On Leaving Gladstone’s Library

Note:  This seemed more like a post about writing than a post about psychotherapy, (although those identities are increasingly tangled up for me) so I posted it at Subtext Consultations. Here are the first few paragraphs and a link to read the rest: 

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How do I write about writing without talking about what I am writing about?

I don’t mean to be cryptic, I don’t mean to build suspense or be tantalizing – because the final product, if there ever is one, will a long way off.

So don’t hold your breath.

So there isn’t any point in my being coy – but I do need to find ways to skirt around the subject of my writing in order to talk about the process, and to acknowledge the incredible gift that has been given to me in the form of a two week stay at an extraordinary residential library in Hawarden, Wales: The Gladstone Library.

To read further please click here.

Listen in:

So: as I sit at Gladstone Library  on a writing retreat –  wrestling with writing a larger piece (referred to by some as “a book” ) and enjoying two weeks of reading, writing, walking and contemplation in Wales –  another thing has happened that readers and friends of the blog might want to know about:

As an excuse to schedule regular chats together: 12920497_559299710898889_471395175850904443_nJason Evan Mihalko Psy.D. ( The Irreverent Psychologist/ @jaypsyd ) and I have started a (probably)  bi-monthly podcast: All That Fits in 45 where we will be psychobabbling about all the things psychotherapetic  that we can fit in a forty-five minute hour.  You can hear our initial and introductory  episode  on iTunes or on Sound Cloud

I’ve learned several important things so far:

  1. I talk WAY too fast and will consume less caffeine before the second podcast.
  2.  My terrible potty mouth that has earned us an “explicit” rating (which is unlikely to change) 
  3. Jason is as thoughtful and available and hilarious as he is on social media, and great fun to talk to.

We will be recording our next podcast tomorrow on boundaries and psychotherapy to release at a later date.

If you would like to hear our meandering explorations of the psychotherapeutic life – you are warmly invited to listen in and to post us questions or topic suggestions for future conversations on Facebook or at Twitter (@AllThatFitsIn45 )

(And deep thank you to Cranky Muse Projects for their amazing artwork on our behalf!)12809693_556335131195347_7678051234958925582_n

 

 

Multitudes 

In everyday conversation we have come to use the word “ambivalence” to mean “indifference”:

“Where do you want to go to dinner tonight?”

“I dunno. I’m ambivalent, you decide.”

But when psychotherapists use that word that isn’t what they are suggesting at all. They mean they suspect or sense that you are chock full of strong and conflicting feelings.

And how fortunate we would be if it were a simple conflict between only two states of mind. Often it is a cacophony of internal voices, needs, impulses, prohibitions, and logical assertions all arguing, interrupting and all talking over each other so that we have no idea what to do:

“I just can’t make up my mind” (into one mind)…

To read more please follow this link to Psyched Magazine

Trembling

 

  1. The world does not know that we must all come to an end here; — but those who know it, their quarrels cease at once. ~ The Dhammapada

Every minute of 2015 someone who loved and needed me was dying,

And my experience, for every minute of 2015, was one of consistent, contained, unrelenting terror. I felt joy, gratitude, hope, sorrow and anger as well – but coursing under it all, was a river of pure fear, visceral horror – a kind of adrenal fuel that drove me into extraordinary feats of care taking, as I crawled along the edge of a knife.

And when they left this earth, my very first experience was relief- a relief that continues to expand – even through the early waves of sorrow – a relief that grows and solidifies underneath me as I integrate my losses and the intensity and duration of the waves of grief modulate, and as I return to life changed and grateful for all that they left behind with me.

And in its absence, I have become intensely curious about the specific nature of this terror, its origin, form and function:

Okay, so I was scared shitless. What was it for?

What, if any, good did it do?

  1. As a fletcher makes straight his arrow, a wise man makes straight his trembling and unsteady thought, which is difficult to guard. Difficult to hold back. . ~ The Dhammapada

I am not afraid of loss, or living with loss, or my own pending sorrows. I have lost many loved ones in my life and know how to take them into me, and keep them with me and draw strength from my evolving internal connections.

But I was and have always been terrified,  horrified by the presence and the threat of suffering in those I love, and in others.

And when death came, it meant that suffering, or the threat of suffering, or both, were over, and I was unburdened of my most primal fear.

