Married to Life

By Will Meecham, MD, MA • 1 min read

BW_Embrace-2When do we commit to life? And how?

We commit when we see our situation in context and when, seeing all the treasures and terrors life promises, we embrace the whole of it.

Easy to say, but gaining such clarity can be a challenge. For decades I resisted the simple act of acceptance, and for decades I endured needless torment. Part of me knew my own attitudes rooted me in my suffering, but it seemed impossible to change my patterns.

Looking back on those struggles from my current perspective, it’s not clear what made the difference. Why did I finally transform? Partly, it was the guidance of a wise counselor trained in Acceptance and Commitment Therapy (ACT). Partly, it took spiritual practice which, for me, meant dabbling in Buddhism, Vedanta, Yoga, Quakerism, Catholicism, Taoism, and so on. Simple aging also played a role. I gave up my youthful dreams, or at least the ones that demanded release, in favor of wiser, quieter intentions.

From my own experience and that of others, I’ve come to believe the decision to try suffices. If we choose to pursue health, even when we have only vague notions about what health truly means, we eventually find it. Resources appear (or we begin to notice them). Fellow seekers enter our lives (or we find them). We gradually blaze a path through the shadows and discover light.

So if the key is making a choice and committing to growth, perhaps we can find some guidance by looking at another type of commitment: marriage.

My wife and I have lived together for twenty-three years, and have been married eighteen. A man my age can’t claim this to be a particularly long time, but it’s enough for me to have learned something about the wedded state. Lately I’ve been looking at the ways committing to life and committing to a spouse seem similar.

In marriage, there are moments of bliss. The wedding day. The tender, intimate cuddling. The mind-blowing copulations. These ecstatic times serve to strengthen the bond between partners. They are analogous to peak moments, those times when we feel the grandeur of being alive. I think here of potent transcendent experiences, such as I recently experienced during a meditation retreat (read this piece for a description).

In marriage and in life, there are also milder flavors of bliss: the shared meals and quiet walks, or the lovely sunsets and the enthusiasm of dogs. These subtler highlights are more numerous and play an equal role in binding us to lovers and life itself.

Of course, there are hard times, too. Married couples disappoint one another, hurt one another, and sometimes even betray one another. Likewise, life serves up loss, illness, and ruin. Some marriages are more troubled than others. Some lives are more arduous, some less.

A partner can let us down by forgetting an important anniversary, by never looking up from the computer, by speaking cruelly, or by choosing the arms of another. There’s a spectrum of severity. Longstanding marriages survive not because lapses don’t occur, or even because the lapses remain small. They survive because of forgiveness and, most of all, because of commitment. Sure, divorce is an option. But if the partners honor their vows, they work things out. Even great wounds have been healed in this way.

Life disappoints us when we have to wait a long time at a red light while feeling rushed, when we lose the career to which we devoted our youth, when we contract a  painful, disabling illness, and when those closest to us die. All of us confront a range of adversity that spreads from mild irritation to devastating grief. Given this, how do we remain appreciative of life? By committing to the journey.

We can and do reject life. Some commit suicide, of course, but many more get lost in substance abuse, obsessive thought, empty entertainments, and sullen refusal to enjoy whatever blessings fate does provide. For instance, we might find ourselves in a town we don’t like, separated from the city we adored. Rather than noticing the peaceful beauty of the new location, we mourn the excitement of the old. We keep ourselves locked in regret, wishing things were different.

We criticize continually, when we could just as easily praise. We reject when we could embrace.

What keeps us trapped in misery? Go back to the marriage analogy. One can divorce, but one can also withdraw. A couple can live together and interact only in the most superficial or (worse) hurtful ways. Each withholds affection and admiration from the other. The marriage continues, but its heart withers.

Only when the couple learns to fully commit to the process of marriage does the relationship blossom to its full, miraculous extent. With total commitment, small annoyances seem humorous and big failures seem forgivable. We cease trying to change our partners and instead honor them for who they are. We see them as startling wholes, at once heroic and fallible.

We can do the same with life. A recurring theme in my writing has been how we do well to expand our perspective. We can see the hardship life inflicts alongside the pleasure it provides. We can see evil alongside good. Decay next to growth. Death balanced by birth. We admire the drama of evolution playing out over millions of years and the turmoil of human culture unfolding over thousands. We open to the big picture and we become less sure of our opinions. Are we really qualified to criticize this ancient, chaotic, self-correcting whole? We begin to wonder, in both senses of the word. We wonder if our judgments are reliable. We wonder at the complexity and beauty of this surging process we call a universe.

To commit to wonder is all it takes. To remain curious, appreciative, and open-minded is to remain married, whether to another person or an entire cosmos. The longer one engages in a committed fashion, the easier and more remarkable such marriage seems.

We don’t need to feel alone when we are married to life. We have a partner who will remain with us to our last moment, without fail. We can watch it with fascination and affection. We can embrace it with tenderness and care, and occasionally with passion and ecstasy.

