By: Norman Fried
September 12, 2008
In her front page article in Wednesday’s New York Times, Anemona Hartocollis reports on the current lives of some of the survivors of the September 11 attacks on the World Trade Center. ”Maimed on 9/11, and Trying to be Whole Again” highlights several men and women who were critically wounded, partially paralyzed, and emotionally transformed as a result of the events of that day. But her article is also a treatise on the human will to survive and to “rebuild a harbor,” as poet Yehuda Amichai once said, long after the ship has gone down.
According to Hartocollis, there is no clear accounting of how many people were injured on 9/11. She reports that $1 billion out of the $7 billion raised was distributed to the injured, including firefighters; a total of 2,680 physical injury payments made in all. Burns accounted for 40 of the 2680 injury payments; no clear numbers are available for the cost of psychological support to families of those who were killed, as well as for those who survived.
What is clear from the testimonies and the stories of the survivors of 9/11 is the triumph of the soul over adversity. Their stories command us to ask: What, or who, is a hero? What is the common denominator among those who managed to escape the struggles of that day, and struggle still to recreate their lives?
According to the ancient myths, the hero is one who is willing to take the first step on a path whose end is uncertain. Like Heracles who bears the misfortunes that the gods have sent him, or Jonah who struggles in the darkness of the belly of the whale, the hero puts himself at the service of whatever necessity arises.
The heroes of 9/11 offer all of us a glimpse of the human heart; their stories of survival include a dimension of vulnerability and the possibility of failing. In rescuing others, or themselves, from an unspeakable fate, and relearning the world in which they now live, the survivors of 9/11 teach us that a hero’s voyage is one of rediscovery. What was lost has to be found: one’s own self, one’s own purpose. Moreover, through their failings and triumphs, survivors motivate all of us to become the heroes of our own story, so that, one day, we may believe in the regrowth that comes out of a fallen world.
The Story of Gana: How An Animal Can Teach Us About Grieving
By: Norman Fried
September 9, 2008
On Friday night, September 5, more than 50 of the world’s most famous TV, film, music and sports personalities came together in an unprecedented television event to raise money in the fight against cancer and related blood disorders. The show, called "Stand Up to Cancer" “(SU2C), introduced the efforts of an organization by the same name whose stated mission is to help advances in cancer research as rapidly as possible. Viewers across America tuned in to see how some of the brightest minds in cancer research – ”Dream Teams” of scientists, clinicians, technicians and other experts - are working together to find a cure for the disease that kills one person every minute.
Naturally, attention is duly paid to survivors of this disease. But those who mourn the loss of a loved one who did not survive often get overlooked.
What can be said about the journey of those who grieve? How do the families and friends who lost a loved one learn to adapt to the new world ahead of them?
The answer may be found in the story of Gana.
Last week, newspapers across Europe and America posted pictures of an 11-year-old Gorilla named Gana clutching the corpse of her three-month-old baby Claudio for days before surrendering his lifeless body to zookeepers. As Gana persisted in cradling her baby, questions by primatologists, psychologists and other social scientists arose, such as: Do animals have a cognitive appreciation of their own mortality? Do they grieve as adult humans do? Or are they simply confused?
In her September 2nd article in the New York Times, Natalie Angier presented data by scientists that suggested a different theory: that elaborate displays of primate maternal grief, like those of Gana toward her son, reveal less about our shared awareness of death than they do about our shared impulse to act as if death never happened.
Indeed, for many of us, a common mode of coping with the awareness of death is denial, and this system of denial rests on two major premises: We are either personally inviolable to death (”It won’t happen to me”), or we are protected eternally by an ultimate deity or rescuer. Coined by Otto Rank as a ”death fear,” our anxiety of separation, loss and lack of connectedness causes us to employ either one of these two fundamental defenses.
“The mind blanks at the glare,” wrote the British poet Philip Larkin in his famous poem entitled “Aubade,” as he contemplated the “dread of dying, and being dead.”
