The Choice Read online

  Jason was tall, with the lean physique of an athlete, but his body was so rigid he appeared more wooden than human. His blue eyes looked distant, his jaw frozen, and he wouldn’t—or couldn’t—speak. I steered him to the white couch in my office. He sat stiffly, fists pressing into his knees. I had never met Jason and had no idea what had triggered his catatonic state. His body was close enough to touch, and his anguish practically palpable, but he was far away, lost. He did not even seem to notice my silver standard poodle, Tess, standing at attention near my desk, like a second living statue in the room.

  I took a deep breath and searched for a way to begin. Sometimes I start a first session by introducing myself and sharing a little of my history and approach. Sometimes I jump right into identifying and investigating the feelings that have brought the patient to my office. With Jason, it felt critical not to overwhelm him with too much information or ask him to be too vulnerable too quickly. He was completely shut down. I had to find a way to give him the safety and permission he needed to risk showing me whatever he guarded so tightly inside. And I had to pay attention to my body’s warning system without letting my sense of danger overwhelm my ability to help.

  “How can I be useful to you?” I asked.

  He didn’t answer. He didn’t even blink. He reminded me of a character in a myth or folktale who has been turned to stone. What magic spell could free him?

  “Why now?” I asked. This was my secret weapon. The question I always ask my patients on a first visit. I need to know why they are motivated to change. Why today, of all days, do they want to start working with me? Why is today different from yesterday, or last week, or last year? Why is today different from tomorrow? Sometimes our pain pushes us, and sometimes our hope pulls us. Asking “Why now?” isn’t just asking a question—it’s asking everything.

  One of his eyes briefly twitched closed. But he said nothing.

  “Tell me why you’re here,” I invited again.

  Still he said nothing.

  My body tensed with a wave of uncertainty and an awareness of the tenuous and crucial crossroads where we sat: two humans face-to-face, both of us vulnerable, both of us taking a risk as we struggled to name an anguish and find its cure. Jason hadn’t arrived with an official referral. It appeared that he had brought himself to my office by choice. But I knew from clinical and personal experience that even when someone chooses to heal, he or she can remain frozen for years.

  Given the severity of the symptoms he exhibited, if I didn’t succeed in reaching him my only alternative would be to recommend him to my colleague, the chief psychiatrist at the William Beaumont Army Medical Center, where I’d done my doctoral work. Dr. Harold Kolmer would diagnose Jason’s catatonia, hospitalize him, and probably prescribe an antipsychotic drug like Haldol. I pictured Jason in a hospital gown, his eyes still glazed, his body, now so tense, racked with the muscle spasms that are often a side effect of the drugs prescribed to manage psychosis. I rely absolutely on the expertise of my psychiatrist colleagues, and I am grateful for the medications that save lives. But I don’t like to jump to hospitalization if there’s any chance of success with a therapeutic intervention. I feared that if I recommended Jason to be hospitalized and medicated without first exploring other options, he would trade one kind of numbness for another, frozen limbs for the involuntary movements of dyskinesia—an uncoordinated dance of repeating tics and motions, when the nervous system sends the signal for the body to move without the mind’s permission. His pain, whatever its cause, might be muted by the drugs, but it wouldn’t be resolved. He might feel better, or feel less—which we often mistake for feeling better—but he would not be healed.

  What now? I wondered as the heavy minutes dragged past, as Jason sat frozen on my couch—there by choice, but still imprisoned. I had only one hour. One opportunity. Could I reach him? Could I help him to dissolve his potential for violence, which I could sense as clearly as the air conditioner’s blast across my skin? Could I help him see that whatever his trouble and whatever his pain, he already held the key to his own freedom? I couldn’t have known then that if I failed to reach Jason on that very day, a fate far worse than a hospital room awaited him—a life in an actual prison, probably on death row. I only knew then that I had to try.

  As I studied Jason, I knew that to reach him I wouldn’t use the language of feelings; I would use a language more comfortable and familiar to someone in the military. I would give orders. I sensed that the only hope for unlocking him was to get the blood moving through his body.

