| Family Therapist
Susan Schwartz Senstad provided psychotherapy for over
20 years. In 1986, she introduced Voice Dialogue in
Norway, where she has trained many consultants, teachers
and therapists as facilitators. Three years ago, she
closed her practice in order to write full time. Her
prize-winning first novel, Music for the Third
Ear, which has been published in five countries
including the U.S. , is about a couple seeking refuge
from the war in Bosnia. Now, in collaboration with Dr.
Beverly Allen, Senstad has written DARING TO
TRUST: Life Lessons From Women in Bosnia, a
book about resilience based on interviews with women
in Bosnia.
The
following text is adapted from a lecture she held at
the Norwegian Palliative Association, Sandefjord, Norway,
30. August, 2001. It has been published as "Smertens
verdi" in Omsorg, Nordisk Tidsskrift for
Palliativ Medisin, vol.19, nr. 1, March 2002 and, in
a somewhat different form in The Literary Review, vol.
45, Nr. 4, Summer, 2002
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THE WISDOM OF VULNERABILITY
by
Susan Schwartz Sentstad
I knew when I agreed to discuss vulnerability and the value
of pain that the theme has far-reaching implications. Unfortunately,
since the heinous acts in New York and Washington the 11th of
September, the topic has also taken on a great urgency.
Geopolitical and personal security require vigilance on two
fronts: physical safety and respect for vulnerability. In these
times of terrorism, it would be easy to allow the former to
overshadow the latter. If we do that, however, we risk becoming
complicit in increasing the danger we are already in.
One value of pain is that it offers the possibility for the
acknowledgement of vulnerability, which then can become a source
not only of tolerance and love but also of personal and political
security. To look more deeply into that, I’ll begin at
the individual level, because it’s there that world history
begins. Later, I’ll widen the perspective to look at the
important impact on society exerted by the work of those who
care for terminally ill people and their families.
***
It is no wonder that vulnerability is a hard commodity to market;
it's usually associated solely with the shameful exposure of
weakness. I prefer to use the definition Drs. Hal and Sidra
Stone have written in their excellent book, Partnering. To be
vulnerable, they explain, is to be without defensive armor,
to be authentic and present.
'When we are able to feel our vulnerability, we are able
to experience the full range of our reactions to the world
around us... - our physical needs, our craving for intimacy,
and all our more sensitive feelings including our loves, yearnings,
fears, shyness, insecurities, and discomforts.' (p.101)
A Norwegian theologian, Sturla Stålsett, and some of his
colleagues have written a wonderful pamphlet called "Vulnerability
and Security." In it, they describe the same thing in their
own way:
'Vulnerability is the unique capacity for receptivity and
empathy which allows human beings to acknowledge and care
for their ethical responsibility for each other, for the community
and their environment. Against this aspect of vulnerability,
we ought not protect ourselves. On the contrary, it is a necessary
precondition for the kind of security that isn't only about
me and mine, or us and ours, based on some implicit assumption
that might makes right.' (p.8-9)
I learned something about the value of vulnerability with one
of the people who meant the most to me: my father.
We seem to specialize in what we need: I didn't become a family
therapist for no reason. My father was a very good person, but
also a man of his times, a good-hearted patriarch, a benevolent
dictator. 'Daddy is a lot like God,' my sister and I used to
say, 'except that God is easier to make contact with.' Daddy
presented himself as strong, self-assured, decisive - and totally
invulnerable. Imagine then, what a shock it was to discover
that he had pancreatic cancer and only a short time left to
live. He was only sixty-three, and I thirty-three. How should
I help him-me with all my family therapy competence?
On the one hand, I thought, my role might be to motivate him
to fight against his illness. Surely an all-powerful man such
as he could win over death, if he really wanted to. Weeping,
I read to him from Dylan Thomas, "Do not go gentle into
that good night,/rage, rage against the dying of the light."
Or perhaps my job was to help him reconcile himself to death.
But how to do that when he'd never shared his worries with me?
And how to do that when our whole family was far more attached
to the myth of his omnipotence, and far more active in imprisoning
him in that myth, than any of us wanted to realize. 'But,
what if you have no job to do in connection with your father's
dying?' a friend of mine protested. 'What if you could just
talk to him like a daughter?" That’s what I did.
