Too Late

Tom was 60 years old when he told me about his 85 year old father who was losing his memory. Tom described how for decades he felt intense anger toward his father.  But now, with his father aging so with dementia, Tom sat slumped in my office chair, crying.

Sure, his father had made mistakes when Tom was a boy.  He yelled at him to go to bed when it turned out that his arm was fractured. He never took the time to go to any of Tom’s sporting events. He didn’t let Tom transfer to the high school of his choice. He hit Tom when he disrespected his mother.

As the years went by, his father did say he was sorry, many times. But Tom’s resentment was too intense and he could not bring himself to forgive.  In fact, as time moved on, Tom’s anger seemed to grow even stronger and he openly told his father many times that he couldn’t wait for him to die…..

As a psychiatrist, this is a scene I have sadly witnessed all too often:  an adult son who harbors years of anger and resentment.   An adult son who is too proud to forgive.  An adult son who never takes the time to look at himself.   

Certainly, I cannot say that I have ever met a perfect Mom or Dad.  But short of significant abuse, forgiveness is one of the greatest things that we can do. With forgiveness, we can break the seeming irreversibility of the past.

As the Beatles sang, “Life is very short…”

Marianne Never Budged

“I just want you to give me my meds”, Marianne announced as she walked into my office.

This was our first meeting.

“Can we talk a little?”, I asked.

“What’s there to talk about?…..

I take Prozac for my depression, Xanax for my anxiety, Lithium for my bipolar, Zoloft for my trauma, Trazodone for my insomnia along with Melatonin, Seroquel for my obsessive thoughts, Adderall for my attention disorder, and Haldol for my voices….. The meds work, doc, they’ve been working for years.  I’m only seeing you because my previous psychiatrist retired.”

I was keeping count. 

Nine medications, nine psychiatric medications!

Madness, I thought to myself.   

But for Marianne this was no madness. This was her life.   She had neatly categorized each medication with a particular diagnosis, as if the complexities of life could be reduced to a label and a pill. 

Marianne had little interest in talking about her life.   Having been abandoned by her parents at a young age and raised in foster homes, she trusted no one.  In our third meeting, I softly inquired about trauma; she looked away.

The years have gone on.

Marianne has remained a closed book.

I once told her that I made up a song about her nine medications and sang it to her -  but her facial expression remained stoic, neither humored nor insulted.

Marianne never budged.  And after time I realized that I had become her enabler, dutifully keeping her on her nine, count ‘em, nine psychiatric meds.   

In her odd way, Marianne was happy with her lot.  She felt safe, reassured, cared for.

Not coming out of her comfort zone.

A little bit like all of us.

Leather Restraints

In the psychiatric hospital, there are times when we have no choice but to put an intensely violent, out of control patient in seclusion.  Sometimes we may also have to tie their arms and legs in strong leather restraints.  I will then order shots of medications, like Haldol and Ativan, to try to calm them down.

This whole scenario is abhorrent, but necessary.

I have wondered what thoughts and emotions one goes through when one is restrained, or stuck, in solitude. An extreme example comes from Herman Melville’s epic novel, ‘Moby Dick’, when a cabin boy named Pip falls into the sea and finds himself surrounded by the open ocean where  “the awful lonesomeness is intolerable.”  Pip ultimately is saved, but the damage has been done and sends him into “madness.” 

Certainly we all need moments to embrace solitude, the beauty of quiet and meditation, the time for internal work.  Private time.  We all need that.

But we would go mad if there seems no hope for interaction, if we were tied up, if we were left forever in the bobbing waves of the ocean.

This is because we all crave connection…

Let us pray for the hostages in Gaza. 

And bring them home - now.