Beauty By Any Means Necessary

My latest post is up at Her.Meneutics. It’s called “Is it a sin to nip and tuck?” and was reclaimed from an article I worked on in 2007 that never made it to print. I offer the original here because my sources* made many points worth considering and because I think it’s a really good piece of work.

The photo above is of my sister Connie Smith before cosmetic surgeons created fingers for her from skin on her thigh. Connie was interviewed for this article. Living in Orange County, California, inspired my interest in the topic; Connie’s embodied experience informed my thinking.

“Beauty often wins love. It just does,” write Karen Lee-Thorp and Cynthia Hicks in Why Beauty Matters. No wonder women, and, increasingly, men are willing to endure the pain and risk of elective cosmetic surgery to attain it. New York Times reporter Alex Kaczynski states it bluntly in her cosmetic surgery expose’ Beauty Junkies. “In the end it all comes down to sex. … We are looking for love. And we will accept lust.”

Few admit this with the aplomb of Cena Rasmussen. This former model readily confesses that her cosmetic surgery addiction was fueled primarily by the bliss of turning heads. By her own admission, Rasmussen has spent years looking in the mirror. More often than not, she has seen reason to improve the image that stares back at her. Rasmussen was twenty-seven years old when Palm Springs, CA, cosmetic surgeon Razi Mazaheri first sculpted her flesh. He was dating Rasmussen’s friend and she was envious of the friend’s evolving, surgically-enhanced appearance.

In one transformative day, Rasmussen had breast augmentation, rhinoplasty, cheek implants and an eye lift. The breast augmentation didn’t heal properly and had to be redone almost immediately. In fact, one-quarter to one-third of breast augmentations will require additional surgery, according to Kaczynski and the FDA.

For Rasmussen, aesthetic surgery would become a biannual ritual that continued for two decades. There were more rhinoplasties, breast surgeries and lifts—eyes, face, neck—and non-surgical procedures as well. The regimen ended with a hyalauronic acid peel in 1999 that burned the skin on her face so badly, she says it left her looking like a “freak of nature.” Since then, Rasmussen has sworn off Mazaheri and has had nothing but $4000 worth of laser treatments to reduce the scarring. Still, she remains undaunted and is planning another face lift—her third, or is it the fourth? She can’t recall.

Racing into the Future

Rasmussen may represent an extreme in the use, or what some might call abuse, of cosmetic surgery, but the trend has been growing exponentially. In 2006, according to the American Society for Aesthetic Plastic Surgeons, Americans spent just under $12.2 billion on 11.5 million surgical and non-surgical procedures.

That’s a 446 percent increase from 1997. Surgical procedures increased by 98 percent and non-surgical procedures by 747 percent. Liposuction, breast augmentation, eyelid surgery, abdominoplasty and breast reduction were the top surgical procedures in 2006, while Botox injections, hyalauronic acid, laser hair removal, microdermabrasion and laser skin resurfacing were the most popular non-surgical techniques.

Ninety-two percent of patients were women, but men had nearly one million procedures. Forty-seven percent of patients were aged 35-50, 22 percent were 19-34, and 25 percent were aged 51-64. Ethnic minorities made up 22 percent of the patient pool.

Sculpting flesh is just the latest in millennia of questionable beauty-enhancement practices. The use of mobile x-ray machines for hair removal early in the last century is another. By the 1930s, the technique seemed “firmly entrenched,” writes Teresa Riordin in Inventing Beauty. She says women appear to have been “either ignorant of the dangers or simply willing to ignore them, given the ease and effectiveness of the treatment.” Sound familiar?

According to Riordin, women have long been collaborators and profiteers in this business. From the mid-nineteenth to the mid-twentieth century, for example, women received one-third of all U.S. patents, but in the category of pre-surgical breast enhancement (“falsies”), nearly two-thirds of patent-holders were women.

So what is a Christian to think about elective cosmetic surgery? Is it a sin to get a nip and tuck? Depends on whom one asks. I asked a variety of professionals and lay people. Their answers are an eclectic brew.

Choice

Lilian Calles Barger, author of Eve’s Revenge, says the choice to have cosmetic surgery is not a free one. “If you tell me, ‘my mother had cosmetic surgery. She’s a very independent woman. She really loves God and she wants to do this, and this is her choice,’ I say, ‘This is not a free choice. This choice is under duress.” Barger describes the phenomena as “appalling,” “gut wrenching,” “fundamentally wrong,” “a failure of the imagination.”

“The body is not just a hunk of meat,” she insists. “The body is significant in Christianity. The Bible talks about how we are to offer our bodies as living sacrifices to God. The question is what are we offering our bodies up to when we do that?” Her conclusion is that we’re offering them up to “false beauty and to cultural norms that we should be challenging,” but adds, “so that is where you can be compassionate, because you can understand that sin is not the sinner by themselves. It is collaborative, communal, reinforced. We support each other in this.”

Barger’s claim was born out in interviews with several cosmetic surgery patients.  In nearly every interview, individual choice was held out as a trump card, but all the women made their decisions within the context of relationships both personal and professional.

