Basic Trust

“Ultimately, there can be no complete healing until we have restored our primal trust in life.” (Georg Feuerstein, 1947—2012)

“Love cannot live where there is no trust.”  (Edith Hamilton, 1867—1963)

I look at my new grandson, sleeping, eating, eliminating, crying, opening his eyes while slowly processing the sights, sounds, smells, and textures of a new and unfamiliar world, helpless now, helpless for many weeks and months to come.

Helplessness is the primal life experience.  The infant, who can only protest and wait, must rely upon the benevolence and attentiveness of the surrounding caretakers.  For an infant, being wet, dirty, hungry, thirsty is beyond personal remedy.  And it is from the earliest life experiences, when those needs are met, that a child begins to develop trust in their world.

Psychologist Erik Erikson, known for describing 8 stages of development covering the lifespan, called infancy the stage of Basic Trust vs. Mistrust. An infant learns trust when breasts and bottles appear on time, when diapers are changed as needed, and solace is offered in times of distress. If an infant’s needs are met; if when hungry . . . fed, if when dirty . . . cleaned and changed, if when crying . . . comforted, and if when tired . . . helped to sleep, that child will develop a basic trust in the benevolence of their world.

Unfortunately, for some, life begins very differently. Too often, in my practice, I saw children who as infants were neglected or abused.  Rather than beginning life surrounded by caring and trustworthy others, basic needs often went unattended. The world, as they first experienced it, was a hurtful and unreliable place to be. Understandably, from early life experiences, they learned to see ‘caretaker’ others through lenses of doubt and suspicion.

Mistrust persists.  For the child who began life mistreated and mistrusting, years later, even caring adults are perceived as anything but caring. A child who mistrusts is a child who is alone and frightened. A child who mistrusts feels that they must fend for themselves. Do something, do anything, rather than feel helpless.

These children will adopt a variety of strategies to feel in control. Some learn to provoke, for it is better to be in control of the time and place of mistreatment, rather than have no control or warning.  Some children will invent an explanation for their mistreatment, usually self-blame.  “I was mistreated because I deserved it.”  It is better to have a reason, any reason, rather than none at all.

Some of these children learn to mask their feelings, concealing from others the turmoil within, for others cannot be trusted to understand the internal chaos and darkness.  As they grow, some will continue to mask feelings by numbing with drugs and alcohol.  Some will ward off feelings of loneliness and helplessness by finding safety in numbers, often affiliating with gangs or cults. Some become like the bullying adults, controlling their inner turmoil by controlling weaker others.

To trust or not to trust, for the infant, that is the question. The question is answered during the youngest years of life.  That answer can last for a lifetime.

I look at my new grandson, helpless, trusting.

Parenting the Intellectually Disabled Child

When a child is intellectually disabled, the demands can become exhausting. Marriages become stressed. There is significant impact upon siblings, as parent time is often consumed by the excessive needs of their disabled child.  The challenges are chronic, the demands are life-long.

A child with intellectual disabilities needs devoted parenting and a team of helping, supporting adults including educational specialists, behavioral specialists, and medical specialists skilled in working with this population.

In my practice, I saw many children with intellectual disabilities.  They came to see me for a variety of reasons; disruptive behaviors, impulsive behaviors, and occasionally destructive, aggressive, or self-injurious behaviors.  These children were vulnerable to depression and anxiety.  Sometimes, because of their diminished cognitive capacity, these children came to me overwhelmed, in a state of panic, some even hallucinating.

Early in my career, I’d had very little training working with these kids. What I learned, I often learned on the fly.  However, over the years, through the many conversations I had with these parents, I compiled a set of parenting tips:

·       There is a fine line, balancing hope and reality.  It is important to determine what is and what is not within your child’s capacity.  It is okay to expect a lot, just not the impossible.

·       Don’t cripple your child with pity, pity for them or self-pity.  Set goals. Have rules and expectations.

·       Siblings may feel over-burdened with responsibility caring for a disabled sibling.  They may feel deprived of parent time and attention.  However, they may also develop a deep sense of compassion and caring for others.  Be sensitive to their feelings and demands.

·       Live your life as fully as possible, attending not only to the demands of your special-needs child, but also attending to your other children, your partner, your spirituality, your friendships, your interests, and your health.

·       Don’t isolate yourself or your child due to shame or embarrassment.  Ignore the looks of others.

·       Network with other families and support groups.

·       Implement a well-conceived behavior modification plan.  Seek professional assistance if-needed. 

·       Encourage acquisition of good communication, to the maximum of your child’s capability.  Seek professional assistance if-needed.

·       Encourage social participation—in special camps, in Special Olympics, etc.

·       Teach your child traits of good character—kindness, honesty, perseverance, courage.

·       Encourage the acquisition of independent living skills to the maximum of your child’s capability.

·       Teach and expect chores and jobs around the house.

·       Encourage and support the development of employable skills.

