Lacking Perspicacity

Posted on April 14, 2014 by iraheilveil

In the mid-70’s, a blind, retired neurosurgeon came to my office in Westwood with a profound dilemma. He had been happily married all his adult life, and just before his wife died about 7 years earlier, she made him promise never to kill himself. She knew their love was the thing that sustained him, and knew he would want to end his life when she was gone. He reluctantly agreed to the promise, but now, seven years later, unable to do surgery or even to teach, his depression was intolerable and he no longer wanted to live. He was caught between his promise to his wife and his passionate desire to die in order to escape a life that became meaningless, lonely, bitter, and exquisitely painful.

I did what a novice therapist might do in such a circumstance, which was to offer some words of encouragement, explore other possible ways to find meaning in his life, but was mostly flummoxed. I talked to my supervisor, who wondered along with me why this wealthy, highly successful neurosurgeon would seek therapy in the first place from a young inexperienced man in his twenties, but offered little else that I could grasp. I did in fact discuss this very thing with the patient, but he didn’t reveal how he got my name or why he chose to see me. I offered him the opportunity to see someone else, but he declined.

At the end of the second or third session, which was to be our last, the patient dismissed me, telling me I did not help him at all, and that I lacked perspicacity. I didn’t know what that meant, although after I looked it up that night I never forgot the meaning. Of course, in retrospect, he was absolutely correct.

Over the years I have thought about that man often, wondering if he went home and injected himself with the combination of drugs to which he had easy access and that would end his suffering. But mostly I think of things I would have said and done differently, and wish, as I have about so many other things, that I could do that one over with the knowledge I have now.

I can never know that if I were to face that blind neurosurgeon for the first time now, with the nearly 40 years and many thousands of hours of experience as a therapist behind me, I could say the right words and offer the right guidance that would effectively ease his suffering. I know that I would approach it differently, but that is all I know.

What I lacked the perspicacity to know in my mid twenties as I sat across from that blind neurosurgeon was that I too I am that blind neurosurgeon, and most likely so are you. Those of us who love deeply also suffer deeply. Those of us who pledge ourselves to a path will meet crises along that path that will feel too big to bear, and those of us who insist on having hearts will have them broken. The suffering that allowing ourselves to feel alive inevitably brings with it is not the thing to be feared; it is life itself.

Yesterday, on my sixtieth birthday, my daughter asked me what the positive aspects of turning 60 were. I was ashamed that I couldn’t think of any, and in her characteristic way, she offered, “Well, at least you’re not 70.”

In the moment, I lacked the perspicacity to tell her that it was being there, with her and the rest of my extraordinary family that was most valuable about turning 60. Maybe, if I make it to 70, I will gain the perspicacity to treasure each moment as if it were the last. Maybe not.

The Last Day of Your Life

Posted on April 7, 2014 by iraheilveil

On a dusty street in old Bakersfield at sunset, a round-bellied alcoholic stumbles out of a bar. On the street, he is greeted by a sober alcoholic who just left his 12-step meeting. Eyeing his fellow inebriated alcoholic, the twelve-stepper confronts him: “You need to admit that you’re helpless over your alcoholism. Take it one day at a time. Today is the first day of the rest of your life.”
The fumbling alcoholic pulls a revolver from his waist, points it somewhere in the vicinity of the good Samaritan’s face, and says, “It may be the first day of the rest of my life, but buddy, it’s the last day of the rest of yours.”
If I were an alcoholic, believing that today is the first day of the rest of my life, as AA and the bumper stickers would have you, might not give me the encouragement I needed to stop drinking. I would most likely think, hell, I have my whole life ahead of me, why stop drinking now?
When I wake up I prefer to think that today is the last day of the rest day of my life, because as I get older the probability of that being true increases. If I were an alcoholic, that belief wouldn’t stop me from drinking either, because if it truly was my last day and being drunk was a preferred state, I might choose to spend it that way. I certainly wouldn’t want to spend it checking into rehab. But fortunately, I do not seem to have inherited the alcoholism set of genes (nor had my parents or grandparents), so in reality I would prefer to spend my last day sober and as conscious as possible.
Waking up believing that today might be the last day of my life has some beneficial effects. First of all, if it ends up not being true, I end each day thinking that somehow I cheated Death. If I am going to cheat anyone and get away with it the one I would most want to cheat is Death. There’s a sweet thrill in that. Second, and most obvious, thinking that each day might be my last allows me to make certain choices: I will choose to do those things that I would most regret not having done before my porch swing years (ok, maybe I am already there). And last, it imbues each day with a precious quality.
Ultimately, I cannot argue with the 12-step phrase that today is the first day of the rest of your life. It is actually one of those cute little mathematical tricks. Even if it were the last day of your life, it would still be the first day of the rest of your life. It just may not end up being a very long day. It is, of course, all a matter of attitude. If any day were the last day of my life, and it was lived well, it is going to be a nice day to die.

