"Hi Jude, Mother Theresa said, "The most terrible poverty is
loneliness and the feeling of being unloved." The man who
cut himself off attempting to guard against suffering, in fact
fosters it. Many suffer with fear of regret, loss, or
rejection; living in the shadows of life from ignorance or a
misguided notion they are shielded from pain, unaware its
avoidance can itself be so painful. This “poverty” is worse
when self-inflected. Though loved, when you feel you are not,
that perception becomes you reality and the fog of loneliness
settles about you; you exist with your own self-defined
ouroboros. This search for constant happiness is epidemic,
driven by societal and parental apathy, exacerbated by the
visions of “being the best and brightest” if only you do
this or that, or buy this or that, or wear this or that, and
even think this or that… Our children learn to believe
life is defined by externals rather than from within, so no
other result is possible than the hollow, transient spike of
happy inclusion followed by the dip into more wanting. They
become "left out"; isolated from abundant options and
opportunities. Their choices contribute to their circumstance,
but lack of guidance and support exacerbates their plight, and
their fate is sealed. The cycles of ignorance remain unbroken;
the suffering without recognition of suffering continues, and
the “happy face” of living becomes a ghoulish mask hiding
the rictus of desperation. Well done, a great
article! Lawson"

There is no freedom when we are slaves to our own  desires and deceptions.

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No one over ten years of age would be terribly surprised by that sort of turn on a dramatic television show.

But Sweets, a psychiatrist whose job it is to support the people who face the most gruesome deaths on a regular basis, is utterly shocked and rattled.

And that interested me even though it was a droll stretch in the script. Because the truth is we are utterly unnerved by the Irony of the Universe. We come unhinged when someone we know has died. “He’s dead? What do you mean?!” we want to know.

Why are we so shocked by death? Why are we so stunned by suffering when it comes, finally knocking on our door? Why does the death of a young man unhinge us when we have lived in the world (in Sweet’s case for a few decades) and seen what the world is made of? Why—when we know there are NO exceptions to the bruising life gives us—do we still think happiness, good endings, and success is some sort of birthright?

I pondered this for a few hours and then it dawned on me: We forget the world is fallen. And it is fallen, all of it…all the time. I don't much like it and apparently I'd rather forget, too, but I keep getting reminders.

Once I had the misfortune of seeing a large hawk pick at a dying, but still-breathing rabbit underneath a juniper to the side of my garage. It was horrifying, but the deed was done and there was nothing I could do except weep as I walked away.

Sometimes, even years later, that image–that most intimate suffering–will pop up unbidden and unwanted while I’m driving or walking or resting. Every time, even now as I write this, I wince in pain.

As a psychotherapist and homeopath, I work with people whose lives are filled with undeserved misery, whose suffering sometimes boggles the mind and keeps me up at night. I have seen enough to know and it should be enough for me to remember what life is really like.

Yet, I’m no different than Dr. Sweets. I forget because I live in America where I can enjoy long periods of relative ease and comfort. I forget that things are fallen when all seems to be going well, the dogs are healthy, my husband is happy, and my family is at peace. I forget because I've been damned lucky.

Up until not too long ago (it embarrasses me to think just how not so long ago that was), I operated under the delusion that somehow everyone else would die, but I would just keep going. And that if I “just did this” or “just avoided that” or “just avoided flying” that somehow my ticket would never get punched. One can get very wrapped up (knotted, really) by this sort of thinking.

I know I’m not the only one, though. I think most of America operates under this delusion and because of it many, many people spend a great deal of their lives anxious—fearful, to be more accurate—and trying desperately yet vainly to control as much of their environment as they can.

Acknowledging the fallen nature of the universe does not mean we stop lamenting suffering, or stop praying for the recovery of a loved one, or ignore injustice or walk away from a wounded animal.

To the contrary.

