Friends

“I don’t have any friends,” he said. Jack went on: “I don’t know what to do about this. How do you go about finding friends when you’re 50? I had a lot of friends when I was a kid; I had a few friends in high school; I met one or two people in college that were kind of friends; I know a lot of guys at work, and a I know some of my neighbors. But I don’t have any friends.”

I have known Jack for a couple of years. His wife and he came to see me for marriage counseling. As is our policy we did a “marital assessment” to understand Jack and his wife before we would engage in counseling of any sort. Our practice is to understand the people we see before rendering any kind of advice and counsel. More accurately our procedure is this: understand the person, understand the person better, understand the person better than anyone else understands the person. Then we might be in the position to counsel or advise. So after this marital assessment it seemed best to see Jack individually and seek to understand him and help him understand himself better. Now after two years of therapy we have made some progress in the marriage, work, and some other matters. But we have come to a major hurdle, a kind of a problem. I understand him pretty well; he understands himself better; but no one else understands him. As he said, he doesn’t have any friends. In a way, I am a professional friend.

Jack went on. He said that his “best friend,” Sam, is someone he has known for many years. Jack and his friend have spent many hours together over many years doing things, playing, and working. But interestingly, they have never really talked. Jack certainly loves Sam, and I expect that Sam returns the favor. It is likely, however, that they have never used the “L word” (love) with one another. Perhaps it isn’t necessary that they tell one another that they love each other. There are people who insist upon saying, “Love you” when they and a phone call. After a while this kind of “I love you” seems to lose its punch. Yet it is interesting that Sam is Jack’s best friend, and a friend for many years, and a friend that he dearly loves, but yet they do not share words of love. More importantly, they don’t talk, meaning that they don’t talk about what they feel, what they want in life, or who they are. Jack and his best friend have never talked the way Jack and I talk when we meet. Jack and I talk about feelings, like hurt, joy, sadness, fear, anger, excitement, and passion. We talk about work and marriage relationships as well but the heart of these talks is still the feelings involved in these relationships. It is what I do for a living: listen to people. They talk to me about their thoughts, feelings, and doings.

I think the best way to look at valuable psychotherapy is to consider that it is a professional friendship. It is a great privilege to be “friends” with so many people, and I do not take the responsibility lightly. I have many “professional” friends, meaning patients whom I see occasionally or regularly. I recently saw a man, now 24, whom I saw when he was pushed into my office by his mother when he was 15. Now he comes in on his own accord. I saw a young man, now 16, whom I saw when he was seven. I saw another returning patient, a girl now 11, whom I had seen when she was six. She remembers that our friendship was all about playing together. It was good to see them again as I recalled our “friendship” that had existed years ago and now was reinstated. Generally, my deeper professional friendships are with adults with whom I can find some commonality of vocabulary and conversation and well as some years of life experience.

I am privileged to have these many professional/patient friendships, where I can have depth conversation about things that matter. And therapy is not all depth and quality. There are also times of frivolity and talk about the weather. Yet these friendships are exclusive to the office…my office. It is necessary to keep “boundaries” with patients, which usually means that there is little or no outside-of-office contact. It is even a bit awkward to meet a patient while at the grocery store. How do you say, “How’re you doing?” when you know that he is not doing well and struggling to stay alive? It is much harder for me to develop and maintain adult friendships, somewhat because of my professional knowledge, but more because of the dearth of true friendships available in the Western world. I once wrote a lead article in a professional association newsletter entitled, “Do therapists have any friends?” Many of my colleagues resonated with my rhetorical question.

All this about friendship, mostly absent in men’s lives, got me thinking: what is friendship? And what are the ingredients of friendship? And how in the world does a man in, say, his 40’s, 50’s, or older develop a friendship? Establishing and maintaining friendship is no easy task, mostly because of words.

