Why we are sad and depressed (and how we can become "happy")

This fascinating New York Times magazine article -- Depression's Upside -- reminds me of a scene from Annie Hall The depressed Woody Allen character stops a good-looking couple on the street:

• Allen: Here, you look like a happy couple, um, are you?
• Woman: Yeah.
• Allen: So, so, how do you account for it?
• Woman: Um, I'm very shallow and empty and I have no ideas and nothing interesting to say.
• Man: And I'm exactly the same way.

In other words (according to Woody Allen, at least), chronic happiness -- as attractive as it might look from afar -- comes at too great a price, the price of being incapable of having interesting thoughts and doing interesting things.

The main psychologists profiled in the Times article say more or less the same thing, but from the opposite perspective: They claim that depression has a function -- the function of allowing people to do the kind of thinking required to come up with creative and effective responses to really tough (and interesting) challenges and questions, including challenges that lead to grief. Evolutionary psychologist Paul Andrews, for example, is quoted as saying about the person who has experienced a divorce or a tough breakup:

“I started thinking about how, even if you are depressed for a few months, the depression might be worth it if it helps you better understand social relationships,” Andrews says. “Maybe you realize you need to be less rigid or more loving. Those are insights that can come out of depression, and they can be very valuable.”

This idea that depression (maybe it's better to just say, sadness) actually has a function that should not be routinely medicated out of existence with Prozac and alike reminds me of some books I have encountered over the last few years that have influenced me, including Healing the soul in the age of the brain and Thomas Moore's Care of the soul. I was also reminded of the New Yorker's recent article on grieving around death, which asks the question of what the function of grief might be.

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I am also reminded of some thoughts I've recently had about the first Psalm (for which I have the Schechter Institute in Jerusalem to thank for the inspiration; check out their new blog on the Psalms). Psalm One starts out:

אַשְׁרֵי הָאִישׁ-- אֲשֶׁר לֹא הָלַךְ, בַּעֲצַת רְשָׁעִים;

וּבְדֶרֶךְ חַטָּאִים, לֹא עָמָד, וּבְמוֹשַׁב לֵצִים, לֹא יָשָׁב.

Which is typically translated something like this:

Happy is the man who does not walk in the counsel of the wicked,

nor stands in the path of the sinners,

nor sits in the seat of the insolent.

But I don't think happy is a very good rendering of what the Psalmist meant here (with the word אשרי/ashrei). The results of following God's ways -- the ways of Torah, as the next verse says -- are not simple happiness; rather, they are a deeper kind of fulfilment and satisfaction -- perhaps, blessed, is a better word, as the King James and some other translations use (even though it is impossible to literally translate ashrei as blessed).

Similarly, the Schechter blog's commentary on this psalm says of translating ashrei as happy:

[C]learly the term is more profound than that, i.e., deeper than our contemporary use of the word “happy.” Ashrei implies peace, satisfaction, fulfillment and tranquility of worldview. (Martin Cohen, noting the term’s centrality, points out that it appears a total of twenty-five times in nineteen different psalms!) Thus the speaker opens with the only “reward” he acknowledges, but that is less reward than description, and the image of the fruitful tree expands upon it. His claim is that the person of faith is“ashrei,” having a deep conviction of the rightness of his ways, of their long-range influence and permanence, and of their benefit to the world.

This kind of deep conviction in the rightness of one's ways -- in the path one is taking through the challenges of life -- is something I value much more than simple happiness. And as tough as the times of depression I've experienced in my life have been, I believe they have played a role in my finding my way towards my true convictions and towards my being able to make my walk through life to be in line with those (challenging!) convictions. In this sense I feel very much to be ashrei at this point in my life. And I have HaShem to thank for that -- especially for the beautiful Torah, including the Psalms, that HaShem has given to us.

The ultimate healing?

I heard a presentation, today, where somebody quoted from a 1998 article where a leading expert on spirituality in healthcare described death as the "ultimate healing".

"There is some sort of built-in conflict between most of our medical measures and spiritual ideas," Penn Folklore and Folklife Professor John Hufford, PhD, told his audience in Medical Alumni Hall. "Just think about the irony: In religion, death is the ultimate healing. That clashes with the whole purpose of medicine."

It was a bit of one of those "sour milk" moments for me -- a moment where I saw a Christian assuming (incorrectly!) that a tenet specific to their own religion was universal to all faiths. While there is a diverse variety of beliefs in Judaism about death and the afterlife, it would be hard to say that Judaism understands death as a healing (or a "victory" as some Christians say). [I wasn't, however, offended or excluded by the presenter today, who was clearly working hard to make me feel included and welcome.]

My prayer is that the experts in spirituality in healthcare can grow to better understand what is their own values and assumptions and what are other people's values.

No One Dies Alone

Our new No One Dies Alone program is profiled in an article today's Reading Eagle (that's me, in the sport jacket and with the tie in the photo at left of us holding an orientation session for our latest group of volunteers).

Here's what the article says about the program:

Berks County, PA - While death is clearly solitary, it doesn’t have to be lonely. Yet for thousands of patients in hospitals across the country it is a lonely experience. Sometimes the family is estranged; sometimes there simply is no family or friends left alive. Sometimes there is no one available to stroke a forehead or squeeze a hand as life ebbs.

But thanks to Lynn Schiavone, that’s not the case at Reading Hospital.

Schiavone is both the catalyst and the coordinator of the No One Dies Alone program that began at the hospital in November. It uses hospital employees and volunteers to sit with patients who are dying, offering the simple comfort of their company.

“A lot of them have outlived their families,” Schiavone said. “Or they’d moved a distance away. I had read about this program and I thought it would be right for this hospital.”

I am so proud of the work the volunteers are doing and of all the folks who came together to set up the program. They are truly blessed!

No one dies alone

יום שני ו' בכסלו תשס"ז

It's a tremendous program started at a hospital in Oregon to provide volunteers to sit with dying patients who have no family. And now we're bringing it to our hospital! Tomorrow night I will be one of the teachers in our very first training session for volunteers in our own No One Dies Alone program.

I am so happy to be a part of making this happen. It's such an important program . . . . and my participation really fits in with my vision of how chaplains need to operate in today's hospitals. The fact of the matter is that very few facilities have the financial resources to afford to fund a large department of trained chaplains to work with every patient.

The effective professional chaplain, therefore, needs to function largely as a catalyst to help others to provide spiritual care to patients. That means that the roles for the chaplain need to be: chaplain as educator and chaplain as leader and coordinator. In my work with No One Dies Alone, I am functioning in those kinds of roles and thus acting as a catalyst to provide compassionate and spiritual care for patients who don't have their own resources.

Here is a short excerpt from what the Oregon hospital's web site has to say about No One Dies Alone:

No one is born alone, and in the best of circumstances, no one dies alone. Yet from time to time terminally ill patients come to Sacred Heart Medical Center who have neither family nor close friends to be with them as they near the end of life.

No One Dies Alone is a volunteer program at Sacred Heart that provides the reassuring presence of a volunteer companion to dying patients who would otherwise be alone. With the support of the nursing staff, companions are thus able to help provide patients with that most valuable of human gifts: a dignified death.