Mental Illness or Moral Illness?

I’m tired. The general world of psychological theory and practitioners who will use “illness” as an explanation and at times, an excuse, for someone’s moral choices and circumstances is maddeningly exhausting. 

What has happened to the tradition of virtue ethics, morals, and an adherence to principles? When did our decisions as moral agents become determined by outside forces? I don’t exactly know the exact date for this cultural abandoning of one’s own responsibility for their choices, but I am here to push back and to make the claim that perhaps the reason for various and common negative psychological symptoms (not all, but many) both on the societal and individual level, stem more from a moral illness rather than an abstract mental illness that is just happening to us. Think about it this way, why is it that when it comes to the bad behavior of others or ourselves we look to circumstances or outside forces to excuse but no one does the same for the good things they do? How come bad behavior is due to an illness but good behavior is of choice? 

While there is a difference between mental illness and moral illness, one often follows the other. Too often today the two are conflated. We hear often in the media and in our public sphere the abdication/dismissal of moral choice and responsibility only to be caught by the safety net of unchosen illness or top down oppressive circumstances. This view on one’s choices is what is called “determinism”; and I reject it. Those that are the most mentally ill - look at the choices they make; does that not have something to do with perhaps not the origin but the continuation of that sickness? Do we not have some kind of control/free will over what we do? I believe we do - and despite what any professor/academic/influencer says to the contrary, we all behave and treat one another as if agency exists.  

Do I still have compassion for someone who has been affected negatively because of circumstances out of their control? Of course! But what good is it if we take from someone the right to their pain, guilt, and shame, which if acted and responded to in virtue, can lead to true positive change? By erasing moral culpability we are led down a different route which naturally culminates in an endless repeating of negative outcomes by attributing immoral actions to an illness out of our control. How is that self-love or love for others? 

Rejecting agency is rejecting the very nature of the human in front of you - nature entailing what resides in each of us: potential, agency and creativity. What creativity? The creative power we to respond to our circumstances as a moral agent and by doing so, increase our chances of creating a life of peace, prosperity, and meaning despite our circumstances.

I’m not naive enough to believe that we are completely free agents in the libertarian free will sense. However, I side with Viktor Frankl that while we are not free from being impacted and affected by our genetics, upbringings, circumstances, etc. we are free to choose our response in the face of those influences. Frankl believed that the slippery and steep slope that a deterministic “mental illness” leads to is “Neurotic Fatalism”. He says:

“Neurotic fatalists, impressed by the ideas of individual psychology (which they misunderstand and misuse), are prone to blame childhood educational and environmental influences for ‘making’ them what they are and having determined their destinies.These persons are attempting to excuse their weaknesses of character. They accept these weaknesses as given facts, instead of seeing that having had such unfortunate early influences only makes it more incumbent upon them to practice self-restraint and seek to school themselves differently.” 

“Neurotic fatalism is only another disguised form of escape from responsibility; the neurotic fatalist is betraying his uniqueness and singularity when he seeks refuge in typicality and courts the unalterable destiny of belonging to a type. (86-87)”

Now comes - what society as a whole once considered a given - to be potentially Frankl’s most “controversial” statement - “A faulty upbringing exonerates nobody; it has to be surmounted by conscious effort”. Gasp! You mean, both things can be true at once? That terrible things have happened to all of us and yet we cannot escape our responsibility to overcome them through our own moral agency and efforts? 

Now, are there obstacles that can impede our obtaining of the elusive “happiness” that we are all chasing? Are there some who are in fact affected by illnesses of the mind? Of course. But, anyone with eyes to see and ears to ear, has noticed the phenomenon of “concept creep”: seemingly every immoral act is due to “mental illness”. Give me a break. 

Much of what ills our minds, is the result not of a mental illness but rather that mental illness follows moral illness. Mental illness can be the result of a long pattern of immoral choices like a cascading set of pools of dark water leading inevitably to a deep ocean that is a life of darkness with no foundation upon which to stand. But the good news is that anyone and everyone, no matter their situation, can be taught virtue. Whether they respond to the teachings of virtue ethics is not in our control, but the teaching of this material is in need of resurrection on a large scale. In pt. 2, happiness will be connected to virtue, “virtue” will be defined, and practical rules of how to pursue virtue will be provided.

References

The Doctor and the Soul: From Psychotherapy to Logotherapy - Viktor Frankl

The Right To Your Pain

One of my favorite novels of all time is East of Eden by John Steinbeck. This American classic ostensibly is a retelling of Adam and Eve and Cain and Abell - focusing on how the choices that we make, the choices we are all responsible for making day to day, effect generations after us in ways that we can’t imagine - and while we may be a member of a group or family that is being affected by a previous generation’s choices, we still have a choice ourselves to do something different - or to do the same. 

The book’s two main characters are brothers who are largely raised in the care of a chinese immigrant Mr. Lee who acts as the family’s butler, or better put, a wise spiritual compass and leader. What Mr. Lee, at various points of the story, attempts to teach is that what we choose to do in the face of pain is not meaningless but quite the opposite, is meaningful to the extent that it can alter the course of an entire family and by so doing, history itself. Mr. Lee emphasizes the powerful potential we all have within us by the very nature of our free will to either build upon or destroy our lives in the wake of tragedy, heartbreak, and challenge. In a pivotal moment of the novel, Mr. Lee is party to some bad news being delivered to his employer, Adam, whose son is fighting in WWI. Adam faces every parent’s worst nightmare - losing a child. One of Adam’s other son’s attempts to conceal the news from his father and in a moment of brutal truth and wisdom Mr. Lee stops the attempt to hide the news and says “Every man has a right to his pain”. Let that statement sink in but in a different way - YOU have a right to YOUR pain. 

Why? Why would that be a right when at first pain is something we want to avoid yet when we think of someone taking away our pain we resist that? It may depend on the pain that’s been taken away. Perhaps it’s the pain that aligns with the truth. Pain that enlightens our understanding and gives a sense of orientation is one that we guard. Although painful, more than the pain to be avoided, it speaks volumes as to the truth and the reality that a deep part of our soul craves. 

As a thought experiment, place yourself in Adam's shoes. What if your child had died overseas and then you found out that another member of your family concealed that from you? How would you feel about that? Would you be angry? Feel betrayed? Why? After all, they’re saving you from pain aren’t they? 

