Wednesday, April 18, 2007


"It's an awful risky thing to live." --Carl Rogers

One of my areas of expertise is in treating the "Borderline" personality disorder, one of several "Cluster B"- type personalities that also include Histrionic, Narcissistic, Borderline and Antisocial Personality organization.

One of the hallmarks of these personalities, particularly the Borderline, is that borderlines seem to have an innate biological tendency to react more intensely to lower levels of stress than others and to take longer to recover.

In other words, they have higher emotional reactions from less of a stimulus; and take a correspondingly longer time to come down. Often, they were raised in environments in which their beliefs about themselves and their environment were continually devalued and invalidated, leading in turn to severe deficits in their ability to appropriately internalize others, an essential psychological task.

One of the many consequences of this failure to internalize others is an inability to grieve appropriately, or deal with a loss.

Today Dennis Praeger has a very good analysis of something that has bothered me for quite a while about the ways we are supposed to respond to significant tragedies in our 24/7 news cycle; and the expectations that are made of us by the popular culture. Praeger wonders why,

Within hours of the massacre of more than 30 people at Virginia Tech University, the president of the university issued his first statement on the evil that had just engulfed the college campus and concluded with this:

"We're making plans for a convocation tomorrow at noon in Cassell Coliseum for the university to come together to begin the healing process from this terrible tragedy."

Other university officials also spoke about beginning the healing process and about bringing in counselors to help students heal;

and then goes on to say:

I believe that this early healing talk is both foolish and immoral.

It is foolish because one does not speak about healing the same day (or week or perhaps even month) that one is traumatized -- especially by evil. One must be allowed time for anger and grief. To speak of healing and "closure" before one goes through those other emotions is to speak not of healing but of suppression.

Not to allow people time to experience their natural, and noble, instincts to feel rage and grief actually deprives them of the ability to heal in the long run. After all, if there is no rage and grief, what is there to heal from?

Indeed. There is this strange belief among the intellectual elites; even among many psychiatrists and mental health professionals that feeling anguish and grief are wrong and must be avoided at all cost. Or if you must feel them, then they must be instantly transformed into a focus on this thing called "healing". Bring out the healing! Open those clinics! Stop those oh-so-negative emotions--before they have an impact on your life! Move forward!

In some ways this attitude could be considered somewhat admirable by many, but sadly, the timing of such sentiments is way off base and very premature. These well-meant but ultimately invalidating pressures to "begin the healing process" actually hinder the natural expression of normal grief, which can only come about after painful reflection and the resolution of a variety of conflicting emotions, including anger, sadness, hopelessness, outrage and regret (to name just a few).

Appropriate mourning also requires coming to terms with the nature and manner of the loss; a quest for justice on behalf of the victim when appropriate; and even the painful re-living and re-experiencing of what happened; until it can be completely processed and internally metabolized.

It hurts and hurts and hurts. But that is how we grow.

George Vaillant once wrote in The Wisdom of the Ego: Sources of Resilience in Adult Life:
We, too, sometimes forget that, contrary to folklore and psychiatric myth, loss in itself does not cause psychopathology. We forget that healthy grief hurts but does not make us ill. Grief produces tears, not patienthood. It is never having anyone at all to love that cripples us. It is the inconstant people who stay in our lives who drive us mad, not the constant ones who die. It is failure to internalize those whom we have loved, not their loss, that impedes adult development.(emphasis mine)

The major ingredient of a normal grieving process is time. It cannot, nor should it be expected to, be resolved or "healed" in a day, or a few days, or even a month or two. For the families of those who died, it may take years and years.

The media spotlight will move on fairly soon--long before the mourning process is anywhere near completed. In that sense, the frantic call to heal!heal!heal! emote! emote! emote! and the overly solicitous understanding and short-term sympathy is often counterproductive and meets all the criteria for encouraging the very traits that are the essence of a borderline personality structure.

To be real; to grieve such a loss, internalizing the lost loved ones and processesing the trauma of their leaving, cannot be done in front of the cameras, or at pep rallies, or even at candlelight vigils the day after the tragedy. It will be done in the privacy of each individual soul that was affected by the loss; each at their own rate and according to their own personal timetable.

Don't misunderstand me. There is a role for the kinds of things we are seeing on TV right now. And I understand that our society in its present state does not exactly encourage more appropriate outlets; nor does it tend to give people the time they really need for this psychological process. But like Praeger, I feel it is simply wrong --though not necessarily immoral, just extremely narcissistic and rather borderline--to focus so steadfastly on personal "healing", which is actually the final stage of grief, and not the first.

If nothing else, we owe it to the memory of those we have lost not to "heal" too quickly, but to take the time to experience the pain and suffering of their loss; transforming it slowly into personal growth and wisdom.

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