A Lesson in Depression

     When I was in graduate school I learned a lesson about depression from a very dubious source.  One evening I was looking for something to do and I strolled over to a dorm to see a girl I knew.  I arrived too late and she had already gone out for the evening, but her roommate Marilyn was getting ready to go out.  

     It’s important to know that this was 1974 and at the height of the women’s movement.  It was also a college that was 70% women.  The women on that campus, felt very empowered.  I knew that Marilyn was going out to find a man to bring back to her room.  Being a friendly fellow, I decided to inquire as to how she went about this. 

     “Marilyn, when you go into a bar, how do you pick out a guy to bring back?” 

     “That’s easy William, when I go in, I look around for the most depressed guy in the bar.  He’s the guy I go after.” 

     “Really!”  I didn’t understand her thinking.  

     “William, you should understand this.  It’s Psychology 101.  A depressed guy wants to be happy.  He believes if he makes me happy, I’ll make him happy and take away his depression.  He makes a great lover, because he will stand on his head in order to please me.”

     Immediately I recognized the wisdom in her thinking.   She taught me an important lesson about depression and people pleasing.  People pleasing, is a curse for most people.  People pleasers have little confidence.  However, there are some advantages to people pleasing.  One of them would have been running into Marilyn, when you are depressed and sitting in the corner of a bar.  

Spirituality and Fibrilation

I consider myself very spiritual.  I’m not very religious, but I am spiritual.  Religions dictate what is acceptable behavior.  Whereas, spirituality dictates from within.  Spirtuality is the belief that we are made up of energy, inside a physical body.  Pierre Chardin once said, "We are not human beings having a spiritual experience.  We are  spiritual beings having a human experience."  My family history is filled with spiritual experiences.  They have had a huge impact on my thinking.

My Grandmother was the first to influence my belief in spirituality.  She was old and wise and loved me.  She would talk to me about life and death.  She told me about the death of my grandfather.  My Grandfather had leukemia and died in the hospital.  She had just visited him.  She sat down in her bedroom and looked over toward the door.  There, in the doorway she saw my Grandfather.  He looked healthy and strong and smiled at her.  He was only there for a moment and he disappeared.  The phone rang.  He had just passed away.  He died a moment before he appeared in the doorway.  I believe that she saw him.    

My other experience was with my father.  Three days before he died, his heart went into fibrilation.  Fibrilation is rapid irregular contractions of the heart muscle.  Treatment requires that they shock the heart, once to stop it, and then shock it again to restart it.  After the event, the doctor explained to us what had transpired.  He assured us that my father was totally unconscious and would not have felt anything nor would he remember anything.  

The following day Dad was again conscious and alert.  “The funniest thing happened to me yesterday.  I was in bed when all of a sudden I felt really strange.  A buzzer went off and the staff started running around me.  Then, they shocked me.  I felt this incredible jolt of electricity going through my body.  The next thing I knew, I was up in the corner watching them.  I could see myself as they all ran around me.  Then they zapped me again and I was back in my body.”  

I remember my mother and I looking at each other in shock.  He had told us that his spirit left his body and then re-entered it.  I suppose we should have doubted him.  Others would tell us that his experience was just electrical stimulation in his brain.  But my mother and I had no reason to doubt him.     

These two experiences stick me with a belief in the spirit.  When the closest people in your life describe having experiences out of their body, it is compelling.  For me, it helps explain life.  

Enabling: First Installment

Addiction and enabling go hand in hand.  Working with addiction, without working with the family is cutting my own throat.  As long as there is someone supporting the addiction (consciously, or unconsciously), the addiction will persist.  Carl Whitaker believed that if you can stop the enabler from supporting the addiction, you’ve done your job.  In reality, it is half the job.  You still have to contend with the addiction. 

I think Enabling has gotten a bad rap.  Enable actually means “to make able,” and that sounds like helping to me.   Helping is not a bad thing?   Helping others is a virtue.  Then how do we distinguish between helping that is positive versus negative.  My favorite illustration comes from parenting.  If I pick up my 1 year old when he falls, I’m being a good parent.  However, if I pick up my 21 year old every time he falls, I am doing him a great disservice.  He needs to  learn how to pick himself up.  

Enabling is doing something for someone that they could do for themselves.  If you are picking up your 1 year-old, you may be doing something for him, that would be difficult on his own.  When you pick up your 21 year-old, you are cheating him from accomplishing something that he can do for himself.  

A great example came at the end of a family session.   A young man who was addicted to substances had completed the rehab. program and was about to be discharged.  We were having a final session.  Near the end of the session the mother asked me if she could pose a question:  

“He has asked me to buy him a car.  He says he’ll need it to get to meetings, therapy and a job.  Do you think I should buy him one?”

