Month: April 2016

April 24, 2016

On the Need for Reassurance: What Do You Do After Therapy?


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When we go to the doctor our expectation is to receive a cure: something to finish off the illness. We might expect a similar result from a therapist. He will apply the magic ointment to make our hurt go away. Typically, however, we are not offered a fix with a lifetime guarantee, but guidance in developing a method — a way of living “differently:” a “practice” designed to enable a more satisfying and manageable life.

Perhaps our desire for someone to “make it better” goes back to childhood. Indeed, depending on people is, for many, an endless and desperate project. We look for them to put things right, whether to captain our team, lead our country, or reassure us everything will be OK. Unfortunately, however, there are no magicians, only experts. They cannot be with us forever and, even if they could, our excess dependence would transform them into the human equivalent of a security blanket.

If life is to be lived with adequate confidence we need a method to practice regularly, not another human as our permanent rabbit’s foot or talisman. Not a replacement for an inadequate parent. Not excess dependency, but self-reliance coming from the development of a new “groove:” a repeatedly rehearsed approach to the challenges particular to our life.

How can we carve out such a path?

This is a big question. Usually, however, other questions take precedence. Will I wear out my therapist? Will he leave me? Will he ever say he cares about me in a convincing way?

The unstated belief is that the mental health professional is essential for my well-being; and the hope he will be there as long as I need him. In effect, he possesses the magic, I don’t. You hear this in the lament of the lonely, as well: I cannot do this by myself and my life can only be better when I find “the one.”

Therapists, at least with most of their clients, recognize they need to be transitional objects. A portion of what they do is to enable the patient to develop a method of living designed to make him (the doctor) unnecessary. Put differently, the client learns to master his problems most of the time.

Many patients resist the notion to the point of hoping to become the friend (or lover) of the counselor after treatment ends. Just as we look to our aged parents for wisdom or reassurance, we want not only the therapist’s attachment, approval, and security, but his guidance, as if he can never be replaced, least of all by relying on ourselves.

The idea of “a practice” is not always mentioned by counselors. Oh, the clinician will assign homework, but he might never say homework must continue when treatment ends. Leaving the therapist’s office upon termination is not enough. Rather, the client must continue to do work on himself, climb even higher, take on different versions of the same challenges, and bounce back when thrown to the floor. He needs to remind himself of his strengths, his successes, and what he must do now. This is a practice: “repeated exercise in or performance of an activity or skill so as to acquire or maintain proficiency in it,” according to the Google online dictionary.

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Your program might involve regular, organized self-reflection; journaling, mindfulness enhancement, recitation of those people and things for which you are grateful, time set aside to challenge negative self-talk, a plan for increasing your compassion, writing down all those difficult moments you’ve overcome; and a step-wise, graduated list of challenges you want to take on and a chart of your progress.

You may already engage in other such practices. Daily meditation would be one. Daily reading of passages from a religious text is another. Professional athletes and body builders maintain a regular workout routine, even in the off-season. The goal is to solidify your thought and action, create a habit, improve your focus, rely on yourself, and beat back whatever might encroach on past gains.

One of the best examples of this idea is found in Plato’s Phaedo, the story of Socrates’s last day. Knowing that he will shortly drink hemlock to fulfill the state’s death sentence, it is perhaps unsurprising that Socrates speaks with two younger philosophers (Simmias and Cebes) on the subject of mortality and whether an afterlife for the soul can be foreseen. Despite his attempt at philosophical “proofs” of the likely existence of an eternity, they acknowledge the extent to which they (and we) are like children in search of a magician for reassurance. They despair that once Socrates is gone, no such person will be able to provide his kind of logical, well-reasoned, persuasive confidence in the possibility of a life after death.

Socrates gives Cebes the following advice, as applicable to therapy as to facing one’s mortality in a philosophical way, in both cases to dispatch fear:

What you should do, said Socrates, is to say a magic spell over him (the scared child in each of us) every day until you have charmed his fears away.