But in bearing witness to our pain, and in tolerating a mourner’s need to grieve in whatever way we feel works for us, a true listener can aid us in our journey from denial towards acceptance. Gana’s need was similar to our own human need to be taken seriously, to be understood and responded to. When one bears witness to our inner world, to our unspeakable fears or forbidden fantasies, one acknowledges and affirms our importance, and we come to discover that denial is not the only mode of coping with a death.
With love and patience, we come to learn that suffering, and the strength needed to endure grief, is not a linear process. It more resembles a spiral staircase on whose steps are the themes of loss, anger, disbelief, and the hope for eventual repair. Like Gana holding her dead baby in her arms, we humans require time to wrap ourselves in our grief. We require attention and respect, and the freedom to express our disbelief, our anger, and our confusion, until - like Gana surrendering her son - acceptance eventually melts away the coldness of our denial.
Understanding Terrorism Through The Eyes of Spousal-and Child-Loss.
By: Norman Fried
July 16, 2008
The developing of wave of female suicide attacks in Iraq introduces a newer, more insidious threat to our American soldiers overseas, and it highlights the need for a greater understanding of the psychology of spousal-loss and child-loss.
According to the United States military, 43 women have carried out suicide bombings in Iraq since 2003, twenty in this calendar year alone. The most recent of these attacks was carried out by a woman named Wensa Ali Mutlaq in Diyala Province, an area that has been hit by more female suicide bombers than any other province in Iraq. In her front page July 5 New York Times article, “Despair Drives Suicide Attacks” by Iraq Women, Alissa J. Rubin suggests that the subordinate role of Sunni women in rural, conservative families makes them particularly vulnerable to pressure, a pressure that may ultimately reach its denouement in suicide.
Military analysts, journalists, and Iraqi provincial council members have all offered their explanations for the developing trend in female suicides bombings. Some suggest that for many young Iraqi women, sexual abuse by older al-Qaeda leaders, carried out under the veil of marriage, is to blame. Others attribute the trend to insurgent recruiters and religious instructors who offer promises of eternal paradise. In one case, a suicide attack was forcefully conducted through the use of remote control detonation.
The search for an understanding of the growing trend for female suicides in Iraq generates new light on the actions of suicide in general; and it asks us to consider the damaging effect that suicide has on its survivors, especially wives and mothers. Studies of spousal grief reveal that bereavement following suicide is qualitatively different from other causes of death. In particular, wives of a suicide are more likely to experience a prolonged search for motives; they may often deny the cause of death; their grief may culminate in feelings of anger more than sadness; and they may become more susceptible to suicide through heredity or family credo. (Ms. Mutlaq lost her husband one year ago while fighting in his province’s capital and her brother carried out a suicide bombing several months later.)
In their book Spousal Bereavement in Late Life, Carr, Nesse and Wortman report additional reactions to suicide, including depressive symptoms, loss of appetite, sleep disturbances, fatigue, and a wish to be reunited with the deceased. In a culture where suicide is considered an act of heroism, even greater complications to the grief response arise.
Given such findings, it becomes prudent that well-planned and immediate attention are paid to the survivors of a suicide within a community. The U.S. Department of Health and Human Services reports that providing social support for victims of stressful life events reduces the likelihood of depressive symptoms. In addition, tangible forms of support, such as helping widows and mourning mothers to develop social networking skills, and maintaining spiritual connections, can also be beneficial. Postvention programs, staffed by professionals who are trained in crisis intervention, have been utilized effectively in our American schools since 1991. These programs has been successful in reducing the likelihood of cluster suicides in the school system, and copycat actions across the nation. Their successes indicate that similar proactive outreach to the survivors of suicide in Iraq can be vital to the safety of our soldiers, as well as a necessary humanitarian effort to our fellow man.
Public Marriage and Private Lives: The Ways we Love.
By: Norman Fried
June 26, 2008
The recent attention and controversy surrounding same-sex marriages in California have caused many of us to focus on our own definition of ”family values;” and have forced others to look more closely at the marital bond in particular. The question of fidelity in marriage has now become forefront in the minds of many journalists, clergymen and psychologists alike.
