the same.

—

Once I came to understand that my patient was still in a relationship with her father, her therapeutic needs became clear.

She needed to grieve the loss of her father to a satisfactory conclusion — a grieving that had been prevented by her fear of bringing up her own loss with her mother as much as her mother’s inability to console her child.

She needed to realize that she had put her life on hold by clinging to a ghost who, of course, could only provide so much warmth.

She needed to open herself to a stepfather who longed to engage her, even if he could not be the plaster saint her father had become; and the peers who were ready to provide their own rewards, even if they could not replace her dad.

—

The therapy worked out well.

My patient did not so much lose her relationship to her deceased father as let him go to a different place in her memory and in her heart.

It helped for her to answer the question, “What would your father want for you if only he could tell you?” Because the only answer he would have given (and she knew this) was that the beloved father of her dreams would want the best for her; and for her to reattach to life and to the people who could give her something that he could not.

After all, he was dead.

And so, she said goodbye to him. At last, she let him die.

So that, finally, she could live.

—

The photo above is of ectoplasmic mist at Union Cemetary, CT on 10/29/2004 by 2112guy, sourced from Wikimedia Commons.

January 10, 2011

The Long Road to Becoming Rich

Most of us are raised to believe the path to happiness is a simple one: get a good education, obtain a high status and well-paying job, find the love of your life, have children, stay healthy, and do good in the world.

But what if you have done all these things and you are still not happy?

My friend “Rock” has given me permission to tell you his story. And his tale sheds some light on what can prevent life satisfaction and how you can find it after all.

—

Rock was a charming, active, and extraordinarily bright and curious little boy, the second of his parents’ two children. Both mom and dad had to work at a time when most middle class American families did well enough on a father’s salary alone, well enough to permit the mother a life at home raising the kids and keeping house. As a consequence, Rock was a “latch-key” child before the expression had been invented, coming back from school to an empty home, passing the lonely time until the after-work arrival of his parents.

The modesty of the family’s material life was no small annoyance to Rock’s mom, who was disappointed in her husband’s limited capacity as a bread-winner. Unfortunately, “Al” Adelstein had no defense against his wife’s repeated verbal assaults. He could do no better with his limited education than work in a hat factory. Purchasing a home was out of the question given the family’s finances, so Mrs. Adelstein faced the further disappointment of living in an apartment when most of her peers owned homes.

The spillover of her episodic avalanche of unhappiness and anger sometimes fell on little Rock.

Not only did he witness his mother’s tirades at his dad, but he discovered she had enough discontent left over to criticize and disapprove of him. Cruel pranks were not out of the question either, as on the day mom and son were waiting for a baby sitter. But, Mrs. A unexpectedly disappeared before the sitter arrived, driving the small boy to a near-panic state, believing he had been abandoned. At last, his mother emerged from her hiding place, laughing at the “joke” she played on her terrified child.

Nonetheless, our boy did surpassingly well at school.

After skipping a full year in grade school, he was to be the only National Merit Scholar in the group of nearly 600 unusually bright, motivated, and accomplished students who comprised the Mather High School class of 1964. He placed second in both the City of Chicago and Illinois State Science Fairs, and went on to acquire degrees from three different Ivy League universities, the last of which produced a combined Ph.D/J.D., that is, simultaneous doctorates in Economics and Law.

In high school, he would sometimes say to me he hoped to achieve something great in his life.

But life is funny about such things, and our friend didn’t become famous.

Instead he went on to be a full professor and (for a time) Chairman in his Department of Economics at Wesleyan University, wrote scholarly papers (about 30 or so of these), gave talks nationally and internationally, and taught with passion and intensity, winning the first ever teaching award given by a school founded in 1831.

And just to give you a sense of the scale of his achievement, he spent a year at the Institute for Advanced Study at Princeton, a place associated with names like Einstein and Oppenheimer.

But still, on some days he thought back to his high school wish to do something great and wondered if the really great thing would ever happen. Because, you see, nothing in the accomplishments I’ve mentioned — accomplishments that seemed so impressive to everyone else — was very satisfying to Rock. And the feeling of discontent he carried with him from childhood into the life of a university professor never left him. This, despite the good education, the high status and well-paying job, the love of his wife Sandy, two adoring children, and the excellent health of all concerned.

He was, perhaps, a bit like Virginia Woolf’s Mr. Ramsay in To the Lighthouse; like him, an academic; like him, unhappy. A man who had:

…a splendid mind. For if thought is like the keyboard of a piano, divided into so many notes, or like the alphabet is arranged in 26 letters all in order, then his splendid mind had no sort of difficulty in running over those letters one by one, firmly and accurately, until it had reached, say, the letter Q. He reached Q. Very few people in the whole of England ever reach Q… But after Q? What comes next? After Q there are a number of letters the last of which is scarcely visible to mortal eyes, but glimmers red in the distance.

For Rock, like Mr. Ramsay, there was always one more letter just out of reach.

…because, in effect, he had not done the thing he might have done.

It wasn’t something Rock talked about much, even to his closest friends. For him, like most men of our generation and before, the “athlete’s creed” is honored: don’t complain, don’t look back, just rub some dirt on your “injury” and keep playing the game — mind over matter, and the heart (and the hurt) be damned.