At least for me, finally coming to terms with the nature of existence and my own mortality has set me free. I no longer have to struggle against the way it is. I no longer worry about “what ifs.” I no longer try to control the things that are uncontrollable. I know that there is little I can do about suffering (though I will never learn to shrug it off) and I accept its inevitability.

What I can do, though, is be truly present to those who are in its grip and I can give more of myself to the things I really can do something about. For instance, the other day my husband and I stopped by a wild bird supply store to pick up some seed. We got to talking with the shopkeeper and we asked her about the sudden disappearance of all the smaller song birds in the area. Where we used to get flocks of robins, finches, titmice, bluebirds and juncos, now we saw absolutely nothing. Not a one in the birdbath. No one on the feeder.

She said, “That’s odd. Maybe you have a predator?” I hadn’t seen anything, but I yielded the possibility. We are, after all, in the foothills of a large mountain and federal land.

The next day while driving home I saw something bizarre: a young hawk standing in front of our house by the edge of the road. I thought it was a hawk, anyway. I stopped the car and the bird looked at me with utter indignation and tried to fly away.

Instead he flopped. His wing was broken. I ran into the house, yelled for my husband to come out with a towel and leather gloves. I said, “Don’t ask, just hurry.”

It was getting dark and I knew if we let him stay there, by morning the coyotes would have found him. Or he would soon die of the pain, an infection or starvation.

We ran after him a little while and finally managed to throw the towel over him. My husband picked him up and we held him in one of the dog crates, covered, until we got in touch with a friend who’s not only a medic but a top-notch expert on raising birds of prey. When we brought the bird to him, he looked at it and exclaimed, “It’s not a hawk. It’s a kestrel. He’s a full grown falcon!”

It was a joyous relief to learn the next day that he’d been handed over to a rehab, Talking Talons, for surgery and hopefully release back into the wild. So, the birds have started returning.

But it is all such a frail thing; it all hangs in so precarious a balance. For them to come back, one kestrel had to be severely wounded.

I am no great mystic. I understand relatively little about how things are the way they are. But I have learned a few things that help me to observe truly and keep my center. The most important one is the simple knowing that if the world is indeed fallen, there was a fall. And if there was a fall, there was a place, a higher place from which it fell. That means that it was created to be quite different than the way it actually is and that it can—and will—be restored to its proper condition, as God intended.

This I do believe—we all, the falcon, the small birds, the Boy on the Train, and all that suffer will one day be redeemed and made new. There will be no balance beam to totter along, no “ironies” of natural law, no struggle to make palatable that which is intrinsically intolerable, no need for philosophical pockets big enough to hold the suffering of the innocent.

One day, the debate will be over. The train will be made to set right on the tracks again. In my mind I hear some of the last words of the last book of the Narnia series when the battles are all over and Lucy, Edmund and Peter stand at the end of all they have known, before all they have ever hoped to know: “Welcome, in the Lion’s name. Come further up and further in!”

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(This article is dedicated to R.M. who inspired it. Thank you for reminding me of what we are supposed to be doing.)

For some reason lately I have been seeing quite a number of brand new social workers for supervision, some of whom are still in graduate school. It has been a poignant and privileged rite of passage for me after all these years to be passing on what I’ve learned.

One in particular touched me. She worked some time ago in a hospital emergency department in another state. As you might imagine, she bore witness to countless tragedies and sorrows, the worst of which was one little girl who had been beaten so severely by her mother’s boyfriend that they didn’t know if she would make it.

When she originally came on the ward she had been warned by the other professionals on staff to “watch her boundaries.” That’s a trigger point for social workers who, as a group, have been known to go the extra mile for patients and clients. This has become an “issue” for the profession as it has grown over the years and tried to maintain its status along with psychologists and physicians. What the well-meaning advisers meant was that she would be facing horror and that she needed to “detach” and “not bring it all home with her.” The real meaning: don’t get involved.

Those were their words. People warned me the same way when I started out.