Therapeutic and Spiritual Perspectives

A disconnect between body and Spirit emerged in the reasoning of two patients who said body sculpting decisions are spiritually insignificant. “I don’t think it is a spiritual issue in any way,” says Rasmussen. “I personally believe that when we die, we’re going to have a glorified body that’s not going to be physical in any way. So what does the Lord care what we do to our skin?” Rasmussen explains that she both saved for her procedures and tithed faithfully throughout the exercise of her habit.

A fifty-something patient who asked not to be identified has had eye lid surgery, a chin implant, a mini-face lift and Botox. She says that as she struggled with the idea of tampering with the body God gave her, she sensed Him saying, “My beloved, you’re beautiful. You don’t need to do this.” She doesn’t believe, however, that tuning out the voice of God was sin. What matters, according to this patient, is “where your heart is.”

Cissy Brady-Rogers is a Pasadena therapist who has had a mastectomy, but no reconstruction after breast cancer years ago. She says that our culture “sets women up to feel shame about our bodies.” Body shame originates at home where children are not taught what to do with developing bodies and sexual impulses. It is then reinforced in school and through the larger culture. This coincides with what Brady-Rogers calls “disembodiment”—the phenomenon by which a subject looks into the mirror and sees that he or she does not measure up to cultural ideals and then comes to view their body as an object in need of repair rather than simply “me.” She says those considering aesthetic surgery would do well to heal the cause of their discontent (shame) rather than treating symptoms surgically.

Sociologist Philip Rieff talked about this disembodiment as “the triumph of the therapeutic” in his landmark 1960s book of the same name. It is a view of self as patient to be cured that he believed had replaced religion as the defining cultural narrative. He wrote, “That a sense of well-being has become the end, rather than a by-product of striving after some superior communal end, announced a fundamental change in focus in the entire cast of our culture—toward a human condition about which there will be nothing further to say in terms of the old style of despair and hope.”

For Christians walking out faithful body stewardship in defiance of this fundamental change, Brady-Rogers (who holds a Master of Divinity degree along with her other credentials) offers another narrative. She says patient-consumers are trying to figure out how to save themselves, just like the Galatians were, and in the process are biting and devouring one another by increasing the social pressure on all of us to conform to false ideals. “There is always going to be some law, some culturally offered avenue to save ourselves, to make ourselves okay, to fix what’s not working.” What Paul said is that it’s not going to work. Christ is the only one who can save us. “We are free to have plastic surgery. There is not a biblical law that says, ‘Thou shalt not have plastic surgery or drive a BMW,’ but what the Scripture says is: do not use your freedom as an opportunity for self-indulgence, but through love serve one another.”

For a woman contemplating aesthetic surgery, she advises, “I would like her to have a group of soul sisters who could support one another in becoming who they are in Christ, and support her in a process of discernment about that decision, not as solo journey. That may be part of the problem; too many women are making these decisions in isolation from other women.”

Idols and their Denouncing Prophets

Although the pursuit of beauty and the power it wields are timeless, a plethora of television makeover shows has normalized the triumph of both the therapeutic and the pornographic. Affluence and materialism, improved surgical techniques and doctors fleeing managed care realities for a cash business have all kept the engine humming along in the direction of more medical intervention to tame unwieldy flesh, according to Kaczynski.

In a 2004 New Atlantis article, “The Democratization of Beauty,” Christine Rosen wrote, “Cosmetic surgery … feeds our envy of those who embody nature’s most powerful but fleeting charms—youth, strength, beauty, and fertility. Its supporters praise its ability to change lives and its critics denounce it as the expression of our society’s worst impulses.”

As Christians reach for the charm, it’s these worst impulses that Hans Madueme, M.D., a fellow at the Center for Bioethics and Human Dignity, insist pose the greatest danger.

He calls the trend “deeply depressing” and says it’s one more area of American materialism that shocks his African family when they visit. The intuitive “yuk” reaction some Christians have towardaesthetic surgery is instructive, says Madueme. It tells us where the culture is moving, and reveals our loves, desires, idols and lusts. He suggests three “functional idols” that come into play with aesthetic surgery: youth, beauty and money. Consumers idolize youth and beauty, while medical providers exploit patients “inordinate desires” as a function of money idolatry.

Gary Churchill, a suburban Chicago facial plastic surgeon and aesthetic patient, offers a different perspective. He believes God directed him to a career that overwhelmingly consists of making women look and feel younger and more beautiful. Churchill was deeply offended when a fellow churchgoer suggested his work is incompatible with his faith. He takes a minimalist approach to surgery that leaves patients looking “refreshed” rather than altered.

Scot Rae, a bioethecist at Talbot School of Theology in La Mirada, CA, had an up-close and personal introduction to the world of cosmetic surgery when his wife Sally was having breast reconstruction after a double mastectomy. Although Rae was shocked to see young women in the surgeon’s office perusing catalogues that advertised buttocks implants, he strikes a middle ground.

Rae says Christians must see medical technology through a proper theological lense. He says God embedded his wisdom into creation through general revelation and that technology is “one of the primary ways that human beings unlock and apply God’s wisdom in the continuing quest to subdue the earth.” Rae allows that this quest was complicated after the fall, but says the three Ds—death, disease, and decay—were brought into the world by sin, and, as such, are legitimate targets for alleviation through technological means.