“Have you ever bought him one before?”  

“Yes, many times.”

“Excuse me?”

“I think I have bought him six cars over the years.”

“Where are all those cars?”

“He cracked them all up.”

“Then I would consider buying him a car like playing Russian Roulette.  One of these cars is going to kill him and you don’t know which one.  Drive him to his first meeting, let him raise his hand and ask for rides from the people in the A.A. meeting.  They love to help each other.  Buying him another car would be like putting a gun in the hand of someone who was suicidal.” 

She probably bought it for him.  Unconsciously, she was killing him, but neither of them knew it.  She may not have been able to resist buying it.  It was wired in to her to help her son.  Remember, enabling is generated by love.  Helping our children is built into every specie.   What person wouldn’t want to help their loved one.  

I don’t like the term “tough love.”  It has too many negative connotations that go with it.  I avoid the term.  However, the person enabling the addiction needs to be motivated to change.  Acknowledging that enabling is generated by love, is tolerated by most family members that enter my office.  

“I know that you love him/her.  Don’t stop loving them.  I just want you to think of a new way to show it.  The way you have been showing it isn’t working.  It contributes to killing your loved one.  They need you to find a new way to love them.”   

Doing the Dishes with Love

When I was first diagnosed with cancer, I consulted with several doctors for their opinions.  I wanted to know how I got cancer and how to get rid of it.  Generally, they all had the same treatment plan, but none of them could tell me how I contracted prostate cancer.  

This was a time of a lot of self reflection.  I was faced with my own life and death issue.  Anyone who has ever experienced this moment knows what Tim McGraw means when he says, “live like you are dying.”  It changed how I was thinking.   I spent considerable time going inside and looking at myself.   I wanted to face my demon.

I took responsibility for getting cancer.  I was told I was wrong.  I was told to accept it.  They said, “shit happens.”  I did not believe that for a moment.  In my thinking, my mind, body and spirit had to be aligned to let in cancer.  I recognize that I am not responsible for the biology I was given, only what I do with it.   I used therapy to work on it.  I talked to the cancer in my body.   I had dialogues with it.  I asked it where it came from.   A memory came back I had buried.  

My early 40’s was a tough time.  We were raising kids, I was trying to make a career, we had a house to maintain and it was a huge amount of work.  After the kids were asleep and my wife fell asleep, I still had to bring up the wood for the wood stove, set a fire that would last all night, feed the cats, turn off all the lights, lock up the house and finally do the dishes.  Through my immaturity, I became resentful that I didn’t have my own time to work on my own stuff.  When you are a therapist, and you give all day, you need time by yourself  to recharge the batteries.  I would stay up later and later to have time by myself and then I was getting less sleep and then I was more angry.  It wasn’t that I didn’t love my family.  I loved them with all my heart.  I was angry at the circumstances of my life.  I was angry with me.  

I can remember thinking, “Is this it?  Is this all there is?  If this is it, I don’t want to do this for 40 more years.  At that very moment I gave myself a message that I didn’t want to live.  I believe that this was when I let the cancer in.  

I knew I had to change my attitude.  If I was to survive I had to change my perspective on my life.  I could no longer afford to be resentful of doing the dishes and all the rest.  One night I decided that if I looked at those dishes and felt resentful, I would leave them for the next day.  But if I could do them with love, I would clean up the kitchen.  Over time, this commitment to only do things with love, grew.  I applied it to other aspects of my life.  I quickly realized that I was doing the dishes more often.  When I approached them with love for the family, it was easy to zip through them.  

I doubt that there are any, oncologists that would agree with my diagnosis.  Andrew Weil, M.D. once told me, “It’s easy to get cancer, harder to get rid of it.”  Getting rid of it meant working on my body, my mind and my spirit.  I know that I needed medicine to conquer my cancer, but my spirit had to believe in it and want it.  

Stop Bending my Finger

For seventeen years, my principle responsibility was Director of Family Services in a substance abuse facility.  The experience shaped what I know about addiction.  Addiction can be very difficult to understand.  I want to use the next few blogs to talk about addiction.  Why would someone take a poison, hoping to make things better, when it only makes things worse?   

The word addiction comes from a Latin root meaning “to dictate?”  This makes sense. When someone becomes addicted they are owned by their addiction.  The addiction tells them what to do.  The classical definition of addiction is: “slavery to a pernicious habit, especially that of certain drugs.”  

However, I found that this information is relatively useless, when sitting across from a 10 year-old who wants to understand mommy’s behavior.  I needed something more to help the child understand.  In his/her mind, “if mommy loved me more,” she’d be able to stop.  “Why isn’t my love for mommy enough?”  

