I’m talking with an elderly man who has always been a physical risk taker, so extremely much so that he is convinced that it is genetic and that he has the gene or genes for this kind of behavior. This risk-taking has led to great accomplishments but also to innumerable injuries, both more and less dreadful, some with irreversible and dire consequences. “I’m still a risk-taker,” he says. Together we get to the idea that both thinking and feeling are risk taking activities that many people avoid because they represent threats to their senses of stability and security. If you think, if you feel, you may not turn out to be quite who you took yourself to be. If you think, if you feel, the world around you, including those nearest and dearest, may turn out to be different than you thought. You can sustain thought and feeling injuries that can be as crippling as physical injuries. Of course, if you do not think and feel, as if you do not move, there are opportunity costs. You lose out on opportunities that may heal and help, even inspire, as well as on those that may hurt. Opportunity costs are extremely hard to characterize, becausethis side of realization opportunities are by definition imponderable. To live with an open horizon is not simple, but is a fundamental freedom. Until this conversation, I had not thought to put mental daring next to physical daring.The two are clearly different, but also share basic features. Security and curiosity meldto make daring possible both in the physical realm and in the mental realm. I got...
“This is not how I drew it up. This is not what the blueprints said. I really don’t know what it is. If it’s my life, I really don’t want it, but I have kids to think about, so that’s why I’m still here. I’m going to go on being here, too. I wonder if I’ll ever get used to myself. I hardly can remember what used to be but I can’t forget it either.” “I feel like I got lost and wandered in to someone else’s life. If they want it back, they sure can have it. I feel like an immigrant. I haven’t learned the language and I don’t really want to learn it.” “I don’t know how I got here. I suppose one thing led to another, but I never had any idea of the destination. I was kind of just along for the ride. I’ve turned in to someone I hardly recognize. The particulars of my life shock me when I stop to consider them, which is why I try not to, which is why I don’t understand what I’m doing here talking with you.” “I don’t like Kafka, but the reason I don’t like him is that he knows too much. He’s too close to truth that is beyond inconvenient. You really can wake up in the morning to discover you have been turned into a huge bug. Some mischief in the night. An accident. Nobody meant you any harm. But how do you learn to live like a bug? And even Kafka is still being polite, because you can be turned into something...
She is telling a story as she has been telling a story for years — this imaginary person, this imaginary patient. This story is not one story but many stories nesting in each other, sometimes bursting into flight to land somewhere else and make a new beginning. She is a reliably unreliable narrator. It is not even clear when she plots beforehand, when she does not, when she is speaking for calculated effect, when she is speaking because she can not help herself, can not any more impede the rush of words from her mouth, She is present at once so carefully and also so self-indulgently. There are so many of her and and this crowd is not even one. I am listening to her story as I have been for years — this imaginary person, this imaginary doctor. I am listening to her and I am making it up as she goes along. I am breaking it into pieces as she goes along. I am elaborating these pieces as they wake me up and develop fingers of dream that reach from her into me and touch me not in one way but in many ways. Listening to her is a kind of ecstasy that almost lets me stand outside myself except that I keep tripping on the threshold. As she is a reliably unreliable narrator, I am a multiply and extravagantly unreliable curator of her story, not from malice, but out of that most peculiar hope of helping. This hope is imbued with pride and shame, the two sides of an exquisite fabric. Look at this side and...
When we discuss end of life medical care, we have to be careful to recognize that the word “end” has multiple senses. We regularly mean it in the sense of “terminus”, where life reaches its stop, its limit and is no more. but we need to remember that “end” also has the sense of purpose. Is life an end in itself? Is life good in itself, no matter how painful and restricted it is, no matter if a person is utterly demented or comatose? If life is good in itself, an end in itself, then whose good is it? Is it a personal good, a social good, a theological good, a combination of all these? Of course the question of what life is for, what its end is comes up for us everyday in our living, if we let ourselves arrive in the vicinity of the question “How shall I live?” and dwell there. What gives lives its worth is not the same for all persons. In fact the diversity is staggering. What life is for, what its end is is not the same for one person in different phases of his life. Different people identify themselves differently with different faculties. When persons can not communicate with recognizable lucidity or at all, then we are in the realm of inference about their dispositions. Inference calls for what can be excruciating...
Freud’s two great contributions were taking child mind seriously in a new way and taking the possibilities of intimate communication seriously in a new way. For Freud, the mind of a child was a marvel in development, that is, a moving marvel with its own predilections. He believed we encountered the history of the child mind in the predilections of the adult mind. The vast field of inquiry into child development received enormous impetus from Freud’s theories. For Freud, a special kind of emotional intimacy, a special kind of conversation, one he called “analysis”, made possible changes in how we experience not just the world around us, but ourselves. Psychotherapy, in all its variety and peculiarity, was born out of this new emphasis, which, of course, hearkened back to rabbinical practice and confession, perhaps also to shamanism. Both of these fundamental notions of Freud, taking child mind seriously and taking the possibilities of emotional intimacy seriously, have borne rich and varied...
Shame is a raw psychological surface, a prototypical border, a first draft of skin. When early attachment is difficult, shame acquires the status of an active drive to avoid what is intrinsic to us because acknowledging it might not be compatible with our survival. Shame is arousal we disavow, perjuring ourselves in a realm before conscience, which may later prosecute us on this basis for crimes of which we have only the dimmest, most diffuse and vestigial awareness. Shame is the origin of much of the disposition of conscience to be bad. Shame is all at once agonizing, voluptuous and addictive. The luxury of shame’s certainty, which depends on the inner fictive presence of a cherished intolerant and absolute other, deprives us of a chance to see ourselves with our own eyes. To the extent that our prior states and situations in life shame us, we will find ourselves lying even to ourselves about our current state and situation. The resolution of our shame requires that we be able to look at it through a maximum security prism. No one of us can do this alone. Our best qualities embarrass us as much as our worst ones. We may be shamed by what is deep, tender, powerful and true about us. Shame and embarrassment are the consternation of the current regime. Consternation may be for the good , as well for ill, but it is always uncomfortable. So many people can let themselves be known only when they know they are leaving, as if they need an escape route from their shame. Shame is a most intimate part of...
