THE MAN I CAN'T REMEMBER

THEME: DOING THE RIGHT THING

The most important human endeavor is striving for morality in our actions.  Our inner balance and even our very existence depend on it.  Only morality in our actions can give beauty and dignity to our lives.  ~ Albert Einstein

A man changed my life one day in his office. I was one of eight or nine people he probably saw that day, certainly not the most dramatic or deeply felt for him, a university-based counselor of many years’ experience. I only saw him once, but our encounter showed me my path and gave me a nudge to follow it. I owe him a lot, but I can’t repay it because I don’t remember his name.

As my college career wound down, I was suddenly faced with the eventual dilemma of any English major –how would my ability to crank out a paper on imagery in “The Love Song of J. Alfred Prufrock” translate into a career? Too bad I waited to contemplate that question until late in my final semester, but I’d been living in the moment, not in reality. The moment contained much drama and tumult, as the Viet Nam War raged and so did protests and marches. The working world seemed very far away.

I was unfamiliar with indecision. I’d always known what my next step would be. Now, I was about to step into the abyss. Why had no one warned me that I’d have some serious career decisions to make? Yikes!

That distress sent me into the college counseling center and across the desk from the man I can’t remember. I don’t recall what he looked like, but I do know that he spotted my counselor-like nature and sent me over to talk to his old pal, the head of the Department of Counselor Training. From there, I entered the program and walked out two years later with my Masters degree.
          When I began, in addition to enormous relief at having direction again, I had lofty thoughts about reducing suffering in the world. If I could provide an authentic human connection with people who felt alone in their worst days, it would be worth doing. And I had some indication that I’d be good at it.

I’d had a rare glimpse of that possibility because the YMCAs I frequented in high school and college were piloting encounter groups, where a small group of strangers would come together, attend to the dynamics of the moment, and develop new skills to connect and become self-aware. The hope was that such groups would help with community building and personal growth, and ultimately societal change.

As I sat in my first groups as a fifteen year-old, I was a spectator. Too shy to speak up, I learned to listen and watch. Pretty soon I was able to take the emotional temperature of the room and of each participant. I could sense how the session was going, who was on the verge of an outburst, who was detached, who was suffering. I had no idea that I was in training for my eventual career.

After the first session, shamed that I had not spoken up, I struggled to come up with what I would have said if I had been able to. That question became my focus in each subsequent group. Once I finally became able to identify what I could have said, I began a long project to improve my timing and be able to come up with it and out with it in the moment. If one of the leaders’ goals was to help participants conquer their own limitations, they had a success story. I was still shy, but I was no longer tongue-tied.

I began to watch the leaders to attempt to figure out which one would say what next. I began to see the spaces where they could. When I stepped back, I could see the amazing fact that if you put strangers in a room with a common mission of communicating from the heart, differences went out the window and community happened.

I wanted more of that. I just hadn’t figured out where to get it until my encounter with the man in the counseling office. My friends were about to run off to teach math, help deliver babies, surf in the Pacific. I would learn how to save the world, one person at a time.

It wasn’t long until I learned I’d have to modify that goal – I would try to help one person at a time improve their functioning. It would be a matter of helping them find their own resilience, not saving anybody. I could only support and witness them as they overcame their suffering. I got adjusted to my limitations, and set aside the grand ambition.

Others didn’t stop so short. Beginning in the 1990s, I began to hear of medications that had the potential to eliminate traumatic memories entirely. And later, techniques that promised to allow the memory to persist but removed the crippling emotions that were attached to it. Now that so much more is understood about memory and how it is formed and stored, and about trauma and its effects, various points of intervention can be identified that weren’t available in the past.

For instance, I was taught in graduate school that once formed, memory was fixed. Now it is known that recalling a memory opens a door to modifying it, or even erasing it. According to the theory of reconsolidation, each time a memory is retrieved, it changes and becomes possible to alter.

I was also taught in grad school that the brain was fixed - it could deteriorate but not improve. Now it is known that brain plasticity allows it to regenerate, form new connections, and even become freed from its traumas.

