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James L. Schaller, M.D., M.A.R., P.C.

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Rebuilding Your Father Relationship

Chapter 1 - Everybody Needs a Father

Jessica was not the girl I had imagined she would be. Having heard some frightening details of her story from my nurse, I had assumed she would be hostile and reactive-a test of my patience. But as she walked quietly into my office and took a seat, I saw that she was a sweet eleven-year-old, the type of daughter who would make any parent proud.

She greeted me respectfully and asked to be called "Red" (which struck me as curious, since her hair appeared more brown than red). She faithfully followed all my directions during our chat, and never once complained. The child obviously had a dash of shyness, but she was able to talk about her feelings-our staff therapist had been a benefit. When I told her that our team was pleased with her progress, she smiled warmly.

I found it hard to believe that just three weeks earlier, this same girl had taken a knife and chased her mother around the house, saying, "I'm going to kill you!"

At that time, she had been living with her mother. Her parents had separated because of her father's alcohol problem; nevertheless, they had come to an agreement that Jessica's father, who was also nicknamed "Red," could see her three times a month, as long as he didn't drink during the visits. Red followed this agreement faithfully for five months, during which time father and daughter regularly talked on the phone, bowled, played games, and even went to Red's softball games.

But then he broke the agreement.

One weekend while Jessica was at her father's apartment, a group of guys came by to watch a football game on TV. They brought beer, and the temptation was too much for Red. When Jessica's mom called to adjust the time she would pick up her daughter, she could tell that Red was mildly intoxicated. Moments later, while Jessica was reveling in the attention of five loud, exuberant men, her mother burst into the apartment and angrily pulled her off the couch and rushed her out to the car.

When they got home, Jessica was told to go wash the dishes piled up in the sink. Her mother had planned to discuss the event over dinner, but Jessica was seething over what her mother had done to her. Somewhere deep in her heart, she felt her basic need for a father's love being thwarted, even assaulted. She could not face losing her father, so she attacked her mother, threatening to kill her with a knife.

Certainly, Jessica's story is extreme. But she is not alone in her hunger for fathering. Jessica's act was wrong, but it is profoundly telling. It points to a need in all of us. Each of us longs for a father's love and acceptance.

Life distracts us. We forget or are unaware of the basic experiences of our past that have shaped and now control us. Sometimes we do not perceive the problem in our father relationship. We need our fathers to be special and good, so we stuff our bad father experiences deep down inside. Father failures hurt too much to face. The mistakes fathers make may be subtle and hard to pinpoint, but they still have immense impact on the lives of their children.

So where do we start? Perhaps with the questions that are behind the title of this book: Do you feel a loss in your father relationship? Does something feel wrong with it? Do you hunger for something that your father relationship should satisfy but doesn't?

Emotional Signs of Father Hunger

Many people have a void inside them that is due to "father hunger," and this disguised hunger has had great impact on the way they live. Do any of these statements apply to you?

The conditions listed above are often associated with incomplete father relationships. The absence of a mature father-child connection creates a void in the soul, a residual "father hunger."

Father hunger is the result of receiving too little quality fathering as a child or young adult. Some argue that even grown men and women need fathers or father surrogates and that the absence of such role modeling and support is associated with less fulfillment in life. In general, father hunger results from too little intimacy between child and father.

Over the last ten years, I have witnessed during counseling sessions the depth of the hunger men and women feel for fathering. Even those in their sixties and seventies have told me of the hunger and longing they still feel. And often the need is hidden, like a deep river of water flowing under the surface. The hunger may be out of sight but it is never gone. I know this from having heard hundreds of people tell me what they want from life. After we get beyond the superficial they say something like, "I want my father to call and talk to me" or "I want my father to stop drinking and come home. I need him so much."

After more time, the deepest waters break through to the surface. The hunger, longing, and disappointments begin to come forth. "I wish my dad were alive." "Dad, I feel so weak without you." "I wish my dad weren't sick so I could lean on him the way I used to." And so it goes.

Most of these people are highly functioning members of their communities. They are respected in their relationships. They are responsible employees. Nevertheless, they obviously have unresolved pain associated with their fathers. They thirst for "father water."1 They have been left with a void, an injury, a psychic thirst that only a father can quench. I am becoming increasingly convinced that this is nearly universal.

In this book you may be surprised to see the extent of your father's role in your most cherished relationships, your vocation, your satisfaction with life, and your experience of God. I will try to walk with you through what may be intense topics, but in the end I hope you will feel less controlled by the past and have direction for further healing.

Father Deficiency

For the purposes of this book, I have identified two levels of father deficiency: obvious deficiency and broad deficiency. Obvious father deficiency has various causes. A father may die before his children reach adulthood. Some fathers desert their children and leave their families to function alone-often in poverty. Divorce causes 40 percent of all children to spend at least part of their growing-up years in a single parent family, and most of these children will have minimal contact with their fathers.2

Sophia Loren is a vivid example of obvious father deficiency. Her life illustrates how fathers impact our love life and marriage choice.

Sophia saw her father only a few times. He put in an appearance at the hospital when she was born, acknowledged that he was her father, and immediately departed. Having seduced Sophia's mother, he now abandoned both mother and child, leaving them to face the shame and humiliation heaped upon them by others in their small Italian town.

When Sophia was five years old she met her father for the first time. Her mother, upon hearing the news that he was coming to see Sophia, became nervous and excited, fussing over the child's hair and dress so she would be as attractive as possible. Sophia remembers that he was tall and handsome, and that he gave her a toy car-a beautiful blue race car with her name painted on the side. After she received it, she ran up to her room in tears. Despite all the lavish gifts she has received, Sophia Loren says that little blue car still holds a special place in her memory.3

In her teen years, Sophia tried to fill in the hole left by her absent father. "I was busy working on films ... I was the head of the family, going out to work everyday, my mother was the wife, and my sister, now back in school, was the child."4

As an adult, though, Sophia still longed for her father, despite the pain he had caused her. On one occasion her sister had arranged a visit at their father's home. He was ill and weak and her sister, Maria, wanted Sophia to see him before it was too late. He took her through his flat, and even showed her his favorite mementos. When she was getting ready to leave, he took one of her hands and said, "I am very proud of you."5

Yet even this good memory brings heartache. Because her father's "I am very proud of you" was the only affectionate thing he ever said to her, it stands alone in a sea of silence.

"Growing up in a small Neapolitan town," she reveals, "it was the dream of my life to have a father." Trying to get over the immense sense of rejection from having been left, she tried to find him in other men. She spent her life seeking surrogates for him-in Carlo Ponti, the husband who fathers her, and in older actors and directors who remind her in some way of the father she never "won."6

Sophia is quite frank and pleasantly transparent about her choice of a husband. In her late teens she was aware of a deep need to be loved. She had met Ponti when she was fifteen, and by the time she was nineteen they were seriously involved. He was forty-one and married, but he soon divorced his wife so he could marry Sophia.