Cebes persists, believing only Socrates, soon to be dead, has the necessary sorcery.

Greece is a large country, Cebes, he replied, which must have good men in it, and there are many foreign races too. You must ransack all of them in your search for this magician, without sparing money or trouble, because you could not spend your money more opportunely on any other object. And you must search also by your own united efforts, because it is probable that you would not easily find anyone better fitted for the task.

Thus, Socrates has advised these well-trained philosophers to repeat their own magic spell over the child within them: to seek the wizard in themselves to calm their anxieties by way of what he has taught them and whatever further ideas they can reason out on their own. In effect, to develop a practice maintaining or enhancing proficiency in dealing with this challenge of life.

The proper approach for the therapy patient might be said to take whatever he has learned in treatment and make it a practice. Yes, this is lots of work, but what is the alternative? Life will not hesitate to provide you with more challenges. We stop growing at our own peril, just as the athlete risks getting out of shape by abandoning his practice routine. Concern for your psyche is not like a diet, to be ignored and replaced with poor nutritional habits once the target weight is achieved.

Whether you maintain a practice or not, your counselor will still be there in most cases. But don’t you think you would be more secure by taking your life in your own hands once he passes the baton?

Your therapist does.

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The top sculpture is The Thinker by Auguste Rodin, sourced from Hiart at Wikimedia Commons. The second photo is of Baseball Hall of Fame pitcher Bob Feller.

April 17, 2016

The Challenge of Pain

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Two years ago I suffered from nerve pain of an uncertain cause: excruciating discomfort below the right side of my rib cage, like a burning cigarette against my flesh. I could not sit for more than a few minutes without a growing conflagration. Trying to sleep on my back delivered the same distress. I spent every day and night for a month standing or on my side. Upon making my return to a humanities class I still had to remain upright for long periods on the commuter train, with frequent episodes in a vertical position in the seminar room. Eventually, medication eliminated my symptoms and life went on without ever knowing for certain what caused the problem, even after extensive testing. I’m long past the treatment and the pain, but my experience was a trial.

I cannot draw parallels or contrasts. Not with you or anyone else, except those who suffer worse for far longer. Too many of you, I know. At the time, however, such knowledge counted for little. I lacked a yard stick to measure the combination of severity, the fraying of the soul, the psychological darkness, the difficulty of passing the minutes without counting the time, the presence of a thing I didn’t understand and couldn’t will away. The worst part? Not knowing if the unseen torturer had plans to leave.

As I mentioned, the most acute stage of the process lasted a month and over two months passed start to finish. The physicians were excellent. One idea persisted: not fear of death, but a life of endless illness. I would be ground to little bits like flesh subjected to mortar and pestle.

Pain tests you. You are asked what you are living for. The longer the pain, the greater the uncertainty of its duration, the louder the question.

Time stretches, food becomes a necessity — not a pleasure. Some folks you tell, others you don’t. The best of those informed remain concerned and supportive. A few disappear, usually to protect themselves from your travail and their fear of contagion; contagion of your distress or, just as often, the idea something else will target them.

Illness does not wait until all else in your life is ready to take on the burden. Issues with which you are struggling pile on, like a football team that’s already tackled you and enjoys the thrill of seeing how many bodies can be stacked on top of your own.

Joy flees, laughter is brittle — a momentary distraction. The “tough guy” images on TV don’t help, but suggest everyone else is more durable. The future — imagination of time ahead that would normally give anticipatory pleasure — slips away. All you want is relief. You work to hold on to your self, the one who prided himself in taking on difficult things, facing people, being a man. Self-image alters. Perhaps you are not who you thought you were; or perhaps you were that man, but are no longer.

You lack control of what is outside and what is inside, all except your response. The messiness of the world you thought you organized is evident, like carefully arranged blocks now scattered beyond reach.

What do you hang on to?

For some it is future plans, jobs to be done, achievements targeted long ago. Gratitude for what you still have is a mental weapon pitched at the physical giant set against you. Meditation can be a salve, but only if you are already an expert.