Addiction is not about logical behavior.  Continuing to put a poison in your body, expecting things to get better, is not logical.  Addiction is about feelings and emotion.  People use drugs to feel better and they work.  If you put a drug in your body, for some period of time, you may feel better, or at least you won’t feel your pain.  Addiction is about feelings and sensation, not about being rational. 

Therefore, using a kinesthetic (sensory experience) explanation captures the essence of addiction.  I use two metaphors:

“When we ask your mommy to stop using drugs, it would be as if we asked you to stop breathing.  Can you imagine what your first reaction would be?  Are you crazy?  I can’t get along without breathing.  I need breathing to live.  I couldn’t possibily stop breathing.  That’s what it’s like when we ask your mother to stop using drugs.  Inside she feels like she wouldn’t survive without using her drug.  We know that isn’t true, but that’s what it feels like to her.”

The second example actually incorporates the horror of addiction.  I tend to use this with older children:

“Imagine for a moment that I was to take your pinky and started bending it back.  Imagine that I just kept bending it and bending it.  After a while, the only thing you would be thinking about is how to stop this fool from bending your finger.  You wouldn’t be thinking about your parents or your friends or your school work.  The only thing you would be thinking about is how to stop the pain in that finger.  That’s what it is like when your parent gets up in the morning and they are addicted.  The addiction makes them uncomfortable and all they can think about is how to stop their pain.  It isn’t that they don’t love you.  They love you just as much as they ever did.  But they can’t think of anything except how to stop their pain.  The problem is that the only thing that will stop their pain, is more of the drug that caused them the pain.  They go on using, day after day, in order to keep the pain away.”

If using more of the drug is what will make the pain go away, how does anyone ever get away from the drug.  Recovery from addiction requires feeling the pain, facing the hurts you experience and you gave to others.  Recovery forces the addict to stop running away and feel their hurts.  That’s why it is avoided by so many addicts that never get recovery.  The pain caused by the addiction is not as profound as the pain they experienced in their life and family.  

Understanding Carl Whitaker

           I first met Carl Whitaker when I was an intern at Elmcrest in 1975.  I had no idea who he was, other than he was billed as the “Grandfather of Family Therapy.”  He lectured in the morning,  did a demonstration with a real family, then finished off the day talking with the audience.  As a 24 year-old student of psychotherapy I was flabbergasted.  He was the most grounded and grown up man I had ever met.  He talked about being a person with the clients.  His demonstration was amazing.  I felt totally in sync with what he was saying.  When he was done, I was surprised to find how many people didn’t understand him, agree with him, or like him.  They didn’t get Carl Whitaker.      
              Many people don’t get Carl Whitaker.  He spoke in primary process.  He talked about the family in ways that would take you there.  This meant that he spent a lot of time in the right side of your brain.  Sometimes I accused him of doing hypnosis and putting us in a trance.  But he denied knowing anything about hypnosis.  His style of talking wakes up the unconscious.  
              One time he asked me if I knew why I could do “his stuff?”  I didn’t have a clue.  I just knew that I understood him.  He said, “It’s because we don’t need them.”  He went on to talk about how we both grew up on farms.  We were isolated on the farm and we learned to be with ourselves.  I don’t know if he was accurate regarding me.  But this was a man that was at peace with himself.       
            I had monthly supervision with him for ten years.  I attended all of his conferences that were close by.  And I know that I captured him as a foster grandfather when he did a therapy session with my brother and I after my mom was murdered.  I was honored when I got a call asking me to be a moderator for Carl at his next workshop.  The job was to sit with Carl on the stage and interpret what he said for people that didn’t understand him.  I agreed with some reservations.  The idea scared me, but I agreed because any time I got to spend with Carl was special for me.    
                The night before the workshop I had a nightmare.  I dreamt that when Carl lectured, I didn’t understand anything he said and I was totally embarassed.  The feeling of fear stayed with me into the day.  I told Carl about the dream when I arrived.  We both chuckled at first.  Then he was more direct.  “No one is going to remember what happens here today.  You are going to be up there with me.  Just enjoy it.”   It was a great thing for him to say to me at that moment.  I went on the stage with the sole expectation that I would enjoy the day.  One more time I would get to work with Carl.  
               Then my worst fear came true.  I didn’t have a clue what Carl started lecturing about.  It was something he thought of at 4 A.M., that didn’t make any sense at 9 A.M.  I laughed at myself and recognized that my mind was just living out my dream.  But then when he took the break at 10, numerous senior clinicians were coming up to me asking me what the hell he was talking about.  No one else understood him either.  
               Creativity results in you having both good and bad ideas.  That morning, Carl’s creativity took over.  His thoughts that morning may have been absolutely brilliant, but I'll never know. 