She said, "I suppose he's the father I never had, the father I needed in my life. Even now. I'm forty-four, but the little, shy, illegitimate, fatherless girl of Pozzuoli is still very much inside of me, and I need the father of Carlo as much today as I ever did."7

In her autobiography, one sees signs of her understanding and healing. Sophia had the courage to examine herself, and the benefit is obvious. She can look at her life and admit to herself: "I sought him everywhere. I married him. I made my best films with him. I curried his favor. I sat on his lap and snuggled him ... I saw him only a few times ... yet he dominated my life."8 She wrote her life story to come to terms with him, to separate the delusions from the truth. And it seems, by extension, to find a stable identity. At least in her life there was a clear starting point. She knew she had a father deficiency because he clearly was gone. What about homes with a father who is emotionally gone? To express the pain of children in these families we need another broader definition of father deficiency.

Broad deficiency occurs when a father lives at home but provides little or no quality parenting. For example, fathers who abuse alcohol or drugs may be unable to have positive relationships with their children. Their behavior may be disruptive to the family, causing financial problems, and forcing the children into overwhelming levels of responsibility early in life.9

In this way an alcoholic father can undermine the emotional health of all family members. Such fathers are "anti-fathers," psychic black holes who consume the strength and childhoods of their children. This is also true of sexually and physically abusive fathers.

For example, it has been estimated that as many as 5 percent of all girls are sexually abused by their fathers.10 One researcher believes that sexual abuse victimizes a million children each year, with physical abuse claiming a similar number. More recent figures show the real numbers are probably even higher. Much of this abuse is inflicted by fathers. Many fathers who would not physically abuse their children nonetheless abuse them verbally, through ridicule and insults.

Some adult children are controlled by insecure fathers and feel unable to choose their own path through life. Some cannot connect with Dad because his standards are considered severe and impossible to obtain-he expects too much beauty, morality, academic or athletic prowess, or artistic ability. Some are denied active fathering because their fathers are weak and ill with chronic illnesses like Alzheimer's disease, stroke, cancer, diabetes, and heart or lung disease. Many adult children, especially daughters, are stepping in and caring for the man they once looked to as a defender and provider. Such a role reversal, even if appropriate, is much like a funeral. For example, a demented father can never help his child again. In fact, he has become her child-at this point she is clearly on her own and functionally fatherless.

Probably the most common source of father deficiency involves fathers who isolated themselves from intimacy with their children by excess work during the children's formative first two decades. Even as retired men these fathers may continue to be emotionally absent from their families, leaving many of their children with an emotional void.

Men have been taught in American culture that real men don't cry or show affection. Subsequently, we have generations of children who have almost never received affection or experienced emotional closeness with their fathers.

Years of counseling have shown me that those who say they have great father relationships are occasionally the most troubled. It is common to use idealization to hide the reality of an unpleasant relationship. Sometimes in my work I have discovered that the child who is close to Dad may actually have been very hurt by his or her father's intensity in the relationship. The difference between overwhelming intensity and appropriate involvement is very subtle. An example of this can be seen by examining the life's work of composer Charles Ives. His father was a good parent by many standards, yet he controlled the entire life course of his talented child, even from the grave. Ives's story indicates that even a genius may live a life largely governed by a troubled connection to his father.

Charles Ives has been called "the most original and inventive, and possibly the greatest" composer in American history.11 He was born in 1874 in Connecticut, the son of George Ives, an energetic bandleader. George was an intense lover of music, and spent hours trying to pass on his passion to his son, making sure that the boy learned how to play a number of instruments. Charles identified profoundly with his father, taking up George's wildly experimental, inventive style of composing.12

Most people, on hearing of a father and son spending so much time together, smile in approval. But there is more to the story. Indeed, some people wonder if Charles was not overwhelmed by his father, perhaps even abused by the man's emotional intensity.

During Charles's college years, a number of conflicts developed between him and his father. Unfortunately, George died at the age of forty-nine before these conflicts could be resolved. Charles's feelings of anger and sadness were poorly worked through, and it appears he coped with his father loss by decades of idealization.

After his father's death, the music of his father filled his mind, perhaps haunting him, and he began to write constantly-utilizing every bit of his spare time to create music.

As Stuart Feder compellingly demonstrates in his book, My Father's Song, Ives's music was an "unconscious creative collaboration" with his deceased father, a way to mourn without mourning. Charles's songs were filled with references to his father, his father's hymns and marches, his father's eccentric sounds, and the sights that had surrounded them as they played together when Charles was a boy.

After almost thirty years of productive composition, Ives's output began to taper off. Why?

Feder believes that Charles's unconscious identification with his father affected not only the content of Charles's music, but the exact time it ceased. After memorializing his father in his musical compositions, Charles "died," in a sense, in that he allowed his creativity to die. Specifically, when Charles reached the age of forty-eight, he began to pull his works together, publishing them in 1922. The following year, when he was forty-nine (the age at which his father died), Ives's creative impulse died. The length of his father's physical life thus marked the length of Charles's creative life. While many of his materials continued to be performed and praised after this time, nevertheless, in his remaining decades Charles Ives functioned largely as a "cantankerous recluse."13

The life of Charles Ives shows that it is often difficult for a child to understand the depths of his father's influence. Ives was a brilliant man but he lacked insight into the effect of his father on him. Though he and his father spent time together, it was not a healthy interaction.

You may think your father was a "good" father, but for your own well-being, you must evaluate the relationship you had and have with him. Some of my patients call their fathers "good" as a way to defend against their "bad" experiences with them. I've heard many abused children quote their fathers as though they are sages. They believe their fathers are "good" because that's better than accepting the dark reality.

Even an involved father may not be a "good" father. Some men have trouble changing from being a protective father of a little child to a mentoring father of a young adult. Many protective fathers struggle to allow a young adult child to develop his own uniqueness, vocation, or parenting style. It's interesting to note that Charles Ives had his conflicts with his father when they stopped playing music together and Charles moved away, showing signs of independence.

Finally, calling a father "good" may be equivalent to saying he was satisfactory, i.e., he was not abusive, paid the bills, and came to birthday parties. Satisfactory may be the norm for American society, but is it good? According to two authors, what is normal is distant fathers who leave their children with feelings of incompleteness.

Victoria Secunda's Women and Their Fathers opens with five middle-aged women sharing lunch as they complain about their mothers. After a period of time, Secunda suggests that they chat about their dads. The conversation comes to an abrupt halt. Slowly it dawns on these women that their fathers are largely strangers to them. Sure, these women are able to talk about sterile facts such as their fathers' ages, birthplaces, employment, and health. But on the whole, their fathers seemed amorphous, mythical, and absent. Indeed, just mentioning them induced a "curious amnesia" in their daughters.14

Lee Salk's My Father, My Son discusses twenty-eight father-son relationships. What is striking about these relationships is the almost universal sense, even among those with kind fathers, that they have not received enough of their fathers' love. All of them felt they needed more.

