Living With Uncertainty

October 29, 2012


Balancing belief and certainty.

Earlier this year my friend Janice died of cancer after a long struggle with the disease. She had fought hard because she had been terrified of the uncertainty that lay beyond death. Her uncertainly included not knowing what would become of her young sons after her death. Though she was a deeply spiritual woman, when the crunch came she could not be sure of her beliefs. It was that lack of certainty which compelled her to chase one experimental treatment after another. With the certainty of hindsight it is very easy for us to say she could have better used that precious time and fragile energy on her sons.

But uncertainty does not have the luxury of hindsight. It is experienced in the here and now.  It is the very background of our lives. We are born into uncertainty (at birth we have no clue whom to trust and what is going to happen), we die in uncertainty (few know what it is to die and what happens after, if anything), and we live our lives with uncertainty ( anything can be taken from us at any moment). Uncertainty makes us vulnerable, naked, and weak. And so we replace uncertainty with the certainty of belief. We imagine we have solved the niggling issue of uncertainty.

But have we really? Is not belief a poor substitute for knowledge? Belief is not certainty. In everyday speech we say things like: “I believe the time is 9 o’clock.” The word ‘belief’ here implies that we are not sure of our facts (it might be 9:05 or 8:55). Or we might qualify a strong opinion by saying, “Believe me, I know what kind of man he is.”  Belief is an opinion where there is room for doubt.

But here’s the catch-22: in order to replace uncertainty with belief, we must suspend all doubt, or it will not work. It is something like when we sit down for a movie (such as James Bond or some Sci-fi) where we voluntarily suspend disbelief, we choose to ‘buy into’ this implausible scenario as though it could actually happen, otherwise we cannot enjoy the movie. When a soldier says “I believe in my country,” he cannot mean uncertain knowledge. His belief needs to simulate certainty, his conviction cannot be wishy-washy. It needs to be so firm that he can risk his life for his belief. When a man undertakes a belief to achieve the impossible he cannot make room for doubt, otherwise he will fail. I know that I made my difficult recovery because I willed myself to believe in my own ability, as well that of a higher power (higher than the medical profession). I had to shun all doubts, otherwise it would not have worked. In other words, belief requires acting as though what you believe is the exactly that way, with full certainty.

This creates a further problem. If you accept a belief as certainty, you close the door to knowledge. Certainty of belief makes you inflexible, intolerant, ignorant. When new data is presented, when old realities give way to the new, our certainty of belief will make us unreceptive to change, to new knowledge. When you shun doubt, you also stop questioning and challenging. When you cannot embrace new ideas, new realities, new evidence, it makes you more uncertain. Early Pilgrims in America firmly believed women with abilities might be witches. Their stubborn faith shut out alternative ideas. So their uncertainty made them burn the accused women.
Science, that debunker of beliefs is itself riddled with uncertainty. Einstein’s Theory of Relatively was once a belief accepted as reality by physicists. Today they say Einstein was wrong, they now believe in The String Theory.  Much of science is conjecture, but science is open to revising its beliefs in the light of new data. Science does not demand that belief replace certainty in the same way that life does.

For us puny humans struggling through life, uncertainty is at every corner. We can’t know everything, we are not omniscient. We are left with belief, with its terrible price of inflexibility, as the only solace from uncertainty. So the question becomes, is it possible to live with uncertainty without resorting to doubtless belief?

I believe it is possible but not easy to achieve the right balance. I accept uncertainty as an inescapable part of living, and, if at times I need a little shelter, I use belief in the same way that scientists do. I act on my belief as though it is the absolute truth– for now, until I come across other data which challenges it.

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Red Flags Of A Manipulator

October 22, 2012


Like a puppet on a string

Manipulators exist everywhere. Not all are obvious grifters and hustlers, some are co-workers, acquaintances, clients, even family. And that is precisely the problem: they appear benign, but slowly and steadily they seize control. Just as bullies stake out victims, so do manipulators, though not always consciously. Our one defense is to remain vigilant of red flags. Whenever I encounter more than one of these within the same person, I know to keep a distance.