I pulled a chair up to his hospital bed and said, 'Daddy, I
love you. Please don't go.' I lay my head on his chest and he
stroked my hair for an entire half an hour. We were so lucky:
we both cried. I got my father, one week before I lost him.
What had happened? Pain had given us the gift of breaking through
what Stålsett and his colleagues call our shared ‘dream
of invulnerability,’ and that had opened the way for love.
***
A few clarifications are in order here: I am not idealizing
suffering; this is no paean to masochism. Nor am I out to discourage
practitioners from alleviating patients' pain that they might
harvest of their precious vulnerability. Rather, this is about
recognizing the gifts that vulnerability can offer. Nor
am I distinguishing here between physical and psychological
pain -- even though they differ profoundly. As Elaine Scarry
points out in her important book, The Body in Pain, physical
pain lies outside the realm of language; it has no object --
is not about anything other than itself but rather simply is.
As such, it is has the power to wipe out the whole spectrum
of psychological affect, everything from pleasure to misery.
There is, however, no physical pain without a psychological
consequence. Sometimes, when physical pain is the expression
of repressed psychic pain, the two conflate. We call being love-sick
having a 'broken heart' because our nervous system communicates
hurt feelings and a hurt body along exactly the same chemo-electrical
circuits. I remember looking down at myself on the day the divorce
from my first husband became final and being totally amazed
that my blouse wasn't dripping with blood, the emotional pain
was that physical. The most important reason not to make
a distinction between physical and emotional pain is to avoid
being seduced by an illusory body/mind split. There was a pole
at the old Central Hospital in Oslo that had twenty-some-odd
signs on it with arrows pointing: eyes over here, throats over
there, hearts that way, intestines around the corner. It may
seem at times as if the great medical project were to succeed
at repairing all human parts without having to deal with any
human beings. In some ancient cultures, the body/mind split
concept is part of a path to loving all living things; mind
control is cultivated as a protection against being swayed by
every raging emotion. For our culture, however, it easily becomes
a form of splitting, an instrumentalizing dualism, an attempt
to bring nature under man's control, as if that were unquestionably
a good aim to have – an expression of the dream of invulnerability.
***
The fact that vulnerability may be a positive thing which requires
openness does not mean, however, that people would do well to
go around without any armor. We ought all be equipped with a
set of good, strong, well-functioning defense mechanisms, because
we need them. Behind the armor of our socialized ego lie aggression,
greediness, passions unchecked by morality. Just visit a child
care center if you care to see how brutal our uncivilized, primitive
impulses were before they came under our conscious control.
Under our armor lie our reactions to all new and old trauma
-- wounds from losses, fears, shocks, humiliations, failures,
abandonments -- the emotional baggage we carry with us from
childhood on. To contain all this, we need our defenses. Children
without defense mechanisms can end up as institutionalized cases.
Nor does lability, a continual swinging from one strong emotion
to another, make for a happy life. But the pursuit of mastery
and control, the attempt to avoid all pain, acts as a lock preventing
us from opening vulnerability's treasure chest. As Drs. Stone
write, 'The paradox is that if we don't have access to vulnerability,
we don't know who we are or what we like or don't like, what
makes us happy or sad.' Just try to be playful with your defenses
in high gear, or creative. Even worse, try making loving, passionate
love with your armor locked – a guaranteed fiasco. Without
access to vulnerability we lack the capacity for empathy, and
to develop our own sense of ethics. If we don't have access
to our vulnerability, every encounter becomes a power play,
a struggle over control and status. As I learned by my father's
deathbed, it was only when we both could bear our own and each
other's vulnerability, when we were willing to confront the
fact that he was 'only' a mortal, vulnerable human being, that
the two of us could really meet, soul to soul. The gift of pain.
***
Too much control is inhibiting, too little is chaotic. Too much
vulnerability is frightening, too little is tragic and lonely.
We need both mastery and openness, both protection for our boundaries
and the ability to surrender them. The problems start when we
define that as an either/or and choose only control. At its
worst, the either/or thinking involved in a total denial of
vulnerability is a diagnostic red flag. The use of the defense
mechanisms of splitting and denial can point to borderline character
disorders. Fortunately, most of us are not suffering from such
disorders. More often than we may like to admit, however, we
do avail ourselves of borderline-style defenses.
