"On Healing" October 2004

Posted on Mon, Oct. 18, 2004
Tough inner critic fosters low self-esteem
By Dan Gottlieb

Hi, Dr. Dan!: My father, who committed suicide about seven years ago, always viewed me as his competitor, and continually sought to kill my spirit. I still can't get my brain around why any father would do this.

Apparently, he did a pretty good job. Every time I was feeling good about myself, and said so, his response was, "Self-praise stinks!"

At this point in my life, I'm chronically depressed, I have a mild case of OCD (Obsessive Compulsive Disorder), and I feel like life is a train that left without me long ago. I have tried many antidepressants, but they all turn me into a sexless cipher. I'd rather be depressed than feel nothing.

Any thoughts?
Ron

Dear Ron: The story you tell identifies low esteem as your problem and your father as the cause. That may or may not be accurate. It may be a story that you have long told yourself to organize your thoughts and emotions.

Consider this: your problem may not be low self-esteem but critical self-judgment. So the problem is not about who you are, but how you perceive yourself.

Tara Brach, in her book Radical Acceptance, tells a story about a middle-aged woman caring for her dying mother. At one point, the mother said: "all my life I have felt there is something wrong with me. What a waste." She died several hours later. The revelation of her inner critic was her final gift.

Another issue I wonder about is that of hope. That's right, hope can be a problem. Many people hope that if they beat themselves up enough, they will become better people. But what if you have no hope? What if you can be the person you are now - without the self-criticism? Then you might see yourself as wounded and struggling, just as many humans do. You might feel less alone and more a part of humanity.

Speaking of misguided hope, there is one more area that may apply. Part of you may still be trying to convince your father that you are OK. What would happen if your father really died? I imagine that finally saying goodbye to this man would be terribly painful. Battling him is a way of avoiding this profound grief.

Of course, your father injured you. But I believe he also suffered terribly for probably his whole life. The vast majority of people who commit suicide do so because of a severe depression that has been untreated. Your father's anger at you - really, anger at himself - was a symptom of his depression.

And speaking of depression, you know more than most about how painful and dangerous depression can be. If your children suffered from a clinical depression, I am sure you would urge them to get help. Well, I am doing that with you. Try medication again. See a good psychiatrist or psychopharmacologist, recommended by your family doctor or another knowledgeable person. The better ones are quite skilled at managing dosage and side effects, and combining the newer medications. There might be some side effects, but you might experience great relief from your pain. And not to do this might risk your life.

I would also strongly recommend psychotherapy. Not only does the combination of psychotherapy and medication help most of those with depression, but you could work on many other important issues with someone who is smart, caring - and not critical!

One other thing. People who suffer the way you do are at risk of becoming self-absorbed. That's because any pain demands attention. My concern is that if you spend too much time living inside your mind - generally a dangerous place - it can worsen your self-esteem. I believe one way to feel better about yourself and your life is to help other living things. Spend some hours each week trying to diminish the pain in other people's lives. Often that is the best way to see what is happening inside your heart.

By the way, about that train that you felt has left you? Do your work, take your medication, be more kind to this fellow named Ron, and then go to the train station. There will be another train coming along shortly.

Posted on Fri, Oct. 15, 2004
A story of anger, sadness
By Dan Gottlieb

When I heard the news of Christopher Reeve's death, I felt great sadness, fear, anger and some loneliness.

Only quadriplegics and their loved ones know what we go through. Christopher Reeve died of an infection related to a decubitus ulcer. Most are unaware that we get these ulcers (also known as pressure sores or bed sores) from sitting in one position for up to 18 hours a day.

Most also don't know about the wild fluctuations in blood pressure or the bladder infections or of the consequences of catheters or the difficulty regulating bowels or the violent spasms that can wreak havoc with our daily lives. Most just think we are paralyzed and would like only to walk.

Personally, I don't care about walking. I have a pretty nifty wheelchair that takes care of that. But if someone could find a way to make my bladder work, now that would change, and certainly prolong my life.

My story can be repeated for everyone who has spinal-cord injury. It can be repeated for anyone who has diabetes, Alzheimer's, Parkinson's, or all of the other illnesses in which stem-cell research could have an impact. When it comes to diabetes, most of us think they just have to test their blood, watch their diet, and take their insulin. We don't know about the wounds that don't heal, the blindness, amputations and often premature death that often go with diabetes. We don't see the suffering.

And the suffering sometimes becomes unfathomable. Not just for those with these horrible illnesses, but for their families. For the rest of my life, I will be haunted by the look in my parents' eyes the first time they saw me in a wheelchair. I hope no one suffers like they did. But they will.