As more wars have created more victims of PTSD, and their suffering has become well-known, the stakes for figuring out how to use these new understandings has gone up. If we ask our service members to kill and risk their own safety for our cause, while we sit in our living rooms watching sports, should we l least offer to remove the scars that remain?

Early on, scientists discovered that a beta-blocker medication called propranolol interfered with the initial storage of a traumatic memory. Later, it was found that the same medication may also be able to interfere when the memory is called up even years later.  Studies continue with other medications that may be even more potent and have the potential to expunge toxic memories entirely, although they may take other nontoxic memories with them.

Another technique called EMDR, for eye movement desensitization and reprocessing, involves no medications, but eye movements guided by a therapist trained in the procedure. It is often successful in blunting the traumatic emotional content of a memory. Other similar noninvasive methods are also in use.

While these interventions are being further developed, several questions present themselves:

Who should receive these dramatic interventions, and when? For example, should a rape victim wait for an intervention until after the trial is over so that her testimony will include the expected display of emotion?

If we become able to erase the terrible events that happen to us from our memories, what does that do to our personhood?

And the ultimate ethical question, should we go ahead and implement every intervention that we become able to do? If not, what will hold us back?

Who will decide which of these measures is appropriate for which individuals? How bad does it have to be to justify the complete erasure of memory?

 The man I can’t remember and I didn’t have to ponder such large questions. He went to work helping me find the answer to my question about what I want to be when I finally grow up.  He asked me good questions: when I’d been the most energized, who I knew that I especially admired, what I thought I could be good at, what I would be proud to do. He didn’t try to erase my discomfort, but did put the right questions in my head, and it turned out I had the answers. Then he handed me some tools to act on those answers, and said goodbye. I sure hope I called back to thank him.
             Future helpers will have a far larger arsenal of tools to work with than he did. They will regularly meet with people in far more distress than I, who may end up forgetting far more than their counselor’s name.

CBH – O4/12

THE LAST THING YOU WANT TO LEARN

THEME: FOR THE SAKE OF THE CHILDREN

There can be no keener revelation of a society's soul than the way in which it treats its children. - Nelson Mandela

Once a year, a group of slow-moving people gathers in my driveway to accomplish a major feat – walking across the street. They have cancer and are in the active phase of treatment which may weaken them physically, but not in the ways that count. They head toward the Wellness House, a cancer support center that sits across from my house. Instead of staying home which they could easily justify, they come out to kick off the 5 and 10K walk that raises funds for the center. There are balloons, music and prizes. While the walkers set out, runners pace around trying to stay loose in the early morning air, dressed in team T-shirts with a loved one’s picture on the front, or a team slogan like Cancer is a word, not a sentence. MORE . . .

The whole event is bathed in grief. No one wants to be there, wearing a picture of a person they love. No one wants to watch someone find it hard to walk across the street. No one would wish this trouble on another.

But life being what it is, you don’t get what you want; you get what you get. And what you get gives you a chance to learn things you never wanted to learn. So the people show up, and what comes out is the resolve that rests underneath the grief.

Anytime of the week, I see folks walking through the doors across the street for a support group meeting, or lecture, or exercise class. Some of them have cancer; some of them love someone with cancer. I feel glad for them that they have this place to go. I feel sad remembering my friend and her family who had no such place to go when she faced cancer back in 1990, when her children were young teenagers.

The ones that hitch my heart the most are the children, hurrying in to join a bereavement support group. The arrival of grief into a child’s life introduces reality, roughly and suddenly. It begins with the illness: Instead of Grandpa being the guy you love to play with, he becomes a sick person you have to take it easy around.  If Grandpa dies, the child begins a lengthy walk with grief, and the adults who remain must learn how to help.

Some of the basics of helping children to grieve are well-understood:

§     Let them see you cry, and tell them that it is normal.  It gives them permission to express emotion when they need to. And it lets them know that they don’t need to hold theirs in to help you.