We may covertly encourage our patients'
to display exaggerated bravery such that they end up
feeling shame for having disappointed us, for not being
as courageous as we've unconsciously signaled to them
that we need them to be.
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We may objectify them, focusing intensely
on the technical side of their suffering.
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We may harbor a secret narcissism in our
longing to alleviate all suffering, a so-called "healing
mania."
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We may even get angry when patients fail
to confirm our omnipotence by insisting on remaining
ill, such as when they prove us powerless to lighten
their loathing of their cancer-ravaged bodies.
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We may use our competence
and our scientific rationality like a shield.
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We may exhibit an unconscious need to
keep the role assignments clear: the patients have to
be vulnerable while we get to be strong. Helen Bamberg,
who started The Medical Center for the Care of Victims
of Torture in London and who, herself, survived the
concentration camp at Bergen-Belsen, tells how the helpers
who cared for liberated camp prisoners did just fine.
Until, that is, the freed prisoners got stronger, started
having opinions of their own, and what's more, started
challenging the staff's authority. That made the helper
anxious ergo furious; they'd lost their monopoly on
strength.
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We may behave as if our energetic resources
were boundless and then over-estimate how much work
we can responsibly take on. Just recently, two nurses
working the second part a double-shift slept through
the intensive care alarm as a female heart patient lay
dying. Sometimes it seems as if health service administrative
policies rely on, even exploit, the staff's denial of
its own vulnerability. I maintain that burn-out is in
large part a result of long-standing neglect of vulnerability.
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- What do you do that you don't really want to do?
- What don't you do that you really wish you could do?
- When did you last do something you didn't really want
to do, just to keep the peace?
- When did you last quit doing something you really liked
doing because you wanted to satisfy someone else.
- When have you forced yourself to go beyond your physical
limits: by continuing to work long after you were already
exhausted; by skipping meals; by forgetting to take a break
even though you needed one; by sitting for hours at your
desk without changing positions; by not getting enough sleep?
- When have you neglected your own feelings while you: made
love; were in pain; felt discomfort; felt afraid; felt shy;
felt overwhelmed?
- Must you always do something; are you unable to simply
be with a suffering person because you need distractions
from how emotionally stirred up that makes you feel?
All these behaviors are ways to put a lock on one’s armor,
not to embrace vulnerability.
***
At this point, I'll take what may seem like a leap from the
personal to the geopolitical and speak about Bosnia, because
it is there that I learned just how dangerous it can get when
vulnerability is disowned. I'll be using Bosnia as an example,
but such dynamics are repeated the world over. Even now,
six years after "peace," after the Dayton Accord,
the wounds are deep in Bosnia-Herzegovina - in the landscape,
the buildings, the human beings. As a therapist, I'd seen individual
pain up close, but never before had I been immersed in and surrounded
by an entire region trembling with the after-effects of mass
destruction, war and evil. All I could do was howl the existential
question: How can people do this to each other? Though the
great puzzle of evil remains unsolved, the concept of the ‘dream
of invulnerability’ does help put some pieces into place.
As I see it, every form of fundamentalism – be the fanaticism
Christian, Jewish or Muslim, Nazi, Fascist or Communist, or
just in the name of ‘patriotism’ – provides an
illusory security. Rather than experiencing how we hate and
fear our own vulnerability, we try to get rid of the shame we
feel regarding what we define as weakness by dividing the world
into the good and the evil, the strong and the weak, the righteous
and the infidels; then we place ourselves, ’securely,’
among the good/strong/righteous. Because the disowning of vulnerability
makes empathy impossible, we’re now free to treat the evil/weak/infidels
as totally unlike us, as hardly human. From there, and with
’God on our side,’ it is but a short step to attacking
these ’monsters,’ using violence. Obviously, these
’Others’ feel righteous in avenging our attacks. The
cycle of violence has begun. Thus, it is precisely what we do
to protect ourselves, search for invulnerability, that becomes
the source of our own destruction. To see how such denial
of vulnerability makes us easy prey for all kinds of fundamentalists
and speculative tyrants, just look with what slick ease Slobodan
Milosevic played upon such self-aggrandizing, other-hating chords
within the Serb culture and in otherwise good Serb people.