Something being a right implies a sense of divine ownership - something about you or your life that cannot and should not be infringed upon or taken from you. A right is only a right as its justifications/origins come from a power that is more powerful than man or government. A right is a right as it is seen as coming from the divine. Rights benefit us, rights protect us, rights ensure our humanity. Does pain fit into that category? Why would pain be a right?

 The reason why pain is a right is that pain gifts/benefits us, protects us, teaches us, and ensures our humanity. Rights are recognitions of humanity and a denial of pain is a denial of our humanity and the amazing potential we have as humans to take pain as fuel to create something beautiful. Pain is also a right because deep down, if someone conceals pain or painful news from us, or tries to rescue us, there is a perceived sense of weakness insinuated in that concealment, in that denial of the right. A denial of a right is a denial of one’s humanness - and part of being human is the potential we have to create. “You can’t handle this pain, let me take it from you” seems to be a gift, yet it’s an insult and a lack of trust. “They” don’t trust us that we can handle it, that we are strong enough, that we couldn’t take our pain and change it into something meaningful and beautiful - what an insult. Does anyone who is pursuing a meaningful life, want to be seen as an individual that has to be shielded from life? An individual that “can’t take it, thus can’t be trusted”? Absolutely not. To be able to receive pain is a marker of strength and maturity. It’s a sign that one CAN be trusted and if YOU can be trusted with pain, others will see that and in turn be drawn to you which, then in turn, will give more meaning to your life because so much a part of meaning in life is tied to relationships. 

Another way in which pain is a right is tied to our pursuit of happiness. The happiness I refer to here is not a happiness that comes and goes but rather more of a longer lasting life fulfillment. The pathway to that kind of happiness is one that includes pain and sometimes, if not often, the pain that comes with truth. Going back to East of Eden, earlier in the story Adam Trask’s situation is a brutal and difficult one - having been not just abandoned by the mother of his children, but first shot by her and then abandoned to raise his twin sons alone (of course with the help of Mr. Lee) Adam slips into a state of darkness. Still confused as to why the “love” of his life would do this, Adam becomes a distant and apathetic father, perhaps seeing his sons as reminders to the pain Kate has caused him. Not quite knowing what happened to Kate, and always wondering what could have been/would’ve been different, Adam stays in this kind of dark detached trance for years. 

Adam, eventually having befriended a local farmer and legend to the valley in which the story takes place - Samuel Hamilton, is visited one (afternoon/evening) by Samuel. Having seen enough of Adam’s pain, the effects it’s having on not only Adam himself but his two sons, and knowing the true location and dealings of Kate, Samuel decides to tell Adam the truth - that Kate is still in the valley, and is owning and operating a local whorehouse. Samuel, before telling Adam, informs Mr. Lee (remember, every man has right to his pain Mr. Lee) that he is going to tell Adam the truth. Mr. Lee is worried for Adam but ultimately accepts Samuel’s choice. Samuel is going to tell Adam the truth because he presupposes that the painful truth is ultimately better for Adam, and really, any of us, than a comforting lie. He believes that the truth is the “true medicine”. 

Adam is told the truth, is shocked, and then he makes the decision to go and validate or disprove Samuel’s claims for himself. Adam confronts Kate, something that takes massive courage, and in so doing is set free. He finds her to be miserable, undesirable, unattractive (not just in a physical sense but emotionally, psychologically, soulfully unattractive) and turns around and walks away from her. Very quickly, Adam is reborn. 

Having been made free from the painful truth, Adam no longer has to wonder not just where Kate is physically, but also no longer has to wonder if his life would be better with her in it. He quickly becomes the father that Cal and Aron -  his two boys -  need him to be. Cal especially receives the love and recognition he has been starving for - and all because of Adam being set free from a painful, but saving truth. 

This is why we all have a right to our pain - because we just don’t know what our pain will lead to. Increased understanding of where we truthfully stand in relation to ourselves, to others, to the world? Increased empathy and connection with those around us? Increased sense of strength to be able to handle that which the world can throw at us, and as a consequence, increased confidence, which leads to more productive action or meaningful choices. 

To have pain, to not be denied our pain, is to be human in the ultimate sense of the word. Adam was being denied his pain the longer Samuel and the rest of the valley kept the truth from him about Kate. Once told his pain, the pain tied to the truth, Adam was made free. He was no longer bound and to be determined from that which he didn’t know, the comforting lie. I bet if Adam Trask were to read the stoics (which there is reason to believe he did as a copy of Meditations by M. Aurelius is mentioned a few times in East of Eden) he would agree that because of the truth, although extremely painful, when finally confronted was empowering. “It’s time you realized that you have something in you more powerful and miraculous than the things that affect you and make you dance like a puppet” (Meditations 165). Adam was a puppet, a puppet to not knowing and imagining what happened to Kate. Left to wonder, his feelings and sorrow completely took over his decision making, his soul, and he was falling short of the father and man he could be. The pain is what set him free - free to become something more powerful and miraculous than the things that affected him. Don’t let the pain of the world or your personal life/experiences cause you to dance like a puppet. Use the pain to help you transform into something more “powerful and miraculous” than the pain itself. Your pain is your right, don’t waste it.

References:

Meditations - Marcus Aurelius

East of Eden - John Steinbeck

A Return to the Shire: Happiness Part 2

I share a theory or philosophy with a dear friend of mine and fellow Lord of the Rings nerd: “Return to the Shire”. When you think of characters or a group of fictional people that exude happiness, it would be difficult to find a more happy people than the Hobbits. Let’s look at how they live, who they are and see if we can’t pull out some characteristics/values that we can adopt in our own lives to be more happy. By doing so, we all can then return to a value system or way of living that is fundamentally simple, good, and meaningful. 

Let’s look at a few excerpts from both The Hobbit and The Lord of the Rings  and see if we can’t make some inferences as to what the Hobbits value as a society/as a people. As we do this, be thinking about what you can do to return to a Shire way of living.

