Ready To Fly











I am standing on the edge of the water,

And I am watching the wild birds fill the sky.

And I am longing to be lifted up among them,

I am not dying – I’m getting ready to fly.

Ready to Fly, by Calaveras*

*Check this song out on the link before you go on. No really – go listen. I’ll wait.

(Dum de dum de dum, la la la, I’m waiting for this amazing, perceptive reader to listen to the song and get back to me, because he/she knows I really meant it when I said “Listen to the song first”.)

Oh, you’re back, having listened to the song! Wow – you’re so amazing and perceptive. Oh, I already said that? Well, that’s okay – it never hurts to put some frosting on the cake!

Good – now that we’re on the same wavelength.

Today we’re going to talk about the deep, dark secret of Western civilization:

Life Ends

(Shhhh, don’t tell! Of course, we can talk about it here, albeit in whispers, because everything that happens on a therapy blog is confidential, right?)

So, yes it’s true – we actually do die at some point. If we last that long, we get old, then older, and then, yep, we up and die. Yes, ALL of us, sport! We don’t know when, we don’t know how: it’s like Russian roulette, but without Zero or Double Zero. Of course, we can “take care of ourselves” in the hopes that this will prolong our lives and provide ‘quality of life’ for endless years. Kind of like Robert Mitchum said in Out of the Past when his girlfriend was playing roulette and losing, big:

Mitchum: That isn’t the way to play it.

Girlfriend: Why not?

Mitchum: Because it isn’t the way to win.

Girlfriend: Is there a way to win?

Mitchum: Well, there’s a way to lose more slowly.

So yeah, sport, you can exercise, you can eat right, you can have so many air bags in your car it would take off if you had an accident. You can ingest vitamins and supplements and Echinacea and ayurvedic balms and homeopathic remedies. You can stand on your head, gobble brewer’s yeast, do puzzles to keep your brain sharp, meditate to achieve mindfulness, and guzzle goji berry juice, acai berry juice and phosphatidylserine elixir, but in the end, there’s still, well,  the end.

There are plenty of books about it, from Living Your Dying to the Stephen Levine books, to The Denial of Death (not for the faint of heart, that one) but all the reading in the world won’t change the fact that, in the final analysis, we’re all taking that long walk on that short plank, and there are no reprieves, last-minute pardons, or stays of execution for the likes of us.

So, all of us are busy interviewing old people all the time, to find out how to do it, to get tips on what aging is like, and to educate ourselves precisely on just what it is to have everyone you know gone, to have no one left who remembers you or your past, to feel all alone in the world, to hurt physically and lose it mentally, right? We just sit ’em down and pick their brains endlessly about adjusting to times they don’t understand, about not having what they know valued anymore, and about how to deal with the fact that everyone’s  younger than them – right?

What do you mean, No? You mean we’re NOT all studying and talking to old people all the time? Are you telling me we just barrel into old age — the hardest thing most of us will ever do – on a wing and a prayer?

What’s wrong with this picture? Can anyone explain this stuff to me?

Okay, let’s pretend you’re an average American young person and I’m teaching your anthropology class, thusly:


Me: You – you, sir, the one in the back with the shaved head and the nose ring.

Nose Ring: Well, old people are, like, you know – weird and creepy.

Me: What do you mean, weird and creepy?

N.R.: Well, they look kind of gross, and besides, they’re all totally out of it.

Me: Out of what?

N.R.: Look, they don’t know anything, man: music, movies, tech, anything that’s, you know, like, actually happening.

Me: Yes, but they had their version of all those things, right? I mean, they had their music, their movies, even their tech: they’ve been there.

N.R.: Been where?

Me: Life. They’ve been there. They could be a kind of, you know, GPS, to life, to aging, to survival, for the rest of us: pathfinders.

N.R.: That still doesn’t deal with the wrinkles, the sagging, all the stuff that’s gross and basically, you know, depressing.

Me: Why is it depressing? Because their faces are a road map of where we’re all heading?

N.R.: Hmm, maybe. Dude, I just don’t want to see or be around that shit, is all I know.

