Sagan: Chaos and Order

You must have chaos within you 

in order to give birth 

to a dancing star.

Frederich Nietzsche

The universe, filled with nebulae, black holes, and the mysteries of time and space, was begotten from atomic chaos. Billions of years ago, all space, matter, and energy in our known universe was contained in a "volume less than one-trillionth the size of a needle point" or about the size of a single atom (deGrasse Tyson, 2004). This preplanetary pandemonium would impregnate our mother in this massive cosmos - Earth's solar system. Out of this frenetic and violent chaos, would come life, order, and beauty. These are key principles of physics and astrophysics: supernovas that outshine entire galaxies are born from massive stellar explosions, their remnants capable of forming ominous black holes or neutron stars and pulsars that are up to eight times larger than our sun; and the untempered chaos of a seemingly libertine universe gives rise to the magnificence of the cosmos.

On July 27, 1994, my own universe imploded when my baby died. I've found myself present with sadness and absent words this July, as I have been during the past 14 voyages of the Earth about its star between June and August. My grief feels like the fledgling cosmos. Chaotic, disordered, confused, violently out of control. Still, I take comfort in reflecting on the genesis of our macrocosm. 

Grief, like our universe, is often indescribable; it is elusive, creviced, and wordless. There exist within it many great mysteries, places unexplored and unknowable given the ephemerality of time. One pithy moment of grief gives rise to a new precipice, like a pulsar in my own universe of loss. I'm sitting quietly with this idea, and I'm reminded of Nietzsche's notion that order will come of the chaos, meaning of the confusion, and that I can, indeed, have my dancing star amidst it all.  Caret initio et fine.

RIP Carl...

November 9, 1934   to   December 20, 1996

A Cry Unheard

Seeking to forget makes exile all the longer; the secret of redemption lies in remembrance.

Richard von Weizsaecker

I picked up a new book last week on the recommendation of a colleague: A Cry Unheard: The Medical Consequences of Loneliness by James J. Lynch. I only wish I'd had this book in hand when I conducted my own research on the effects of social support on women after the death of a baby.  This seminal book is filled with clinical research on the dangers of social isolation, including the effects on the body and health.  Lynch captured data demonstrating the devastating health consequences of shame, anxiety, anger, and fear that was unrecognized, undetected, and most importantly, unheard.  I think this fact, for me, was the most important. It wasn't that the emotions themselves were "bad" or "negative" as contemporary theorists might imply. It was that the person experiencing them, and others too, did not acknowledge the emotions that created the problematic outcomes.  They were abandoned- both by others, and also by themselves.

In sum, he found that such social disenfranchisement can lead to fluctuations in blood pressure and respiration, depressed immune functioning, heart disease, hypertension, and a host of other physiological maladies. He notes that: "Those lacking social support, those who live alone, those who struggle with chronic loneliness, those who lose a loved one, all exhibit sharply increased risks of dying prematurely."

I've posted a great deal about narcissism, grief, and finding gratitude- and how, when the time is right, there is an imperative to move beyond our own suffering and see the suffering of the other.  There are some bereaved who may never move to that space where they are willing, thus able, to do that. Lynch calls this the "black hole". He says:  "Like black holes in space, such individuals absorb all light and all objects around them while emitting nothing back. Nothing escapes their...emptiness."

Conversely, he recommends looking "out into the world beyond the confines of your own skin...listening to a bird sing can lower blood pressure...gazing at the stars" too. "Listening to one's fellow (hu)man in dialogue can lower blood pressure."  Basically, moving beyond the necessary narcissism of early grief.

Lynch believes that "dialogue is the elixir of life and chronic loneliness its lethal poison". But what about the dialogue often aimed at bereaved parents? You know- those promptings to "move on", "God has a plan for you", "at least it wasn't one of the older ones", "you can have more", "everything happen for a reason", "time heals all wounds", and "aren't you done grieving yet"s?  Lynch said that dialogue can also be used to create distance, that it can be used to manipulate. He asserts that "empty language suppresses hope...and is spoken from outside our own hearts...(where) human dialogue is ruptured, destroyed, or reduced to a living hell" when abused in this way.  He termed it toxic talk, and far too many bereaved parents have experienced a litany of such dialogue.

