Kate

Dear Kate,

What I would do, if I were you: I would go be with your family. But with your family or not, you will still have the problem, in a sense, of not being able to do anything. It will still be mainly a question of how to bear what has happened.

There are times when you can do something and times when you can’t. It’s the times when you can’t that interest me the most — the times when your radio gets only one channel, when the only thing you can get is the broadcast of your own heartbeat. Those insipid little tunes your head plays when you’re not looking — What’s for lunch, did I pay the car insurance, when’s my vacation, did I feed the dogs today? — they interest me too, but mainly for the way that, if you sit still long enough, they seem to crackle and die out. What’s left, eventually, as we sit and think about our loved ones far away, imagining the house that may or may not still be standing, is the quality of individual consciousness in moments of crisis and impotent fear. Speechless before the big winds of historic weather, at first we find the music frantic and grating. It’s a little ditty that goes something like this: Where is my family, are they OK, what will they find when they return, what will they find, what will they find, will we be OK, will we be OK?

And then if you continue thinking about it, it tends to slow down and go something more like this: OK, I am here, I seem to be safe, my family is safe, there will come a time soon when I will see them all, if we have to rebuild we can rebuild.

And then you can take a long, long walk, swinging your arms freely at your sides, getting in tune with the walking. And then you can look around you for signs of the world as it still exists, willed into existence in some places, willed out of existence in others, as though there were holes where things leak out, and other holes where things leak in. As though the world were like our houses, porous in places, temporary at best, but filled with music and memories.

Forgive the silliness of the metaphor, but you’re like a little music box. It’s the quality of the music you make that makes the difference. I’m not saying there’s nothing you can do. But it’s the cans themselves you’re collecting that make the music. As you collect the cans, pay attention to them. Don’t throw them all in a frantic jumble into a random paper bag; pay attention. This is food. This is you doing the essential thing. Essential things quiet the heart. So pay attention to the music of the cans of food. Pay attention to your own little minuets — you dig?

Of course there are many other practical things you can actually do to help. But I am no expert in all that. There are many better places to learn about that — Web sites and television and radio, the newspaper and magazines: By now the whole world is focused on what to do. I’m just one small voice focused on the other stuff — how to do nothing as effectively as possible, so you get through whatever it is without going crazy.

I’m just focused on how to tune in to that great fulfilling station that plays all your favorites. All you have to do is become an antenna. Sit on your own rooftop and be still, knowing that you, at least, do not need to be rescued. You’re already home.

- – - – - – - – - – - -

What? You want more?

The issue is that one of my sisters is undiagnosed mentally ill and has harassed me by phone for many years. I have told her not to call or leave messages because I do not listen to them. I have blocked her email and have had to block her texts. By harass, I mean she will phone bomb my phone with messages that are rambling, abusive and full of self-pitying statements that she is the victim of my horrible treatment. She will leave anywhere from three to six to ten messages in a row, and they become increasingly aggressive and mean. According to her, my non-existant responses are abusive.

I used to think I was a bad sister, but recently I found out that she was arrested for stalking an ex boyfriend, and that information made me think that I am not the only one she harasses. I Googled her name and found the arrest and another past arrest in the local police blotter. I also found out that my mother and other sisters recently blocked her from their phones. Which is what I did, as well.

Needless to say, I did not invite her to my wedding. But I feel bad about [not inviting] her teenage kids. We were close when they were little, but now they live mostly with their dad. I don’t think there is time to try to contact them before the wedding because I don’t know their dad’s address, but I am wondering if I should reach out at all? Even though my sister is sick, I don’t want to get in the middle, and I am afraid they don’t understand why they were not invited. Also, my sister — in one of her nasty calls — said that if I try to contact her children she will get an order of protection from me.

Wanting to be the Best Aunt Possible

Dear Aunt,

When one is a teenager and one’s mother is mentally ill, there are certain family functions to which one simply won’t be invited. One may try to be stoic about such things, but they sting.