—

In the summer of 1998, my buddy and I took a long road trip from his home in Connecticut to the Baseball Hall of Fame in Cooperstown, New York. It was the fulfillment of a childhood wish of two middle-aged baseball fans who were also two life-long friends.

And, it was a time to be together and talk.

Really talk.

When I’m alone with someone for a while, I often ask, “If you could have dinner with anyone in the history of the world, living or dead, who would it be?” You get some interesting answers. Jesus is mentioned a lot. Great writers and musicians are named along with other famous people of various kinds. But, Rock’s answer was a little bit different.

“Well, if I could really have dinner with anyone, I’d like to have dinner with my mother — I’d like to think she would believe I’d turned out pretty well in life.”

You see, Rock’s mother died just after he graduated from college, so she never knew about some of the items on his long list of achievements, although his Science Fair and National Merit Scholarship awards, not to mention his admission to M.I.T., all happened well before her death.

Our conversation didn’t stop with that question and, as our time passed on the road, I got to know more about Rock’s home life — the turmoil I related earlier.

One story in particular stands out.

In order to get to the University of Illinois campus at Champaign/Urbana, where the State of Illinois Science Fair was held, Rock had to carry his science project and take public transportation. While it was a bit of a chore, the return trip was sweet. Imagine, at age 16, you have placed second among all the potentially eligible students in the State!

And so it was that he walked in the door of his parents’ apartment, feeling pretty full of himself, beaming at the thought of his triumph; feeling what you feel when you are young and the sun is out and the day is glorious and your adrenaline is flowing and you are on top of the world.

His mother greeted him.

“How did you do?” she asked.

“I finished second in the State of Illinois!” he enthusiastically answered.

“Why not first?”

Before Rock and I reached the Hall of Fame, it was clear to both of us, I think, that the “great thing” he hoped to achieve would never be great enough to make him feel whole. And the roots of his unhappiness were to be found in the circumstances of his early life with his parents. Not even a Nobel Prize or a plaque in the very Hall of Fame we were to visit could have cured the sense of being insufficient to win the approval of his folks.

As the therapist he saw soon after would say to him, “The heart has no clock on it.” Meaning the injuries of childhood wait for us to attend to them. The wound is sometimes as fresh as the day it happened, even if 30 years have passed. And so, at last, the “athlete’s creed” was set aside through the hard work of therapy, and he was able to feel good about an adult life that, all along, had been good objectively.

—

My friend is one of the Zeolites, a small group of high school buddies — all members of the same park district softball team of years past — who created a college scholarship for the disadvantaged kids at our old school. And Rock has donated more money to it than just about anybody, as well as traveling from Connecticut to Chicago nearly every year to be with us and to be present at the scholarship ceremony, as many of the out-of-state Zeolites are.

He is a smart, funny, and decent man, a man of enormous emotional generosity, warmth, and good will.

Best of all, Rock’s story has a happy ending. Because, in fact, in the aftermath of therapy, his wife Sandy helped him realize the “great thing” was something he’d actually achieved long before.

Not the kind of greatness he expected to lead to fortune and fame, but the kind that sends generations of young people into the world who are somehow different and better because of his influence, and who even today frequently return to Middletown, Connecticut to let him know he was the teacher, the one teacher, who made a difference in their lives.

In 2007 we honored him at the annual dinner of the Mather Class of 1964/65 for the difference he made in the lives of the Zeolites and our class’s effort to make a difference in the lives of a few of Mather’s recent graduates. In addition, he received an engraved paperweight as a token of our affection and esteem.

Although he has given the scholarship an awful lot of money, he is not wealthy in any conventional sense.

Rather, he is rich in the hearts of all those students whose lives he has touched.

He is rich in the love he has for his family and friends.

And he is rich in the love and respect his family and friends have for him.

It should be no wonder then, the inscription on the paperweight with which he was presented reads:

Rich Adelstein

…the noblest Zeolite of them all…

From the Mather Class of 1964 and 1965

And the Zeolites

May 4, 2007

—

The photo above is of Rich and Sandy Adelstein.

December 27, 2010

A Christmas Story: Telling the Truth and Breaking the Heart

Was she seven years old? I don’t remember my eldest daughter’s exact age when she asked the question:

“Dad, is Santa Claus real? Nicole (a friend in school) said he isn’t.”

I had learned long before this, the value and importance of being honest.

I looked at Jorie, but perhaps could not see just how invested she was in her belief in Santa.

What I could see, however, was that she trusted me. And, in the few moments before I answered, I quickly determined that I could not break that trust.

“No Sweetie, he isn’t.”

I can still see her little face melt into a waterfall of tears. I comforted her as best I could; so did her mom.

It was not the last time that I caused pain to someone I love, but I think it was the first time I’d done this to any child of mine.

Welcome to the real world, honey; the place where things aren’t always as they seem or as we would like them to be. A place where hard reality trumps fantasy; a place where someone who “loves you to pieces” tells you something that breaks your heart into pieces.

That was a long time ago. I’ve wondered what else I might have done instead; something to save this little person from the pain of a message amenable to postponement.

