The Value of a Heart Attack

I had a heart attack a couple of months ago, and it has been a very good thing for me. Let me explain. I’m not saying that I’m “glad” that I had a heart attack, and of course I wish I hadn’t had this event, but as I look at the larger picture, I see that this has been a good thing for me in several ways.

Briefly, I had been having some tachycardia for some time, perhaps a year or two. More specifically, I had been having occasional chest “pressure” (not so much pain) off and on when I was walking, running, or playing basketball. So, now I am pretty sure that the blockage in an artery that led to the heart attack had been happening for a couple of years, and very likely to some degree for many years. The night I ended up going to the hospital was challenging. First, I’ve never been in a hospital, never been on any medication, and never have had surgery of any kind since I had a tonsillectomy when I was six. So, I was not particularly prepared for the symptoms of consistent chest pains that eventually led me to go to the ER and then by ambulance to the hospital and quickly in surgery for angioplasty. From start (midnight Monday morning) until noon Tuesday, being a total of 36 hours, I was all of what I didn’t want. Through many adjustments, however, this is an event that is past and I can reflect on the many positive things that occurred at that time and have occurred since then. Let me elaborate:

Life saving

I would be remiss if I didn’t recognize that the various medical professionals who assessed me and ultimately performed the angiogram performed well to the person. It is impossible to know if this heart attack might have healed itself had I chosen not to go to the hospital. But it is possible to think that I might have died. I am thankful for professional people who know what they are doing, and I am thankful to be alive.

New learning for old thoughts

There are two important things that I “learned” during this whole process: I will die; I need to live. Previous to this incident “knew” that I would die, but now having possibly been minutes away from dying, the fact that I will sometime most surely die is a lot more real. Previously, I had an academic understanding of dying, but now I have what appears to be a more personal understanding that I will die.

The more important thing that I learned during this process is substantially more significant. Previously, I “knew” that I wanted to live but I didn’t put much thought, much less feeling, into it. I just enjoyed living. After the incident, I discovered something substantially different from wanting to live. I learned that I need to live. I realized that I am alive to serve people and that these people seemingly need me. Most specifically, I need to live for the people I see in my office, often because I am the only person who really knows them, and in some ways the only person who loves the whole of them. This is no small thing, and I have always taken this privilege of knowing people seriously and with great appreciation that people put their lives in my hands. Now, however, I see this task as even more intense. I have had several patients say something like, “Please don’t die Ron,” which seems to affirm the apparent fact that I need to be alive. In God-talk, I think that God yet wants me to be of service to people. This includes most specifically the people in my office, but also in the writing that I do and want to do. Interestingly, these days I find my therapy with people to be focused on how people can be of some service to humanity. I have always focused on people understanding themselves, being themselves, and communicating themselves, but therapy is not ultimately about oneself but rather how one can serve humankind out of a foundation of self.

My needing to be alive is also for my family and friends, of course, but frankly these folks could do with my dying better than people for whom I am the only person in their lives that knows them. I don’t know if I will live for hours or decades but I want these hours or decades to be useful to humankind.

New family

My family has solidified since this cardiac event, and to some degree it has been reframed. Deb and I had the privilege of having a foreign exchange student from Sweden live with us for his senior year in high school along with Jenny and with Krissie who was also a senior. We had occasional contact with Andreas (“Andy”) over the intervening years but he contacted us not long after Krissie died two and a half years ago and flew over here to be with us and refresh our relationship. He refers to us as “Mom and Dad” and to his mother as his “Swedish Mom” (his dad died 10 years ago), and it is a pleasure to have a “son”, almost as if he had replace the loss of Krissie. When Andy heard about my heart attack, he immediately bought a ticket to fly here because he “didn’t want me to die” before he could renew our relationship. So we planned a journey with Andy from our home in Wisconsin through Omaha where we picked up Jenny and then the four of us proceeded to visit with our good friend, Tim, in his Mountain-side home just outside of Denver. While the five of us were sitting around the dinner table, I realized that this group of five is my “family” even though I am biologically related only to Jenny.

Since that time I have come to see that people have different families in different constellations. Very often people see “family” as only those biologically related to one another, but this doesn’t always work, especially when one or more people in the biological family are toxic, or perhaps just not personally developed. People can do well to discover what their new family is, or what they want it to be as they grow in life. My own “family” has changed many times over my years from my family of origin with originally 4 members, then 5 when my sister came along 9 years later, then my fraternity family, then my first wife and I, then my seminary family, then my graduate school family, then my wife and two daughters, then my daughters and I after the divorce, and then Deb, Krissie, and I when Krissie came to live with us, then the 4 of us, then back to Deb and me with Jenny on the side. And now this new family of 5. I see people often struggling with biological family and coming to a way of seeing what their new family can be. I am reminded of what Jesus said when he was on the cross and was informed, “Your brothers and mother are here for you.” He said, “Who is my family but the ones I have love and have loved me.”