Secunda and Salk show us that something is missing in father relationships, even in "normal households."

The implications of this father void are not trivial. When I talk to psychologists, social workers, psychiatrists, pastors, priests, pastoral workers, and schoolteachers, I repeatedly hear an emphasis on the need for healing the effects of father deprivation. In subsequent chapters I'll use cases to show the specific effects of such deprivation on your work, love life, emotional struggles, and identity. But you may also be surprised to learn how seriously spirituality can be distorted, blocked, or rendered empty-even among those who are considered spiritual giants-due to trouble with their fathers.

Chapter 3 - The Search for Lost Fathering

Angela was eight, with stringy brown hair and a wiry frame. She had just started ballet, and was obviously proud of her new white costume.

She was aware that her daddy and his guests were laughing out on the porch, so she thought it would be a great opportunity to show off the routine she had just learned.

Smiling excitedly, she tiptoed onto the porch and into our midst.

Her father glared down at her.

"What are you doing out here?" he demanded.

"I don't know," the little girl whispered, taking a step backwards.

"Didn't I tell you never to interrupt adult conversations?"

"Uh ... yeah ... "

"Now that we have all seen your costume, you can go back inside," he said firmly.

Sadly, with obvious embarrassment, the little girl turned and went back inside the house. We didn't see her again for the rest of the evening.

My heart fell when I saw how Angela's father responded to his little girl's longing for attention. That child needed to know she was important before the world had a chance to knock her down and make her feel like a loser. But instead of giving her the affirmation she needed, her father shamed her in front of his friends. He berated her need to be noticed.

I have met many Angelas in my practice, at my church, and among my friends. They may be adults now, but inside they are still children looking for a father to say, "What a lovely outfit! Could you please show us a few dance steps?" How many adults still ache to hear their father figures and mentors say, "Hey, gang, have you met my wonderful daughter? Boy, do I love her! She's the best!"

Angela went to her room that evening with a bruised heart, emotionally beaten down. Her hunger for affirmation not only remained; it had grown. Being shamed on the porch had only increased her need for encouragement.

As time goes on, things will change for that child. Her body will become a woman's body, her mind that of a woman. Her sense of the profound subtleties of human relationships will grow. She will put herself in positions and relationships that will let her be seen and built up. And, quite possibly, she will spend the rest of her life trying to earn the kind words she missed that day on the porch.

John is driven by the same desire. In a group setting he usually tries to answer every question, even if he really doesn't know the answer. He draws the attention of the group to himself because he needs others to praise him. Why? As I have gotten to know John and hear him talk about his father, I have learned that in John's experience for every kind word that came from his father's lips, there were at least three critical ones. John has been seeking approval since he was a little boy, trying to heal himself and show that his father's devaluing comments were wrong. John's actions say to the group, "Please notice me and tell me I'm special." Yet John is no longer a child; he is forty-eight years old.

Someone may protest that I am making too much of the father-child relationship. After all, a father is only one person among many who shape a child's identity. While that's true, it's also true that for many children their father has nearly defined their identity. And we are wrong if we think years or success cause us to outgrow our desire for a father's encouragement.

For example, I remember a restaurant owner, Tommy, who told me about the day he bought a brand-new Lexus. He went out to dinner with his parents and girlfriend, and after dinner, he went out to the parking lot to get the car. He began walking faster and faster to get to his car, finally breaking into a trot.

"Why am I running like this?" he asked himself. He felt ashamed of his behavior. I'm thirty-eight years old, he thought. Why am I acting this way?

As he and I discussed the incident, the answer emerged. Tommy's parents had parked on the opposite end of the street, and he wasn't sure they would wait with his girlfriend while he brought the car around. He was running because he wanted to make sure his father saw his fancy new car. Surely, he reasoned, if his father saw the sort of car he was driving, the man would admire and respect him.

But that's not what happened. His father's reaction was negative: "Never thought I'd see you in something like that. Bet the payments are a nightmare, huh? Well, hope you enjoy it anyway."

Tommy was deflated by his father's reaction, of course. But then again, his father had always been much freer with the insults than the praise-and so, even as a thirty-eight-year-old man, Tommy was still looking to his father for what he had never received as a child, and he was still coming up empty.

Why do fathers matter so much to people like Tommy? Why can't they be satisfied with a blessing from their mothers? The answer may have to do with a father's role in developing his children's identities.

Fathers and Uncertain Identities

A child begins life united to his (or her) mother. The child literally is fused into his mother's body. Even after birth, the infant is singularly dependent on his mother; she is the source of his nourishment and security. Over time, however, the child learns that the mother is a separate person-a potentially frightening realization, because independence means that you can be alone.

So where does the father enter in? In past decades, he was considered an outsider to the mother-child fusion, and referred to as the first "outsider." In many homes, the job of raising infants and young children was traditionally delegated to the mother; fathers represented "the world," the part of experience that was "out there," beyond the front yard of our homes.

However, in recent years fathers have come to be seen as capable of bonding very early with their infants. In fact, researchers say that whoever cares for the child's physical needs in a tender and appropriate way will be noticed by the child.1 Burlingham notes that even in the mother-child act of breast-feeding, the child can be looking up at the father while suckling.2 This means that infants can get messages from their fathers and may bond very early with them-if the men are tender and nurturing. But while it is possible for men to bond with infants, such tender intimacy is rare.

A child's father is typically the first male to write his thoughts and feelings on his child's heart. Fathers, therefore, need to be sensitive to the messages their every word and action inscribe on that tender surface. Their children enter the world like tiny sponges, ready to absorb every little impression about themselves and their identity. They are unsure of who they are: Am I special? they ask. Am I valuable? Am I good? Am I merely an annoyance? Their fathers play a primary role in answering those questions.

Last month I was playing golf with a close friend when he hit a ball into the water hazard. (I suppressed the urge to dance, and managed a sympathetic look.) Later, he hit another ball into the water.

"Joe," he muttered to himself, "you are as brainless as a crow." On the final hole he hit the ball into the woods and said the same thing.

After the game I asked him where he picked up the "brainless as a crow" expression. He said he wasn't sure; we dropped it, and the conversation turned to other things.

A few days later I was at a party when Joe's older sister dropped a paper plate full of goodies onto the carpet. Her immediate response was to scold herself for being-you guessed it-"brainless as a crow."

Naturally, I asked her about that unusual saying. She paused for a moment, and then remembered that it was something her father had always said to her when she was "bad." Today, these two adults still belittle themselves with the same words their father used, even though the man has been dead for twenty-five years.