Should I have said, “What do you think, Sweetie?” Was there a possible Socratic dialogue — an artfully crafted sequence of questions leading her to the same truth and not hurt so much?

Could I have tried to change the subject, to avoid the answer and let her continue to believe anything she wanted?

Or, should I have simply lied? “Of course there is a Santa, Sweetie.” And then left her open to the potential ridicule of friends, as well as some doubts about whether her dad was trustworthy.

Janet Landman, in her book Regret: the Persistence of the Possible, likens regret to the dilemma of coming to a fork in the road and making a choice. You walk down the chosen road for a while, before you realize it isn’t quite as good as you had hoped. Eventually you conclude, “I probably should have taken the other path.”

It really doesn’t matter which road you choose. Nothing in life is perfect. But in your imagination the alternative remains idealized. Only in your mind, in the world of abstraction and fantasy, does perfection reside — the perfect job, the perfect mate, the perfect result, the perfect performance of whatever kind.

And, for me, the perfect answer to a simple question.

Sometimes in life there is no ideal solution, no right path, only a bunch of imperfect possibilities. And, of course, we never know what it would have been like to choose the other road at that precise moment. Because, as Heraclitus said, “You cannot step into the same river twice.” Meaning that with the passage of time, the river has changed, and so have you.

No, you cannot un-ring the bell. No do-overs when it comes to the knowledge of whether Santa is real.

We must live with the inevitable heart breaks, whenever they come. In the one life we have, we can never be quite certain what would have happened had we lived it differently.

Ultimately, one can only accept the terms life allows. The contract we (metaphorically) sign by having the audacity to take our first breath at the moment of our birth allows for no escape clause from hard knocks. Not, at least, while life goes on.

I still wish I could have protected Jorie from the terrible knowledge I delivered so innocently that day, not just the knowledge about Santa, but about life. Indeed, as I think about it, it isn’t the knowledge from which I wish I could have sheltered her, it is from the pain of life itself.

But, such things are not in our power. Life will have its way with us. If we are lucky, we will also have the compensations of beauty, joy, friendship, laughter, learning, and love.

Jorie and I lost a little innocence that day.

The good news?

Our love abides.

October 18, 2010

Parenting: When Love is Not Enough

Well meaning parents don’t always do well.

Or, to put it more bluntly, you can mess up your children without really trying.

Take the following example: two caring, well-educated, good people. They were in love with each other and loving toward their children.

One child was handsome, outgoing, and had a sunny disposition. Other children and adults were drawn to him. He awoke every morning with a smile on his face and brought cheer to those around him. Although not a great student, this boy was certainly bright enough; he made his way more than adequately in the world of friendship, study, and eventually, work.

His brother, however, did not have it so easy. To start, his body was ungainly. Even as a kid, he lumbered and lurched in locomotion. His cumbersome, block-like (not overweight) form caused him to stand out. Because of a lack of refined adroitness in matters of balance and dexterity, he was always the last boy picked in the choosing of teams on the playground and in the gym class.

To the good, he was astonishingly bright and intellectually curious, but this only fueled the separateness he felt, to which his graceless body also contributed. Outgoing though he was, peers tended to shun and ridicule him. Social skills did not come instinctively and this young boy’s efforts at outreach neglected the usual questions that facilitate social contact: queries like “How are you?” or “What did you do over the weekend?”

Monologues rather than conversations were the result, further emphasizing this kid’s peculiarity and securing his status as an outsider.

His parents were at a loss. Certainly, they treated their dear son with kindness and affection, and applauded his prodigious intellect and curiosity about the world. But, when they saw his unhappiness and discovered that peers marginalized and ridiculed him, each of the parents tried to put a good face on things. While they defended him when they actually witnessed the cruelty he received, the boy’s hurt was not discussed very much at home. The parents minimized or ignored his pain, believing it best to encourage him to believe that things would soon get better and telling him not to let the ill-treatment of the other children bother him.

Soon enough, this child tended to his wounds by himself, confiding little in his parents, as if he instinctively realized that they would not or could not offer him any response that would feel good. Those times late at night, often just before bed, when a child is most vulnerable and open to spill his pain, passed without the flow of consolation. Thus, like many children (especially boys) who find themselves feeling empty and alone, deadening his emotions was preferable to exposing his heart to further injury.

To be fair, mom and dad figured that their boy would come to them if he needed or wanted to talk, and read his attempts to kill his emotions as a lack of need for the solace that can be achieved by having a shoulder to cry on. Indeed, they thought that he would be angered by any attempt to invade his privacy and bring up uncomfortable topics.

Nor did the elders provide guidance in how to be more reciprocal with people or give him direction in how to create conversations rather than monologues. They never pointed out that it was important to show interest in what others were doing or saying, despite the fact that both of them routinely displayed this with their children and in their own social lives. Instead, the parents reasoned that their son was already feeling hurt and rejected; and they feared that they might injure him further by telling him that his conversational style could be improved.

—

By the time of his adulthood, our subject had become what one might expect based on his early life. Surpassingly bright, he went to an elite college and had a coterie of those who admired his intellect and creativity, but no real friends. The pain of rejection had long since been pushed down deep inside, to the point that he might not have recognized the need or value of “closeness.” He was as out of touch with the emotional side of his own life as he was with the feelings of his conversational partners. Our young man seemed to have little need to find out about what was going on “inside.” Nor did he understand that his failure to ask questions to peers could be seen as arrogance, indifference, or peculiarity.