In his May 26 article in New York Magazine, entitled The Secret Lives Of Married Men, Philip Weiss attempts an answer to the question of infidelity and the “affairs” of men, many of them in the public eye. Citing the “outings” of Elliot Spitzer, Governor David Paterson, and New York Congressman Vito Fosella (who recently admitted to having two families); and after collecting opinions from anonymous men that he questioned for his article, Weiss deduces that men’s hunger for sexual variety is a “basic and natural and more or less irresistible impulse.”
Weiss’ qualitative findings provide us with an interesting socio-biological, but limited, interpretation for the controversy of male infidelity, and they beg the question: Is sexual impulse alone the driving force behind men who have extra-marital affairs? Researchers in the fields of clinical psychology and marriage and family therapy argue differently, as they assert that the wounding actions of an affair are often rooted in deeper, more unconscious origins. Marriage therapists suggest that people often choose a spouse based on their own (sometimes negative) parental models; and they, in turn, re-enact within the marriage the “dramas” which they experienced in their families-of-origin. This recapitulation of earlier, more primitive themes, often renders each member of the couple at risk for ”acting out” behaviors; behaviors that may reach their apogee in an affair.
When a marriage is converted to the unconscious mission of rescuing its protagonists from an “unjust” history, and restoring them with a second chance to “make it right,” married men may find themselves trapped in a web of bad feelings that grows with time and insidiously replaces what was once promising and positive with despair and negativity.
Were the actions that caused Elliot Spitzer to replace his public identity as Governor with that of Client #9 the result of unresolved negative conflicts from his family of origin? Did New Jersey’s Ex-Governor McGreavey’s extramarital affairs have their psychological roots in unfulfilled aspects of his inner psyche? We on the outside will never know. But it is prudent for us to consider that marital discord subsumes a complex network of emotional states, which include breakdowns in communication, conflicts in values, financial stressors, unreal expectations and projective distortions on the part of each spouse. Considering these contributing factors places “irresistible impulses and the need for sexual variety” quite low on the proverbial list.
The Lessons of Father's Day During Wartime.
By: Norman Fried
June 15, 2008
In the five years since the start of the fighting in Iraq and Afghanistan, many newspapers have published articles about the men who lost their lives in battle. In reading their stories, I am moved by a common theme that runs throughout: Many of the fallen soldiers were fathers who left little children behind. Some war widows have re-married; many children have inherited new father-figures. But their connection to the past, and to the men who dreamt of raising them and guiding them through life, remains altered still, and forevermore.
The approach of Father's Day invokes a host of emotions for which many are unprepared. For some, it leaves us anxious, as we recall the man who couldn’t be there when we needed him, or the man who is not here now when we need him the most. For others, it stimulates feelings of gratitude as we honor the times we had with our father by our side. There are some among us who never knew our father; others who have not yet separated and, thus, never had to learn to say goodbye. Regardless of our own individual story, we are, all of us, reminded at this time every year just how important fatherhood is; how lives are shaped, and paths are forged, through the direction and guidance of a man older and wiser.
As children, we follow in the footsteps of our fathers, our teachers, and our earliest heroes. As adolescents and young adults we struggle to find our own path, to reach a place that is wholly “ours,” new and unmarked. And when we arrive as fully grown adults to this new place, we sometimes discover that we’ve been here before. We learn that projections from the past are often being replayed in the present, like tapes of our earlier, more primitive selves. And on these tapes, the voices of our fathers, our earliest teachers and guides, quietly resound, surreptitiously guiding us through the generations.
Fatherhood is a gift filled with paradox. It can teach us about the power of love while it surprises us with the pain of loss. It is a challenge that some of us accept through careful planning, a burden that others endure through time and trial. But when we allow ourselves to learn the lessons that this journey is trying to teach - about family, and friendship, and honor and fear; about sensuality and sorrow, and supplication and love - then, even in the pain of its absence in our lives, we can say thank you. For we have felt the love of another - someone wiser and stronger; or perhaps someone younger and more needful - and we can never be the same again.
Memorial Day: Remembering Those That Can't Remember.