This demonstrates the degree to which the words and actions of our fathers affect our identities. Our fathers are carried around inside us long after they have died. We continue to model them, dialogue with them, and listen to them, even after they have been gone for decades. Many of us continue to mirror the image of ourselves that our fathers have written on our souls.

Individuals who did not receive a supportive self-definition from their fathers when they were children can sometimes feel insecure and easily shaken. Those who did receive encouragement and support are more apt to stand strong in the face of life's raging storms.

Jean is a ten-year-old who has a pale face framed by rather unflattering glasses. She is not especially outgoing, but the kids in her school and neighborhood seem to love her.

Jean's father spends a good deal of time at home with his family. He is considerate and respectful to his wife, and he is constantly holding and praising his daughter. He laughs a lot and seems to genuinely enjoy his daughter's company. My impression is that she first faced the world with this message on her internal blackboard: "I am fun. People like to hold and hug me. I have value just as I am."

People who enter the world feeling valued have a benefit that is not often recognized. Others respond differently to them than they do to those with fragile identities. Why? Because individuals project a "spirit," an "identity" that people pick up. For example, the child who enters a new playground thinking, "I am worthless, and nobody will like me," often finds the other kids treating him as if he is worthless. And, as Jean illustrates, the reverse can be true. People pick up her contentment and security, and they treat her accordingly.

But many people do not have Jean's sense of wholeness and cohesion, and Cathy is a prime example. I met her after she had attempted suicide.

Unlike many suicidal patients, Cathy did not appear to have any clear signs of a biological depression. She had experienced no weight loss or gain, no fatigue, no problems concentrating, no sleep irregularities, and no appetite changes. After I ruled out biological depression, we talked about her life. It seemed clear to me that her sense of identity was dissolving because her husband had asked her for a divorce. She could not think of being alone; that was "impossible," she said. As we talked further about her marriage, it became evident that her husband had provided her the love and attention her father had never given her.

Cathy's father had worked ten to twelve hours a day as a corporate salesman, and was often on the road for days at a time. When he was home he was emotionally unavailable. She said he was typically grouchy and irritable, "like he would be much happier if we weren't there."

Her mother had also felt alienated by the man, and had looked to her children to be her friends. Cathy found her mother's behavior too stifling and emotionally incestuous, and she wanted out of the house. At the age of twenty-three, Cathy met Tim, a man who seemed to be able to provide the "out" she wanted.

When I asked her about the events just prior to her suicide attempt, she said softly, "Tim asked me to come into the dining room. He said, 'I suppose now is as good a time as any to tell you this ...'"

She caught her breath and continued, "When he says this I'm freaking out thinking 'Oh, no, what's this all about?' I got really scared, and I could barely follow him because I was so tense. His face looked so hard. He'd been distant before, but this was different." She stopped to wipe her eyes.

"He told me he wanted a divorce."

After a few minutes, she went on. "I can't live without him. Please help me get him back. I'll never make it by myself!"

Cathy is grieving the loss of a spouse, of course; but she is also experiencing the dissolving of her psychological self. Her identity is like a puzzle board with each piece held in place with glue-and Tim is the glue. Because her father, the first key male in her life, was emotionally absent, she was unable to get glue from him. She entered the dating arena looking for someone to glue her fragile identity together. Tim played that role for a while, but now he is gone, and her identity is fragmenting-like a puzzle knocked off the table and onto the floor.

Pam's situation illustrates the same principle in a more subtle manner. Her father and mother were divorced when she was five, and she sees her dad two or three times a year when he is "in town" on business. In our last session, we talked about her employer, a professor at a local university, whom she has known for three years.

"I'm bummed out today," she told me.

"Why is that?"

"Dr. Reynolds and I aren't getting along all that well. My job's just not as fulfilling as it used to be."

I was under the impression that she had been satisfied with her work, but we hadn't discussed it much. As we talked further about her week, she mentioned that her father had unexpectedly come to town and invited her to lunch. She described their lunch as "annoying."

Then, when she returned to work, she felt that Dr. Reynolds was responding to her differently.

"We went over some class handouts and a research proposal, and I had this sense that he didn't like me-like he wished he had another secretary. He was critical and distracted. I don't know ... I just didn't want to be there working with him."

A general pattern emerged over the months that followed. Pam became more sensitive after a difficult visit with her father. After time with her dad, if she was criticized, it would hurt more than usual. If affirmation and praise stopped flowing toward her, she became insecure and needy. Her father shook her identity. When her father flew out of town, it seemed he left with Pam's confidence.

Pam was often able to get Dr. Reynolds to help restore it. He was able to glue her back together with his encouragement and attention. She loved it when he was "nice." But she hated it when he was "too businesslike." When he criticized her, even for legitimate reasons, she experienced it as a catastrophe, because she needed him to hold her together and make her feel whole.

We all need people to support and affirm us, of course. But Pam's unresolved identity issues were causing her to relate to her employer inappropriately. She longed for his affirmation after her father's visits, and when Dr. Reynolds did not supply it, she lost interest in the job, and in him.

My sense is that many people do what Pam did. They seek to heal their father issues in unproductive ways. They overwhelm a spouse, their friends, mentors, or work associates. Sometimes their hunger to feel valued causes them to join abusive groups and unsound or manipulative religious organizations in an effort to find loyal acceptance and self-worth. They run to substances like alcohol, drugs, and excess food, or try to fill their void with a "high" from compulsive exercise or self-debasing sexual experiences. They work themselves mercilessly because they hope that achievement will earn them a sense of value and self-respect-something their fathers never gave them.

It is not merely a child's identity that a father influences, but also his or her life goals, motivation, sexuality, and relationships with other people.

Go Ahead and Hurt Me-I Deserve It

"Why won't she leave him?"

One of my staff asked me that question once about one of my clients who was in an abusive relationship. One often hears of people who are repeatedly abused, yet decide to stay with the abuser. Why do they endure such treatment? While I believe the answer to that question has many elements, part of the answer relates to identity. Your self-concept dictates, to a great extent, how you allow people to treat you.

Julie illustrates this principle. She was sexually molested by her father from the time she was eight until she was twelve. When she finally became able to talk about it, she asked, "What was it about me that caused him to pick me over my sisters? There were four of us, and he picked me out."

That was the wrong question. It sounds as if her experience has made her embrace a masochistic vision of herself. The real question was, "Why did my father engage in sexual abuse?" But children see the world in terms of themselves. A child's mind reasons, "Bad happens because I did something to cause it-because 'I stepped on a crack,' or 'I was bad.'" Like many children, Julie felt she was being abused because of some personal defect, though the defect, of course, was her father's.

Unfortunately, as Julie entered adulthood she emotionally disconnected herself from the abuse. She treated her father as if nothing had happened, and tried to live as though nothing had happened. But it had happened, and it affected the way she let others treat her. For example, she regularly let her roommate violate their rental agreement, and when a conflict arose, Julie readily accepted blame, even when her roommate paid the rent two weeks late or invited guests for a weekend without consulting Julie.