Still, our youthful gentleman led an interesting life because he sought out intellectual stimulation and threw himself into numerous activities within the world of the sciences and the arts. But, it remained a solitary existence, even if it was no longer clear to what extent he felt marginalized, so cut-off did he seem from the matters that connect head and heart.

His parents still tried to put a good face on their son’s way of living, as much as they knew about it, since they continued to be hesitant to ask him sensitive questions. But deep down they wondered whether he could possibly have any close friends (not to mention lovers) given his way of talking to people. Even now they felt that it was too late to bring up things that might cause him pain or trigger his anger at them for prying into his life.

Instead, the parents would occasionally comment to friends about their unusual son, make good-natured jokes about him, and simultaneously take enormous pride in his considerable intellectual and vocational success in the very stimulating, if strangely disconnected life he had fashioned for himself.

In defense of the elders, it should first be said that they could have done much worse. Their son didn’t do drugs, steal cars, embezzle money, or trip old people crossing the street. They parented him instinctively, as most of us do with our children. They certainly did not want to hurt him but, in their tiptoeing around his emotional pain, they failed to recognize opportunities to provide needed consolation and guidance concerning the social skill he lacked.

One can imagine that things could have been different. Had the parents been comforting and validating of his early humiliations rather than choosing to minimize them, perhaps he would have felt less isolated and not cordoned off his feelings even from himself. Had mom and dad gently guided him in how to converse, he might have had more social success and seemed less odd because of his penchant to prattle on about himself. If the parents encouraged their child to salve his own and others’ unhappiness by first providing that soothing themselves, maybe intimate relationships would have flourished.

It is impossible to know for sure. Child-rearing isn’t like a laboratory experiment, with an experimental and a control group. The “what if” questions are never answered with certainty. Sometimes nature has its way, no matter a guardian’s best and most understanding efforts at nurture.

—

Raising children isn’t easy. If you are lucky, you have a child like these parents’ first born, who responded well to the instinctive default parenting style of mom and dad.

But, for those of you who have more than one child, it quickly should become clear that they do not come out of the womb as identical sprouts, each needing just the same amount of sun, temperature, water, and nutrition. No horticulturist would treat a tropical plant in the same way that we would care for one that can only flourish in a more temperate climate.

And yet, even today, parents too often believe that “one size parenting” fits all children, and that it is the child’s job to adapt to the parents’ approach to upbringing rather than the other way around.

Put another way, you can be a good parent to one child and a less-than-good parent for another, simply by taking the identical approach to each of them.

The rule is simple: be the parent your child needs you to be.

Search yourself. Ask what your offspring requires. What will work best for this particular little human being?

Then, if you discover that the required approach to child-rearing doesn’t come easily to you, learn and stretch yourself.

You are responsible for a human life.

No job in the world is as important.

—

The above image is Vincent van Gogh’s Mother Roulin With Her Baby.

September 29, 2010

On Sacrifice

Would you like to know who you are? Then it is essential to know what is of real value to you. One way of finding that out is by asking the question, “What would I be willing to give up for something that I claim is important to me? What would I be willing to sacrifice for love, or great wealth, or power, or honor, or for my child’s well-being?”

What we are willing to sacrifice defines us, both as individuals and as a society. But first, let’s look at what the word sacrifice means:

The on-line Merriam-Webster’s dictionary gives the following definition of the noun sacrifice:

1 : an act of offering to a deity something precious; especially : the killing of a victim on an altar
2 : something offered in sacrifice
3 a : destruction or surrender of something for the sake of something else b : something given up or lost <the sacrifices made by parents>
4 : loss <goods sold at a sacrifice>

Thus sacrifice involves loss and giving something up.

In primitive societies, it often included murder.

Human sacrifice was intended most often to appease a God, win the God’s favor, or avoid the God’s wrath. Igor Stravinsky wrote a famous ballet about this, The Rite of Spring.

More recent depictions of this sort of behavior have included Friedrich Dürrenmatt’s 1956 novel, The Visit. In this story a wealthy woman (Claire Zachanassian) returns for a visit to her home town, a place that has fallen on hard times. She departed in disgrace many years before when she was impregnated by her young lover. This person denied the charge of paternity and bribed two people to support his case by claiming that they had been intimate with her. Shamed by the townsfolk, Claire eventually turned to prostitution.

Her return home is noteworthy for a “proposition” she has for the town where her former lover continues to live as a respected businessman. She will bequeath an enormous sum to the hamlet if it will do one simple thing: put to death the man who caused her disgrace. In effect, the book asks the question of what this woman is willing to sacrifice for revenge (her money, her morality) and what the town’s people are willing to give up for money. The movie of the same name starred Ingrid Bergman and Anthony Quinn.

More recently, a very different sort of sacrifice is depicted in a 1967 episode of the original Star Trek TV series, The City on the Edge of Forever. While in an irrational state, the ship’s physician enters a time portal on an alien planet, one that takes him back to 20th century USA in the midst of the Great Depression.