  “We’re going for a walk,” I said. I didn’t ask. I gave the command. “Captain, we will take Tess to the park—now.”

  Jason looked panicked for a moment. Here was a woman, a stranger, talking in a thick Hungarian accent, telling him what to do. I could see him looking around, wondering, “How can I get out of here?” But he was a good soldier. He stood up.

  “Yes, ma’am,” he said. “Yes, ma’am.”

  * * *

  I would discover soon enough the origin of Jason’s trauma, and he would discover that despite our obvious differences, there was much we shared. We both knew violence. And we both knew what it was like to become frozen. I also carried a wound within me, a sorrow so deep that for many years I hadn’t been able to speak of it at all, to anyone.

  My past still haunted me: an anxious, dizzy feeling every time I heard sirens, or heavy footsteps, or shouting men. This, I had learned, is trauma: a nearly constant feeling in my gut that something is wrong, or that something terrible is about to happen, the automatic fear responses in my body telling me to run away, to take cover, to hide myself from the danger that is everywhere. My trauma can still rise up out of mundane encounters. A sudden sight, a particular smell, can transport me back to the past. The day I met Captain Fuller, more than thirty years had passed since I’d been liberated from the concentration camps of the Holocaust. Today, more than seventy years have passed. What happened can never be forgotten and can never be changed. But over time I learned that I can choose how to respond to the past. I can be miserable, or I can be hopeful—I can be depressed, or I can be happy. We always have that choice, that opportunity for control. I’m here, this is now, I have learned to tell myself, over and over, until the panicky feeling begins to ease.

  Conventional wisdom says that if something bothers you or causes you anxiety, then just don’t look at it. Don’t dwell on it. Don’t go there. So we run from past traumas and hardships or from current discomfort or conflict. For much of my adulthood I had thought my survival in the present depended on keeping the past and its darkness locked away. In my early immigrant years in Baltimore in the 1950s, I didn’t even know how to pronounce Auschwitz in English. Not that I would have wanted to tell you I was there even if I could have. I didn’t want anyone’s pity. I didn’t want anyone to know.

  I just wanted to be a Yankee doodle dandy. To speak English without an accent. To hide from the past. In my yearning to belong, in my fear of being swallowed up by the past, I worked very hard to keep my pain hidden. I hadn’t yet discovered that my silence and my desire for acceptance, both founded in fear, were ways of running away from myself—that in choosing not to face the past and myself directly, decades after my literal imprisonment had ended, I was still choosing not to be free. I had my secret, and my secret had me.

  The catatonic Army captain sitting immobile on my couch reminded me of what I had eventually discovered: that when we force our truths and stories into hiding, secrets can become their own trauma, their own prison. Far from diminishing pain, whatever we deny ourselves the opportunity to accept becomes as inescapable as brick walls and steel bars. When we don’t allow ourselves to grieve our losses, wounds, and disappointments, we are doomed to keep reliving them.

  Freedom lies in learning to embrace what happened. Freedom means we muster the courage to dismantle the prison, brick by brick.

  * * *

  Bad things, I am afraid, happen to everyone. This we can’t
change. If you look at your birth certificate, does it say life will be easy? It does not. But so many of us remain stuck in a trauma or grief, unable to experience our lives fully. This we can change.

  At Kennedy International Airport recently, waiting for my flight home to San Diego, I sat and studied the faces of every passing stranger. What I saw deeply moved me. I saw boredom, fury, tension, worry, confusion, discouragement, disappointment, sadness, and, most troubling of all, emptiness. It made me very sad to see so little joy and laughter. Even the dullest moments of our lives are opportunities to experience hope, buoyancy, happiness. Mundane life is life too. As is painful life, and stressful life. Why do we so often struggle to feel alive, or distance ourselves from feeling life fully? Why is it such a challenge to bring life to life?