By: Norman Fried
May 28, 2008
In addition to the more than 4000 American soldiers who have died in combat during the five years of fighting in Iraq, a recent Rand Corporation report estimates that an additional 300,000 soldiers have suffered traumatic brain injuries (TBI’s), including brief losses of consciousness, disorientation, impairments in memory and lapses in cognitive and intellectual functioning. Even more disturbing is a report by the Defense and Veteran’s Brain Injury Center, a joint Defense Department and VA organization, which states that 900 soldiers have returned home with severe TBI symptoms caused by explosions that delivered blunt and permanent damage to the brain, and they may result in a life marked by insurmountable cognitive, social and physical deficits.
In his article entitled The Sergeant Lost Within, Daniel Bergner writes in Sunday’s May 26, 2008 New York Times Magazine about one such American soldier, Sgt. Shurvon Phillip, who, after an anti-tank mine exploded under his Humvee in Anbar Province in 2005, can no longer speak and can barely emit sound or move any part of his body. Bergner’s report is but one of many case examples of the casualties of a war that renders men unable to remember the life they had before they were injured. Moreover, his article begs the question: What are the ways that life acquires meaning if memory ceases to cooperate?
For neuroscientists, memory creates a kind of mental shortlist from which ongoing events (and rules and assumptions about the world) are kept available. For psychologists, memory allows us to maintain an ongoing account or commentary of our lives; it helps to define who we are and who we can become.
As survivors of loss, especially those who have lost a loved one in combat, we learn that memory serves our grief by integrating trauma into future growth and transformation. Though some may feel trapped in the memory of days gone by, our memories can be used to to shape and to guide us forward. We thus carry our loved one’s good name, his reputation, his valor in combat and his strength as a fighter. And we learn that no one is truly gone as long as there is someone who remembers.
And for those who can no longer remember, the rest of us must do so in their stead.
Grief in the Aftermath of China's Earthquake: Reflections on Loss and Recovery.
By: Norman Fried
May 19, 2008
The great Isreali poet and writer Yehuda Amichai once said that “To live is to build a ship and a harbor at the same time, and to complete the harbor long after the ship has gone down.”
The cries of hundreds of parents in Dujiangyan and Juyan, China whose children lay in makeshift morgues as a result of the earthquake that struck Sichuan Province last Monday, killing nearly 29,000 people thus far, may likely resonate with Amichai’s very true, and very sad words. For the death of a child, especially in a country where most families are only allowed to have one, is incomprehensible and incomparable. And still, life asks us to go on.
Many authors and grief therapists have written about the familiy’s long dark journey toward recovery after the death of a loved one. And the best of them, to my lights, remark poignantly on the need for an appreciation and an understanding of how the grief journey unfolds. “Acceptance” remains the eventual goal; but many bridges need to be crossed in order to come close to such a state of being.
For the mothers and fathers of earthquake victims in China, their grief, and the strength needed to endure their human suffering, will not be a linear process. It will more likely resemble a spiral staircase on which are recapitulated themes of shock, disbelief, denial, anger, panic, and the hope for eventual inner solace. Women will grieve differently than men. Women and mothers may find themselves surrendering totally to grief; allowing it to invade every part of their being. As a person who is suddenly stricken lame must accept the fact that she can no longer walk, they will learn that something utterly foreign is required just to get from one place to another. Men, on the other hand, may likely believe that in order to survive they must function. They may fear, as most men in mourning do, that giving in to grief will cause them to implode, to deteriorate, never again to be the person they once were.
Thier grief will require labor, respect and nurturing. In their search for relief from emotional and existential pain, they may find themselves wrestling with their greatest fears, their deepest sorrows. Grief is asking them , as it asks all of us, to be aware of ourselves and others; to look daringly at the goals that fate has set before them. And as they grow through their trials, they can hopefully gain the ability to venture on, free from the sorrow that presently, undoubtedly, holds them in place.
Thus as we read and reread the headlines and the articles about the devasation of life and family in China, we ask for the world’s compassion; for the care and attention that can help transform grief into hope; and sadness into the strength to carry on.