All of this is fairly straight forward, nothing earth shattering or bone shaking here.

Just basic empathy: We would of course, as empathic people, feel distressed by the suffering of others.

But my primal fear irritated me like a severe allergy, it whispered in my ears all day long and it told me this:

“You must do whatever you can, every single thing you can, to control, eliminate, prevent, head off, or reduce their suffering. Any suffering they experience is your responsibility to respond to with all of the resources at your disposal. You must be available 24 hours, ready in a flash, to take action to do anything, everything, you can to prevent it.”

  1. “May both the layman and he who has left the world think that this is done by me; may they be subject to me in everything which is to be done or is not to be done,” this is the mind of the fool, and his desire and pride increase. . ~ The Dhammapada

I’m sure my red-alert-readiness, my foolishness,  actually bugs the shit out of others  in the moments when they are working hard, and maybe even succeeding at withstanding their own emotional and physical suffering.

And of course, I have to consider how this reactive allergy to the discomfort of others led me to this profession, how I am called every single day, to sit in the presence of sufferings that are not mine.  I have chosen a life that requires  that I sort through- thirty some  hours a week for  twenty plus  years – what sufferings I can help alleviate and what suffering is not mine, is beyond me, is unsoothable.

And to tolerate my own impotence in the face of it.

  1. Him I call indeed a Brahmana who, even here, knows the end of his suffering, has put down his burden, and is unshackled. . ~ The Dhammapada

As a psychotherapist I am so often powerless –  pressed into circumstances where any action I consider or any power I claim only serves to disempower the client I hope to serve. The more powerless I am the more I must acknowledge that the person sitting opposite me on the couch is the only one with the power to make sense of their own anguish.

Sometimes even actions as still as listening, bearing witness or sitting near are worthless in the face of suffering.

Then, I am afraid.

Sometimes fear is all I have to offer.

Because I’ve become curious, I have  asked clients who experienced severe suffering in my presence how my fear impacted them.

“It let me knew that you really cared.”

“I could see that you really got what I was going through and understood how horrible it was.”

“It meant a lot to me, it showed me that you loved me.”

Hearing this offered its own relief, but still, I wonder what I might have offered if I had been less afraid.

Fear can create an inflation, an adrenal hubris,  which can seduce me into assuming responsibility for distresses and discomforts that I can never soothe or assuage. 

And although I have built up the capacity to contain my behavior, the fear rings like a malfunctioning alarm that cannot be turned off once it detects suffering in the air. 

  1. Him I call indeed a Brahmana who has traversed this miry road, the impassable world and its vanity, who has gone through, and reached the other shore, is thoughtful, guileless, free from doubts, free from attachment and content. . ~ The Dhammapada

 

What if I could accept other people’s suffering as inevitable and unavoidable, as their own property without being afraid? Could I be more present, more connected?

Could I have been more effective if I weren’t so afraid?

Can I “hold” fear differently?

If this fear is a kind of empathy in itself – and I suspect it is – if I am holding and absorbing fears that others cannot hold alone,  is there a way for me to withstand them differently or better?  

Is it a human necessity for the alarm bell to be activated ? 

Is it possible or desirable to remain committed to ameliorating what suffering we can and still stay peaceful in the presence of intractable suffering?

Is it even “right” by my own values to “stay peaceful” or detached in the presence of intractable suffering?

Is that healthy detachment? Or indifference? Self-preserving? Or self-centric?

Or just cold?

  1. Him I call indeed a Brahmana who has left what gives pleasure, what gives pain, who is cold and free from all germs of renewed life, the hero who has conquered all the worlds. . ~ The Dhammapada

 These are questions that, consciously or unconsciously, psychotherapists and care providers wrestle with every single day. Psychotherapists need to build defenses and force-fields,  finding  ways to detach,  to self preserve and allow others to claim ownership of their intractable sufferings.

And let’s be frank: I suck at detachment.

 I wonder if it is possible not to defend, or distance – but to remain authentically attached, compassionate and peaceful when others suffer near us.

Isn’t the capacity to maintain some internal peace intrinsic to our ideas of mature compassion? 

Can we allow ourselves to be empathically affected by the intractable suffering of others and not tremble in its presence?

I tremble.

I just wonder if it’s mandatory.

It might be.

