Rounding the Corner…

COVID-19 is a very strange disease.  We are learning more about it and in doing so, understanding how better to treat it.  I was recipient of the lessons past experiences had taught medical providers, and study of the COVID-19 virus taught them the dos and don’ts of treatment from which I benefited.  One of the lessons learned was that about 12 -14 days following the first indication of symptoms, COVID patients would most often begin to get better.  In my case, the treatments seemed to be working and as the medical doctors and nursing staff would remark, all indicators were moving in the right direction.  Was this my day?  Was it the day that I would round the corner and begin to move towards a COVID-free reality?  The medical staff hinted that this may be the case.  Was it true?  Could the worse be in the past?

This day, my rounding the corner day, came at the end of a few difficult nights.  No matter what one does; no matter how disciplined one’s thinking may be, it is difficult to keep thoughts of doom at bay and quiet the anxiety produced when one confronts their mortality.  One of these nights, when it seemed that the oxygen saturation levels had once again become a problem, it was easy to become discouraged.  The disappointment that sets in when one thinks they are doing better only to be confronted with what yet needs to be accomplished is overwhelming and even in the midst of the nurses’ care, one feels alone—very alone.  On that night, in the midst of my despair, I thought about calling Becky, my wife, but I didn’t.  Why?  I did not want to burden her any more than I already had.  So in my loneliness, I rode it out, concentrated on my breathing and my dread was overcome with thankful sleep. 

I don’t know for sure if it was the following night, but on this night panic seized me.  That is a strange thing.  As a mental health professional I was supposed to understand anxiety, I was supposed to be able to deal with panic.  But there in the darkness of the room surrounded by loneliness, the panic penetrated any peace I may have had slicing away my calm and filling me with dread.  The result was a type of hyperventilation that further cut into my oxygen levels. Fortunately, the night nurse realized what was going on and gave me some Xanax.  I took it and it did its job, the panic eventually giving way to blessed sleep.

Was this day to be my rounding the corner day? I certainly welcomed it if it was.  I wanted to put the experiences of nights past behind me and hoped that remaining nights in the hospital would only get better.  However, thoughts of being better seemed risky.  What if I hoped this to be the case only to find out it was not?  Shaking my head, I refused to entertain such defeating thoughts.  This was my rounding the corner day.  From here on out, I would begin to get better; I would begin to walk down the path towards healing.

The hospital room I was in had a large picture window that looked out over the surrounding buildings and trees towards the East.  On that morning, there were no clouds and as the sun begin to peer over the trees, I could not help but realize that this was Sunday.  My mind drifted back to when as a pastor of the Brush United Methodist Church, I would open the service with the words, “This is the day the Lord has made; let us be glad and rejoice in it.”  This was the day the Lord had made; it was my rounding the corner day and as I watched the rising sun and meditated on those words, I smiled and allowed the brightness of the sunrise to fill me with promise.  This is the day the Lord has made and it is my rounding the corner day; things were going to be better.

As I watched the sunrise, the hospital begin to come alive.  The medical staff started their regular rounds of poking and probing to see if I was on way to my rounding the corner day.  Not too long into his process, the night nurse came in excited.  My vital signs were all good, the best they had been for a long time she told me.  “I think,” she said, “you have rounded the corner.”  This is the day the Lord has made; it is my rounding the corner day; let us rejoice and be glad in it. Not long after that, the attending physician came it.  He was a tall, esoteric person whose eccentricity easily gave way to his care and compassion.  He repeated the news given by the nurse and indicated that all the blood markers were headed in the right direction signaling that the infection was beginning to fade.  As we talked, he began to mess with the oxygen levels, turning them down watching the saturation levels, which did not move.  He turned them down again and again, the saturation levels stayed where they should have stayed.  He left only to return in a short while, to turn them down yet again.  This was a good sign.  It was my rounding the corner day and hopefulness of that moment began to define the day that filled me with promise.  This is my rounding the corner day.  It is the day the Lord has made; let us be glad and rejoice in it.  And from that point, things did start to get better.

Faith…

Fides quaerens intellectum…”faith seeking understanding.”

St. Augustine

I retired as a minister in the United Methodist Church after twenty-three years of service.  Admittedly, this was a mixed bag.  I had been the pastor-in-charge for several churches, and when pastoring in Missouri, was the pastor of a 2-point charge.  Every other week I would lead the services in a small rural community, and on the off Sundays, the minister leading the service was a Baptist.  It was a strange combination.  However, during many of my 23 years of service, I was either the associate minister at a rather large United Methodist Church, or I taught in colleges and universities along the Denver Front Range area or both.  I suppose if I were to name that which energized me the most it would be teaching, and I taught not only religious studies, but was a part time instructor in philosophy at Red Rocks Community College for over 20 years.  Teaching philosophy had become my passion for it provided keen challenges to the simplicities of dogmatic faith that all too often capture people’s imaginations limiting their experience of God and restricting their faith.  My ministry, then, was a mixed bag not only because the varied nature of my ministerial positions, but because I yearned to bring the deep existential nature of faith into the highly critical and demanding rigors of philosophical thought to make sense of the divine nature of our everydayness.