Julie endures such abuse because of the "lessons" she learned from her father. His behavior "taught" her to expect such behavior as a child; consequently, she endures it as an adult. When she was a child she was too young and too small to resist her father, but that is no longer the case. Julie needs to confront her father, and come to terms with the effects of that relationship. Only then will she treat herself with respect-and expect such treatment from others.

Eddie is a college English teacher in his forties. He once heard me speak on father-child relationships and decided to come for counseling. We talked about his disappointment with his work and about his father's worsening lung cancer.

Eddie wanted a greater closeness with his father before he died. He did not understand why he felt angry towards his father. How can I be angry with a man who is weak with cancer? he asked himself. Eddie also thought of all the fun they had had in recent years watching football together. It didn't make sense.

Eddie started a journal in an attempt to understand his confusing emotions. As he journaled, his mind often turned to his childhood years. He kept seeing mental pictures of his father sitting around the house looking sad and disappointed, a mood that filled the house.

When Eddie was a child, his father would often complain angrily that Eddie had left his room a mess, or that he was doing his chores improperly. Eddie also had the sense that when they ate dinner together, his father was not especially enjoying his company.

He believed that he was somehow responsible for his father's unhappiness and felt that he must have been flawed to cause his father to be so depressed and irritable. As we talked about it, Eddie realized that he had generalized his father's nagging and complaining to mean that his father had rejected him as a person.

"I always sort of thought he loved me," Eddie explained. "Later in life, we became quite free in our words of affection. But I think it has to do with an overall impression."

"What do you mean?" I asked.

"When I was young, he'd get angry at the work I did on the house. The painting was sloppy, the windows weren't clean enough, the dishes weren't washed promptly enough. When I was older, he didn't like any of the girls I dated. Then, when I was married and had two kids of my own, he didn't like the way I was raising them. I don't know. What's the point?" He sighed deeply.

"What's the bottom-line message you take away from this?" I asked.

"That I'm stupid and he wished I hadn't been around."

You see, a double layer of communication was going on between the two men. In recent years they had developed the capacity to express their love for each other, yet other messages had been communicated by decades of disagreement and disapproval. Unpleasant verbal and nonverbal communication from the father in the past carried more weight than more recent positive communication. The message of four decades was far stronger than the recent warmer words between them. These insights helped explain the alienation the son felt. In the months prior to the older man's death, Eddie was able to discuss his unhappy earlier dealings with his father. After some tense conversations, Eddie and his father slowly achieved a greater intimacy and understanding. When Eddie's father finally died, Eddie had closure in their relationship.

Much like My Father

Ken's relationship with his father is threatened by the elder man's tendency to criticize his son. For example, last year his father came to a party at Ken's house. While Ken was barbecuing the chicken his father made a big deal about the poor job he was doing.

"You're letting the chicken burn!" he said. "Did you marinate it?" "You'd better get those flames out." Ken told me he got so mad at his father he wanted to "punch his lights out."

But for all his indignation toward his father, Ken treats his own family the way his father treats him. During a family therapy meeting, his older children said he is "a chip off the old block." They say he is controlling, opinionated, and critical, not only toward them, but toward his wife as well.

I see this pattern again and again: The children who resent their father's behavior often unknowingly mimic that behavior. It seems to be a natural tendency. When a child is hurt by his father, he relates to others the way his father related to him. But there is an additional psychological principle that may contribute to why Ken could be considered "a chip off the old block."

Leonard Shergold explains the mechanism that can cause someone to identify with an abusive father in his book, Soul Murder: The Effects of Childhood Abuse and Deprivation. Overwhelmed by the sheer power of the adult, and utterly dependent, the child is emotionally crushed. The child must have a "good" parent, and therefore, sees the parent's bad acts as "good" or legitimate.3 In other words, if the only person the child can depend on to protect and defend him is cruel and abusive, the child tries to justify the cruelty. The alternative, that there is really no one to protect and defend him, is just too hard to take.

There is hope for hurting children, though. Abuse does not have to be repeated. Decades of criticism and neglect can be overcome. But healing first begins with further insight-insight into the ripple effect a father has on all the family relationships.

Chapter 8 - The Orphan's Need for Security

Many of Charles Dickens's books have a character like Oliver Twist, a frail orphan who was born in a dingy poorhouse. Dickens's portrayal of the orphan is powerful because he experienced childhood isolation and orphan-like fears himself. He knew that without a loving, protecting father, the world can be a dark and scary place.

Because many novels have autobiographical elements, the character of Oliver Twist may offer insight into Dickens's own sense of isolation. Oliver was clearly born without a father, and from the first words of the story, the raw vulnerability and isolation of his life are poignantly clear.

For a long time after it was ushered into this world of sorrow and trouble ... it remained a matter of considerable doubt whether the child would survive to bear any name at all ... The fact is, that there was considerable difficulty in inducing Oliver to take upon himself the office of respiration-a troublesome practice, but one which custom has rendered necessary to our easy existence; and for some time he lay gasping on a little ... mattress, rather unequally poised between this world and the next: the balance decidedly in favor of the latter ... There being nobody ... Oliver and Nature fought out the point between them.1

According to Peter Ackroyd's extensive biography of Dickens, the book's plot was associated with "the pains of his childhood,"2 including an incident in Dickens's childhood in which his father's unwise handling of money sent the man to prison for three months. Indeed, the entire family (with the lone exception of Charles) was sent to prison because of the father's indebtedness. For three months, Charles walked through a huge city alone, "cold, isolated, with barely enough to eat."3

Such experiences are not quickly or easily processed, and will make a lasting imprint on anyone-of any age. In the story of Oliver Twist, the newborn baby had to fight for the very air to breathe, a symbol of the orphan's struggle for life, for love, for everything. And, like the infant in Dickens's novel, the emotional orphan may not even be aware of his struggle-or its cause.

Pastor Fred grew up in a family with a very weak, passive father who was emotionally removed from the family. Because his dad was listless and disinterested, Fred never "connected" with him emotionally. Consequently, Fred has trouble "connecting" with and caring for the individual people he has been given to shepherd, and that's very bad news for those parishioners looking for his empathy.

When he was hired last year to serve in a moderately sized church, Pastor Fred surrounded himself with people who would support him. But it has become evident that he does not connect with them as people. They are impersonal pawns that he uses to prop up his empty inner world, a world in which he was left alone and undefended by his withdrawn father. When he talks about caring for his parishioners, he has no idea, really, what he is talking about; he is playing a role. He was never really cared for or valued himself, so he doesn't know how to care for the members of his congregation.

