Thursday, August 18, 2011

Existential Therapy Meets the Irreverent Psychologist

Imagine the following two stories which are basically true.

The patient asked, "What happens if my plane breaks up over the ocean and crashes?"

"Well then I suppose you'll die," responded the irreverent psychologist.

"Well now that's comforting. Aren't you supposed to say something comforting, something to make me feel better. I feel that we've lost a little safety here."

"You'd feel even less safe if your plane breaks up over the ocean and your last thought before you died is that I lied."

"Thanks a whole hell of a lot, Doc."


I was in Palm Springs getting ready to venture out into the desert  to look at the early spring flowers that were blanketing the landscape. I distinctly remember looking into the mirror. That lump on my forehead. I can't really pretend like it's not there anymore. I can't really explain it away by saying that it's just the natural contour of my head. I can't explain it away by saying that I'm just a lumpy sort of guy.

I know what a lump means. It doesn't mean something good. I know what it means when people avoid thinking about their lumps: they are avoiding something that is too scary to contemplate. They are avoiding something that is too unimaginable. They are avoiding death.

I couldn't avoid it. I couldn't be that person.

I returned from the desert and made an appointment with my doctor. "Hmmm. It's a lump," he said. "Great help you are doctor," I responded. X-Rays, CAT scans, MRIs, and bone scans followed.

For one full week I sat with my lump. I sat with my fear of death. I was not yet even done with my doctorate and I might have bone cancer. I  might have brain cancer. I might be dead before I finished my doctorate.

I head back to the doctor to talk about my head. "Not cancer," he said. "Stop shaking."

I'll save you from the medical gibberish, but I had a bizarre condition most commonly seen in cats. I needed to see a neurosurgeon. I needed to have a portion of my cranium removed and replaced with titanium. I would be just fine, though a little more thick headed. I was hoping I could attach notes to my head with a magnet but apparently that doesn't work. I know this because I tired. Twice.

Viktor Frankl, Irv Yalom, and a raft of others have taught me that we should not avoid thinking about death.  In fact, that we should think about the finite amount of time we have every now and again. When we turn off our defenses and tools of avoidance we become closely connected with a single unalterable fact: we all have the same destination and that destination is death.

On a good day I don't find this destination particularly sad or scary. I find it liberating. I find it enlivening.

"You know exactly what I mean. You know that I hope that if your plane is crashing apart, your final moments are filled with connection, and presence, and knowledge. That is the best we can do. That is the only thing we can do. We're all heading full tilt to that destination of death. How are you going to get there? Hasn't that been exactly what our work together has been about?"

How are you going to get there?

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