Snow Falling in Armenia

Posted on March 31, 2014 by iraheilveil

Sunday morning in Yerevan

I woke up this morning to the shocking beauty of snow falling outside the window of my hotel in Yerevan, Armenia. I am not talking an occasional snowflake, but a major snowstorm, with six-inch thick piles on the balcony ledges. Now, as I sit in the hotel restaurant, I see just a few people outside on what would normally be a bustling Sunday morning, trudging through foot-deep snow. I had planned to spend the day showing my wife some of the sights around Yerevan that have changed in the 7 years since she has been here. But I think instead we will be spending the day inside.

I have been to Armenia so often that I needed extra pages added to my passport, and in fact am now the proud owner of an Armenia residency passport. It feels like home away from home for me. When I tell my Armenian friends who live here how much I love it, they tell me “that’s because you can leave.” Touché.

Yesterday I spoke on “Inclusion: Best Practices” at Yerevan State University. The chair of the psychology department, in typical Armenian fashion, welcomed me warmly, and I owe a debt of appreciation to Narine Vardanyan, the director of International Child Development Center, for planning and executing the SRO presentation. I believe Shant TV even was there; it’s not difficult to make the evening news in Armenia.

For readers who don’t know it, Armenia is a tiny country, the size of the state of Maryland, with a population of under 3 million. It is a country with a proud, ancient history with archeological evidence of civilizations here dating to before the Bronze Age (4000 BCE), although the kingdom of Armenia officially began after the fall of Urartu about 500 BC, give or take a hundred years. The kingdom of Armenia was once huge, stretching from the Mediterranean to the Caspian and Black Seas, encompassing all of what is now Syria, huge parts of Turkey and Iran. In 301, it became the first nation-state to officially declare itself Christian, making the Armenian Apostolic Church the oldest state church in the world.

More ethnic Armenians live in the diaspora than in the country itself, not unlike Jews. Largely due to their location on critical trading routes, and also because of their religion, they have been associated with the “merchant class,” and have both benefitted and suffered as a result. During the Ottoman Turks’ conflict with Russia in the early twentieth century, amid fear that the Armenians living in the area would side with Russia along with widespread racism, the Turkish military systematically murdered, raped, marched and starved a million Armenians. And, just as there are rabid Holocaust deniers spreading inane ideas on the internet, there are those who deny the extremely well-documented genocide of the Armenians.

Another similarity between the culture from which I came and the Armenian culture is the strong emphasis on education and the arts. 99% of its population is literate, and the list of prominent Armenian singers, scientists, politicians and artists is wildly disproportionate to their numbers.