Sadly, it is true that all sides in the Bosnia war committed
atrocities. All the victims on all three sides deserve our empathy
just as all the war criminals on all three sides deserve to
be brought to justice before the Tribunal. But it is indisputable
that the Serbs committed the most crimes, and that only the
Serbs had rape and genocide as their systematic, strategic policy.
As Branimir Anzulovic writes in his book, Heavenly Serbia: From
Myth to Genocide, "…the primary driving force leading
to genocide is not the pathology of the individuals organizing
and committing the genocide, but the pathology of the ideas
guiding them. These ideas are often produced and propagated
by relatively normal people who may be unaware of the consequences
of their escape from reality into myth." (p.4) Many of
the myths which permeate the Serb culture and religion, Branimir
writes, carry utopian promises of a perfect society which can
only be achieved though by the extermination of those groups
accused with obstructing that society's emergence. Also
relevant to the Serb culture are the theories of psychoanalyst
Alice Millers, from her book For Your Own Good: Hidden Cruelty
in Child-rearing and the Roots of Violence. She traces German
susceptibility to systematic cruelty to authoritarian parenting
practices in which children are beaten, berated, ridiculed and
shamed. In other words, their vulnerability is violated. That's
more than enough to create vengeful adults, "willing executioners"
as author Daniel Goldhagen called them. A new handbook about
more humane methods to raise and teach children has been gratefully
received in the Balkans; apparently, the longing for a kinder
society is quite strong.
***
To our surprise, Dr. Allen and I came upon a model for what
the citizens of warring societies need to learn if they are
to achieve peace when we visited the UN International War Crimes
Tribunal for the former Yugoslavia in The Hague. There, we interviewed
the people responsible for protecting witnesses both for the
prosecution and for the defense of accused war criminals. We
asked some of the Witness Protection employees how they managed
to treat all witnesses fairly and with respect, even those who
most likely were mass-murderers and rapists. They described
a process of acknowledgment of their own personal vulnerability
- the opposite of denying it. Once they allowed themselves to
bear the pain of their own horror, anger and revulsion, they
were free to set their belief in human rights and justice above
their impulses toward vengeance. Had they not admitted to themselves
their darker feelings, those might well have got the upper hand.
That is: they could control their feelings because they dared
to feel them. 'People who are clear about their own vulnerability,'
Stålsett and his colleagues write, 'will more often pursue
cooperation than confrontation and conflict. This simple observation
is also valid on an international level…History is full
of examples, of the fact that the idea that a person, nation,
region or "civilization" can be secured against any
and every form of vulnerability actually leads to an escalation
of conflicts and brutality in human relations.' (p.36 &
14) One would hope that all the governments preparing to avenge
terrorism might keep that fact in mind.
***
Our journeys through Bosnia-Herzegovina shook my soul, but opened
my eyes. Beverly Allen and I interviewed people from all three
warring groups, in all sorts of life situations and from a variety
of social classes. Two particular interviews, one immediately
after the other, made a deep impression on us and are a lesson
in the importance of vulnerability. The first was with a
Muslim peasant who had been gang-raped during the war by her
Serb neighbors while her ten-year old son was forced to watch.
She is married to a man who himself survived merciless torture.
When we asked the woman about feelings of vengeance, she said,
sadly and soberly, that she hoped those who committed the crimes
would be brought to trial. She did not, however, blame all Serbs.
All the while, as she recounted the details of her torment this
woman stroked the wispy, dark hair of her 3-year old daughter
who was resting on her lap, caressing the child slowly and tenderly.
The contrast between the images of atrocities her words created
and the sight of her loving gestures was almost unbearable.
How did that one body of hers contain, simultaneously, those
two realities? This is precisely what not splitting looks like.
Our next interview was with an educated Bosnian Serb woman in
Banja Luka, the 'ethnically cleansed' capital city of the Republika
Srbske. This woman survived the war without significant loss
or injury. As opposed to most of the other woman we interviewed,
this one spoke with bitter hatred about Muslims. And about U.N.
soldiers who had arrested indicted Serb war criminals while
their children watched – which this woman, with a total
lack of perspective, considered a most horrifying abuse. This
interview was also hard to bear, but now because the woman was
so closed, so clenched-hearted in her denial of the crimes committed
in her peoples' name. For which of these two women is the
prognosis for living out a more-or-less normal capacity for
love best? My guess, ironically, it that it's the victim. She
seems to be in the midst of a healing process while the other
woman seems to be in a frozen avoidance of one.