Words
There are many jokes that have as the main ingredient some kind of reference to women talking while men are essentially silent. The data on actual number of words used and the quantity of talking indicates that men talk more than women. The caveat to this interesting fact is that men tell stories and they talk about things. I played basketball last night with a bunch of guys many of whom I have known for 15 years or more. There was plenty of talk, like, “Did you watch the NFL playoff game?,” “What do you think of the Badgers losing two games in a row?,” “It’s supposed to snow five inches tonight,” and the like in addition to the routine teasing me about my 70-year old body trying to keep up with these young bucks of 30, 40, and 50. There was lots of talk, lots of chatter, and lots of friendly razzing. But there was nothing of emotional content, nothing of personal substance, nothing of feelings, and nothing of depth. Now, we might not expect this kind of talk with a bunch of guys playing basketball on a Sunday night. I imagine, however, that if 18 women were playing basketball on a Sunday night, there would be much more than, “How about those Packers?”

Words of depth, words of feelings, and words of personal revelation don’t come naturally to men. At least they don’t come naturally to North American men. My wife and I have had the privilege of being in southern Europe, Greece and Italy, a couple of times. We found a remarkable thing: southern European men talk. They talk about themselves. They talk about feelings. They talk about philosophy. They talk about important things. Walk around Athens or some small town in Greece and you will see men talking…and talking…while they drink that awful Greek sludge they call coffee. I think the reason they spend so much time talking about those small café tables is that it takes two hours to drink (or is it eat?) Greek coffee. It is amazing to watch town after town, street after street, café after café where men are talking. Not to be seen in America. Guys here are working, watching TV, or drinking beer…at least most men. When I have the privilege of seeing a man in my office, I am usually the first man he has talked to in his 20, 30, 40, or 50 years. Words, at least important words, don’t come easy to most American men. I often tell men something like, “At your age of 40, your intellectual ability is at least 55, your vocational/work commitment is maybe 60, your personal ethic is 70, but your emotional/social ability is about age 12. Amazingly, most men say, “Yes, I feel like a child, or adolescent at best when it comes to words, friends, and conversation.”

Feelings
I just had a phone call with a man I saw in my office 15 years ago. I will call him Jim. Jim is a very successful businessman and has had many trials in life, trials I will not elaborate to keep his confidence. I haven’t seen Jim for the past 15 years, but he called me today to ask for help in his process of helping a friend. His friend is dying. His friend is dying of an “incurable” disease. His friend has chosen to take an alternative medical approach to healing, and at least by the report I had today, this approach is not working. Jim has tried to help his dying friend “correct” his direction with his last years or months of life. I told Jim that while his desire to help Jim was admirable and laudable, it was deficient in a central ingredient: feelings. Jim is trying to convince his friend what Jim thinks is the right thing to do. Now, I don’t know if it is right for this guy to continue with alternative therapy or go in a different direction. And I don’t know how he should talk to his kids about his disease. But I know this: Jim’s decision on these matters is not about facts; it is about feelings. And likely, neither Jim nor his friend knows how to find a path into these feelings.

In previous blogs I have discussed the basic feelings in life: fear and anger (defensive feelings), and joy and sorrow (love feelings). These feelings become complex as they are felt and expressed and often combine together in various ways. Feelings are not the only part of a true friendship, but they are a central ingredient. If a friendship is all about feelings, it is insufficient. If it is all about doing, it is insufficient. If it is all about thoughts, it is insufficient. A growing and valuable friendship has to have all three: feelings, thoughts, and doings. Getting men to find and express the “f word” (feelings), as I call it, is usually quite a difficult task.

Women
In many ways women have many more friends than men. And they certainly have the ingredient of feelings in these friendships much more than men do. I envy the way most women can talk about their feelings, sometimes at the same time. This is quite remarkable. I won’t belabor the neuropsychology of this phenomenon here but to note that there are significant brain differences between the male and female brains that allow a more free flowing expression of feelings in words for women. This is the good news.

