Tuesday, March 3, 2015

At What Cost?

Why do the people think so little of death?
Because the rulers demand too much of life.
Therefore the people take death lightly.
Tao Te Ching

The reported numbers of American service men and women who are taking their own lives is both staggering and heart-wrenching.  As someone who has worked in the mental health field for three decades, I have seen firsthand how the suicidal impulse takes root and grows stronger as the suffering individual sinks further into depression.

As the nation takes on the challenge of understanding why so many military personnel are choosing to end their lives, those of us on the front lines of mental health treatment are trying to find ways to both respond to those in need and prevent future episodes. 

While there is obviously no one factor that determines whether or not any individual would choose death over life, it seems clear that one of the primary elements is that the perceived cost of continuing on is too high.  It is often said that the ultimate fear is that of death. I have found that this fear is often trumped by the fear of a life lived in unending pain; whether that pain is physical, emotional, or mental.  

I have to confess that as someone who has never worn a military uniform, I cannot imagine the sacrifice that one makes when deciding to serve one’s country.  I can, however, imagine that the reward for that service often comes in the form of feelings of pride, honor and duty.  I can’t help but wonder if wars that lack of an easily identifiable enemy, have no clear-cut delineation of winning versus losing, and are based on the inherent clash of ideals, diminishes these rewards. Instead of feeling victorious, we now have men and women left with PTSD, redeployments, separation from loved ones, and fighting in alien territories devoid of the grounding mechanisms of normalcy. 

It’s known that often before taking their lives people will try other methods to cope with the burdens of daily life. Alcohol, drugs, sex and other compulsions are methods of self-medicating the growing darkness within.  Others will turn to self-improvement techniques and even seek professional assistance.  In the absence of any meaningful relief, the desperate seeker begins to see suicide as a reasonable alternative that, ironically, returns a sense of control.  

As a psychotherapist sitting with people who have either attempted to end their lives or are giving serious consideration to the possibility, I know that it is next to impossible to instill in another person the will to live.  When confronted with absolute hopelessness and intense pain, the casual list of reasons to live often falls inadequately short.  The isolation that accompanies deep states of depression is so powerful that those experiencing it can have a sense of detachment even when surrounded by caring individuals eager to help. Paradoxically, the very concerns of trusted others can further deepen the growing darkness as there is a feeling of letting down these helpers by not getting better.

 It seems far too simplistic a solution to heed the advice of the ancient text of the Tao Te Ching and stop asking so much from our service men and women.  “War is hell,” we are told and those that enter into its circles are surely going to be forever changed.  But does this mean that they also have to surrender the hopes, dreams and aspirations that drive most people through rough times?  Is it reasonable to expect that depersonalization that if often a prerequisite for the battlefield will be left behind and not come home with those who have been trained to see the world in terms of black and white and to  become “an army of one?”

While research demonstrates that early intervention, hospitalization and medication can save lives, we need to consider methods beyond crisis management.  The bigger question is how to help our military personnel recover from wounds that are largely invisible, deeply psychological and inherently corrosive to their sense of humanity.

The basis of most trauma work begins with the supposition that returning one to an emotional and mental state that existed prior to the trauma is unattainable.  Instead, efforts are focused on helping the person move from victim to survivor and on to thriving through the process of reframing the traumatic experience. This is done through molding a new life that both honors past experiences while at the same time breaking free from one’s personal history.  While much of this work takes place on an individual basis, making it a lasting experience requires weaving this experience back into the fabric of society.

According to Dr. Judith Herman, in her book Trauma and Recovery, the final stage of recovery from trauma involves “Restoring the connection between the survivor and his/her community.”  The loss of this connectedness is what leaves many people feeling like they have been sentenced to a life of solitary confinement, imprisoned by emotions beyond their control. 