First The Hobbit:

“In a hole in the ground there lived a hobbit. Not a nasty, dirty wet hold, filled with the ends of worms and an oozy smell, nor yet a dry, bare, sandy hole with nothing in it to sit down on or to eat: it was a hobbit-hole, and that means comfort…

The door opened on to a tube-shaped hall like a tunnel: a very comfortable tunnel without smoke, with panelled walls, and floors tiled and carpeted, provided with polished chairs, and lots and lots of pegs for hats and coats - the hobbit was fond of visitors.”

Hobbits value a comfortable living space - not overly complicated but cozy. Cozy with lots of ways to accommodate guests and company. They value socializing, connection, and fellowship. They see how the richness of their life is tied to the richness of their relationships. 

“They are inclined to be fat in the stomach; they dress in bright colours (chiefly green and yellow); wear no shoes, because their feet grow natural leathery soles…and laugh deep fruity laughs (especially after dinner, which they have twice a day when they can get it).” 

Hobbits enjoy good food, colors of the earth symbolizing life, growth, renewal, and health. Wearing no shoes shows a connection to nature. To laugh (especially after a meal) implies an approach to life to not taking things so seriously and the value of communal interaction over food (something we as a society and most importantly as families are losing touch with).

After helping the dwarves retrieve their gold from the dragon Smaug, Bilbo is given the chance to choose his own payment/reward. It says, “In the end he would only take two small chests… ‘That will be quite as much as I can manage,’ said he.” 

Bilbo is aware of his limitations. He knows riches can only add so much to his life and while he enjoys being comfortable, he knows that there is much more to life than silver and gold. Additionally, he is fully aware of the headaches that too much wealth can bring. 

Perhaps one of my favorite lines from the Hobbit is at the very end as Bilbo and Gandalf are reminiscing of their past adventure as they smoke their pipes. Bilbo gets overwhelmed with the part he played in the adventure, almost giving himself too much credit for his role in the whole thing and tying himself to a grandiose plan that is universal in scope - afraid of what could’ve happened if he hadn’t accomplished his task. Gandalf then says, “You are a very fine person, Mr. Baggins, and I am very fond of you; but you are only quite a little fellow in a wide world after all. Thank goodness! Said Bilbo laughing, and handed him the tobacco jar.” 

With a society seemingly obsessed with the self, valuing fame, likes, subscriptions, followers, etc. it’s refreshing to hear a character find relief at NOT ‘going viral’. 

Now, onto Lord of the Rings. Tolkien gives some deeper insight into the way of living found within the Shire:

“They love peace and quiet and good tilled earth: a well-ordered and well-farmed countryside was their favorite haunt. They do not and did not understand or like machines more complicated than a forge-bellows, a water-mill, or a hand-loom, though they were skillful with tools.”

“Their faces were as a rule good-natured rather than beautiful, broad, bright-eyed, red-cheeked, with mouths apt to laughter, and to eating and drinking. And laugh they did, and eat, and drink, often and heartily, being fond of simple jests at all times, and of six meals a day (when they could get them). They were hospitable and delighted in parties, and in presents, which they gave away freely and eagerly accepted.”

Once again, we see a people that value simple living, a connection to the earth, working with their hands, development of skills, good food and drink, laughing and a sense of humor, and receiving/giving of their time and efforts to help others feel happy.

Tolkinen goes on to say “Nonetheless, ease and peace had left this people still curiously tough. They were, if it came to it, difficult to daunt or to kill; and they were, perhaps, so unwearingly fond of good things not least because they could, when put to it, do without them, and could survive rough handling by grief, foe, or weather in a way that astonished those who did not know them well and looked no further than their bellies and their well-fed faces.”  

“They shot well with the bow, for they were keen-eyed and sure at the mark. Not only with bows and arrows. If any Hobbit stooped for a stone, it was well to get quickly under cover, as all trespassing beasts knew very well”. 

The Hobbits or “Shire-folk”, are not just soft party goers. They are resilient. They know how to do without. They use the memories of the past and the potential pain of the future to increase their gratitude for what they have in the moment. That is why they value and exaggerate the good things they have. They are hardy, strong, and self-sufficient. 

Much later in the story, there is a brief moment where Sam and Frodo are separated, requiring Sam to wear the ring of power for safe keeping on a chain around his neck, until it can be returned to Frodo. The ring immediately begins to tempt Sam:

“As Sam stood there, even though the Ring was not on him but hanging by its chain about his neck, he felt himself enlarged, as if he were robed in a huge distorted shadow of himself, a vast and ominous threat halted upon the walls of Mordor….Already the Ring tempted him, gnawing at his will and reason. Wild fantasies arose in his mind; and he saw Samwise the Strong, Hero of the Age, striding with a flaming sword across the darkened land, and armies flocking to his call as he marched to the overthrow of Barad-dur. And then all the clouds rolled away, and the white sun shone, and at his command the vale of Gorgoroth became a garden of flowers and trees and brought forth fruit. He had only to put on the Ring and claim it for his own, and all this could be.

In that hour of trial it was the love of his master that helped most to hold him firm; but also deep down in him lived still unconquered his plain hobbit-sense: he knew in the core of his heart that he was not large enough to bear such a burden, even if such visions were not a mere cheat to betray him. The one small garden of a free gardener was all his need and due, not a garden swollen to a realm; his own hand to use, not the hands of others to command.” 

I underlined that last sentence to emphasize Sam’s wisdom, humility, and goodness. With the entire world offered to him what does Sam do? He stays true to his values and virtuous living. He communicates to the ring a message from his own heart - you have no power over me for I value freedom, simplicity, and the opportunity to make a quiet and peaceful life of my own.

Lastly, on the slopes of Mount Doom, when all hope is seemingly lost, Sam begins to sing:

“Though here at journey’s end I lie

In darkness buried deep,

Beyond all towers strong and high,

Beyond all mountains steep,

Above all shadows rides the Sun

And stars for ever dwell:

I will not say the Day is done,

Nor bid the Stars farewell.”

Sam, a Hobbit, a son of the Shire, is a resilient and hopeful being. He never loses hope and with that hope he retains his steadfastness even in the face of utter destruction. 

The Shire is a state of mind. The Shire is the natural consequence of living a certain set of values and holding onto those values. One can make the argument that the Shire or the Hobbits are too simplistic, too traditional, and not very “progressive”, but one must think “progress towards what?” Would it not be “progress” towards a healthier and happier life to return to a Shire of our own? A state of mind/being/circumstances where things are simpler, and the small things in life are placed at a higher value? Things that actually matter? Like relationships, good food, good books, humility, helping others, sharing meals with loved ones, working with one’s hands, less screens, etc.