At the instant that this happens, the Enterprise starship disappears from its orbit of the world on which the time portal exists. Captain Kirk and Mr. Spock, already on the planet in pursuit of Dr. McCoy, recognize that he must have altered history in such a way as to result in a universe in which their space vehicle never existed. Kirk and Spock therefore enter the time portal themselves at a moment in history slightly before they believe that McCoy reached 20th century earth, in order to prevent whatever action he took that changed subsequent events.

While back in time, Kirk and Spock meet a social worker named Edith Keeler, who runs a soup kitchen for the down-and-out victims of the Depression. Soon, Mr. Spock uses his technological prowess to discover that Dr. McCoy will eventually have something to do with Edith Keeler herself.

In one possible historical thread, Spock finds a newspaper obituary for her. In another, however, he discovers that she will lead a pacifist movement that delays the USA’s entry into World War II, resulting in Hitler’s victory and the very alteration of events that prevented creation of the star fleet of which the Enterprise starship is a part. Thus, in order to create the more benign future known to the three officers, Edith Keeler must die.

There is only one complication. Captain Kirk and Edith Keeler (played by Joan Collins) have fallen in love.

The climatic moment comes when Dr. McCoy and Captain Kirk see each other across the street for the first time on 20th century earth. As they rush to reunite, Edith Keeler (on a date with Kirk), attempts to cross the street to join them, heedless of the fact that a fast-moving truck is headed toward her. The doctor attempts to rescue Kirk’s love, but is restrained by Kirk from doing so. Edith Keeler is killed.

The heartbreak is heightened by the incredulous McCoy’s indictment of his captain and friend: “I could have saved her…do you know what you just did?.” Unable to speak, Kirk turns away while Mr. Spock says quietly, “He knows, Doctor. He knows.” Thus, Kirk has sacrificed Edith Keeler’s life and his own happiness, to prevent her from actions that would have led to world enslavement by the Third Reich.

—

I have always been troubled that two of the most important biblical stories involve human sacrifice. The tale of Abraham and Isaac finds the former, the founder of the Jewish faith and monotheism, asked to sacrifice his son Isaac in order to prove his devotion to God. As he prepares to do this, an angel appears and stays his hand. A lamb is slaughtered instead. Rembrandt depicted this beautifully in the painting reproduced above.

Remember now, that I’m a psychologist. I cannot look at this painting without wondering what the child Isaac might be thinking and feeling in the aftermath of this moment. How will his relationship with his father be changed? Might there have been other possible ways of testing Abraham without permanently scarring his son?

The foundation story of Christianity poses a virtually identical dilemma, with the sacrifice of Jesus to pay for the sins of humanity. I fear that we are so used to abstracted representations of these events, that we have become inoculated against the trauma depicted by them and the human, societal, and theological implications of such horrors, reportedly authorized by God.

Of course, most of our sacrifices are much less dramatic. Do we give up eating what we might want in order to be fit and live a longer and healthier life? Do we brush off the attractive member of the opposite sex who “comes on” to us, in order to maintain our marital fidelity, avoid injuring our spouse and children, and keep whole our integrity? Do we sacrifice time having fun or attempting to climb the career ladder in order to go to our child’s boring orchestral recital and enduring hours of “Twinkle, Twinkle, Little Star” played by tiny violinists, all of whom are out of tune?

I’m sure you can imagine many more such choices and sacrifices of your own.

We make decisions, all of us, about the question of national sacrifices too. Jobs vs. clean air, tax cuts vs. social services, giving to charity vs. keeping the money for ourselves, liberty vs. the promise of security, and most poignant of all, the decision of when war is necessary despite the sacrifice of the unlived lives of our young adult children.

Just as an exercise, you might want to make a list of all those things you spend time on that are inessential, all the things that you could live without if it came to something really important.

Or, still another exercise: if you could only take 10 things or 10 people with you to a desert island, who or what would they be and who or what would you leave behind? And what cause would be great enough for you to agree to go to a desert island in the first place?

Who are we as a nation? Who are you as a person?

We might know more about our country and ourselves if we first ask what we are willing (and unwilling) to sacrifice.

—

The top image is the Sacrifice of Isaac by Rembrandt. The second picture, taken by Michael Gäbler, is of Adi Holzer’s hand colored etching Abrahams Opfer from 1997. Finally, Caravaggio’s version of the same scene Die Opferung Isaaks from 1594-96, sourced via the Yorck Project. All of the above come from Wikimedia Commons.

August 10, 2010

Guilt about Betraying Parents: “They Did the Best They Could”

Young children are not the only ones who believe that their own mom and dad are the best in the world.

You know the sort of thing I mean: “My dad is stronger than your dad” and the like.

Adults do this too. Or, at least, try very hard not to think the worst of them.

Any therapist with experience has heard many heartbreaking stories about children who have been abused, deceived, lied to, cruelly and unfairly criticized, used, mistreated, and neglected. He has heard from the adult children what their parents did do and didn’t do — about folks who perpetrated the abuse directly and others who looked away or simply told the son or daughter to “try not to upset dad” rather than protecting him or her from dad.

