Pete was a wreck. A happily married fellow with three young children, he would traditionally came to my office every six months to get his Zoloft for his severe OCD. He enjoyed telling me about his family, his work, his love of sports. Things were all pretty routine - until they weren’t. Pete shared that he had met a woman at the gym. At first they would joke around, but soon the flirting started and in short order, Pete was infatuated. It got to the point where the two of them would text each other so they could rendezvous at the gym at the same time. Pete was feeling increasingly weird and anxious about all this, keeping a secret from his wife, but he couldn’t help himself, couldn’t stop himself. Seduction had taken over. And then, the woman invited him to her place. Pete asked me what he should do. "I’m a married man, Dr. Guterson, and I want to stay married, and I’ve got three children. But I can’t get this other woman out of my mind.” Pete was shaking now. He clearly wasn’t himself. He was lost. His mind had been taken over. In the world of spiritual mental health, Pete had entered the realm of what the sages call ‘temporary insanity’. No, he wasn’t psychotic; he wasn’t schizophrenic or manic. But his passions were so intense that he had lost his way. I turned close to Pete and said, in no uncertain terms, “You have to end this, completely and totally. You cannot even be friends with her because your infatuation won’t let you. Text her that the relationship is over, that you are devoted to your wife. And then block all her numbers and emails. Erase all texts. Destroy any gifts. And never return to that gym again.” I added, “If this relationship with her goes on, it will ruin your marriage, your family, yourself.” I imagine there are those in the mental health profession who would disagree with this directive approach.
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"Ramblings on the Psych Ward"
In most places of work, including my psychiatric hospital, certain unique phrases become part of the daily parlance. Phrases like “The Dewey Cocktail “. Twenty nine year old Chuck Dewey was a manipulative fellow with little regard for others. For Chuck, people were simply pawns for him to use. But now he found himself behind the walls of the locked psychiatric ward and therefore he was not in control. It didn’t take long for Chuck to start slamming doors and threatening other patients half his size. He stood 6 feet 5 inches and with his muscular frame, he was one scary fellow. “Get me out of this hell hole”, he screamed, and when the staff attempted to defuse his posturings, he started flailing his arms and punching fiercely at everyone. It took eleven staff members, two of whom were now bleeding, to finally pull Chuck down to the ground….. ….“Haldol 15 milligrams”, I yelled to the nurse; “and Benadryl 50 milligrams and also Ativan 2 milligrams; give them all IM (intramuscularly) right now!” Within moments, this trio of meds - an antipsychotic, an antihistamine, and a benzodiazepine - were shot into the upper arm of Chuck, and in short order he had calmed down and was well on his way to sleep. The staff loved the quick effects of this confluence of medications - and so named it, “The Dewey Cocktail.” But I didn’t feel so good about all this. I wanted to reach Chuck, not just knock him out. I tried and tried, but couldn’t get anywhere. Chuck persisted in seeing the world as his playground and he was incapable of expressing any apology or remorse. Anger and narcissism blinded him. More violent outbursts followed and unfortunately, the newly coined Dewey Cocktail had to be delivered twice more, both times again with quick success. The sages say that the strongest of persons are those who can control themselves. When we respond with rage, when we allow our limbic system to take over, we have then become slaves to our passions and lose our chance to learn from the situation. If this rage turns to physical violence, there is no time to waste, and a band-aid cure becomes necessary, a band-aid like the Dewey Cocktail. When Chuck finally was discharged from the hospital, he turned to me and said: “f… you, Guterson, you’re a good guy, but f… you.” I thanked him actually and said that I learned a few things from him. And I told him that I hope he will look in the mirror someday. …..two days later, a fresh patient got totally out of control. Every effort was made to soften the patient by verbally trying to calm him down, but to no avail. As his violence escalated and fears of others getting hurt intensified, the nurse turned to me and whispered, “Dr. Guterson, time for ‘The Dewey Cocktail’?” Indeed it was, as it has been many a time in our little psychiatric universe, but it still remains a mere band-aid at best.
(continued from the last ten weeks)
Q: Dr. Guterson, you talk a lot about the soul? Maybe you can help me understand what a soul is?
A: Our soul, which is an actual piece of Divinity, is sent to earth into our body. As a result, we have both a body, with all of its material and physical needs and cravings - as well as a soul, which yearns for just the opposite, for transcendence. Body and soul ideally should work in harmony, taking that which is physical and infusing it with spirituality.
According to Chassidic philosophy, the structure of the soul consists of three intellectual powers (which we discussed last week) and seven emotional powers. These are what make the human being tick. In a spiritually healthy person, intellect drives emotion. In other words, once we truly internalize the inspirational flash and development of a G-dly concept, then our emotions can come into the picture, step by step.
The first emotional power is unbridled kindness, also depicted as expansion. Let it flow! Let it go! Give and give! When we see the good in others and in every situation, then life is filled with a positive and generous attitude.
But - be careful: unbridled giving can reel out of control. This leads to the second emotional power which is awe, a contraction, having the might to hold back. It is the ability to say ‘no’ and knowing what to say ‘no’ to. Strength of character entails limits and boundaries.
The third of the soul’s emotional powers is a synthesis of the first two, and therefore is depicted as harmony and balance. As they say, “it’s all in the delivery” - to know when to say ‘yes’ and when to say ‘no’, when to give and when to hold back - and to do this in an empathic and balanced way.
Let me add that empathy - to truly put yourself in others’ shoes and thoughts and feelings as best as possible- is one of the most important skills to learn in life. Some people are able to do this intrinsically; others have to really work at it. But it is achievable.
(More on the soul’s emotional powers next week…)