Mother's Day and the Iraq War.
By: Norman Fried
May 11, 2008
In the five years since the start of the Iraq war, newspapers around the country have published countless articles about soldiers who have died defending our freedom. In particular, the Department of Defense and the New York Times have identified and published the names and stories of 4,066 American service members who have died since the start of the Iraq war. In reading the articles written about many of our service men and women, I am moved by a common thread that runs throughout: every soldier is a son or daughter to someone in our country, and, sadly, thousands of mothers will be facing a difficult challenge as Mother's Day is honored.
The celebration of Mother’s Day presents challenges for so many among us who suffer with loss, but the mothers among us who have lost children have perhaps the hardest challenge of all. The changes in the family structure that are created by the death of a child (regardless of whether the loss is recent or whether it happened long ago) are more poignantly felt on ritual days such as this one. Just as the seasons have their cycles, and the moon has its rhythmic pull, so too does our grief. Indeed there are days when many of us are undaunted by the grief we feel inside. Then suddenly, and without warning, we find ourselves honoring another milepost in our lives, and we are confronted with the competing emotions of joy and sorrow.
Mother’s Day poses challenges for all parents who have lost a child, be it through wartime battle, disease, accident or suicide. The celebration of love and life that grows through honoring our mothers makes us vulnerable to the pain of any loss, and some memories are not easy to forget. We remember places that we went together with a loved one, the taste of a favorite soup, the smell of his hair, or a song she loved to sing. We are confronted with the memory of his face in the doorway, her telephone voice saying “I love you.”
But this celebration of love and life also includes glimmers of happiness and momentary, almost gleeful, wishes for the things that this life has to offer. For quietly lying underneath the memories of our loss are the parallel forces of hope and desire. And as they are revealed, so too is our strength.
Through it all we remain grateful. We are grateful for the love we had and the life we knew when we were with our loved one; we are grateful for the wisdom their living has imparted. We speak of the lessons that they taught us and the love they offered when they were alive.
Thus on Mother’s Day, as on all days, we need to be grateful for the struggles our fallen soldiers endured in the name of freedom, and the gifts they have given us by fighting our fight. Moreover, we need to be ever mindful of the pain that too many American mothers must endure as Mother’s Day comes around. For grief knows no calendar, but love and gratitude can withstand the test of time.
The Real Art of Psychotherapy.
By: Norman J. Fried
February 20, 2008
Daphne Merkin writes about television’s recent interest in psychotherapy in her New York Times Magazine article on Sunday, January 27. In it, she describes the therapeutic encounter as a ”painful drama” in which a professional “trained in the art of paying close attention” listens to someone “trained in the arts of repression and denial.”
Ms. Merkin’s view of the therapeutic journey is highly misguided and sadly myopic. For those who “cast a suspicious eye” on the “whole enterprise,” as Ms. Merkin states, this description may seem accurate. However, for the many who struggle to truly improve their life’s condition, Ms. Merkin’s views cast a negative and naive shadow on a process that has, at its very core, the power of personal transformation through wisdom and healthy love.
Psychotherapy, when conducted correctly, is not, as Merkin states, “costly malarky.” True, the patient and the therapist sit “across from each other week after week talking, pausing and adducing motivations.” But the goal is NOT a release from “entrenched patterns into a place where old wounds reign.” The goal for most, rather, is to learn to live alongside one’s old wounds; to befriend, even embrace, what is frightening and terrible inside. In the words of the poet Rainer Maria Rilke, “Perhaps everything terrible is in its deepest being something helpless that wants help from us.”
The beauty of psychotherapy, and the gift that it provides, is that through a healthy, loving relationship, transformation, acceptance and truth can ultimately prevail. If we are successful in our quest, we discover that, unlike the tidal wave of pain or confusion that once carried us under, our struggles transform us through a spindrift of self-awareness and self-acceptance. There are indeed times when we may still see the world through a haze of sadness or confusion, but the future, and our place in it, comes lovingly back into view.
Complimentary and Alternative Methods of Care For Childhood Cancer.