I had an uncle who was so into technology he wished to live to witness how men might change the world. I know of a former patient who stays alive because almost her whole family died in the Holocaust. She will not give away by choice the thing taken from them without choice, no matter the suffering she endures.

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Perhaps you reframe the challenge before you as a test, the way a Stoic philosopher would. They thought pain was something unremarkable because such a time comes to most of us. Greatness, they say, is the product of the bravery you show only when events turn against you, not on the sunny days.

God can figure in, though individuals so sustained would not all give you the same definition of the role he plays. Then there are people toward whom you feel love and responsibility. You persist because of what they mean to you and what your absence would do to them. Made aware of the extent of your distress, they offer support and love more strengthening than water and food.

If, like me, you are lucky, the crisis ends. You recall it, but as an idea, not a sensation. Now, however, you are different. It is time to make sense of what happened, who you have become, and whether you wish to live in the same way, with the same values and expectations as before. You did not predict your response to the pain any more than you predicated its onslaught. One day you were fine, the next day you were not.

My friend Rick wrote a profound comment to my last post: “these are emotions we are normally unfamiliar with until the event happens, and so we do not know how to deal with them.” The surprises of life, especially when they are as terrible as he described (the suicide of his mother), leave us unprepared. Moreover, they can cause us to redefine ourselves. Those who act heroically or stoically perhaps think better of themselves. More commonly, however, we struggle with the blows life delivers and our self-image also becomes one of the casualties or, at least, one of the personality characteristics transformed by our bout with suffering. Perhaps the pain provides an opportunity to grow, but if so, without a guarantee.

You have been marked. Remember, though, that in the Hebrew Bible, there is also a story of being marked. Cain murdered his brother Abel, for which he received the “mark of Cain.” This, however, was not to harm him, but God’s warning to stop those who might wish to punish Cain for the crime.

For the rest of us there is no such indelible symbol evident to the world. Whether God has used a different way to safeguard you is for you to say. For myself, however, I was lucky to have a sustaining love and enough will to keep going. Objectively, the time was short, however much it seemed endless.

True, I know more about human frailty and my own limitations now. I think I am more humane, but do not think me a hero. I wouldn’t have chosen the ordeal had I been promised some great reward for my persistence. Nor would I volunteer for such “learning” again.

We are clay and sculptors of that clay, both at the same time. Its final form, however, is not our work alone. Unseen hands offer their careful, kind, or calamitous touch.

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The photos are of the sculpture, Pain by Antoni Madeyski. The first of these was provided by A blakok. Both are sourced from Wikimedia Commons.

 

 

April 10, 2016

Another Side of Suicide: The Strange History of Punishing the Deceased

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Would you talk to a casual acquaintance about suicide? Probably not. Such weighty conversations most often occur with someone intimate  — a therapist or close friend. Without such discussion, full knowledge of suicide becomes difficult. Moreover, even those who understand the psychology of suicide are unlikely to know its history. They are unaware, for example, that suicide victims in Europe during the Middle Ages were often punished for the act of self-murder.

I imagine you are asking, how can a person who is already dead be punished? Leaving a body unburied was one way. An ancient example is found in the Sophocles play Antigone, where Polynices is prohibited from burial because he participated in a failed revolt against Thebes. The rationale for this disrespect went beyond the expectation of a corpse ravaged by animals: the absence of proper burial would prevent him from going to the Underworld, the Greek’s version of the afterlife.

Of course, Polynices didn’t kill himself. By the Middle Ages, however, Christian clerics ranked suicide as worse than murder. In their opinion, taking the life of another did not rob the victim of his soul. The soul of the deceased was expected to find no difficulty in making his way to heaven. A suicide, on the other hand, killed both body and soul; in effect, a double murder. No room for repentance existed. Suicide was a crime against God.

Local authorities went to astonishing lengths to exact retribution from one who had killed himself. The body was sometimes preserved via embalming and sought to put the deceased’s remains on trial. The corpse might be hanged head down, strangled, whipped, or thrown from his window or roof. Such public displays were intended to discourage others from attempting similar self-harm.