What does this mean, in practice? It means tending the body, mind, heart, and soul. Not just our own aggregation of these properties, but that of our partner which, if our partner is life itself, means caring for the people and organisms all around us and the biosphere itself. We commit to doing our best to treat others and ourselves with gentleness when possible and firmness when necessary. We recognize that we will fail, as all fails, from time to time, but we commit to forgiving ourselves and everything else for not living up to our expectations. We begin to accept the world and all it contains as a startling whole. We no longer wish this universe were different; we admire what it is.

At which point, we realize life always knew best. As if reconciling with a spouse who made the right choice despite our vigorous objection, we admit that the cosmos was wiser all along.

Was that career really right for us? Did the old neighborhood provide the resources needed for personal growth? Do we really know what’s best? We begin to wonder. And in wonder, we find love.

And it all begins with a choice: the choice to commit wholeheartedly to living, come what may.

Forgiving the Unforgivable

By Will Meecham, MD, MA • 2 min read

UntitledThe weak can never forgive. Forgiveness is the attribute of the strong.
–Mahatma Ghandi

Forgiveness. Few topics evoke stronger responses from victims. Should we forgive? If so, why, when, and how?

These are complex questions, and this essay highlights but a few principles I gleaned from forgiving the adults who raised me. I suggest visiting The Forgiveness Project for more comprehensive guidance.

My mother cared for me from my birth until her death when I was six. She suffered from worsening depression during that period and finally took her own life. I remember her as occasionally playful and loving but often tearful and distant.

At first I resisted blaming her. How could I direct anger toward such a frail soul? But in young adulthood I started feeling bitter: her depression and suicide cast long shadows. Why didn’t she work out her difficulties and stick around to raise me? By my forties, after years of depression and suicide attempts of my own, I understood better. I’d experienced firsthand how despair deludes people into thinking suicide the only option. Feeling kinship with my mother made forgiveness easier.

My father had left the household when I was four, but took over my upbringing following my mom’s death. He was an alcoholic, and like most men of his generation did not express much affection, though he seemed to care about me. Unfortunately, he failed to protect me from mistreatment, despite ample evidence of its occurrence.

His alcoholism angered me, especially when I watched his drinking as a sober adult. I saw him belittle family and friends. I observed how alcohol enabled him to ignore problems, and it was clear he’d used it to wash away the signs of child abuse. But I still loved him, and to my regret I didn’t forgive him until after his death. Forgiveness only became possible when I woke up to how easy it is to screw up in adulthood. This lesson of middle age wasn’t available earlier on.

My stepmother, Della, was my most difficult forgiveness problem. She never wanted children and married my dad thinking his kids would stay far away. She harbored deep resentment about being forced to raise another woman’s offspring and took it out on my sister and me with calculated cruelty.

Desperate to keep her from hurting me, and because I needed mothering, as a child I tried hard to please Della. I became like a kidnap victim: cringing and subservient. I wanted to believe she loved me, so from the start I forgave the abuse.

But this was premature, based on childhood wishing, not mature resolution. Before I could legitimately forgive, I needed to consciously blame. Years of raging followed, starting in late adolescence. I confronted Della and my father and told everyone who would listen about her brutality. Predictably, this caused a rift in our family. Only after my anguish was spent could I return to the possibility of forgiveness.

Around this time I found out more about my stepmother’s own childhood. I’d known for years that Della had been severely abused by her uncle. But at my dad’s memorial service I learned that the uncle had been coerced into raising my stepmother (and three siblings) after her parents died. Encountering this startling parallel allowed me to place my stepmother’s actions in their larger historical context.

Appreciating the bigger picture is what makes forgiveness possible. Recognizing shared human frailties and the flow of toxicity through generations enables us to feel compassion toward those who abused or failed us. We don’t minimize or excuse wrongs, but we view them from a more healing, communal perspective.

Our reward is greater openness of heart: forgiveness leads to freedom.

© 2013, Will Meecham, MD

Note: The foregoing essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where all fourteen can be found (look in the News & Views section). The CPTW site was only started earlier this year and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I have posted seven essays of the series here. Today’s entry concludes the set.

Finding Pearls in the Muck of Trauma

By Will Meecham, MD, MA • 3 min read

800px-Revelation_SculptureThe wound is the place where the Light enters you. ― Rumi

A reliable means for transcending hardship is to endow it with meaning. Biblical faiths point to the will of a loving but mysterious God. Eastern traditions invoke karma, viewing misfortunes as correctives for misdeeds in past lives.  Such explanations have comforted millions over centuries.

We can also make peace with adversity more prosaically. Anyone who watches human progress knows that challenges often spur growth. Resilience converts problems into opportunities; setbacks may thus appear beneficial in retrospect.

When I lost my surgical career due to neck disease, my psyche shattered. I nearly killed myself and for a time lost my grip on ordinary reality. For almost ten years I felt crushed, isolated, anxious, and depressed. Early on, it would have been impossible to imagine feeling strengthened by the loss.