Me: (Looking at the whole group) Is this true? Does he speak for all of you?

Group: (Hanging heads, looking down, pawing the ground.)

Me: Do I take your silence to mean Yes?

Group: (Hanging heads, looking down, pawing the ground, muttering.)

Me: So, let’s review: For the biggest Final any of us is ever going to take, we are not going to study with the only people who could possibly teach us how to prepare for it, how to take it, how to do well on it, how to learn from it, or how to make it be the best it can be – is that what you’re telling me?

Group: (Shuffling of feet)  Woman in red head scarf raises her hand.

Me: Yes?

Red Scarf: Dr B – just because they’re old, that doesn’t mean they know anything.

Dude In Back: (Waving hand in air) Are we allowed to use our vape sticks in here?

Me: Is that what’s important? Really?

DIB: Totally.

Me: Are you using it to quit smoking?

DIB: Duh – yeah, dude. Well, you know, sorta.

Me: Well then, how about learning how to quit smoking, from a generation that smoked all the time?

DIB: Like Mad Men?

Me: Yeah, but for real, not some fake sissy American Spirit herbal cigarettes on a TV show.

DIB: That’s a thought. But they never vaped, dude.

Me: No – they had a little trick they used: it was called Cold Turkey. And if they could quit that way, and you can’t even quit with the fabulous vape stick, maybe they could teach you some things.

Red Scarf: Excuse me – I was trying to say something.

Me: Oh, I’m sorry – sometimes even the Therapy Blogger makes mistakes. Go on, Red.

RS: I was saying that just because they’re old, it doesn’t mean they know any more than we do.

Me: That’s true – they don’t, necessarily, but just because they’re old, they have at least a pretty good chance of knowing more than you do, wouldn’t you say? Think of it this way: wouldn’t you hope, and expect, that you’d know more at 75 than you do now, at 20-something? And if you were 75,  would you want all you’ve been through, all your knowledge, just discarded because you’re old? I mean, we now have laws about elder abuse, but do you notice no one ever talks about elder use?

RS: Well, what do they have to teach us? What it used to be like? What good’s that do us, now?

Me: You think life was just invented in the last twenty years?

DIB: (Waving hand in air) Excuse me – my vape stick won’t draw. Can I be excused to rewind my coil?

Me: I give up – class dismissed. Assignment for next week: five hundred words on what you would ask if you  put on a Hazmat suit, and actually talked to an old person, face-to-face.

DIB: I’m an artist – do I have to use words? Can I use, like, sketches and drawings and shit?

Me: Listen, Picasso, you can take that vape stick and stick it . . .

RS: Dr. B – please! Don’t forget, you’re the teacher!

Me: Oh, thank you, Red, it almost slipped my mind there for a moment. If a teacher falls in the woods and no one learns anything, is he still a teacher?

RS: Well, you’re trying to teach us to talk to old people, right? Well, you’re old and we’re talking to you, aren’t we?

Me: (Sigh) Didn’t I hear somebody say “Class Dismissed”?


Well, there you have it: we’re all on the bumpy road to Old Age, but nobody wants to do any personal research on it, like we would for any other form of endeavor. My god, if we buy a car, a dishwasher, or even a new set of tires, we do endless study on it, we talk to people, we read reviews and we obsess for weeks before making a decision. But you don’t see anyone knocking on the doors of retirement homes, or seeking informational interviews with the ‘inmates’. There are no unpaid internships with elders, there are no “Aging Gracefully” classes being offered at junior colleges, there are no bestsellers: How to Age Like You Like It, or The Years Are My Best Friend, or Doddering Your Way to Wisdom and Joy. We treat aging, and therefore death, like it was the plague, like even being around old people might be catching, like cooties. And yet we analyze, research, categorize, and poke our noses into everything else that goes on in life. Why not death?

Because we’re scared – and we’re not even subtle about it:

I don’t want to talk about it.

Call my attorney.

Senility? Forgetfulness? Loss of sight, hearing, balance, memory?
Don’t call us, we’ll (not) call you!