However, faith is a quality of life that defies simple definition, and its reality is something that can never be contained in dogmas and statements of belief.  When I retired from the ministry, I did not retire from faith; I retired from the medium I had used to communicate and practice my faith—institutionalized religion.    In doing so, I admit that church services did not remain a focus in my life, but I have never been able to nor have I the desire to turn my back on faith.  Faith, whatever is, is the existential reality of God’s love and grace as we live day to day and attempt to enter graciously into the lives of others.  As such, it is a reality that brings conviction of the goodness of life and the belief that in the end, goodness will triumph,  More practically, however, faith is the presence of God that sustains us in times of need and inspires us with the thought that no matter how difficult, life will be redeemed.

This is no more evident than when one’s health is threatened by COVID-19.  In the midst of this health challenge, faith cannot remain an abstraction, but becomes the very fabric of life allowing us to look beyond the immediacy of the disease to the hope of healing.  In faith, we turn to powers beyond the self to aid us, to inspire us and to help us embrace life.  While the possibility of death was certainly a nagging thought, faith focused not on death but life.  While a person who, like me, is in a high-risk category, the thought of being overwhelmed by the disease perdured, but faith did not allow this to be the last word.  It turned my attention from feeling bad to imagining the time when I would walk out of the hospital.

I realize that many who have been overcome by this disease are also people of faith, whose determination like mine was to live.  They didn’t make it.  I make no pretense to understanding the “whys’ of this situation.  I do not know why I lived, and others did not.  I do not know why my faith delivered me from the throes of death.  I believe, however, that the answer is not found in reason, but the very faith that saved me.  Somehow in the intricacies of that moment, the prayers, hopes and kind thoughts of others powerfully interacted with the care and expertise of medical personnel and the disposition of faith allowed me to focus on these words, these efforts and the expertise of others to finally walk out of the hospital.

It is still not over and even though home, I look to the day with eyes of faith.  What will tomorrow bring?  I do not know.  But what I believe is that by keeping my eyes on the prize—life—there is little that can come between me and my hope that the graciousness of our universe will continue to lift me up so that the life I have left to live will be one of hope, promise, graciousness to others, and one of seeking to understand that which is not understandable—faith. Fides quaerens intellectum…”faith seeking understanding.”

The ER…

When my wife saw that my oxygen saturation was 84, she was quite alarmed.  She didn’t say much at the time, but unbeknownst to me, she consulted our PCP and friend, Dr. Elias Hernandez, and her daughter, an ER nurse who works in a COVID unit.  Both said the same thing…get him to the ER. 

As we drove to the hospital on what seemed to be a dark and gloomy night, the gloominess was intensified by the fear and uncertainty of COVID-19.  It is a disease that does not discriminate and  attacks all people of all ages, but is particularly difficult for those who fit in the high risk categories: obese, diabetic, high blood pressure, a senior adult, and unfortunately I seemed have nailed every one of them.  So, as we drove to the hospital in near silence, I could only wonder what the future held in store.

“Was I going to die?” was a question that nagged me, but I did not give it much airtime and turned instead to focusing on what I could do to get better.  That was my power and doing what my care providers asked me to do was my hope. 

You enter the hospital alone; your wife cannot accompany you.  As I entered the ER door, she called out to me reaffirming her love and warning that it may be a while before we saw each other again.  At the time, while I found that thought alarming, I did not give it a lot of thought.  I just simply did not feel good.

As soon as I entered the ER, they assigned me a room and began taking my vital signs.  Soon, I was speaking with the ER doctor.  At the time, my oxygen saturation had improved and read between 90 and 92.  The doctor explained that they would not admit me to the hospital unless it dipped under 88 and was about to send me home, when my 02 levels sank, dipping to 82.  At that point, I was there to stay and it was a good thing I did.  That night was a struggle requiring 15 units of oxygen to get my levels where they needed to be.  It is interesting what you think about at such times…or don’t.  I don’t think I really thought about dying; I don’t think I thought about living.  I just wanted to feel better and tried to do all that the staff asked of me to do while at the same time trying to maintain a pleasant attitude.

We made it through that difficult night, and the next morning I was sitting up in a chair, eating breakfast and gulping 15 units of oxygen into my lungs that I might breath at a 94 level of saturation.  I wasn’t aware of how much oxygen that truly was, but I was pleased to have made it through the night and wondered what the coming days would bring.  Would I get better?  Although the staff were cautiously optimistic, it was too soon to tell.  The difficult times were still in front of me and I worked on developing a positive mindset focused on doing what was needed and giving little room to the alternatives.  “Was I going to die?” was a question that nagged me, but I did not give it much airtime and turned instead to focusing on what I could do to get better.  That was my power and doing what my care providers asked me to do was my hope. 