New body awareness and care

I talked to the cardiologist who supervised my brief hospital stay and noted that I usually work out three times a week, run three times and week, play basketball regularly, and have a pretty good diet. His answer, “Well, if you hadn’t been doing these things, you might have had a heart attack at 58 instead of 78,” noting that my genes are the primary reason for the heart attack (LDLs, “bad cholesterol primarily). So, my diet and exercise need to be substantially improved. We have now been two months on a largely Mediterranean diet replete with lots of veggies and fruit. I have found it interesting that my tastes have changed a bit, that I feel satisfied, and that I snack a whole lot less, and certainly a lot less sugar and other “cheap” carbohydrates that are gluten-based. I am interested to see how this diet change holds up over time.

The second thing that I have done for my body is to be more consistent with my workout routine, now daily with running (winter on the treadmill), lifting, and planking. I used to struggle to maintain a marginal workout and now I find that I can increase all of these activities. Likely, my heart is responding to the diet and exercise.

There is a third element that I must admit which is loosely related to what I must call anxiety, albeit with a bit of chagrin because I am loathe to admit to having any psychological disorder. Indeed, I come from a family all of whom have suffered from some form of anxiety, so whether I acquired it genetically or socially, I am inclined to think too much about things, namely things I do. I think most of this has to do with my “caretaker” temperament, namely a person who is property oriented and a “doer” in life. I have always been inclined to think about what I need to do in a day’s time or a week’s time, something that is good at the start but not in the end because such thinking can lead to a kind of anxiety because I always have things on my mind to do. To a fault. So, I found a mantra that has helped me deal with my caretaking/doer nature without changing who I am: In Due Time. Note the play on words with “do” instead of “due” but of course, it could also be “In Due Time” as well. It has been helpful as I lie in bed for a few moments in the morning with my espresso and think of what I might do in the day.

The value and limitations of professional people

First, I am not inclined to rely upon “professional” people for the most part. This is a part of my independent nature, something like, “do it, do it wrong, do it over, do it right” orientation to life. Furthermore, I am suspicious of many professionals who tend to stretch beyond their actual level of competence and often see their profession as central in life. Well, I certainly do the same because I think that everything is psychogenic, i.e. psychologically caused, like my heart attack for instance. So, over the last two months or so I have consulted with various professionals who rendered advice, or in some cases a regimen of “treatment” for my heart. Some of them have been helpful, some harmful, but all of them have been people of intelligence and integrity. Likewise, all of them have been limited in understanding things beyond their own profession and they have not always seen me as a unique person not always fitting into the mold of everyone else.

The cardiologist, for instance, very bright and certainly capable, a guy who does heart transplants and the like as well as the simpler angioplasty that he did on me. He put me on several medications, namely statins, blood thinners, and a beta blocker. I suppose most people whom he sees in his practice profit from his diagnosis, advice, and treatment. But most people are not me. So, I am on these three medications for a few days until my body erupted against these meds, in fact to such an extent that I actually fainted for a few seconds. As a result of my body reaction to these meds, I just stopped taking them and seemingly have survived well without medication. It is important to note that I have never been on any medication ever so my body is not prepared for medication of any kind. So, I look on this brilliant cardiologist as doing his job well and serving hundreds of people, but he didn’t serve me. I hold no grudges.

In addition to the cardiologist I saw a naturopath, actually starting a couple of weeks before my heart event. This individual, someone with three doctoral degrees, put me on a series of “supplements” to assist in my heart. I saw her originally before the heart event and she did a brief interview and then had me take some blood tests and then the supplements. Long story short, the supplements were really bad for my body, which erupted in a nearly whole body rash. I got off the supplements immediately (with her advice) but it took seven weeks for me to get over the rash. With this individual, too, it is likely that she did what works for most people, but not for me. I am a bit displeased that she didn’t see the heart attack as a possibility because I mentioned that I had been having some tachycardia and other heart-based symptoms, but again, perhaps most people would have profited from her hole regimen of meds, just not me. I hold no grudges.

I consulted with a trainer whom I happen to play basketball with about my workout routine. Cory was very helpful with some recommendations for diet (drink 8 glasses of water every day and confirming the Mediterranean diet), but more importantly recommending an increased workout routine, which I have followed. He too is limited in his overall understanding of who I am and certainly not aware of the psychogenic element or my lack of desire to be body buff. But he was helpful.