The bad news is that men are usually quite at a loss to deal with women who have this much better ability to express feelings in words. Women can also express their feelings in tears much more easily. I believe this ability women have is a combination of certain neurological factors and cultural factors. I have seen southern European and Middle Eastern men express feelings in words and tears quite easily and freely. But we are not living in the Mediterranean. We’re in America. We’re in a culture where woman have…dare I say this…the monopoly of feeling words. Men, at least men in this culture, can’t keep up with a normal woman if it is in the realm of feelings, especially feelings surrounding hurt, helplessness, needs, and sadness. I am often with a couple in my office where both of them are hurt and sad, but it is the woman who is crying, not the man. The man gets mad or is just silent. He doesn’t have words for his feelings of hurt and sadness. He thinks that such feelings are a sign of weakness, but more importantly, he just doesn’t have words for these feelings. In our American male culture, you just don’t express such feelings at work or, for that matter, on the basketball court. You just feel them. And then these feelings (of hurt and helplessness) usually deteriorate into analysis, anger, or addiction. I call these the “three A’s” to avoid expressing feelings.

It is no small task for a man to find words for feelings that we might call “softer,” like hurt, helplessness, and sadness. It takes a lot of work. It can be done, but there is little in American culture that truly rewards men finding the process of feeling these feelings, and then expressing these feelings. If a man truly works at establishing and developing a friendship in adult life, he will need to establish and develop his vocabulary for feelings. He has all the feelings he needs to have. I abhor the expression, “Men are not in touch with their feelings.” Men are completely “in touch” with their feelings. They just don’t have a vocabulary for them. When I am the first man in a patient’s life with whom he has expressed his feelings, I feel privileged. Then it is my task to help this man find other men to express these same things.

Loving and Liking

I have been musing about the business of loving and liking. More accurately, I have been thinking about such matters for many years, certainly as most people have thought about these important elements of life. Deb and I have dealt with so many couples over so many years that it has become almost routine for us to tell couples something like, “The problem that you two have is that you love each other, but don’t like each other.” This is a bit of simplistic statement, but often true for couples who find themselves arguing frequently, sometimes painfully critical of each other and deeply unhappy. We also say, half-jokingly and half-seriously, “You two got married for the wrong reason: you loved each other…you didn’t like each other. You didn’t spend enough time together before you got together, fell in love (often physically and emotionally), but you really didn’t know each other enough to consider the matter of “liking” because love was so predominant. So this has been a bit of a sad mantra that we have come to say to many couples who find themselves in relationships that are unhappy, sometimes abusive, and almost always intensely critical of one another.

I continue to think that there is an important distinction between liking and loving, as well as a way to explain long standing relationships that seem to have more arguments and unhappiness than joy and satisfaction. But I think there is more to the scheme, and my more recent thoughts have sprung out of my examination of my own relationships. Indeed, I have some people that I love but do not like, and others that fit the very opposite, i.e. people that I like but do not love. But the situation seems a bit more complicated. In my more recent musings I have discovered that I miss some people and do not miss others. This missing seems to be evidence of loving, and the absence of missing seems to be evidence that love is not part of the relationship.

I have a former friend whom I miss and love. I have not seen (call him…) Sam for many years, and yet I miss him quite often, and think of him fondly. Interestingly, however, I ended my relationship with him beginning about 10 years ago and completed the process about 8 years ago. I ended the relationship because I found that there was much about “Sam” that I didn’t like. We shared a certain lust for life, conversation, and a bit of athletic endeavors, but over the 20 years that I related to Sam I found myself increasingly unhappy with him and silently critical of much of his way of life. More importantly, I found that I had made quite a move towards his way of life and interests but I felt that the favor had not been returned. He was quite unaware of my feeling increasingly unhappy and (silently) critical until I broke the news to him 10 years ago about this time of year. After some wrangling, talking and not talking, I asked him if he could meet me more on my playing field. After some months of silence, I emailed him and heard from him that he had decided or discovered that he “didn’t want to” do as I had suggested. This now ended relationship is yet one of love for me sans the unhappiness and criticalness that it once had. I prefer this state of love at a distance to disliking at closeness.