Effusive Flattery: Manipulators are charm personified–but only when they need you. I once had  a patient repeatedly tell me that all of the nurses were dumb and lacking in common sense. But me, I was the one exception. I fell for it at first, but soon clued in to what his game was. Then he did not hesitate to slag me off also.

Promise of Rewards: They’ll promise you the world, but always vaguely and in the future. Though the favors they need are here and now. Michael, a hairdresser friend of mine used to specialize in elderly women clients, some of whom were widows who had mobility issues. One of his ‘old dears’  promised him she would leave him a tidy sum of money in her will (because she had no one to leave it to) if only he were kind enough to do home visits, and of course not charge her for the shampoo and set. Michael soon discovered that she had made the exact same promise to her house cleaner, the gardener, the grocer and who knows who else. Naturally, when the old dear did finally die, her estate went to charities. All those small business people who had extended their generosity received a big fat nothing.

A variation of this is the threat of being disinherit by a grandparent (if you marry the wrong person).

Divide and Control: The British built an empire with this technique, and it happens at the office also. One such manipulator was hired as my co-worker. He soon confided  to me that his wife was dying of cancer. Oh and, please don’t tell anyone else, because I trust you but not them. I felt burdened by his deeply personal secret. I extended favors to him out of obligation. What I did not know was that he had confided the same ‘secret’ to a few others within the organization. By drawing us individually  into his curtain of secrecy, he effectively created a divide among the rest of us. The others were also feeling obligated to do him favors.

Milking Pathos: They are expert at using guilt to make you run after them. Financial hardships, extreme ill-health, a family tragedy, all are exaggerated for effect (passive-aggressive). Bob routinely calls our house, breathless and panicked: Help, I’m dying.  Last week he was dying because of a malfunctioning DVD player. We have learned not take his cries seriously anymore. He is The Boy Who Cried Wolf. I wonder what will happen when he does have that fatal health crises, will his friends just assume it is another cry for attention?

Emotional Blackmail: This is more sinister. If you do confide some deeply intimate secret of your own to a manipulator, he or she will not hesitate in using it against you. Make no mistake, manipulators are utterly selfish. And thoroughly shameless. They don’t care if you get hurt, just as long as they get what they need.

Win or Lose: Just like card-sharks manipulators are excellent at concealing. And they have the patience to call your bluff, should you try to resist. Stan went for a meal with his long-time friend, Cathy, a seasoned manipulator. Stan was fed-up of always picking up the tab. He decided to ignore the check when it was placed on the table. His defiance did not go unnoticed. Though the annoyed waiter kept on hovering, Cathy went on chatting for an hour after the check was presented. Finally Stan caved in to the waiter’s glares and paid up. Cathy knew he would, for manipulators it is all about control. For manipulators it is a game of win or lose. They do not believe in win-win.

Non-listener: A subtler signal of a manipulator is that during conversation you can’t a word in edgeways. It is all about him. If you do manage to interject something from your life into the conversation, it flies by without response. Such one-sided conversations are harbingers of wholly one-sided relationships. Keep away.

Possessiveness: Manipulators see you as their property and hence expect you be at their beck and call. If you make a vague excuse why you cannot help them, they get indignant and demand to know what is so urgent that you have to leave them. They are resentful of other people in your life. Because I am soft-spoken and empathic, I am sometimes mistaken for a chump by manipulators. Particularly in my volunteer work, where my role is that of carer and giver, hence just tailor-made for a one sided relationship–NOT.

I am ever vigilant for these red flags, though I refuse to give up on being kind.

This list is by no means exhaustive. Please do share any other tactics that have been used against you.

Is Self-care Selfish?

