Sunday, November 20, 2016


                                  SOMETIMES, REPRESSION IS NECESSARY FOR PEACE OF MIND - 

Across the oaken table from me in the Refectory was a priest in his mid-eighties who has had a distinguished and memorable career in leadership, scholarship and fidelity.  But he profoundly disturbed me when he “opined” that we were witnessing the death throes of the Religious Community to which we both belong. He pointed out that we will have no ordinations this year nor the next nor the next. We have ONE novice and four students spread over a four year theology course.  With such a poor backup in the manpower pool, and with a graying, arthritic priest population, the prospects of staffing the Community in the future look bleak.

Yet, the relatively young and recently elected President of this particular Community writes that hopefully we are on the brink of one of the most glorious eras in our history.  This strikes a somewhat dissonant chord in my own aging brain. Are we dying or are we about to blast off the launching pad into unforeseen glory?  The old timer bases his dreary prediction on numbers and observable facts while the comparative youngster enthuses and hopes from a speculation perspective.

 What is one to make of this?  Is it just an old man spewing sour grapes and a young man just bouncing off his fantasies and wishful thinking? Is it again the old man dreaming revisionist dreams and the young man seeing visions of what he hopes will be so?  I don’t know but suppose that the old man is right and the young man knows, unconsciously, the truth: demise is near and inevitable.            What does the young man do? How does he as leader inspire enthusiasm in his troops? How does he fire up morale? Indeed, how does he live with himself if he senses that he is presiding over an increasingly moribund situation? And this  in spite of the raucous cheerleading on the sidelines?   

Does he take semi-refuge in the theological speculation that God might raise up groups for a specific time and role in a specific era to meet a specific task and let them lapse into extinction when their need is no longer present or pressing?  Or does he hustle around trying to find some palatable, Couesque, self hypnotizing mantra that we are getting better every day in every way (as the ship sinks)?  How would he or any other human being survive in the face of the painful and traumatic?

On Feb. 23, 2003, the New York Times ran a lengthy article on Repression airing the new and provocative hypothesis that, contrary to the Sacred Cows of the Psychotherapeutic Community, it is sometimes far better to avoid, deny or repress painful, traumatic or threatening material. Those of us who were trained within the last 40 years had it drummed into us that it was essential for the emotional and mental health of our patients that they face, embrace, and dissect   traumas, fears and perplexities with full scale enthusiasm. They were to throw their emotional guts right out front, pick them up and regurgitate again and again. Only then would they be free people   --- so went all the hoop-la- and badda bing, badda boom, badda bing.

Yet with all the academic and clinical pressures from colleagues and mentors, something just didn’t wash. We all saw some of our patients come back unchanged again and again in spite of all the embracing of pain and sorrow and anger. In fact, consonant with the Times article, it seemed almost as if the focusing - - even riveting - - -  fueled the problems. It kept the problem front and center which demanded more time, more concentration, more energy funneled away from enjoyment of one’s life. 

A 43 year old student of mine who was supposed to be centering on learning the art and science of counseling was intently hooked on the recollection of her being sexually molested, thirty years prior. She insisted on “ talking this out” in personal therapy, lectures and supervision hours.  She was personally unattractive, unmarried and uninteresting.  Her ONE claim to possess the spotlight was the telling and re-telling of her unhappy childhood experience. Her life centered on having others listen to her sad story as she eked out of anyone she met any possible shred of sympathy for  “ poor me.” Meanwhile, life was speeding by her. She angrily resisted any suggestion that she might MOVE on in her life. But she seemed almost to enjoy her misery. Is this healthy?

In the movie, ANALYZE THIS, which was about a Mafia boss in therapy, the psychiatrist is presented as having two verbalizations with a self pitying client. One, the public one, was the  standard Sacred Cow  response of empathy and understanding.  Two, interiorly and truthfully, he said:  “ Why the_____________, don’t you get yourself a life?”

We are seeing in many patients, a PROLONGATION of pain and trauma, when we allow the endless and narcissistic wallowing in the traditional  “ pity pot.” We are called to be healers yet it does look, in some instances, that we are enablers. It would be far healthier--- at least in some patients---- to put the lid on the pain, do a spot of repression, denial and avoidance, and GET ON WITH IT!   There are so many wonderful, awesome and fulfilling things in life which are available but which need attention and energy. To substitute the almost maternal offerings of our offices for the really satisfying possibilities of the real world is tantamount to alchemy! God forgive the therapist who stokes the patient’s fire of self pity and fear for financial rewards! Although hopefully infrequent, it has been known to happen. 

Allowing a patient to give disproportionate attention to a past trauma - - - with full awareness of the research on PTSD (post traumatic stress disorder) -- - - can actually harm a person’s healthy development since it places TOO much of a patient’s personal failures on someone or something else.  A therapist can never forget the lesson of Shakespeare:  ‘ THE FAULT, MY DEAR BRUTUS, IS NOT IN THE STARS, BUT IN OURSELVES.” It can get too comfortable in the chair or the couch when one can blame one’s failure in life or unhappiness on something other than self.  