Yet here I am, writing with some surety about recovery from trauma. Absent the turmoil of that difficult decade, there might never have been impetus for me to battle my way to clarity. Prior to reversal, professional success had compensated for the vulnerability bequeathed by childhood adversity. Career loss triggered disintegration, which forced me to rebuild myself as a more mature person.

To find meaning requires enlarging one’s perspective. Psychiatrist Viktor Frankl’s masterwork, Man’s Search for Meaning, describes how concentration camp horror offered an opportunity to serve. The decisive moment came when Frankl bypassed a chance at escape in order to remain with his patients in the makeshift medical ward.  By expanding his circle of concern beyond the personal, he discovered meaning in an otherwise dreadful situation.

Gaining peace of mind after my collapse demanded that I acknowledge the pervasiveness of loss. Each year countless people lose jobs, health, homes, and loved ones. Seen in perspective, my meltdown appeared out of proportion to my circumstances. This prompted a deeper search. Soon I confronted coping mechanisms that hadn’t improved since adolescence, driven by self-centered attitudes and surrender to despair. It felt shocking to admit how much of my behavior was dictated by narcissism and emotional reactivity. I knew it was trauma that had retarded my development, but it was time to grow up.

Studies of post-traumatic growth highlight strategies that help people enlarge beyond victimhood to find new meaning and purpose. These include positive reframing, writing and discussion, social and therapeutic support, education, healing narratives, empowerment, and spiritual exploration. During my struggle to recover from adult hardship and childhood trauma, mentors encouraged me to try some of these tactics, and I stumbled upon others on my own.

My relationships with others improved as the lessons learned from breakdown helped reawaken my loving nature. My sister and I had not been close for many years, largely because I disapproved of her drinking. In 2010, just ten months before Janice died of liver disease, I looked at her choices anew. My feelings of anger and terror around alcoholism yielded to empathic understanding: drinking was the only comfort my sister trusted. I saw that although she was dying tragically, she had lived heroically. No matter what she endured, Janice always sounded upbeat and interested in others. It was just possible that alcohol enabled her sturdy optimism.

One of Don Miguel Ruiz’s Agreements is: “don’t take anything personally.” We can learn to support others instead of condemning behavior that makes us uncomfortable. For many years Janice’s drinking had felt like a personal affront, when in fact it had nothing to do with me. My sister’s final gift was this lesson in nonjudgmental, nonreactive affection. Like so many painful experiences, losing her cut deeply but also opened me to a more expansive understanding.

At their best, religions discourage myopic outlooks. If there’s a loving God, then there’s a bigger picture even if we can’t see it. And if our circumstances connect with countless prior lives, then excessive concern about temporal difficulties seems misplaced.

But meaning can be found simply by opening our eyes and hearts, which reveals how tragedy affects us all. We can make peace with suffering by helping others, by embracing their concerns as our own. Life isn’t personal; it’s collective. Accepting this truth is both a mandate and a blessing of maturity.

© 2013, Will Meecham, MD

Note: The foregoing essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where most of the pieces are already online. The CPTW site is new and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I am gradually posting portions of the series here.


Is Suicide Painless?

By Will Meecham, MD, MA • 2 min read

693px-Edouard_Manet_059-1A recent comment on an earlier post–The Shocking Truth of Suicide–sets me thinking. The reader’s thoughts are quoted below, followed by my response:

“Unfortunately, our society still doesn’t get it that suicide is a gift, it’s a balsam of peace, it’s a right, a human right exclusively. No other animal has the intelligence to say “rien ne va plus.” We can stop suffering all sort of circumstances that life forces us to live. Committing suicide in a psychotic episode is another thing, or while intoxicated. I am talking about the last resort, euthanasia. Too bad that people judge the different so harshly.

“It’s the religious bias: killing yourself is a sin. … Suicide is a precious gem, to be used only one time, if we must. It’s a gift from whoever gave us a big brain. No other creature can do it, and doing it to somebody else is murder. It’s a basis human right. Face it.”

These statements present a viewpoint opposite to our standard thinking, where we look at suicide as tragic. The author makes valid points. But there are some wrinkles to consider:

First, when a person commits suicide, they take permanent action against transient mental conditions. Every time I’ve neared suicide and managed to live past the impulse, I’ve been glad to still be alive. Grateful I was spared. This despite the fact that while in the depths I wanted nothing but death. So one reason to discourage suicide is that the urge usually passes, but death doesn’t.

And by the way, people who survive the jump from the Golden Gate Bridge often say that the moment they started falling, they knew they’d made a mistake.

Second, when a person kills him- or her- self, others suffer. The pain of losing a loved one to suicide differs from the pain of bereavement due to old age, illness, or accident. It feels like a judgment on the worth of the relationship. When my mother took her own life (I was six) it scarred me for life. It takes a long time to heal from a loved one’s suicide.