October 15, 2012


Self-absorbed or self-sustaining? Metamorphosis by Salavdor Dali

Navel-gazer! Self-absorbed! Selfish! Harsh names sometimes given to those us devoted to self-care. We meditate, we introspect, we dissect our daily lives. We  fuss over what to eat and what to avoid, we are disciplined about exercise. Heck, we are disciplined about discipline. So is the criticism fair? Are we just glorified narcissists?

The question startled me when it was posed to me by Mary, a young woman whom I have known for many years. I had observed her during her turbulent adolescent years but now she has managed to find her grove by helping others. Initially her question knocked me sideways and then it made me look at myself critically (but of course).

I think people misunderstand self-care because they confuse it with self-indulgence. Wanting the best for yourself does not mean over-indulgence. Starlets such as Lindsay Lohan are examples of over-indulgence that is detrimental to self-care.

In my own volunteer work I come across any number of less famous persons who do not take care of themselves: substance abusers, gamblers, the socially challenged. Such people end up requiring a great deal of assistance from strangers and institutions. At homeless shelters, at hospitals, at welfare offices, and of course the prison system. Let me hasten to add that I am not a Republican nor a Conservative. I do believe in a compassionate society. I accept that people have greater and lesser capabilities. Some of the people needing assistance did not chose to be in that circumstance. That said, I wonder how many of them would have been better positioned to cope with adversity had they acquired the skills of self-care during better times?

I grew up in family where we had little money to go around. Which meant we learned early on how to manage finances, how to prioritize expenses, when to be thrifty. Skills which are paying off to this day. There was no ‘helicopter parenting’ in those days. We were left to independently discover the skills for better living. And I am grateful for that. Coddled children  seem to grow up under-equipped for the stress of adult life. We had no Papa Walton to sort out our problems, and June Cleaver was not there to mend our clothes and pack our school lunches. If we needed clean clothes, we figured out how to do laundry. You want to eat? then better learn to cook. If you want nutritious meals, then read up on what is good for you and which is harmful. Sure, we made some errors along the way (even a few massive ones), but we acquired the skills of independence, self-reliance and self-care.

Of course none can go it totally alone. Self-care does not preclude seeking out external assistance when required. But it does involve liking yourself enough to want the best for yourself–the best health, the greatest happiness, the least stress. It requires self-respect.

One of my patients, Marty, jokes about swallowing a fistful of pills, thereby ending his predicament (he has had a leg amputated and is due for several more surgeries). I do not believe his threat is sincere because he puts in so much graft in getting better. He soaks up advice, he follows his medication regime, he is diligent with his physiotherapy. As he lays in his hospital bed he sometimes gets frustrated by the enormity of the recovery ahead of him, hence he speaks of overdosing on pills. But lying in that same hospital bed he also plans the changes he is going to make in his life when he returns to his apartment. After years of self-neglect, he has discovered self-care and therefore I do not believe he is serious about suicide. The two things are contradictory. He said that thanks to me he now has self-respect. People with self-respect do not self-harm, we have others skills at our disposal for mitigating our suffering. We have had ample practice.

Whenever you take an air flight, there is the mandatory safety instructions before take-off. Interesting that we need to be reminded that in the event of an emergency “to secure your own oxygen mask first before assisting your children and family members.” Self-care feels counter-intuitive. But rationally it makes sense. You can be of no use to little Johnny and baby Jessica if you are gasping for air yourself. The same applies in daily life. How can you help people around you if you yourself are struggling? You need to have credibility before others respect your advice. I very much doubt that I would have inspired self-respect in Marty had I  not had it myself.

Which brings me back to Mary. She got so caught up in helping so many others that she burnt out. She was hospitalized from exhaustion, both physical and emotional. Her family had to intervene to get her back to functioning. So to answer her question, no Mary, self-care is the opposite of being selfish: if you don’t give yourself adequate attention, you become the  center of attention for others.


“Mummy says you are too uptight and that is why no man wants you.”