The now-adult children will make up lots of excuses about such things: “They did the best they could” or “They didn’t know any better” or “Lots of parents were that way when I was growing up” or “How can you expect anything better when my folks had even worse childhoods themselves” or “They were having so many of their own problems at the time” or “Other people had it worse than I did” or “They’re old people now and I wouldn’t want to hurt them (by bringing this up)” or “It happened a long time ago; what is the point of talking about it now.”

Or simply, “It feels wrong to talk negatively about them.”

Most of the patients about whom I am speaking come to therapy with some sense of personal inadequacy, low self-esteem, and unhappiness, if not depression. Some have these feelings despite a considerable set of personal achievements. They may be captains of industry, millionaires, doctors, lawyers, college professors, and professional athletes. Many of them have a good and loving spouse and adoring children. But, no matter what has been accomplished or how good their current life is in an objective sense, it doesn’t seem to be enough.

Others try to fill themselves up with acquisitions: a new car, a new house, a new spouse, a new watch or appliance or piece of clothing; and, for a brief period — an hour, a day, a month — this might even boost their mood. But then, things return to the steady-state of emptiness as the shopping-therapy fails.

For these people, the ones who seem to “have everything” but remain unhappy, the Marilyn Monroes of the world, the solution usually requires that long-standing internalized negative self-attributions (critical thoughts or beliefs about oneself) be reviewed and challenged. Sometimes cognitive behavior therapy is able to achieve this.

But there are other instances when the negative verdict of a difficult childhood is so indelibly stamped on the soul of the patient, that he must look back at the original painful source of his injury, grieve his losses, and reevaluate who his guardians were and what they did, or didn’t do.

In cases such as this, the set of excuses I mentioned earlier becomes a problem. Words like “They did the best they could” stand between the patient and his ability to look frankly at his early life without feeling that he is betraying his parents in so doing.

Here is what I frequently say to those of my patients in this predicament:

First, you will do no harm to them in talking to a therapist. There is no rule that says they must be told what you are relaying to a counselor. Indeed, if your parents are dead (as is sometimes the case), then they cannot be told and are safe from any injury that you believe you might do to them.

You need not concentrate only on what they did that might have hurt you. It is equally important to look at what they did that might have helped, and at the complications in their own lives that made good parenting a challenge.

But, even if they showed you some consideration and kindness from time to time, if it really wasn’t so bad, why are you careful to raise your child differently than you were brought up?

Realize that good child rearing is not simply the sum total of all the positives and negatives of your parents’ approach to you, such that the former will always balance out the latter. Imagine that your parent gave you a million dollars and put it in your right hand; and then said, “Now in return, you must allow me to disable your left hand.” Would this be an example of good parenting? Would the provision of a million dollars compensate you for the lost use of your left hand? Not to just anyone, but due to the behavior of your parent?

Yes, it is likely true that some others had it worse than you did. But does that mean you are free of injury? Imagine that you are walking down the street. You pass a man in a wheel chair. He is moving the vehicle by use of his two arms and you think to yourself, “Poor man.” But, a few blocks down, you now encounter another wheel chair-bound individual. Unlike the former person, this man’s arms are incapacitated.

If you are to measure the physical state of these two men against one another, you are likely to evaluate the second man as worse off than the first. But, just because the first person is better off, one must admit that he still is unable to walk.

As I said, there is almost always someone worse. But that doesn’t mean that your injury counts for little or nothing.

Finally, the look back is intended not to keep you focused there, but to liberate you so that you can live more fully in the present; it isn’t to be angry with your parents or to harm them (although anger might be involved in the grieving process). Rather it is to free you from the weight of a childhood that you still carry, the sense of your own falling-short that you can’t otherwise shake, to leave you lighter and less burdened by the long reach of your youth.

Wouldn’t loving parents want this — for their child to be happy and free from any hurt they might have caused? What would you want for your child?

You see, the heart has no clock built into it. Even though you may think very little about the time elapsed, the heart still keeps a living record of the damage, as fresh as the day it was inflicted. You’ve tried ignoring it; you may have tried other types of therapy. Perhaps it is time.

You needn’t feel guilty. You needn’t feel disloyal. Your heart waits patiently for its cure. The therapy is not intended to place blame or to harm your parents, but to heal you.

Looking back may be able to help with that.

—

The image above is Parent with Child Statue, Hrobákova street, Petržalka, Bratislava by Kelovy, sourced from Wikimedia Commons.

July 27, 2010

Watching Your Parents Age

There comes a time in life when you notice that your parents are aging — particularly if you live at some distance from them — see them only once or twice a year. A few more wrinkles, a little less hair with a little less color, an infinitesimally small decline in the speed of the mind or the body.

As spectator sports go, this one isn’t much fun to watch.

Of course, it touches the heart of the child who, like most children, loves her parents. And, if the parent is wise or observant, he or she can see the concern in the child’s eyes as the offspring anticipates worse to come, up to and including the death of the people who once-upon-a-time meant everything to her, and still mean almost as much. Such a parent might remember back to the experience of witnessing something akin to the “time-lapse photography” of her own parents, with all the same attendant concerns now felt by her offspring.

As the famous Latin phrase reminds us, “sic transit gloria mundi.” So pass away the glories of the earth.

What is one to do?