Other punishments included dragging the body by a horse through the street; being pulled apart, burned, decapitated, and quartered; or put into a barrel and thrown into a nearby river, thereby ensuring the remains would be the problem of a downstream community. It was also common for the victim’s property to be destroyed until authorities realized this cruelty harmed the person’s spouse and children. Thereafter, the family received some consideration. Nonetheless, a Christian burial was out of the question.

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Exceptions to the negative judgment of suicide were rare. The church, however, did let the famous strongman of the Israelites off the hook retroactively. Samson’s strength depended on his full and lengthy head of hair. Once the Philistines discovered this (thanks to Delilah), his locks were shorn. Samson was taken prisoner and blinded by his enemies. Some time later, the biblical hero was tied to the pillars supporting their temple and made a spectacle. Unbeknownst to his captors, however, his hair had grown back sufficiently to return his strength. In the act of revenge and suicide, Samson pulled down the structure’s supporting columns, causing the death of all, himself included. The church forgave the suicide by assigning responsibility for Samson’s self-destruction to a divine command.

The religious prohibition of suicide had unexpected and unfortunate consequences. A German jurist, Karl Ferdinand Hommel, described one example in 1766. Hommel realized the Christian position on suicide unintentionally encouraged the murder of children, something he called “indirect suicide.”

According to the jurist, some of the faithful who wished to kill themselves hesitated because they would be damned to hell. More than a few, however, realized they could murder an innocent child and still have time to repent before the public execution they desired, thus achieving their own death without causing eternal damnation. The deceased youngster, they reasoned, would go directly to heaven.

Over time both the religious and the public view of suicide began to change. In some circles, life came to be seen as something belonging to oneself, not to the state or to God. Suicide was increasingly thought of as a mental disorder or a medical problem, not a moral failure, despite lingering negative judgment against it. Laws gradually changed and self-murder became decriminalized. Although the practice of punishing the deceased ended in Europe long ago, not until 1983 did the Bishop of Paris state that self-destruction was no longer a sin, but rather a disgrace. He recommended mercy toward those who committed suicide.

Should you wish to know more about this topic, you will find it in an excellent book used as source material for this essay, Marzio Barbagli’s Farewell to the World: A History of Suicide. If nothing else, Barbagli’s volume reminds us that in a world where savagery still exists, we have nonetheless made significant progress in the name of the living as well as the dead.

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The cover of Farewell to the World: A History of Suicide is followed by Guercino’s 1654 painting Samson and Delilah.

April 3, 2016

Marilyn Monroe and Rachmaninoff: Can Movies Sell Music?

Sex sells everything or so it seems.

My earliest recollection of any connection between sex and music was the 1955 film The Seven Year Itch, with Tom Ewell and Marilyn Monroe. The former imagined seducing the latter when a combination of circumstances fueled his fantasy: a stale, seven-year-old marriage; his wife’s temporary absence; and the availability of Ms. Monroe, his smoldering new neighbor. Ewell’s plan was to use Sergei Rachmaninoff’s Piano Concerto #2 to win her ardor. The scene above depicts his strategy.

Classical music in film usually isn’t intended to engender lust, although the cinematic hit “10,” starring Bo Derek (with Dudley Moore playing the Ewell-like role), gave it a try in 1980, with Ravel’s Bolero serving to keep the erotic pace. Various recordings of the piece dominated the pop and classical charts in the months following.

The use of such music raises the question of whether a movie featuring a classic opus can open the audience to classical scores beyond those pieces featured in the film. Favorites like Richard Strauss’s Also Sprach Zarathustra (2001: A Space Odyssey), Samuel Barber’s Adagio for Strings (Platoon), or Mozart’s Piano Concerto #21 (Elvira Madigan) raised interest in the featured works, but not other selections from the oeuvres of those composers. In light of these failures, should a film be expected to convince a classical newbie to dive deeper into the world of symphonic music simply because of its connection with a single appealing piece?