Like Madueme, Rae believes our intuitions are helpful, but sometimes in need of re-education. “They give us sort of yellow lights, but not necessarily red or green.” He offers a three-fold grid for evaluating aesthetic surgery. First, he says,” We are not our bodies, but we don’t devalue the body.” Second, “Medical technology, in general, to help alleviate the entrance of the effects of sin is a part of God’s common grace. And I think you can make a very good case that aging is a consequence of sin.” Third, “There’s a dynamic interaction between the soul and the body. So that’s why I think it makes sense that both men and women who have a change in their bodily appearance can feel better about themselves, and vice versa.” He concludes, “I think the bottom line is that you get principles and parameters out of Scripture and those form the fence around the field in which there’s freedom to make decisions.” If his eyelids were to droop in ten years, Rae says he would consider a nip and tuck.

Marketing toward Insecurity

To those who suggest that cosmetic surgery is marketed toward women’s insecurity, Ray Anderson, senior professor of theology and ministry at Fuller Theological Seminary in Pasadena, CA responds, “We need to look at it much more realistically, that it’s on a continuum. It’s on the same continuum as other aspects of embodied cultural life that effect our self-image….The solution to that [marketing towards women’s’ insecurity] is not to demonize an industry, but it is to revitalize the soul, the self in such a way that one is free to make use of products, services, opportunities within responsibility without having to be branded in ones own mind at least to be capitulating to that culture. We have to be strong enough so that Christian women now need to be socialized in the Christian community in such a way that they are able to make good choices with regard to products and opportunities to enhance their appearance and self-esteem within their culture.”

Anderson’s son-in-law Gregory Evans is chief of aesthetic and plastic surgery at UC Irvine Medical Center in Orange, CA. His practice is equally divided between corrective and aesthetic surgery. Evans says, “We all as physicians help people, but our area of the field is really trying to focus more on quality of life issues. … So one day a hand, another a cleft lip, breast reconstruction, injecting Botox around the eyelid—so we’re involved in the whole facet of a person.” Evans acknowledges the potential for exploitation, but offered a four page code of ethics from the American Society of Plastic Surgeons as evidence that his board is serious about combating unethical advertising practices fueled by greed.

The only board certifications Kaczynski trusts are those offered by the American Board of Plastic Surgery and the American Board of Medical Specialties.

Anne Brattli is an aesthetician and salon owner in Sarasota, Florida. Brattli found out the hard way that not all board certifications are equal. Ignorant of uneven licensing practices in the industry, she briefly went to work for Kurt Dangl, a practitioner who was later featured on 20/20 and in Beauty Junkies for his part in the death of a breast augmentation patient whose anesthesia was administered by an unlicensed “nurse.”

Brattli says Dangl offered free surgeries to employees after four months of employment. At first she considered a tummy tuck or liposuction. But after witnessing the grisly realities of the operating room (which were visible from the break room where employees ate their lunch), Dangl’s arrogance and myriad grotesque complications, she changed her mind. Eventually she learned that Dangl’s primary training had been in dentistry and took an early and permanent maternity leave.

Brattli has been examining women’s faces under a high-powered microscope for a decade. She identifies a nagging problem with medically enhanced beauty. “When you’re talking to someone who’s had Botox and they smile at you, they don’t look sincere and you can’t put a finger on it, but it’s because they’re smiling at you with their mouth and not with their eyes. When you get a person who smiles with their eyes and their mouth, you feel like they’re genuine. With Botox, it doesn’t matter if they’re genuine. It just never reaches their eyes.”

“Sooner or later a person that resorts to some artificial way of delaying aging or overcoming some perceived abnormality is going to have to deal with the fact that you’re going to have to live with what you’ve got,” concedes Anderson, who, at 80-years-old, is still dying his hair and beard dark brown.

Wisdom from Tarnished Humanity

Some women, like Connie Smith, never have had a choice about the bodies they inhabit. Smith was born with multiple birth defects [her term of choice]: congenital constricting bands that cut off most of her fingers at or below the knuckles, a clubbed foot and webbed toes. With sponsorship from March of Dimes, cosmetic surgeons created digits that have served her well for more than 40 years. Perhaps it is women like her, Brady-Rogers and Sally Rae who have the most to teach us about living within our imperfect, aging bodies.

Smith is a homemaker and is divorced from her husband. Facing the idea of mid-life dating and re-entry into the job market, she has no plans for medical enhancement. She feels the same cultural pressures that others do, but says when she feels good about other areas of her life—particularly her relationships with God, family and friends—her birth defects don’t bother her or others. “When I’m feeling good, I project an air of confidence, she says, “My hands are the last things on someone’s mind; they are looking at my face or my body, or they are listening to my words. My hands are irrelevant. When I project insecurity, I feel like some people treat me like I’m invisible. They’re looking at me in a different way.”

Transcendent Pursuit

Rieff and Kaczynski may be correct that the therapeutic and the pornographic have triumphed. The theologians may be correct that technology can be either used responsibly or abused in a Christian context as it alleviates the effects of the fall. Feminists and therapists may be correct that the industry exploits women’s greatest insecurities and culturally induced shame. But there’s also something uniquely American and Protestant in the wholesale rush to embrace medical enhancement.

David Brooks describes this strain of perfectionism in American life in his book On Paradise Drive. He writes, “Unlike some other bourgeois nations, we are also a transcendent nation infused with everyday utopianism,” a utopianism that “lures us beyond the prosaic world” and “gives us a distinct conception of time, so we often find ourselves on some technological frontier,” Of these ever-expanding frontiers, Brooks duly notes that we occasionally look back on them with regret.