But this list of facts is hardly relevant as the snow continues to fall on the buildings and streets of Yerevan. In the next week I will continue to observe staff, meet with government officials and other stakeholders in order to promote partnerships in continuing the success of the school for children with special needs that, at the behest of a small group of caring and courageous parents, began here almost a decade ago. In that time we grew from a core group of just a few students to treating over 80 children today. If we can successfully raise the needed funds, we will soon move from a crowded, converted apartment to our own facility. The continued survival of the school and its remarkable growth is a testament to a group of parents trying to do the best for their children, but mostly to the incredible dedication and hard work of our loving and talented staff. Apres!
For more information about the school in Armenia, see www.autism.am

Annie Hall meets Alexis Hymen

Posted on March 24, 2014 by iraheilveil

The prize for best article-title-of-the-month goes to an article I found perusing the Journal of Family Psychology. The title was simply “Alexithymia and Marital Quality: The Mediating Roles of Loneliness and Intimate Communication.” Makes a psychologist proud.

Woody Allen said that the inspiration for the name “Annie Hall” came from the word “anhedonia,” which is psych-speak for the inability to feel emotions. Alexithymia, which very literally means “without words for emotion” and less literally means the inability to express your feelings, has a similar ring. So what should we name the lead character in our new verbally inspired film? “Alexis Hymen” comes to mind, although if I didn’t know a few people with that last name in Brooklyn I would think it had a distinct Ian Fleming ring to it.

Many people have improbable names. I knew a Peggy Beach who had a sister named Sandy. No kidding. And just the other day I was listening to CNBC and heard a political commentator being referred to as “Crystal Ball.” I thought it was a joke but by the third time she was announced that way I realized that was indeed her name.

My last name is improbable just because it is one of those names that is so rare. As a kid I was told that if I ever went traveling throughout the U.S. and needed a place to stay I should pick up a local phone book and look up my last name. If anyone had that name, they were related. Apparently, the Heilveils would do a lot to save a few dollars on a motel room if they could find someone to bum a room off of.

One of the key findings of the above-mentioned research was that “…higher alexithymia was associated with greater loneliness, which predicted lower intimate communication, which was related to lower marital quality.” The amount of data crunching that went into reaching that conclusion was enormous, and the research methodology was impressive, so now there is empirical support for what we already think we know.

Yes, dear, I know it’s important to tell you how I’m feeling, because that will make us more intimate, and then our marriage will be much better off. So, for the sake of our marriage, I want you to know that I am feeling sad that I am so inadequate at expressing my feelings, and guilty that because I am so lousy at this I am probably destroying our marriage, and really angry at those researchers for agreeing with you and making me look like the bad guy again.

That’s what Alex would say to Alexis, if only he could.

Air Hollywood: Flying the Friendly Skies

Posted on March 17, 2014 by iraheilveil

The tagline for this blog begins with the words “aviation” and “autism,” and to say the least it is difficult to find ways of integrating the two topics. A company called “Air Hollywood” has now made it easy.

Air Hollywood is not an airline per se; it is, as their name might suggest, kind of a fictitious, Hollywood airline. Their business focuses on providing sets for the entertainment industry, including interiors of any kind of airplane you can imagine, cockpits, terminals, gates, etc., as well as stock footage and almost anything imaginable that is needed for movies and is aviation-related. You have seen their work in films such as “Flight,” “Wolf of Wall Street,” and “Kill Bill” as well as hundreds of others.

Recently, Air Hollywood took on a new project. They have decided to offer classes on preparing children and adults for the entire commercial-aviation related gamut of challenges that face them. Over-stimulation at check-in areas, fluorescent lights, airport waiting areas and queues, boarding airplanes, and sitting in a confined airplane, all can pose challenges to those with autism. They call their program “Open Sky for Autism,” and it is being offered for free. It promises to help acclimate those with autism by using supervised repetition during simulations of airport arrival, ticketing, check-in, baggage check, TSA screening, boarding, in-flight simulation, and deboarding. They even do one better than the “real” airlines, and offer complimentary lunch and refreshments! Their opening event is scheduled for April 5^th. Here’s the link: http://airhollywood.com/opensky/

If you have been following either this or my last blog for a while, you know that I am more than intrigued by people who do good things when they don’t have to. I don’t know the folks at Air Hollywood, but I do know that for whatever their reasons they have decided to do something good for a chunk of humanity that needs it, something that is frankly difficult to do and outside what a typical therapeutic agency or clinic has the means to do.