Let’s start with the music attached to Ms. Monroe and Ms. Derek in the already mentioned films. Does any lonely soul watching Tom Ewell or Dudley Moore think he might achieve his romantic fantasy solely by his choice of CD while on a date? Surely no man with a recording of Bolero or Rachmaninoff playing in his living room regularly brings sex to the mind of women. Thus, a film’s featured sound track, if it is to cause anyone to listen after the cinema’s end, will have to stand on its own. Powerful men have an evolutionary/sexual advantage connected to the need of our female ancestors to find a protector and bread-winner. Contemporary males who listen to Bruckner give their dates no clue to those talents.

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Nor is film likely to create wide interest in classical music without a sexual connection to ladies like the two featured above. No boom in the record sales of Richard Strauss’s other compositions was created by Stanley Kubrik’s use of Also Sprach Zarathustra in Space Odyssey, nor did Mozart’s 600+ compositions fly off the store shelves because the slow movement from his Concerto #21 was featured in an art film hit.

Those who believe cinema might increase the classical audience should consider what must be overcome to do so. Music used in movies competes with dialogue, scenery, and plot for the viewer’s attention. By comparison, the standard concert hall symphonic fare offers no dialogue, no story, and the unremarkable sight of a group of sitting musicians — usually at a distance — fiddling, drumming, and blowing; all dressed in similar outfits.

Music at a concert is supposed to speak for itself, while a movie’s narrative line is intended to transcend the background audio. The implied message is that the score is secondary, designed only to create a mood. If the film tunes are being given second class status by the movie makers, why would anyone believe the rest of the composer’s works were worth their time?

Then there is the obstacle classical music confronts when it is heard by an audience of the uninitiated. The standard wisdom of the crowd is that classical music is “relaxing” at best, boring at worst. If they listen to something attractive on the film’s soundtrack, most may conclude the beauty or excitement is an anomaly, nothing like the standard classics they know or think they know. Surely this belief doesn’t spur the listeners to explore beyond a particular piece that, for them at least, is the exception proving the rule.

One more challenge stands in the way of the film-goer’s transformation from someone who doesn’t listen to many classics to one who does: effort. Anyone who wishes to learn to love the classics must put in a good deal of time. The Beethoven Symphony #5 takes somewhere in the neighborhood of 35 minutes no matter what. A Rodin sculpture, on the other hand, can be observed for whatever unit of time you wish to put into the examination. Concert promoters do what they can, but they cannot generate motivation or cut the score without mutilating the art.

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Don’t underestimate the effort required to become a convert to an unfamiliar art form, even in the case of visual art. Chicago’s grandly successful and much visited Millennium Park was expected to generate increased attendance at the nearby Art Institute when the former opened in 2004. The failure to achieve the expected bump in Art Institute admissions was “a puzzle” to the museum because the art repository was only one block from the new outdoor venue. Perhaps part of the answer then, is that movies are movies, paintings are paintings, and Bolero’s ability to attract an audience guarantees no crossover even to another of Ravel’s famous works, like La Valse. Those who go to a public park want a park experience, not one authored by Van Gogh. Those who visit a Chinese restaurant aren’t looking for pizza.

Presenters have added movie screen close-ups of the players to the concert experience, big screen painting reproductions to enhance performances of Pictures at an Exhibition, iPads to provide a technological jump from the old style paper medium of program booklets, and lectures before concerts to tell the audience what they might want to notice when the program starts. In the end, however, do these produce the “buy in” intended? Doesn’t the music live or die on its own merits?

Concert promoters have tried about everything to expand the audience for the classics, with questionable success. What can one say that hasn’t already been said? Two things:

  1. In the words of impresario Sol Hurok, “If people don’t want to come, nothing will stop them.”
  2. If you have a seven-year itch, try some talcum power.

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Following the scene from The Seven Year Itch is a poster from the movie “10” featuring Bo Derek. The bottom image is the Crown Fountain (facing Michigan Avenue), part of Chicago’s Millennium Park.