§     Communicate clear and realistic messages. “Grandma died.” “Her body stopped working.”  “It cannot be fixed.”

§     Avoid confusing statements like “She’s gone away,” or “She’s sleeping,” or “She’s gone on a trip far away.” Children are concrete thinkers and will misunderstand those references and wait for their loved one to show up one day.

§     Watch how you portray God. Instead of implicating God in the disappearance of a loved one, as in “God needed her so he called her home,” promote him as a source of comfort and help, if you so believe.

§     Don’t be afraid to ask questions of your child, and encourage him to do the same. Find out what your child knows about death, and about the terms you are using to explain the death. Your conversations may need to be repeated again and again as your child grows in understanding. You may still be talking about this periodically for years, as kids need to reprocess their grief as they move through developmental stages.

Other realities about grieving children are less well-known:

§     Kids are masters of intermittent grieving. They may seem in the depths one minute, and then ready to dash out to play the next. It is as if they have a circuit breaker that saves them from overload. Be assured that this is normal.  In fact, the rest of us might be smart to learn from them.

§     Kids often believe that they are responsible for the death of a loved one. Since they naturally believe that the universe revolves around them, they overestimate their power, and their responsibility. They can imagine that anything they did wrong could be the reason for a loved one’s death.

§     Grief is not one-size-fits-all. For children as well as adults, there are wide ranges of emotion, as well as different styles of grieving. Everyone has an individual grief footprint. Avoid imposing outside constructs like stages of grief or expectations about timing.

Expect siblings to grieve differently from each other, because they will. Make sure they know that and reassure them that as long as they do not stop themselves from grieving, they will be okay.

§     It is important to involve children in story-telling about the deceased, and in rituals of remembrance. But judge carefully how and when to carry this out. There is no rule about whether a child should attend a wake or funeral. That decision can even wait until the last minute, and the child should have a chance to weigh in.

Whether they attend or not, let other rituals emerge over time. A visit to Grandma’s favorite picnic spot, or cooking a meal made up of her favorite foods, or remembering her birthday by going through family pictures can all be healing. Children can suggest their own favorite ways of remembrance.

§     Finally, make sure they know that grief gets easier over time, even though it never fully goes away. Tell them that the power of good memories grows, and the intense longing lessens.

This year when the day for the walk arrives, I plan to concentrate on the children in their T-shirts, who are doing what they can, and their parents, who are showing them how.

CBH 03/12

SHE COULD HAVE HAD IT ALL

THEME: TAKING A LEAP

All growth is a leap in the dark, a spontaneous unpremeditated act without benefit of experience. ~ Henry Miller

I get temporarily popular every time a celebrity overdoses, suicides, or runs into some sort of ditch. Given my therapy background, people want to hear my attempt to explain such behavior. With Whitney Houston’s death, the question seems to be a three-parter: Why couldn’t she 1) kick that Bobby Brown aside, 2) get clean and sober and stay that way, and 3) get back to singing like she was supposed to?

There is an angry question lurking just below: How could she have a gift like that voice and squander it? 

As I sit here I contend with dueling earworms.  With Whitney singing, “I will always love you…” and Adele belting, “We could have had it all…” it’s hard to think. But I’ll take a crack at it.

I will stipulate that the behavior of an addict is incomprehensible to the normal bystander. Broken promises, lies, financial ruin, lost jobs, fractured relationships, and all the rest render the addict irresponsible, weak, pathetic, and stupid in the eyes of others. Their behavior looks and feels intentional.

The people who care about them eventually need to take a step back to save their own sanity. Into that space, especially with celebrities, others who don’t actually care about them step in ready to take part. Plus, anyone in the vicinity who shares their affliction helps to keep it going. It is a powerful system bent on its own continuation, and might help explain Bobby Brown’s continued presence in Whitney’s life. Whoever sent him away from the memorial service at least made a point.

But how does the addiction take a death grip on an otherwise capable, even exceptional, person like Whitney?