·       Plan ahead for your child’s emerging sexuality.  Have clear and concise rules about appropriate and inappropriate behavior.  Supervise the environment, allowing your child access to media compatible with intellectual and emotional maturity, not physical maturity.  Define and enforce rules of modesty and privacy in the household.

·       Monitor phones and computers. Protect your child from potential predators.

·       Plan ahead for your child’s adult care, legal protections, and financial needs. Begin this process many years in advance.  Seek out organizations and support networks that can assist you through this daunting task.

I often witnessed in these parents a great deal of courage, dedication, and love for their children. I hope that, over the years, my tips helped some of these parents to navigate their challenges with a bit more direction and confidence.  Whatever I was able to teach, I know that I was taught as much or more in return.

Economics

When my son was little, in his infinite curiosity he would spend hours asking the question, “Why?”  Just when I thought I had given him the answer, he invariably asked another, “Why?”  One day, trying to be patient, I answered a long string of whys.  Eventually, I stumbled upon the answer that seemed to satisfy his need to know, and my need to explain.

“Daddy, why?”

“Son, economics.”

And thus, I discovered The First Law of Economics:  If the question is why, the answer is economics.  Wars are fought because of economics.  Candidates win or lose elections because of economics.  Star actors and athletes are obscenely overpaid while star teachers remain obscenely underpaid . . . and why?  Economics.

Personal choices are the result of economics.  Most every choice we make, we consider in the balance.  What’s the price?  What’s the prize?  Is it worth it?  Can I afford it?  Or as advertisers like to ask us, can I afford to live without it?  It’s human nature to want to get the most for the least.  We search out bargains.  We buy a dollar lottery ticket with the outside hope of winning millions.  All of this which leads me to The Second Law of Economics:  People want the greatest prize for the lowest price.  Corollary to the Second Law:  Advertise either the low price of having, or the high price of not having.

In medical practice the price and prize is eruditely referred to as the risk-benefit ratio.  Any medication, any medical procedure, has possible risks and side-effects that must be weighed against the potential for benefit.  There is no medicine and no procedure that comes risk-free.  Every prize has its price, which segues nicely into the often ignored Third Law of Economics:  There is no free lunch.

No matter the prize, there is a price to avoid . . . the compromise of one's beliefs and principles.  Few prizes, if any, justify the cost of sacrificing personal integrity. Over the years, I have observed this Fourth Law of Economics: The greatest threat to beliefs and principles is poverty and wealth.  The Fourth Law of Economics paraphrased:  Money, too much or too little, tends to corrupt.

I started my blog 4 ½ years ago, one week after I began my retirement.  Monday, after 4½ years of retirement, I go back to work.  Don’t ask me, “Why?”

40 Principles of Parenting*

There are hundreds of books offering advice to parents.  The books range from the very straight-forward to the very philosophic.  Some provide a general overview of parenting. Others are written about children with specific challenges. Some are practical how-to books.  Others tend to focus on the parent-child relationship.  There are so many books because there are so many parents asking questions and there is no one right answer.  When it comes to raising children, there is little scientific consensus.  There is mostly opinion.

I taught a course on parent guidance to young doctors.  In this course we reviewed many parenting books, good and bad.  Though each author had a unique perspective and opinion to offer, there were themes, ideas about ‘good parenting’, that seemed to reoccur through many of the books.  From this, my class distilled 40 principles of good parenting.

This is likely the longest blog I’ll ever write, but it’s far shorter than the book I had intended to write.  I once thought I would write a book based on these 40 principles.  Well, here are those principles, given to you in their bare form, without the commentary or illustrative examples that I would have included in my book. Yet, for those of you who are parents, I hope you find this list helpful.  Feel free to delete from the list any principles with which you disagree.  Please add to the list any additional principles you’ve discovered and embraced in your parenting journey:

Principle I:  Parents must provide children with the basics; food, shelter, medical care, and a safe/protected environment.  All other principles are secondary and contingent upon this first.

Principle II:  Parents should provide leadership.  Good leadership is calm and confident.  Leadership remains so even in the face of challenge and crisis.  When parents scream, threaten, nag, or hit, credible leadership has been lost.

Principle III:  Parents should model what they teach.  Model character.  Model willingness to change.  I have heard it said, “If you don’t model what you teach, you’re teaching something else.”  Parents model for their children ‘how to be’, how life is meant to be lived.

Principle IV:  Parents should raise adults.  It is the task of parenting to prepare children to become independent.  Give your children the opportunity to develop skills that will lead to competence.

Principle V:  Parents should avoid, when possible, win/lose battles with their children. Children who win these battles become insufferable.  Children who lose these battles become sullen and resentful.  Parenting is not a contest of wills.  It is a journey of parent and child together.

Principle VI:  Parents should remember to use the wise words, “go play” with their children. In other words: turn off the screens go outside, go exercise, go use your imagination.  Go find the resources within yourself to be entertained, to wonder, and to explore.