If it isn’t mandatory it might still be unavoidable. I am no Buddha, and no one I know thinks I’m on the road to Nirvana.  

Yet, I also wonder what life might look like, what consolations I might have to offer if I could accept my right and limited place in the world, to love with all my heart, to do all I can and should do, to be able to recognize clearly and preceisely when I should do no more, and then to calmly instill confidence in others that I believe they have the power and capacity to contend with, withstand or come to terms with their own suffering. 

And then, at that point, allow myself to rest, still and present, peaceful and unafraid.

May all sentient beings have happiness and its causes,
May all sentient beings be free of suffering and its causes,
May all sentient beings never be separated from bliss without suffering,
May all sentient beings be in equanimity, free of bias, attachment and anger.

 

(The Dhammapada translated by F. Max Muller)

Installments

I might, sometimes, be a good enough psychotherapist – although there are certainly those for whom I have not been good enough.

But I am most certainly a terrible business woman. I dread doing my professional accounts each month, my financial books are shaggy and unkempt.

And an interesting unconscious habit, a persistent black out, a fiscal “tick” has stuck with me from the moment I hung out my shingle: I spend hours making up bills – and I forget to hand them to my clients to collect my fee.

I have even (and this has happened repeatedly) written up a statement in the last five minutes of a session, for the client sitting in front of me, said “Goodbye! See you next week!” walked them to the door and listened to the elevator doors closing behind them – and looked down to find a monthly statement: the CPT code and session dates, any previous balance (from the month before when I also forgot to give them their bill) the total due and my license number – still in my hand.

I’m a shrink, right? I am trained to think about such things – so of course I do, and I have – for the past twenty years – and I still haven’t cracked it.

I’ve tried all kinds of behavioral interventions and mnemonics – set alarms, and organized visual reminders – nope.

I’ve set up rituals, which I adhere to, of reviewing the bookkeeping tasks for the day – uh-uh. Nothing penetrates the blank-out.

I’ve even held the remaining bills for the day in my lap, and forgotten to distribute them.

I mean, I get them distributed eventually. Some by hand, some electronically –but in fits and starts and herky-jerky – and in the end I feel very valued and valuable to my clients – and I am grateful that I usually get paid, and paid well enough to care for my family. But this odd billing disorder isn’t born of complacency. There have been many years where I was scraping by, or short on rent – and still found myself with a stack of undistributed bills sitting on my office end table at the end of the day.

I own my worth. I can set my fees at a rate that reflects my value and training and expertise. Sure, there are lots of therapists in NYC who have a higher average fee than I end up with as my sliding scale and flexibility with clients in crisis, and pro-bono cases drag my averages down. But that is not unconscious. That is my choice, those are my values, and that is what helps me to curate a healthy and diverse generalist caseload.

I’m not inhibited about talking about money, and I like getting paid. I can talk openly, and even enter into conflict about my fees – I make sure to manage fees in a way that protects my clinical relationships from resentment or overextension. My fees are high enough to require a significant, if proportional, commitment from my clients, and to meet my own needs for reimbursement for what I have offered up.

And so I dig deeper than that:

I sit in a room of my very own, and the world comes to me.

Seekers, from every walk of life, from every profession, from many different cultures, come to my door.

They bring with them, each of them, hundreds and hundreds of stories to tell. Thousands upon thousands of myths and dreams, narratives, of hopes and heartbreak are laid at my feet. The more still I sit, the more stories are offered to me. 

Like gifts. Like precious offerings. 
These stories, priceless and sacred, are left behind with me, a pile of totems, charms and  talismans to protect and instruct  me as I move through  my own story. 

Like a safe deposit box I am filled with other people’s treasures.

If I am very very lucky, and I have held still enough and said the magic words, whatever they may be, often enough (I am very very good finder of magic words) I may be allowed to become a part of these stories, and to help create their meaning and influence their outcome in some small way, and hopefully for the better (but you never know for sure with magic words, what forces you will unleash).

There are boring bits. Long periods of exposition or sometimes endless description of the landscape – but I’ve learned to rest during those patches because soon enough – the tale will pick back up and we will be facing demons and dragons and rescuing royalty and sitting on the edge of our seats and escaping by the skin of our teeth.

