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Monday, April 10, 2006

56. The Wisdom of Gordon Livingston

Subj: The wisdom of Gordon Livingston M.D.
Date: Wednesday, December 1, 2004 8:29:17 AM
From: MKomrad

I thought this was a meaningful article to pass along from the Washington Post about the gleanings of a life in practice by a wise psychiatrist .
Mark Komrad MD

Take Two Truths And Call Me In the Morning

By Roxanne Roberts
The Washington Post

Quit talking. Stop listening. We'd all be better off with a "mute" button on the soundtrack of our lives.
That, in a word or four, is the essential lesson of life, according to psychiatrist Gordon Livingston. After three decades of hearing people pour out their dreams, disappointments and fears, his single most valuable piece of advice is this:

"We are not what we think, or what we say, or how we feel. We are what we do. Conversely, in judging other people we need to pay attention not to what they promise but how they behave. . . . We are drowning in words, many of which turn out to be the lies we tell ourselves or others."

Most of the heartbreak of life, he says, comes from ignoring the reality that past behavior is the most reliable predictor of future behavior. Good intentions aren't a substitute for good acts. Sweet nothings mean nothing. Just do it. It's a harsh truth, especially in Washington, where words, promises and spin all swamp deeds.
This lesson is the second essay in Livingston's new book, "Too Soon Old, Too Late Smart: Thirty True Things You Need to Know Now." Actually, it's 30 things that you needed to know when you were young but wouldn't have listened to -- but better late than never.
In 1991, Livingston's oldest son, 22-year-old Andrew, committed suicide after a long battle with bipolar disorder. Six months later, his youngest son, Lucas, was diagnosed with leukemia. A few months later, after a bone-marrow transplant from Livingston caused complications, Lucas died. He was 6 years old.

"The lesson, if there is a lesson to be learned from something like that, is that we endure what we must," he says. "I don't find anything more profound than that. Most of the lessons that people imagine bereaved parents learn are really lost on most bereaved parents: This idea that somehow you achieve some sort of 'closure,' which is a word that is just hated by parents who have lost children, because there really is none to life's really profound losses. And then people say, 'You're so strong. You got through this.' And the answer to that is, 'What choice do you have?' "
He gets real life -- he's been married twice and has four adult children. He also gets reality, which is how things are, which is frequently not how we wish or hope they would be. His 30 truths begin with: "If the map doesn't agree with the ground, the map is wrong." This was a lesson he learned as a soldier at Fort Bragg in North Carolina, trying to figure out why the hill on the map wasn't there. The map was wrong. It was a lesson he never forgot.
"The concept of people constructing a map in their head of how the world works, and then getting it to actually conform to the ground they operate on seemed like a good starting point for thinking about what we do, and what we're trying to do for our kids," he says.
What we do, more often than not, is make lousy choices, and Livingston points out the reasons why. But this is not, in any conventional sense, one of those kick-butt, get-real motivational guides from best-selling life coaches. Livingston is the sadder but wiser man. He is more Job than Dr. Phil, painfully aware of life's losses and limitations, trying to spare you a little hurt. He thinks in paragraphs, not in sound bites.

In the world according to Livingston, life is not fair. Bad things happen, often to the most innocent. A good life can fall apart in a split-second. It can be unbearably sad. Sometimes the best you can hope for is simply to survive. Patients told him about broken promises, unrealized expectations, people who said one thing but did another. He says the biggest lie people struggle with are the words, "I love you."

"So many people are just in agony because they're being told that and are trying to reconcile that with behavior that is not loving," he says. "Of all the lies that damage us in life, that's the one that hurts the most, and most frequently."

Cynics like to cite studies showing depressed people have a clearer grasp of reality than do optimists. Livingston shares the truth-squading but not the cynicism. The key to happiness, he argues, is looking at your life not as it should be but as it is. Only then can you honestly plan your future. So many of the essay titles are stripped of excuses or platitudes:

• "The statute of limitations has expired on most of our childhood traumas."

• "Any relationship is under the control of the person who cares the least."

• "Our greatest strengths are also our greatest weaknesses."

• "Only bad things happen quickly."

• "The problems of the elderly are frequently serious but seldom interesting."

He got that last one from a New Yorker cartoon and worried that the old folks would be offended. But the point was that spouses die, bodies fail and nonstop complaining only isolates the elderly at a time when they need people the most.
Livingston's truths are offered pretty much at random, except for the first essay about the mental map as well as the last one: "Forgiveness is a form of letting go, but they are not the same thing."
"We live in a culture in which the sense of being wronged is pervasive," he writes. "If every misfortune can be blamed on someone else, we are relieved of the difficult task of examining our own contributory behavior or just accepting the reality that life is and has always been full of adversity. Most of all, by placing responsibility outside ourselves, we miss out on the healing knowledge that what happens to us is not nearly as important as the attitude we adopt in response."
The essential question, he says, is always the one he has scrolling across his computer screen: "What's Next?"

Next for Livingston means returning to a full-time practice with a new medical group. Retirement doesn't interest him. "It's what I do," he says. He's grateful he had the time to write the book. "In a way, the process is complete for me," he says. "It's more now than just words in the air. It's words on a page."

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