The picture is yet more complicated. How about the people that I “don’t miss” but seemingly have relationships with. I have come to believe that I don’t love these people even though I like them and see them fairly regularly. As with any really important matter in life, love is undefined, and for the most part unexplained, so I can’t explain or really define what love is except to state what the Supreme Court once said in a defining ruling: “We don’t know how to define it, but we know it when we see it.” So I “know” that I love Sam, and I “know” that I don’t love James. How odd this seems.

I am lucky to be married to my best friend, someone I both dearly love and much like. There are, of course, things that I don’t like about Deb, and she returns the favor, but we have come to accept these disliked things with less and less distress over our 37 years of being together in one way or another. I think I have the best of both worlds with Deb, namely the worlds of loving and liking, but this love her and like her certainly makes loving and liking other people difficult in comparison. Try as I may, it still is difficult to find people with whom we can have both. Love seems to come unbidden, while liking seems to be more about similar interests and experiences. I am sure there is much more about the subject that I do not know, but I am still learning.

Knowing, Expressing, and Governing Feelings

The business of psychotherapy is largely about feelings. We tell our patients what most therapists tell patients: you have to express your feelings. Certainly, this is true: in order to be satisfied, happy, and productive in life you need to express your feelings. But the story is much broader than simply expressing your feelings. There are predecessors to the expression of feelings and there are subsequent behaviors to feeling expression.  So we have come to say that people need to: (1) know what they feel, (2) accept what they feel, (3) value what they feel…and then (4) express what they feel…before they learn to (5) correct what they have expressed…and finally (6) govern what they express.

Children do well expressing their feelings, at least until they are taught to do otherwise. Before being shamed for having feelings of sadness and disappointment, children naturally express their feelings of joy at having something and sadness at losing something. Interestingly, we often have to help people re-learn this simple phenomenon of feeling joy at loving and sadness at losing. Already by middle childhood most children seem to learn that there must be something wrong with their feelings, both joy and sadness. As a result, the feelings of joy and sadness that are love based are supplanted with feelings of defense, namely fear and anger. Most of the people that come to our offices have undue fear (usually shown in anxiety) or anger (usually shown in depression) because they have not learned the importance of these two very basic feelings of joy and sorrow.

But the story is much bigger than that, and we think that many well meaning people, as well as many qualified therapists, do not help people by suggesting that they simply need to “get in touch with their feelings and express them.” The business of feelings and expression of feelings is much bigger, much more complicated, and much harder than expressing feelings. The very competent Gestalt therapist, Joseph Zinker, said that in his workshops and therapy, there was a “lot less yelling and screaming” compared to his earlier days of therapy where such expressions were lauded and applauded as evidence of personal growth. Indeed, yelling and screaming could be very valuable as a person learns to have these angry and sad feelings, but that is not the end of the story.

The first three ingredients of “getting in touch with feelings” are knowing, accepting, and valuing all feelings. This is hard work. While Cognitive Behavioral Therapy (CBT) is valuable, we are concerned that people in therapy think before they feel. We think it should be the other way around: feel first, think second. Then we add a third: act or speak third. If CBT is too simply presented or taught, it can have the effect of repressing feelings, which will most certainly spring up at some later time. Our approach is to help people know what feelings are, namely two forces each with two feelings. The forces are love and defense. The force of love that leads to joy when I love something and the feeling of sadness when I lose something. The force of defense leads to fear and anger. All four of these feelings are valuable to know, accept, and value. We frequently say, “There is nothing wrong with your feelings,” and sometimes add, “but there might, however, be something wrong with the way you express them.” So before one expresses feelings, it is important to know what you are feeling. And, of course, the situation is complicated because I can have two, three, or four of these feelings at the same time, or alternate among these feelings. So we begin with a simple naming of feelings: joy, sadness, fear, and anger.