Principle VII:  Parents should raise children with encouragement.  Parents must convey a belief in their children’s capacity to learn, to grow, and to accomplish.  Parents must discipline with a tone of encouragement, "I know you can do better."  Parents must find ample occasions in which to give praise.

Principle VIII:  Parents should strive for consistency.  Parents are human.  There will always be good days and bad.  There will always be situations better handled or poorly handled.  Consistency means that despite the everyday ups and downs, there remains a consistent set of beliefs and guiding principles.

Principle IX:  Parents should be flexible and creative.  Different situations, different circumstances, different ages may require different responses.  What works with one child may not work with another.  What works at one age may not work at another. A common error is to keep trying to do what has already been proven not to work.

Principle X:  Parents should talk to their children about being part of a family. Families are interdependent systems.  Parents lead the family, but like the engine of a car, there are big parts and little parts. For the engine to run properly, each part must do its job.  A family relies upon one another, and every job is important to the function of the family.

Principle XI:  Parents should respect and value their children.  Children are not property or baggage.  Treat children not as ‘its’ but as ‘Thou’s.’

Principle XII:  Parents should attend to their children’s character.  Make ‘being good’ more important than ‘being happy’.

Principle XIII:  Parents should provide their children with a moral compass; begin with the Golden Rule, “do unto others.”  A religious parent can teach a child the moral precepts of the faith.  A secular parent can teach a child the principles and morals that guide the family.

Principle XIV:  Parents should make rules and expectations that are simple and clear.  Plan and discuss rules, expectations, and consequences in advance.  Set age-appropriate limits.  Encourage children to participate in the planning.

Principle XV:  Parents should make consequences proportionate to the misdeed.  When possible, allow natural consequences to follow.  When necessary, make consequences follow logically from the misdeed.

Principle XVI:  Parents should negotiate with their children, increased privileges for increased responsibility.

Principle XVII:  Parents should avoid too much talk and negotiation when implementing consequences.  Implement consequences calmly and firmly.

Principle XVIII:  Parents should utilize time-outs for both children and themselves.  This is a time to cool off, to think and to reflect.  Rather than lash out, rather than let your amygdala do the talking, say to a child, “I need time to get my thoughts together”, “I’m too angry to speak right now”, “I don’t want to say something now I’ll regret later”.  Don’t react. Don’t try to reason with a child who is in an unreasonable frame of mind.  Talk will usually escalate the situation.  Wait until everyone has cooled off.

Principle XIX:  Parents should turn mistakes and misdeeds into learning opportunities.  It is far more important that children learn from mistakes rather than how children are punished for mistakes.  Discipline, as in the word disciple, means to learn.

Principle XX:  Parents should make their children not just the problem, but participants in the solution.

Principle XXI:  Parents should, when possible, give choices, not ultimatums.

Principle XXII:  Parents should model good communication with their children.  They must be fully present.  Put down the electronics.  Make eye contact. Speak to children at their eye level.

Principle XXIII:  Parents should acknowledge with empathy their children’s challenges but remind their children consistently that challenges are different from excuses.

Principle XXIV:  Parents should encourage their children to do even better, but not so much as to lead to excessive frustration and failure.  Teach children that challenges are not to be avoided.  Challenges are there to accept and embrace.

Principle XXV:  Parents should avoid the overuse of bribes.  This includes star charts, stickers, and other forms of ‘rewards for good behavior’.  Avoid raising children who automatically ask, “what’s in it for me?’

Principle XXVI:  Parents should discipline. Discipline is different than punishment.  If a child sets out to learn to play a musical instrument, discipline means practicing 15-minutes every day.  It may be boring.  The music may not sound good at first.  Scales are no fun.  But if you stick with it, the music begins to sound better.  Stick with it over time and you may become a musician.  Punishment is “you’re grounded for not practicing.”  How many times you’re grounded matters little.  Whether you had the discipline to practice is what will count in the long term.

Principle XXVII:  Parents should be forgiving of their children and of themselves.  We are all imperfect.  We all struggle.  Most times we and our children do the best we can.

Principle XXVIII:  Parents should be ready to ‘coach’.  A coach teaches skills, and a coach is a motivator.  Coaches come up with game plans, but it’s the players that must execute the plays. When you play games with your children, compete less, coach more.

Principle XXIX:  Parents should encourage their children to set goals.  Help children to have a vision not only of what they want to be, but who they want to be.

Principle XXX:  Parents should not do for their children what their children are able to do for themselves.

Principle XXXI:  Parents should teach children to observe and respect personal boundaries.  Parents are entitled to their privacy. Model and teach age-appropriate modesty and privacy.

Principle XXXII:  Parents should value and support education and learning.  Encourage curiosity.  Encourage reading.  Encourage exploring.  Encourage outings to museums or the library.  Provide an environment conducive to homework and study.  School is a child’s primary job.