I deeply appreciated Lynch's honest explorations as a medical doctor, professor, and human being.  It confirmed that the bereaved should be sensitive to their own needs; and then, when ready, actively engage in moving beyond the self.  The (temporarily) non-bereaved should engage in dialogue that is comforting and from the heart. They should not seek to cure or heal or absolve. Rather, they should seek only to be with the suffering. They should use words with great care and intention, for it is easy to destroy a fragile other with a few, seemingly benign, syllables. 

Allow them to remember, and invite them warmly back from exile.

The Risk of Love

The most secure prisons are those we construct for ourselves.

Gordon Livingston, M.D.

How does one live in a world where children die? 

Living in 21st Century, relatively affluent American society we are unaccustomed to the idea that children die. Yet, there was a time, not long ago- and still true in many parts of the world, when many, many children died. Two dead children in a family of four was not the exception just 100 years ago, or more commonly five dead children in a family of ten.  But our worldview- our very expectations upon which we construct our futures- patently rejects the idea that our families can be swiftly shredded at Death's whim. Due to medical advances, sanitation improvements, and other accoutrements of modern life, most have become wholly unfamiliar with early death, both during infancy and childhood as well as early adulthood, in Western society.

In fact, many believe they can beat Death at His game. Many nonprofit organizations exist to eradicate Death. They are single-cause focused. They want to cure, prevent, heal, and prolong. All worthy causes, indeed. But Death is a formidable enemy who will not secede. We may cure cancer one day, or heal brain injuries, or prevent suicide or car crashes or stillbirth or SIDS...but Death will, for us all, come one day. We can only hope that He comes for the parents first, and then that He comes for parents at the end of their lives, and not prematurely.  We can only hope that for the rest of the world's children, too. Sadly, in a world of inequity and suffering, this is unlikely.  

That is why the MISS Foundation exists. Because since the beginning of man's time on this planet, children have died. And until man takes his final step on this earth, children will continue to die.   We can be imprisoned and paralyzed by fear, anxiety, grief, despair, and sadness. Our children's lives are certainly worthy of such psychological woes.  I think of the purgatorial state of the mother in the film "What Dreams May Come."  Her prison- one of her choosing- was painful for me to watch... it represented a familiar place to which I'd once condemned myself.  In a sense, perhaps, punishment to an austere life is the only justice a mother can give her dead child.

Perhaps not. 

Perhaps, instead, our penalty for outliving our children is the task of seeking connection in the midst of an imperfect world, reinventing ourselves in the midst of our child's ghost, rebirthing in the midst of suffering, or finding a way to love despite the pain. Love, Livingstone says, is the ultimate risk. When we cannot change the parts we wish were different, the unfairness and cruelty of life, we've only one  choice.  To live or die.  Yet, to surrender our existence would be to abandon all that is beautiful about our children who died. Indeed, he says, living after a traumatic death is both an act of will and an act of surrender. He speaks from very personal experience.

Livingstone is a bereaved parent twice. His eldest son completed at suicide, and his youngest, only 13, died of leukemia. How does one exist in a world where children die? I think, perhaps, through that for which we are willing to risk everything- love.

Getting Through the Human Experience

To be alone is one of the greatest evils.

William James

Psychopharmaceuticals are plentiful here in the United States as a way to help individuals cope with  psychic angst.  Pharmaceuticals are marketed as a means to help anyone who is bereft with depression, PTSD, personality disorders, anxiety, PMS, menopause, postpartum-related depression, mood disorders, dysthymic conditions, and even grief.  

A high number of bereaved parents, in my experience mostly mothers, are also prescribed anti-depressants. For some, these pharmaceutical remedies can bring equilibrium to a person who is fraught with debilitating mental illnesses.  Yet, are we pathologizing normal, albeit painful, human experiences of suffering?

Indeed for others, according to Dr. Elio Frattaroli and psychiatrists critical of the overuse of prescriptions, SSRIs are being used as a shortcut to healing, the McDonald's treatment plan of the 21st Century- the comfortable numbing of a society.  We are afraid to feel suffering.  We are uncertain of our own strengths to cope with loss. We do not know how much we can- and should- rely on one another to help us through the human experience.

Interestingly, while SSRIs can help some selective patients with legitimate mental disorders, there are also long-lasting effects of SSRI use. Researchers at the University of Ottawa have discovered a correlation between stillbirth and other negative birth outcomes and SSRIs.   While other studies have demonstrated inefficacy of some SSRIs, even in the case of the severely depressed wherein SSRIs were no more efficacious than a placebo. In some cases, it's worse than we realize. SSRIs were identified to increase violent thoughts toward self or others, including suicidal thoughts. The FDA has warned of these dangers at least twice; yet so many people remain enslaved in a cycle of medication and remedication.