After knowing (and naming) feelings, one needs to accept them and value them. Accepting feelings begins with knowing that there is noting wrong with feelings, and then adds the dimension that there is something very right with feelings. Feelings are very central to what it means to be human. I need to feel fear when, for instance, I step off the curb of the road and hear a truck coming close to the curb, so I can get back on the sidewalk. I need to be angry when I am attacked so I can properly defend myself. Indeed, we spend a good deal of time trying to help people move away from the preponderance of the defensive feelings of fear and anger, but there is nothing wrong with these feelings: they keep us alive. They certainly keep an infant alive when she might, say, be choking, hungry, or simply lonely. Knowing the love-based feelings of joy and sorrow is equally important, and we strive to help people feel more joy and sadness and less fear and anger. The biggest difficulty, however, is to help feel sadness to the same degree and in the same amount of joy that they feel. We tell patients, “Whatever you love, you will ultimately lose” and follow this up with, “so you can become better at loving in the future” and “not try to hang on to things that you have lost.” So accepting and valuing feelings is valuing this whole process, hopefully over time, being more loving and less defense.

But the story doesn’t end with knowing, accepting, and valuing. There is a very important need to express feelings. But following expression of feelings, there are equally important elements of correcting these expressions of feelings, and then the most important aspect of governing expression of feelings. Since I work most with men, I continually find that men are not very fluent with expression of feelings, and usually particularly inadequate in expressing feelings of love. Sadly, many men fall into the trap of being good at joy and anger, but terrible at fear and sadness. This limitation in many men is the probable cause for the significant amount of anger and indulgence (unrestrained joy) that men express in early life followed by an equal amount of anxiety (fear) and depression (sadness) men experience in later life. It often takes me months to help men know what they feel before they can express their feelings. Most men simply have never had anyone tell them that it is good to feel sad…because it is evidence of love, and it is good to feel fear…because it is the first line of defense. So expression of feelings is good, but generally early expressions of feelings are quite inadequate. They need to be corrected.

I frequently tell my (male) patients to learn the expression, “Excuse me, I am not communicating very well yet. Please give me a moment to get my thoughts and feelings in order so that I can do better at communicating.” Instead of this self-expression most men (and women) end up saying something like, “You’re not listening. That is not what I said. You are just being defensive. You have it all wrong.” Instead of these defensive (as well as offensive) expressions, it is valuable to say some form of the popular (sport) court expression, “My bad.” It is so easy for men on the basketball court to say, “My bad” but so hard for them to say it when they are trying to communicate with women. That matter, however, is beyond the current discussion. So “correcting” an expression does not mean that I am wrong in my feelings, but rather that I have not adequately expressed them. I often tell men to begin with a precursor statement like, “I want to talk about my feelings, but this is new for me, and I don’t think I will be perfect. So I would like to ask a bit of liberty until I can express my feelings.” To my knowledge no woman in all history has heard such a statement.

Finally, after expressing and correcting the expression of feelings (not correcting the feelings, mind you), there comes the truly mature element of governing the expression of feelings. Few people ever arrive at this state in maturity. They repress their feelings and end up with colitis, ulcers, heart disease, and cancer (yes, cancer and heart disease). And equally importantly, they fail to communicate their feelings. Psychiatrist Gabor Mate’ has spoken well with this phenomenon in When the Body Says No. So if governing the expression of feelings is not repression, what is it? Governing feelings is containment of feelings. This means that the person knows, accepts, values, expresses, and corrects the expression of feelings, and then arrives at a new place in life: it is not always valuable to express feelings. But this is true maturity, and not a place where many people reside. Rather, they repress or they express, but they do not govern and contain. When I contain my feelings, I feel love: love of myself, love of the other person, and love of real and meaningful communication. But I need about 20 hours of therapy to help my readers understand governance of feelings. Or maybe you just need to wait until Deb and I publish Good Grief in which we discuss sadness, expression, and governance.