We tend to overcomplicate happiness - a “Return to the Shire” is needed. 

References: 

The Hobbit - JRR Tolkien

The Lord of the Rings - JRR Tolkien

#9 - Happiness pt. 1: Happiness is Simple but HARD

Mental health/therapy in pursuit of feeling happier and more satisfied with life does not have to be complicated. Sure, there are times where a dive into a complicated and painful past can be productive and helpful in that it will answer perhaps the “why” of our patterns, responses, emotional raw spots, etc. But understanding can only get you so far; at some point, you are faced with the question of “now what?”. It is a delicate place to be in therapy. It is an uncomfortable place to be. Because now you are taking on ultimate responsibility for your choices. My argument is that those choices - the choices you must now make to feel better, to feel healthier and happier, and to live a life of deep satisfaction may be difficult but they are simple. 

The first choice is to “remove the spoon”. The concept of “removing the spoon” comes from an old joke: 

Patient: Hey Doc, every time I take a sip of coffee I get a pain in my right eye.
Doctor: Take the spoon out of the cup.

Call it a type of bias or selective blindness, but how often do the answers to our problems involve the removal of something that is causing pain and yet we are consciously or unconsciously choosing not to remove it? While this removal of the spoons in our lives can be painful and come with serious trade-offs that need to be examined and taken into consideration, it nevertheless can be the key to long-lasting change. The pain that comes from the removing of these spoons (setting boundaries, letting an unhealthy relationship die off, weathering the tantrum of your young teen who needs his phone taken away) is undeniable, but so is the long term and WORSE suffering that will come if we leave these spoons in our cups.

Okay, so now that you’ve removed the unhealthy and harmful elements of your life, it is time to replace them with healthy and helpful rituals, habits, and practices that leave us feeling deeply satisfied and that our lives, while not always “happy” are still good.

To know what to fill your life with will require attentiveness -  pay close attention to when you are feeling truly good (deep satisfaction) vs just better (pleasure).  But what is meant by “truly good” vs “better”? To feel truly good is a result of living in alignment with not just any value system but a system of values that have been shown to lead to a life of internal and external peace, strength, purpose, healthy and reciprocal connection with others,  and most importantly a meaningful satisfaction. It is living a life of virtue. Virtuous teachings we choose to follow, behaviors we do, aspects of our lives that we prioritize, characteristics that we strive to emulate, undeniably leave us with a sense that our integrity is preserved and not only  are we uplifted but so are those around us. 

To feel “better” is a momentary/temporary increase in mood. It is the pursuit of pleasure. But moods shift - sometimes very quickly, and we eventually come back to a certain baseline. This sudden increase in mood (pleasure seeking) is very dopamine driven and can be the result from a chemical reaction from eating a PB&J, drinking alcohol, watching porn, etc. Famed neuroscientist and host of the Huberman Lab podcast, Andrew Huberman in a recent episode of his podcast laid out a great rule - beware of unearned dopamine.* Unearned dopamine is not lasting, it wasn’t earned, but it’s dangerous because it programs our brain to consistently seek the easy wins in life that require very little of us and yield massive pleasurable feelings; and it’s these easy wins that usually lead to misery and a life lacking in meaning. Virtue on the other hand is the opposite: it’s a slow burn, it requires much of us but what it yields is a deeper sense of safety and security as well as reasons to be happy (relationships, meaningful work, soul-strengthening experiences).

So, if we spend most of our time (notice, “most” and not “all” - for even the best of us need moments of non-destructive pleasure now and then in the form of that extra episode of a series we’re watching or that delicious slice of cake) pursuing that which is meaningful and deeply satisfying we establish for ourselves reasons to be happy and not just chemical causes to be happy. 

After all of this attention paid to what leads to happiness I propose a principle to cement into your psyche: that your happiness is tied to virtuous activity. 

All of this “happiness is virtue” comes from many ancient thinkers but I’d like to highlight one: Aristotle. In The Nicomachean Ethics, Aristotle believes that the key to happiness is living a life of virtue. He says, “It is virtuous activities that determine our happiness, and the opposite kind that produce the opposite effect” (23).  In this statement Aristotle states that our happiness is an active process and something within our control. Later he goes on to say, “that happiness is a kind of activity; and an activity clearly is developed and is not a piece of property already in one’s possession” (247). So often we, as people, will view happiness as being predicated upon the possession of possessions. Once I have this, that, the other thing…then I’ll be happy. Aristotle believes happiness is (to an extent) separate from one’s possessions and more tied to “an active process”. 

So here is a process for happiness: First, remove that which is harming you. Second, keep track of and identify times, actions, responses, routines, and values that help you to feel truly and deeply good (an alignment with virtue and the health of your soul), and then…do more of that. 

We are aware, we are sentient. We are not idiots. Tap into that deepest instinct that lies within you (an instinct that the  ancient Greek philosophers, stoics, Jung, Frankl, Christ, Buddha, etc.) all recognized as existing and be honest with yourself. 

Start by honestly recognizing what is truly going well in your life and what is not. Then think of a time when things were better. Compare and contrast. Get rid of what you’re doing now that is hurting you and resurrect that which at one point helped you. Given the context of your present moment the “what has once worked” may require some tweaking but that’s okay, take your time, be patient but do not forget nor deny what truly is good for you despite the pain, discomfort, change, regret, etc. that may come with what is required for you to live the life you are meant to live. 

Aristotle says it best:

“The function of man is a kind of life, namely, an activity or series of actions of the soul, implying a rational principle; and if the function of a good man is to perform these well and rightly; and if every function is performed well when performed in accordance with its proper excellence: if all this is so, the conclusion is that the good for man is an activity of the soul in accordance with virtue, or if there are more kinds of virtue than one, in accordance with the best and most perfect kind”  (16). 

References: 

The Nicomachean Ethics - Aristotle (Penguin Classics, 2004)

* Huberman Lab Podcast, “Understand & Apply the Psychology of Money to Gain Greater Happiness”. Dec 2, 2024.