I am not an expert in the use of psychopharmaceuticals for the severely depressed.  

I do, however, know that there are voluminous studies on the benefits of human connectedness, social support, and compassionate others.  Being connected with and supported by others helps women have healthier babies with higher Apgar scores. It helps women cope with the stress and angst of breast cancer. It reduces the effects of postpartum depression.  It helps the homeless and mentally ill.  It even helps accelerate recovery from a myocardial infarction (heart attack).

We are a society of aloneness, a society afraid of really experiencing our own emotions and the feelings of others. Many are emotionally bankrupt, while others are depleted of the most basic of human empathy. We are rushed, hurried, and harried. We do not have time for pause, or reflection, or grief- we have not scheduled suffering into our calendars. Our lives are consumed and constricted by things that are not real- Hollywood gossip, Blackberries and Palm Pilots, parties, Prada shoes, and consumerism. We are so diverted from what really matters that we hardly recognize that which is real- even real relationships. So few of us really have time for authentic relationships- the types of friendships in which we can entrust our pain and suffering. And it takes a tremendous amount of psychic energy to maintain the fraudulence of empty lives.  Is it any wonder so many in Western society face the types of existential crises that cry out for meaning and purpose and connection?

There is no substitute for human relationships. In the absence of meaningful connections to others, we will not survive as a species nor as individuals. We need one another to help us through suffering. We need guidance through the human experience. The answers do not lie in a bottle or in a pill or in distractions or in diversions. Our salvation from suffering, what will save us from the darkness, is the hope, love, empathy, and compassion we offer and receive from one another. It is the only way through the human experience.

Have you come to that Red Sea place in your life 

where there is no way out but through?

Merritt Malloy

Love and Despair

In the abyss 

I saw how love held bound

Into one volume all the lives whose flight

Is scattered through the universe around;

How substance, accident, and mode unite,

Fused, so to speak, together in such wise

That this I tell is one simple light.

-Dante, from the Divine Comedy

Love, or what Bowlby would call attachment, is a phenomenon unique to humans. Or is it? There is neuroscientific evidence to demonstrate that animals display some type of attachment behaviors, most often observed between mothers and their offspring, in the animal kingdom.

And where there is love, there is grief.

Many animals, from cows to dogs to baboons, exhibit fierce grief responses when separated from their mothers. They first enter a phase of protest, pacing back-and-forth, searching and yearning for the object of their affection.  Some mothers, in response to the separation from their babies, begin self-harming behaviors, such as chewing their own limbs or intentionally injuring themselves.  A puppy separated from his mother will "let out a piteous whine, high-pitched and grating as every aspect of his behavior broadcasts his distress" (Lewis & Amini, 2000).   This behavior is even observed in rats.  

Mammalian protests in the animal kingdom mirror human physiologic responses to loss. During protest,  hearts palpate, catecholamines and cortisol flourish, and the body is on high alert and arousal.  High levels of chronic cortisol, the stress hormone, can compromise the immune system, interrupting important processes for the body. In sum, intense disequilibrium to the homeostatic condition can occur- very dangerous, not just psychologically, but biologically too.

This is the state of despair.  The anchored weight of grief turned inward. Apathy, lack of focus, anhedonism, bleakness...hopeless and helpless...alone in the world.   

If separating animals from their offspring can cause disruption, just imagine- in the human relationship- the depth of emotional responses to such separation. The architecture of attachment is complex, particularly the attachment between a human mother and her child. Woven into the relationship are generations of evolutionary adaptations tailor-suited to accommodate the unique relationship that will require bonding like no other relationship on the planet. What happens when that bond is prematurely broken? Despair. A state of despair.

Yet, human beings also have the capacity to help one another. Studies suggest that connectedness with like others has powerful effects on the brain- mainly, the limbic system- as well as our experiences of loss. Being helped by and helping others is a powerful healer. No, it isn't magic- there is no panacea- no voodoo that can cure a mother's grieving heart. But both social support and social outreach have powerful effects on a person.  

The MISS Foundation  provides a safe place for grieving families in despair.  It's a place to first find help, then later to provide hope to another. Family and friends- communities- should also strive to provide a safety net to help. Something so unspeakable- something so tragic- should never be endured alone.

Just as despair can come to one only from other human beings, 

hope, too, can be given to one only by other human beings.

- Elie Wiesel