Incidentally, on 9/11, we had one therapist for every three persons. It has been noted that there was NO appreciable help from these offerings. Support came from the GROUP feeling and the camaraderie of all of us involved in Ground Zero. I have pushed some of my own patients to get on with their lives and DO something rather than sit in my office and have me hold their hand even figuratively!  Even Sig Freud noted that catharsis alone was probably useless at best and harmful at worst.

Still, the hypothesis remains. FOR SOME PEOPLE, repression and denial may be essential for their peace of mind.
For example, some uninformed and insensitive hospital chaplains have insisted on brutally telling ALL terminal patients that they are dying. This is poor practice and fails to note that SOME terminal patients NEED to deny their own deaths. This negative procedure is more for the chaplain’s need to feel that he is doing his job. The role of the helping person is to help - - - not to hurt !! Surprisingly, denial and repression are sometimes a real way to help the hurting one. Let the chaplain find some other mode of resolving his own hang-ups. It might be helpful to  recall  that (at least theoretically) the chaplain, the therapist, the priest  are there for the good of the “ other”. The patient is not supposed to minister to us but we to them.

So, if the young President of a dying religious Community finds it too painful to face the brutal truth, who can blame him for his avoidance? By the use of repression he can continue with enthusiasm and energy, to find some kind of meaning in what is truly still available. We all can do it, with God’s help, and some of us can bite our tongues as we thank the New York Times for at least occasionally publishing something of value.

p.s. this was written over ten years ago (2016).  Some of the observations are  in sync with certain levels of  the fixed and immutable in human nature and derive from the essence of natural law, but some  observations reflect  the unpredictable possibilities for change so inherenrt in human nature and  behavior.  Plus ca change, plus le meme chose! 
                                     An  aha moment 

For  two long,  frustrating and demanding years, I had been instructing a  brilliant young Jewish woman in the  mysteries of the  Catholic Faith. She was  too bright for me. At every turn she would clean my clock intellectually in spite of  all my fancy syllogisms, theology and history.  I could get nowhere with her.

However, somewhere in her soul or psyche was a kind of gnawing  wish for some sort of Faith. She was an agnostic, leaning slightly towards atheism but too intelligent to accept it.  She, somewhat irked with me,  asked was there anything further I could offer her. In desperation , I volunteered what she called a stupid prayer. The prayer of the atheist.

                           Oh, God, if there  is a God, help me !

Some time later, she wrote me that she had been to a movie which she had to leave. She was experiencing the most urgent  need to find a Catholic church immediately.  On entering the Church, she genuflected and when her knee touched the floor she was flooded with a belief in God  which she has deeply retained to this day  when she is now 80 years old.

Basically, this was a moment (to me) in my life I could call  “a ah—-  out of the blue— cloudbursts of joy—-elation—-cataclysmic  surprise——-floating on air— bring me giants to slay—.   A moment  never to be repeated  but never to be forgotten. A moment when the Lord used me to help a good person move towards Him——but in His, not my, way..

Certainly,  for her it was THE  ah ha exprience.  To meet the Lord  not through human strivings or skills, but through something simple,rustic and even stupid like  The Atheist’s prayer.”  There is a lesson to be learned
               I Asked  “why” on Visiting an Alzheimer’s Patient!

Although it is extremely clear to me that asking “why” in the face of the terrrible negatives of life, is futile and even stupid, I still have the surging unconscious roiling within me that struggles to emerge  with shouting and symbolic fist thumping.  I know well that angrily responding to negatives  with a furious why is no route to resolution and peace of mind.  Yet I still do it! I scream affectively to the Lord:  “Why do You allow this to go on? Why do You allow such obscenities to happen at all? These good innocent people—what did they do to deserve such a gruesome finale to their lives?  Why? Why? Why?

I know cognitively it is in responding to the how that I can carry on with peace of mind..   How will I deal with this huge pain (of whatever stripe it might be), is the mature and efficient response.  This is the sensible question,This has  to be the mode  for successful resolution.  I  know this  but I, with multitudes of others,feel the opposite.

With such a cognitive/affective  psychic makeup, I recently visited  a relative in a dementia facility. She is advanced in the disease, unable to read, write, watch television, use the  telephone or carry on a conversaton more than a few words. Her day is eating,sleeping 14 hours a day  and looking vacantly out at some far distant horizon which only she can see. When she does try to talk, it is with a painful  groping for words—-and she will stop and say “I don’t  know what I am trying to say.” Or she will engage in what sounds like incomprehensible babble.

It is exceedingly difficult and unsettling to see this woman who  attained two degrees from an  ivy league school in such an infantile  state..A  woman  who ran complex  nursing departments  in a large New york city medical center…a woman who was charming, easy to meet and a facile conversationalist. ,  Now she was unrecognizable, a puzzlement. A substantively “different” (?) human being. A caricature!

