Shirah Vollmer MD

The Musings of Dr. Vollmer

Glee in Sorrow: How To Reconcile

Posted by Dr. Vollmer on December 4, 2013

 

Lonnie, sixty-one, diagnosed with terminal pancreatic cancer, tells Brady, seventy, female, since they have been friends for fifty years. Brady has an internal and an external reaction. Her external reaction, predictably, is one of concern, with offers to help in “any way” she can. Her internal reaction, though, troubles her. “I actually felt relieved that she got cancer and that I was still healthy,” Brady says with a sense of both guilt and glee. “It is as if you felt that there was one cancer ticket out there and she got it and so now you are in the clear,” I say, pointing out that our minds take us to interesting places and being mindful of where we go creates a depth to our awareness. The fear that a cancer diagnosis generates for all is palpable in Brady. Superficially one imagines that when a friend has a terminal disease, we rally to the cause with both concern and altruism, whereas, the complicated nature of “why not me,” creates another layer of feelings which can be both troubling and relieving. As narcissistic beings, all news is filtered through our own wishes and fears, and that layered over, our higher cognitive functioning kicks in, allowing us to be more giving and understanding of the other. The more Brady can understand what Lonnie’s diagnosis means to her (Brady), the more open she can be to understanding what the diagnosis means to Lonnie. As with all troubling news, the person grapples with how to integrate it into the mental space, and the more difficult the experience, the more likely that guilt and/or  fear are going to dominate the mental landscape. For Lonnie, Brady tells me, has handled her diagnosis matter-of-factly, suggesting that she has not started the emotional journey of dying. For Brady, her guilt at feeling she missed the bullet, troubles her, and causes her superego to scream that she is a bad and unworthy person. At the same time, she is fearful that Lonnie will get wind of Brady’s relief that it is not her (Brady), and so she unconsciously keeps her distance from Lonnie. She tells Lonnie that “she is coming down with something so she better stay away,” leading me to wonder if this avoidance is secondary to Brady’s discomfort with Brady’s internal world. Working with layers, Brady can come to see that all feelings are welcome, and as such, behavior is another story.

10 Responses to “Glee in Sorrow: How To Reconcile”

  1. Jon said

    Brady’s reaction to Lonnie’s sad news shows that she sees the world (or at least this part of it) as a zero sum game. You, Shirah, express that as “It is as if you felt that there was one cancer ticket out there and she got it and so now you are in the clear.” To me, this is a case where having a more sophisticated mental model of how the world works shows how an intellectual understanding can improve the emotional health of a person. Intellect and emotions are indeed separate, but they are intertwined. Is it not the case that understanding these interconnected ways of dealing with the world (“working with layers”) is part of the task of psychotherapy?

    • Yes. Brady is an intelligent lady, but as with all of us, under stress, in this case Lonnie’s diagnosis, her magical thinking became simplistic, and although she understands she could be stricken as well, for a few brief moments, she felt elation, and not sadness with this news and then we worked backwards to theorize that she did feel, at that moment, that life was a zero sum game. Our minds do many interesting things to avoid vulnerability, and assuming a zero sum game is one of them. Thanks, as always.

  2. In my experiences over the years with not only the many overwhelming medical situations I went through with my daughter but also her death at age 21, I found that with these kinds of stresses our more primitive wishes can dominate rational thinking at times. Our society’s social structure including many aspects of organized religion (again in my experience) creates a sense of shame and guilt rather than encouraging recognition and understanding of these irrational feelings and wishes. For this reason so many people unfortunately have little awareness of what they experience “beneath the surface” and continue to suffer from unconscious guilt…..having little chance or support to mentally work these things through.

    • Oh Eleanor, your response is so touching and I am sorry about your daughter. Yes, we are on the same page. Recognition of magical thinking far outweighs the burden of trying to not think about thinking. Thanks.

  3. Shelly said

    What an interesting concept, that Brady is internally happy that she “missed the bullet,” when her friend Lonnie shares that she has a deadly diagnosis. I realize that each person deals with disruptions and sorrows differently and I would be remiss to say that this emotion is at most selfish and horrifying. But Lonnie needs support and caring, not for Brady to pull away at this time. Could you not teach Brady, in this fictional account, to strengthen her external world a bit, and be there for her dying friend?

    • Hi Shelly,
      I do not think the issue is that Brady is not there for her dying friend, but rather the guilt that Brady feels over having a sudden internal experience of glee, in the face of such devastating news. Unraveling the nature of Brady’s reaction was our task so that she can be there for Lonnie in a way which feels authentic and caring. Embracing one’s reaction rather than fleeing is the key to a deeper sense of “being there”. Thanks.

  4. Ashana M said

    I think it makes sense to be grateful for our own health every second we have it, but it’s hard to maintain that kind of gratitude–it’s easy to take our immense privileges for granted. Sometimes the misfortunes of others remind us of how very much we have. Gratitude is not a bad thing. At the same time, it reminds us that we have what we have only because life isn’t fair. But life just isn’t.

    • Yes, but in particular, Brady experienced guilt with her glee, thereby subtracting from her gratitude, and giving her grief and fear about her reaction. She was taken aback by her response which put her in a mental state of confusion and pain, different than the pain of learning devastating health news about a friend. Thanks.

  5. Eleanor said

    This particular blog topic has really kept me thinking a lot about the whole idea of society’s condemnation of our “supposedly unacceptable” feelings and wishes involving others when under these kinds of stresses. We are all human and our abilities to cope only go so far and magical and irrational thinking can take hold for any number of reasons. As I mentioned earlier, negative value judgements from our social structure creates feelings of sinfulness and shame and guilt, adding to the sense of badness the person already feels. Speaking from my experiences I’ve found that so many folks are hesitant to look deeper in situations like this. However, only with insight and non judgemental understanding of our magical thinking can these feelings be understood and worked through. (Sorry for the rant 😉

    • Oh, no, please do not apologize for the rant, as I very much appreciate your perspective. Yes, “unacceptable feelings” falls prey to the harsh superego creating guilt and shame, leading to discomfort and anxiety. Healing the superego is our work, by changing the notion of “unacceptable feelings’ to “unpleasant feelings.” Thanks.

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