Later in life, when her teenage kids are adults and begin having their own problems adjusting to work and relationships and feeling anxious and depressed themselves, they’ll get into therapy and start talking about their mother. Perhaps this wedding to which they were not invited will come up in conversation, and they will see what happened — why their mother could not be invited, and by extension why they could not be invited either — and maybe they will begin the long process of building compassion for everyone involved.

But you know, as I write that — and I thought I could be steely and objective about this! –  I really wish you could get a message to the kids now, before the wedding, if that can be done discreetly, and just explain, however such a thing can be explained, that you love them and think they are great kids and wish they could be there. You know? Just to say you love them and you’re sorry they can’t be there? Is that crazy? I just think, imagining how it will feel years later, if you could do this, it might eliminate some future bad feeling. I am no expert in manners, and weddings seem to be full of manners, so there may be some transgression or unforeseen consequence in what I am suggesting. It’s just that if I were one of those kids, I would appreciate knowing how you feel. It would eliminate some of my confusion and fear about where I stand in the family, what with my mother having all these conflicts with others.

These kids have feelings. Don’t they deserve to know something like the truth — maybe not all the grisly truth, but something like it — to know that they matter and that they aren’t being ostracized because of their mother’s unpredictable and disruptive behavior? It’s not her fault she’s mentally ill. Her kids may feel the whole situation is grossly unfair.

In their filial loyalty, they may turn against you for a time no matter what you do. If so, you will have to accept that. Remember what you have learned living soberly, that in protecting ourselves from certain evils, in making healthy boundaries, we will hurt people’s feelings now and then, and not everybody will think we’re swell, and sometimes all you can do is try to be kind and hope for the best.

Let us hope when you see your sister’s children one day, you will be able to talk as adults, and that you can say to them how much you wished they could have been there and how difficult the circumstance was. And let us hope that they are able to give you some signal that they understand and do not hold it against you, that you and they all know how hard it is to live in a family in which alcoholism, addiction and mental illness travel like colds among the members.

But for now, you are planning a wedding and doing your best to make it come off smoothly. For now, you are one of the survivors. Make it a good day. Rejoice in your good fortune.

I’ve battled most of my life with depression, the causes of which are probably not of very much importance (absent alcoholic father, frequent moving, mentorless young adulthood, spotty employment, fear of commitment, and the crowning insult, a miscarriage and the end of a relationship). Perhaps these things, along with hopefully some joys and accomplishments, are just things that make up life. Unfortunately, I have been short on joys and long on disappointment, which has led me to become a very negative person.

After my miscarriage last year, I decided to give therapy yet another chance. Despite going into it with an open mind, I have come to the realization that no one can help me. Not a therapist, not my mom, not any friends, not my astrologer. Sure, people will listen for a while. They will give well-meaning advice and pep talks. They may even tell me that I am full of good things and that the world is a better place with me in it. I have even tried things like pharmaceuticals, acupuncture and the like. I’ve done all the things that are suggested to people like me. Volunteer! Exercise! Take up a hobby! Do some yoga! Meditate! None of it helps, and all I want to do is end the pain in the only way I know how. I know that this will cause those around me to suffer, but I cannot hang around and be miserable indefinitely just so three or four people don’t have to deal with my loss and be sad for what, two or three weeks, plus maybe around the holidays?

I would like to know your thoughts about someone like me. I’m sure that there are many others for whom therapy was not helpful and who continue to suffer every day.

Miserable in Paris

Dear Miserable in Paris,

You will get over this depression.

A significant number of women remain depressed almost three years after a miscarriage.

But they come out of it. You will, too.

One study showed that 13 percent of women who had a miscarriage remained depressed 33 months after. That’s almost three years.

The fact that you are still depressed does not mean therapy didn’t work. It means you’re not there yet.

While you’re getting well, when thoughts such as “Therapy doesn’t work” and “No one can help me” arise, tell yourself what bipolar author Terri Cheney tells herself: “That’s my depression talking.”