And each session there is a new and amazing hero, in a new story, and I am their trusty side kick, or their genie in a bottle, the village fool, the scape-goat, the ugly step-sister  the crone in the hut at the edge of the forest, or the princess they have yearned for, or the Queen on her throne or the wickedest witch of all.

And the protagonists move through their tasks so heroically, with such courage and fortitude, I am continuously stunned and surprised by each new trick, each riddle solved, and every feat of strength.

And the story is so engrossing, so compelling, and it offers me so much even as I play my delimited  part within it, that I am swept up and satisfied and filled. And like all big stories, big myths and dreams, I have been transformed myself by the tale.

And I think what happens – is that I just forget.

I forget, and sometimes it just makes no sense to me,

that I am actually supposed to be paid at this point in the  adventure, as I wait, dangling in suspense for  next week’s installment. 

Nothing More

I can’t write authentically about anything other than early bereavement right now. Except maybe compound bereavement, complex bereavement, working as a therapist while you are actively bereaved. After your toes have been curled around the edge of the abyss watching several loved ones slowly slowly fall into it every single day for a year or two.

How you think, but you have thought before, that it has stopped – that the dying has paused – and that maybe the universe will offer you a decade or two to catch your breath before you again lose someone who is part of your psychological and logistical infrastructure – but what if it doesn’t pause (last time it didn’t) and what if it keeps going – and swallows someone else up you love, or you?

What if lightening strikes repeatedly in the same spot? What if freak events, school shootings, car accidents, house fires, drug overdoses, aneurisms or just more cancer cancer cancer keep coming?

About the feeling of falling down a rabbit hole, the floor pulled out from under you, and having no idea when or if you will hit solid ground again.

About the terror of looking forward – because it means encountering the days, years, minutes ahead without someone who you might have assumed would travel through time with you but is gone, and not just gone for right now, but gone always. Never to be seen or heard again

I can only in this moment write about how it is also hazardous to look back – because if you calculate all that you have negotiated and all the heartbreak of the death and dying cluster you hope you have passed through (but who really knows for sure) you will feel a fatigue so great, so crushing, so heavy that you know your body actually demands three solid months of sleep to recover – but there are children to care for and bills to pay, and the unflinching and unceasing demands of life to keep up with.

And the past has other dangers – sometimes called memories – which can comfort and soothe and strengthen you but can also turn against you into a brutal accounting of what exactly has been taken from you, and what is no longer with you in the present moment.

About the strange alienation when you hear normal people talking about everyday things – and who, understandably try to engage you in conversation about everyday things, while you are actually still living in the crack between the worlds where every second is both sacred and terrible and as far from everyday as humanly imaginable – but you somehow – strangely- without understanding how – are still able to chat and smile and nod and act “as if” you are a part of this earth – when you haven’t really come back yet, and aren’t sure who you will be when you do return.

And the times when you do feel normal – uncannily normal – like nothing happened, nothing changed – when you go about your business, and again, kind and well meaning people treat you as if you are still altered (you aren’t are you?) but you feel regular and you just want to cash in on that for the time being but everyone’s concern disrupts the illusion and you remember you have just had a human being that you cherished amputated from your life.

The self-compassion that you have to cultivate in order not to push or shame yourself, when you feel nothing, or you feel totally fucked up, or you feel fine, or you feel the worst, searing burning pain, or you feel terrified, or you feel lost, or you feel a little manic-y in your love of life, your appreciation for what is good or kind or just or beautiful, or your slightly panicked need to say every positive grateful thing you feel to the people around you over and over again in case you don’t get to say it later, or in case the moment arrives where you will never get a chance to say it at all.

How you search for places to put your thinking – or behaviors to engage in – that comfort you for a second and how you hope that thought or that photo, or that song, or that peaceful spot doesn’t dry up on you and lose its ability to function as a balm for all your sorrows.

Gathering your thoughts before sleep, trying to court dreams which make this make sense, or which offer consolation.

And how, you go to work, and you want to go to work, to tend to and care for others who mean the world to you – and stand shoulder to shoulder beside other people who are contending with challenges and suffering, loss, illness, bereavements, alienations of their very own – and your power to take those in, take those on, and mirror it all back can make your own wound useful – but can also exhaust you and expose you to profound re-injury – the most painful kind of re-wounding when you work from your vulnerability and it is rejected or attacked.