  If you asked me for the most common diagnosis among the people I treat, I wouldn’t say depression or post-traumatic stress disorder, although these conditions are all too common among those I’ve known, loved, and guided to freedom. No, I would say hunger. We are hungry. We are hungry for approval, attention, affection. We are hungry for the freedom to embrace life and to really know and be ourselves.

  My own search for freedom and my years of experience as a licensed clinical psychologist have taught me that suffering is universal. But victimhood is optional. There is a difference between victimization and victimhood. We are all likely to be victimized in some way in the course of our lives. At some point we will suffer some kind of affliction or calamity or abuse, caused by circumstances or people or institutions over which we have little or no control. This is life. And this is victimization. It comes from the outside. It’s the neighborhood bully, the boss who rages, the spouse who hits, the lover who cheats, the discriminatory law, the accident that lands you in the hospital.

  In contrast, victimhood comes from the inside. No one can make you a victim but you. We become victims not because of what happens to us but when we choose to hold on to our victimization. We develop a victim’s mind—a way of thinking and being that is rigid, blaming, pessimistic, stuck in the past, unforgiving, punitive, and without healthy limits or boundaries. We become our own jailors when we choose the confines of the victim’s mind.

  I want to make one thing very clear. When I talk about victims and survivors, I am not blaming victims—so many of whom never had a chance. I could never blame those who were sent right to the gas chambers or who died in their cot, or even those who ran into the electric barbed wire fence. I grieve for all people everywhere who are sentenced to violence and destruction. I live to guide others to a position of empowerment in the face of all of life’s hardships.

  I also want to say that there is no hierarchy of suffering. There’s nothing that makes my pain worse or better than yours, no graph on which we can plot the relative importance of one sorrow versus another. People say to me, “Things in my life are pretty hard right now, but I have no right to complain—it’s not Auschwitz.” This kind of comparison can lead us to minimize or diminish our own suffering. Being a survivor, being a “thriver” requires absolute acceptance of what was and what is. If we discount our pain, or punish ourselves for feeling lost or isolated or scared about the challenges in our lives, however insignificant these challenges may seem to someone else, then we’re still choosing to be victims. We’re not seeing our choices. We’re judging ourselves. I don’t want you to hear my story and say, “My own suffering is less significant.” I want you to hear my story and say, “If she can do it, then so can I!”

  One morning I saw two patients back to back, both mothers in their forties. The first woman had a daughter who was dying of hemophilia. She spent most of her visit crying, asking how God could take her child’s life. I hurt so much for this woman—she was absolutely devoted to her daughter’s care, and devastated by her impending loss. She was angry, she was grieving, and she wasn’t at all sure that she could survive the hurt.

  My next patient had just come from the country club, not the hospital. She, too, spent much of the hour crying. She was upset because her new Cadillac had just been delivered, and it was the wrong shade of yellow. On the surface, her problem seemed petty, especially compared to my previous patient’s anguish over her dying child. But I knew enough about her to understand that her tears of disappointment over the color of her car were really tears of disappointment over the bigger things in her life that hadn’t worked out the way she had hoped—a lonely marriage, a son who had been kicked out of yet another school, the aspirations for a career she had abandoned in order to be more available for her husband and child. Often, the little upsets in our lives are emblematic of the larger losses; the seemingly insignificant worries are representative of greater pain.

  I realized that day how much my two patients, who appeared so different, had in common—with each other and with all people everywhere. Both women were responding to a situation they couldn’t control in which their expectations had been upended. Both were struggling and hurting because something was not what they wanted or expected it to be; they were trying to reconcile what was with what ought to have been. Each woman’s pain was real. Each woman was caught up in the human drama—that we find ourselves in situations we didn’t see coming and that we don’t feel prepared to handle. Both women deserved my compassion. Both had the potential to heal. Both women, like all of us, had choices in attitude and action that could move them from victim to survivor even if the circumstances they were dealing with didn’t change. Survivors don’t have time to ask, “Why me?” For survivors, the only relevant question is, “What now?”

