"On Healing" April 2004

Posted on Mon, Apr. 19, 2004
Treat son's anger by talking of fears
By Dan Gottlieb

Dear Dr. Dan,

The father of my children died of a massive heart attack at age 56. My sons, except for one, realize they must be cautious in their lifestyle, health and nutrition and live accordingly, not haunted by the expectation that their death too will occur at age 56. The sole dissenter exercises religiously and eats well but voices the belief that he, too, will die at age 56. Recently I told him I want him to stop thinking that, or he will die at that age, that he must tell himself he will live to old age. His reply was that he is a Type A personality, as if that dooms him. I replied, "Well, change!" He became angry and said it is not possible because it is in his genes. I did not say anything further but thought, "You do not want to change. Type A involves a controlling personality... People are leery of crossing you because of your reactions... There is power in that."

Can a person with Type A personality change?
-Joan

Dear Joan,

There is some truth in what your son is saying. Some. What puts your son at risk is not his Type A personality, but his anger. According to a study published in the March 16 issue of Circulation, anger and hostility raised men's risk of atrial fibrillation - an irregular heart rhythm.

But, according to Elaine Eaker, an epidemiologist who directed the study, some Type A characteristics, such as being competitive or feeling that time is of the essence, were not related to atrial fibrillation.

And yes, anger is treatable. The vast majority of people I have treated who have problems with their tempers have done quite well with a combination of antidepressants, psychotherapy and/or stress management techniques such as meditation or yoga.

But your son's anger isn't the only problem.

Want to know the worst way to approach an angry person? Get into a battle of wills with them by telling them there is something wrong with them and they must change! Your son may very well be a controller and that could be related to his anger. But judging from your argument with him, please consider the possibility that you are a controller also.

I don't know about your son, but I would guess that you are arguing because you are frightened that, because of his attitude and his personality, he might die at age 56. First of all, the fact that he thinks he will die at 56 does not mean he will die at 56. The mind is pretty powerful - but with very rare and dramatic exceptions, not that powerful. As a matter of fact, a study recently published in the journal Cancer showed that optimism had no impact on the longevity of nearly 200 people with lung cancer.

But if I were in your shoes, I would be frightened because I love my child so much and I would feel helpless to stop what is potentially life-threatening. There are few things more difficult in life than tolerating our helplessness in the face of a loved one's suffering. But when we don't tolerate our helplessness, we inevitably try to change someone else. That never works. Never.

I also wonder if your son is angry because he, too, is frightened about the possibility of his death and feels helpless to stop it. So here are two frightened people who love each other arguing about a superficial point, not the more important underlying issues: love, anxiety, helplessness, life and death.

If the two of you could talk about those issues rather than try to change one another's behavior, not only would the dialogue be richer, but you and your son would grow closer. You are fighting with your son because you love him so much. If you just let yourself love him, and open the dialogue about your fears and helplessness, he may do the same. Ultimately, the issue boils down to dealing with death. His death, his father's, and maybe yours.

In the process, please don't make death the enemy. If you spend too much time fighting with your son to keep him alive, then neither you nor your son will be able to experience the love you have for each other. And isn't that what life is about anyway?

Posted on Mon, Apr. 05, 2004
Seeing life in its proper perspective
By Dan Gottlieb

Last week, Sam, my 4-year-old grandson, went to play with his father in a cluster of bamboo growing near a lake in their neighborhood.

Sam has PDD, a developmental disorder on the autism spectrum. As a result, he often sees things quite differently than other children, and sometimes his perception can be breathtakingly clear. This was the case when, while running through the 25-foot stalks, he turned to his father and said: "Oh, Daddy, look how little we are." Sam's beautiful observation about our true position in nature is often forgotten.

As adults, we lose that perspective. We often think that who we are and what we do is terribly important. We live our lives at such a frantic pace that we come to believe everything we do cannot be done without.

When I give lectures, I often ask people if they would be willing to give up one of their activities, other than sleep, and find 30 minutes a day as a first step to reducing stress. Most say they could not possibly imagine giving up anything they do. It reminds me of a story I once heard Leah Rabin tell about her late husband, the former prime minister of Israel, Yitzhak Rabin. She said he would often say: "The cemeteries are filled with people who are indispensable!"

When we are driving or waiting in line and become angry at the person in front of us because we are in a hurry, we assume that we have more important things to do. And our relentless pressure to accomplish more, earn more, accumulate more and be more are examples of how we feel that what we do and who we are have become much more important than the world around us.

What does this do to our children? After all, our children learn from our behavior and not our words.

Over the last several years, I have spoken with hundreds of children about their lives. They complain about relentless pressure to achieve coming from peers, teachers, parents and themselves. These children believe that if they don't get good grades and go to good colleges, they are unlikely to be happy. And how do they define happiness? As you would expect from children, most define happiness in terms of wealth, power and prestige. But what is most striking is that not one of the children I spoke with defined happiness in terms of relationships, love, children or community.

Maybe we're teaching our children the wrong lessons about security and happiness. And why?

Perhaps we have not forgotten how little we are; perhaps we have become afraid of how little we are. So we pursue power and wealth to help stave off those frightening feelings of smallness. Most gun purchases are about making us feel bigger and safer. So are gated communities. The world has become more frightening, and fear forces us to focus on our own interests.

Sure, to acknowledge our smallness is to acknowledge our vulnerability. That's the bad news. But the good news is that to acknowledge our smallness not only takes pressure off, it also acknowledges our relationship with the larger world.

The great philosopher Rabbi Abraham Joshua Heschel said that awe is an intuition for the dignity of all things, a realization that things not only are what they are, but also stand, however remotely, for something Supreme.

When my precious grandson looked at his father and himself and observed their smallness, he felt awe in his heart. Imagine how safe and happy this world would be if we could all feel more awe.

•

My last column was about the health-care system and what I called "medicine's illness." After being in the hospital several days, I had experienced a long wait in the emergency room, mistakes in medication, unclean rooms and other problems. I was grateful that I had received an accurate diagnosis and treatment. But I felt medicine was giving itself the wrong diagnosis. It diagnosed itself as having financial insufficiency and thought the treatment should be more money. I thought this diagnosis and treatment would never heal medicine's malady.

I received over 100 letters and e-mails from patients and members of the health-care community. Surprisingly, many who work in health care thought my perspective was accurate. A bit too simplistic perhaps, but accurate. Lynne Mikukiak of Northern Liberties captured the essence of the consumer community: "Today in my local dog park the talk turned to HMO horror stories," she wrote. "I listened for a while, then asked: 'But what are we going to do about it?' No one had an answer and neither do I. If you or your readers have any ideas about what we can do besides vote for consumer-friendly politicians, please share them."

Dear Lynne: Of course, I don't have the answers either, but I will send my column and some of my readers' concerns to both presidential candidates to find out their position on the illness of health care. I will report their responses back to you. In the interim, your group in the dog park could be the beginning of a small network, which could develop into a larger network which could humanize health care. If you think that's naive, think back to the '60s and '70s when a group of kids developed a network large enough to end a war.

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