What Do We Owe to Those Who Are Dying?

Joseph Burgoin
Destinations
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Unbearable Emotion
34

A friend of mine has a relative in the final stages of dying; some of his difficult interactions with this relative (not an immediate family member) have stirred thoughts about our obligations to and expectations of those who are dying.  I'd like to talk about two related aspects of the issue:  First, to what degree do we conceive of old age/death as a kind of second infancy that changes all the rules?   And second, are people in the final stages of dying exempt from the expectations we usually have for other people -- such as consideration, fairness and reciprocity -- and do their needs always trump our own?

I've known clients with parents who expected them to sacrifice their lives entirely in order to care for them in the final stages of dying.  Some of these parents had done reasonably well in their parenting role; others had been entirely deficient and then became infantile and demanding when forced to confront their mortality.  What comes to mind is the Biblical commandment to "honor your father and mother."  I've always found it relevant that the Bible does not says you should "love" your parents; rather, you should accord them a certain level of respect, given that they brought you into the world and reared you.  But what are the limits of "honoring"?  Does that mean you must take care of them during their dying months, even to your own detriment, even when they did a miserable job taking care of you when you were small?  How does forgiveness come into play, and are some failures unforgivable?

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Good and Bad Reasons to Take an Antidepressant

Joseph Burgoin
Depression and Bipolar Disorder
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Detours
·
The Medicalization of Mental Health
69

Thirty-five years ago, I received a phone call from my friend Lily about a car accident involving a mutual friend of ours, Terry.  The three of us had just graduated from UCLA the week before.  Terry, along with her sister, brother-in-law and niece, had gone on a trip to the Colorado River.  En route, along a two-lane highway, another vehicle tried to pass them and the line of cars ahead.  The driver mis-calculated the distance and as a result, a semi-truck coming from the opposite direction swerved to avoid the passing car, struck our friends' car and instantly killed Terry's sister, brother-in-law and niece.  Terry survived but suffered severe and irreparable brain damage.

I had given up my apartment following graduation and was briefly staying with my parents before leaving on a long trip.   When I came out of my room after the call, deeply upset and in tears, my mother immediately went to her bathroom and returned with a blue, 10 mg Valium tablet which she pressed into my hand.  Her response to my grief was to offer me the same medication she used to keep her own pain sedated.  I hadn't thought about that incident in years, but recently, in considering some of the wrong reasons people take antidepressants, the memory came back to me.

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Self-Love and the Sense of Well-Being

Joseph Burgoin
Destinations
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Self-Esteem and Self-Sabotage
53

I've been struggling with this term self-love which seems to be gaining currency of late.  Given that I have no problem with words like self-respect, self-esteem and self-hatred, it might seem surprising that I resist the idea of a love for the self.  My threshold obstacles to accepting it are two-fold:  an overlap with the concept of narcissism, and my aversion to some New Age, wishy-washy formulations that focus on love to the exclusion of other darker emotions.

As I often do with problematic words, I start with a dictionary definition from Merriam-Webster.

Self-love:  love of self
a:  conceit
b:  regard for one's own happiness or advantage

There's the first of my problems -- definition 1(a) places self-love in the realm of narcissism; definition 1(b) hints at a kind of ruthlessness.  From this point of view, self-love doesn't appear to be a positive attribute; self-love verges on egoism and selfishness, overemphasizing the wishes of the individual to the disadvantage of other people.  My impression is that the meaning of the word is currently undergoing an evolution, however, largely inspired by developments within New Age thinking. Check back with Merriam-Webster in ten years and you'll find an additional definition.

I did a little online research about other conceptions of self-love and came across the following, from a website called Inner Self:

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The Interpretation of a Dream

Joseph Burgoin
Destinations
·
Self-Esteem and Self-Sabotage
·
The Psychotherapy Relationship
12

I've read and taught Freud's The Interpretation of Dreams several times; it's fascinating and beautifully written, a ground-breaking work that brought dreams from the realm of superstition and divination into the world of "science".  On the other hand, while I admire Freud's insight and careful demonstration of his ideas, I find his stipulation that dreams represent wish-fulfillments too limiting.  In my experience, dreams represent all sorts of things about ourselves and our states of mind.  When dreams become the subject of a psychotherapy session, associations are crucial, of course, just as Freud instructed; but they may sometimes be those of the therapist, based on familiarity with the client -- as I hope the following interpretation of a dream will show.

This session dates back several years.  My client Ryan was at that time in his late 30s, living with another man in his first stable, long-term relationship.  Although Ryan and his partner Seth were nearly the same age, Ryan thought of him as quite a bit older, mostly because Seth seemed more professionally secure and responsible.  In his earlier relationships, Ryan had always looked for someone to "take care of" him, someone he idealized and expected to be a sort of all-gratifying parent.  Because they were based on fantasy rather than reality, these relationships naturally lasted only a short time.  Ryan and Seth had been living together for two years at the time of this dream; while their relationship retained some of the features of Ryan's earlier brief liaisons, he had come a long way in becoming more personally responsible:  he carried his own weight financially and had grown quite serious about developing his career.
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The Mostly-Bad Mother

Joseph Burgoin
Depression and Bipolar Disorder
·
Detours
195

During a recent session with a client, she was revisiting some memories about her mother, familiar to both of us since the beginning of her treatment.  Although her parents provided the basics -- food, clothing, a roof over her head -- they were both disastrous on an emotional level.  As the session unfolded, my client repeated many painful details from her childhood, and yet amidst all those memories, I caught little glimpses of the way she had at one time found her mother beautiful.  It made me think about the spots of goodness to be found in the mostly-bad mother, and how hard it is to hang onto them.  It's an issue I continue to struggle with in relation to my own mostly-bad mother.

I could describe my own parents in very much the same terms as my client's:  they fed us, clothed us, gave us a very nice home and bought us used cars once we learned to drive.  In financial and material terms, I had a comfortable, upper-middle class upbringing.  Emotionally, it was fairly awful.  I won't burden you with the details; many people have more horrific stories to tell and entered their teens even more scarred than I was.  Suffice it to say that I suffered from severe bouts of depression and at 18 concluded, on my own, that I badly needed professional help.  Without telling my parents, I went to consult a psychiatrist who was a casual business acquaintance of my father's.  He intervened on my behalf and spoke to my parents.  Later, after an endless and agonizing argument in which my mother and father insisted that either (a) I was making "it" all up; or (b) I was so mentally ill that nothing would help, they finally agreed to pay for my therapy.

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