A Fight with COVID-19

I realized that my job was to get better and getting better is found in compliance rather than opposition. I did everything the medical staff asked me to do as best as I could do it and it appears to have paid off. I am now back home.

On Wednesday, November 11, I went to my office and before opening, as is my practice in this COVID-crazy world, I took my temperature. This is something I do everyday and I take “proper’ precautions when seeing clients in my office. I have them fill out an affidavit stating that they have not been exposed, take their temperature and try and practice social distancing. In other words, I try and take all the precautions; I don’t want to catch COVID-19. On that fateful Wednesday, as a looked at the thermometer, I was in for a surprise. The first reading was 100.3. When I took it again it was 99.5. I packed up my stuff, locked the door behind me and went home.

It was at that time the symptoms began to worsen and I knew I was in trouble. I scheduled a COVID-19 test for the next day and by the time the results came back positive, I was already fairly positive that somehow I had COVID-19. It was not long before my oxygen levels were falling and I ended up in the hospital on November 17. I was released today, November 24. I was there for exactly a week.

There are a couple of things to say about this. First, thanks to a persistent wife who is a retired Family Nurse Practitioner and her daughter who is an ER Nurse in a COVID unit in Cheyenne, WY there was little delay between becoming symptomatic and going to the hospital. This was an essential part of my treatment and we were able to begin treating the disease early before the symptoms had become too extreme. Second, the staff, nurses and medial doctors at that hospital were amazing. They were kind, compassionate, instructive and very hard working. They literally fought for my life. To all of these people, my words cannot convey the depth of my gratitude and respect. Their expertise, competence care did truly nurse me back to health. Finally, I realized that my job was to get better and getting better is found in compliance rather than opposition. I did everything they asked me to do as best as I could do it and it appears to have paid off. I am now back home.

A fight with COVID-19 is a very strange process for always hanging back in the recesses of your mind is the thought that this virus could kill me. If so, I may never see my wife and loved ones again. I did not give this thought much space in my thinking. Rather I concentrated on what i need to do to get better, bur still, the thought was there and it was frightening. It is a fight that is exhausting for the virus promises to exhaust your energy reserves making it sometimes difficult to focus energy on getting better, so you sleep…a lot. As a way of reflecting on this experience, the next few blogs will represent an overview of my experience and the thoughts I had. I hope they provide some insight but most of all, I hope they are taken as a warning. COVID-19 is nothing to take lightly, and it can kill, maim, and permanently scar you even if you survive. It is indeed frightening stuff and we should exercise extreme caution in an effort to avoid it.

Family Therapy: It’s all about the Relationships

Psychology is all about the “self.”  That should not be surprising because even though Freud—the progenitor of psychoanalysis—included in his notion of the self the “superego,” which is Freud’s acknowledgement of environmental impact upon thought processes, the primary focus was not upon society, but the individual and their neuroses.  Since that time, psychology has been mostly an individual affair until following WW II when a group of thinkers began to embrace the insights of systems theory forcing them to think outside of the box of individualism.  Systems theory privileges one’s environment over the individual.  That is to say, the individual is not the author of its environment; the environment is the author of the individual. 

This may seem like a subtle shift, but it had landmark implications and the ones who drew upon the insights of this new orientation were loosely referred to as “family therapists.”  Built upon the observation that when one child’s behavior changed for the better, the behaviors of other children in the family deteriorated, family therapists began to understand that family dysfunction was due to the family system more than just one individual member of the system.  Quite often it would seem that one person was the problem because the family would scapegoat a family member as the culprit.  “Fixing” the family member did not fix the problem leading those of us who teach family therapy to warn that “very often, the problem is not the problem.”  Interestingly, this is as true of couples as it is families and so the principles that apply to family systems also apply to a couples.  Indeed, in all of this, systems thinking turned attention from individuals, or more abstractly “things,” to relationships.

In order for families to “work,” they must be shaped by rules that bring meaningful order to what would otherwise be chaos.

Let’s talk about this for a moment.  What does it mean to say that relationships as opposed to things or individuals are primary?  The first thing we must note is that this not the reduction of psychology or family therapy to some type of strict behaviorism.  Behaviorists such as John Watson and B.F. Skinner were asking similar questions to those in systems theory but were using different conceptual frameworks.  Taking on Freudian psychotherapy, these practitioners claimed that we can know nothing of the subjectivity of a person.   Rather, all we can know about a person is their behavior and by stimulating behaviors in certain predictable ways, we can modify or change them (operant conditioning).  So, if we associate a bell with the feeding time of a dog, when we ring the bell dogs will begin to salivate whether we feed them or not.  While human beings aren’t dogs, behaviorists found that conditioning worked nearly as well for human beings as it did for dogs and that much of what human beings do are based upon habitual routines conditioned by the environment input of one’s surroundings.  We may not know what a person is thinking, but we can observe their behaviors and by inserting certain stimuli and rewards into the context of their routines, we may not change the way they think, but we can change the way they behave.