As medically altered faces and bodies become more commonplace, will the era of Botox and DD breast implants be one we regret? Will the dangerous excesses be abandoned as x-ray hair removal machines were? One can only hope.

*Note: I have not updated the information in this piece. Source affiliations and cosmetic surgery stats may have changed.

Thanks again to our newest NF heroes

 

These sponsors helped us raise $2,640 for The Children’s Tumor Foundation:

 

Mr. Jeff Scheller

Ms. Florence Anne Kohut

Mr. Aiden Long

Mr. and Mrs. Bruce C. Neary

Mr. and Mrs. John H. Oostdyk

Mr. Albert J. Stahl

Mr. and Mrs. Robert H. Speight

Mr. Roy Larsen

Mr. and Mrs. Bruce V. Koczman

Mr. and Mrs. James W. McCombs

Mr. Richard D. Kroll

Mr. Greg Cambeis

Ms. Kathleen Sommers

Ms. Katy Laundrie

Ms. Amy Zambrano

Mr. and Mrs. Richard Gifford

Mr. Rob Moll

Mr. Gary Gnidovic

Mr. and Mrs. Dan Carver

Mr. Richard Heffner

Ms. Dee Lamorte

Ms. Judy Scheller

Mr. and Mrs. Philip Benyola

Ms. Heidi Peck

Mr. and Mrs. Carleton W. Westerlund

Ms. Cherie Carl

Mr. and Mrs. Nicholas P. San Filippo

Mr. and Mrs. Robert A. Mack, Sr.

Mr. and Mrs. John J. Bogosian

Mr. and Mrs. Roger L. Faulkenbury

Mr. and Mrs. James J. Jensen

Mr. and Mrs. Michael Trapani

Mr. and Mrs. Mark Smith

Ms. Sara Mummolo

Dr. and Mrs. Gary S. Cuozzo

Mr. Tony Papalia

 

 

Here is the summary of another study that I’ll be including in my letter to The Children’s Tumor Foundation to encourage them to better educate and support families in regard to ALL possible outcomes of this debilitating disease.

NF1: Psychiatric Disorders and Quality of Life Impairment

Neurofibromatosis type 1 (NF1) is often associated with psychiatric disorders, which are more frequent in NF1 than in general population (33% of patients). Dysthymia* is the most frequent diagnosis (21% of patients). There is also a high prevalence of depressive mood (7%), anxiety (1-6%), and personality (3%) disorders. The risk of suicide is four times greater than in the general population. Bipolar mood disorders or schizophrenia appear to be rare. The impaired quality of life associated with NF1 may play an important role in the development of psychiatric disorders. Quality of life assessments may help to identify a population at high risk.

*Dysthymia — depression; despondency or a tendency to be despondent

Thanks again friends! May your generosity be returned a hundred-fold!

Victory on Parity

From NAMI:

Victory on Parity!

October 3, 2008

By a vote of 263-171, the House this afternoon gave final approval to the Paul Wellstone-Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 as part of the Emergency Economic Stabilization Act (HR 1424).  President Bush is expected to signed the legislation late today or early tomorrow.

A Triumph for Consumers and Families

This victory in the House ends a nearly 20 year effort to require group health plans to cover treatment for mental illness on the same terms and conditions as all other illnesses.  NAMI is extremely grateful for the tireless work of advocates from all over the nation that contacted their Senators and House members to push for this landmark legislation.  The advocacy voice of people living with mental illness and their families made a tremendous difference in securing this long sought victory.

NAMI also salutes the leadership of the sponsors of parity in Congress including Senators Pete Domenici (R-NM), Edward M. Kennedy (D-MA), Mike Enzi (R-WY) and Christopher Dodd (D-CT) and Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN).  Today NAMI also remembers the contributions of the late Senator Paul Wellstone (D-MN) in bringing parity forward.  After nearly 20 years, their efforts have resulted in mental illness treatment no longer being subject to 2nd class status in our health care system.

What Happens Next?

President Bush is expected to sign HR 1424 very quickly in order to restore confidence in sagging credit markets.  The parity law becomes effective 1-year after enactment of the bill.  This will mean that group health plans will no longer be able to impose limits on inpatient days or outpatient visits or require higher deductibles or cost sharing for mental illness or addiction treatment that are not also applied to all other medical-surgical coverage.

There is a special effective date rule for collective bargaining agreements that would delay imposition of the parity requirements until the next collective bargaining contract goes into effect.  The law requires that the Departments of Labor, Health and Human Services and Treasury issue regulations within 1 year, although failure to issue such regulations will not delay the effective date of parity.

In the coming weeks, NAMI will be developing educational materials and guidelines on how parity will impact insurance coverage for consumers and families.  For now, NAMI advocates can celebrate a landmark achievement!  

Saddleback Civil Forum on the Presidency 10 am

 

 

In a few hours, I’ll be glad I got here so early. Right now, I’m glad I brought a couple books:

Trauma and Recovery by Judith Herman, M.D. and An Unquiet Mind by Kay Redfield Jamison. Research for another project.