Sexual decline? Hair in your ears?  Shaky hands? Having to move out of your own house, to be “put in a home”, where you have the honor of living in sterile segregation from the rest of society – for your own good, of course?
Take a number – a high number.

Reminds me of Casey Stengel, the former manager of the New York Yankees, who, after many years of unparalleled success, and multiple World Series championships, was unceremoniously dumped by management, ostensibly for being too old. His response?

“I’ll never make the mistake of being 70 again.”

Our obsession with youth, our denial of aging, of death, our trying to thwart the years, to slather ourselves with potions to stay the hands of time – these things aren’t just minor societal quirks; they are a rejection of a part of ourselves, of something that all “flesh is heir to”, that should be a mark of dignity, an ‘honorable estate’. I’ve always thought (yes, even when I was a kid) that there is nothing more impressive than a man or woman who has come through the many years intact, who still finds good reason to get up every morning, who still believes in things, takes joy in things, finds things to appreciate, and at long last, has come to terms with, and maybe even found beauty in, our finitude, our limitations, and our imperfections.

This is something to be proud of, just as a couple who has been there for each other through the long seasons of life, for forty, fifty, sixty years – has something to be proud of, for the rest of us to honor, to learn from, to study, to revere. It’s easy to feel hopeful and full of yourself, to feel possibility is unlimited, to rub shoulders with immortality, at 25. But to feel hopeful at 80, to respect yourself, to look in the mirror and see the good, strong years reflected back – that is a big deal. To be an older couple who still loves one another, still laughs together, and cries together, and has found out what it really means to love another person deeply, 50 years after the crush is over – now, that is a big deal.

I mean, we’ve all memorized the Five Stages of Grief, right? What stages do we go through when we are confronted with something new, something hard, that we can’t deal with? : Denial, Anger, Bargaining, Depression, then Acceptance. Well, folks, as a society, as far as aging and death, we’re all, embarrassingly, still in kindergarten: Stage One – Denial. Like the old joke about bringing a knife to a gunfight: in the marathon of life, we’re trying to run the 100 yard dash. Then we’re shocked, shocked, when we get to the last third of the race and find ourselves exhausted and helpless: of course we are – we only trained for the 100! There are millions of older people out there who are at the Acceptance stage: why don’t we ask them how they got there?

But no – our idea of ‘researching’ the aging process is to ask some old guy,

“So what’s your secret?”

And what answer do we want back? Something that takes work, or maturity, or time? Hell no: we want to hear,

“Kale,” or “Raw honey,” or “Bee propolis.” Something easy and quick, that we can take, or swallow, or toss down without addressing anything more than two inches, or two years, in front of our own noses.

So, let us all take a vow to prepare ourselves for aging, rather than just clinging desperately to youth, to open our minds, just a little bit, to older people, to listen to them and not dismiss everything they have gone through, everything they have to offer. Let us try and envision what it would be to welcome old age, to pack away, carefully, all the memories and lessons of our youth, but to ALSO have respect and veneration for those things that it takes long years to anneal, to harden, to forge into something beautiful, but beautiful in a new way, not physically, but spiritually.

Let us all face our older lives with grace and dignity, so that, when it is our turn to go, we can smile and say,

I am not dying – I’m getting ready to fly.

















Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.

The Mystery of All Beginnings








It’s a wise child that knows its own father.

And furthermore, it’s a wise child indeed that really ‘knows’ its own father or mother. I was talking to an older patient the other day who is dealing with her own mother’s decline – making decisions about care facilities, sorting through the boxes and boxes that are all that is physically left of her mother’s life. It seems, and is, strange, that a whole life ultimately comes down to someone rummaging through boxes and saying “In” or “Out”, while a rented dumpster yawns outside. It’s enough to make you philosophical, if you’re an upbeat type, and downright sad if you have an unfortunate predilection for tragic sweep, as some of us do.

Anyway, as she picked, sorted and differentiated the formerly treasured detritus of her mother’s life, she found herself pondering just how well she really even knew her mother. And this got both of us to wondering how well our children know us.