Post Infusion

It was 1997.  I was sitting on the back deck, when I received a phone call from the doctor.  Unceremoniously, he told me that I had cancer and to let him know when I wanted to do something about it.  I was diagnosed with an aggressive form of prostate cancer.  I was shocked.  My wife was shocked.  To be told you have cancer is like getting sucker punched.  The next few nights I spent talking to my Higher Power.

I couldn’t go back to that doctor.  His coldness scared me.  I started doing my own research.  Over the next few months, I elicited several “second” opinions.  I was surprised that none of the doctors could actually tell me how I contracted cancer.  I finally asked one of them if I could have gotten it through voodoo.  He assured me that voodoo had nothing to do with it, but he offered me no credible reason why.  Without any viable alternative, one can speculate that voodoo may have been involved.  

I had a prostectomy at Yale.  It was a powerful experience because in my mind, I was saving my life.  They took out my prostate and I assumed the cancer with it.  However, several months later my PSA (prostate serum antigen test, used to measure prostate cancer) started climbing.  After all I had been through, basically they were saying, “oops, we didn’t get it all.”  I was advised to have radiation treatment.  After 30+ radiation treatments I was again told, “oops, we didn’t get it all.”  I asked what next and was told there was nothing next.  I was to wait until I was really in trouble and then they would poison me with chemotherapy. 

Well this didn’t sound very attractive to me.  In my own sophomoric fashion, I decided to take over.  I felt responsible for conceiving cancer, so I would be responsible for eliminating it.  I remember at the time talking to Andrew Weil, M.D. about my plan.  While he supported it, he also added, “It is much more difficult to get rid of cancer than to get it.”  That didn’t stop me.  I changed my diet, my exercise routine, my spirituality, and my entire view of life.  I started going to Bikram Yoga almost two years ago, which was great for my body.  It got me ready for the ordeal ahead.  But the most important thing that happened was a change in my thinking.  I began to live like I was dying.  The result was that for over 15 years, I kept the cancer growing slowly.  In addition, I did a much better job of taking care of myself.  My family, friends, and especially my wife were an incredible help with this.  But this past summer, it got out of the box.  A number of events happened all at once.  

Sloan Kettering and Hartford Hospital joined forces.  I was approved for a new treatment regime that had been developed by Sloan Kettering.  I would receive hormone therapy and chemotherapy at the same time.  They had found that this was vastly more effective.  We planned to start the chemo therapy after my daughter Kelly’s wedding in October.  

From October through mid-February I received chemotherapy, or as they call it ‘infusion.’  Every three weeks I would get a new dose.  The following week I would feel terrible, the second week a little better, than the third week, almost normal.  Then we would go back and start the process all over again.  The negative effects were cumulative.  It was a horrible ordeal.  The treatment team at Hartford Hospital did their best to make me comfortable.  But most of the time I just felt terrible.  My energy level was gone.  I had constant physical problems.  I started to look like Uncle Festes from the Adams Family.  I see ads for chemicals that cleanse your body and I chuckle.  You haven’t had a cleanse until you’ve had 5 months of chemo.  Its like having a very caustic detergent being flushed through your veins periodically.  I finished the chemo treatments in February, yet the affects are still with me.  I still look like Uncle Festes.  I’m still tired and achey.  But everything is slowly getting better.  Despite my whining, I know that I had it better than many chemo patients. 

I am told that they can no longer find any evidence of cancer.  I am officially in remission.  I’m good for another 10,000 miles.  Now I can focus on healing from the chemo, getting my body back and taking back my life.  

During this period of time, we were relatively isolative.  I did work in the office, but avoided social events.  We were worried about compromising my immune system during treatment.  In addition to avoiding social events, I avoided talking to friends and family.  Much of the time, I didn’t have the energy to do any more than I was doing.  People that knew what I was going through sent me love.  But I still needed to isolate.  This was something I did for me.  I could’t risk any negativity getting in my head.  In the late 90’s when I told people about the cancer, I was sometimes confronted with people who believed it was a death sentence.  Not knowing who would say what, I avoided most everyone in my life except for my clients, my closest friends and my family.  I avoided both the positive people and the negative people in my life.  However, it allowed me to remain confident that the treatment would work.  Everyday I told myself that the treatment was working.  

With chemotherapy behind me, I wanted to let everyone know what happened.  Once my picture appeared on Facebook, we started getting more inquiries.  I might as well let everyone hear what happened all at once.  So, this is also an open apology to those who felt kept out during my ordeal.  I can understand your frustration with my lack of responsiveness.  You have a right to feel left out.  I hope you will understand how I made this decision.  

Everyday feels special.  I acknowledge and appreciate the love that has been around me.  It is a gift I have been given.  And everyday, I will try and earn it all over again.