Every religious tradition with which I am familiar preaches charity. Growing up, I learned that the yields on the corners of each of your agricultural fields should be left for the hungry and poor. I applaud any company that uses its resources to do good.

When Less is More

Posted on March 10, 2014 by iraheilveil

Two years ago, I began writing a post titled “When Less is More,” but never finished it. I suppose I couldn’t figure out a way to get my point across in a short enough space for a blog post, failing miserably at making less more.

But last week I came across a post written by Greg McKeown of Stanford Business School. Turns out he recently published a book called “Essentialism: The Disciplined Pursuit of Less,” which I will undoubtedly add to the queue of 35 books by the side of my bed. In the meantime, in the spirit of “less is more,” here is a link to a short video summarizing his ideas:

http://youtu.be/T9x6D09AKBU

The point I was trying to make in my unpublished blog post two years back was that doing a little to help others often makes the biggest difference. I told the story about a family therapist who recounted that in the early years of family therapy big changes in family structure were often wished for and expected, but it rarely turned out that way. The irony was this: family members who experienced very small changes in their family’s functioning often perceived those changes as having huge consequences. Less is more.

Behavior analysts working with children with autism or with any complex, daunting set of problems, systematically break complex challenges into their smallest teachable components. Good flight instructors do the same. Perhaps one element of being a good instructor in any field is learning how not to let knowledge of complex phenomena get in the way of teaching the most fundamental, simplest elements.

Whether it is the journey of a thousand miles that begins with the single step, or losing 40 pounds a few ounces a day, or building a small house in which to fulfill big dreams, as Mies van der Rohe proclaimed many years ago, less is more.

Pilot in Command, or Directing the Dream

Posted on March 3, 2014 by iraheilveil

I had a recurrent dream when I was a child that I was being chased by faceless, flying demons wearing black capes. I frantically flew away (without benefit of airplane or wings, Superman-style) trying to escape them, and managed to wake up just before they destroyed me. I woke up sweating in fear nearly every night of my childhood.

A psychoanalytic dream interpretation book I bought at a supermarket checkout stand diagnosed the dreams as symbolic of a sense of impotence, a helplessness and hopelessness to have an impact on the frightening world around me. And later, when I heard a late night talk show psychologist say that one could control one’s dreams just like a director directs movies, at about age 18, I turned around and faced the demons, daring them to expose their faces, and they all at once disappeared. I never had that nightmare again.

We each fight our own unique demons throughout our lives, and learning to fly was for me a symbolic way to overcome a life rooted in fear. I don’t know how many other pilots share that motivation, but I do know that nearly every pilot with whom I have ever spoken shares the quickening of the heartbeat and chill down the spine that comes the moment one loses the chains of gravity and launches into sky, leaving the earth and its accompanying worries below and behind.

Flying, like directing my teenage dreams of being chased, is one way some of us attempt to manage fear. The term that every pilot learns immediately when taking flying lessons is that he or she is the “pilot in command,” a way of drilling deeply into one’s psyche that the ultimate responsibility for making the decisions and taking the actions that will keep you and your passengers alive is yours, and it is a responsibility that doesn’t cease until all occupants are safely off the airplane.

Being pilot in command means that you are in ultimate command even when a controller tells you what to do, that no matter what anomaly or distraction threatens you, you are where the buck always stops. It means, ultimately, that no matter how frightening the demons are that are chasing you, you must turn toward them and face them. And that is the only thing that will make them go away.