Of course, let’s be intellectually honest and admit that life has a tragic dimension. People will die unhappy. Some of us will not be able to rise out of whatever it is we are stuck in. Some of us will die senselessly in automobile accidents, others will be tortured by madmen, others will commit unspeakable crimes and get away with it, others will put guns to our heads and the trigger will jam …

To be equally honest, life has a miraculous dimension, and some of us will wake up one day and realize it’s not so bad after all, and our hormones will balance out or our neurotransmitters will start transmitting after being jammed, or we will eat the right carrot or see the right television infomercial and buy a juicer or get a crystal that cures us, and we will walk barefoot on the sunny streets of Santa Barbara believing that a fortune teller in Venice read our palm and everything is settled now, nothing to worry about, everyone is fine.

While we’re at it, let’s admit that no one really knows. But I want to be one of the ones who says, I want you to make it. I believe you will come out of this depression. I have been depressed myself, and I have read about depression and followed treatment regimes and read many letters from depressed people and talked to depressed people, and my experience has been that most people come out of it if they don’t kill themselves. So don’t kill yourself. Give your body time to heal. If you need to crawl into bed and stay there for a few days, do it. But also do the things that will eventually bring you out of it.

Maybe no one thing you do will cure you of depression. But each thing you do will help a little bit: eating well, exercising, talking about your experience with other women who have experienced the same thing, doing yoga, meditating, sleeping well, walking in fresh air, reading books with hopeful messages, studying “Feeling Good” by David Burns and doing the exercises in it, continuing therapy or finding a new therapist who will be more engaged, taking time off, getting a massage, doing breathing exercises, taking vitamins, getting your hair cut, doing one nice thing for your body every day, staying out of situations that make you depressed, seeking out laughter, seeing funny movies, staying away from alcohol and caffeine, taking a sauna, swimming, sailing, riding a ferry, being in the mountains, taking a long drive to a resort, seeing a great chamber orchestra, hearing jazz, giving money to street musicians, riding the Metro, buying some clothes, talking on the phone to people who really love you, petting a dog, going to a museum, standing on the Seine watching the tourists go by in boats, walking by Cathedral Notre Dame, taking the Eurostar to London, eating a croissant, checking your adrenal glands, remembering to laugh every hour … all these things together may help.

Still, you may remain depressed for a while. And it’s not easy to do what you need to do to get over depression when you are depressed. That’s the maddening thing about it. It’s hard to think well. It’s hard to form an intention and carry it out. I know. Yet we do what we can. We eke out a little life while waiting for rescue, while waiting in our shipwreck in our floating misery being eaten by the tides and pecked at by birds, while waiting to reach some kind of land and eventual comfort and bliss.

What happens when therapy doesn’t work is you keep trying. You try different things. You try cognitive therapy. You try everything. You try nutritional supplements, and you don’t stop any one thing. You keep doing all the things that could possibly work. You keep an open mind. You try antidepressants. You read and learn everything you can. You use your intelligence to tell yourself the truth, which is that you are going to come out of this, and then you try to believe yourself when you’re talking to yourself.

You tell yourself what happened: You had a miscarriage and a relationship ended and your support system fell apart, and you acquired a serious depression which you are eventually going to emerge from.

Here are some other things you can do. They may work and they may not. You might as well give them a try, while you’re waiting. Write down all the accomplishments you have ever had. Include things that happened in school and things that happened when you were a child. How were you able to take care of yourself and others in your household? Write down all the things you are proud of. Visualize the things you would like to have in the future. Visualize happiness. Visualize pleasure and exhilaration. How were you able to save others from abuse? How were you able to recover from trauma? What were the high points of your relationship? Envision them. Envision your happy moments.

Write down even all the little accomplishments you have had. Make a list of all the times you have felt happy. Look at them. See what elements they had. See if you can re-create some of those moments. Post this list on the wall where you can see it several times a day.

It can’t hurt.