Third, usually only one part of the total self wants to die. If the entire self were on board with the concept, suicide wouldn’t be so difficult. The heart and lungs battle for life even as the ego tries to end it. The hallmark of a good suicide plan is that the act is committed without chance of reversal. A person jumps off a high bridge, pulls a trigger, or takes pills that sedate before the body starts to feel pain. It’s obvious the organism wants life even if the mind doesn’t. In that sense, suicide is indeed homicide. It’s a murder of a living, breathing body.

Fourth, a failed suicide attempt can lead to grievous injury. Back when I was a physician who operated on eyes and faces, I saw a number such cases. One man destroyed his entire face and both eyes with a shotgun, but the pellets missed his brain so he lived. No matter what problems he faced before his suicide attempt, he faced much worse problems afterward.

Most of these objections evaporate in the case of a person facing imminent death from terminal illness. The chance of recovery and an easier life no longer exists. The condition is not reversible. Loved ones will soon confront bereavement no matter what. The body will die anyway.

But except in cases of impending death from disease, attempting suicide seems like a tragic, destructive, dangerous act aimed at ending pain that’s likely transient. It’s not judgment that makes suicide prevention a good idea; it’s compassion.

And yet, I do understand suicide’s call. I’ve attempted it twice myself and contemplated it many times. Ending life can seem like the best choice. But the allure is a dangerous fraud perpetrated by a suffering ego that craves relieve regardless the cost to future, family, friends, body, and health.

It’s not suicide I judge harshly, it’s the lie that makes it seem like a good option.

With all that said, it’s worth keeping in mind the point of the post that prompted the comment quoted above: suicidality most often grows out of adverse childhood experience, out of early bereavement, abuse, chaos, and neglect. So there is an answer: heal the past to secure the future.

How Childhood Trauma Fuels Enlightenment

By Will Meecham, MD, MA • 2 min read

Katie_Walking_Labyrinth_2-1Blessed are the poor in spirit, for theirs is the kingdom of heaven.
–Mathew 5:3

Writing about childhood adversity, often a depressing topic, appeals to me because I know recovery is possible. What’s more, I believe those of us from traumatic backgrounds are well positioned to approach what spiritual disciplines call enlightenment (or realization, awakening, etc). This may sound surprising, but I’ve seen evidence for it in myself and others.

My younger years felt poisoned with dissatisfaction, rage, and confusion. Looking back, it’s clear I struggled with many of the difficulties known to stem from adverse home life. Here is my breakdown of the common problems, derived from multiple sources and framed by personal experience: poor self-concept, emotional reactivity, social unease, feelings of emptiness, problems with focus, and stress-induced bodily symptoms.

During the years of my recovery, each of these qualities changed from feeling wholly negative to seeming at least partially positive. Taken together, in their new form they help me appreciate life’s majesty even in the face of pain, loss, and illness. To feel privileged to be alive regardless of circumstance is, I suspect, near to realization. There is room for much greater maturity, but most of the time I feel contented and unafraid. What more does a person require?

Here’s how each affliction can be retooled to favor spiritual growth:

Poor self-concept can transform into secure humility. Whereas the well-adjusted person feels solidly established as a personality, we who were mistreated when young grew up feeling fragmented and hollow. Thus, even after we gain confidence, we remember our vulnerability. All wisdom traditions place a premium on humility, and the wounded enjoy a head start.

Emotional reactivity, properly harnessed, fosters attunement to others. What I once saw as excessive sensitivity I now recognize as the foundation of empathy.

Social unease comes from fear of embarrassment and betrayal. Scratch its surface and you’ll find a demand for acceptance and trustworthiness. Interpersonal anxiety can be reconfigured into a barometer for authenticity.

Feelings of emptiness sound bad, but consider that “emptiness” is also a catchword in Eastern meditative traditions. The connotations are different, but related. The emptiness we feel when discouraged is tainted by meaninglessness. Life appears beset by hazard and doomed to death. But if we discover beauty in life’s uncertainty and transience, then that same emptiness feels, paradoxically, full. This deep concept, best approached through meditation, tells us emptiness is the flipside of plenitude. Post-traumatic despair might be closer to post-recovery bliss than we normally think.

Problems with focus are problems of dissociation. While suffering abuse as a child, I would escape to an alternate mental world that felt distant and safe. Detaching when stressed has caused problems in adulthood, but the ability to alter consciousness offers a surprising benefit: it facilitates entry into the heightened states valued by spiritual seekers. In the extreme, shifts of consciousness can impair reality testing, so they shouldn’t be pursued without responsible preparation and guidance. But while remaining mindful and grounded, I’ve been blessed to experience transcendent awareness with greater than average ease.

Finally, the somatic symptoms that follow stress and trauma can serve as guides to bodily state. Attending to them has helped me better inhabit my body. Embodiment, in turn, promotes mindfulness and relaxation.

