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On the unconscious needs underlying the relation between the ill and their caretakers.

One of the difficulties which lies at the basis of much possible conflict between the ill and caretakers is this. Most of us seem to unconsciously desire in our lives someone who will be there for us in the worst of times, those times where usually no one would want to be with us! For supposedly, this kind of thinking goes, everyone wants to be with you when you are rich and beautiful and young and powerful. One of the most dramatic examples of such a desire can be found in the work Like Water for Chocolate link where the youngest daughter cannot marry because tradition holds she MUST take care of her aging mother. Having many children is a way of assuring one’s future security.

 

And in this same vein, this is why marriage vows include for better and FOR WORSE. For, according to the “normal” way of seeing things, being there in the worst of times must be somehow enforced as NO ONE would want such a thing! This kind of thinking is highly distorted. However, one thing is true, being in those situation which include the “for worse” part, specially in the case of illness (but think also of the case of unemployment) does not usually mean that BOTH parties find themselves worse off. Usually when one person falls ill, the other does not; when one person is unemployed, the other is not.

 

When one of them actually falls ill, then the ill person actually might find —or at least he thinks he has found—- what he deeply desired, namely, someone who unconditionally loves him. But on the other hand, the caretaker finds something radically different, not only that someone does not care for him —for many caretakers are left alone to care for their loved ones—- but also deeply and unconsciously they come to realize that no one will be physically able to take care of them if they in fact become ill! This helps to understand the anger felt by the mother in Like Water for Chocolate. (Not to mention the meeting of other needs which will not be met, such as those regarding sexuality, the possibility of a family, ….)

 

The only path towards ameliorating the caretakers condition in this respect is for her to come to a clear understanding of how problematic such a deep desire for having another take care of her —–even when the situation does not involve illness— actually is. This holds true for the ill person herself as well. For we humans, as Aristophanes’ discourse in Plato’s Symposium tells with fine comic revelation, are deeply afraid of living a life of true self sufficiency, and by this I mean, primarily, a life of reflective self-sufficiency. In this respect, one can say that caretakers and the ill are in need of a serious reconsideration and understanding of those deep desires which in normal conditions remain constrained, but which in times of crisis come to the fore as they had never done so before. If unprepared for this appearance, the likelihood of growth in true and deep friendship under such circumstances is close to nil.

 

I think these reflections hold some of the central keys to understanding why it is that Aristotle ends his considerations on friendship —-–some of the most famous and powerful in the history of reflections on friendship—– with what appears to be a very strange question, namely: Do we need friends more in good fortune or in bad? (Nicomachean Ethics, IX, 1170a21) True happiness might include friends, but might point beyond our everyday distorted considerations of what friends are. And however that may turn out to be, one should and must be one’s own best friend.

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Appendix to ‘On illness 13’: “The Yellow Wallpaper”: a short story for all caretakers.

THIS SHORT STORY SHOULD BE A MUST READ FOR ANYONE INTERESTED IN UNDERSTANDING, AT LEAST IN PART, THE DEEP UNCONSCIOUS NEEDS WHICH LIE AT THE BOTTOM OF OUR RELATIONS TO THE ILL. IN THIS RESPECT, THIS POST IS A CONTINUATION OF THE PREVIOUS POST ENTITLED: REFLECTIONS: ON ILLNESS 13.

(please read the former to see the context of this story)

 

 

 

Charlotte Perkins Gilman, The Yellow Wallpaper (1899)

(Printable version in PDF format)


It is very seldom that mere ordinary people like John and myself secure ancestral halls for the summer.
A colonial mansion, a hereditary estate, I would say a haunted house, and reach the height of romantic felicity–but that would be asking too much of fate!
Still I will proudly declare that there is something queer about it.
Else, why should it be let so cheaply? And why have stood so long untenanted?
John laughs at me, of course, but one expects that in marriage.
John is practical in the extreme. He has no patience with faith, an intense horror of superstition, and he scoffs openly at any talk of things not to be felt and seen and put down in figures.
John is a physician, and perhaps–(I would not say it to a living soul, of course, but this is dead paper and a great relief to my mind)–perhaps that is one reason I do not get well faster.
You see he does not believe I am sick!
And what can one do?
If a physician of high standing, and one’s own husband, assures friends and relatives that there is really nothing the matter with one but temporary nervous depression–a slight hysterical tendency– what is one to do?
My brother is also a physician, and also of high standing, and he says the same thing.
So I take phosphates or phosphites–whichever it is, and tonics, and journeys, and air, and exercise, and am absolutely forbidden to “work” until I am well again.
Personally, I disagree with their ideas.
Personally, I believe that congenial work, with excitement and change, would do me good.
But what is one to do?
I did write for a while in spite of them; but it does exhaust me a good deal–having to be so sly about it, or else meet with heavy opposition.
I sometimes fancy that in my condition if I had less opposition and more society and stimulus–but John says the very worst thing I can do is to think about my condition, and I confess it always makes me feel bad.
So I will let it alone and talk about the house.
The most beautiful place! It is quite alone standing well back from the road, quite three miles from the village. It makes me think of English places that you read about, for there are hedges and walls and gates that lock, and lots of separate little houses for the gardeners and people.
There is a delicious garden! I never saw such a garden–large and shady, full of box-bordered paths, and lined with long grape-covered arbors with seats under them.
There were greenhouses, too, but they are all broken now.
There was some legal trouble, I believe, something about the heirs and coheirs; anyhow, the place has been empty for years.
That spoils my ghostliness, I am afraid, but I don’t care–there is something strange about the house–I can feel it.
I even said so to John one moonlight evening but he said what I felt was a draught, and shut the window.
I get unreasonably angry with John sometimes I’m sure I never used to be so sensitive. I think it is due to this nervous condition.
But John says if I feel so, I shall neglect proper self-control; so I take pains to control myself– before him, at least, and that makes me very tired.
I don’t like our room a bit. I wanted one downstairs that opened on the piazza and had roses all over the window, and such pretty old-fashioned chintz hangings! but John would not hear of it.
He said there was only one window and not room for two beds, and no near room for him if he took another.
He is very careful and loving, and hardly lets me stir without special direction.
I have a schedule prescription for each hour in the day; he takes all care from me, and so I feel basely ungrateful not to value it more.
He said we came here solely on my account, that I was to have perfect rest and all the air I could get. “Your exercise depends on your strength, my dear,” said he, “and your food somewhat on your appetite; but air you can absorb all the time. ‘ So we took the nursery at the top of the house.
It is a big, airy room, the whole floor nearly, with windows that look all ways, and air and sunshine galore. It was nursery first and then playroom and gymnasium, I should judge; for the windows are barred for little children, and there are rings and things in the walls.
The paint and paper look as if a boys’ school had used it. It is stripped off–the paper in great patches all around the head of my bed, about as far as I can reach, and in a great place on the other side of the room low down. I never saw a worse paper in my life.
One of those sprawling flamboyant patterns committing every artistic sin.
It is dull enough to confuse the eye in following, pronounced enough to constantly irritate and provoke study, and when you follow the lame uncertain curves for a little distance they suddenly commit suicide–plunge off at outrageous angles, destroy themselves in unheard of contradictions. (more…)