I suppose everyone is now familiar with the term ‘transference’ – the mainstay of traditional psychotherapy. This means, in the Freudian interpretation of things, that the patient will transfer (i.e. project) onto the therapist elements of relationship (internalized transactions, views, issues, interactions, identities, images and ways) that the patient experienced with key figures from their past, usually parents. But what one begins to realize after years of doing therapy, is that this ‘transference’ is also in play in how people relate to their own parents, as well. That is, very often the child’s-eye-view of a parent is skewed, distorted, and colored strongly by a myriad of factors, among them the one-off peculiarities of that child’s relationship with the parent, the stage of life of the parent (and the parents’ marriage or other significant relationship) when the child was young, the specific issues that were going on at the time for the parent (that may or may not be characteristic of their life as a whole), and things the child literally does not know about the parent and his or her life.

This is one of the reasons why I often make it a point to meet the patient’s parents personally, if they are still alive. I sometimes hear things that astound me – no, not just “there are two sides to everything”, though that is certainly true – but things I could not have imagined. Things like this:

A mom who was bitterly described as “always distracted and preoccupied” by her grown daughter (my patient). The mother told me, in strict confidence,

Dr. B – I was battling cancer most of those years. I didn’t want to burden the kids by telling them about it, especially since I was a single parent. Oh sure, I guess I was preoccupied, but you have to understand I was all alone with my pain, and terrified about what would happen to the kids if I died. And please don’t tell her now, because after all, we made it through, so let’s just let sleeping dogs lie.

A father who was called “needy and over-involved” by his son, who confessed, tearfully,

I have to tell you the truth now. My wife, may she rest in peace, was having an affair with our minister for at least twenty years before the diabetes got her. I knew it all along, but she didn’t know I knew, and I never could confront her about it. Sure, I guess I did wrong by taking comfort in closeness with the kids, but she was gone a lot of the time, supposedly on ‘church business’, and I guess I covered up my hurt by throwing myself into being a dad. I know it sounds stupid, but I still loved that woman so much, I could never leave her. So, sure, I was a fool for staying, and I was over-involved with the kids, but sometimes, that’s life.

And often, parents say things that not only confirm what the patient has said, but confirm it in spades, such as this revelation by a woman in her fifties:

I know I should never have had a child. I had no business getting pregnant, and should have taken care of business when I did, but I was too scared to get an abortion, and I thought Joe would help out financially, but he disappeared right away. Honestly, it sounds horrible, but I resented every day I was saddled with that baby. I could have done something with my life, but instead I changed dirty diapers, did laundry and lived on hot dogs and beans. By the time the kid was gone, I was too old to train for doing anything worthwhile, so I got into a bad marriage, for financial security, which took even more years out of my life, and now, well, here I am.

Others are just as surprising – not so much in their words, but rather in their presence or personality. A man whom his son once described as “an overwhelming, towering presence” was in actuality a very slight, mousy man, with a barely audible voice. A woman who was said to be harsh and cold described, with obvious warm feelings, how much she had enjoyed baking brownies for her children’s friends.

Do I take all, or any, of this at face value? Of course not – but these things are all part of the ‘stew’ that makes up the complexity of any parent. Often, when meeting the parent, I will notice, with pleasure, things that are not on the ‘agenda’, such as how much the patient’s voice sounds like the parent’s, or certain small mannerisms of the parent that are echoed in the patient, or ways of saying things, expressions, attitudes, that have been inherited, or appropriated, by the child. Sometimes the parent will reveal hidden stories and motivations that are deep-background clues to ‘what happened’, such as the woman who told me she married the patient’s father on the rebound from her true love, or the accountant who told me that he was on his way to being a saxophonist with a top swing band, when his father died and he had to forget his dreams and get a job to support his mother and three brothers. These things matter, because children pick them up on an unconscious level, and often, knowing this information, you can see how these ‘undigested’ elements in the lives of the parents, play out in the lives, and choices, of the children.