Spiritual Evolution

 
Harvard Medical School professor George E. Vaillant was the speaker at yesterday’s UC Irvine Psychiatry and Spirituality Forum meeting. Vaillant is Director of Research for the Department of Psychiatry at Brigham and Women’s Hospital.  His research has involved charting adult development and the recovery process in schizophrenia, heroin addiction, alcoholism, and personality disorders. He is the Director of the Study of Adult Development at the Harvard University Health Service, which has prospectively charted the lives of 824 men and women for over 60 years. Vaillant has been at the helm for 30 of those years.
 
Vaillant titled his lecture Positive Emotions, saying that spirituality is another name for positive emotions and psychiatry doesn’t talk about positive emotions, religion does. The lecture wasn’t as thorough as I would have liked, but the book sounds intriguing.
 
Here are my notes:

1. Introduction

  • Negative emotions are about me and now, while positive emotions are future and other focused.
  • [Positive?] emotions are the unwelcome guest at the academic table. This truth is so dramatic that the leading text of psychiatry includes 1-600 lines about:
 
sin
terrorism
shame
anger
anxiety
depression
 
    but only
 
5 lines about hope
1 line about joy
0 lines about love
0 lines about compassion
0 lines about forgiveness
 
Vaillant had to delve into hymns, psalms and prayers to find such words. He says religion, for all its defects, allows us to pull positive emotions up into consciousness.
 
  • The average Fortune 500 company lasts 40 years; most family fortunes are gone after 3 generations; most nations after 300 years. The world’s great religions are all committed to compassion and unselfish love. All have lasted 1400 years or more.
  •  45 year olds-to-75 year olds with strong community involvement become less religious, more invested in grandchildren, etc. Same group experiencing bad life events that are not self-inflicted (eg. philandering, alcoholism), increase religious involvement.
  • Brain continues to myelinate until age 60. Parts that myelinate in adult life connect passions to fore brain and social judgment. Thus, 70 year olds have less trouble with depression, impulse control and anti-social behavior than people half their age. The heart and brain grow in simultaneous awareness.
  • Compare a golden retriever to a clergyman. Put both in a trunk. Drive around in the desert for an hour. Ask yourself: Which one will be happy to see you when you open the trunk? Maybe it’s not only humans that God constructed in his own image.

 

2. Mental Health Scales

The Four Fs (me focused) [did he mean 3 Fs and an L?]
Fight
Feel
Feed
Lust
 
PANAS (Positive/Negative Affect Schedule, positive emotions):
Interested
Excited
Alert
Active
Attentive
Enthusiastic
 
  • Induce positive emotions, scores go up; induce negative emotions, scores go down.
 
Positive Psychology (introduced 1999):
Happiness
Contentment
Good Cheer
Well-Being
Pleasure
 
  • No place for passion or joy on scale.
  • Freud thought awe was an infantile emotion.
  •  1943 Antoine de Saint-Exupery: It is only with the heart one can see rightly; what is essential is invisible to the eye.
  • Don’t believe everything you think.
  • 1943 Autism recognized as a relational rather than cognitive ailment. Attachment is different from cognition.  

 

Vaillant’s Scale (unique):
Faith/Trust
Compassion
Hope
Love
Joy
Awe
Forgiveness
Gratitude
 

3. Case for Spiritual Evolution

Murder rate in 1300 50 times what it is today. In the 19th century, US spent more on defense than health care. Now inverted. In 1900, both the World Health Organization and Boeing 747 were equally unlikely dreams. Nobel Peace Prize and Olympics instituted.

 

  • Real Darwinian success evident in unselfish love.
  • Religion may kill many, but so do automobiles.
  • Religion is just as dangerous as new-fangled tranquilizers.
 
4.  Q&A

 

  • Hippocratic Oath can be summed up as: Don’t do unto others what you wouldn’t want them to do unto you.
  • Love and service are vital to healing.
  • Found nothing in medical library about joy. One of the most powerful ways to produce joy is for a lost person to be found (peek-a-boo, sick person recovers, etc.). Not love affairs; affairs all about me.
  • AA meetings: more consistent hugs than anywhere else. Hugs heal, invite expression of “poor me’s.”
  • Psychiatrists: overpaid, overworked. [and yet, we’re grateful for the good ones]
  • 10 years hard data proves AA works better than psychotherapy for treating alcoholism.
 

A Father’s Admonition

Help on the Way

Here is the impromptu message that Jeff gave at Gabriel’s memorial service in New Jersey. It’s only 12 minutes long, and it’s full of wisdom …

jeff-scheller2

If you’d like to respond to the invitation at the end of Jeff’s message, email him at exploring.intersections@yahoo.com.

And here, for your blessing, is his sister Sudie singing I Can Only Imagine with unexpected joy …

i-can-only-imagine1

[Special thanks to Holland Davis for preparing these recordings for upload, and for your continued friendship. To Mercy Me, if I’m violating copyright law by posting Sudie’s version of your song, well, please send me a bill.]

