"On Healing" January 2004

Posted on Sun, Jan. 25, 2004
Mr. President, here's a real marriage initiative
By Dan Gottlieb

Dear Mr. President:

I understand you are planning a $1.5 billion drive for the promotion of marriage. Although my political leanings are not as conservative as yours (even my wheelchair has trouble turning right), as a trained marital and family therapist I'd like to offer some thoughts.

Most marriage begins as romantic love. The passion in the body usually guides the thinking process. In the early stages, people say they love one another, but what they really love is how they feel with that person. In time, the intense emotions dissipate and people slowly get to know one another as they truly are. Disappointment is almost inevitable. The big question is what people do when they realize the person they are living with is not exactly the one they wanted.

Many people, unfortunately, try to change one another into their own vision - a vision they might have learned from their parents, their childhood dreams, or even television. Nevertheless, people try to change one another to have their needs met. As you can imagine, Mr. President, this turns into a vicious cycle of frustration, disappointment, anger, hurt and emptiness. Many of these marriages end in divorce.

But some people actually learn to love their partner for who that person is. We call this mature love. Mature love is when you understand your spouse has baggage and weaknesses and even old wounds, and you love them - not despite their wounds but partly because of them. More than toleration of differences, mature love involves coming to embrace them. When one spouse feels pain, the other can feel compassion. Mature love looks deeply into our spouse's eyes - and sees the heart.

We mental health professionals long have known about the power of role models. If we grow up in loving families or caring communities or nurturing and generous cultures, we are more apt to be loving people. So how do we promote mature love? Role modeling. Please use your pulpit and power to promote genuine compassion - and by this I do not mean politically expedient conservative compassion.

Here is an example of the kind of compassion I am talking about, one that comes from an open heart and teaches love. Imagine that you are gay or lesbian. Then imagine the pain of being in a culture in which you are systematically rejected, scorned, sometimes killed and told by religious leaders that you are a sinner - particularly at a time when volumes of research show that homosexuality is not simply a "choice." Try to feel the fear, alienation and pain. And if you are moved to tears, then you are feeling genuine compassion.

If I had $1.5 billion to promote marriage, I would use the bulk of it to role model compassion. I would help couples living near the poverty line to get jobs that gave them dignity and respectable income. I would help them find safe and healthy day care for their children. I would help create a community where they found ample support and nurturance.

With the rest of the money, I would take couples that are not happy with one another and temporarily house them in poverty areas. I would use that money to pay their expenses while they devoted their time and energy to feeding the homeless and caring for people who desperately need it.

Why? Because when we focus on our own suffering, it gets worse. But when we take an active role in contributing to helping others, personal pain diminishes. I am sure feeding the hungry would help many of these couples develop compassion and respect for the larger world, each other, and themselves.

Ultimately, marriage involves love. And mature love involves embracing differences with an open heart. It is impossible to have an open heart and a closed mind.

Posted on Mon, Jan. 19, 2004
Don't tolerate intolerance
Home is where kids learn to love and, unfortunately, to hate.
By Dan Gottlieb

As we recall the life of the Rev. Dr. Martin Luther King Jr., I often wonder how he managed to maintain his nonviolent position in the face of all the aggression and inhumanity he experienced.

As Dr. King explained it in "An Autobiography of Religious Development," a 1950 essay, "It is quite easy for me to think of a God of love mainly because I grew up in a family where love was central and where lovely relationships were ever present."

He devoted his life to the pursuit of social, political and economic freedom for all. Because of that pervasive love in his family, Dr. King may have always had a sense of internal freedom.

All of us learn about life from our families. We learn whether the world is a safe and loving place or whether it is a dangerous place of which we should be wary. We learn about whether people are good or bad and we learn about love, relationships, priorities and values. And we also learn about hatred, prejudice and intolerance. Granted, some forms of discrimination are probably hardwired, but family is where intolerance is nurtured.

If you think I am talking about someone else, listen to a typical conversation at your house. How much time is spent talking about people who annoy you - including family members? Do you comment about "those" politicians, or "those" new neighbors? Do you express intolerance about any group of people?

Every time words of discrimination and anger are expressed in the house, children absorb them like secondhand smoke. And in that moment of judgment or prejudice, all access to love is cut off because it is impossible to be close-minded and loving at the same time. And the consequences can extend beyond our own home.

After the 9/11 attacks I chaired a panel of high school students discussing discrimination. One of the panelists was a young Muslim woman wearing traditional garb. She said that she had only experienced discrimination once since 9/11: "I was on the subway platform and I looked up and saw a woman looking at me with hatred in her eyes." When I asked her what it was like for her to be on the receiving end of that stare, she began to cry and talked about how frightened and self-conscious she felt. Every act of hatred, discrimination, prejudice or intolerance causes suffering. Words cause pain. And they cause pain to those who hear them and those who speak them.

To begin the process of change, perhaps we should think very differently about child-rearing. What if we stop preparing our children for a difficult, competitive and challenging world, and try to envision the world we would like to see them inhabit? Probably that would be a world of kindness and generosity. Perhaps it would be a world where compassion was more prevalent than criticism; one in which injustice to one would feel like injustice to all.

When you are done visualizing the world you would like for your children, begin thinking about how to raise children capable of creating such a world.

Once we have the vision and the goals, we are ready to take some steps:

Make a commitment to yourself to make a genuine effort to care more and criticize less. Remember, you are beginning a process that will last a lifetime. So don't criticize yourself for not doing it well the first day!

Notice how you feel when you are being critical or judgmental versus when you are feeling caring or loving.

Make it a family policy that there be no criticism of anyone at the dinner table.