Another thing that flavors this stew, is that families often operate on the level of mythology – aspects of the parents’ (and children’s) lives, and unquestioned ‘family values’ become distilled into a kind of handy (and oversimplified) shorthand:

You know Dad – he’s always happy-go-lucky.

Jimmy’s the brain, Johnny’s the athletic one, and Sally’s always been a dreamer.

Mom’s obsessed with cleaning – it’s all that matters to her.

Well, everyone knows the baby of the family is always spoiled rotten.

Mom and Dad never had a real argument in thirty-five years.

And on and on. While most of these things, like all stereotypes, have a basis in reality, we forget that they are merely short-cuts that ‘stand for’ the person, not the actual whole person. In therapy, we often spend a lot of time helping patients break out of these internalized family stereotypes of themselves, these iron maidens of the soul, and sometimes we help them confront their parents about having these simplistic, limiting views of them. But children do this to their parents, too.

I have often heard patients say that, for example at holiday get-togethers, when wine is drunk and old stories are told, they were shocked and surprised by the things they learned about their own parents.

Uncle Joe told me Dad used to be the one who approached the girls first, because he was the one with all the sex appeal.

My straight-arrow Dad used to sneak into baseball games at Candlestick Park.

Aunt Jane said Mom was a real hottie in her day.

I found out Dad used to be the middleweight boxing champ of the First Division.

And sometimes we glean things that are not so benign, such as past criminal behavior, legal and financial troubles, past marriages and/or children, stories, or whispers, of rape, incest, and other abuse, as victim or perpetrator. Often these things don’t ‘fit in’ with our set ideas about who our parents are, or were, or should be. Human beings like things seamless, packed nicely and tied up in a bow. But lives are not really like the movies – people are complicated and multidimensional, not all one thing or another. Therapy often involves helping people navigate the rapids of disturbing complexity: the woman who was molested by her own father, even though he was ‘the nice parent’ (as opposed to the mother), and in some ways a wonderful person; the mother who was always ‘nice’, but on closer inspection, turns out to have only shown a mask to the world, because she was in fact emotionally uninvolved.

Early in many people’s treatment, therapists have a tendency to reinforce patients’ key, monolithic views of their parents, in order to help the patient access, and express, all the unspoken, unprocessed negative feelings that have been crippling them. They must recognize, and ‘claim’, the child’s-eye-view of the situation, in order to establish a baseline self that they can build upon. At this point, if the therapist were to point out elements of the parent that run counter to what the patient is struggling to express, the patient might tend to retreat from manifesting the new self and say, “Oh, so you are saying I was crazy all along”.

But later in the process, when a more consolidated self has been established, it is sometimes possible to begin to broaden their conception of the parent, without it threatening the self – to begin to see the parent as “only human”, and to understand, in a new way, the actual reasons for the parents’ harmful behavior towards the patient, without using it as an excuse, or a negation of the harm, or of the patient’s (hard-won) feelings about it all. And sometimes this ‘humanization’ of the parent can help the patient adopt a more humane attitude towards him or herself as well.

It is a hard thing to see your parent – the being that was once the center of your world, a titan bestriding the earth, the being that all else flowed from – begin to age and fade, to watch a once-transcendent, critically primary life slouch towards obscurity and disconnection with “fortune and men’s eyes”. It is hard – partly because it is such a confrontation with the reality of our own onrushing fate – to see a life reduced to trash bags.

At those times, it feels as if the Government should provide a wonderful biographer for each and every person, to ensure that their struggles, their ups and downs, their failings and their dreams, realized and not, are properly documented for posterity, and maybe, to establish once and for all, who this person really was. Failing a wonderful biographer, we hope that we, as the children, have at least taken from them and their life story what was of value, what was significant, what really mattered. We hope that we have at least been a witness to their times, a fair witness who took to heart the meaningfulness behind whatever they had to give the world.

Though our aged parents’ last chapters are, as often as not, ignominious, we hope that we are at least the torch-bearers of whatever small measure of glory they possessed. Because, whether we really understood them or not, this carrying forward of their essential humanity is all that remains.











Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.