Well, at the most basic level, there is nothing one can do to stop the aging process, one can only slow it. Perhaps your parents can be encouraged to exercise more, eat better, take their vitamins, and get regular medical check-ups. Or, if you are the parent, you can do this without encouragement, realizing that the longer you remain fit, the more satisfying your life can be and the less concern you will visit upon your kids.

But, at a relationship-level, there are some things that can be done. In fact, quite a few.

The first, is to ask yourself what is the status of the relationship. Are you able to be yourself around your folks? Do they really know you? Do you have to bite your tongue for fear of setting-off a conflict? Do you speak with them about things more personal than the weather, the score of the Cubs game, and other small talk? Do you say “I love you” to them and do they let you know that they love you and are proud of you, in words and deeds? Are they too critical? Do they treat your children (their grandchildren) well?

And if there are problems between you and mom or dad, what then?

The first thing to consider is how long you have carried this concern inside yourself. Is it something minor or something that has caused great pain? Are you contributing to the problem by your own comments, actions, or inactions? Would therapy help to process the sense of injury or anger and the feeling of not measuring up to what your parent(s) expected; the failure to obtain your parents’ whole-hearted approval, dedicated time, and expressions of affection?

Most adults want to think the best of their parents, and attempt to put the past behind them, however unfortunate it might have been. Trust me, there are almost always parents who were worse than yours. But this does not mean that yours were good, or that the issues you carry inside of yourself are finished just because you rarely think about them.

I know, you have thought to yourself, “they did the best they could.” But as Winston Churchill said (and could have applied to any of us): “It is not enough that we do our best; sometimes we must do what is required.”

If there are things still unfinished between you and your folks, it is often helpful to make a final effort to put them right (unless you have already done this or your folks are clearly beyond redemption). While aging parents are not regularly open to a reconsideration of what they have done for you or to you, at the very least such an attempt sometimes serves to relieve you of the regret you might feel once they are gone, as you say to yourself “If only I had…”

And, if such an effort fails, this can open the door to needed therapy to grieve the injuries, losses, and unhappiness of that relationship — the things that never got resolved. If, on the other hand, you come to a new understanding or intimacy with your parents, all the better, while you still have time — the time of their lives — to enjoy this reformed and improved connection.

But what should you do if you get along well with your folks, feel loved and have always felt loved by them? How can you deal with their aging?

First, don’t forget about them. If they made time for you, you should make time for them. A good way can be to talk with each of them about their early life, one-on-one. You might discover some interesting information about your family history and even see patterns in your parents’ lives that you are repeating in your own; some good, some not so good.

You may discover that your parent lights up when talking about the past. Their heartbreaks and disappointments in life can also be of no small assistance in forming your own understanding of how your folks came to be the people who they are, and parented you in the way that they did.

And, while they still have life, enjoy them and let them know how much they mean to you. Say the things you would say in giving a eulogy, only do it while they can still hear it. (Good advice in relating to your friends, as well).

Talk with them about what is really important. What have they learned in life that they might want to pass on to you? How do they feel about aging? How do they feel about death and whether there is anything beyond death?

I know this can be touchy stuff. Here is some more: speak to them about writing a will and take a look at it, if they will allow you. Yes, this makes it seem like you are only interested in cashing-in on their worldly goods once they are gone. But, a properly written will that the heirs find acceptable can make the distribution of their estate much easier for all of their kids and avoid court battles and life-long enmity among those relations.

Even more important, ask them how they would like to approach medical emergencies, life support, and extraordinary medical procedures. And, if you can, persuade them to write a “living will” and designate someone to have their “power of attorney” for health care decisions in the event that they should become unable to exercise such judgment on their own.

Here is a story about how this can come in handy, as well as about the difficulty of following your parents’ wishes in just such a situation.

In my mother’s last days, at age 82, she lay unconscious in a hospital bed. She’d lost my dad about seven months before. My two brothers and I knew her to be depressed following his death and in chronic pain from a variety of ailments. She had told me that she prayed every night to her mother and my father that she should die. My folks had assigned the medical power of attorney to my brother Ed, and we all knew by what was written and what was said to each of us, that she did not want anything extraordinary done to keep her alive.

A few days before she died, during one of Eddie’s visits to the hospital, one of her physicians approached my brother and strenuously urged him to authorize an extraordinary procedure. My brother listened as the man attempted to “guilt” him into acting in a way that he knew my mother would have objected to had she been conscious. Eventually the brow-beating ended with Ed still steadfast in upholding my mother’s wishes — but he had been shaken.

Shortly after, I arrived to join stalwart Ed in our vigil at the hospital. Almost before he could say “hello” to me, Ed told me what had happened and, totally unlike him, broke down in my arms. Unless you have “been there” as Ed was, having to say “no” to a medical professional insisting that you should do everything possible, however small the odds, to keep your loved one alive, I don’t think that you can know what such an experience feels like.

This was the woman who had given him life and had comforted him in difficult moments; who protected him, fed him, laughed with him, and cried for him.

But, he did the right thing, the thing my brother Jack and I knew was necessary, and the thing that my mother had unequivocally expressed to be her desire.

Churchill’s words apply here too: “It is not enough that we do our best; sometimes we must do what is required.”

