On being a human being

I started writing this entry months and months ago after a conversation with one of my long time patients.  She was referring to her husband’s tendency to . . . do, do, do, do, do . . . and to have great difficulty getting him to settle down and just . . . be.  I thought the play on words was amusing and thought it would make a great blarticle at some point.  I went on my way . . . doing, doing, doing, doing, doing . . . and seem to have lost track of . . . being.

Life has been busy.  And, at times, difficult.  I have become very aware of my own feelings of being overwhelmed with factors in life and I am seeing how others in my family are being effected by their own feelings of being overwhelmed.  It is so easy to get yourself over stretched these days.  The competition for my time is fierce as it is for everyone else that I know.  Too many things to do and not enough time to do them.  It leads me (and perhaps you, too) to have feelings of inadequacy and, at times, anger and sadness.  It is especially difficult for me to see this in my own kids who are all stretched thin with obligations and expectations that are placed on them (and that they place on themselves).  This concern peaked for me when my daughter (during a moment of upset) said she couldn’t spend 10 minutes chillin’ because she had too much to do.  Never mind that her actual ability to . . . do, do, do, do, do . . . was compromised by her upset state of mind and she would be completely ineffective in getting something done.  I think of times when I have been completely overwhelmed . . . with stuff in my head and stuff outside my head . . . where I should have stepped back and calmed myself down . . . but did not.  And I thought . . . “holy crap . . . I’ve created a human doing . . . not a human being!!!”

Time to wake up.

As often happens, answers to problems present themselves if you keep your mind and your eyes open.  A while back a patient who was battling cancer tried to tune me in to Jon Kabat-Zinn and “mindfulness meditation”.  While I have meditated on and off all my life (my parents took me to learn Transcendental Meditation back in the 70’s), it is something that has NOT been at the core of my day (to say the least).  On a recent visit, he again brought this to my attention, as did another colleague of mine . . . and the light bulb went off. 

Mindfulness meditation has it’s roots in Buddhist meditation techniques of using your breathing as a focus of staying in the here and now.  It is not religious and it is not spiritual.  It is simply about being here and now.  Realize, that almost all of our thoughts are an evaluation of the past (often a negative evaluation) or an imaginary creation of what the future might be.  None of these are real.  The only real is here and now.  Your review of your past experience is very subjective.  It is very much based on the attitude that you bring to it.  Your memory of events is selective.  Think about how many times you have had mistaken interpretations of an event.  Concrete events have happened in the past . . . but your emotional experience of them is hardly fact . . . it is subjective . . . it is interpretation . . . it is conjecture . . . it is not real.  The future ???  Hasn’t happened yet.  Anything you think about it is a dream.  It is made up.  It is not real. 

What is real is that your breath goes in . . . your breath goes out . . . your breath goes in . . . your breath goes out . . .

Letting go of the dreams of the future and the evaluations of the past has a very healing effect.  As Kabat-Zinn writes . . .

“The formal practice (of mindfulness meditation) can give you the strength and the self-knowledge to go back to the doing and do it from out of your being.”

Being a “human being” is not about not doing.  It is about doing from a different place.  About not getting lost in the doing and not mistaking what you do for who you are.  It is about tapping into your true self-worth–deeper than anything that can be done and not dependent on what you do or how you do it.  Has it made a difference for me? Yes.  I’m still overwhelmed at times.  I’m still sad, anxious, upset, and irritable at times.  I’m getting better, tho’, at catching myself . . . and witnessing myself . . . and calming myself . . . and centering myself . . . and being here . . . now . . . the breath goes in . . . the breath goes out . . . in . . . out . . . in . . . out . . .

–Dan Hartman, MD

Consider it a promotion . . .

A challenge for any parent is the changing role they have as their children develop over time.  Obviously the role we play in our children’s lives is different when they are 1 is different than when they are 18.  From my experience, the difficult years are those middle adolescent years when we move from the role of benevolent dictator to the role of consultant.  What do I mean by that?

In our child’s early years, we certainly try to help them make good decisions.  Much of the early years are spent being very directive, however, specifically telling them what to do and when to do it.  ”Do your homework” . . . “go to bed” . . . “dress warmer . . . it’s going to be cold today” . . . etc., etc.  At first, most (but not all) of our kids are fairly accepting of this.  They will follow through on our orders and do as they are told.  If they do not, then there is a consequence.  ”If you don’t do your homework, you will not watch TV for a week!!!”  The consequences are rarely the natural consequences of the act or omission, it is clearly a punishment.  The punishment is intentionally aversive . . . it is meant to underscore our authority and to mold their behavior to that which is beneficial for the home environment and society as a whole.  At some point, however, this becomes increasingly less effective.  When you give non-natural consequences for behaviors, kids get angry and think you’re a jerk.  Again, some of this is inevitable.  As parents, we are, be definition, imbicles who are out of touch.  More importantly, there does come a time where it is more beneficial for the child to experience the natural consequences of their behavior and to allow those consequences to influence their future behavior. 

Natural consequences are the consequences that naturally follow an action.  Step in front of a moving bus and you get hit and get hurt.  This is so obvious, we don’t need to remind most kids about this.  There are countless examples where kids just don’t get it sometimes and it would just be better to let life teach them, rather than to have you act as a nagging parent.  For example, one of the recurrent problems is getting up for school.  Why they expect high school age kids to get up at the crack of dawn to make it to school by 7 AM is beyond me . . . but they do.  And this sets up one of the most common power struggles in the American household.  “Get up . . . get up . . . get up . . . GET UP !!!!!“  “you’re going to miss your bus”  “Why do I have to do this every morning” “blah, blah, blah, blah” . . . waste of time.

Unless there is a clear reason for the morning difficulty (insomnia or other sleep difficulty, medication side effects, etc.,) it tends to be better to use the natural consequence as the motivator.  Let them miss the bus and have to walk.  Give them a ride if you must (they can pay for gas, too!), but don’t give them an excuse note . . . after all, there is no excuse.  After a few unexcused absences, the school will give them a consequence.  You can be sympathetic, but let them deal with the consequences.  You can problem solve with them . . . but let them deal with the consequences.  Don’t get them off the hook.  It is certainly a balancing act, these middle years.  But if you back off and give advice and support, and let them make their way in the world, they will learn the lessons that they need to learn and be able to move on to greater things.  You can then become the consultant . . . someone to turn to if they are not sure what to do.  Or someone to turn to when things are not going well.  When they do, you can ask . . . “do you want my advice?”  If they say no . . . keep your mouth shut.  If they say yes . . . give your advice.  But the role of a consultant is one of adviser, not director.  They may take your advice and they may not.  Learning to weigh and consider different points of view and different avenues of advice is a very important adult skill.  Sometimes not listening to parents and making the wrong choice is a good learning experience.  As a parent, it can be difficult to watch.  But better if they try their wings when you are available to advise and help then when they are out of the house, on their own, and subject to greater consequences and penalty.

–Dan Hartman, MD