Overcoming the Suicidal Perspective

In the opening line of Albert Camus’ philosophical classic The Myth of Sysyphus, the ultimate question of philosophy is laid out: “There is only one really serious philosophical problem, and that is suicide. Deciding whether or not life is worth living is to answer the fundamental question in philosophy. All other questions follow from that.”  In Hamlet, Shakespeare wrote “to be or not to be, that is the question”. Many people, more than you think, have thought about death as a release. A release from the pain, suffering, uncertainty, demands, and disappointments of this world. That’s understandable since there is so much of it around us at all times.  

To be frank, suicide is a sickness of perspective. In her book, Night Falls Fast: Understanding Suicide, Kay Redfield Jamison discusses the perspective of someone struggling with suicidal ideations or behaviors . She helps us to understand it by keeping in mind the 3 “I’s” of suicide (notice how these are all perspective/judgment based):

My pain is:

Intolerable - I can’t take it anymore

Inescapable - I can’t get away from it

Interminable - It’s never going to end.

 If all you are seeing in your life is unnecessary suffering from which there is no escape, no end, and is beyond your capacity to tolerate it, then what else might you conclude other than making an exit on your own terms?

Because pain narrows our vision and isolates us it is crucial to pull back, and take on a different and more accurate “gestalt” type view. Gestalt psychology emphasizes viewing the image as a whole or the entirety of a set of patterns to better understand our reality. The gestalt theory says that the whole of an object or image/scene is more important than its individual parts. When we are in pain, we lose focus and perspective of our lives as a whole - most importantly the potential of what it could be. This is understandable depending on how brutal the pain is that we are experiencing. When one is in pain, be it emotional or physical, being able to think about anything else can feel impossible.

The key to managing our pain and combatting/managing the suicidal perspective is making a crack in those otherwise solid concrete “I” perspectives listed above. By asking certain questions and challenging one’s assumptions that have led to concluding that our pain is intolerable, inescapable, and interminable we allow some of the light in; for in the darkness our perception is limited to what is right in front of us but in the light, more is illuminated and that includes meaningful paths or perspectives that can give us what we need the most in those moments: hope.  

The key to all of this working however is faith (not necessarily religious faith). Choosing to live, despite our darkest moments of pain and hopelessness, is dependent on a faith that life has meaning, purpose, and a mission for us to accomplish. 

We may be blinded to how all of the pieces of the proverbial puzzle that is our life fit together, but if we have faith in life having meaning and purpose, and do our best to fulfill whatever significant tasks are asked of us, I believe our perspective will change and at the end of life, the puzzle comes together to reveal something deeply significant and beautiful that otherwise would not have happened if we did not endure. 

Finding “something to do, something to love, something to hope for”* that matters more to you than your pain just may be what is necessary for survival when the darkness comes and  “night falls fast”.

We can’t predict the future, so how do you know your life will always be like this? I have seen people on the edge; wanting to end their lives based on an assumption that their life is and will always remain intolerable and inescapable. I have also seen those same individuals who make it through and stay alive to then look back on that prediction only to be proven wrong but in the best way possible. 

We don’t know what will happen to us and maybe that is a good thing; for if we did know, we would be robbed of the meaning that comes from striving for a better life. Maybe it’s not the life we thought we would have and we don’t know what life will bring but that is the best part - for while we can’t control what set of paints we’ve been given, who’s to stop us from mixing these paint colors and creating something meaningful and uniquely beautiful onto the metaphorical canvases of our lives?! 

References:

The Myth of Sisyphus - Albert Camus

Night Falls Fast: Understanding Suicide - Kay Redfield Jamison 

*Quote attributed to George Washington Burnap, 1841

Self Acceptance

The type of self acceptance that I find most helpful is to accept that you have enough worth to try your very best in life - to improve your life and the lives of those around you. Very often we hear in pop culture and in more prominent psychological figures/speakers the phrase “I am enough”; almost as if it’s a battlecry opposing the shame that has been wrought upon them from individuals or systems in their life.

 “I am enough”. What does that mean?! It’s important to ask that because depending on what someone means when they say they are “enough”, it can lead to healthy changes or a worsened quality of life and relationships.

When working on acceptance the tricky thing is that it can go either way. A client can feel liberated from things holding them back and improve, or they can use “acceptance” as a justification tactic (deliberately or unknowingly) for more unhealthy lifestyle choices.  How about this take on “I am enough” - You HAVE enough worth to do the hard and more meaningful thing in your life. You HAVE enough worth and you owe it to your future self to strive upward, to accept the pain of life, to be honest with yourself - even if it is difficult. To “accept” means to accept possibilities that yes, you’ve made mistakes but you can redeem yourself! By accepting pain and truth we “shall be made free '' - and I believe in the truth of our potential to choose how we react to a setback, mistake, or a negative circumstance in a certain way to come out better for it. It is better to be liberated by a painful truth than to be imprisoned and doomed to repeat failures in a feedback loop all kept alive by a comforting lie. 

Please, do not deny what you have been through but also don’t define yourself or the rest of your life by it. We are more than our pain and our circumstances/our past. We must accept our potential to improve and to overcome and to hold ourselves accountable to that vision of who we truly want to become.

In order to become the best version of ourselves, we must first accept what we do not want to about ourselves. To view what we otherwise would turn away from can be the beginning of great and positive change. To view and accept what is in us that is undesirable can be painful and simultaneously healing. In the Lord of the Rings, the elf queen Galadriel offers Frodo the chance to gaze into a magical reflective pool that will show him things of the future and of himself. She says “Many things I can command the Mirror to reveal, and to some I can show what they desire to see. But the Mirror will also show things unbidden, and those are often stranger and more profitable than things which we wish to behold.” (362) The things we do not wish to behold are often the more profitable. If we can accept these things in our life (be honest with ourselves) we can then start to change.

By accepting both our flaws and also our potential to overcome these flaws, besides self-honesty, psychological flexibility is necessary. To be psychologically flexible is to accept our emotions, our faults, our setbacks, our failures, our situation and to not draw unchangeable conclusions but to stay open to possibility for movement (forward movement). Psychological flexibility is to remain open to not just the negative side of ourselves or our story but also the positive and optimistic side. If we can pull out all that is within, and start to look at it without conclusive judgment, we just may have a shot at making healthy, long lasting changes. 