 

 

Depression: Out of the Shadows on PBS

I wish I’d seen this documentary months ago … then I might not have missed or misread the warning signs for suicidal depression that Gabe was exhibiting. These symptoms are used to diagnose adolescent depression, but could just as well have described my 23 year old:

  • Depressed mood or irritability (being extra-sensitive)
  • Decreased interest or pleasure in all or most activities
  • Weight change (up or down) or appetite disturbance (increase or decrease)
  • Insomnia (not able to sleep) or hypersomnia (sleeping too much)
  • Difficulty with psychomotor tasks (doing things very slowly)
  • Fatigue (tiredness) or lack of energy
  • Feeling worthless
  • Difficulty with concentrating, thinking or making decisions

 

Other warning signs include:

  • Sudden behavior changes
  • Anger, agitation or irritability
  • Risk-taking
  • Giving away prized possessions
  • Withdrawal from social groups
  • Huge changes in dress and appearance
  • Constant boredom
  • Extreme sensitivity to being rejected or failing at something
  • Frequent complaints of physical symptoms (for example, stomachaches, headaches, sore throat) without a clear physical cause
  • Missing lots of school
  • Trying to run away from home
  • Having a hard time paying attention and concentrating

 

From the PBS depression fact sheet for adolescents and college age students:

“One out of four young adults will experience a depressive episode by age 24. Depression is caused by a variety of factors, including genetics, environment and adverse life stressors. Teens that have chronic illnesses or have experienced trauma are at greater risk of developing depression. …

When your teen goes away to college they are exposed to many stressors that can lead them to develop depression or other mental illnesses. Moving away from friends and family, taking care of yourself for the first time (money, laundry, etc.), having to make new friends, and being academically challenged can be overwhelming. It’s harder to know how your teen is doing when they are away but you should know that surveys have shown that about 50% of college students report feeling so depressed that they have trouble functioning. Many colleges have established good mental health awareness programs and services to aid students. It’s a good idea to know ahead of time how these issues are handled.”

You can plug in your zipcode here to find out when Depression: Out of the Shadows airs on your local PBS station. I only caught part of it last night, but learned so much in that brief introduction that I’ll be watching and recording the entire show on station KCET tomorrow evening at 7pm.

The Depression: Out of the Shadows website includes plenty of informative resources and links. If you suspect that you or someone you love is suffering from depression, get the help you need. 

Update 5/24: I apologize to those of you who were looking for this documentary on KCET last night at 7pm. It was only on digital KCET and is not listed for the coming 2 weeks. I’ll post the next air time when I can confirm it.

Update 5/26: Depression: Out of the Shadows will air on station KOCE (Huntington Beach) on Thursday, May 29 at 8pm. I’m setting my Tivo this time. (At 7pm, a show called Men Get Depression Too will air.)

 
 
 
 
 
 

 

Grieving a Suicide

 

Wheaton College professor John Walford gave a passionate testimony about his brushes with suicide at a recent Wheaton chapel service. There have been three recent alumni suicides in the past year, and the university is rightly concerned about a trend that reflects an alarming three-fold increase in youth suicide. 

While I commend both the university in its desire to address the issue with a strong exhortation and Dr. Walford for his transparency, the message fell short in that it lacks the expert advice that might have provided students with consolation, deeper understanding and tangible help.

Today I’d like to commend to you InterVarsity Press editor and Christianity Today columnist Al Hsu’s excellent book, Grieving a Suicide. I met Al in February at the National Pastors’ Convention and noticed this book on a display table. After Gabe’s death and before we left for the services in New Jersey, I asked him to send me a copy. It was waiting for me when we returned to California. I’m reading it for the second time and ordered 10 more copies for family and friends. (I received the shipment yesterday and will distribute the books forthwith.)

Al’s book is dedicated to his father, Terry Tsai-Yuan Hsu, an accomplished electrical engineer who took his own life after a debilitating stroke. Al brings to the topic both a survivor’s understanding and good scholarship.

The book is divided into three parts:

  • When Suicide Strikes—Shock, Turmoil, Lament, Relinquishment and Remembrance
  • The Lingering Questions—Why Did this Happen? Is Suicide the Unforgivable Sin? Where is God When it Hurts?
  • Life after Suicide—The Spirituality of Grief, The Healing Community, The Lessons of Suicide.

 

In Part I, we learn that “the grief that suicide survivors experience is described by psychologists as ‘complicated grief.’ … Those of us who experience complicated bereavement are actually grappling with two realities, grief and trauma. Grief is normal; trauma is not. The combination of circumstances is like a vicious one-two punch. We are grieving the death of a loved one, and we are reeling from the trauma of suicide. The first is difficult enough; the second may seem unbearable.”

Al categorizes the resultant turmoil as follows:

  1. Shock, disbelief and numbness–“‘The immediate response to suicide is total disbelief,’ writes a suicide survivor. ‘The act is so incomprehensible that we enter into a state where we feel unreal and disconnected.'”
  2. Distraction—“Friends of survivors may need an extra measure of patience … traumatic grief has caused an inability to focus.”
  3. Sorrow and Despair—“Survivors often fall into a state of melancholy and depression … In some ways we may unconsciously identify with the hopelessness that precipitated our loved one’s death.”
  4. Rejection and Abandonment—“Suicide feels like a total dismissal, the cruelest possible way a person could tell us that they are leaving us behind … So we feel abandoned. Our sense of self-worth is crippled. All our doubts and insecurities are magnified a hundred-fold.”
  5. Failure—“Feelings of failure may surface any time a survivor had a caretaking role … Our feelings of regret and guilt may seem overwhelming, but they eventually subside as we realize the death was not our fault.”
  6. Shame—“Beyond the combination of normal grief and traumatic grief, survivors of suicide suffer an additional insult to injury—the societal stigma that surrounds suicide.”
  7. Anger, Rage and Hatred—“We may hate our loved one for doing this to our loved one. We grieve the suicide and rage against him simultaneously.”
  8. Paralysis—“A simple phone call had triggered an anxiety-filled reaction.”
  9. Sleeplessness—“We lie awake, with our thoughts flying in all directions.”
  10. Relief–“About half of suicides are at least somewhat expected due to ongoing depression or patterns of self-destructive behavior. In our sadness, we are shocked to discover that we are glad it’s all over.”
  11. Self-destructive thoughts and feelings—“One danger of being a suicide survivor is the possibility of falling into suicidal despair.”