Humility, empathy, authenticity, plenitude, transcendence, and embodiment: not a bad starting point for enlightened growth. Every limiting quality can thus be reshaped into something advantageous. In future posts I plan to describe some strategies that enable these transformations.

The road to wellness presents challenges; in particular, emotions may feel overwhelming at the outset. I hope knowing trauma’s legacy can be reborn as spiritual maturity will embolden those just starting out.

© 2013, Will Meecham, MD

Note: The foregoing essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where most of the pieces are already online. The CPTW site is new and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I am gradually posting portions of the series here.

When Childhood Drives Us to Drink

By Will Meecham, MD, MA • 2 min read

529px-Johannessen_-_Trinkerfamilie_-_1916-1It’s hard to get enough of something that almost works.
–Vincent Felitti, MD

Adverse childhood experience (ACE) grows out of a family system. No member escapes unscathed. Thus it’s not surprising that my older sister, Janice, suffered trauma’s aftereffects along with me.

As a boy I admired Janice. Her concern for me softened the impact of hardship. Unfortunately, in adolescence she gravitated toward risky habits. She drank alcoholically and took so much LSD she suffered a psychotic break at age sixteen.

Despite the obvious downsides to her behavior, I emulated my sister. Janice moved into her own apartment when I was twelve, and soon after I began using marijuana and drinking when I visited her on weekends. By age fifteen I was smoking pot several times a day and drinking several times a week, a pattern that continued for the next decade.

After getting accepted to medical school I gave up pot, given its obvious incompatibility with clinical study. But eliminating marijuana abuse spurred escalation of my drinking. In response, I joined Alcoholics Anonymous (AA) just before starting my internship. That was back in 1987, and aside from a couple of brief relapses the following year, I’ve been sober since.

AA teaches one to admit vulnerability, correct errors, and foster spirituality. All these steps proved necessary, but I’ve never felt fully at home in the program. The premise of the twelve steps is that alcohol is the root problem. In my case, that just didn’t seem true.

Vincent Felitti (co-architect of the original ACE Study) explains: “the major factor underlying addiction is adverse childhood experiences that have not healed with time.” Although the ACE results weren’t available back in the eighties, I already knew that my upbringing had primed me for chemical dependency. Not only did all my family members drink and use drugs, and not only was I encouraged to participate at an early age, but I felt so fearful and insecure that intoxicants seemed vital. And it appeared obvious that my anxiety and low self-esteem grew directly out of childhood neglect, bereavement, and abuse.

AA helped me break free of addiction. Other twelve step programs, like Alanon and Adult Children of Alcoholics, showed me that many of my difficulties arose not from my own substance problems, but as adaptations to those of my family. I consulted therapists who helped me explore the conflicts in my home of origin and how they undermined my maturation. Often I was prescribed medications, which occasionally proved helpful.

These early programs and therapies moved me forward but dealt with peripheral symptoms, not the central problem. Although I knew intuitively that my difficulties could be chalked up to childhood hardship, my support system focused on discrete conditions like depression, anxiety, or addiction. Consider this alphabet soup, a partial list of my diagnoses: ADD, BAD, BPD, CD, GAD, PTSD. That no single ‘official’ syndrome fit my constellation of symptoms underscores the poverty of this approach.

More recently, clinicians have treated my symptom complex as the predictable result of developmental trauma. Yes, my moods fluctuate, and I’m prone to anxiety and dissociation. But tracing my afflictions back to a single source relieves much frustration. I feel understood for the first time ever.

Janice, I’m sorry to say, never found the help she needed. In 2011 she died of liver failure, the consequence of chronic alcoholism. From what we’ve seen above, the true cause of her premature death was formative trauma.

The ACE study demonstrated that early mortality increases with degree of childhood adversity. Let us be grateful that the study also raises awareness, so those of us who remain can find effective routes to physical and mental wellbeing.

© 2013, Will Meecham, MD

Note: The foregoing essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where most of the pieces are already online. The CPTW site is new and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I am gradually posting portions of the series here.

The Creative Response to Trauma

By Will Meecham, MD, MA • 2 min read


Suicide is, after all, the opposite of a poem.
–Anne Sexton

We’ve become accustomed to celebrities dying from self-destructive behavior. Media commentators often ascribe the tragic end of young, promising lives to the temptations of sudden fame and wealth. However, there may be a darker story behind such deaths. British researchers have documented a relationship between childhood adversity and the demise of music stars.

The romantic notion of the passionate, unstable artist captures popular imagination. For me as a young man drawn to poetry, Anne Sexton exemplified brilliant talent housed in an agonized soul. It’s easy to see why her lyric chronicles of mental torment spoke to me: Sexton suffered from depression and mood swings, attempted to assuage her pain through creativity, and ended her own life. She seemed a famous version of my mother, who lived and died along a similar trajectory.