Principle XXXIII:  Parents should respect the power of words to hurt or to heal.  Labels matter.  When possible, find the positive label for children.  To label children ‘determined’ or ‘strong-willed’ is preferable to ‘defiant’ or ‘oppositional’.

Principle XXXIV:  Parents should encourage the use of words.  Children who can talk out a problem are less apt to act out.  Read to your children.  Have conversations with them.  Teach them to express their thoughts, their ideas, their feelings, and their beliefs.

Principle XXXV:  Parents should teach children manners, how to say ‘please’.  Teach children gratitude, how to feel thankful.  Teach children to be givers rather than takers.  Teach sharing, generosity, and social responsibility.

Principle XXXVI:  Parents should guide children towards role-models.  Help children to distinguish a role-model from a celebrity, a hero from an idol.

Principle XXXVII:  Parents should give their children the gift of a family narrative: the history of the generations, the culture, the religion, and the associated values.

Principle XXXVIII:  Parents should ‘remember when’.  You were once that age.  Empathize with your child’s developmental challenges.

Principle XXXIX:  Parents should remember to hug, to kiss, and to say, “I love you.”  These are powerful antidotes to sadness, discouragement and anger.

Principle XL:  Find the joy in parenting.  It is hard work.  It is a 24/7 job.  But children can be a great blessing.  “For to miss the joy is to miss all.”  (R.L. Stevenson)

 

*an abridged version can be found on the blog from Jan. 7, 2019

The Unknowable

“As we acquire more knowledge, things do not become more comprehensible, but more mysterious.”  (Albert Schweitzer, 1875—1965)

Once, humans looked at lightening with awe and without understanding.  Maybe they thought that lightening was sent down from the heavens by the gods.  Now, we understand lightening as a natural phenomenon.  Much of what once had no explanation, is now easily explained.  As a result, there are many who believe that nothing is beyond the limits of our understanding.  They believe that some things are yet to be explained, but someday we will be able to do so.

I believe otherwise.  There are limits to what we can ever know.  A dog can only know what a dog’s brain allows a dog to know.  No amount of teaching will open a dog’s mind to the world of math, or music, or literature.  (But then again, no amount of sniffing will allow me to know the dog’s world of scents.) Similarly, a human can only know what a human’s brain allows a human to know.  Maybe, the universe is far more complex and mysterious than I am wired to fully understand. Maybe there is an unknowable realm that exists beyond the human brain’s capacity to ever understand.

I am fascinated by the truism that whenever one question is answered, ten more questions take its place. During my professional career, few discoveries led to any definitive answers to complex problems.  Most discoveries lead to the realization that many problems are far more complex than we ever really imagined, and the solutions to those problems remain frustratingly elusive.

Bear with me, and try to visualize an x,y-axis with a horizontal line drawn near the top.  On the graph, picture a curve slowly climbing towards that horizontal line, approaching it asymptotically, getting closer and closer but never crossing, never even touching, the horizontal line.

The ascending curve represents the extension of human knowledge over time. Under the curve is the sum of human knowledge.  Above the curve is the unknown.  Above the horizontal line is the realm of the unknowable.

No matter how far we progress in our knowledge, I believe that there is much that will always remain, for us, unknowable.  Will we ever be able to explain how mind and sentience emerge out of inorganic matter?  Defying description and all rules of cause-and-effect, will we ever be able to explain what is free-will (and I do believe there is such a thing)? Is it possible, even likely, that there exists a mind, or minds, greater than the human mind, in that realm of the unknowable?

The realm of the unknowable is the realm of maybes.  Maybe, within that realm, is a source of creative energy.  Maybe, within that realm, is a source of moral valence, right and wrong.  Maybe, from the realm of the unknowable emerge strands that temporarily connect that realm to ours, leading to what we call mystic experiences, precognition, revelations, or God-moments. 

I am agnostic.  I don’t know.  I live with maybes.

My Story

“The tendency of the human mind to see everything connectedly is so strong that in memory it unwittingly fills in any lack of coherence. . .”  (Sigmund Freud, 1856—1939)

“It’s cloud illusions, I recall . . .”  (Joni Mitchell, 1943--) 

I have an internal narrative, a story I tell myself, about myself.  My story is built upon memories.  However, over a lifetime I recall only bits and pieces.  I forget much.  I remember best the unusual out-of-the-ordinary occurrences.  I occasionally recall seemingly random and otherwise trivial memories. I often forget the everyday occurrences of my growing-up. 

There is bias in my recall. The memorabilia, the photos and the papers I hold on to, that I use to reminisce, have been kept and stored over the years because they are flattering or they bring to mind select special moments.

I remember best that which is most compatible with my self-narrative.  I likely filter and discard those memories that might refute my self-perception.

And, the story I tell myself, about myself, is different from a story about me as it would be told by my wife, or children, or friends. Whose story would be closer to the Truth, if there even is such a thing?