As long as you are alive, you have a chance. Life, if you don’t die, is long. One or two years is not so long a time. I first visited a psychotherapist about 20 years ago, and I have seen several since then — four total. Four different practitioners of different healing arts, well, more actually, if you count others; and then there’s all the help I have gotten from individuals, and chance encounters, and all the meditation and exercise and walking and talking and traveling and reading and working.

I’m not depressed today. I’m listening to Bach, looking out over the garden, where there are purple flowers.

I would try everything. I would try fish oil supplements and exercise and vitamin B. I know for me nutrition is extremely important; I cannot have alcohol and only rarely can I drink coffee, and I must eat plenty of fish and vegetables and take vitamins. I must. I don’t care what the science says. That’s what I have to do.

Attitude also makes a difference.

We have this friend who thinks she is the luckiest woman in the world. She was walking across the street right in front of her house and a truck ran a stop sign and crushed her. She was dragged under the truck because the driver didn’t see her. But people saw her being dragged and screamed, and the truck stopped and she survived.

She’s in a wheelchair now but considers herself lucky because she survived. She was lucky enough to get an elevator put into her house so she could travel between floors more easily and not have to be carried. The thing is, with her roommate, they have to always remember to keep the elevator at the correct floor. Well, so her roommate’s friend comes over and leaves the elevator at the wrong floor. And she backs her wheelchair into the elevator and falls to the bottom.

But she survives! She considers herself the luckiest woman in the world because she survived.

See also:

• How cognitive therapy works
• Nutritional supplements for adrenal fatigue

I did not understand why my body wasn’t enough to satisfy him. I was willing to give him sex whenever he wanted, yet he chose to relieve himself to other girls. He explained to me that he had “this urge to see other women naked.” He promised to stop, but once again, a few months later, I found some porn on his phone’s browser history. He confessed that he had been watching it during his lunch breaks at work. I was very upset and went to stay with my mother for a few weeks.

He was very apologetic but told me he would never get over his craving for porn. He also promised that he would go to therapy for his porn addiction and would try to stop because it hurt me. He went to therapy, but it seems like they just talked about why porn was so alluring to him rather than how to stop it.

After a few months of therapy, he quit going. I decided to take action, and I monitored his computer daily and kept tabs on him to check if he was watching porn. I also decided that keeping him away from triggers would help him not crave it as much (he agreed). Whenever we would rent movies for example, we would choose ones without nudity in them. I also went as far as refusing to go to the beach with him (because I knew that if we went he would be checking out young girls and may even have to masturbate to them later on).

By placing these limits on his behavior however, I am worried because I adversely made him hypersensitive to seemingly nonsexual things such as a girl wearing short shorts. Now that he is deprived of nudity he has admitted to becoming very aroused by things that were formerly not very arousing, since that is all he has access to.

Now simply going into a supermarket full of teenagers dressed in provocative clothing worries me. He admitted he would never get over this teen fetish/desire for teen porn he has. Currently he swears he hasn’t watched porn for over six months. I have no idea if he is lying or not because I have stopped checking his computer for evidence because it started too many fights about how I was “too controlling.”

I am not sure what to do. I love him, but at the same time I hate that aspect of his personality. I am staying with him hoping that he really has stopped, but deep down I do not think he has. If I were to catch him again, I would leave him for good.

But I am a bit worried that if I leave him, this problem will exist in my future relationships, since most men watch porn these days.

Should I stick around and hope that he is telling me the truth? Should I tolerate my significant other watching porn despite it hurting me? Or should I just seek a guy that does not watch porn or is willing to give it up for me?

Porn Widow

Dear Porn Widow,

You could just leave, you know. You’re 20 years old. You have options.

Think about it. If you deeply, deeply love him and want to devote yourself to being with him, of course you can do that. But you don’t have to.

You don’t have to stick around and help fix him or wait for him to fix himself or sit up worrying about what he is doing. You can just leave.

He’ll be OK if you leave. It will hurt, but he’ll get over it. If he wants to devote himself to recovering from porn addiction, it might even be best for him. He could be celibate for a while. It might help.