I have been a psychotherapist and crisis counselor for nearly 30 years. I have worked with rape victims, survivors of war, children who had been abducted by drug lords, parents who were abused by their own offspring, addicts who had been lost and left to die on the street, and a full retinue of the mildly neurotic. I have stared into the abyss with friends and colleagues at Ground Zero and had to breathe the acrid smell of death.

But what I have learned is that there are boundaries and there are boundaries. Some should be zealously guarded and some not so much. And whenever I have made a real difference I have absolutely become involved though not in the way you may imagine or some may fear.

I will explain through her story.

As the baby was being treated, she called the proper authorities, as was legally required. She watched as the mother and boyfriend were carted away. And she stood nearby as the baby, broken and battered, moaning in pain, was gently set to rest in a small bed in PICU.

She was told to go home, that she’d had a hard day, and to have a glass of wine. There was nothing more to do.

But something inside her rebelled at that: there’s nothing more you can do.

And, against all the advice of authority, against all the warnings, she went into the PICU and sat with that little girl, breathing gently with her, resting her own fingers carefully in the child's small hands, smoothing the downy hair on the little girl's head, the one place that had gratefully been spared from the brute’s rant. She sat with her for hours until the little one was able to rest. She talked to her. She sang to her. She hoped for her. And then she reluctantly went home.

The case moved on from there and she doesn’t know what happened to her or the family. But there she was in my office, years later, wondering if she’d done something horrible by not letting go, by not listening to the advice of the nurses and administrators who told her to detach, to not take it home. “Did I make a terrible mistake?” she wanted to know.

Through tears as I listened to her and through tears as I write this, I said “No. You did everything right.”

She didn’t understand how she could be right and feel pain that way and disobey the warnings she’d been given. But I did. And I have found that when you do the right thing, there is often no way to sidestep the pain and sorrow that is common to us all. Nor should there be.

Suffering and Professional Boundaries

Social workers’ boundaries are important, but not in the way we might think.

I think there are actually two separate questions in this larger issue and it is a far more complicated topic than people might imagine.

Boundary Question One: How do we face suffering and not get lost in it? How do we help people in pain without absorbing it? How do we have empathy and compassion without becoming the patient? What do we do with suffering if we can't fix it?

Boundary Question Two: How do we treat people in a clinical setting and keep our focus on them rather than using the session or relationship as a way of working out our own lingering issues? How do we stay clear-sighted about the pathology and vigorous in our pursuit of  health and the well-being of our patients?

These are two separate issues and I believe that we often confuse them in clinical practice.

I hope I can answer them both briefly and simultaneously by drawing on my experience and explaining what I think is necessary in any healing relationship.

Over the years, despite accruing more and more “tools” for my clinical tool bag, despite learning more and more techniques and styles, I have actually simplified. One of my mentors in graduate school told me, “Learn them all well so you don't have to use any of them.” I didn’t know what she meant then, but I do now. She also told me, “Don’t for a second think it’s you doing the healing. It’s the love.”

So, the distillation is this:

• Presence and Pacing

• Compassion and empathy

• Seeing someone fully without bias and without projection

• Spiritual context

Presence and Pacing

Presence is paramount. It is foundational. The ability to be fully present in the moment with whomever is there, with whatever situation confronts you, is to be adaptable, available, and genuinely healing. It addresses both Question One and Question Two in that being in the moment (as opposed to the past or the future) allows you to feel fully, be ready to do what is needed, and then move on to the next moment. When you are in the moment truly, you will be more adept clinically. You will know the situation at hand is not about you and that it will not last. You can fully feel and know that when you go home you will be fully present to the joy and life that is there.

This is not easy and it has taken me many years to learn. Being present has a caveat. It means we are there for all of it—the pain, the glory, the defeat, the sorrow, the loss, and the redemption. All of it.