I have learned that no one knows everything, and certainly no one knows everything about me. Nor should they. I just need to “consult” and then fit that consultation into my own system and experiment with my body and soul to go what ultimately feels right and helps me.

All in all, my heart attack was good for me in all of these ways. I feel better than I have felt for some time, perhaps a year or so. Certainly, my being better has to do with all that people have done for me and what I have done for myself.

Wanting it Both Ways

I have often “wanted it both ways” in many of life’s circumstances:

  • I want to eat as much sugar as I want. I also want to have low glucose in my blood
  • I want to lose weight. I also want to eat too much food at night
  • I want to slim down my belly. I don’t want to do the planking that might help
  • I want to have friends who know me. I don’t want them to know enough to know me
  • I want to be able to play good basketball. I don’t want to practice enough to do that
  • I want to work a lot (because I enjoy what I do). I don’t want the fatigue that comes with too much work
  • I want to write blogs without grammatical/spelling errors. I don’t want to do the careful editing required to do that
  • I want to go to Europe. I don’t want to have to abide by the Covid rules to do so
  • When in college I wanted to postpone studying until the wee hours of Sunday night with the result of my grades suffering and restricting me in future endeavors. I wanted people to see that I am capable and intelligent without the “union card” of a good GPA.
  • …and many more

You might have such dilemmas or perhaps more serious ones like some of the people with whom I engage in some way:

  • A family individual who seriously assaulted me with vicious gossip some time ago, but wants to have a good relationship with me without apologizing for his/her action
  • Another family member who created a huge mess in my house that I found after he/she left the house. They also want to have a trusting relationship with me
  • The patient for whom I did an extensive neuropsychological evaluation that cost her pennies but she wasn’t didn’t think I spent enough time with her to write the report I did so she won’t pay the pennies until she is satisfied.
  • The guy who races by me on the right side on the interstate together with a one-finger salute because he is not satisfied that I am driving only the speed limit

Or, you may be like some of my patients who want it both ways, like:

  • The guy who wants his wife to trust him but isn’t honest with him
  • The guy who wants to get over the basic fear of life that has plagued him all his life but doesn’t want to face the terror of the origin of this fear
  • The introverted man who wants people to love him but is unable to reveal enough of himself to allow people to see him enough to love him
  • The guy who is gay but wants to be married and have children
  • The guy who is very bright but quite under-employed because of his lack of advanced education, but doesn’t want to go to college in order to be professionally satisfied
  • The kid who wants to be liked but is unable to manage his selfishness in order to have people like him
  • The mom who wants her child to grow up but can’t let go of her undue mothering of him
  • The dad who wants to have a relationship with his introverted son but doesn’t want to affirm the challenge of knowing and loving an introvert
  • The extravert who says anything that comes to his mind but doesn’t want the effects of many people being irritated with him.
  • The guy who wants to drink as much as he can but doesn’t want to suffer the negative effects his drinking has on his family
  • The man who tends to tell people what they should do because he is a high boundary person but also wants low boundary people to like him
  • The guy who married the wrong woman but wants to magically fix that by staying with her despite his being unable to love her
  • The adolescent who wants to reserve sex for marriage but gives herself to boys for the sake of “being loved”
  • The man who wants to express his beliefs openly but is afraid of losing friends as a result, so he has no friends
  • The man who was abusive with his wife for 30-odd years but wants her to “forgive and forget” now that he has admitted his error
  • The man who did not maintain a good financial basis in his life but wants some kind of miracle to bail him out of his dilemma
  • The man who has distrusted everyone all his life but wants to “just learn to trust” people so he can have a meaningful relationship
  • The man who has been married unsuccessfully five times because he “needed” a mother figure but wants to have a companion, not a mother
  • The man who used illicit and expensive drugs for 10 years but also wants to have financial security
  • The man who makes a lot of money in a job he hates but doesn’t want to change jobs because he will not make as much money in a profession he would really like to do
  • The man who stays legally married and as such damages his current relationship because he needs the “benefits” of his wife’s insurance

These and many more are but some of the people in my office who “want it both ways.” They want what they want and then they want something else that is not consistent with their first wants. In most cases, these people have made understandable mistakes in their lives, the things that we all do, but they don’t want to pay the price for what they have done.