I have a laundry list of explanations in my head, cobbled together from years of observing and theorizing. Pick your favorites.

*One theory says that all the addict wants to do is chase the exquisite pleasure of his or her first time. Maybe, research suggests, the pleasure that an addict gets from using his substance is on a whole different level than most people would experience. The problem is that the pleasure is never to be found again.

*Addicts describe their disordered thinking as if they are constantly spinning, which only allows them to encounter reality occasionally on a brief fly-by.

*Some describe finding that the first time they ever felt normal was during their first use. Later, many can feel normal only while under the influence. Worse, as they become physically addicted, to not use becomes painful due to withdrawal symptoms. It is no longer a matter of pleasure, but pain.

*Once life becomes too painful to face, drugs and alcohol provide escape. Pain can originate with losses, or failed expectations, or runaway expectations, or the depressive effects of the chemicals, or a hundred other sources. Once an addict finds his way to oblivion, it becomes a regular destination.

*Addiction is a disease that takes charge over the body, mind, and spirit. It makes the decisions, dictates the feelings, and drives the behavior.  The individual is no longer a person with free will, but more like a host to an aggressive parasite.

*What goes on is an expression of cellular changes, the interaction between brain chemicals and receptors, that expresses itself in egregious behavior.

*Outside influences of people, places and things can start things up, keep the process going, or encourage relapse. Bobby Brown and the music industry come to mind.

*The individual hasn’t done enough “research” yet to become convinced that the problem is unmanageable and that therefore entering recovery is necessary. Denial slips into and out of place. The lucky ones hit bottom in time.

*Finally, it is indisputable that the addict misses a lot, being under the influence and possibly in a blackout for many crucial experiences. What they can’t remember is not part of their experience, and therefore does not motivate them toward change.

Those ideas and theories form a mudball of cause and effect. They may all be true, or not. They certainly make clear that there is no one simple answer.

If it’s hard for me to understand, it’s even more incomprehensible to the addict. And no one is more disappointed in the addict than he or she is. They wish for normalcy. But achieving it in the face of addiction is a big order. It requires large doses of knowledge, support, and hope. The longer the track record of failure, the less accessible those become.

Meanwhile, the addiction offers its own gifts: immediate pain relief, oblivion, escape. Whether the addiction seeks to chase the sublime or escape the intolerable, it’s an ironic struggle. While the body and mind duke it out in a private battle, it cannot be won without outside help, practical or spiritual, or both. How to make that happen remains a mystery for many.

Maybe we should confine ourselves to other question: Do we have gifts we are squandering? At least we can do something about that.

CBH 02/11

MY BRAIN ON FREDDIE MERCURY

THEME: GOOD INTENTIONS
I may not have gone where I intended to go, but I think I have ended up where I intended to be. ~ Douglas Adams

Sometimes I wake up with a song in my head. Often the tune quickly dissipates, like the last wisps of a dream I can’t hold onto, fleeting and forgotten. I may recognize it as part of a commercial jingle (“1-800-588-2300 Empire”) that I hear all the time, or a line from a familiar song (like “This Land is Your Land” which I heard the other day). Its unimportance helps it go away.

But other times, the song stays with me all day long and into the next. My blood seems to pulse to its rhythm, and the words run like a news crawler in my brain, no matter what else I’m doing. When it finally lets up a couple of days later, it’s a relief.

Usually I know exactly where it came from, and that it’s my own fault. It follows a binge of sorts, like when I play the Leonard Cohen Live In London concert album intending to hear “That’s How the Light Gets In” just once, you know, to check on the lyrics and remember exactly how he said it (“Everything has a crack in it/That’s how the light gets in,” that perfect line). My good intentions are then overrun by a need to hear the whole thing, and try to place myself back into the concert I heard at the Chicago Theater a couple of years ago, a better-than-church transcendent night.

And then I play it again, and a few more times over the day, until I have worn a groove into my brain that sleep won’t erase.

