Thursday, December 29, 2011

Faith

How do we define faith? As in faith in someone or something, faith that one can believe our leaders, faith in our own integrity and, ultimately, in God or some formulation of spirituality. Some, of course, profess to have no faith, at least not of the spiritual variety. God help them.
Few questions in our lives trump those that arise around what we find worthy of our faith. For many these never get beyond personal relationships and issues, matters such as politics having either no interest or yielding no figures considered worthy of trust. That way, one fears, lies despair, the absence of or emotionally absent refusal to hope. Such a malaise, for example, lies behind our lack of confidence in Congress at the moment.
Just as those in whom we have faith must earn it, we have to earn the ability to have faith. Four years ago Mother Teresa’s diaries revealed her struggles with faith, struggles that caused some shock among those who misunderstand the way faith works in our lives. Not a steady state, it eludes us at times in the face of events that confound it. Faithfulness does not imply immunity from such moments, it describes the steadfastness with which one fights against them.
I remember with some poignancy an acknowledgment of and exhortation to persist in this fight to preserve faith and the forms it takes in our lives. I had just entered a monastic community outside of Charleston, South Carolina as a prospective member, or postulant, postulating or hypothesizing myself as a monk, if you will. One of the older brothers who had recently transferred from another order leaned toward me one day in the hall that ran through the infirmary. In a monastic version of a famous scene from The Graduate—“One word: plastics”—he spoke one word to me: “Persevere.” Take everything that comes at you and keep going, no matter what. Expect difficulties and get past them.
I think of that advice often, albeit at the time I did not take it, leaving the monastery ten months later. So many times we have faith in the wrong thing, or in the right thing or person but for the wrong reason. The left-wing deserters from the Obama bandwagon come to mind as an example of misconstrued faith, faith that Obama would mirror their own desires perfectly. As a yoga classmate lamented recently, we do not come by perfection easily; perhaps we should prick ourselves when we think we have found it.
A Dominican friar recently gave an Advent retreat at my church. In his first talk he mentioned the opposition between fantasy, based in despair, and hope or faith, which yield imagination. It struck me as a useful model for me, however imperiled any such generalization and most binary oppositions as a genre of thought. My own thinking certainly bears out his logic. When I lurch from idea to idea now, I try to interrogate its motivation. It has become a useful exercise.
Faith acknowledges the positive in life, the fact that good exists, that our lot can improve, past or present evidence to the contrary. Faith does not expect crazy chances to triumph, but quiet perseverance. Faith does not give into despair, but fights it valiantly. Faith respects the steadfast and does not require the spectacular.
I wonder if our current malaise does not reveal a crisis of faith, a tendency to yield to despair. We need to recognize this crisis before we truly lose our bearings. If we do, God help us.

Chapel Hill, NC
December 23, 2011

Wednesday, December 7, 2011

Meds

I watch a certain amount of CNN’s newscasts; apology complete. Over the weekend they ran a story that reiterated one that has cropped up in many forms in recent years: do we over-diagnose and over-medicate kids for psychological and behavioral disorders, autism and ADHD (attention deficit hyperactivity disorder) leading the pack? The question seems to admit the easy answer of “yes.” Too easy. For complex patterns of sometimes intertwined behavioral sets, no easy answer can account for all variables, let alone all outcomes, benign or otherwise.

Usually in such instances one can simply defer to the professionals, but in the case of childhood behavioral maladies we lack the consensus of opinion to render that recourse viable. The problem begins with the fact that kids will by definition sometimes come in an unruly package. Defining when that unruliness crosses a line to pathology poses problems even for professionals, let alone putting a name on the transgression, given the resemblances among the identifiable disorders, and the genetic relatedness of some. Autism and ADHD, for instance, share a chromosomal allele.
The plot thickens when we add medications to the story, for to some battered parents and teachers they seem to offer that elusive quark, the “quick fix.” And here some professionals object with many layfolk that we use too many meds too freely. Perhaps; and no wonder, since some really work, or seem to, or do for a time before our systems acclimate to them—the case with Ritalin, the wonder-drug of ADHD.

But at this point the story can get weird. Some argue that the alleged fact of ADHD’s or autism’s over-diagnosis—I have heard this case made by professionals particularly with reference to ADHD—suggests that the disorder really does not exist. I suppose Psychology Departments leave the teaching of logic to Philosophy Departments, but such thinking has serious ramifications for those who have a truly clinical case of whatever behavioral nexus we might consider.
I have gone through a couple of diagnoses as an adult—ADHD and manic-depressive illness, or bipolar disorder—that both illuminate and confuse the issue. The fact that doctors and other professionals find these disorders hard to diagnose, or may get stuck in a one-size-fits-all diagnostic rut or fad, does not eliminate the pain of those so diagnosed, the pain the meds can and often do ameliorate.

Often. Not always. I remember Prozac as though through a cloud of jello, and Depakote as a ruthless secretary re-filing the folders of my brain at painful will one weekend. Wellbutrin helped my depression but probably made me manic, or rather facilitated the emergence of a manic episode that cost me a career I had worked very hard to nurture. So, no, think not of all meds as benign for all patients. In the trial-and-error world of medicating, one claims universal efficacy for a drug at the risk of one’s reputation for sanity.

On the other hand, once having established that I do not tolerate lithium—it nearly killed me—my new combination of meds works quite well. I could have given up after lithium, but so could the mother of a child mentioned in the CNN segment, until she found the right professional with right answer for her child after he had received the supposed death sentence of severe autism. Instead she found a doctor who diagnosed the child as having ADHD, and successfully medicated him.
Health professionals forget at their peril—and their patients’—that they have lives in their hands, not classroom abstractions. And we forget that though diagnostic fads no doubt live longish and prosper, to dismiss the diagnosis as such misses the point: that some of us need some version of it at some time in our lives to flourish. Punish those who give out Ritalin as candy, but remember that the diagnosis of ADHD did not develop in a first-grade classroom, but in the practices of those who know something whereof they speak, and have the compassion to persist through their mistakes.

Chapel Hill, NC
December 5, 2011