Pacing is a term coined by Milton Erickson, M.D., the greatest hypnotherapist in American history. It  is also a technique I focus on quite a bit when I teach Verbal First Aid to first responders, medical personnel and clinical professionals. It means to "move with" or "walk along." It can include mirroring (to some extent) but I use it mostly to stress the act of being with another person. When a person is in pain and we are hoping to move them to a state of greater comfort, we do what is called pacing and leading. We pace their pain (I can see your wound and your discomfort…) and then lead them, sometimes one tiny step at a time, to healing (…so as I hold your arm and apply this bandage, you can rest more comfortably and stop the bleeding). Without the pacing, there can be no proper leading.

Pacing requires presence. Presence implies pacing. It is an emotional and spiritual partnership that may last anywhere from a few seconds at an accident scene or at an ER or go on for years in a psychotherapy setting.

Compassion & Empathy

This is not the same thing as taking on another’s pain. It is a communion, an experience of commonality, not a sympathy or an absorption. It is also NOT a projection of our own feelings onto them and this is where our skill must be honed and refined over and over again. Sometimes it means feeling what someone else is feeling, but that doesn’t mean it’s ours. It is a subtle difference, but an important one.

Many of the patients that come to social workers have been hurt terribly. We may in fact be the first person in their lives to genuinely feel them. (S.W. Recall: Winnicott’s “The Good Enough Mother.”) This can be in and of itself enormously healing.

What I have come to both believe is that feeling is not the problem. Over-interpreting and/or ignoring feelings is the problem. And that’s where we—as healers—can get into serious logjams.

In fact, it is the social worker’s ability to feel fully (and know what to do with those feelings) that is the hub of all clinical work. If we can’t do it, how do we expect our patients to do it?

Seeing Fully

When I was in school for classical homeopathy, my teacher used to warn us, “If you can’t see your patient, you can’t heal him.” He spent five years talking to us about the power to see.

I think this is true in any clinical setting. We open the door, a patient comes in and sits down. What do we see? What do we want to know? Can we see the hurt? What’s broken or bruised? What still works? How does it still manage to work?  These are the questions we want to ask and have answered.

Seeing someone truly may also entail some detachment, but not in the way it is used colloquially, which is to “not feel” what our patients are feeling. To see the truth means not get beguiled by façade. Most patients will come to us with a well-practiced façade in place, a mask they use to get through their lives—to hide pain, to forestall an accounting, to deceive and manipulate for one thing or another. We have to see past those deceptions, both conscious and unconscious. We have to see past the acquired skills and into the recesses of a person’s heart. We have to observe carefully. They may say they feel fine, but they can’t stop biting their nails. They protest over much about how calm they are, but their feet don’t stop tapping, they sigh repeatedly, or their eyes twitch.

As healers we are observers. Both of ourselves and our patients.

Spiritual Context

I cannot imagine doing this work at this point without two backups: One is the homeopathic philosophy and Materia Medica of Samuel Hahnemann and the second, most important one, is God. Suffering is intolerable (our own or anyone else’s) without some context within which we can hold it. Suffering or pain without meaning in a purposeless, random world is utterly intolerable. When there is meaning and purpose, even the worst pain becomes manageable.

Over the years, my work has become more about serving God (this is not about proselytizing by any means) than adhering to an agency code or a diagnostic manual, more about being present and truly healing than politically correct for the moment, more about truth and love than techniques.

I explained it to that young social worker that while others may not have understood what she did for that baby, God did. And the baby did. I am as sure of that as I am of the nose on my face. That baby heard her soothing voice, felt her calming breath and heartbeat, rested in her loving hands. Is there a better “technique” than that? I don’t think so. Those few hours she spent with that child may have changed the trajectory of her entire healing process.

I no longer aim for detachment, though I respect it. I no longer aim to fix every broken thing that is presented to me, though I very much want to alleviate suffering and disease. I no longer aim solely for technical skill, though I love learning.

What I am for is this: I aim to be present. I aim to see the truth. I aim to serve. Doing this work for so many years has required that I become more like a tube than a vessel. I do not “hold” other people’s pain, but I allow it flow through me and then up to God, Who can do with it what must be done, whatever that is so that peace and health and love are restored.

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