Like Anne Sexton and my mother, I tried to ease despair through artistic outpouring. Although writing gave voice to my distress, it didn’t lighten my mood or prevent suicidal fantasies. Penning verse felt healing, but I required additional strategies to truly heal. Unfortunately, the mental health system of the twentieth century proved inadequate to my needs. Sexton, too, had found psychiatry impotent and poetry insufficient. Her work appealed to me not only through its expressive success, but also its salvational failure.

My despondency derived from a painful childhood. Growing up I endured my mother’s death, a preceding divorce, and subsequent abuse, all against the backdrop of frequent relocations and paternal alcoholism. Feeling unhappy seemed the inevitable consequence of a harrowing upbringing.

Beset by depression and reeling from such chaotic history, it felt natural to write introspective poetry, just like Anne Sexton. What never occurred to me was to inquire about the poet’s own childhood. Might she have endured trauma growing up? Might that have explained her mood instability and suicide?

It turns out Sexton came up in an alcoholic home amidst hostility and mental illness. There may have been abuse, though that remains controversial. It appears her psychiatric distress resulted, at least partly, from childhood adversity. Which means her powerful verse probably did as well, since in her case angst and poetry appear inseparable.

Recent studies have elucidated the long-term effects of early trauma. We now know that rates of depression and suicide attempts correlate strongly with degree of childhood adversity. Connections between creativity and mental illness have also been documented. Mozart and Van Gogh serve as potent examples of this association.

If childhood hardship leads to mental health problems, and if psychiatric disorders are common among artists, can we conclude that early trauma sometimes fuels creative drive? Possibly. The researchers who linked pop star deaths with adverse childhood experience speculate that in some cases artistic ambition gets sparked by painful upbringings.

Creativity benefits our culture but seldom rescues the artist from his or her despair. Fortunately, we have entered a period of burgeoning insight into trauma and its remedies. The knowledge arrived far too late to save Sexton and my mother, and too late for me to avoid critical losses. Still, I’m glad routes to recovery became available within my lifetime; like many others I’ve followed them to stable contentment.

We can now imagine the day when the wounded will excel in aesthetic innovation but also possess skills to dilute the corrosive effects of adverse experience. Artists will thus be freed to express painful legacies without succumbing to them. Using proven strategies, we can free artistry from tragedy.

© 2013, Will Meecham, MD


Note: The foregoing essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where most of the pieces are already online. The CPTW site is new and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I am gradually posting portions of the series here.


From Misery to Mission

By Will Meecham, MD, MA • 2 min read

Bundesarchiv_Bild_183-R38586,_Berlin,_Essen_für_bedürftige_KinderTo ease another’s heartache is to forget one’s own.
–Abraham Lincoln

Despite interests that included writing, ecology, and neurobiology, in my early twenties I decided to enter a helping profession. Given my history of adverse childhood experience (ACE), this choice was predictable. Those from traumatic backgrounds often favor helping careers. For instance, nursing students report greater ACE history than those in unrelated fields. For many, including myself, clinical work engages caretaking habits developed during chaotic childhoods.

Eventually, I acquired skill as a subspecialty surgeon. With that craft came recognition and reward. Raised with little love and support, it seems likely I sought validation by succeeding in a competitive field while serving others. Regardless of motivation, the work was of value, and assisting patients helped me feel better about myself.

Unfortunately, my surgical career ended early due to neck problems. I had learned to push myself beyond my limits, performing surgery for increasing hours despite harsh discomfort. Commuting home each night, my body rigid with pain and tension, I would notice myself clenching the wheel while holding my breath. I was working to heal my patients but neglecting my own wellbeing.

When searing pain began to undermine the quality of my procedures, and after doctors failed to offer a viable treatment, I saw no option but to abandon my career. The decision was reached impulsively and later regretted, but it probably was the right choice. Nowadays I know how to care for my body and psyche, but back then I lacked the tools.

Since my self-esteem rested on the pedestal of my profession, early retirement devastated my spirits. After some rounds of suicidal depression alternating with manic inflation, which culminated in two psychiatric hospitalizations, I began a long struggle with despair, panic, and self-loathing. The battle lasted nearly a decade, but I eventually recovered from the shock of career loss. More importantly, I gained release from the devastation wrought by my upbringing.

In my opinion, recovery from formative trauma requires recognition of both our wounds and the strengths that grow out of them. Of course, believing that early horrors can germinate into positive qualities seems to risk excusing mistreatment of children. We should avoid suggesting that all ordeals build character, but we are each free to conclude so for our individual traumas. Understanding how early hardship motivated me to serve helped me view my past in a more nuanced and healing way. Similarly, writing now about overcoming trauma lends meaning to my losses.

We all know examples of those who respond to misfortune with positive acts. Whether famous or obscure, wounded heroes excel as artists, family members, healers, activists, and reformers. Harnessing the energies of trauma enables many to benefit humanity. However, although sublimating pain helps lessen it, those burdened by significant adversity need to direct some of their concern internally. If committed passion flows outward but never in, there is a danger of depletion and burnout.

