Sunday, March 07, 2010

The Importance of Transgenerational

You know, it's all so fresh. I went to a conference last week, a really good one, and three-quarters into it realized my family had buried my father only two weeks past to the hour. I have no idea what happened in the third quarter of the presentation.

Later today somebody called me, left voicemail for me to call back. I totally thought it was about business, but all he wanted was to call, to see how I'm doing. That just threw me.

My dreams scare me.

I go through the usual words with people: It's hard. I find myself crying at nothing. I have a headache. I'm cold. I have a stomach ache. (Somaticizing isn't hard, but it is an art).

And it's very different, not what I would have thought it would be.
You get a break and it comes back. You're surprised every time.

Heck, I had four months to get used to the idea that my father was living on borrowed time, and we had some very intimate moments. Dying is very intimate if you share it, and it occurs to me that maybe some people have an extended dying just so they can be intimate.

Probably we can never be prepared, can never predict what it will be like, no matter the type of relationship we have had with a parent. If you take a hit, you shouldn't be surprised, and if you don't, it's okay. The books on death and dying recommend that if possible, grieve as a family. Discuss your different trajectories, mark important days, discuss memories. Let the emotions roll. And spread it out, talk to all kinds of people if you feel like it.

Meanwhile, here I am at work as if nothing has happened and it really feels this way at the moment. Gotta' love the brain.

A follow-up on eulogies:

I started out mine about my father admitting that before writing the eulogy I looked up the rules of eulogies in one of the rule books. There, in black and white and a little Hebrew, it said:
You can exaggerate. Not that much, but if there's a question, you can. You can err on the side of the positive.
Now this is incredibly important information. I don't know anyone who can't stand to be idealized a little bit in life or death, do you?

A story:

A man was dying. He had lived a full life but was clearly, undoubtedly, beleaguered with not one personality disorder, but with features of several. He hoarded, he was narcissistic, he stole on occasion, and his jealousy was completely, totally irrational, bordered on psychotic at times.

His son, let's call him Eugene, went to the funeral of a friend's father. His friend spoke glowingly of the deceased, tearfully, and as Eugene listened, he panicked.

"I'm ____ed," he moaned. "What in the world am I going to say about my father? My father was such a nothing compared to this guy. So selfish! And he's not going to make it through the year! He could die any day now!"

Eugene went home and quickly wrote a eulogy emphasizing whatever good he could find in his father's life. The focus was entirely on his father's good qualities, and he made some of the bad sound comical, not dysfunctional.

When the time came, when his father died, Eugene stood up in front of the crowd at the chapel and delivered a wonderful eulogy, had people in tears of laughter and love, and everyone said what a wonderful man his father must have been.

Eugene didn't know what to do, didn't want to correct anyone who said, Your father sounds like he was such a wonderful man. You were so lucky to have had him; what a wonderful family it must have been to grow up in. So he would disclose just a little now and then.

"My father was difficult," he might say. Or, "You couldn't correct my father, if you did he would call you stupid."

But this bothered him, made him feel guilty, besmirching the name of the dead, his father, the man who gave him life, for better or for worse. So he stopped it and let the positives of his dad's life eclipse the negatives. He could talk about the truth with his wife and his mother, for they knew this man. They grieved who he hadn't been, too, and their emotions were plenty rich. With others, however, he took one for the team.

He found that he was really angry and his anger wouldn't quit. Unable to shake it, he went to therapy. Here he learned that this is normal, being angry at someone who didn't treat you well, who could be irresponsible, difficult. Eventually he would be able to let it go, who his father really was, even forgive.

Perhaps it's not much of a story. But let me tell you how some of us would work a therapy like this, thanks, in part, to what we know about mental illness.

For sure we'd aim for acceptance while working through the full range of grieving, the sadness, the anger, the guilt, the denial, the shame-- the Kubler-Ross stages of grief. And some of us might even bring in other family members.