During Fred's therapy it seemed at first that I was simply a token therapist; he could be talking to anyone as long as he was getting attention. After two years, however, a slow change began to take place. Fred began to see me as a separate person; when I was out sick he seemed to genuinely feel for me, not just because he was missing what I could do for him in therapy. Slowly, but steadily, Fred has grown. In finding someone who genuinely cares for him, he has come to the place where he is beginning to be able to genuinely care for others.

Orphan psychology also affects how we respond to criticism. When we are put down and told we "are not quite right"-particularly by someone as important as a father-we can tend to see the entire world as a dark and unfriendly place, a place in which we feel outcast, rejected, and alone.

An emotional orphan who is criticized by a spouse, a friend, a lover, or an employer is likely to react with hostility or quick withdrawal. That's because the people closest to us shoot at closer range. And, if the father's critical nature has already left a scar, the orphan will be particularly sensitive to criticism.

Pleasing Others to Feel Safe

Tricia has always been close to her father. He is fairly intense, a real "go-getter" in corporate law. I would describe her as being very much like her father, because she has his high "standards," which she applies to her nursing career, relationships, morality, financial security, and her family. He taught her these things when she was growing up, through his own example and through regular, consistent criticism-most often the latter.

Tricia exhibits constant restlessness, though she does not appear to have a biological anxiety disorder. Her restlessness seems instead to be fueled by her desire to please so many people and, even more specifically, by her desire to avoid criticism, because "it hurts so much." She goes out of her way to please people in order to prevent their hurtful criticism or disapproval. During one session, when she was slouched down in her chair, looking totally out of it, I told her, "You look more tired and sleepy all the time."

She sighed. "Well ... it's been a busy week, and I'm tired."

"What made it so busy?"

"I offered to stay late at work Monday because my nurse supervisor-she's a friend of mine-needed me to work a double shift. And Tuesday was rough because my friend from church had a baby, and I was organizing meals for ten days and cleaning her house."

"How did you come to do that?" I asked.

"Oh, I volunteered to do it at my local home group meeting. We usually do this for new mothers, and when no was else was speaking up ... ah ... the home group leader looked over at me and ..."

"And you thought she wanted you to volunteer?"

"That's right. And then last night my mom asked me to help her set up the house for my cousin's baby shower. So I went over, and it took twice as long as expected. I guess it was fun-well, my mother seemed to enjoy it-but I never said I could stay for five hours."

"So why did you?"

"Because my mother would tell me she really needed me ... or she would say I wasn't being thoughtful to my cousin if I left."

Tricia finds it painful to refuse anything to anyone. The more someone expects, the more she is willing to submit and ingratiate herself to them. She fears that refusing her time to someone will earn her criticism and, in a small way, rejection. She uses offensive pleasing to keep everyone liking her, and to prevent the pain of anyone criticizing her.

Using Criticism to Feel Safe

Tricia tries to please people to be safe, but Christopher manifests his orphanhood in defensive criticism. In other words, he believes in lowering the boom on the other guy before the other guy lowers the boom on him.

When Christopher was a child, his father was usually at work from eight in the morning until seven at night, and then was irritable when he got home. Generally, the family's priority was not intimacy; it was getting out of Dad's way and avoiding his verbal attacks. Christopher grinned when he talked about his home environment, but as the memories unfolded it was clear that there was nothing funny about it.

He became sad as he recalled being told over and over again to "be quiet." He said he rarely did fun things with his father. In one session, Christopher mentioned that his conception had been an "accident." He wasn't sure how he had learned this, but insisted that he had heard it a number of times.

He thought he had found the love of his life in Melanie, a girl he had dated for five years, but shortly after they became engaged she called it off.

I met him when Kate, his new fiancée, talked him into coming for premarital counseling. She felt that Christopher was constantly "adjusting her." As later became apparent, he had been quite hurt by his father's critical tongue, and his joking bravado was really a defense mechanism. When his ex-fiancée, Melanie, broke off their relationship, she added to Christopher's sense of disapproval. He never talked about his fears or insecurities, but dragged his feet in his relationship with Kate instead.

Most importantly, he was regularly critical of Kate. After discussing "the facts" over two sessions, Christopher began to listen to Kate's appeals that "he is trying to make me perfect before he will marry me." He initially thought she was exaggerating, but he slowly gained insight into his fear of a commitment to her, realizing that he was afraid to "take in" another person who could hurt him.

Orphans and Control

Margaret was molested by her father when she was about eight years old. She later learned that her younger sister had also been abused. She has had some counseling over the years and currently works in a department store. She has a couple of long-term friends, one of whom is her roommate.

Margaret came to see me because she was depressed and because she was having trouble with her roommate, who felt that Margaret's standards for cleaning the house were "to the moon." I assumed that meant too high. Margaret liked things organized and clean. She also liked things clearly scheduled and predictable. If I kept her waiting for five minutes, she would become intensely annoyed; a cancelled appointment could ruin her entire day.

We eventually addressed her need for a controlled and ordered environment. When she was a little girl, her father's incest had subjected her to boundary violations that shook her deeply. In response, she tried to order her world in a way that compensated for the tremendous chaos of her home. Control, order, and predictability became her solution to her father's abuse. Unfortunately, she was still trying to offset her father's conduct in new environments and relationships that held no threat for her.

Margaret's need for control and order also translated into an acute concern for morality. She adhered to strict moral principles-and expected others to do the same-but she was motivated largely by fear, not piety. To her, morality was a way to control the world in the hope of preventing the kind of violation and trauma she had faced as a child. Because she had been overwhelmed by her environment in the past, she now wished that all those around her would act in ways that were morally predictable and safe. In this way Margaret is like so many with orphan emotions who try so hard to write a different ending to their experience, only to cause other problems with their "solution."

Orphans and Fantasy

Many father-child relationships are characterized by fantasy, especially ones in which a father is dead, absent, or abusive. If a father dies while his children are young, they may fill in the blanks, continuing their relationship with a fantasy father. Others use fantasy when their dads are frequently away from home, perhaps imagining their fathers working in faraway places. Still others use fantasy when a father inflicts hurts on them that are too distressing to face. Some in this latter group use fantasy to construct a romanticized view of their fathers, magnifying their fathers' good aspects and minimizing their faults.

The Orphan's Need for Certainty

Ron is a minister from Maryland. He sends me an occasional client as a "last resort." Before he referred the first client in my direction he wanted to meet with me a couple of times to make sure I was competent. Our lunches were nice breaks in the day; he has a delightful sense of humor. Nevertheless, I was struck by his sense of certainty regarding controversial issues.