Extend your sense of caring to the larger world. Remember, if you want your children to live in a world where people care about one another, teach through action. For example:

Gerda Weissman Klein was 17 years old when the Nazis took her from her beloved home and sent her on Hitler's infamous "death march" in which hundreds of women died from exhaustion and hunger. When she later arrived in the United States, she said that no child should ever experience the kind of hunger she did. As a result, she has created a foundation (www.kleinfoundation.org) devoted to teaching school children compassion for others and how to contribute to diminishing hunger.

Almost every spiritual leader the world has ever known has told us to feed the hungry and pursue justice for all. It's time to listen.

Every family should have a cause to which its members are devoted. And devotion takes time, care and investment. Make an active contribution to diminishing the suffering of others. It will teach your children - and it will change you.

The question is not whether we will be extremist, but what kind of extremist will we be. Will we be extremists for hate or will we be extremists for love? Will we be extremists for the preservation of injustice - or will we be extremists for the cause of justice?

- Martin Luther King Jr.
"Letter from Birmingham Jail," April 1963

Posted on Mon, Jan. 05, 2004
Alzheimer's center offers support, activities and respect
By Dan Gottlieb

I was surprised when I first entered the Lawrence Park Adult Day Services in Broomall. Because the center specializes in adults with Alzheimer's disease and other forms of dementia, I expected a nursing-home arrangement with few activities and people staring off into space or talking to themselves.

But when I entered the large room, even though it was the end of the day, I saw that people were interacting with the staff, music was playing, and there was a feeling of liveliness.

I went to the center to tape some interviews with patients (who are called participants) and staff for a radio special on Alzheimer's. As I looked around, I was struck by the sense of playfulness. I noticed greasepaint, easels, children's toys and blocks, and many musical instruments.

I noticed the similarities between this atmosphere and the atmosphere in my grandson's preschool. And then I heard laughter in the next room. At that moment, I was able to see similarities between these adults and those children better than differences.

Alzheimer's affects five million people in the United States, and 15 million worldwide. The numbers are expected to quadruple as baby boomers age. Alzheimer's usually begins with what appears to be memory loss, which affects almost half of all people as they age. But as Alzheimer's progresses, patients become confused, disoriented, and eventually unable to speak or provide self-care.

Although there is no cure, nor reliable treatment, there is reason to be hopeful, according to Samuel Gandy, director of the Farber Institute for Neuroscience at Thomas Jefferson University. We are beginning to understand what is happening inside the brain of someone with Alzheimer's.

"Because of genetic research, we have been able to identify the proteins that start the disease... which fold over on themselves and become plaque, which is distributed throughout the brain and poisons nerve cells," Gandy said. Because of that better understanding, pharmaceutical companies are aggressively working to develop medications, some of which look promising.

"But," Gandy cautioned, "unless we get a drug that works within the next couple of decades, there will be two kinds of people in this world: those with Alzheimer's and those taking care of them."

Like any other chronic illness, Alzheimer's has a ripple effect. Typically with Alzheimer's, insight is one of the first things to go. So the burden of care often falls on loved ones who meet initial resistance. The task of caring for someone with Alzheimer's can be so stressful that loved ones are at increased risk of depression, isolation, and even something called caregiver's dementia.

The first of my interviews at the center was with program assistant Steve Poltz, who wore a purple bandanna, horn-rims and a scruffy beard. Here's how he described his job: "I come to a room with people whose minds are all in places other than this room because of the Alzheimer's. My job is to go around the room and get them to agree to play with me today."

One of his participants is "living in France during World War II," Poltz said, and his job is to join the man there and keep him company rather than challenge his reality and try to bring him back to Broomall.

Another participant is a woman who used to run a program for cancer research. "Sometimes I am her chauffeur, sometimes I am her butler, and sometimes I am a professional colleague," Poltz said. "But whatever I am, we are spending time together in her world."

It's hard to enter the world of someone who might be paranoid or terrified. But Poltz feels that to deny anyone his or her reality is not moral. Many developmental psychologists would agree.

And then I met Hannah. She appeared to be in her 80s and was a little plump. But what struck me as Poltz led her into the room was her cherubic smile, which never seemed to go away. When they sat down, Poltz said: "This is Hannah; she is one of our great singers."

At first I was impressed by how clearly she spoke and how logical her answers appeared. She said she was aware of changes in her mind, as she was getting more forgetful. She explained that her daughter placed her here because she worked full-time and didn't want Hannah home alone all day. I wondered if she was in the very early stages of Alzheimer's or even if she had been misdiagnosed - until I met her daughter, Sissy, who arrived to take her mother home. She has been living with and caring for her mother for about 2 1/2 years.

When I told Sissy her mother sounded mentally clear, she replied: "That's today. There are other days when she is confused and disoriented. Some days, questions are asked so many times I feel I am ready to explode."

She began to cry as she described how guilty she feels when she runs out of patience. Through her tears, Sissy recalled how one day her mother kept belching, over and over. Finally, Sissy ran out of patience and said: "Will you please stop doing that!"

In that instant, Hannah, despite not understanding what she was doing wrong, said under her breath: "I wish I didn't breathe any more. I can't stand hurting my daughter." I was struck by the fact that although Hannah's mind was deteriorating, her love for her daughter remained intact.

I asked Hannah if she would sing something for us. With Poltz on the guitar, she sang the most beautiful version of "Let Me Call You Sweetheart" I have ever heard. By the time she was done, all of us were crying.

And that's when I realized the difference between the Lawrence Park Adult Day Services and my grandson's preschool. At his preschool, there are no tears of grief, no tears of helplessness or impotence. And no tears about what is in store for the future.

To hear more about the interviews and Alzheimer's, listen to "Voices in the Family" next Monday at noon. On Jan. 21 at 9 p.m., WHYY-TV will present a special on Alzheimer's called "The Forgetting." For more information, go to www.pbs.org/theforgetting.

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