How is this different from systems theory and family therapy?  The common ground is found in a shift of focus from the individual to an individual’s environment.  Behaviorism is all about the manipulation of environmental factors to shape the behavior of the individual.  Systems theory is all about examining the “rules” of the system in an attempt change the rules to change the function of the system.  When this happens, everything defined by the relationality of the system also changes. In other words, “The whole is greater than the sum of its parts.”  This may sound subtle, but the implications are profound and to understand this, we need to think a little more about the interrelationality of the whole.  Communication theory is helpful at this point.

Have you ever looked at a television that has no signal?  The screen is just a confusing mess of tiny little dots resembling a nondescript, grey-colored cloud.  If you so desired, you could stare at this screen for hours, but the cloud of dots would never become a picture.  The TV screen is in a maximal state of information.  All its circuits are on transmitting information without boundaries.  Nothing on the screen creates boundaries that allow it to transmit pictures.  There are no boundaries creating letters forming words.  This is the curious thing about communication; when data is transmitted without boundaries, the amount of data transmitted can be mind-boggling, but the transmission is devoid of meaning.  We need boundaries to bring focus to the data being transmitted, which will focuses the data into a significant form of transmission, a transmission that brings meaning.  So, when a picture is transmitted on a TV screen, not all dots are transmitting at their optimum capacity,  Some are green, blue, red, etc. in an effort to create boundaries so that the picture (meaning) can be transmitted.  In order to develop meaning, data must necessarily be limited by boundary conditions and boundaries are lines of demarcation in relational matrix that allow perception to be focused upon a particular type of meaning or function.  What’s more, these boundaries are developed and shaped by particular rules on how data should be shared.  If the rules are corrupt, data transmission will overpower boundary formation and chaos (meaningless will result).

Families, family therapists contend, work in much the same way.  In order for families to “work,” they must be shaped by rules that bring meaningful order to what would otherwise be chaos.  Without going into detail, let me briefly describe a family I worked with that was similar to the grey cloud of the TV screen.  There were five kids in this family ranging in ages from two to ten.  The father was mostly absent from the family system (in family systems theory, absence is still a presence because it denotes a type of negative relationality) and the mother had less than a high school education.  She lived in a basement apartment with only two bedrooms.  Since she had little support from her husband, she not only worried about how to pay the bills, but how to make her children “happy.”  As often happens, the path to happiness for her was to allow them to do whatever they wished, which normally did not entail happiness, but battles over the possession of toys and struggles for their mom’s attention.  Her way of trying to bring order to this was to scream at her kids and threaten spankings.  It didn’t work.  The family was in chaos.  In one of our first meetings, I didn’t intervene at first, but just watched.  The poor mother, overcome by the lack of boundaries and meaning rules eventually sat on the floor with her back to the wall, knees elevated and simply buried her face in her hands.  This is a family functioning like a TV screen without a picture, and if one were to try and fix one of the kid’s behaviors would have done little to fix the family because the rules remained the same.  To fix the family system would mean to dismantle (unbalance) the dysfunctional family rules and reintroduce new, more meaningful rules that would shape a happier and more meaningful family picture.  That is the work of family therapy.

This also happens when working with couples.  One couple I worked with illustrates this well.  He was a slender man and she was a rather full-figured woman.  I had not met with them before and I watched as they entered my office (watching how people enter the office along with how they arrange themselves tells you almost as much about their problems as do their words).  One sat on one side of the couch and the other sat on the other side of the couch with about three feet between them.  “What brings you here today?” I asked.  It was not long before I witnessed what brought them here.  It was the TV screen without a picture.  One said something causing the other to become defensive and in a short while, they sat on the couch and yelled at each other.  Wondering how long this would go on, I simply watched.  I think it may have continued through the whole session if I had not eventually intervened, but I saw what the problem was.  It was the chaos of poorly defined boundaries based upon dysfunctional rules that brought no meaningful focus to their relationship.  The work of couple’s therapy is to help them formulate meaningful boundaries based on functional rules that will help develop a more meaningful picture.

In all of this, the emphasis is not upon the family members or the individuals who comprised the marriage.  It was on the relationship(s) as defined by the system.  To be is to be in relationship and if we hope to exist in a meaningful way, the relationships we keep, those things that bring focus to ourselves as well as each other, must be relationships defined by meaningful boundaries and functional rules so that we can feel good about ourselves and each other.