Ron has a deep commitment to the Bible, and yet I believe his certainty has little to do with "faith." In fact, I think it is an example of his lack of faith. He was born in suburban Atlanta, the oldest boy in a family of five. He told me:

It would be two in the morning and my mother would be walking by my room to go to the hospital. She'd tell me that everything was fine, and that she'd be back in a few hours. But the redness in her eyes let me know that she was not fine. She'd tell me my father was ill and would probably be in the hospital for a few weeks. I didn't let it bother me. It had happened before and I could see the slight warning changes in his behavior. He would start talking faster and work more around the house. Mom would ask him if he was taking his medication. He would complain that he didn't like the way it made him feel, and after a while he would become irritable, and then he would start spending money. After that, he'd just disappear for a few days. Sooner or later, someone would see that he was acting bizarre and call the police. He'd wind up at the emergency room in the hospital once again.

Obviously, Ron did not have much stability in his home while he was a child. He could never be sure when his father would stop taking his medication and become manic or psychotic.

It may have been that uncertainty in his childhood that made him long for certainty as an adult. While I never did get to know Ron well, I was struck by his adamant feelings on difficult political, theological, and moral questions. He seemed to have all the answers, no matter how complex the question. Ron's opinionated views may have grown, to a great extent, out of the fathering he had received when he was a child. The point is that he brought his need for certainty, his fear of further chaos, to his reading of the Bible. And in the end he had more answers than Moses.

Now that we have discussed Margaret's need for control and Ron's orphan-like hunger for certainty, let's combine them. And I want to do it by talking about my father.

My father was not only intelligent, he was also driven. Once, looking back on his life, he told me, "Sometimes when I think about how I was back then, I sort of shudder. I realize now how much I gave to get out of poverty, as if I'd have been willing to sell my soul just to become a doctor and have a little money."

He was the tenth of eleven children, born in 1932, the same year his father walked home from his engraving work in tears because his pay had been cut in half. My father was too young at the time to understand it, but the story of his father's tears was retold on many occasions and was a source of fear to the entire family.

My father grew up in Lancaster, Pennsylvania, far from the Amish farms associated with the area. His family lived in a narrow, poorly heated row house with minimal insulation and a tin roof, and my father slept in the attic. In the winter he could see his breath, white fog floating out from under the covers to join with the fog of his three siblings in the same room.

My father was also deeply affected by wartime life. From the age of nine until the age of thirteen, he was faced with rationing. He would stand in line for meat, flour, and sugar. He vividly recalls regularly going to the meat market and waiting an hour in line for a pound or two of ground beef. And often after an hour wait there was no meat left.

During the war, he also came to realize that the poorer people were sent to the combat lines and exposed to the worst threats of the battle. Many of his older brothers-in-law were in the infantry or paratroopers. He also had a sister who served. But most disheartening was the death of his cousin, a man who lived only three doors up the street. Three others from his block also gave their lives in battle, and my father wondered whether the streets in affluent neighborhoods had so many dead.

My father especially wondered about this when he delivered newspapers in the Grandview area of Lancaster and saw the single homes with large, beautiful lawns. Imagine actually having so much room that you wouldn't hear your neighbors' conversations through the wall, he thought. And you could play music and no one would complain about the noise.

All these experiences combined to create a fantasy of a different life. A life with no wage cuts, cold winters, meat lines, or war dead. A world in which the privacy of a home was guaranteed, and one in which you were self-employed-and therefore in control of your own future. It was this fantasy that empowered him to spend thousands of hours in study to reach it.

Sometimes orphans become isolated by spending countless hours on their business or studies-whatever it is that will save them financially.

While my father had loving parents, he nevertheless had a specific area of orphan-like vulnerability. He swore that he would never be poor, no matter what it took. This is typical of the orphan mentality. Those who have experienced the economic vulnerability of the orphan often swear that they will never face it again. Some will do anything to avoid poverty.

The Orphan and Friendship

I first heard about the street children of Rio de Janeiro from my close friend Tim Manatt, a man who travels throughout South America and Mexico every year. He saw thousands of children living there in the streets. Such children have a great deal to teach us about the relational alternatives people use when they are alienated from their fathers.

Street children show us the importance of friends to orphans, or those with incomplete father relationships. They show us that friends can sometimes become a surrogate family, and any change in friendships can be very disconcerting for the orphan.

It is estimated that there are presently forty million abandoned children on the streets of Latin America's cities.4 Some are "cute" children who can be seen begging at an airport or hotel, shining shoes, singing for small change, or carrying groceries; others are pathetic waifs, dope addicts, and irresponsible rebels.

While there are significant dangers from living on the street, one study showed that the physical and emotional health of the street children is often better than that of their brothers and sisters who remain at home.

The street children have developed a level of life that very adequately compensates for the deprivations in their homes. The authors who have studied this phenomena note a significant difference in the average weight which favors the street children when comparing them with their siblings at home, which [is due] to better nutrition.5

Much of the research shows that these children, though mostly uneducated and illiterate, are surprisingly intelligent, and have a keen ability to take care of themselves. Indeed, begging in such a competitive environment is hard work that requires intelligence, social insight, and stamina.6

But some ask, "If these children are so smart, how do they come to live on the dangerous streets?" The answer lies in where these children come from. Most are not abandoned, but come from fatherless families. If a father or stepfather is present, he often makes the children work and hand over their earnings. With either an absent father or one who seems to care only about the money, the children begin to look to the streets for caring, secure relationships, often finding better relationships there than at home.7

In the streets, they find two key replacements: peer friendships and older, father-like males. The boys typically begin to investigate the relational options on the streets and discover that they are better than the options at home. At night these small boys can be seen huddled together under blankets or newspapers, squeezed into cardboard cartons, in ways that are a picture of the emotional comfort they find in these intensely close relationships. In the daytime much of their attempts at finding food or money are done together, and they typically share in each other's success.8

All of this makes me think of the dozens of adolescents I have treated, so many of whom have followed a path similar to that of these street children. These children began to look outside their homes for emotional replacements for their fathers (and occasionally their mothers). Their friends became their families, and their older friends or mentors became their heroes. While part of this process is typical of adolescence, it often occurs early or is more pronounced when the child feels like an orphan due to a mediocre father relationship.

Orphan Survival

While some of those with orphan feelings give up (emotionally or physically), many rise from their loneliness and make a decision to take care of themselves. They learn how to take the best advantage of any situation.

In the evening ... [Roberto and Antonio went to fashionable Sixth Avenue]. After receiving some malignant looks and rude comments from people, they stopped on a side street where a rather young affluent couple were dining at an open-air restaurant, a few feet from the street. When the boys asked them for food, the couple tried to ignore them. The two boys sensed that they were intruding on a special occasion and so were insistent, thinking that they were likely to be paid to leave the diners alone. Finally the man who was dining told them in a loud voice to leave. When they did not, he called the waiter for help, who halfheartedly told the boys to go. They went across the street, maintaining minor eye contact with the diners, who were losing the pleasure of their occasion. As the waiter disappeared for the moment inside the restaurant, Roberto approached from one side and asked once again for something to eat; Antonio came from the other direction and grabbed a piece of meat off the man's plate. Running and laughing, they headed into the darkened street ... [And] tiredly entered their vacant corner, which they called "home."9

Could it be that Roberto and Antonio were not just trying to fill their empty stomachs? They might have met with quicker-and less risky-success elsewhere. The two boys seemed to be also working that day to fill their emotional hunger and emptiness, and their stimulating exploits helped them do that.