From the Oracle at Delphi we’re told, “know thyself.”  From Socrates we’re told that the unexamined life is not worth living.  If true, I must examine my self-narrative with a critical eye, asking a series of important questions.  First, how consistent is my self-narrative and how accurate am I with my facts?  Where might my recollections be distorted?  What has been over-emphasized, made bigger than it was at the time?  What of importance has been glossed over? To what degree have I over-emphasized the unusual and neglected the day-to-day?  I must not only examine the contents of my narrative, but I must ask what have I omitted from the story.  What have I ignored? What have I forgotten? Why have I forgotten?

I need to examine closely my explanatory biases.  How do I explain what I do and why I do it?  To what do I attribute causality?  To nature?  To nurture?  To chance and circumstance?  To my free-will and the choices I have made?

For those of you who, like me, have a self-narrative, we do so because we are wired to do so.  We look at the night sky, see patterns in the stars and invent the constellations.  We look at the clouds and imagine them to be identifiable pictures.  In the same way, we look at the scattered fragments and memories of our lives and turn them into a comprehensible whole.  My internal narrative creates order in my life.  It’s an attempt to explain who I am and why I am.  My narrative fills in gaps where memory may be elusive.  My narrative attempts to construct a good story about a decent man, who tried to make a difference.

In its written form, a memoir, I hope my story will be remembered when I am no longer, if not as an autobiography, then as a work of historical fiction.

Go Play

“Play is really the work of childhood.”   (Fred Rogers, 1928-2003)

“Imagination is more important than knowledge.”  (Albert Einstein, 1879-1955)

“We don’t stop playing because we grow old; we grow old because we stop playing.”   (George Bernard Shaw, 1856-1950) 

Last summer, I sat for an hour watching my 4-year-old granddaughter play contentedly in her garden. She drew in the dirt with sticks.  She rearranged pebbles.  She sniffed herbs.  She closely examined worms and roly-polies.  All the while, she was talking to herself, inventing stories.  For the most part, she was engrossed in her own thoughts and imagination. I was careful not to interrupt.  Only once-in-a-while, she’d look back to make sure she knew where I was, and then she would return to her play.

While she played, I thought about what I was watching.  Professionally, I’m well versed regarding the importance of children’s play.  Play is essential for normal healthy development.  It is necessary for the development of gross and fine motor skills, for the development of language, for the development of attention, for the development of social skills, for the development of affective regulation, and for the development of cognition and imagination.

When I was young, I remember my mother telling me, “Go play.”  In other words, turn off the television, and find something else to do.  I’m sure there were times when “go play” felt dismissive, my mother wanting me to get out from under foot.  Only as a parent, and now as a grandparent, do I appreciate the wisdom of those two little words, words that say so much more.  Turn off the screens.  Go outside. Go exercise.  Go use your imagination.  Go find the resources within yourself to be amused, to be entertained, to wonder, and to explore.

I don’t suspect my mother was fully aware of the developmental importance of those two words.  But, then, a good deal of parental wisdom is instinctual. Play, too, is instinctual. Nobody had to teach my granddaughter how to play in the dirt. She just knew to do it.

When my granddaughter played in the garden, she did so with no self-consciousness, and with no concern for time.  Her play was pure process, having no obvious objective. I was there in the background watching and monitoring her safety. Otherwise, the rules and limits of her play were hers to imagine and invent.

I, too, sometimes play.  I play chess and poker.  I play Wordle and other word games. I play guitar.  I play pickleball and golf (poorly).  Fishing is my play.  Writing is my play. For all the ways that I play, my play is very unlike my granddaughters, certainly far less spontaneous and far less imaginative, often regulated by conventional rules, and almost always having a measurable outcome.

The purpose of play in young children is developmental mastery.  But what is the purpose of play in a senior like myself?  Does it help me cognitively?  Does it benefit me physically?  Is it good for me emotionally?  I assume the answer to each of these questions is yes.  Therefore, when I’m sitting too long in front of a screen, or otherwise not knowing what to do with myself, I need to remember, “Go play.”

Mahomes

One year ago, after the AFC championship game, I wrote a blog called “Yips”.  The Chiefs dominated the Bengals for the first half of that game, but just before halftime, they failed to score from the 2-yard line.  The second half was all Cincinnati. The Chiefs could do nothing. During the second half of the game, Patrick Mahomes appeared to freeze, even panic.  I was concerned about this season. Could Mahomes regain his confidence or would he continue to be plagued with the yips?

This year’s AFC championship game was a rematch, Cincinnati coming into Arrowhead to play the Chiefs.  Despite Mahomes playing with a high-ankle sprain, the Chiefs completely dominated the first quarter. Yet, they scored only 2 field goals. In the second quarter they scored a touchdown on a Mahomes pass to Travis Kelce. Towards the end of the second quarter, the Chiefs intercepted a Burrow’s throw, but went 3-and-out, using only 19-seconds of the clock.  They punted and the Bengals wound up with a field goal prior to halftime.  The score at the half was 13 to 6, Chiefs. The Chiefs got the opening kickoff in the second half, but again went 3-and-out.  There was an uneasy déjà vu feeling about the game.