I include and close with a fantastic quote from American psychologist Carl Rogers on the connection between self-acceptance, psychological flexibility, and change:

“To the extent that this person is open to all of his experience, he has access to all of the available data in the situation, on which to base his behavior. He has knowledge of his own feelings and impulses, which are often complex and contradictory.  He is freely able to sense the social demands, from the relatively rigid social “laws” to the desires of friends and family.  He has access to his memories of similar situations, and the consequences of different behaviors in those situations. He has a relatively accurate perception of this external situation in all of its complexity.  He is better able to permit his total organism, his conscious thought participating, to consider, weigh and balance each stimulus, need and demand, and its relative weight and intensity. Out of this complex weighing and balancing he is able to discover that course of actions which seems to come closest to satisfying all his needs in the situation long-range as well as immediate needs. (118)

References: 

Carl Rogers - On Becoming a Person

Practicing Intentional Loneliness a.k.a. Solitude

You would think that in a world that is so “connected” via the internet and various other technologies, that loneliness would not be a main struggle we have as a society or as a species. However, the epidemic of loneliness continues to spread. That feeling, the feeling of loneliness, or rather the fear of being alone, is so powerful that I have seen it lead to individuals tolerating, or even inflicting, other kinds of pain and suffering just to avoid it. 

Philosopher Blaise Pascal said, “All of humanity’s problems stem from man’s inability to sit quietly in a room alone.” There has been research (Univ. of Virginia) to suggest that people struggle with being alone just with their own thoughts to the extent that they would accept an electric shock vs. being alone for only 15 mins. 

 “Alone. Yes, that's the key word, the most awful word in the English tongue. Murder doesn’t hold a candle to it and hell is only a poor synonym.” - Salem’s Lot - Stephen King. 

An interesting concept when it comes to loneliness is objective vs subjective reality and experiences. It is in fact possible for an individual to be objectively surrounded by others, and yet subjectively feel alone. Researchers out of the University of Chicago, Hawkley and Cacioppo state that “Loneliness is synonymous with perceived social isolation, not with objective social isolation. People can live relatively solitary lives and not feel lonely, and conversely, they can live an ostensibly rich social life and feel lonely nevertheless. Loneliness is defined as a distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships” (bold and italics added). 

Did you catch that? Loneliness has more to do with our perception of being alone rather than the objective reality of not being surrounded by people. 

While feeling lonely is linked to our perception of being alone, we cannot ignore the fact that we, as a species and as carriers of a deep and rich psyche, do need objective time with others around us but not just any time; rather time that is spent IN PERSON enjoying or engaging in something meaningfully shared. Difficult and rigorous observation/analysis is not required to plainly see that “online connection” just doesn’t cut it. It’s not fulfilling that need for connection no matter how badly we want it to (there is plenty of neuroscience to confidently back up this claim). The need and call from within, to seek out others and connect with them much like our ancestors within a tribe, is real and must be heeded. This may require you to step out of your comfort zone, to be the initiator, to confront some pain, but the health of your mind, body, and soul depends upon it. 

There will however inevitably be times when we are alone. So, is it then possible to objectively be alone and yet, not feel alone? Yes, and it (solitude) is a skill just like any other that needs to be practiced. I frequently will have my clients face their times of being objectively alone with the perspective of it being a gift; the gift of solitude rather than the burden of loneliness. 

I would encourage any and all to institute some intentional loneliness. To purposefully carve out just 10-15 mins of your day and to be with your thoughts. Put away the screens, turn off and hide your phone. You can go into this time of intentional loneliness with a question in mind from your actual life and experiences, a general philosophical question (feel free to google “philosophical questions to ponder” and pick one!), or you can enter this intentional time of loneliness with the goal to “just be”: to find a quiet place in nature or in your home, and to “just be” in the moment. To “just be” is not necessarily the emptying of the mind but rather paying HYPER attention to all that is around you. Find a park bench, step away from the office and go outside and practice what the buddhists call “mindful walking or being”: paying hyper attention to the sights, sounds, smells all around you - by doing so, you lose a sense of “otherness” and begin to feel connected to all that is.

By practicing intentional loneliness we build up the tolerance for those times when we are objectively alone so that we don’t feel  alone but rather see it as a beautiful and recharging gift. In an age of so many parties, actors, industries, companies, corporations, etc. competing for our time, give some time to yourself and your own mind - connect to that part of you that is connected to the deeper and grander force that connects us all. It just may be the type of grounding you need in a world whose ground is constantly shifting beneath our feet.

References: 
Avoiding Loneliness through Electrical shock - https://www.science.org/content/article/people-would-rather-be-electrically-shocked-left-alone-their-thoughts

Loneliness perceived, Univ of Chicago research - 

https://academic.oup.com/abm/article/40/2/218/4569527

The Unpopular Truth About Compassion

Compassion is not compassion without wisdom or consequences. Compassion is presently being conflated with giving an unchained subjective moral license to do as you please. To be compassionate is to do nothing but affirm, affirm, affirm. But if we affirm without wisdom or boundaries - we most likely lead those we love to more harm and problems. Many historical atrocities have been done to those in the name of “compassion” - the road to hell is paved with good intentions as they say.

I do not align with Nietzsche on many aspects of his philosophy but when it comes to compassion and what that truly means, I agree. He says, “But if you have a suffering friend, be a resting place for his suffering, but a hard bed, as it were…: thus will you profit him best.”

What Nietzsche is saying there is to provide as much relief as is needed until that person can get up and continue on their way. We can’t make things too comfortable or else they’ll never leave. If they don’t leave, that doesn’t profit the version of themselves that they could be! This is a tricky balance to strike, but it is vital to the growth of our loved ones and our children. How irresponsibly toxic for us to provide too “soft of a bed” to those we love. It invariably leads to the weakening of their legs and back to bear the weight of their proverbial crosses in life. 

I’ve worked with many addicts that have said that the best thing for them was when someone that truly cared for them told them not what they wanted to hear, but what they needed to hear.  To tell someone what they need to hear is providing that “hard bed” that Nietzsche described. 