Dreaming appears to be a fairly ubiquitous phenomenon, shared by most animal species on earth. (New book title: Do Plants Dream?) Whether dreams are simply the “residues of the day,” whether dreaming is a form of catharsis or working through of conflicts, most dreams probably don’t need a conscious director. To beg the aviation metaphors a bit, they probably do just fine on auto-pilot. But when the content of our dreams become disturbing to us, whether those dreams occur during sleep or wakefulness, it is time to find the pilot in command within us.

Nervous Mice and Cancer

Posted on February 24, 2014 by iraheilveil

In the Yiddish-speaking world from which my mother came, every compliment had a slight critical inference. Being called a “nice guy,” for example, implied that yes, you are nice, but you probably wouldn’t last long in the real world. Now, a large body of research supports the notion that being nice may not be so good for one’s health.

Years ago I was asked to do a presentation at the Wellness Center in Pasadena, a place devoted to supporting cancer survivors. I knew my audience, all cancer survivors, was going to be well versed, so I boned up on the literature as best as I could, and I read hundreds of abstracts and several key articles on the relationship between cancer and anger, which was the topic I decided to speak on.

Most of us are familiar with the research describing the “Type A personality,” the hard-driving, ambitious, compulsive personality associated with heart disease. Years later, cancer researchers developed a profile they called the “Type C,” or cancer-prone personality. The “Type C” personality is described as patient, dependable, emotionally repressed, thoughtful and unassertive. In the literature, I have seen it described simply and elegantly as “nice.”

The most recent literature associates “Type C” traits with autoimmune disorders, within which cancer can arguably be included. Saying though that cancer is associated with a certain personality type is a sticky wicket because anything that correlates personality factors with cancer can lead quickly to self-blame; after all, one’s personality is something one can supposedly do something about. So, as I say often, it must be emphasized that correlation does not equate to causality, but just gives us some things to think about.

In a recent study at Stanford, hairless mice were exposed to ultraviolet rays for 10 minutes at a time three times a week for 10 weeks, exposure roughly equivalent to that of humans who spend just a bit too much time surfing (the real kind, with the ocean beneath them) or sunbathing. After several months, as was predicted, every mouse developed skin cancer. But here’s the rub: the “nervous” mice, that is, the ones who had proclivities for risk aversion and reticence (which had been previously determined by behavioral tests), had more tumors than the calmer mice and were the only ones to develop invasive forms of cancer. In this study, the researchers used measures of reticence and risk aversion to define a mouse as “nervous,” but it seems just as valid to call reticent and risk-averse mice “nice,” and besides, “nice mice” just sounds a whole lot better.

Generalizing from mouse behavior to human behavior isn’t a terribly reliable thing to do, but it is necessary because doing this kind of research with humans raises some fairly significant ethical concerns. So, while we can’t say for sure that nice guys always finish last, at least for mice, we can probably say that nice mice come to a finish first.

Study citation: PLoS ONE, online, April 25, 2012.

The Most Annoying Word

Posted on February 17, 2014 by iraheilveil

In a survey of over 1,000 people conducted at Marist College in Poughkeepsie, NY, 39% of people age 60 or over rated “whatever” as the most annoying word or phrase used in conversation, coming in as the clear front-runner over second-place “like.” Whatever.

Actually, maybe because I am not quite yet over 60, I don’t find “whatever” disturbing. In fact, I actually like it. And “like” doesn’t bother me much either. To me, “whatever” has a lilting, poetic quality, and while some may find it dismissive, I find it a charming way to remind the listener of what is important in life. Maybe that’s because being dismissive is not something to be dismissive of. Saying “whatever” at just the right moment reminds the listener that life is too precious to spend it worrying about the corporatization of the world, the subjugation of particular groups of people, or the price of tea in China. “Whatever” can be thought of as a vocal cue to detach from one’s ego, perhaps a quick and dirty form of meditation that can save us from having to spend 20 minutes twice a day doing the real thing.

I might actually consider silently repeating the word “whatever” as a method of reducing blood pressure. Now there’s a study for you.