Ed did exactly that, displaying a kind of courage not to be found even in war-time.

So, if you are lucky enough to have an acceptable relationship to parents who are still around, take advantage of the time. And if you are parents who are lucky enough to have healthy and devoted children — same message.

Treat the time as precious — the time and the people.

—

The image at the top is Rembrandt’s Head of an Old Man in a Cap.

The image at the bottom is my brother Ed, hitting a double in a 16″ softball game at Chicago’s Peterson Park, a number of years ago.

May 20, 2010

Telling Your Children Too Much: The Danger of Role Reversals

“My children are the most important thing in my life.” I know you have heard that before. You might well have said it yourself, believe it, feel it, and it might be true.

But are you injuring them anyway?

What I’m talking about here is the tendency to confide in children; to tell them things that they shouldn’t have to hear.

Such as?

Feelings of depression and loneliness, criticism of your spouse, and details of your sex life (whether good or bad).

Questions to them about how you should handle your relatives and friends. Disclosures of insecurity about your abilities or your appearance.

Why not talk about these things?

First, you are the parent, not a friend. Even when we are older, we want to see our parents as people who are capable, strong, reliable, confident, and who will always be there. As children of whatever age, we want to know we can, in a pinch, go to our parents — count on their wisdom, and depend on their honor. We really don’t want parents to be friends, although it is good if they are friendly. We shouldn’t have to “take care” of the parent’s emotional life, serve as a confessor or a therapist; or function as a go-between for one parent in order for one alleged adult to get along better with the other nominal authority figure in the house.

Our children shouldn’t come to feel we are an emotional burden on them, the one who needs parenting rather than the other way around.

If our progeny are to separate from us, become independent, create healthy families of their own, take good care of themselves, and navigate the white water of twenty-first century life, it does not help them to take on the parenting role of their own parents.

I have known children who were required by one parent to retrieve the other from a neighborhood saloon. I have known children who were expected to accompany one parent on her detective work in an attempt to discover whether her spouse was cheating on her. I’ve known kids who were told to ask for the child support (much too common), expected to mix the parent’s favorite alcoholic beverage, smoke pot with mom, lie to the other parent, or cover dad’s money mismanagement; and when older, double-date with a divorced parent and take over the job of being the isolated parent’s social life.

It is usually the mom, not the dad, who cries on the child’s shoulder, gives too much information, and creates the emotional burden for the child. Dads are less likely, even today, to talk about their emotions and their weaknesses and insecurities. A father’s stoicism can be a problem for a child, but not usually in this particular way. Nor are fathers as likely to compete with mothers for a child’s attention, interest, and camaraderie.

Instead, when dads become a burden it is usually a consequence of their misbehavior, addiction, or life failures. Regardless, neither parent should communicate that the child must “choose sides” or take over the psychological role of a spouse, because one parent is estranged from the other and needs support. While such parent-child relationships are not frankly incestual in a physical sense, they can be emotionally incestual and contaminating, fraught with a sense of something not right and a feeling of complicity in the usurpation and betrayal of a much-loved guardian.

Even after childhood is over, we still prefer our parents to be bigger than life, ideal models capable of solving any problem, all deriving from the same instincts that caused us to say “My dad is better than your dad” when we were little. Of course, as adults we know it isn’t true.

A funny story: my dad told his three sons (when all of us were still small) he’d been a famous Chicago Cubs pitcher, but somehow, quite mysteriously, all record of this time in the Major Leagues had been lost! Moreover, he’d been so reliable, hard-working, and constant that he could pitch nearly every day. And so, his teammates came to call him “Rain or Shine Milt Stein.”

Soon enough we realize stories like this are not true. Soon enough we become aware our parents do not embody the perfect mix of human qualities. Eventually, we see that our elders have failures of judgment, imperfections of mood, and suffer from doubts and worries just like everyone else. We realize even our parents cannot protect us from heartbreak, failure, and injury. Soon enough we see them aging and grasp they will not be around forever, and might even come to a point when they cannot fully care for themselves. Life reduces everything to size sooner or later.

If you are a parent, don’t accelerate this process; know that your children need protection not just from the outside world, but from you — from your intimacies and personal problems and sleepless nights just as much as they need their own privacy and the permission to fail, to learn, and to grow on their own — to come into their own and own their lives, not to be hostage to your judgment, your worries about them, or worries about you due to an invitation or requirement to know you too well.

A parent is a guardian and a custodian, not an owner; a loving authority, not a buddy. A child is not on the planet for the purpose of fulfilling your life, but rather, to fulfill his own.

Your life is your job, not that of your offspring.

One of the greatest favors a parent can do for a child is to take good care of himself or herself both physically and emotionally, not expecting anyone else to achieve that result for him (or worry about the fact it is not being adequately accomplished). And yes, this means even such things as eating well, following medical advice, and making oneself as physically fit as possible.

How important are your children to you? Not in words, but in deeds — in the way you relate to them and the care you take of yourself?

If you haven’t put your words into action, might it be time to start?

—

(The reproduction at the top of this page is Rembrandt’s Young Woman Sleeping)

Dr. Gerald Stein

Blogging About Psychotherapy from Chicago

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