In the chapter from Part II on remembrance, Al offers this helpful advice:

“Because of the corrosive, personality-altering nature of suicidal depression, ‘by the time suicide occurs, those who kill themselves may resemble only slightly children or spouses once greatly loved and enjoyed for their company.’ The days, weeks and years following a suicide may be a time of gradually recovering the memories of our loved one, of discovering true and lasting remembrances of their life.”

The chapter I have most marked up is the Why chapter. From our first conversation at 5:00 in the morning after Gabe died, Aaron Kheriaty gently but firmly instructed us that the suicide will never make sense. And yet we try …

Al writes, “We must make a distinction between causes and triggers. Suicide might be triggered by divorce or the loss of a job, but those may not be the actual causes … Suicidal desires run much deeper, and if one event does not trigger the suicide, another might.”

Nonetheless there are some defining characteristics:

  1. Medical and biological factors—“Studies show that about two-thirds of suicides had suffered from clinical depression or had a history of chronic mental illness.”
  2. Psychological factors—“Psychiatrist Karl Menninger suggested that suicides have three interrelated and unconscious dimensions: a wish to kill (the self), due to some degree of self-hatred; a wish to die, arising out of a sense of hopelessness; and a wish to be killed, coming from a sense of guilt. …  The agony of depression is so great that the suicide musters the resolve to do away with the pain, at the expense of his or her own life.”
  3. Sociological factors—“In the last quarter-century, society has tilted toward the individual rather than the communal … The glue that holds communities and families together is disappearing … [Suicide] rates among the young, more socially alienated generations have tripled … The more socially isolated we become, the higher our risk.”

Al mentions other factors like suicide as philosophical protest, the higher tendency toward depression/suicide in those with artistic temperaments, suicide because of grief (eg. 9/11 survivors) and suicide as atonement.

He says we may be asking the why question when what we really want to know is How could they do this to me?  For him, it is helpful to realize that his father “did what he did to end his pain, not to cause pain for me.” 

Each life and death is both common and unique. Dr. Walford’s experience with the temptation toward suicide sounds familiar and yet very different from Gabe’s. He communicated it in his chapel message through the lens of spiritual battle. That is one lens. The context of Gabriel’s death reads to me like a perfect storm of contributing factors. I see his suicide through a compound lens.

Walford chose a route to suicide that allowed him the opportunity to come to his senses. Gabe did not. Is one man more spiritual than the other because of method or outcome? I think not.

In Part III of Grieving a Suicide, Al talks about life after suicide. In the chapter on the healing community, he gives good advice on the language we use to describe suicide. Instead of saying someone “committed suicide” as if the victim were a criminal, we can say they died by suicide or they took their own life.

The final chapter offers five lessons we can learn from suicide:

  1. Suicide reminds us that we live in a fallen world.
  2. Suicide teaches us that life is uncertain.
  3. Suicide reminds us of our mortality.
  4. Suicide shows us the interconnectedness of humanity. Al was surprised to discover how well regarded his father was by his peers and what a profound impact his good gifts had on them. He and his family were comforted by the outpouring of support they received. We’ve had these experiences as well.
  5. Suicide demonstrates the necessity of hope. Amen and amen.

Our family has been mercifully spared much insensitivity and ignorance in the wake of this tragedy. I can’t imagine going through this without the wise counsel of those who’ve walked the road before. Grieving a Suicide is a book I don’t ever want to recommend again because doing so would mean someone else enduring this type of senseless tragedy. And yet, a suicide occurs every 17 minutes in the United States.

If you are a pastor or lay minister, prepare yourself with knowledge before you try to minister to the grieving and confused. This book will help you do that; it includes a helpful appendix of suicide prevention/survival resources. If you are a survivor, it will be a balm to your soul.

Thanks Al!

[photo ©cas 2007: sunrise at Mustard Seed Ranch, Warner Springs, CA]

Chronic pain harms the brain, but what about the spirit?

A new study published in the journal Neuroscience finds that “chronic pain can disrupt brain function and cause problems such as disturbed sleep, depression, anxiety and difficulty making simple decisions.”

HealthDay News reports:

“Researchers at Northwestern University‘s Feinberg School of Medicine in Chicago used functional MRI to scan brain activity in people with chronic low back pain while they tracked a moving bar on a computer screen. They did the same thing with a control group of people with no pain.

In those with no pain, the brain regions displayed a state of equilibrium. When one region was active, the other regions calmed down. But in people with chronic pain, the front region of the cortex mostly associated with emotion ‘never shuts up,’ study author Dante Chialvo, an associate research professor of physiology, said in a prepared statement.