Cincinnati tied the game in the 3^rd quarter.  The Chiefs responded with a beautiful Mahomes pass, to once again take the lead. Later, with the lead and the ball, Mahomes inexplicably fumbled the football, which was recovered by the Bengals. Cincinnati went on to once more tie the game.

Chiefs got the ball back, but with a little over two minutes left and the score tied, they punted on 4^th-and-long to Cincinnati.  With Burrow as quarterback and plenty of time left, I was again expecting the worst, but the defense rose to the occasion. When Cincinnati had to punt with thirty seconds left in the game and no time outs for the Chiefs, I thought the game would go into overtime.  Skyy Moore fielded the kick and made a good return, putting the Chiefs near midfield with 19-seconds left.  Then, Mahomes, sore ankle and all, ran for 5 yards down the sideline and got a 15-yard roughing the passer call on top of that.  Harrison Butker kicked a 45-yard field goal with 8 seconds left and the Chiefs won. It’s on to the Super Bowl.

This game was one of the gutsiest wins I have ever seen.  Mahomes was severely hobbled by a bad ankle.  Travis Kelce played with a bad back. Three of the Chiefs starting receivers and two starting defensemen went down injured.  There were moments when Mahomes was not at his best, but he never froze or panicked.  On one good leg, he was better than Burrow.  On one good leg, he led a decimated team to victory.

Mahomes has had an MVP year.  The doubts I had a year ago are no longer.  I lived in Denver during the John Elway years, and his five Super Bowl appearances.  I lived in St. Louis when Kurt Warner emerged out of nowhere, to begin his Hall-of-Fame career.  I now live in Kansas City and can say without reservation, Patrick Mahomes is the best I’ve ever seen.  My apologies Patrick, I once had my doubts.

Resilience

“Resilience is knowing that you are the only one that has the power and the responsibility to pick yourself up.”  (Mary Holloway, resilience coach)

 My father was born in 1919, the middle of three boys. His mother died in the winter of 1925 when the three boys were all still young.  After her death, their father moved frequently, usually following some get-rich-quick scheme.  They moved from rental to rental in order not to have to pay the landlord.  When there was nowhere else to stay, the boys slept on park benches. Their teen years coincided with the Great Depression, during which time they had very little. Not only was poverty widespread, so was antisemitism. At 17 my father left home and moved to Dallas to take a job selling shoes.  Shortly thereafter his brothers joined him for the opportunity to earn some money.  During the war, my father flew 25 combat missions over Europe.  His brothers served stateside.

I was reading my uncle’s memoirs and his description of those times. The brothers faced loss and hardship without counseling, without support, and without financial assistance. Given the circumstances of their lives, I was particularly struck by one comment in the memoir.  My uncle said that neither he nor his brothers ever felt sorry for themselves. 

All three of the boys went on to lead productive and successful lives. None of them ever seemed bitter or resentful about the conditions of their growing up. To my knowledge, none of them ever had any serious mental health crises. None of them were users of drugs or alcohol.  My father became a restauranteur and later an antique dealer.  His older brother became a professor of English and later the Dean of Liberal Arts at a local university.  His younger brother became a mechanical engineer, spending most of his career working for the federal government.  By societal standards, they led conventional middle-class lives. Each of the brothers married and remained married.  Each helped raise well-educated and successful children.

I don’t want to over-glorify their accomplishments.  I know my father paid a significant emotional toll as a result of his early losses and hardships.  I know less about the emotional toll that childhood hardships took on my uncles.  By the standards of these times, my father and his brothers would be considered victims of significant trauma and neglect.

I am struck by how different the times were then compared with the times now. What for me is the most poignant aspect of their story is that they never felt like victims. They never acted like victims. I never heard them blame others. I never heard them lament life’s unfairness. I never witnessed my father or his brothers acting as if the world owed them something. They expected to have to work, and they did so. From the crucible of their childhood, they emerged self-reliant, and they emerged resilient. 

I respect and admire what all three were able to achieve. Perhaps it’s a son’s curiosity, perhaps it’s professional curiosity, but I can’t help but wonder. Against all odds, how did they do it?

Role-playing

“All the world’s a stage, And all the men and women merely players.” (from Shakespeare’s As You Like It, Act II, Scene VII)

In our lives we must play many roles.  The roles we play are often particular to the society in which we live, the religion in which we grow, and the families into whom we are born. We play our roles in order to navigate life smoothly and successfully.

At a young age, we are taught the script of the well-behaved child. A few years later we learn the script that directs our role as student.  During these same school years, we learn the complex and nuanced scripts that govern social interactions. Then comes adolescence, when trying out a variety of new roles and new scripts is the norm.

In my lifetime I’ve played many roles. Is it pejorative to label myself an actor and a player of roles? Yet, what are we if we are not enacting a role?