The world deserves saving, but so do those who strive to save it. Mistreated children learn to appease and protect guardians, often at the expense of stable identity and self-esteem. We begin to heal when we understand the desire to offer gifts as positive but recognize how it can undermine wellbeing if personal needs remain ignored.

Treating oneself well sounds easy, but those from troubled pasts know it to be challenging. Childhood misfortune makes it difficult to distinguish self-care from selfishness. Erratic swings between refusing comfort and indulging cravings are common. But insights from psychology, meditative traditions, and neuroscience offer hope. We can learn to soothe ourselves without yielding to addiction, and we can begin to help others without sacrificing our own mental and physical health.

© 2013, Will Meecham, MD, MA

Note: The foregoing essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where most of the pieces are already online. The CPTW site is new and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I am gradually posting portions of the series here.

Recovering from Childhood Adversity

By Will Meecham, MD, MA • 2 min read

Note: The following essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where most of the pieces are already online. The CPTW site is new and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I am going to post the series here.

Although the world is full of suffering, it is full also of the overcoming of it.
–Helen Keller


Did you or someone you know grow up in a dysfunctional home? I doubt anyone in America can honestly answer “no.” Childrearing occurs in households managed by two highly stressed parents (and often just one) with minimal outside support. Addictions and overwork are common, limiting quality and quantity of nurturance. Abuse is widespread but under-recognized. The culture frowns on open discussion of weaknesses and mistakes, so family toxicity accumulates amidst shame and secrecy. Traumatic upbringings result.

Of course, homes vary. Many parents maintain perspective and do a “good enough” job, so children grow up feeling loved and empowered. Other guardians, especially those freighted with shame, rage, and despair erupting from their own painful pasts, may cope less well. Misery translates into mistreatment, and the next generation enters adulthood with psychological frailties. Sometimes the traumatized decompensate early in life. Other times inner conflicts remain partially suppressed, only to overwhelm after major setbacks like divorce or job loss.

Healing from trauma is possible. The Center for Post-Trauma Wellness (CPTW) guides both lay and professional audiences toward effective remedies for the impact of trauma, with emphasis on whole person support for recovery. Writings on the site support trauma recovery through diverse means: news reports, personal accounts, professional analyses, training opportunities, etc.

My contributions will present the perspective of an informed layperson. I happen to be a (retired) physician, but I trained as a subspecialty surgeon, not a psychiatrist. And although I studied neuroscience in graduate school, sophisticated tools were not yet available for investigating trauma’s biological traces.

The most relevant background I bring to this project is a traumatic upbringing followed by arduous recovery in adulthood. In resolving the problems bequeathed by my past, I learned a lot about childhood adversity, mental health, and meditative practices. The effort paid off: I now feel more flexible and contented than could have been imagined in younger years.

My entries will examine trauma effects, treatment options, and research results through the lens of personal experience. The pieces will not describe day-to-day struggles but instead focus on past and current vulnerabilities, their likely mechanisms, and strategies that help me manage them.

The challenges I faced growing up inform my writing, but when possible I’ll avoid describing them in detail. Trauma appears to produce similar outcomes regardless of its precise nature. Most adults raised under painful circumstances suffer from some combination of poor self-concept, emotional reactivity, social unease, feelings of emptiness, problems sustaining or shifting focus, and stress-induced bodily symptoms. Anxiety, depression, stormy relationships, addictions, erratic job performance, and/or poor health often result . This cluster of difficulties, shared to some degree by most who survive adversity, draws us together in healing. My individual story is important only to the extent it illuminates common themes.

Yet details matter. For instance, sexual molestation leads predictably to turmoil around physical intimacy, whereas parental loss instills fear of abandonment. Even within a single category, like sexual abuse, we recognize distinctions. Someone whose parent gradually eroticized their relationship may have felt both confused and aroused, and is likely to have trouble setting healthy boundaries. On the other hand, someone who was forcibly raped by a visiting relative will tend toward panic and dissociation when approached by intimate partners.

In writing entries, I will strive for balance. The narrative will be kept general enough to apply to most trauma survivors, but with sufficient personal detail to maintain clarity and emotional appeal. Consider this a work in progress, open to comments and suggestions.

Trauma is a common problem that undermines both individual and collective wellbeing. Let’s solve it together.

© 2013, Will Meecham, MD

Letter from the Brink of Sanity

By Will Meecham, MD, MA • 4 min read

497px-Statue_of_Saint_Paul,_Damascus-1How to tell a story that has no beginning and no end? A tale that was ongoing before you were born and continues to this day?

Choose an episode that pressed your first footprints on some new path. Like the time you landed in a mental hospital. Not the first time, when you were bent on squeezing the life out of your sad, broken body, but the second. The time you saw God, or thought you did. Start there.