  * * *

  Whether you’re in the dawn or noon or late evening of your life, whether you’ve seen deep suffering or are only just beginning to encounter struggle, whether you’re falling in love for the first time or losing your life partner to old age, whether you’re healing from a life-altering event or in search of some little adjustments that could bring more joy to your life, I would love to help you discover how to escape the concentration camp of your own mind and become the person you were meant to be. I would love to help you experience freedom from the past, freedom from failures and fears, freedom from anger and mistakes, freedom from regret and unresolved grief—and the freedom to enjoy the full, rich feast of life. We cannot choose to have a life free of hurt. But we can choose to be free, to escape the past, no matter what befalls us, and to embrace the possible. I invite you to make the choice to be free.

  Like the challah my mother used to make for our Friday night meal, this book has three strands: my story of survival, my story of healing myself, and the stories of the precious people I’ve had the privilege of guiding to freedom. I’ve conveyed my experience as I can best remember it. The stories about patients accurately reflect the core of their experiences, but I have changed all names and identifying details and in some instances created composites from patients working through similar challenges. What follows is the story of the choices, big and small, that can lead us from trauma to triumph, from darkness to light, from imprisonment to freedom.

  CHAPTER 1

  The Four Questions

  If I could distill my entire life into one moment, into one still image, it is this: three women in dark wool coats wait, arms linked, in a barren yard. They are exhausted. They’ve got dust on their shoes. They stand in a long line.

  The three women are my mother, my sister Magda, and me. This is our last moment together. We don’t know that. We refuse to consider it. Or we are too weary even to speculate about what is ahead. It is a moment of severing—mother from daughters, life as it has been from all that will come after. And yet only hindsight can give it this meaning.

  I see the three of us from behind, as though I am next in line. Why does memory give me the back of my mother’s head but not her face? Her long hair is intricately braided and clipped on top of her head. Magda’s light brown waves touch her shoulders. My dark hair is tucked under a scarf. My mother stands in the middle and Magda and I both lean inward. It is impossibl
e to discern if we are the ones who keep our mother upright, or if it is the other way around, her strength the pillar that supports Magda and me.

  This moment is a threshold into the major losses of my life. For seven decades I have returned again and again to this image of the three of us. I have studied it as though with enough scrutiny I can recover something precious. As though I can regain the life that precedes this moment, the life that precedes loss. As if there is such a thing.

  I have returned so that I can rest a little longer in this time when our arms are joined and we belong to one another. I see our sloped shoulders. The dust holding to the bottoms of our coats. My mother. My sister. Me.

  * * *

  Our childhood memories are often fragments, brief moments or encounters, which together form the scrapbook of our life. They are all we have left to understand the story we have come to tell ourselves about who we are.

  Even before the moment of our separation, my most intimate memory of my mother, though I treasure it, is full of sorrow and loss. We’re alone in the kitchen, where she is wrapping up the leftover strudel that she made with dough I watched her cut by hand and drape like heavy linen over the dining room table. “Read to me,” she says, and I fetch the worn copy of Gone with the Wind from her bedside table. We have read it through once before. Now we have begun again. I pause over the mysterious inscription, written in English, on the title page of the translated book. It’s in a man’s handwriting, but not my father’s. All that my mother will say is that the book was a gift from a man she met when she worked at the Foreign Ministry before she knew my father.

  We sit in straight-backed chairs near the woodstove. I read this grown-up novel fluently despite the fact that I am only nine. “I’m glad you have brains because you have no looks,” she has told me more than once, a compliment and a criticism intertwined. She can be hard on me. But I savor this time. When we read together, I don’t have to share her with anyone else. I sink into the words and the story and the feeling of being alone in a world with her. Scarlett returns to Tara at the end of the war to learn her mother is dead and her father is far gone in grief. “As God is my witness,” Scarlett says, “I’m never going to be hungry again.” My mother has closed her eyes and leans her head against the back of the chair. I want to climb into her lap. I want to rest my head against her chest. I want her to touch her lips to my hair.