In order to free those being held hostage to traumatic experiences, we need to become the bridge that brings them back to a social network that provides a protective barrier from the death and destruction that was their reality.  This effort has to be more than banners, ribbons and parades and instead have all the intensity of the front end of service.  What is called for is a basic retraining; a boot camp mentality to help warriors rejoin the fabric of society that nurtures compassion, cooperation and connection.  What better way to pay tribute to those who serve than to return to them their personal sense of decency, dignity and self-worth?

Friday, February 27, 2015

The Last Laugh: Putting the Fun Back into Aging

The Zen teacher Shunryu Suzuki said, “Life is like stepping onto a boat that is about to sail out to sea and sink.”  I have to confess, the older I get the more I see the humor in this because, as the old line goes, “It’s funny because it’s true.”
As our nation gets ever grayer there is more and more emphasis being placed on the process of getting older.  Let’s be honest, a lot of the news is not only not funny, it’s downright frightening.  Must it be this way?  When did getting older become synonymous with getting serious?  They say laughter is the best medicine. Who needs a good dose more than us whose bodies are falling apart, whose medicine cabinet increases with the number of candles on the birthday cake?  It makes perfect sense that finding the fun in aging is essential to doing it well.

As a card carrying member of AARP, I find there are many things about getting older that strike me a funny.  As a psychotherapist, who regularly sits with others who are also on the train to Oldsville, I find many people often miss the humor in life because they think the joke is on them.   For these folks fun is something one grows out of and many cannot even remember the last time they had a good laugh.  

Western culture, with its youth-addicted mindset that sees aging as an insult, only contributes to the ever-increasing morose view of what, in the rest of nature, is a necessary movement of the life cycle.  It is not comedy when the most mature among us are marginalized and dealt with in polite tones of indifference?  And how funny is it  that today’s banner carriers of the Younger is Better crowd will be tomorrow’s consumers of social security benefits, brain training apps, and whatever new drug is getting ready to replace Viagra? 

Rather than waiting for something to come along and tickle our arthritic funny bone, we can use our time-honored wisdom and bring fun back into our lives.  The good news is being more lighthearted does not require more doing. Face it, getting old means having less energy so what’s the point in having to work harder; leave that for the young.

We can start by putting the brakes on some of things that are creating barriers between ourselves and experiencing joy.  Some things that come immediately to mind include:

1. Stop trying to find your “purpose” in life.  The apparent separation between “life” and “you” is simply a distortion of perception.  You are life’s purpose and the attempt to find that which is already there is, quite frankly, somewhat comical.
2. Stop making lists of every body part that no longer works like it used to.  It’s hard smile when your focus is on the fact that the muscles that make that happen are not as toned as they once were.
3. Stop talking about “The good old days.”  Nothing spoils the fun of a present moment experience like still living in the past.  Be honest, the “good old days” were filled with stress, worries, ulcers and headaches, whoopee!!
4. Stop reading books that tell you how to stay young.  Despite what so and so best seller says aging is not an affront to nature and the notion that you’re doing it wrong is hysterical.
5. Stop comparing yourself to “the Joneses.”  If you’re lucky, you’ve already forgotten who these people are anyway and, if not, realize that they’ve gotten older too.

Now that we’re no longer building those psychological barriers to having fun it’s time to get practical.  First take this quick test:
When was the last time you had a really good laugh?  If your answer was, “During the Carter administration,” you need an emotional Heimlich.  So here goes:

1. Take out the old photo album and chuckle at the number of hair styles you’ve gone through and how at the time you thought “Damn, I look sexy!”
2. Put on an old TV series, preferably a drama, and guffaw at what we used to think of as good acting.
3. Go ahead and play that favorite tune from when you were an angst-driven young adult and giggle at how seriously you thought your life was back then.
4. Watch almost any movie involving aging actors and chortle and their attempts to keep up with their way too young sexual partners.
5. Pick up almost any magazine with a smiling senior celebrity on it, talking about how to stay young and smile back, realizing that with any good photo editor you too could look years younger.

