Last night I dreamed of . . .

being Gomer Pyle in the Marines going through basic training. The Sergeant really let me have it for not being up to snuff. I'm sure these dreams of late are representative of current real life struggles that cannot be avoided. It was more difficult than usual working with grieving patients this past week after seeing that dreaded look of death in my fathers' eyes last Sunday. For the first time the denial I have clung to weakened as I felt a little shock. He really is dying and there is nothing I can do about it. I placed him in his hospital bed and tried to adjust it to make him feel more comfortable. My mother spoke to me about concerns of a business nature but it was very hard to concentrate or think clearly. I have seen that look several times before in patients I treated in the hospital and they always died. It is an ominous sign but the exact time of death cannot be predicted with any certainty.

Less than a year ago I had an idea for a post entitled Three Old Men but I never wrote it, I suppose because of the painful emotions I didn't want to feel. The piece was about two of my uncles and my father who were all on the last pages of their lives. Uncle J.C had suffered a severe debilitating stroke as he entered his late eighties. Uncle Milt was diagnosed with terminal lung cancer as was my father. Uncle J.C. lived until December. Uncle Milt died yesterday. My father's fate hasn't been sealed yet but it wouldn't have surprised me if he had been the one to pass yesterday. Uncle J.C. will be remembered for his stories and laughter, uncle Milt for his colorful prayers at Roberts Chapel. My father's obituary isn't due yet. I write of these things to facilitate my own grief and feel that this forum is as appropriate as any.

I feel blessed in being skilled at helping others grieve and have had a bit of practice doing so. It's so much harder being the one who must grieve. I've grown to realize that in this life the only escape from grief is your own demise. Parents grieving a child is the ultimate loss for which no words can appropriately comfort. Allowing them to verbalize their feelings and encouraging them not to hold back can be helpful. I met with a father today whose son would have turned 18 yesterday had he not accidentally overdosed on drugs provided by peers. For 18 months he has sunken deeper into the abyss of dysfunction. His wife grieves as deeply but has been able to cope more effectively by allowing herself to feel the anger and sublimating through her work. The husband seems to have given up and has provided very little in his efforts for her to work with. She fears coming home one day and finding him dead. He just can't seem to respond. Their marriage is in big trouble. This type of situation causes me to feel frustration and helplessness. His noncompliance with medications and choice to smoke pot instead are a bad sign. He numbs himself to the point that her threats to leave him barely registered. The grief he feels becomes frozen until the drug effect wears off then the emotions return at an amplified intensity. All I can do is try to facilitate communication between the couple and insist that he follow my treatment instructions. I can only hope for the best for it is not possible to follow him home and hold his hand.

Sometimes a loved one remaining alive can cause more grief than a premature death. Generational curses among families is a real entity. I spoke with a morbidly obese profoundly unhappy relatively young mother today. Her plight saddened me as she went more deeply than usual into some of her issues. Due to abuse issues among the preceding generation her mother had always been cruel to her in a relentless manner despite persistent efforts to win her mothers' love. Though obviously mentally ill, her mother never received any treatment and was a survivor of incest and abuse herself. As a child, the patient was blamed by her mother for her biological father abandoning her mother. After being informed by the patient's mother of her pregnancy, this trophy man cursed the young woman telling her he didn't want children after which he left never to be seen again. Throughout her childhood she was repeatedly reminded of how she had ruined her mothers' life. She found her only soothing comfort in food and eventually reached a weight of over 400 lbs. She has battled valiantly to shed weight but her progress has been marginal. Gastric bypass has not been recommended due to airway concerns and other health risks. A recent argument with her uncle resulted in him calling her a big fat bitch. She lamented that the bitch part was tolerable but the fat part seared like a hot knife. Even though he approached her later to request her baby sitting services he never apologized for his words just as her mother has never apologized for any of her many put downs. A couple of her kids have adopted the pattern of mental cruelty they have observed.

Helping her understand how abuse is passed down from generation to generation seemed helpful. I reiterated how such families seem to have the one or more chosen to break the cycle of abuse. These chosen ones are usually abused and ridiculed, even seemingly persecuted at times, but what makes them different is they make a conscious decision not to become abusers themselves as is the more common pattern. Though referred to as weak by many, such individuals are usually quite the opposite. They will make a special effort to ensure that their children or grandchildren never feel the pain of sexual, physical, or emotional abuse that they themselves may have felt. I view such individuals as heroic and incorporate into their therapy a means of rebuilding self esteem and terminating their inner quest to discover the source of their constant pain. The true source of their insanity lays within their circumstances which awaited them long before their birth. Those who successfully endure the pain long enough to find the light of truth can have a rebirth and rebuild a life with a functional support system as they learn who they really are.