She is replicated multiple times in her fellow “residents” who stare and sleep and eat and drool and spout sounds or words with no apparent  connection to the environment they are in. They rarely truly speak. They look emptily at others. They do  not know the names of their fellow patients and seem not to care.  If anything would fascinate them,it would seem to be food which has apparently an almost hypnotic appeal for them.

The over all atmosphere ,then, would be depressing—even in the best of these  dementia worlds.  This faciity which  is operated by nuns, is superior to many I have seen. It is clean  and bright. A chapel is provided for daily Mass if they could remember what a chapel might mean! Programs are offered  with some limited succcess  but also with a bit of unreal  expectation from these poor people who are confused, angry, afraid, lonely, and debilitated and whose capacity  for real response is seriously limited. The spectrum of the disease is wide, but no matter where the patient is placed on that line, it is sad and unsettling.

Basically, the problem is organic. That is to say that there is  a serious physical deterioration in the brain which makes it impossible to retain data or information stored in the dendrites.  Memory facility is methodically  destroyed until there is nothing left but a vegetable state awaiting death. There is no cure. (As of now)  All one  can do is  stand by and watch  and  do what one can to make life easier for the patient and assist his passage to His Lord.

The atmosphere is bound to invade the souls of the residents.They  all seem to break into passivity, their wills look broken.  Perhaps, this is caused by the heavy unending, unyielding  sameness of routine and the powerful insistence of the”Staff” to obey.  Perhaps it is caused   by the inevitable array of medications they all take daily, not only for specific illnesses but for some kind of  “management” medication. In any event,  there  is much  empty gazing, much nodding off  and much waiting for meals or bedtime. 

Prima facie, one asks —why should this go on? For what purpose?  Is there any real meaning in this terrible panoply? If one is basically pagan, there is little reason to continue this debacle. Progressive governments are already seriously discussing ways—-with humane methods, of course  -  of “terminating” the useless, expensive, time consuming procedures needed to take care of this  non-productive population. Kill them!  Mercifully, but kill them. It is effective and better for them in the long run, anyway. However find another, less threatening word than “kill”  but which has the same imperative to do the job.

Parenthetically, a kind of reasoning,  somewhat similar yet different, is used to justify the brutality of killing young humans in the womb.”It is expensive to have babies. It is very inconvenient now. It is an
encumberance  to us who have to do the caretaking. We don’t  want this additional burden.Times are tough enough.”  And endless variations on these themes.

For a believing Christian, however, there is a huge  transcendental truth running through all of this.   Namely, every single human being, regardless of age or physical condition, or mental disfunction or socio-economic status, or race or religion  or education or political affiliation is a true child of Almighty God Himself. Each is to be treated as such regardless of anything. Control of Life and its expectancy belongs to Him.  It is His Call as to when life shall cease for any child of His. There is (generally) no justification to take anyone’s life—that prerogative belongs to the Creator Himself. 

Street assasins, thieves, cartels, angry husbands and frustrated wives, blood thirsty military leaders lusting for personal glory, all violate the sense of the sacred about human life. Society  has always considered Murder  as one  of the extremely serious offenses which oppose God’s will and the rights of Man. Everyone has the right to life, young and old, and even those should be protected who cannot defend themselves in the womb! Euthensia and abortion,  when stripped of the  buzz words, are unjustly taking human llife..Some will label it more clearly,  murder!

No matter how inconvenient the  “dementias” are or can be,they are His children and they must be protected and cared for.  They cannot  be simply ”terminated”  by a deluded  and sometimes evil government! 

But where do the carertakers fit into this scheme?

Does any one tell us of their spiritual life ? Those who feed and clean and clothe and watch the mentally ill?—Have many seen the patience and care and the love  nurses and aides give to these unfortunates?  It is generally more than a job. To see the tenderness in word, action and mood is an inspiration.  To see the staff move into the “world” of the patient  with the more than infrequent unreasonable demands, calls to mind the mandate of the Master……”…whenever you did it to one these, my least brethren, you did it to Me…”

I saw them caress those sad persons from whom  others  (even families) flee after a perfunctory visit, their consciences temporarily salved—- leaving  a cheap box of candy  to show how caring they are! The caretakers are there  24/7—often frustrated themselves,  elated when  they see the dementia people light up at the attention and  saddened when they get little or no response.  

It is more stressful  than caring for a baby where one gets joy and fun. It is a difficult ministry,  (an appropriate word description especially for  caretakers with a spiritual dimension)   which  carries the ever present mood factor of death ——which can come at anytime. Several times I have seen a blanket covered body being taken out by  black suited, business like funeral directors. But no matter what! It is the Human Famify Under God.  It is the duty of  all of us to defend and protect life—-
Do we take the lives of criminals?  Do we kill each other in wars? Is it moral?  Serious  reflection and prayer and awareness  are needed to resolve and understand the huge mysteries of life. Others, more talented than  I, must wrestle with the wider picture. I, as one little human being, simply react to the inexplicable fact of  dementia and pray the Good Lord to  give us insights so that we can respond as loving Christians at least to  this one terrible imponderable.

written  in New York City, 2016, at  the age of 95.