***
Some say that we must be careful not to ascribe a collective
guilt to all citizens in a war-mongering dictatorship. Enver
Djuliman of the Norwegian Helsinki Committee responds to that
question in his article, "The Difficult Reconciliation."
'Citizens bear responsibility for what a dictator does since
no dictatorship can be maintained without the tacit agreement
of the people. It is also the case that the people have re-elected
the very regimes that have committed the worst offenses, and
done so several times. Does personal responsibility stop there?
Or are people also responsible for the kind of prevailing
atmosphere in a society which is required for the establishment
of criminal regimes.' [italics mine] (p.7)
This brings the topic home. For now it becomes clear just
what a radical force the work of all caretakers and therapists
may be. Of course, leaders always bear more responsibility
than do those they lead. However: The way we live our personal
lives has repercussions on our world. When we embrace and
respect both strength and vulnerability, that of our patients'
as well as our own, we impact on society's "prevailing
atmosphere" such that we contribute to the prevention
of "the establishment of criminal regimes."
Dr. Nigel Sykes of the St. Christopher's Hospital in Britain
said that people perform a public health function by engaging
in a family's experience of death. They help shape not only
the relationship of that family to death and dying, but that
of the entire culture, and of generations to come. So
it is with the honoring both vulnerability and strength: we
each help to vaccinate society against intolerance, hatred
and war when we bear to be present with a suffering person,
in strength and in softness, listening and feeling. May peace
begin here.
Allen,
Beverly. Rape Warfare: The Hidden Genocide in Bosnia-Herzegovina
and Croatia. Univ. of Minnesota Press, 1996
Anzulovic, Branimir. Heavenly Serbia: From Myth to Genocide.
Hurst & Co., London, 1999
Djuliman, Enver. "The Difficult Reconciliation"
title article of anthology: The Difficult Reconciliation,
Enver Djuliman, ed. The Norwegian Helsinki Committee,
2001.
Goldhagen, Daniel Jonah. "Hitler's Willing Executioners:
Ordinary Germans and the Holocaust." Abacus/Little,
Brown & Company, U.K., 1997
K.I.S.P. (The Committee for International Questions
of the Interchurch Council for the Norwegian Church,
Sturla Stålsett, leader). Vulnerability and Security:
Current Geopolitical Security Challenges from an Ethical
and Theological Perspective. Den Norske Kirken, 2000.
Miller, Alice. For Your Own Good: Hidden Cruelty in
Child-rearing and the Roots of Violence. Virago Press/Little,
Brown & Company, U.K., 1987.
Scarry, Elaine. The Body in Pain. Oxford University
Press, New York, 1985.
Senstad, Susan Schwartz. Music for the Third Ear. New
York: Picador/St. Martin's Press, 2001. Other editions
and translations: London: Anchor Books/Doubleday, 2000.
Muziek voor het derde oor, Amsterdam: Arena, 2000. Musikk
for det tredje øre, Oslo: Pax forlag, 2000. Das
Nullkind, Munich: Deutscher Taschenbuch Verlag, 2002.
Stone, Hal, Ph.D. and Sidra, Ph.D. Partnering: A New
Kind of Relationship. New World Library, Novato California,
2000.
On 9/11/2002, Drs. Hal and Sidra Stone sent this article
out via email before Susan Schwartz Senstad had a chance
to update the references information about the various
translations of the novel she's written. This is to
let people know that those whose mother tongue is Dutch,
German or Norwegian or those English language readers
outside the U.S. and Canada can also get the novel in
their own countries and language, as follows:
In English in Europe, Australia, etc. - in all countries
besides U.S. and Canada:
Music for the Third Ear. London: Anchor Books/Doubleday,
2000, or in paperback, Black Swan/Doubleday, 2001.
In Dutch:
Muziek voor het derde oor, Amsterdam: Arena, 2000.
In Norwegian:
Musikk for det tredje øre, Oslo: Pax forlag,
2000.
In German:
Das Nullkind, Munich: Deutscher Taschenbuch Verlag,
2002.
And, in the U.S. and Canada:
Music for the Third Ear, New York: Picador/St. Martin's
Press, 2001.
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