Family therapists will sketch out at an emotional family tree, inquire about the suicides, the mental illness, the infamous experiences in the extended family, reaching back in time. We want to know who left town and never came back, what became of the black sheep, what the norms are in the family about differentiation, and why. We inquire about how anger is expressed, and sadness, and who set these rules, and why. We want to know the meaning of success to those who are no longer living, and the meaning of failure.

To investigate, to get more of the story, patients are encouraged to interview living elderly relatives, to find photographs, letters. The job is to uncover, if possible, the good in the family, but also the mental or behavioral disorders, too, and the quirky, if not always so pleasant, personalities.

Based upon this, some of us will proffer a tentative individual diagnosis or three, defining, psychologically, members of the family who may have long since passed away, at least labeling the features. This may or may not make people feel better, but it is what it is and it's something to consider, something important to talk about, something to grieve.

"Is it genetic?" patients ask about a particular diagnosis.

We'll say yes, if we think so, or admit we don't know. Maybe, maybe not, depending upon who is fertilizing whose egg. But it's a good thing to know, isn't it, that if an ancestor has features of a disorder, that descendants might have these features as well?

For whether or not things are genetic, everything behavioral can be learned and passed down. All of us struggle with our nature, and we fight how we've been nurtured, too. Both are likely to be transgenerational, even dysfunctional in some way.

I like to think that we can fight both, that much of personality can be shaped and confronted in a nice way, and that most mental illness can be treated. We may have to change how we define success and failure.

The kicker, the part that is most difficult for many patients to buy in this psycho-educational family therapy, is that it's good to "out" our mentally ill, personality disordered, addicted relatives. Out them to the children, mainly, expose those who, dead or alive, have or had issues, or were perhaps differently-abled.

Certainly when it comes to mental illness, rather than attempt to erase a person from the family tree, own the mishigas, (rhymes with wish-ih-moss, Yiddish for craziness) and vaccinate the kids, empower them.

It's so funny. When you tell your kids about the colorful people in the family, they get it right away. And no, they don't want to be just like them. The research on self-fulfilling prophesies has always been a little light.

All that said, you don't have to roast anyone at a funeral, not unless you know your crowd.



CZBZ said...

Welcome back, therapydoc.

An interesting thing happened in my family when one of my relatives was diagnosed with ADHD. We started looking around at the 'black sheep', the ones who were impulsive and hard to understand because they had trouble in school (unlike their siblings and cousins). We began to see ADHD relatives cropping up on nearly every branch.

Now maybe we were diagnosing the dead but what matters to me is how family members responded.

Suddenly, my Mother teared up thinking about her brother, the renegade who never could get his life together. We looked at my father and said we were going to change his name from DAD to DADHD. Understanding more about people's mental problems paved a path for understanding and yes, even forgiveness.

When we look at the family tree with all it's bipolar leaves and ADHD apples and an occasional narcissist thrown in for good measure, we connect to our ancestors even more deeply.

Though I must admit that family reunions and ancestral story-telling has been a big part of my culture and familial environment. I grew up hearing about my great-great-great ancestors---in a Technicolor presentation. Not black-and-white. ha!


CiCi said...

Having all the tools in the world and years of experience as a therapist can't take the place of the pain and grief when you lose someone you love.I do admire you for getting your life to the normal work/home schedules and for knowing you need this time to not be 100% every second of the day. It is nice to know your friends call just to see how you are. Those are keepers.

Isle Dance said...

((((TherapyDoc)))) I am thinking of you. And sending lots of healing your way. I'm so very sorry.

And I'm thinking this means...

If I'm the Black Sheep,
if I left the family,
it's okay for me to tell
those who come calling,
the truth of why I left?

Politely, of course.

I always thought I was supposed to
keep it hush-hush. Or feel guilty for speaking. But that has meant
I've been denied support, too.

Rachie317 said...

Hey Therapydoc - so, so sorry for your loss. This post was very helpful for me to think about as my family deals with the loss of my mother's father, who passed away suddenly a few weeks ago.