There is a lot of difference between psychoanalysis and family or couple’s therapy.  Whereas the former’s emphasis is upon the individual and different psychopathologies, the latter emphasizes the systemic relationships that comprise the family and the relationship between couples.  Because the whole is greater than the sum of the parts, you just can’t fix the family by fixing an individual.  It doesn’t work that way.  “It’s all about the relationships, man,” to use the colloquialism of years ago.  It’s not about the individual.

Post-Truth COVID-19 “Facts”

While researching a different topic, I began to think a great deal about truth, especially the phenomenon known as “post-truth.”  Minted as the Oxford Dictionary’s 2016 word of the year, post-truth denotes an environment where people judge the facts based upon how the facts measure up to their ideological point of view, a point of view that they believe to be true.  From an epistemological perspective, this is just the opposite of the way it should be.  Epistemologically, facts should shape our point of view so that when the facts do not line up, we are forced to change our point of view, adjusting it to the facts.  Shaping our thoughts of reality to the facts no matter how inconvenient they may be is the way of science.  Allowing our beliefs to shape the facts is the way of religion at best, demagoguery at worse.  When religious, political or philosophical ideology becomes the standard of measurement for the legitimacy of facts, then as Lee McIntyre in his book, Post-Truth warns, political domination is not far behind.

When post-truth becomes the accepted standard, then truth suffers and when truth suffers, people will suffer as well.  It would be nice if we could just wish bad things away or live in the world as we would like it to be, but we cannot.  What I call COVID-19 exhaustion has opened people’s minds to the claims of post-truth ideology, an ideology that claims the worse is over even while new cases of COVID-19 skyrocket.  It is an ideology that claims that exposure to the disease is necessary to boost the immune system, even though such notions have been debunked by science.  It is the desire that those who say that the disease will just go away are right, but it won’t and isn’t going away as recent statistics have demonstrated.  We are exhausted by the idea of social isolation; we are tired of social distancing;  we do not like wearing masks—they make it impossible to breath although if one contracts the disease, they may discover what it means to not be able to breath; we grow weary of the loss of jobs and the uncertainty of our economic security; we worry that we or our loved ones will catch the disease and may die or be permanently affected by it; we wish that a vaccination would be discovered and believe that such a discovery will happen soon.  All of this and more leads to exhaustion and exhaustion leads to the belief that the worse is over even though the facts tell us otherwise. We are anxious, we are depressed, we are lonely, and we turn to belief as a way of understanding the facts rather than allowing the facts to shape our beliefs.  We embrace the world of post-truth.

When post-truth becomes the accepted standard, then truth suffers and when truth suffers, people suffer as well.  It would be nice if we could just wish bad things away or live in the world as we would like it to be, but we cannot.  What I call COVID-19 exhaustion has opened people’s minds to the claims of post-truth ideology, an ideology that claims the worse is over even while new cases of COVID-19 skyrocket.  It is an ideology that claims that exposure to the disease is necessary to boost immunity to the disease, a claim that science has not been able to corroborate defying the best advice of scientists not to do so .  It is the desire that those who say that the disease will just go away are right, but it won’t and isn’t going away as recent statistics have demonstrated.  We are exhausted by the idea of social isolation; we are tired of social distancing;  we do not like wearing masks—they make it impossible to breath although if one contracts the disease, they may discover what it means to not be able to breath; we grow weary of the loss of jobs and the uncertainty of our economic security; we worry that we or our loved ones will catch the disease and may die or be permanently affected by the disease; we wish that a vaccination would be discovered and believe that such a discovery will happen soon.  All of this and more leads to exhaustion and exhaustion leads us to believe that the worse is over even though the facts tell us otherwise. We are anxious, we are depressed, we are lonely and we turn to belief as a way of understanding the facts rather than allowing the facts to shape our beliefs.  We embrace the world of post-truth.

Denial, which is what post-truth ideology is all about, is never a pathway to mental health.

A post-truth world is extremely frustrating for medical personnel and scientists for it is basically a denial of their hard work and their willingness to put their lives on the line that others may have a chance to live.  The fight against a pandemic such as COVID-19 cannot be fought based upon feelings and beliefs.  It can only be fought by drawing upon the hard, cold and inconvenient facts brought to light by scientific research.  We do not slow this disease down while we await the slow and arduous development of a vaccine by ignoring the warnings of scientists and medical professionals who base their treatment upon science.  The inconvenient truth brought by the facts of science is this thing is not over and is once again speeding up especially in the United States.  The inconvenient truth is that hundreds of thousands of people are dying from this disease—still—and shows little signs of letting up.  The inconvenient truth is that wearing a mask in public will greatly reduce the spread of the disease.  The inconvenient truth is that developing the vaccine is a slow process that could take years.  So, if we listen to the facts of science, we will wear a mask at the very least, and if we are reasonable (basing our behaviors upon the facts rather than feelings and beliefs) we will continue the practice of social distancing and when exposed, social isolation. 