That is not to say that there aren’t words that get me really tweaked. At the top of my list is the word “issue.” I don’t mind the word when it is used to describe the location of a particular magazine article, or even the result of two people spending some happy time together, but I have a real issue with using it because people are somehow afraid of saying they have a problem with something, or God forbid may actually have a conflict. For some reason, it is now more acceptable for people to have “issues” than problems, worries or concerns.

Try these two next sentences: There are several other words with which I also have issues. Or: There are several other words that irritate me (or get my goat, bother me, annoy me, etc.) Which do you prefer? And yes, I am also bothered when people say “oftentimes,” a totally useless expenditure of syllables (they could just as well have said “often”). It is one of those words that I think people say because they want to sound more intelligent but backfires on them. The more often they use the word the less intelligent they sound.

Now, please don’t get the impression that I am holding myself out in any way to be a verbal virtuoso. I frequently (oftentimes!) use words incorrectly, partly because I want to learn and hope those better-educated people around me will correct me, which they sometimes do. A good friend is someone who will tell you when you are screwing up.

Undoubtedly, there are many intelligent people who will oftentimes have issues with what I am saying. It is fine; my judgment of you will be wrong and it will be fleeting. Whatever.

Sleeping in Security, Waking in Happiness

Posted on February 10, 2014 by iraheilveil

With apologies to Coleridge, behavior analysts are capable of “all things great and small.” You might recall the story of Skinner covertly conditioning a hand waving response in a Freudian nonbeliever at a meeting in the psychology department at Harvard. In case you haven’t heard it, Skinner was attending a faculty meeting when a guest psychoanalyst was criticizing behaviorism. Skinner wrote a note to the colleague sitting next to him, saying something like, “watch while I condition a hand-waving response.” Each time the analyst gesticulated with his hand, Skinner smiled at him. Sure enough, after a while, the analyst was waving his hands wildly.

If behavior analysts have the skills to covertly condition a hand waving response, teach a child with autism to talk, teach me how to tie my shoes (I need a refresher on this one), and keep people awake at nuclear power plants, then certainly we have the skillset to contribute to making the world a kinder, more peaceful place.

Behavior analysts, and psychologists in general, have often tried to extend their reach and apply their knowledge not only to the lives of one human at a time but to humanity as a whole.

Montrose Wolf, one of the pioneers and creators of the term “applied behavior analysis,” moved to Kansas primarily because it was there that he was given the opportunity to create solutions for problems of segregation and poverty. Skinner, whose shoulders Wolf and other behavior analysts stood on, wrote “Beyond Freedom and Dignity” (and perhaps “Walden Two”) in order to address societal ills, and psychologists from nearly all disciplines have typically expanded their focus from the individual to society at large, often toward the waning years of their careers.

Not long ago, a conference entitled “Behavior Change for a Sustainable World” took place in Ohio; behavior analysts from around the world met to discuss how they could use their skills and knowledge to combat climate change and other threats to a sustainable world.

Most behavior analysts I know are overwhelmed with the challenges of helping even just a handful of children, as the rest of us are often bogged down daily with the tasks of caring for our families and ourselves. So it is only for the purpose of inspiration that I present to you these thoughts:

22 years ago, while under house arrest, Myanmar’s democracy icon Aung San Suu Kyi won the Nobel Peace Prize, a prize she could not claim until just a year and a half ago. When she finally appeared before the peace prize committee, she gave one of her typically extraordinary speeches. (You can read it in its entirety here.)

When referring to the international plight of refugees, Suu Kyi said the following:

“Ultimately our aim should be to create a world free from the displaced, the homeless and the hopeless, a world in which each and every corner is a true sanctuary where the inhabitants will have the freedom and the capacity to live in peace. Every thought, every word, and every action that adds to the positive and the wholesome is a contribution to peace… Each and every one of us is capable of making such a contribution. Let us join our hands to try to create a peaceful world where we can sleep in security and wake in happiness.

Clear For Takeoff

The Psychology of Flying

Author Archives: iraheilveil