The old adage of “He who laughs last, laughs the best” should be the mantra of a generation that has seen more than its share of tears and heartache.  This does not have to mean that we stop being responsible and become old fools.  It simply means that we’ve reached the point in our lives where a sense of humor can replace the failing senses of smell, taste, touch, sight and sound. 

Tuesday, December 16, 2014

"It Is What It Is." Or Is It?

Acceptance of what has happened is the first step to overcoming the consequences of any misfortune. – William James

It’s official; the phrase, “It is what it is,” has become our nations’ go-to mantra for living in the modern age.  I’m sure of this because, not only do I hear it repeatedly from my psychotherapy clients from all walks of life; I heard a report on NPR where the U.S. Solicitor General, Donald Verrilli, used it in an argument in front of the Supreme Court. (Click here for the transcript of the report).   Talk about putting an official stamp on something.  The only thing left is a constitutional amendment to use the phrase in place the words E pluribus unum on our currency.  

My initial impression on hearing the use of this phrase was one of wonderment.  Had the nation suddenly adopted a Zen-like acceptance of the here-and-now?  Was this a sign of a new age of enlightenment where people no longer resisted the natural flow of life?  And, most importantly, is my job as a stress therapist in jeopardy now that people are no longer worrying about things they can’t control?
These questions were quickly answered as I began to listen to the context in which most people were using this modern proverb.  Rather than it being used as the open door to a more proactive life lived in accord with the Now, it was the closed and barred door of resignation that, “Life hurts and there’s nothing you can do about it.” 
Feeling, once again, secure in my chosen field, it still bothers me to think that so many people are using this pseudo-acceptance as a primary stress coping skill rather than  true acceptance.  True acceptance reflects an inner state of “yes,” while resignation is the contracted “no.”  Acceptance says, “It is what it is. Now what will I do?”  While its opposite says, “It is what it is.  I think I’ll go crawl under the covers.”
At a deeper level, this phrase has all the clarity of a muddy lake.  Absent an understanding of, (to quote former president Bill Clinton) “what your definition of is is,” there’s no way of knowing what we’re accepting.  Is your is the same as my is?  Is there a universal Is that reflects the ultimate truth? And don’t even get me started on just what “It” refers to. 
If you want to verify that the people uttering this phrase have no conceptual basis for its use try this quick test.  The next time you hear someone use this phrase respond with one of the following:
  1. Is it really?
  2. No, it is what it isn’t.
  3. No, it isn’t what it is.
  4. No, it is what you is.
Stand back and watch the sparks fly as the person’s brain grinds its gears trying to wrap their head around that.
Before throwing the baby out with the bathwater (a time-tested, proverb) perhaps we can salvage this phrase before it ends up on the idiomatic garbage heap along with “Hang in there baby.” If we want to put the stamp of an authentic, perspective-shifting, helpful maxim on “It is what it is”, we need only follow a few simple rules:
  1. No using the phrase simply because we lose interest in a topic, situation or person i.e. “Oh look at the time, well, you know, it is what it is.
  2. No using the phrase in place of a necessary, open and honest, discussion i.e. “Johnny what’s up with these failing grades?”  “It is what it is, Mom.”
  3. No using the phrase to defend an indefensible position, i.e. “So, Chuck, it seems that you’ve been embezzling from the company again.” “It is what it is, boss.”
  4. No using the phrase to side-step personal responsibility i.e. “I can’t believe you decided to invest our retirement savings in the return of the 8-track player.” “It is what it is, hon.”
  5.  No using the phrase as a pseudo-spiritual ladder to prove that you are more enlightened than everyone else i.e.  “You really think you’re better than us don’t you?”  “It is what it is.”
We would be wise to heed the words of the great American psychologist William James when he pointed out the acceptance is only the “first step to overcoming the consequence of any misfortune.”  Perhaps, then, there will come a day when, rather than reciting mantras, we will begin to live their meaning.