"On Healing" December 2004

Posted on Mon, Dec. 20, 2004
When life throws you a wicked curve
By Dan Gottlieb

Dear Sam:

You frequently ask why I'm in a wheelchair. When I tell you my legs don't work, you ask why.

Because you're only 4, I have tried to give you explanations that can make sense to you. But here is the real answer: 25 years ago today, I kissed my wife and my two daughters (your mother) goodbye and walked across a newly frozen lawn to my car to go to work. Those were the last steps I ever took.

Two hours after that walk across the lawn, the wheel of a tractor-trailer hit my car. In that moment I became a quadriplegic. The last thing I remember was that big black thing in the sky coming toward me. That big black thing changed my life.

Since that day, I learned that almost everyone could point to a single event that permanently changed their lives. It could be a divorce, a diagnosis, or the sudden death of a loved one, but at those moments, lives are forever changed.

And inevitably when that happens, we all want the same thing; we want what we had yesterday. That's often true even if we thought we were unhappy with our lives.

Most of us live with the thought that we have a road map. Even if we are unhappy, we have a sense of who we are and what our lives are about. We assume that life is relatively predictable and that tomorrow will be pretty much the same as today. But when trauma happens, we lose our road map.

When I had my accident, my greatest pain was that I couldn't figure out who I was or where I belonged. I was now different from my friends, family and colleagues. And when I heard a doctor refer to me as a "quad," I realized I now belonged to a group I didn't want to be in. Sam, this sense of not belonging caused me terrible pain.

I recently interviewed a woman named Jackie for a radio show. She had been diagnosed with AIDS seven years ago. When we spoke, she said she had known that she had AIDS for over 20 years, but waited to be diagnosed. She said she knew because in the past, she had been an intravenous drug user and all of the people she shot up with had died of AIDS.

When I asked her why she waited so long to get diagnosed, she explained that, as an African American, she already felt disenfranchised, and, as a substance abuser, she felt even more isolated. She was afraid that if she also carried an AIDS diagnosis, she wouldn't belong to any group anymore. She would have rather died than become completely disenfranchised.

Sam, when we experience a life-altering event that is not our choice, most people try to clutch on to the old road map and rail against the gods of fate that caused this change. I certainly did. For the first several years, I was frightened and insecure. Then I became severely depressed. I felt lost, hopeless and worthless.

And most of all, I felt utterly disconnected from the larger world. All I could see was who I was not and I was unable to see who I was becoming.

And then the telephone began to ring with patients asking me to help them. In the ensuing hours, days and months, I grew to understand that the help I gave my patients had nothing to do with my ability to walk; it was about my heart and mind. And in that work, I found my connection to the larger world.

Psychotherapy and medication helped with the depression, but I never would have rebuilt my life without those telephone calls.

There is an old Sufi saying: "When the heart weeps for what it's lost, the soul rejoices for what it's found." On the other side of despair, we can discover life anew.

Shortly after her diagnosis, Jackie became an outreach specialist for "Philadelphia Fight," a comprehensive AIDS service organization. She uses her own experience to support others when they first get diagnosed. For the first time in her life, she feels good about herself as a contributing member of society. At the end of our interview, she said: "Heroin almost took my life, but AIDS saved it."

Sam, sometimes a road map, even a harmful one, can help us feel that life is predictable. It can give us a feeling of identity and security. But sometimes that same road map can prevent us from becoming who we truly are.

Love,

Pop

Posted on Mon, Dec. 06, 2004
Self-criticism never a good thing
Self-assessment is healthy; angrily berating one's faults is destructive.
By Dan Gottlieb

Dear Dr. Dan: I am the parent of a fairly impressive 14-year-old. She plays violin and piano, reads three or more books at a time, and writes enthusiastically. Her fault? Self-criticism.

While my husband asserts that criticism helps us grow and achieve, I am suspicious and try to refrain from overly harsh criticism whether or not it is true. My daughter tends to overlook her many strengths and focus on her weaknesses. Sometimes when she practices the piano, her whole body language screams "I STINK." I am afraid that too much self-criticism can be debilitating.

I would love to hear more on this subject. We need to be critical of ourselves so that we can get the most from life, but not so critical that we make ourselves miserable.
- Concerned Mother

Dear Concerned Mother: Some anxiety actually improves performance (more so for boys than girls). In moderation, it can provide motivation, and help focus the mind. But too much anxiety interferes with performance.

Self-criticism is another thing altogether. The internal voice of self-criticism is generally an angry and judgmental one. Think about how you feel when you experience self-criticism. Now recall the voice of a coach or teacher from your childhood who really believed in you and gave you incentive to perform. Think about how you felt when you heard that voice.

I am hard pressed to imagine self-criticism ever being a good thing. Certainly, self-assessment is important. But the part of your mind doing the assessment could be friend or foe. If you like the person you are, your judge will tend to be more like your supportive teacher. But if you are unhappy with yourself, your judge will be neither objective nor kind - and will vary day by day, depending on your mood. This part of your mind that is passing judgment - I wouldn't trust it very much.

Recognize that most of us who are self-critical expect too much of ourselves.

Which brings us back to your daughter. When a 14-year-old says "I stink," it may just be a sign of adolescence or frustration. But if there is a larger pattern of self-deprecation, it could be an early sign of depression. Obsessing on one's performance could also be an early symptom of an anxiety disorder. The most important factor to watch is whether she seems happy with her life.

Of course, there will be moments and even days when she is frustrated, but if there seems to be an overall pattern of unhappiness, please consult a mental-health professional who specializes in children. Even if you are seeing early symptoms of depression or anxiety, both are treatable, especially with early intervention.

Most parents who witness their children's self-criticism instinctively try to change their thinking. Many say things such as "you are being too hard on yourself." This is not helpful. When you challenge her thinking, you are really criticizing her for criticizing herself. Of course, I wouldn't want you to just agree with her criticisms, either.

Perhaps you could share how you feel when you get angry at yourself. Then try to understand how she feels beneath her frustration. Maybe that way you could help her find different ways to express her feelings without turning it on herself.

Like many people, your daughter may not be aware of her gifts. Most children that age are self-absorbed. And the more they focus on themselves, the more unhappy they become. Try to help her get off the performance merry-go-round. Spend time with her doing things that give you both pleasure.

Also, it is healthy and important for families to get involved in the larger world. Many times people learn what they can do through performance. But they learn who they are from helping others.

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