I cannot resist an open house. I love snooping for decorating ideas, and admiring clever architecture. My friend was not so keen. He pointed out that the agent will demand we leave him our names, our addresses, our e-mails and our telephone numbers. Watch out for incoming spam! He is right, it is now a common marketing ploy. “Yes, but no one said the contact details had to be accurate, ” I said. My friend was mortified. It deeply offended his sense of honesty. I did not want to enter into a debate  about the difference between honesty and appropriateness. It was neither the time nor the place. And isn’t that the crux of it?

As a writer I continuously think about appropriate words, the correct tone, the precise phrasing–and if it is fiction I am writing, the details around them are a pack of lies anyway. However, if I manage to get the context and reference of the lies right, then I might reveal fundamental truths about the human condition to the reader. Thanks to this training in daily life I am now more aware of what I say, to whom I say it to, and just much to reveal. And of course I give attention to the tone and phrasing. Because I now appreciate that being appropriate is much more than being accurate with the facts.

I am sometimes startled by patients at the hospital when they reveal too much confidential information to me, a stranger. One patient (who lives alone) confided that he has $5000 cash hidden in his apartment freezer. His address is on hospital records–if I were the dishonest sort! In his deep loneliness he confessed the facts with dangerous accuracy, but was oblivious to its inappropriateness. Appropriate dialogue, just like appropriate conversation, reveals only as much as the readers needs to know–no more, no less.

With the popularity of cellphones, more and more people are saying too much in the wrong place. I can never forget the young woman who entertained a crowded streetcar during  rush-hour one evening. I was sandwiched midway in the vehicle. She was at the back chatting loudly into her cellphone, in the midst of breaking up with her boyfriend. It seems the young woman had been unfaithful with his best friend. She was so caught up with her emotions that she was unaware that as she revealed these salacious tidbits, the rest of us on that streetcar fell silent. We did not want to miss one word. (It turned out she had slept with most of his soccer team.) She was being honest confessing to her boyfriend, but not in the appropriate place.

 Others get the place right but not the timing. A friend was rushed to hospital with kidney failure, her life hung in balance.  When she did come round, an inexperienced intern choose that moment to reveal to her that, by the way,  we found a cancerous tumor in your breast. Sure, the patient needed to be told this information at some point. But did it have to be now, when she was regaining consciousness? The intern was honest, but it was an appropriate time.

Then there are those who get the place and time right but the phrasing is inappropriate. I once had a cardiologist tell me that I would be dead in six months from a second heart attack. That was four years ago. In sharp contrast, another cardiologist said the same thing but he did it constructively. He advised me to start exercising, because if I did not improve my heart function, I was at a high risk of another heart attack, possibly a fatal one. Same information, but one was appropriately phrased, the other was merely honest.

We can get the time, place, phrasing right, but if overlook the tone of voice, we will be dishonest. Because the tone of voice is always truthful, it reveals the genuine mood and emotions of the speaker. I read a lot of amateur fiction and much it fails to engage the reader precisely because the writer has not grasped the significance of tone and mood. If this is true in fiction then it is doubly so in daily life. We may like to believe we are rational, practical people but the reality is we respond to emotions much more. This is why insincere apologies do not work: the words may be correct, but the resentful, angry tone of voice will betray the speaker’s true feelings. It is also why advertisements come across as insincere.

Nowadays so many people, from telemarketers to shopkeepers ask for inappropriate information. People of colour routinely complain about being asked that question: Where are you from? But here’s the irony, the only reason we find the question intrusive is because we feel obliged to answer honestly. It is not necessary. I say, first figure out the motive for the inquiry (why is this stranger asking me this question? What does he hope to gain from this information?) then answer appropriately (though not always accurately). If you ever travel to India this question gets outrageously magnified. Indians will shamelessly ask what caste you belong to, how much money you make, why you are unmarried. It was in India I realized that a ridiculously inappropriate question deserved only a ridiculously dishonest reply. It is a polite and humorous way to let them know that I am not playing their game.