Paying the price

  • The two family members I mentioned above have caused great damage to me psychologically but aren’t willing to pay the price for their errors. The price would be a simple apology without justification, something that most people seem unable to do readily.
  • The people who have not pursued the education necessary to achieve a place in society and in a profession that suits them don’t want to pay the price of going back to school and doing so. They would rather pay the price of unhappiness in their current lives.
  • The people who entered intimate relationships honorably but somehow knowing that the relationship was not good for them. They don’t want the stigma of a divorce so they pay the price for ongoing personal unhappiness
  • The man who suffered great damage from his alcoholic home, something that caused him to suffer through life so much so that his life is largely suffering and surviving, not thriving. He is unwilling to pay the price of deep therapy to heal his early wounds.
  • The man of Muslim heritage and birth who has hidden his homosexuality all his life and suffered failure in relationships, family, and vocation. He isn’t willing to pay the price of rejection in order to have a meaningful life.

I think we all “want it both ways” and don’t want to “pay the price.” Paying the price for an honest, loving, and meaningful life can be huge, but there is always the price. Sometimes, the price is excessive and it is just not possible to pay the price, but I think this is rare. More often, we carry childlike beliefs that we can do as we want and not pay the price in later years. I pay the price for not attending to the potential damage to my lungs from working around asbestos. Now, I must cope with how to live with the results or find some way to rectify it. Whatever I do, I will be paying the price because I can’t have it both ways.

Love V: Love Problems

This is (probably) the last of the blogs on love. Previously, we looked at a bit of theory of love, “not being love right”, temperament-based love, and being “seen” so you could be loved.  This blog will be devoted to a very basic concept that we have developed about feelings, emotions, and love. If you have read our blogs or the books we have written, you will be familiar with the concept of “love problems,” but allow me to summarize.

Theory of feelings

We propose that “feelings” are a central ingredient of human existence, that they are an so important that they are undefinable, like time, space, and love, and that they are never wrong because they emanate from our souls, which are most certainly never wrong. That having been said, the expression of these feelings can be “wrong,” or at the very least, inadequate. We experience our feelings sequentially physically, emotionally, cognitively, and actively (which includes speaking). The physical and emotional aspects of our experience of feelings are both unconscious, while the cognitive and active experiences are conscious. Furthermore, we usually have a natural tendency to note the experience of feelings in one of these ways, and then we may have the same or a different means of expressing these feelings. Perhaps the most prominent element in the experience and expression of feelings is within the emotional range although many people are much more cognitive or active, and some are almost entirely physical.

Theory of emotions

You will note that we make an important distinction between feelings and emotions, with emotions being a subset of feelings. We propose that there are four basic emotions, and then combinations, cognates, and expressions of these emotions. Importantly, all of the emotions have to do with love in some way. These four basic emotions have to do with time, namely:

  • Joy is the experience in of loving something in the present
  • Sadness is the experience of losing something that I love in the present
  • Anger is the experience of feeling the loss of something in the past
  • Fear is the experience of feeling the possible loss of something in the future.

Note that all of the emotions relate in some way to something that I love. Note further that three of these four emotions have to do with loss: present loss leads to sadness, past loss leads to anger, and future loss leads to fear.

Love problems and emotions

So, why do we talk about “problems” with love? We do that because we have so much difficulty with the emotions surrounding sadness, anger, and fear. We somehow think that we should be joyful all the time. Two important facts are related to this theory of feelings and emotions: (1) love is at center of life and (2) we lose everything we love…eventually. We find that people have trouble losing something that they love, whether that loss is in the past, the present, or the future. We try to help people (1) trust that their feelings are never wrong, (2) that their feelings erupt towards loving something, and (3) this love always leads to some kind of joy.

What we love is very important to notice because we do not restrict the concept of love to the love people. Rather, we suggest that we can love anything with equal passion. Many people have a primary orientation towards love of people, but many more have just as deep a love for nature, property, ideas, history, science, or something else, whether physical or theoretical. I wrote a bit about this in the Love III blog, Temperamental Love. Expanding love beyond the love of people is very important if we are to understand each other. Thus, it is hard for people with what we call the “lover” temperament to understand “caretaker” people who love property more deeply than people. As you can see, this can lead to relational problems, but I am not speaking so much about relationships as I am speaking of just what happens when we love something. Importantly, whatever we love, we will eventually lose. That is the “love problem.”

Sadness: this is the natural emotion that erupts from losing something. When I am sad, I am in the present. I may be thinking of something that I loved and lost in the past, but if I am sad about that loss, I experience it in the present. We will examine potential loss in the future momentarily.