This, however, leads us back to COVID-19 exhaustion.  How do we cope with the anxiety and depression created by this exhaustion?  Feelings are a big part of our life and play an undeniable role in our beliefs about society, but they also have a significant impact upon our beliefs about ourselves and our loved ones.  But when our emotions get out of balance, we have problems.  COVID-19 exhaustion is a sure sign that our emotions are out of balance and are beginning to control us rather than us controlling them.  Much of this imbalance grows out our feeling of being controlled by others rather than being able to control our own destiny.  This is as true of economic worries as it is our relationships with friends and loved ones.  Human beings are communal animals and when the inconvenient facts of science tell us we cannot be with each other, we don’t like it and we rebel if only in our minds. The energy required by our rebellion leads to exhaustion, anxiety and depression.

When post-truth becomes the accepted standard, then truth suffers and when truth suffers, people will suffer as well. 

Denial, which is what post-truth ideology is all about, is never a pathway to mental health.  Mental health becomes a possibility when we can move from denial to acceptance, when we can turn from delusional desires to facing reality.  We are communal animals.  That is a fact, which means that we do not thrive in social isolation.  However, there is a lot of difference between social isolation and social distancing.  We live in communities based upon our desire to work together to build a better life.  That is a fact.  However, communities are not lost by wearing a mask and taking the precaution to social distance to slow the spread of COVID-19.  My point is that our exhaustion comes from refusing to accept the changes brought to our world by COVID-19.  As we begin to understand the transmission of the disease, we also begin to understand how to reconfigure our way of being with others.  We must think outside the box about the norms as we once knew them and begin to examine new ways of being together that minimize the dangers of contracting COVID-19.  To stand behind someone separated by 6 feet in the grocery store is a new way.  Standards of cleanliness must change.  Making sure that our environment is clean and as sterile as possible is a way of being together while slowing the spread of the disease.  Wearing a mask in public is a new way of being together and it will slow the spread of the disease.  Accepting this new reality rather than rebelling against it, accepting new standards of being together rather than trying to live with old standards, is one of the best guards against COVID-19 exhaustion.  We call this ACT Therapy, which I may explain in a different post,, but suffice it to say that if we learn to accept the inconvenient facts of science and the new way of being together they imply, then we will do a great deal in not only slowing the spread of the disease, but we will learn to protect ourselves from the exhaustion that often goes with it.

Down the Rabbit Hole…

I have been observing for some time the journey of the mentally ill, but the existential nature of this journey is not as real as when it affects the life of a loved one.  In a metaphorical way of thinking, mental illness is the repetitive journey down the “rabbit hole” in such a way that the journey is thought necessary and the thought of necessity creates a feeling of impending doom that one constantly seeks to escape (anxiety) or that one accepts as their reality (psychosis).  To live in light of this doom is to open the door of life to depression, a persistent gloominess that accompanies the necessity of the rabbit hole.  From the perspective of one who watches the journey, my desire is to jump between them and entrance to the hole.  I want to stop their journey, to disrupt the repetition that they may understand that the journey is not necessary, but to act in a brash fashion such as this is to join forces with the suspicious darkness of the rabbit’s domain; it is to somehow diminish the pain of their journey and minimize the fear they feel.  Such diminutive attitudes have accompanied the walk of the mentally ill throughout the history of humankind forcing upon them a sense of shame that only heightens their feelings of necessity.  “Just get over it!” is the cruel retort of those who walk in a different type of darkness, the darkness of ignorance and intolerance.  But if one trained in the art of empathy is unable to block the journey with a cognitive-behavioral slight of hand, then what helps those grown weary of heir journey and the angst of instability? Or, for those who watch their loved ones journey down the rabbit hole, how can they help without getting caught up in the hopelessness of necessity?

For any who have worked in the realm of mental health, they know that help is a precious way of embracing the journey of the mentally ill while at the same time being mindful that is the journey of the one filled with anxiety, overpowered by gloom, filled with the suspicion of paranoia or haunted by the dauting shadows of delusion that is being observed.  The empathetic observer (the therapist) cannot make the journey their own.  The malady of the rabbit hole is the reality of the one who is sick.  In this, stubbornness clashes with necessity.  To make the journey their own would put the empathetic observer in the position of owning the problem thereby making it all about the observer, an act that allows the observed (the client) to further lose themselves in the darkness of the hole and validates the notion that their journey is inevitable; that it is necessary.  Stubbornness then gives way to necessity and the help so earnestly desired is lost to the hole’s darkness.  But empathy is a stubborn refusal to submit to the necessity of the journey through a confrontation.  This is not a confrontation of “I’m right and you’re wrong.”  It is the reflexive confrontation that emerges from the stubborn refusal to accept the problems of the observed.  This happens when the observer stubbornly refuses to become the observed thereby creating a environment of countertransference where the observed is confronted by their self.