I'd love for you to write more about which/how many mental health issues are truly genetic vs learned behaviors passed down through families. I have been really pondering this question a LOT recently and can't quite get a good (aka coherant) post together about it. I'd love to hear your thoughts.

Take good care of yourself.

Jack Steiner said...

I have thought about my own eulogy. I know what I want to be said about me, but I hope that whatever is said is honest and truthful.

Let me live up to that standard.

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lynette said...

it is good to hear from you, writing from the land of life and grief. my father's death left me almost completely dysfunctional for at least six months -- at that point, i made it onto antidepressants, which made me functional, but no less in grief.

it is almost five years. the grief for my father -- who was not by any stretch perfect, but he adored me and i loved him -- broke down emotional walls and barriers, and allowed a whole tidal wave of other crap to surface.

i am working on reassembling the pieces so that i can be transformed into who i am meant to be now that my father is gone. it is hard work. the grief still comes.

i gave the eulogy at my father's service -- with me he was wonderful, but i told the truth about his quirks and his temper and his fussiness. people laughed, people cried. i grieved.

i contacted my ex-husband at the time, and apologized for not having been able to understand how he felt when we were married and his mother died. he replied "how could you know?" i couldn't have.

bless you, therapydoc, in the journey ahead. nothing can prepare you for this, not even being a trained therapist.

Kellen said...

I'm sorry to use your comments section, but I cannot find your email address. How can I write to you? I'm a therapist also and wanted to talk to you about your blog.

My email is kellen(dot)vonhouser(at)



Lisa said...

"They grieve who he hadn't been, too". So powerful, so necessary. And with my clients, I find that they begin grieiving and even raging who their loved ones AREN'T or CAN'T Be long before they pass...

Kellen said...

This is such a beautiful article. I'm so glad you call it grief and not "depression". And your description of the feelings which come up, emotional and somatic, is eloquent. So many people are told to "stop crying", "it's O.K." or to "get over it". It's nice to see someone embrace and validate it as a normal healthy process.

I think Lisa has an excellent point too. I'm working with a client now whose father was a true sociopath. They are not only grieving the father they lost, but the one they never had and never will have. They could not trust him enough to let him get close to them because he would manipulate them. And that has a sadness of its own I think.

The Blue Morpho said...

I'm very sorry for your loss. You bring up some excellent points about the transgenerational nature of mental illness, and how a knowledge of our past can help us understand our present. And to make some kind of peace with it. These same ideas have been helping my spouse deal with the loss of a father, now four years ago, but still hurting.
Blue Morpho

Wait. What? said...

Welcome back. I know the fog, or I remmeber it I should say, I was young when my grandmother died, but it cut me just the same, we were unusually close.

As for black sheep, Bingo and leaving town? Bingo again!

I like how you work things through here, and I get so much from it.

Margo said...

Sandra Bullock said "mishigas" at the Oscars last night. XOXO.

Anonymous said...

I'm sorry for your loss. I remember how hard those first few weeks were after my mother died. I felt physically weak, and her death felt somewhat like what I experience if there has been a constant sound that suddenly ceases so that you feel acutely aware that the sound is gone. My brain didn't seem to work as well as I wanted it to, though I don't remember having distressing dreams.

I really appreciated this that you wrote, about looking back through family history, owning the problems, the emotional family tree. These are things I've been thinking about in other areas of my life. I think it's important for people to do that work, to look and try to figure out what the patterns are, own the good stuff and figure out how to stop the things that aren't serving people well.

I do have a friend, one of six children, who unfortunately suffered abuse from both of their parents. And when their father died, someone who'd been known in the community, and people were speaking nothing but words of praise, one of the grown children got up and said "My father...was an SOB..." I gather it was rather cathartic for her, though no doubt unsettling to the people who'd come for the memorial service.

Unknown said...