But how do you know what will truly be helpful? How do you know what that thing is that the other needs to hear? Hard to say. But to pause and practice wisdom is necessary. To ask, what does this action/message give to the other person? Or, does this “compassion” do something for me?  Does this provide a clearer path to true and lasting peace in their life? Is what I’m about to say hopefully going to lead to the growth of their soul? These are good questions to ask oneself when trying to strike that aforementioned “tricky balance” of soft but not too soft. 

A good formula to keep in mind is one that I have used throughout the years of practicing therapy (especially with adolescents) - 

Compassion = boundaries + attunement*

*Boundaries - what is okay/what is not okay based on tried and true classical principles of behavior

*Attunement - empathizing with someone’s emotions and what they are going through.

Allowing others, in the name of compassion, to act in misalignment with good tried and true principles, harms them. It’s not compassion. It’s cowardly niceness. But to only come down as a hammer is not compassionate either. We must express empathy for the difficulty someone faces in living according to principles or boundaries set. Also, we must express empathy for the challenges that people face of no fault of their own. However, that empathy must be paired with an expectation of responsibility to endure our afflictions in alignment with a set of values. 

This is important: There are times that when one acts in misalignment with values, growth occurs. This is natural and part of the process in all of our lives. The key word however is growth. If what someone is doing is resulting in growth or evolving towards a better life free from needless suffering then great! In contrast, if the choices of someone you know are keeping them in a stagnant, repetitive feedback loop of needless suffering, then it may be time to provide that “hard bed”.

A word of caution: Understand your limits of influence. You can say and point something out but it is still their choice to help themselves or to follow your words of counsel.  But you have at least done your part. Their autonomy (context dependent, e.g. you can respect an adult’s autonomy more than say a child or minor under your care) will need to be honored or else it then becomes your victory and not theirs. 

While it is wise to understand and recognize your limitations of influence and wisdom, it is foolish and sad to believe you have nothing to offer. When offering that “hard bed” - are we presuming we know better than them? Perhaps. But to constantly assume we don’t know what is good for someone can be just as, if not more harmful. Once again, there is value at times to leave those we love alone to make their way through life. To know when to involve yourself or to remove yourself (the “tricky balance”) requires patience and the wise questions previously mentioned.

I’ll end with this - Sorry, the kids/teens are not in charge. Purely psychologically speaking, it says in the New Testament that to enter the kingdom of heaven one must be like unto a child; note how it encourages us to be like a child but NOT to be childish. To let a child or a loved one make life altering decisions beyond their capacity to understand the consequences of those decisions, leads them to more suffering: all while you sit back in the name of “compassion”. This is not only childish but dangerous and weak. It’s not about going around telling everyone what to do - but giving people the space to “live their truth” leads to a loss of tradition and values which ends with more depression and anxiety. Why? Because what’s more anxious and depressing than trying to figure out how to navigate this world from scratch on your own?! No limitations set = limitless options = heightened anxiety.

Matthew 15:14 says, “Let them alone: they be blind leaders of the blind. And if the blind lead the blind, both shall fall into the ditch.”

Do not willingly blind yourself to the hard things or to hard conversations with loved ones. If we do, the blind attempt to lead themselves. And they will lead themselves…right off a cliff….all because of your “compassion”. Yes, you may not know everything, but you don’t know nothing! There are the blind that need our help. Perhaps you’ve learned some hard truths along the way that have given you a broader vision. Do not be afraid to share it. It may be the most compassionate thing you will ever do.

Citations - Thus Spake Zarathustra - F. Nietzsche

      The New Testament - KJV Bible

There is so much to be said about trauma that while writing this I found it hard to narrow in on exactly what I would like to say but if you’ll be patient with me, let’s see if we can make some of this all connect. 

Firstly, there is a debate happening in the mental health field. Despite what it may seem like, not every therapist is on board with using the word “trauma” to describe anything that is beyond one’s capacity to cope. I am unapologetically one of those therapists. Not everything is a trauma response. Could it be? Sure, but is it? 

I saw the other day online an advertisement saying that “procrastination IS a trauma response”. Once again, I guess it could be? But to say such a blanket statement like that seems a little presumptuous. When I was in college, procrastinating starting many papers to the night before they’re due, resulting in pulling an all-nighter, was not a trauma response but rather the result of a misaligned value structure; I valued spending time with my friends rather than buckling down and writing a paper. Procrastination for most of us, is something so natural (the avoidance of pain/discomfort) and where it could be a trauma response depends on the context of the situation. But that’s my point, to label something as traumatic I believe deserves specifics and a well thought out exploration of the proverbial landscape. When we make the term too general and broad, it becomes meaningless.

It’s important to use caution when using the label “trauma”. If “trauma” is defined as anything that goes beyond our ability to cope with (as I have recently had it presented to me as such by other colleagues), then we run into the “your truth” problem (getting further away from what actually IS because of endless interpretations of “my/your/their truth”). How many times have I heard “I can’t take it anymore”. Can we really not take it anymore? Or do we convince ourselves as such? Do we undercut our ability to “cope” because of a label we have subjectively decided by ourselves as being true? I believe more often than not, we do. 

Please don’t misunderstand me. It’s not about telling someone else that what they’ve been through isn’t as bad but more about telling yourself. It’s also not an invitation to discredit what you may be going through but rather an invitation to take perspective on what you are going through so that you can find in your pain a stronger inner belief; a belief stronger than the pain that you can use to not only endure but to endure it meaningfully. You are bigger than your pain.

Comparison (like judgment) can get a bad wrap. We have these emotions and cognitive abilities for a reason and just like anything, they can be used wisely or misused foolishly. Comparing what you’ve been through vs someone else can be helpful (see ourselves as capable of handling what we’re going through) or it can be harmful (jockeying for the “top spot” of the one ultimately the most victimized in an attempt to justify our behaviors, our virtue, elevate our status/credibility, etc.). 

As referenced just above, a risk in comparing what you are going through to others is the invalidation of your pain. That is not the goal. The goal is to: Yes, accept that what you are going through is hard but to also accept that others have been through hard things as well (maybe harder), have gotten through it, and you can too!