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Why caretakers must reflect on the complex desires behind their care-taking.

One of the main reasons as to why reflective self-transformations among caretakers is so difficult lies in the deep need caretakers have of perceiving themselves as doing good to others. Each caretaker must seriously reflect on the nature of such a troubling human need. If no such reflection has been undertaken, the possibility of having a self-critical spirit as regards the caretaker’s own actions becomes more and more difficult to achieve.

It seems the main reason for this dilemma is as follows: the caretaker gives meaning to the narrative of her life through caretaking itself. In this same respect we all admire such individuals for what we (and they) perceive —though this is part of the problem— as their altruistic sacrifice for others. (see Aristotle, NE, Book I) However, this perception only solidifies in the caretaker the sense of their deserving recognition as regards their alleged sacrifice for the other, specially for the pains and troubles one has to undergo —supposedly— in the taking care of the ill. I say allegedly for it would surely be odd to choose a way of life in which one thought of one’s actions solely as a sacrifice! Such a choice would never allow for true happiness in either the caretaker, or the ill person herself! And once such a mental attitude is set firmly, the chances for such a person to reconsider the very foundations of their reasons for doing good become harder and harder to bring forth to the light of criticism. And if the person who seriously asks the caretaker to reflect on their own unquestioned desires and needs is the ill person herself, then sense of ingratitude seems to skyrocket!

This is in part one of the reasons why ill people must hear recognition demanding phrases such as “well, at least you are not in the street, at least you have me, …….”; one of the reasons why most doctors –though not all– will be disappointed when their patient asks for a second opinion; one of the reasons why traditional doctors will become very defensive when spoken of alternative possibilities, telling their patients that if they do so “it is their responsibility, ….”; one of the reasons why families/couples/parents will constantly argue how much sacrifice the ill are for them; one of the reasons why convincing others that illness is not a burden is almost impossible.

Under such conditions, which unfortunately are the norm and not the exception in our human condition, the ill must be careful and have the tools to counteract —even if they are in a condition of total physical disadvantage—- such tendencies which lie in the deepest, most troubling and most ambiguous human needs. The ill must never forget it is they who are at a disadvantage, not those who in their health do not have the courage to undergo a reflective critique of their needs.

In plain language, there is a saying in Spanish, constantly recovered by Doctor Payán, that says “El camino al infierno está hecho de buenas intenciones.” (The path to hell are made through good intentions.”) In literature a dramatic example of such a process lies in the short story entitled “The Yellow Wallpaper” (1899) link by Charlotte Perkins Gilman which tells the story of a husband and ill wife and which should be obligatory reading for ANYONE involved in the caring of the ill. Finally, and most importantly, it is Aristotle’s Nicomachean Ethics which shows the path towards an understanding of such deeply problematic needs, those needs associated with the goodness presupposed by those who hold the life of virtue as the crowning life for human beings. It is little wonder to find Aristotle arguing that true happiness can never be found in such a sphere (Book X). The life of total dedication to virtue leads only to a secondary kind of happiness.

In other words, the possibility of seeing such dilemmas is inaccessible to caretakers unless they happen to come into contact themselves, or through friendly others, with the critical spirit that guides the liberal arts education which follows the Socratic spirit of courageous, serious and continuous self-reflection on the dangers permeating our deepest, most unconscious, human needs.

(Note: Of course, another extremely powerful view of this dilemma is that of Nietzsche and his genealogical deconstruction of the good. I fear however, that such an approach is so dramatic that most caretakers will not be able even to perceive its importance.)

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