By: Norman J. Fried
February 14, 2008
Cancer in children is a relatively rare disease, and yet, according to Dr. Linda Granowetter, Oncologist at Mount Sinai School of Medicine, it is the largest non-accidental cause of death of children between the ages of 2 and 16 years. Six thousand children are estimated to be diagnosed with cancer each year in the United States alone, and thanks to increasing cure rates, one out of every one thousand adults today is an adult survivor. Pediatric oncology treatments continue to develop and they include conventional chemotherapies, bone marrow and stem cell transplants, radiation therapies, surgery to remove solid tumors, and oral medications designed to end the proliferation of abnormal cells in the body. In addition, more and more Americans are turning to complementary and alternative methods of care to treat this disease. More specifically, the American Cancer Society (ACS) reports that Americans spend more than $34 billion on alternative and complementary treatment methods, and visit alternative practitioners more often than they see primary care doctors.
The distinction between complementary and alternative therapies is important to make, as they are quite different in scope and outcome. According to the ACS, complementary therapies are those that are used along with conventional medicines. Some of these methods help to relieve or lessen the side effects of standard treatments; they may provide the patient with greater energy, relaxation as well as psychological support. Alternative therapies are treatments that are used instead of conventional methods in an effort to lesson or cure the disease. Alternative treatments are considered by some physicians to be harmful and dangerous if they are used in place of conventional medicine. These are methods that are less likely to include evidence-based, peer reviewed protocols (treatment measures that are tested by a strict set of national and/or international guidelines.) Open, trusting and non-critical patient-doctor communication, however, can help some families to make informed decisions about whether complementary and/or alternative methods are likely to produce improved conditions for their loved one with cancer.
Perhaps the most popular category of complementary treatment is known as holistic therapy or holistic medicine. These methods of care focus on the relationship between the mind, the body and the spirit as a catalyst for healing. Common among them is aromatherapy, or aromatic medicine. Using fragrant substances distilled from plants, aromatherapy is promoted as a natural way to help patients cope with chronic pain, depression and to stimulate the immune system.
Guided imagery or visualization therapy is another complementary method of treatment that is used with children with cancer and other diseases. Considered by many to be a relaxation technique, imagery involves mental exercises designed to relax the mind and body by altering brain waves, lowering blood pressure and decreasing heart rate. The use of distraction through imagery has also been effective in reducing emotional anxiety before or during a procedure, as well as in relieving physical pain in some patients.
Music Therapy, or Sound Therapy, which is the active or passive use of music to promote healing, has been found reduce pain and reduce chemotherapy-induced nausea and vomiting. Music improvisation, song writing and/or music performance all seem to aid in the reduction of rapid heart rates, depression and anxiety.
Spirituality and prayer have been found to be important mind, body and spirit agents in improving the quality of life and the promotion of a more positive outlook for some people with cancer. Larry Dossey, MD, in his book Healing Words, The Power of Prayer and the Practice of Medicine, asserts that prayerfulness permeates cases of profound illness that improve spontaneously. “If the disease disappears,” Dossey says, “then we are grateful. If it remains, that too is reason for gratitude.”
Another commonly used method of healing in the mind, body and spirit category is yoga. This form of non-aerobic exercise involves a program of posture and breathing exercises. Based on Hindu philosophy that combines dietary guidelines, meditation and physical exercise to maintain a mind/body/spirit union, yoga has helped to relieve some of symptoms of discomfort associated with cancer treatments. In addition, it has been correlated with an increase in relaxation, greater control over respiration and other bodily functions, and a general sense of well-being.
Many other holistic approaches exist, including Native American Healing, Shamanism, Neurolinguistic Programming, Meditation, Tai Chi and Qigong. While there is a paucity of empirical research to prove the effectiveness of these methods in treating or curing cancer and other blood-related diseases, all of these methods have been correlated with improved quality of life, a reduction in chronic pain (even for a short time) and the lessening of anxiety. In the aggregate, when combined with proven conventional treatments, mind/body/spirit methods of healing can be useful under the care and supervision of a responsible and educated health care team.