"On Healing" April 2007

Posted on Mon, Apr. 30, 2007
Va. Tech tragedy and the need to be secure
By Dan Gottlieb

In the two weeks since the tragic massacre at Virginia Tech, we have learned a great deal. We learned that Seung-Hui Cho had been troubled his whole life and that, despite several attempts, the mental-health system was not able to provide the care he needed. We learned that he was bullied and that no one helped. We learned that in Virginia, as in many other states, guns are readily accessible.

But we did not learn what we really want to know:

How can we find security in a world that feels increasingly insecure?

Security is a fundamental human drive, more primitive and primary than even love. The shootings violated our sense of security, so some things will change. Most will not.

We are increasingly security-conscious as a nation and as individuals. Gated communities have cropped up in pursuit of security. People are buying handguns for security. We push ourselves and our children relentlessly - also about security.

Yet most people still don't feel secure because the kind of security we really want doesn't come from alarm systems. What we want is the feeling of security we experience at a gathering with people we deeply care about and who care about us. Or the feeling we experience when we are so devoted to someone or something that we temporarily forget our own needs.

More metal detectors and better-trained campus police are coming, along with ever-louder debate about gun laws. And although it has become evident that the mental-health system, both public and private, is woefully inadequate, that probably won't change much. Why?

Dramatic change requires more than money and legislation. It requires changing our thinking about how we care for people with psychological problems. Ultimately, it challenges us to change our thinking about how we care for one another.

I attended a lecture in Philadelphia several years ago by Deborah Prothrow Stith, associate dean at Harvard medical school and an expert on youth violence prevention. She was the mother of young children, and pointed out what may seem obvious: Most of her time, energy and resources went to them. It's just a fact of having children. She went on to say that if she did not invest her resources in her children when they were young, they would require even more as they got older.

It seems that her prediction is coming true on a national scale. Leisure time at home with the kids is decreasing. So-called entitlement programs that take care of young children and families are shrinking. At the other end, violent killings and prison populations are growing.

As individuals, we must invest more time and energy and resources in all of our children. We know there are many small children out there who feel alone, isolated and uncared for. If everyone could find an hour or two each week to invest in children, it may just change the world.

We don't know what would have happened with Seung-Hui Cho if more adults had shown a genuine interest and perhaps protected him from bullies as a child. But we do know there are many more children out there who need that kind of help.

Two hours a week at a local elementary school or boys and girls club can change the world. Not only that, but a personal commitment to helping our nation's children will expand our own networks of people we care about. This alone will enhance that feeling of security.

And for the children?

Every person I've met who overcame great adversity as a child has told me that at some critical point, there was someone who believed in him or her. I wonder if Seung-Hui Cho had one.

Posted on Mon, Apr. 16, 2007
Fear can remain long after its cause
By Dan Gottlieb

Dear Dr. Dan: My husband wants a child, and I am ambivalent. I am not sure I would be unhappy with a child; I might accept him and bond with him, but I might also resent my husband if it becomes difficult to deal with or if I end up doing the majority of child care.

Another factor is that I have been dealing with a low-level depression for years, and I am afraid of how this might affect a child's character and the quality of care I could give.

Until now, I've tried to accommodate my husband's wishes, without ever being sure how I would feel if we actually had a child.Anonymous

[I wrote back asking for more information because the letter talked mostly about her fears - she never said what she wanted. The response, below, suggested to me that her history needed to be addressed before she could face her future.]

I would like to heal from my childhood, I'd like to be taken care of, not have to take care of another's needs. I was sent to boarding school from the time I was 8 years old until I graduated high school. There were no parental figures; I was unable to make friends, and I was alone. I still cry any time I talk about it. I would like not to be sad anymore.

I am afraid of being responsible for a child's happiness and for screwing it up, although I know that all parents can't help but screw up and scar their children at some time.

I love my husband, and I care about his happiness, but I hold myself back a little all the time, expecting to be hurt or abandoned again. I feel terrible that I may take away something that he wanted so much (a child).

Dear anonymous,

When you talk about what you truly want, everything changes.

Sometimes childhood wounds become embedded deeply in our psyche and seem to take control of our lives. I can only imagine the great fear and sadness that you felt as a child sitting alone. Logically, one might say that so many years have passed, why does it hurt now?