You are not married. You haven’t made a solemn promise in front of friends and family to stay together. You don’t have children. You don’t own a house together. You have not blended your families. Few practical obstacles prevent your separating.

You can stay with your mom while you find a new place of your own.

Of course you have deep feelings. I’m just looking at it from a detached viewpoint. From here it looks like leaving him makes sense.

The overwhelming question is this: Do you really want to spend your crucial, wonderful 20s struggling in a relationship with a porn addict?

Here is a scenario: You tell him that you respect his efforts to change, but you don’t want to risk it. You know he’s tried, but you’re just going to cut your losses and move on. And then do it.

In your new life, you can tell every man you date, right off, that you are absolutely anti-porn and that you are looking for a relationship that is completely porn-free.

You may spend months or years looking for the right man. But why not try to get what you want? You have time.

Once you find a new relationship, here is a very wise suggestion about how to say what you want.

And now, because I did a good bit of reading in the course of coming to a decision, here are a number of interesting resources and links:

• Partners of Sex Addicts Resource Center
• MarriedToASexAddict.com
• Therapists who specialize in sex and porn issues (If he went to therapy and all they did was talk about why he finds porn so alluring, maybe he should find some new therapists to talk to.)
• “Cupid’s Poisoned Arrow”
• Prolonged exposure to dopamine may play a role in depression
• Naomi Wolf: Is Pornography Driving Men Crazy?
• your brain on porn (role of dopamine)
• Demise of Guys?

First is the marked difference in the circumstances of our lives. I am a successful professional and businessman, and she is a financially struggling graduate student. (When we first met, she was still an undergraduate.) I have no problem paying for all our dates, our meals, traveling together, etc. It seems only natural, since I have the means to do so, and the financial impact for me is truly negligible. At times I have done even more for her financially, such as pay for many of her material needs, e.g. textbooks, school and living expenses, etc. She has never asked me to do this; I have always offered without prompting. On occasion, my girlfriend has expressed some discomfort about the things I have given her, saying that it feels like a sugar daddy-sugar baby relationship; but conversely, she has not turned my gifts down either, mainly because I insist. For both of us, there is definitely no sense of obligation or strings attached or quid pro quo. To me, it just seems like a natural thing for me to do, to help take care of someone I love. My family, however, is concerned that she is taking advantage of me, and I can certainly understand their perspective. They do not understand why a beautiful, young woman would want a relationship with someone old enough to be her father. Early in our relationship, I posed the same question to her. She told me that she has always been attracted to older men (she had earlier ended a relationship with a 35-year-old man) and found “boys” her own age to be immature and superficial. How can I convince my family — and I suppose to a certain extent myself — that she is not a gold digger?

The other problem we have encountered is the reaction of other people — strangers, acquaintances, friends and family — to our relationship. It ranges from, at best, surprise, to bemused cynicism, to being scandalized, to outright hostility. Noone we know reacts, at least initially, to our relationship favorably. This was of course predictable, and I thought I had prepared myself for the reactions of others when we first started dating. But I must confess that constantly battling the tide of negative opinion weighs on me. I am a very youthful, active 49, and have been told that I could easily pass for someone ten years younger. The problem is that my girlfriend is also extremely young-looking, which accentuates the age difference. Walking in public holding hands invariably engenders stares and second looks. Do we just have to resign ourselves to withhold all displays of public affection until she starts looking older (by then, hopefully, I will still maintain my own youthful appearance)? I know it shouldn’t matter, but the opinion of others matters to me. Especially problematic are the attitudes of business friends and colleagues who knew and liked my ex-wife, and who consider my current relationship at best highly unusual. How do we deal with them? At least my girlfriend and, for the most part, her circle of friends find our relationship much less problematic.