To give in to the brain’s circuitry in a deterministic fashion is to reduce human experiencing and the phenomenon of mental illness to a type of fatalism immune to the confrontation necessary to mental health. 

Harold Anderson

In this confrontation, vulnerability is laid bare and the possibility of fear cautions the observed to proceed with trepidation sometimes heightening their shame to a place where the observed turns from themselves and flees to the menacing darkness of the hole.  The confrontation of which I speak is a dangerous place where the light of healing pierces the darkness of the hole bringing hope.  But the light is dim and the source from which the light emanates is fragile.  Its fragility must be guarded with care.  It is the therapeutic relationship that guards the fragility of this hopeful light.  It is the care of this relationship that creates a therapeutic environment inspiring the observed to confront themselves so that perhaps for the first time they begin to see themselves as they really are.  In this confrontation, the “no” of necessity begins to give way to the therapeutic environment so that in their confrontation with themselves, the observed begins to realize the graciousness of their subjectivity.  They do not want to be ill.  They do not want to suffer from anxiety or depression, they do not want paranoia to dominate their life, they do not want the shadows of delusion to usher them once again down the rabbit hole of their illness.  The power of the self is gracious and its ‘yes” to life is brought into confrontation with the “no” of the rabbit hole’s necessity.  When this happens the “no” of necessity weakens and the self’s “yes” to life becomes a very real possibility.

This sounds good, but is this not simply idealism?  While one may admit that mental illness is not something that one can just “get over,” is not mental illness a condition of the brain’s chemical and electronic configurations patterned on the genetic blueprints received from family and conditioned by experiences of one’s environment?  Put differently, is not mental illness an illness of the brain so that little can be done about it since one cannot reconfigure the DNA of the brain and its chemical patterning?  It is difficult to argue with those who point to the suborn obduracy of the brain’s function as the source of mental illness, for in so many ways it is the brain that determines the nature of our world and our experience of it.  A depletion of serotonin can cause a depressed state; a reduction in our dopamine levels can decrease our sense of pleasure. For those who suffer from bipolar disorder, the function of the brain is most certainly a factor and the shadowy hauntings initiated by delusion finds its cause in the circuity of the brain.  To give in to the brain’s circuitry in a deterministic fashion is to reduce human experiencing and the phenomenon of mental illness to a type of fatalism immune to the confrontation necessary to mental health.  Part of the healing that comes from the confrontation of the observed with its self is found in acceptance.  We not only are confronted by the gracious reality of our subjectivity, but we are also confronted by the reality of our subjective experience as conditioned by our physical status.  The graciousness of the self that occurs with confrontation empowers the one suffering from diabetes to accept their condition so that they can take steps to increase the quality and longevity of their life.  Likewise, those who suffer from mental illnesses such as bipolar disorder, personality disorder, or schizophrenia learn to accept their condition through an honest encounter with their selves that they may accept the care of their caretakers by taking the medication required and engaging in therapeutically empowering process so that they can refuse the rabbit hole and say “yes’ to life.

Whatever the path, the route to wellness is a long and arduous task that is often filled with disappointments caused by the shame that comes from vulnerability or the weakness of physiological function.  The journey down the rabbit hole as well as the journey to mental wellness is an emotional journey where the negative emotions of the rabbit hole often scream more loudly than the whispering emotions that accompany the light of hope.  It is this imbalance—the imbalance of mental illness—that the therapeutic relationship helps the observed to manage.  Being mindful of one’s environment and one’s sense of self, the observed must learn the blessings of a well-disciplined mind.  Mental health is the ability to balance one’s emotional life so that negative emotions do not overwhelm the positive.  Such management, such discipline is the goal of the therapeutic relationship and the key that unlocks the gracious power of the self.  It is this discipline that is the work of therapy.

The process of therapy is difficult enough when the observed is one we do not know.  It is nearly impossible when the observed is one whom we love.  The reason lies in the balance of emotions that is the heart of therapy.  When a loved one suffers, we want to save them.  We will do anything to try and alleviate their suffering and in that we lose perspective.  And even if we do an admirable job of maintaining the role of the observer, the emotional exhaustion of watching a loved one suffer drains us and empties our self of its gracious power.   The toll can be devastating to the health of the observer while overcoming the stubbornness of empathy with the sympathy and compassion of our love.  In this, the confrontation necessary to the observed does not take place and necessity prevails.  The rabbit hole threatens victory widening its entrance to admit two instead of one.