I have found in my practice that I never have to encourage my clients to take that perspective directly. Once they are validated and seen in their pain, they start to take perspective and wisely compare their pain to others on their own. Then, subsequently, their vision widens and they see not only a path out of their suffering or their metaphorical dark cave, but also things that now, in the present, they have to be grateful for. Once we validate our own pain (man, this really sucks), and to accept that it sucks vs judging it, our mind is free to take in perspective, use comparison wisely, and hopefully find meaning in what we are going through. But this has to be a personal choice. To have others tell you (like a know it all therapist on a blog) to compare your pain to others in the moment doesn’t work. This is more of a personal tool to be used once we have shown ourselves the proper care to see the hurt, see the difficulty, and to acknowledge it. Teddy Roosevelt said that “No one cares how much you know, until they know how much you care”.

I fully recognize that the subject of trauma can be complex and difficult to navigate. Hopefully I have presented some things to consider before we go around labeling everything as “trauma”. I call upon those in my industry to please use caution before calling someone’s pain or difficult circumstances “trauma” because if you recognize anything as trauma while that can be validating to some, it can be invalidating to others. Just imagine for a second: Are you really going to feel good, honest, and solid about yourself claiming/believing you are traumatized because you went through a bad break up, or a teacher yelled at you in grade school all year while you stand next to a first responder of 9/11 and or a survivor of the holocaust? Or, would you at least pause a moment and think about what you’re about to say? Would you at least take a second and wonder if you truly are traumatized? That pause, brought on by a wise and cautious comparison of someone else’s pain to yours, isn’t necessarily a bad thing. If you don’t feel your pain to be a fair comparison to the hypothetical examples above, that may mean something about your pain: Not that you’re a terrible person or a wimp because you’re struggling, but that you are stronger than you think. That with some perspective, you can still find what you, internally and externally, DO have that will allow you to get through your current struggles. 

Acceptance and recognition followed by proper perspective, helps us to make healthier choices that can free us from prolonged needless suffering. Pain can be so isolating - that’s why by first validating our pain, followed by a broadening of our horizons/perspectives, we can potentially see that our pain does not have to be all consuming of our identity and story. 

 Depression Part 2

Okay, let’s get a little more deep into the topic of depression; what causes one to be depressed? Also, what is behind the rising rates of depression? (an increase the likes of which has never been reported before). This can be complicated because of the sheer complexity of our brains, our individual personalities, our personal experiences, etc. Is it a chemical imbalance issue? Is it a spiritual issue? Some kind of combination? 

Empirically, it is most likely NOT due to a chemical imbalance. I know. This is hard to take in since according to recent surveys 80% of the public believes depression is caused by a chemical imbalance. However, in July of 2022, the University College London published their large-scale review of  various studies involving tens of thousands of participants, to determine if serotonin levels (high or low) have any influence on being depressed. The study’s lead author states “It is always difficult to prove a negative, but I think we can safely say that after a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin.”

Let me be clear, I am not saying that our emotional struggles/depression have nothing to do with chemicals in our body or other biological factors, rather I just wanted to highlight that relying on the “chemical imbalance” theory as the go-to/main cause for our depression is narrow minded and may blind us from other things that may better explain the cause and/or continuation of our depression more accurately.

So, if it can be reasonably argued that depression is not correlated with serotonin levels, then what might be causing this spike in depression? 

Once again, as often is the case, we can turn to the past for answers/insight. Viktor Frankl, in his book The Unconscious God, writes of what causes a societal uptick in depression.  What Frankl believes is that a societal shift in depression would be the result of an “existential vacuum”. An “existential vacuum” is defined as “not only a sense of meaninglessness but also of emptiness” (90). What leads a society to feel this sense of meaninglessness and emptiness that arguably has more of an impact on our depression than a chemical imbalance? Frankl lists 3 causes:

1. A loss of traditions and values

2. Reductionism (the view of human beings as being nothing more than primal drives and instincts

3. An obsession with the self

All 3 of these causes can begin to feed into themselves and create a deadly feedback loop. If we do not have spirit in us, if we are nothing more than another animal in this world (reductionism) and our spirituality is nothing but a culturally conditioned response to events or a mere firing of neurons in our brain, then there is no deep meaning in our traditions and values. Our traditions and values are no better than any other set of belief systems; so why hold onto them? Why not just give into our animal desires? If there is no meaning to be fulfilled in following our set of traditions and values then we naturally turn inward. Why not look out for me and my own? If there is nothing calling to me, outside of myself, of value and meaning, then hyper self-interpretation and analysis follows.  Frankl states:

As the boomerang returns to the hunter who has thrown it only when it has missed its target, so man returns to himself, reflects upon himself and becomes overly concerned with self-interpretation only when he has, as it were, missed his mission, having been frustrated in his search for meaning. (97)

Have certain traditions and values caused harm to individuals or sets of people at various times in history? Of course. But there is a difference between the innate goodness of the value, the meaning that can be had if we fulfill that tradition or value and our human proclivity to fall short. We have to, of course, switch out the bath water from time to time (re-evaluate our value system) but that is different than abandoning the entire system as a whole (throwing out the baby with the bath water). When that occurs, we are on our way to an existential vacuum. 

So what might be done about this? Might there be a turnaround in the depression levels in our society if we return to a set of traditions and values that offered us a way out of ourselves/our own hyper self-interpretation? If we start to view ourselves as not only biological in nature, but also spiritual, might we begin to feel our life has purpose and meaning? If we are spiritual creatures who have a responsibility to fulfill a set of values in this world, might we start to look outward for ways to fulfill that purpose? Yes. Yes. and Yes. 

I tell my clients frequently that we all need something to do. We need a quest or ideals to strive for (much like the ideals found in traditions and values). Stories, movies, and video games that are predicated on a quest are widely popular. There is a reason for this. To live our life as if it’s a quest; to live and pursue a mission is how we ought to live. When we live as if we ought to live, fulfillment follows. Living as we want to live, to pursue what we think is “freedom” (turning our back on tradition and values to live unencumbered by moral rules/guidelines), to satisfy our physical desires (reductionism), leads to an obsession of the self; If that occurs, misery is what follows. 

So, pursue what is meaningful. Pursue something that will place a demand on you. Pursue something that is focused outside of yourself. Have patience with yourself as you attempt to discover that meaningful pursuit in your life…what else are you going to do that is more worthwhile than that?