I once played the role of physician.  I went to medical school and studied for the part. I followed a script that defined professionalism, and that codified ethical practices. Furthermore, my script demanded I follow a plethora of regulatory rules and laws.  I didn’t like or agree with all of the rules, but I learned my role, applied my knowledge, and followed the script. Along my professional journey, I had role-models who showed me how the role could and should be played.  As I matured in my role as physician, I tried to be a role-model for others. I played the part to the best of my ability. I was playing a role, but never acting contrary to my beliefs, principles, or good judgment.

When does role-playing cease? As a child, I attended Sunday school where I was taught the rules and scripts of my religion. I was taught the words to the prayers, and I dutifully recited them.  Yet, there is a vast difference between enacting the role of pray-er, and authentic prayer. There is a vast difference between following the scripts and rules of religion, and authentic belief.

Thinking about role-playing has led me back to theologian/philosopher Martin Buber.  Role-playing occurs in the realm of what Buber called the I/it. I/it describes interactions that characterize the preponderance of our day-to-day encounters. We walk into a store.  We are greeted by a friendly clerk.  We exchange some friendly words in response.  We say ‘please’ on cue and ‘thank-you’ on cue and our scripts smooth the interaction. We leave the store, mission completed.  Our pleasant interaction was not about authentic relationship, rather it was functional.

Buber said the alternative to I/it is I/Thou. I/Thou is characterized by full presence when encountering the other, be that other a person or God.  There is no script and no secondary agenda. I/Thou happens in the moment, it is authentic, and it is only about the relationship.

Perhaps I/Thou and role-playing can occur simultaneously.  A teacher, fully present in an encounter with a student, remains a teacher.  A doctor, fully present in an encounter with a patient, remains a doctor. With immersion in authentic prayer, one still remains a pray-er.

I/Thou is authenticity superimposed on the roles we otherwise must play.

 

Spinoza

“Of all the things that are beyond my power, I value nothing more highly than to be allowed the honor of entering into bonds of friendship with people who sincerely love truth.”  (Baruch Spinoza, 1632--1677)

I don’t much talk about him with friends or family. I would just bore them. But here in the obscurity of this blog, I can write about Spinoza, a philosopher who fascinates me.

With the expulsion of Jews from Portugal, Spinoza’s family settled in the comparatively welcoming city of Amsterdam. There they became moderately successful merchants.  Spinoza was raised with a traditional Jewish education.  However, after the death of his father, Spinoza expressed doubts about Jewish teachings and was subsequently excommunicated.  Rather than seek forgiveness or repent, Spinoza turned his back on those who exiled him, and changed his Hebrew first-name ‘Baruch’ to the Latin ‘Benedictus’.  However, Spinoza was never baptized and never converted.  He lived a relatively modest life, unmarried, supporting himself as a lens-grinder, at the same time doing the philosophic work that would place him amongst the greatest of all Western minds.

In historical context, Spinoza lived at a time where many Jews were caught in the mass hysteria surrounding the false messiah Shabtai Zvi.  Spinoza went the opposite route. He wanted to free religion from religious dogma that preyed upon fear and superstition. For Spinoza, contemplation and reason was the pathway to God. Spinoza also believed that contemplation and reason was the pathway to joy, and that the greatest joy comes from the contemplation and understanding of God.

Spinoza’s god, what came to be called the god of the philosophers, is wholly immanent and never transcendent. That is to say, God exists within all of nature, but God does not exist apart from nature.  God has no personal identity, nor does God govern or intervene in a personal manner.  Spinoza’s god is indifferent, neither a dispenser of justice nor mercy.  “He who loves God cannot endeavor that God should love him in return.”

Spinoza was an early modern thinker. He was an advocate for religious tolerance, especially freedom of thought and opinion. He was among the first to question the inerrancy of the bible, speculating that it had been written over time by multiple authors.

Spinoza’s ideas were consistent with later developments in science and psychology, refuting Cartesian dualism, while emphasizing mind/brain unity.  He wrote extensively about the emotions in order to understand and master them through reason, a foreshadowing of modern CBT.  

I am fascinated by Spinoza and yet I find significant shortcomings in his philosophy. He advocates for calm reason, but where in his philosophy is there a place for fervor and passion?  He most values thought and contemplation, but what of action and deed?  He believes that there is a reason for everything, but where in his philosophy is there Mystery?  He believes that every effect must have its preceding cause and is a strict determinist. Yet, what of free will?

For all of my misgivings, Spinoza still has an attractive message regarding how to live . . . put energy into contemplating life, not death, and seek that which brings joy to life.  “The proper study of a wise man is not how to die but how to live.”  And whatever my misgivings, I enjoy glimpses of Spinoza’s biting wit. “Surely human affairs would be far happier if the power in men to be silent were the same as that to speak.”  Funny and true.

A.I.M.