It's funny, I am taking this personal essay writing class and we are delving into all these things that are super personal and super sad about our pasts, parents passing, feelings of love etc, and we keep joking that the class is cheaper than therapy. But the further into the class we get, the more we realize, this is actually true. It is therapy, and at 22 bucks an hour, way cheaper, but so necessary and so cathartic!

Anonymous said...
This comment has been removed by a blog administrator.
Wondering Soul said...

Can't believe how much spam you get TD... What on earth have you done to deserve that much?!

Wanted to say that I am so sorry to read about your loss.

I'm guessing that you are "coping" and that most parts of your world are carrying on...
But am feeling for the part that possibly feels a little bit lost and numb and hit.

I'm very lucky to still have mine.

Hoping that you can make little bits of space for yourself in the midst of all the pain and angst belonging to others.


Anonymous said...

I've tried to leave a comment several times but something won't let it go thru. If this one does, I'll rewrite the original one. So sorry for your loss. Take care.

Anonymous said...

I hadn't read you in about a month or so. Please know how I sympathize with you. Lost mom a little over a year ago. Lost my mind for about the first two months afterwards...grieved long and hard. Now I'm losing my dad. I've not gone to the cemetery since we buried her...I figure I'll be back out there soon enough to bury my dad next to her. I like what you said about certain people pro-longing their passing. Perhaps that is what dad is doing. I expected him to die at least 3 or 4 times since December. It is so strange, the one child out of four that had the most contentious relationship with him has become his most ardent protecter and defender. Once again, sorry sorry sorry.

jss said...

I wrote a post about this topic recently. The propagation of the family illness and/or dysfunction from generation to generation by means of behavior.

I am tired of hearing that alcoholism is passed down and around to members of the family by means of a gene. I had no chance, he had no chance, we all had no chance... it's in our genes. It is inevitable.

therapydoc said...

You're all so wonderful and I appreciate every word. I'm very appreciative that you don't beat me up for going around and around, not focusing particularly well, and only hinting at what I think is important.

There were some very important points to this one, mainly that kids do get it when we talk about mental illness, and if we speak about it rationally, use ourselves and our extended families as examples, we can prevent some of the drama associated with it. Mental illness, behavioral DISORDER, is universal, we all have it in our families. If you think you don't, you're probably in some serious denial.

We can't always fix it, but we can do some risk management, assuming we can get past the stigma, we can prevent some of the craziness by preparing our children. And yes, with some effort, with the best resources, we can fix it most of the time.

But prevention is better.

The other thing is that we do need to protect confidentiality and privacy, we should never speak about someone else in a derogatory way. That might mean losing the attitude about mental illness.

And yes, I liked that line about intimacy in dying, too.

Anonymous said...

I don't think I've ever commented before. I, too, am sorry for your so great loss. Is it possible to be glad in some small corner that you have reason to grieve so deeply? Maybe that's not a fair question at a time like this. For me, one parent is gone, one still here. I have no reason to grieve the loss of either, in fact, it's all about relief--and grieving what will never be. And I try to imagine what it would feel like to grieve a beloved parent.

Syd said...

TD, I'm glad that posted on this. I'm also very sorry to hear about your father. I have lost both my parents. It was very difficult. I see many of the dysfunctional aspects of my maternal and paternal side of the family. Fortunately, I am able to see that they too were just human and subject to many shortcomings but many wonderful traits as well. The baggage that another carries can be one that we choose to pick up or not. I still wonder what happened to a first cousin who was effectively banished from the family for the possibility of being gay. I would like to find him and reconnect--to let him know that he is missed and loved and to make amends.

April_optimist said...

I love this. We DO need to acknowledge who people really were--all of it. We DO need to go through anger to get to forgiveness if someone abused us. For one thing, it's a statement that we DO matter and that we DO deserve not to be abused. I often tell writing students that if they are working on a memoir, it helps to look at the hopes and dreams and fears of all the people involved--especially those seen as villains. In understanding, there is so much growth--and a chance to heal.

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Anonymous said...

All of these spammy comments seem a bit ridiculous!