Anger: this is very important because anger is also a “love problem.” If I am angry, I have lost something in the past, the past being a few minutes ago or a few years ago. We refer to anger as delusional, namely being an emotion that erupts as a way of changing the past. Why do I throw the hammer and swear when I missed the nail? Because I (delusionally) think that this hammer-throwing expression of anger will change the fact that I missed the hammer.

Fear: this is equally important because if I am afraid that I will lose something in the future. This “something” could be a dollar on a bet, a good friendship, a job, or anything. Fear is also delusional because if I think/worry/fret about what I might lose in the future, this anxiety will somehow change the future.

As you can see, all losses have to do with love. So, how do we cope with loss?

Coping with loss is a love problem

We normally cope with loss with sadness, anger, or fear. We content that we need to be sadder and hence less angry and less afraid. But this is no easy task. The difficulty with facing loss, at least in America, is the fact that our culture is not particularly emotionally mature. We do not generally understand emotions and allow them to run their natural course. Particularly, we tend to get angry way too easily and stay angry longer, and likewise we get way too worried and stay with worry way too long. Both emotions are hard on one’s health, work, play, relationships, and life at large.

It is hard enough to allow to be sad, especially for us men because sadness is normally portrayed as weakness. Indeed, there are some people that come to sadness and tears so easily that it seems to be an escape from reality. But the larger number of people simply haven’t found a way to be sad, which means loving, losing, feeling sad, and getting over being sad. Getting over being sad? What does that mean? It means allowing sadness to run its course. The key of all of these emotions is that sadness ends. Anger doesn’t end. Fear doesn’t end. Sadness ends…if we allow it to run its course and finish. However, this is a challenge because I am truly sad, that moment of my existence is filled with the feeling (= intuition) that I will be sad forever. Simply put, I need to allow myself the freedom to be sad frequently enough to get familiar with the process:

  • Love something
  • Enjoy this something
  • Lose this something for some reason
  • Feel sad
  • Allow sadness to run its course
  • Finish being sad
  • Love again
  • Love better knowing that whatever I love, I will lose.

Dealing with anger and fear are more difficult but the “cure” for these emotions (the subtitle of our book, The Positive Power of Sadness, is to learn to be sad. It is easier with anger, but it is not easy. Whenever I am angry, I have a “love problem,” i.e. I have lost something that I loved, whether it is the nail I was hammering or my favorite friend. I got angry because I raced right past the sadness of losing my friend or hammer and got “delusionally” angry. Unfortunately, anger doesn’t end like sadness. It just metastasizes into my physical, cognitive, emotional, and relational systems and becomes an unfortunate and harmful part of those systems. The cure for anger is to realize that I love something and lost it. I have a love problem when I’m angry.

If anger is hard to move back to sadness, fear is much harder largely because when I am afraid, my brain gets into the action and “protects” me by churning up cortisol so that I can be prepared to fight. The brain doesn’t know that I am thinking/worrying about something in the future because the brain, as a machine, doesn’t understand the future. The brain is singularly in the present and has all it can do in order to keep you alive with blood flow and breathing. So, while fear is also a love problem, it is much harder to “cure”.

Curing anger and fear

I say what many patients think is an outrageous statement: “I am going to help you get to the place where you are never afraid and never angry. Just how will I propose to do that? I will help you feel the sadness that is under both fear and anger, and the love that is under the sadness.

It’s easier to “cure” anger than fear. If I am angry, I can point to a specific loss, like someone who hated me for some reason. I lost his/her approval. Curing the anger I feel towards him will simply be facing the fact that I loved him and loved our relationship, but now I have lost both. I have a love problem. If I stick with the love, I will eventually feel sad, my sadness will run a course, I will finish being sad, and then I can go on with my life. Perhaps, I will find a way to reinstate my friendship with my friend or establish another friendship. Or maybe I will just fix the garage up as a way of loving a fixed up garage. I will replace anger with sadness and when sadness, I will love something better, perhaps realizing that garages have a nasty tendency to deteriorate over time leading to…sadness.

It’s harder to cure fear, but this is how we try to help people do it. I ask the individual to picture the potential loss, attempt to replace the fear of loss with actual loss and allow the feeling of sadness to erupt. This is simple but very hard to do. It is hard because people (their brains) are so use to worrying that doing this anticipatory loss feeling of sadness is quite a challenge. Properly done, you will actually feel the potential loss and sadness and love in the present. This will cure your anxiety. A lot harder than it sounds because you are going against the brain, the culture, and the individual’s resistance to feeling anticipatory sadness.

Sadness is a lover problem. So are anger and fear. But sadness ends and makes you a better person and a more loving person because you know that you love but for a moment, however long that moment is. Anger and fear do no such thing.