This region remains highly active, which wears out neurons and alters their connections to each other. This constant firing of neurons could cause permanent damage.”

Here are some resources that suggest better days are possible:

American Chronic Pain Association

The National Foundation for the Treatment of Pain

The Mayday Pain Project

American Pain Foundation

Families “lost” in the trauma of mental illness

From an article about Britney Spears in USA Today:

 The National Alliance estimates about one in 17 Americans suffers from a serious mental illness, and mental illness affects one in five families. But as common as it is, families often are in the dark because mental illness is not on their radar the way cancer or heart problems are, Burland says.

Often, they don’t even know the symptoms.

That’s what happened to Sarah O’Brien, 30, of Takoma Park, Md., who was diagnosed with bipolar disorder 12 years ago after an incident in which she lost touch with reality. But she looks back and realizes she was exhibiting less obvious symptoms — from obsessively picking at her face to taking drugs — years before that.

Yet not even she recognized her own symptoms.

“I blamed everything on my parents or thinking I was at a horrible school,” says O’Brien, who now works with the National Alliance on Mental Illness to help others with mental problems. “I was always blaming stuff on something outside myself.”

No one else recognized it “because mental illness was not on someone’s radar screen — and because there was so much stigma. To people looking in, I was probably selfish, reckless and moody. The reality was that I was suffering inside. I wouldn’t wish it on anyone.”

Once a person or one’s family recognizes a potential problem, getting help is the next step. And it’s often a difficult one.

Often the person suffering from the mental illness does not understand that she or he is sick, says Ira D. Glick, a physician and psychiatry professor at the Stanford University School of Medicine.

“If you go break your leg and run into the doctor, the doctor will put a cast on it and give you medicine for it,” Glick says. “You say, ‘Thank you. Thank you.’

“In our field, when somebody has bipolar disorder or anxiety disorder or depression or schizophrenia, what do they say? What do most people say?

‘There’s nothing wrong with me. I don’t need this treatment.’ “

That is why it is so important to have family involvement, Glick says. “We see the family as a partner in the treatment team. It’s the patient, family and doctor all working together to make a diagnosis, set goals and carry out treatment.”

But because it is so difficult under most state laws to have a person hospitalized, families often have to wait until there is a crisis, Burland says.

“You must wait until they meet the criteria for hospitalization … in most states they have to become so gravely disabled that their life is in danger,” she says. “And then you have to call the police or you have to call the crisis team at the hospital to come into your house and take your family member to the hospital. And I want to tell you that it’s one of the most traumatic events that will ever happen to you.”

The ordeal is compounded because of the stigma associated with mental illness, Burland says.

“Families say this is the only illness in the world where you don’t get a covered dish. People don’t call, don’t inquire. The cultural understanding of mental illness is either that it’s their fault for getting ill, or it’s the fault of their family.”

Families often “beat themselves up horribly,” says Judith Orloff, author of Positive Energy and a psychiatrist and assistant professor of psychiatry at the University of California-Los Angeles. “They come to blame themselves. They think it’s their fault that this person is mentally ill.”

That is why it is so important to have compassion for them.

“Try to stay away from judging so harshly,” Orloff says. “Send any positive energy or thoughts.”

For more information, go to www.nami.org.

The Moral Instinct

Harvard psychologist Steven Pinker’s piece, “The Moral Instinct”  from last week’s NY Times Magazine is a nice compliment to Audi’s lecture. It’s a long and interesting, if sometimes predictable, read. In it you’ll learn why Bill Gates may be morally superior to Mother Theresa. That’s just the hook though. Here’s a clip from the conclusion:

“Moral realism, as this idea is called, is too rich for many philosophers’ blood. Yet a diluted version of the idea — if not a list of cosmically inscribed Thou-Shalts, then at least a few If-Thens — is not crazy. Two features of reality point any rational, self-preserving social agent in a moral direction. And they could provide a benchmark for determining when the judgments of our moral sense are aligned with morality itself.

One is the prevalence of nonzero-sum games. In many arenas of life, two parties are objectively better off if they both act in a nonselfish way than if each of them acts selfishly. You and I are both better off if we share our surpluses, rescue each other’s children in danger and refrain from shooting at each other, compared with hoarding our surpluses while they rot, letting the other’s child drown while we file our nails or feuding like the Hatfields and McCoys. Granted, I might be a bit better off if I acted selfishly at your expense and you played the sucker, but the same is true for you with me, so if each of us tried for these advantages, we’d both end up worse off. Any neutral observer, and you and I if we could talk it over rationally, would have to conclude that the state we should aim for is the one in which we both are unselfish. These spreadsheet projections are not quirks of brain wiring, nor are they dictated by a supernatural power; they are in the nature of things.

The other external support for morality is a feature of rationality itself: that it cannot depend on the egocentric vantage point of the reasoner. If I appeal to you to do anything that affects me — to get off my foot, or tell me the time or not run me over with your car — then I can’t do it in a way that privileges my interests over yours (say, retaining my right to run you over with my car) if I want you to take me seriously. Unless I am Galactic Overlord, I have to state my case in a way that would force me to treat you in kind. I can’t act as if my interests are special just because I’m me and you’re not, any more than I can persuade you that the spot I am standing on is a special place in the universe just because I happen to be standing on it. …”