When Reeve died, I felt sadness in the same way a soldier must feel when a friend dies in combat. I lost a fellow quadriplegic - a fellow warrior. He was a man about my age who lived with his injury for nine years. I've lived with mine for 25. That's why the sadness. That's why the fear. But I am not so much concerned about me. I've had 25 years to accommodate this disability. My fear is for those behind me.

I recently saw a 16-year-old boy for consultation. He had been a quadriplegic for six months. His young mother accompanied him and both looked dazed. But I was most struck by the beauty of his innocent face. He told me that his girlfriend had left him, and he cried when he said he would never know what it would feel like to make love or dance at his wedding.

Nevertheless, the consultation went well. He asked me many questions about how I managed my life and for the first time since his accident, he felt both understood and hopeful. I showed him around my house, invited him to see my van, which was adapted so that I can drive independently.

At the end of the consultation, he smiled for the first time. He was truly grateful for what he received and said so as he and his mother turned toward the door. As I heard his wheelchair go down the hall, instead of feeling gratification, I wept. I cried for all of the suffering I knew he would endure.

And why am I angry about Reeve's death? I'm angry because we have policy being made by the Bush administration that is based on personal religious dogma and rubber stamped by an obedient Congress. Decisions are made which honor only one's personal beliefs and fail to make genuine eye contact with those who suffer. Sen. John Kerry talked about using stem cells from frozen embryos, and not the destruction of life. President Bush clings tenaciously to his beliefs and turns his back on everything else.

Stem-cell research is not a miracle. But it does offer hope to those who suffer that tomorrow can be better than today. And most of us who suffer aren't asking for miracles. We would be happy with one extra year of clarity, the ability to heal a skin wound more quickly, or even a working bladder.

Like George Bush, I pray. So now I will pray that no other parents have to experience the agony my parents lived with.

Posted on Mon, Oct. 04, 2004
Lost in a techno trance
By Dan Gottlieb

For 10 years now, you have been hearing Dan Gottlieb write about compassion, insight and reflection. Not today. I've had it! Kindness doesn't cut it, so I will try the more direct approach: "Wake up, people. You have drifted into some kind of bizarre, machine-dependent self-important trance."

Here's the deal. I am sick of going to restaurants and sitting alone while my companion is learning that her cousin from Cleveland just discovered a hemorrhoid. Or that someone's 35-year-old daughter is struggling to get a baby-sitter so she can go out that night.

Now there's something we have forgotten - the meaning of a real emergency. I recently called the marketing director of a hospital. Her machine said: "I can't come to the phone now - but if it's an emergency, you can call me at...." Could someone tell me what a marketing emergency really consists of? If you are a surgeon and nick an artery, that's an emergency. Hemorrhoids? Baby-sitters? Marketing? Not emergencies.

And I have a special message to my friends who keep sending me copies of e-mails about how precious life is and how we need to spend time enjoying nature - spend time actually enjoying nature rather than reading about it, and STOP SENDING ME E-MAILS.

Speaking of computers, I think there is a special place in hell for people who invented instant messaging. When I am on my computer, I am usually working and would rather be somewhere else. So when I am sitting there writing a column or lecture, and I have a precious moment when my mind is focused, someone will inevitably pop up on my screen and say: "Whaddya doin?"

I've been troubled by the use of technology for a couple of years. But when I recently had dinner with a friend, I realized everything was getting out of control. After he sat down, he removed from his belt a cell phone, a pager and a BlackBerry. I thought we were having dinner, and all of a sudden I felt like I was in a conference room!

But here's what pushed me over the edge: Last week when I pulled in for gasoline, the attendant approached me while he was on a cell phone. I said to the person I was talking to: "That's it, everything is out of control and I have to write about this. No one is talking to anyone anymore." Then I fell silent.

The person I was talking to was on my cell phone.

Jung said that which we hate is part of us. I am not angry at you (well, I am), but I am angry at me. Because I have become one of them. I check my e-mails before my first cup of coffee, and if my mind wanders for a millisecond (which happens about every four seconds), I've checked my e-mails again or my voice mail. Many things conspire to turn that millisecond of distraction into 45 minutes. So work that used to take me one hour to complete now takes double that time.

And now, my daughter has introduced me to the world of wireless. This is really cool. So now I can sit out on my back deck and work on my computer. But it is on my back deck where I love reading books and looking at the birds. But now I answer e-mails. And sadly, I answer those e-mails on my deck because - well, I don't know why. Like most of us, I have fallen into the trance that tells us if we return calls in the car, we will be free when we get home. Or if we get to our e-mails now, then we can relax. Never works, but you already knew that.

I usually conclude my column with some helpful hints about what can be done to resolve the problem I've just talked about. Not today. No, no advice. For me, I have to decide whether to visit my therapist or reboot my brain. But for now, I think I'll rent the Matrix trilogy again.

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