But it isn’t just Leonard. My periodic visits to You Tube to see Freddie Mercury and Queen’s Live Aid set, which pundits call “the greatest live performance of all time,” set me off too. Just this fall, I commemorated the 20th anniversary of Freddie’s death by viewing the entire Live Aid performance, let’s just say, more than once.

But then I woke up to an exhausting, sweaty full-tilt version of “Radio Ga Ga” first thing in the day. I’d prefer to listen to Freddie when I invite him, not when he just decides to show up. I guess the truth is that since I invited him in the first place, it’s just that he never left. All right, more truth. It appears I can’t stop my binges once I start. Like all addicts, I believe I can control my conduct, but also like all addicts, I can’t control the consequences.

But it’s not all disturbing. Today I woke up to Temple Grandin, the autistic brilliant animal scientist portrayed by Claire Danes in the movie of the same name, belting out “You’ll Never Walk Alone” during the scene of her college graduation speech. A few days before, it was the Beach Boys’ “Good Vibrations,” which transported me back to my college dorm room when everything was ahead of me.

My friend Lorraine helped direct my attention to all of this. She seems to have a related and more mysterious version of this song phenomenon. She wakes up every day with a different song in her head, but not one she can pinpoint a connection to. The day we had lunch, she reported that Leon Russell’s “Delta Lady” showed up, not that she can remember hearing or particularly liking it. Her preferred playlist –Beatles, Eric Clapton – never appears and she wonders why. She is on the case, and has learned that this condition has a name, involuntary musical imagery, sometimes called musical imagery repetition or MIR.

Well-known prestigious scientific journal Wikipedia reports research showing that 98% of individuals experience this phenomenon, which it prefers to call earworm. Apparently women find that it lasts longer for them, and are more irritated by it than men.

Clearly, I have a touch of that too. I don’t know where “Good Vibrations” came from for instance, except that I must have a vault in my brain where all rock and roll tunes and lyrics from the sixties and seventies are stored.

I realize now that I was warned of trouble of this sort early in life by one of my favorite childhood stories. Robert McCloskey, the Make Way for Ducklings guy, wrote two Homer Price books, a series of stories about small-town boy Homer and a peculiar bunch of friends and relatives. In one, his Uncle Ulysses installed a shiny new jukebox with changing-color lights that cast a mesmerizing glow on his “up and coming” lunch counter. A mysterious stranger came in, installed a new song on the jukebox, and disappeared. Customers were entranced by the song, but then could not get it out of their heads, no matter what they did. Worse than that, they could not stop singing it. Soon, the entire town was afflicted. (Lyrics: “In a whole doughnut/There’s a nice whole hole/When you take a big bite/Hold the whole hole tight…”) The ultimate solution (spoiler alert) was to go to the library and consult the wisdom of Mark Twain. Why Twain? Because in an essay, he had posed the dilemma of getting something stuck in your head and not being able to shake it. Lorraine and I and Wikipedia are not the only ones to ponder this.

I’m sorry to include this last issue, in case it brings to life some buried demons, but Homer got me thinking about the songs that I take pains to avoid completely, lest they re-infest my brain. First, and worst, Disney’s “It’s a Small Small World” (“It’s small world after all/It’s a small world after all/It’s a small world after all…” until you want to scream). Then there’s Debby Boone’s “You Light Up My Life” (“to give me hope to carry on/You light up my days and fill my nights with song” – that’s for sure). And, affection for Julie Andrews aside, there’s “Do Re Mi” (“Doe a deer, a female deer/Ray a drop of golden sun…”) ad infinitum. Maybe there are bad song receptors in the brain that bind with such “doggerel” (Twain’s word) and won’t be extinguished.

In fact, maybe that’s the message. While I go around thinking I’m in charge around here, my brain is doing plenty on its own. It plays the songs it wants to hear, thinks the thoughts it wants to think, and lays down its own pathways, at least until I catch on and try to get it in line. Until then, I guess I have a soundtrack all my own, even if I’m not the one holding the baton. 

CBH - 01/12