Often loneliness, desperation and even panic nag at even the trained observer when a loved one enters the rabbit hole of mental illness.  How do you observe a mother, father, sibling, or child when the rabbit hole beckons, and their lives are filled with its seeming necessity?  When a loved one enters the rabbit hole the trained observer’s training becomes a feeble guard and the desire to rescue, to protect the loved one looms large.  The trained observer’s compassion comes into conflict with their professional identity, which accounts for their exhaustion.  Not only are they caught up in a fight with the rabbit hole and its seeming necessity, but they are at war with themselves fighting a battle with the depths of their love and the “objectivity” of their professional stance.  Indeed, the battle between these two extremes become a spectrum upon which emotions bounce from one end to the other.  When this happens, the trained observer is confronted with their own necessity—survival.  If not them, then who?

If the loved one lives in a place where there are numerous support personnel, they are fortunate and they can draw upon their support to soften the trained observer’s feelings of desperation, and provide breaks that can ease their frustration.  In these situations, it is important that the trained observer avail themselves of help and develop a space in which other trained observers can help.  Psychiatric care can improve the chemical imbalance of the observed’s brain and trained mental health providers can ease the tortured structures of their mind.  When such are available, the trained observer can loosen their control and find rest in the competent care of others.  But what happens when this care is not readily available as is the case in remote areas where trained observers especially in mental health are not available?  Then the trained observer must locate support structures for their own well-being (family and friends) and avail themselves and their loved one to the limited health and mental health resources available.  The trained observer, in these instances, must care for themselves for only by doing so will they be able to manage the spectrum upon which their life will inevitably fluctuate.

Watching those who live out the necessity of going down the rabbit hole of mental illness is a process that is indeed complex and demands careful attention on the part of the trained observer.  Empathetic observation strives to bring the necessity of the rabbit hole into conflict with the essential goodness that lies within the observed thereby freeing their drive to wellness.  When, however, the observed is one we love, the existential realities of necessity that drive the observed into the hole of mental illness threatens the very well-being of the loving observer.  The dialectical tension so necessary to the freedom of health threatens to fade into sympathy and the darkness of the hole begins to penetrate the lives of the loving observer and the observed.  In such instances, the loving observer must find refuge in support structures that alleviate them of their need to intervene to save their loved one and relieve them of their suffering.  This is difficult to do for the path to mental wellness is complex and sometimes long. Looking deep into the recesses of self, the loving observer must relinquish the reigns of care by caring for themselves and only then drawing upon available resources to help mediate their love.  The rabbit hole of mental illness may be difficult for many to avoid, but by finding the goodness that lies at the heart of the self, both the loving observer and the observed who is loved can find relief.

An Introduction to Me…

Who am I? Well, that question may take a while to answer. I grew up in Boise, Idaho the oldest in a family of four. My mom and dad were hard working, evangelical Christians and we attended the Church of the Nazarene. When I was about 15, I decided to rebel against the standards and values held by my parents and rejected their church tradition. In the vernacular of the times, “I dropped out and dropped in.” I became a hippy and engaged the culture that wanted to make love, not war. I was never involved in many protests, but like the protesters, I opposed the Vietnam War and sided with the Woodstock revelers, those who worshipped at the altar of love, drugs and rock & roll.

This lifestyle is not easily sustained and when I was in my second year of college, I realized that if I continued on this path, I would not graduate; in fact, I may not live past the young age of 30. I heard a song by U2 today and the title of the song was the reality that set me upon a different path. It was entitled “Love Lifted Me,” and indeed that was the power that set me down a new, more meaningful path. My parents loved me; my grandparents loved me; and my family members loved me…and they prayed for me. It must of worked, because I turned from a life of drugs and returned to college in preparation of becoming a minister, a goal I achieved in the early 80s when I was ordained a United Methodist Minister.

While it was true that the direction of my life changed radically, it is also true that we take lessons and values from the life experiences that defined our past. Inherent in the rebellion of my youth and the radicalism of the hippy movement was a prophetic voice that defined me as a person. It was one that would not let me rest content with the status quo. Challenging the norms of society, however, can be done in much more constructive ways than drugs and rock & roll. Don’t get me wrong, I still love rock & roll and the blues that inspired it, but I can do without the drugs. What I want now is to find ways of lifting society out of the mire of alienation and prejudice by discovering the spirituality and power that comes from divine relationality (I will elaborate on this in future blogs).

Since starting on my new path, I have earned two master’s degrees, a Ph.D. and have done post-doctoral work in the area of psychology and marriage and family therapy. I work as a marriage and family therapist, have taught MFT theory at the master and doctoral levels, and I also taught philosophy and religious studies for more than twenty years while retiring from the ministry in 2006.

I’m not done yet. I still work as an LMFT, am working on a book on spirituality and plan to begin teaching philosophy at the undergraduate level simply because I enjoy teaching. I hope that my work and passion for meaningful relationships grounded in a deep and abiding spirituality will touch some while bringing greater joy and purpose to their lives.