The abandonment may have been back then. But fear stays. It sounds like much of your life has been about your fear of again experiencing that terrible pain from childhood. To manage your fear, you protect yourself by not opening up. This is natural, and it makes sense. We all do it to a certain extent. As much as we wish to be fully understood by others, we are equally afraid to open ourselves up all the way for fear of rejection. But the greater the fear, the more we protect ourselves - and the more alone we feel.

Understanding the cause of your anxiety hasn't helped. So consider this possibility: The issue that most affects your life is not fear of being abandoned; it's fear of repeating the emotions you had many years ago. The problem is that all of those emotions are still living inside you. As a child, you needed great care and compassion. You still do, and it must begin with you.

You started the process by holding off on your decision to have a child and by writing this e-mail. Next, I would recommend psychotherapy. It provides an environment that feels safe and nonjudgmental, allowing these very scary emotions to gradually come out. Once you are able to fully feel these emotions, painful as they may be, you will no longer be afraid of them. The process requires courage, unyielding compassion, and care for yourself.

Once you've had those experiences, the pros and cons of this decision will probably be more clear (although making the decision may not be any easier). You may or may not choose to have a child, but let your choice be based on your wishes rather than your fears.

Posted on Mon, Apr. 2, 2007
They're choosing the life that remains to them
By Dan Gottlieb

If you were Elizabeth Edwards; if your raison d'etre were to change the world by electing former Sen. John Edwards president of the United States; if you discovered you had Stage 4 metastatic breast cancer; what would you do?

It's always easier to focus the debate on someone else, but let's say you've just learned that your time on this planet will now be measured in statistics and probabilities, and the data are grim: A very small percentage of people with (your disease here) live a decade. Would you continue your work and live the same way you always have?

Maybe you would change your life dramatically to do what you've been postponing for years. Or maybe, as most people fear, you would fold up your tent, get inside, and wait to die.

"Elizabeth Edwards is setting a powerful example for a lot of people," White House press secretary Tony Snow said a day before announcing his own surgery for what turned out to be the most advanced form of colon cancer. Snow immediately decided to take time off and devote all his energies to fighting the disease. Very few people actually fold up their tents in the face of tragic news. Given the choice of life or death, we choose life.

A close friend called a few years ago to tell me she had developed a lump in her breast that was probably cancerous. She had already had cancer in the other breast and now was facing a double mastectomy. "I don't think I can go on like this, it's just too difficult and the future is so bleak," she said. I sat quietly for a few moments, knowing better than to try to talk her out of that early anger and despair. And then she asked if I knew a good doctor. We may rail against the injustice, we may face the unknown with confusion or dread, but given the choice, we choose life.

Most healthy people I know don't consciously choose life. They tell themselves the life they are living is in preparation for a future of less stress and more happiness. A man with terminal cancer once said to me: "I feel like my whole life has been a dress rehearsal for this moment." When not forced to choose between life and death, most people simply don't. Their real lives, after all, are just around the corner.

So what would you do if there were no corner?

Many have told me that, in the moment of crisis, something opened up inside of them. Of course they felt fear and confusion, but life and its meaning became clearer. When John and Elizabeth Edwards lost their son in a car accident 11 years ago, he gave up a lucrative law practice to run for the Senate because, he said, he wanted to devote his life to making the world a better place.

Several years after I became a quadriplegic, I accepted that my time on this earth would be much shorter than I would like it to be. I decided that, in the time that remained, I would do whatever I could to make the world more compassionate for my grandson, indeed for all children of the future. Then, two years ago, I faced surgery from which, realistically, I might not have awakened. In the silence of my hospital room only hours before the operation, I wondered: If I survive this surgery, would I like to do anything differently with my life?

For me, the answer was no. I felt I was living a meaningful life that brought me joy and humility, and I would be deeply grateful if I could simply continue living as I had. In the moment I realized how fragile life is, I also realized how precious it is.

Many years ago, I took a course on mindfulness meditation. A fellow student had metastatic breast cancer. When we chatted at the end of the program, I asked her why, given all the things she could do, had she signed up for a course like this? "All my life, wherever I was," she said with a warm, gentle smile, "I was always somewhere else. In the time I have left, I want to be where I am."

I imagine Elizabeth Edwards and Tony Snow have a pretty clear sense of what their lives are about. So in the face of limited time, what did they do? They chose life.

What would you do?

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