But perhaps biggest the issue I have with our relationship is that I am worried that as I continue to get older, she will be a vibrant, still-young woman saddled with an increasingly decrepit old man. I am still very fit, healthy and active, but I worry that in 10 or 20 years, my health will start failing, and she will be stuck with me. I love my girlfriend, and if not for the issues noted above, I would wish us to have a long, happy life together. As much as I can look after myself and stay young for her, I am worried that the inevitable discrepancy in our physical well-being will lead to guilt on my part and resentment on hers. I have discussed this with her, told her that in many ways she would do better to find someone nearer her own age, but she has always dismissed my reasoning out of hand, seemingly without giving it any thought. Is this a legitimate concern I have? How can I be certain that she knows what she may be getting herself into?

Mr. September

Dear Mr. September,

Your concerns sound reasonable. But what are you to do about them? You cannot change your age or hers. You cannot change how your friends and colleagues think and feel. You cannot change the reactions of strangers. So why not accept your situation exactly as it is?

As to what to say: It might help to memorize and agree upon certain phrases that politely define your relationship and clear up misconceptions. A little lighthearted humor might help; sometimes it’s refreshing to be disarmingly frank: “She’s my girlfriend.” But I leave it up to you. I intuitively sense that you are diplomatic and alert to social nuance.

Accepting the situation exactly as it is may require giving up the illusion of control. If you are a successful businessman and professional, you may be accustomed to feeling you are in control. It may be a habit to orchestrate events so that chance events are eliminated, when possible, and hedged against, when not.

But what if an undersea earthquake causes a tsunami and wipes out your town?

It is a mistake to assume that only visible dangers matter. Have you read “The Black Swan”? You might enjoy it. To greatly oversimplify, one lesson of that book is to prepare for the unknown. To assume that it will be the unforeseen that will surprise us is more or less tautological, yet we seem to have trouble with that.

Maybe we translate uneasiness about the unknown into concern about the known. For instance, your concern about what may happen in the future may be a way of dealing with your concern about the present.

The future is uncertain for everyone. It was uncertain for you and your wife. You probably planned to stay married but something changed. You could not have planned for that. Age can shift the balance of a marriage. But so can other things.

Youth is no protection against disease or accident. Your wife could get sick. You might end up being her caregiver. You must be ready to take care of her just as she must be ready to take care of you.

She is young and may not care to think about what might happen later. One day she might find she’s no longer in love with you. She may leave you. But if you and she were the same age, she might leave you as well. You can’t know. Neither can she. She doesn’t have to be a gold-digger to wreak havoc on your life. She may just be a person who wants to do what she wants to do when she wants to do it. If her feelings should change, then she might leave you. Would that make her a bad person? Would it make her a bad person if she promised to always love you and then stopped loving you? If she follows her heart, and her heart changes, and she is not able to see that coming, does that make her a bad person?

This is love. This is life. Nothing is certain. Accept it.

My sister believes she is doing what my mother wants, but my mother is unconscious.

The doctors keep telling us that my mother’s organs are failing; they need machines to keep her “alive.”

I am worried that my sister is freaking out, is terrified of losing our mother and is not dealing with the situation rationally.

How can I keep her from losing her sanity?

Thank you for considering my question.

Trying to Stay Calm

Dear Trying to Stay Calm,

While your sister struggles to absorb the facts, she will do everything in her power to preserve life. Only as she accepts that her mother is soon going to pass out of this world will she begin to let go of the emergency measures to which she is desperately clinging.

While it would not be right to take actions or make decisions behind your sister’s back or contrary to her wishes, I think it would be OK for you to contact a hospice organization just to talk with them.

The hospital may help you contact hospice, or you may contact them on your own. Explain what is going on and how you view it, and seek to understand what the options are. Hospice workers are experienced in helping anxious family members cope with the inevitable.

Tell them that your sister has the decision-making power. No one should pressure anyone to do anything.

As the end-of-life drama unfolds, it is a good time to sit and wait and contemplate. It’s a good time to look back over your mother’s life and honor her accomplishments and her spirit.

In the words of Dame Cicely Mary Saunders, who did much to establish the modern hospice movement, “As the body becomes weaker, so the spirit becomes stronger.” You can rest assured that as your mother approaches death, she is prepared. She has had time.

It is your sister who now needs time.