"The greatest revolution of our generation is the discovery that human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives.” (William James, 1842—1910)

Towards the last years of my practice, I began to conceptualize a theory of psychotherapy, a distillation of what I believed to be the most important components of therapy. AIM was the result, AIM standing for Attitude, Involvement, and Meaning.

ATTITUDE is a word easily tossed around, but a concept little examined. Attitude is the manner in which we face the challenges of the world. It is not a cognition or belief, but it influences our thinking. It is not a behavior, but it gives direction to our behavior. It is not an emotion, but it has an emotional valence, good or bad. Psychotherapist Viktor Frankl called attitude the last of our freedoms, the freedom to choose the attitude with which we face the circumstances of our lives.

Patients enter into therapy with a variety of attitudes. Some enter unwillingly, others eagerly.  Some enter with doubt, others with optimism.  Some come emotionally detached, others fully engaged. Some come close-minded, others open to change. The work of therapy begins with recognition and acknowledgement of one’s attitude, whatever it may be. Then, on the premise that attitude is a choice, patients can consider their options, and determine what attitude best serves their particular goals both in therapy and outside of the therapy.

INVOLVEMENT is participation in important and gratifying activity. It happens with immersion in creativity or spirituality. It happens in interaction with nature or involvement in community. It happens in close friendships and in relationships.

To understand involvement, we can look at what stands in contrast:  detachment, avoidance, escapism, self-absorption. Involvement stands in contrast to otherwise trivial pursuits.

Engagement with life is essential for healing and for health. The talking and the exploration that occurs in context of therapy sessions is valuable, but it is not enough. An important goal for those in therapy is to get involved.

MEANING stands in contrast to nihilistic despair. Viktor Frankl believed that humans are inherently meaning seeking. “Why am I here? For what purpose?”  Life’s difficulties can be better endured if life is lived with identified purpose and meaning. Friedrich Nietzsche famously said that those who have a why can bear almost any how.

To ask, “What is the meaning of life?”, may be unanswerable.  But we can instead ask, “What do I want from life?”  “Who do I want to be?”  “How do I triumph in the face of life’s hardships and challenges?” “What will be my legacy?”

The answers to those questions of Meaning emerge when circling back to Attitude and Involvement.  With the right attitude, and involvement in important and gratifying pursuits, one may subsequently discover that life can be filled with meaning.

A good acronym is easily remembered and seems to confer some degree of credibility and gravitas. There is CBT, cognitive behavioral therapy; DBT, dialectical behavioral therapy; and ACT, acceptance and commitment therapy.  Now there is AIM.  “AIM for your mental health,” or if you prefer, “Ready . . . AIM . . . Bullseye!” I think it has some potential.

Losing Streak

“Life is not a matter of holding good cards, but of playing a poor hand well.”  (Robert Louis Stevenson, 1850-1894)

Warning:  The following contains content suitable only for the mature poker player.

Since the beginning of the pandemic, I have been playing free online poker.  With over 20,000 players on my site, I worked my way up in rank to 62^nd place.  However, over the last 3 months I have lost about 20% of my winnings and have dropped down in the standings.  I need to figure out what’s happening.

The most convenient explanation is bad luck.  I remember quite a few hands where I had a big advantage going into the turn and river, but my opponent got a lucky card, and I lost a big stack of chips.  Blaming my losing streak on bad luck has a certain appeal.  I can rationalize how I’m still a good player, just on a run of bad luck . . . but then I will keep losing.  Alternately, I can succumb to the trap of superstition, seeking out amulets and charms in order to turn my bad luck into good luck . . . and keep losing.

I’ve toyed with a conspiracy-theory explanation.  Maybe the cards are not being dealt in a truly random manor but are in-fact rigged. Again, it's an explanation that protects my self-esteem.  I’m playing good poker.  I’m just the victim of an outside plot to set good players up for bad beats.

The more likely explanation for my recent losing streak is that I am now playing for higher stakes against more experienced and skilled opponents.  To win at poker you don’t have to be a great player, but you need to be better than the competition.

I’m sure that a poker pro, watching me for a few hours, could spot and correct some of the flaws in my game. Unfortunately, what I fear is happening is that skilled opponents are spotting and exploiting those very same flaws. Having no poker pro at my disposal, how do I turn losing back into winning?

I can start by being patient, trying not to win back all of my losses at once.  I will swallow my pride and, for a while, go back to the lower-stakes games.  I will seek answers to some fundamental questions. Did I size my bets properly? Did I keep losses to a minimum on my losing hands?  Did I win the most possible from my winning hands? Did I make foolish calls? Did I make good folds? How might I have better played the cards I was dealt?

With free on-line poker no real money is involved, and yet I put a fair amount of time and energy into thinking about the game I love. Poker is a game of probability, not certainty. It is an intriguing balance of luck and skill.  As in life, any of us, at any time, can get dealt a bad hand.  It’s not hard to play the good hands. But it takes skill and practice to play the poor hands well.

(addendum 3-31-23)  I have recovered my losses and then some.  I am currently in 48th place.