When you feel an emotional hole, you will look to anything that might possibly fill it. Sometimes individuals with orphan feelings use food, drinking, constant exercise, sex and aggression, movies, intense music, excess work, or drugs-anything to temper their sense of vulnerability.

Occasionally I see a desperate orphan-like survival reaction in the middle of marriage counseling. John and Lila had been married for six years and had one newborn child. After the baby's birth, Lila cut her work hours, bringing on new financial pressures, and John's work responsibilities were increased (with no raise). These developments added a significant amount of stress to their relationship. Both parents reacted like orphans.

"When I try to share my feelings he reacts and gets his 'Mr. Know-It-All' face on," Lila said. "I want to pop him one when he gets that pompous look."

"She can share all the feelings she wants," John chimes in. "It's not the feelings I get annoyed at, although the first three minutes in the door is hardly the time I want to hear them. Her expectation is that at any moment I will drop everything else and try to meet her needs."

"What is it you want from her, John?" I asked.

"You know ... some space. A little bit of freedom. Not feeling as if I'm giving my last ounce of strength when I'm with her."

"And Lila, what do you want from John?"

"If I share my feelings with him, I don't want to be told that I'm wrong, and have him belittle me."

"Anything else?"

"Ummm ... yeah. I just doubt that he's ever going to have time for me, because-"

"She says that even after I've been with her for three hours," John interrupted. "She never thinks I'm spending enough time with her, even when I've spent the entire weekend with her."

In listening to them, I was struck by their orphan-like insistence that they each be heard. They were unable to hear each other's concerns because they were in an "emotional protection mode."

John cried out for freedom and space because he could not find the emotional resources to listen to Lila's feelings. Lila thought that John should put her feelings above all else. However, John is emotionally impoverished; he has no "energy" to meet many of Lila's needs, and reacts by refuting her comments or intellectualizing them away. Basically, both of these people have decided that they will survive in this marriage-regardless of the cost to the other person. They will "survive" by talking over and over again about what each wants, by ruthlessly defending their individual rights-in short, by acting like orphans.

The Orphan's Loneliness

We can see, from John and Lila's example, that marriage does not prevent loneliness. In order to combat loneliness, a marriage needs a measure of intimacy and some wholeness from which to give. Loneliness can occur in the largest families, in the most crowded conditions, and at all stages of life.

One of my patients, a woman whose father was an irritable alcoholic, told me she used to fill her bed with big dolls and stuffed animals. Then she would cry herself to sleep at night as she heard her father ranting and raving throughout the house. Whenever he started shouting, she would clutch her big teddy bear in an attempt to find the comfort and protection she could not find in her father. She told me through tears that her best friend while she was growing up was that stuffed animal.

My ninety-year-old grandmother is far more mature than that little girl, but she fights orphan loneliness, too. She and I are very close and talk on the phone at least a couple of times a week. She still lives in her own home, alone, with an occasional visit from my parents. She explains how age isolates: "You reach your fifties and a few of your friends die. You are affected by it, but you have other friends and you move on with your life. But by the time you reach your eighties, your spouse has died, and any living friends have moved to Florida or are in a nursing home. Your body decays, and your knees hurt just to stand up. And going out looks more and more impossible because anything-heat, cold, whatever-really bothers you."

As my grandmother has aged she has increasingly talked about death, but I guess that is appropriate as her body grows weaker and her feelings of loneliness increase. Some say death is the one thing we do alone. It is the point of our greatest loneliness. But in the case of Mildred, I would have to disagree ...

The Loneliness of Facing Death

Some moments of aloneness are not everyday experiences. Life ebbs and flows, and so does the sense of isolation. There are valleys. And there are mountaintops.

My experience with Mildred was one of those peak experiences in isolation. She was the first person I ever escorted into death.

She was an elderly woman who had been hospitalized many times; she had been through radiation and chemotherapy for the lymphoma that had spread throughout her body. I was a raw, new subintern, a fourth year medical student, assigned to her for a month.

When I went in to see her for the first time it was 6 A.M. and she was sound asleep. I hated to wake her, but my job required it. Mildred was annoyed by the interruption. I apologized for troubling her, in a sleepy manner that only burned-out medical students can do, and asked if she minded my listening to her lungs. She said she was perfectly willing to do whatever I asked, just as long as I didn't ask her to use any of her own muscles. It was obvious that she felt miserable, but there was still a glimmer of her old mischievous nature showing through. She struck me as the kind of person who, as a child, had always gotten under her teacher's skin. I'm sure that she had been full of adventure and trouble, but wise enough not to get caught in her mischief. We became fast friends.

After a few weeks, it became clear that Mildred was going to die, but no one wanted to admit it. Her doctors procrastinated, but it was reaching the point where I felt she should be told where things stood. She would talk to me about what was going to happen when she went home, and I would sit there listening as if I thought it was really going to happen. It made me feel like a terrible fraud, so I finally asked the senior doctor's permission-which he granted-to talk to her about her situation.

Mildred accepted the news stoically. After we talked about her terminal condition, I came to see her two or three times every day. Her two daughters came to visit, too, but they had their own responsibilities and were already letting go-years of hospitals had worn them out. Soon our conversations turned to questions of faith. It seemed to be a comfortable place for us to be-a young doctor and a dying old woman, one person standing at the door of death, experiencing the ultimate orphan emotions, and the other acting as a simple human presence in the dark hospital room.

We prayed every day. Mildred said it helped for me to hold her hand and pray that God would be with her. She was so different from me. We were separated in age by half a century, of different gender, from different ethnic groups. I had nothing but a future, she had nothing but a past. But when we prayed, God changed the desperation of a dying orphan into gentle confidence and peace.

I was not with Mildred when she died. I had said good-bye the evening before and we had talked very seriously about her death. During our last conversation I told her I would see her on the other side, and I hoped she would be there to greet me when my time came to undertake the journey she was about to make. She smiled and nodded. She died early the next morning-sometime around 6 A.M.

Her death took me back to my first day with her, when I haltingly entered her room about that same time in the morning. I thought about isolation and vulnerability, and how, in the end, we are all orphans left to go on our final journey alone. I had walked her to the foot of the mountain and waved good-bye, but in the end she climbed alone. Yet I do believe that Someone escorted her on her final climb.

Note: Reading this article assumes you have read the informed consent on this site. Never self-treat based on this article. Always consult licensed medical and mental health practitioners.
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