In fiction writing, as in daily life, appropriate dialogue needs constant attention. This is because accuracy is a science, but honesty a fine art.


Once, for a short blissful time, you had your parents undivided affection. Or so you believed. Then perhaps  around aged three you realized that there were others who lay equal claim to your parents’ affections? Welcome to sibling rivalry.

Sociologists agree that how you negotiate sibling conflicts sets the template for all future relationships. Far beyond the first born and last born stereotypes, the very essence of our personality is shaped by how we interact with our siblings. The tools with which sisters resolve jealousies, or the rules of competition laid out by brothers predicts, I believe, how successful you will be as a spouses,  fathers, friends and co-workers.

One of my patients, Barbara, a woman in her eighties, demonstrated to me just how primary this sibling relationship is. She was very frail and I found her all alone, staring aimlessly at the hospital ceiling. I introduced myself as a hospital volunteer and we began to chat. Soon she opened up about her intense loneliness.  “My father is dead, my mother is dead, my daughter is dead. My husband is also dead.” And then she paused, sighed and her eyes welled-up. “And my sister has died.” She could no longer hold back her anguish at the memory of her dead sister. I thought it interesting that out of all her relationships, it was the loss of her sister that ignited the most grief. The sister had died some forty years ago.

When I thought about it deeper, it made perfect sense. Siblings do shape us rather fundamentally. They are our most enduring relationships. We may lose our parents to death, spouses may divorce, friends come and go, but love ’em or not, siblings are for keeps. They may at times be maddening, but the durability of the relationship forces us to discover skills to negotiate positive outcomes. And the ultimate prize for successful negotiation is parental approval. A craving so deeply ingrained, so primal that practically every religion refers to its deity as either Our Father, or the Universal Mother. In that vying for parental approval most of us discover our unique talents that sets us up for future careers and hobbies. And sometimes we go out of our way to avoid certain professions and interests simply because that was our sibling’s thing.

Of course much can go wrong with this competition for parental affection: one or both parent could die, or the rivalry could turn bitter and remain unresolved. Observe this for yourself: whenever you come across a person who is socially awkward, shy and isolated or has difficulty trusting other people, then inquire casually into his or her family history. I guarantee that there is an unresolved sibling conflict in his or her life. Closer to home, my older brother never learned to accept my right to my parents’ affection. Had he learned to do so, he would have, I believe, made a better father to his son.

I am reminded of Morley, another patient at the same hospital. He has had some serious medical complications of late but he has been a recluse most of his adult life. He has no friends, no family contact, not even acquaintances. When he had his aneurism, he was discovered bleeding by a concerned neighbor. It is as if all his life he has been replaying his sibling conflicts with everyone he is in contact with.  By his own admission his apartment is hoarder’s mess, much like his sibling relationships. Both he and his siblings remain profoundly committed to their childhood animosity.I know Morley suffers because of it, and I suspect so do the other siblings.

How do I tell this man that it is never too late. How can I express to him that it is my experience that by healing these primary relationships, he will learn to trust others again?  He, like many adult siblings, assumes that siblings are of the dead and buried past. What he forgets it that unresolved conflicts do not die, they lie festering and contaminating all in its vicinity. He is wrong to believe it is too late to make amends.

It is not even necessary that the siblings be present to heal the relationship. To simply understand the dynamics of the relationship, to go beyond blame and guilt, is beneficial enough. As soon as one acknowledges the impact of a dysfunctional sibling relationship, it begins to loosen its grip. Deep understanding and insights have the power to mend broken bonds, sometimes even beyond death.

The parents may be deceased, the sibling may be deceased, but by continuing to hone new skills in your sibling relationships, the very core of your personality evolves. If you put efforts into getting these few relationships right, it pays rich dividends with every other.

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