And can you really withstand that right now?

Usually, yes, absolutely. The connection and the potential of intimacy makes it all worth it, and probably there is an internal mandate to keep doing it because what else can you do? What other way of working in the world will cook this stew into something  digestible?

But sometimes momentarily no. Not at all. It is not withstandable and why did I ever take on this fucked up job of absorbing other people’s aggression and confusion and wishes for me to be perfected when I am not I am not, I have never been and I am certainly not now, not at all. Who did I think I was? I suck at this, it is the worst and is there anyway to get out of this at this point?

Suddenly remembering that even your breakability is valuable because it connects you to the brokenness of others

Finding seconds of relief and stacking them upon each other.

Remembering you are grateful for the love that you are now grieving and for the love and kindness, and the attempts at kindness that are all around

Remembering what those you have lost would want for you.

Trying to see yourself as they saw you.

Arguing with them in your head. Giving them back the fucked up bits that they might not have accepted when they were alive.

Learning to speak to yourself in their healthy voice.

Recalling that everything  you are contending with that feels unnatural is natural.

That grief is part of the natural order of things, and allowing it to function in your life as a natural force.

And remembering  that it is all expectable. Necessary. Unavoidable.

That all this is just grief itself.

Nothing less. Nothing more.

 

 

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(For an accompanying discussion on the processes of bereavement and how you can support those in early bereavement please read this. )

 

 

 

 

 

 

 

In Memorium

Update: The Astraea Ellie Conant Fund closed on June 30th after six months of fundraising and after an amazing glorious float in her honor rode down the middle of the NYC Pride Parade. At the time of its closing just over $18,000 had been raised in her memory to support LGBTQ youth in Korea. 

I know many people who read this blog made contributions and I thank you for your kindness, and support and for helping to change the world in Ellie’s memory. 
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Recently I wrote a post entitled “Death Ed.” for a dear friend,  a chosen sister who was facing a terminal illness.

She died early New Year’s Day, peacefully, in the arms of her amazing partner. We received the call as we were eating ttok mandoo guk, the traditional Korean New Year soup that she had taught us to make.

It is nearly impossible to describe Ellie to those who have not met her. It is also nearly impossible to explain to those who do not know us how it is that we became a family. Her own words are more effective than any of my own.

She helped to raise my children. She helped me care for my sick and dying mother.

She fed my Korean children the food her Korean mother fed her as a child and taught them to cook it for themselves.

She was there on our worst and best days as a family.

She understood my children in places that I will never comprehend, but will always respect.

She made me laugh my ass off even in the darkest times. She stepped up for me, and permitted me to do the same for her.

She changed people’s lives who met her one time, for ten minutes and never ever forgot her.

It has always been easier for both of us to give help and harder  for us both to receive it. But somehow we learned to ask and accept and receive help from each other.

And because Ellie was such a supportive soul, and so encouraging about this blog:

  

 I will take what we learned together and ask my What a Shrink Thinks community to help us make sure that this loss generates care and consolation for others:

Before her death, Ellie spent time thinking about her legacy, the causes and the people on this planet that she most wanted to support – projects that would serve as extension of her core values and passions. She decided that her memory would be most honored by caring for LGBTQ youth in Korea. With the help of Astraea Lesbian Foundation for Justice we are able to direct donations made in her memory toward a shelter in Korea for LGBTQ youth, as well as other projects.

Please help her extraordinary and nurturing spirit continue to work for change, compassion and liberation in this world.

Please share this post and follow this link to the Astraea donations page, and be sure to indicate that your donation is in memory of Ellie Conant. 

Donations will be accepted through June, 2016–both the month of Ellie’s birth and the annual Pride celebration she loved so much. How fitting that we support her in spreading Pride into the world.

To my beloved adoption community:

So many people have reached out to us to ask how they can support  our children through the loss of their dear dear Imo.

This is how:

Please click and share this link and help us raise up and support multiracial and LGBTQ voices annually at the KAAN conference.

Our bonds as a family were forged & solidified there, it is an annual community/family reunion for us  and we hope you will all help us to keep Ellie’s generous spirit present at the conference so the kids can see that she is not forgotten. 

She left us with so much , and I hope that we can extend that abundance to others.

With a full and grateful heart,

Martha

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