In the first hospital the fence around the roof-terrace garden rose four feet above your head. Like an inmate, you were led into this pen each day, where you felt the moist San Francisco breeze and the warmth of a sweet pale sun shining through chain link. It might have been pleasant, but you didn’t experience it that way. Demoralized, you were battling a long-checked rage, decades old, now turned against your own body in the desolate dark between thirty-minute bed checks. At night you wrapped your head in cellophane (your sister unknowingly smuggled it in to you) and jammed plastic down your throat, hoping to choke. Each time you reached for death the pain grew too intense, and you broke free to fall backward gasping, frustrated and ashamed. You sensed raving demons in your stark gray room; they loomed over your narrow bed, clinging with curved nails from the steel grate that saved you from jumping out the tenth story window.

No. Don’t mention that hospitalization. Talk about the next one.

Where to begin? How about in the emergency room a week after discharge from the suicide watch? Or earlier, when you were descending the stairs toward the kitchen. The air conditioning was running full-blast, even though it was only March. You were sweating, flushed, blood pressure climbing. Your wife was chilling the house to slow the rivulets flowing off your forehead, the wet patches soaking through your tee shirt, and your incessant pacing. She convinced you to lie down, but you jumped up within minutes. As you descended the stairs you knew. Or thought you knew. You became the chosen one, the prophet called to speak of science in spiritual terms. You saw a shaft of white light, a radiant knife rising up (or plunging down?) through a field of vision that had gone red and floated with stars. You must have been close to passing out; maybe you stood up too fast. But you saw that luminous, righteous blade and you were opened by it. You felt splayed before the truth: you had a destiny, and not the one you expected. You knew, or thought you knew, that glorious, shining column to be the body of God.

After a decade spent in medical and surgical training and seven years more, you had a profession. Maybe not a calling, but a good job: impressive, honorable, and lucrative. Yes, you had walked away from it, defeated by unbearable neck pain, but you hoped for another career just as promising, something to reestablish stature and reassure you of worth. You never thought of becoming a prophet until that moment on the stairs, but you saw later how the idea made sense to a broken psyche. What better way to prove yourself than to become God’s appointed one? The fact you thought this appointing sensible proves, to most people, that you were delusional. Grandiose is the technical term. And yet here you are, writing out loud about it. Admitting insanity, even if temporary. To what end?

Because that luminous blade and all that followed changed you forever. Vivid experience forced you to reappraise your education and your assumptions, until you had no choice but to reject the consensus moderns live by, to admit you don’t know anything for sure any more. Worse, you don’t even want to be sure. For you, faith has become a matter of loving curiosity, not surety, so you choose to live in peace with ambiguity rather than in hell with conviction. If it takes a measure of craziness to force change on a personality, you welcome it.

Your insanity was of a particular sort. You didn’t hear voices, at least not as if there was someone actually speaking to you. Your elevation to rank of ‘prophet’ was revealed through wordless gnosis, not by a disembodied messenger. But even absent commanding hallucinatory voices, whatever understanding you’ve gained sprouted (initially) out of the remnants of a shattered psyche. Out of an unsound mind working to break free of disaster.

But unsound isn’t the same as wrong. Consider what happened next. The red cloudiness had cleared by the time you reached the refrigerator. Before you could open the door a crimson spark caught your attention. It hovered two feet in front of your face and attracted you the way light draws in moths. As you stared at this tiny, potent presence, it exploded in a burst of blood-tinted light, replaying in a moment the full sweep of time, space, and matter. Your body, mind, and soul felt immersed in a replica of the Big Bang. Without questioning why or how you were granted the privilege, you witnessed creation arising from subatomic scales to fill the entire span of the modern universe in a sweeping vision that unfolded in a realm beyond normal sight. From quark to quasar scales the cosmos evolved as a single form before your mind’s eye. Awed, you inhaled an atmosphere of omnipresent love and rightness. Living energy animated and united all. A chorus of celestial voices sang, sounding both distant and near at hand, resonating with the pulse of manifestation. You felt flooded with bliss and basked in divine affection. Every lingering doubt about God was erased and you knew that life has meaning and the universe is filled with purpose. The power of these truths radiated outward and felt as warm and welcoming as an open hearth. At the same time, you understood your own usefulness to causes greater than you had ever dared imagine.

Can a moment outside normal time that reveals meaning and elegance beyond prior experience be considered an error? A mere paroxysm of diseased brain tissue? Or should it be taken seriously, accepted reverently like a gift from God? Might it, in fact, have been such a gift?

You don’t know the answer even now, more than a decade later. But you have made your choice to honor the experience, to learn from it, to use it as a beacon while building a new life and a new identity.

Maybe you could have discounted it. Maybe you could have dismissed it as nothing but manic psychosis or temporal lobe seizure, the way your doctors inclined, if so many other dramatic experiences hadn’t unfolded over the next forty-eight hours and, in less chaotic form, over the many years since.

In those early days a parade of visions, realizations, and interventions came your way, leaving you dazed but elated, broken but glad. Think back…


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