These thoughts are prompted by my personal history and situation, but they amount to vague and ungrounded fears. (How is potential defined? How many friends equals enough? Can I be sure about the future? How would I know if I were taken seriously?) It surprises me that I care so much about thoughts with so little solidity.

Why do mere ideas carry such weight? It’s a question worth asking from time to time. In answering, my first impulse is to turn to neuroscience. What might a basic understanding of the brain suggest about why beliefs feel important?

In simplest terms, we have emotional centers deep in the cerebral cortex that color our attitudes. The amygdala is a prime emotion generator responsible many negative feelings (and a few positive ones). It recognizes threats and primes us to react. It drives our rage and our terror.

Emotion centers are often considered more primitive than brain regions responsible for rational thought, because they evolved earlier. But emotions are vital even to logical decision making. It’s been shown that when people suffer damage to these ‘lower’ brain regions, they sometimes lose the ability to make choices. Despite being able to list the pros and cons of competing options, they can’t choose among them. Why not? Probably because they lack the feeling that choices matter. Without an emotional sense of better vs worse, the result is indifference or paralysis.

Emotions are valuable. They aren’t infantile, rudimentary surges that overwhelm higher thought. They’re the engines that propel us toward what matters in life. Still, although feelings are vital and necessary, they get us in trouble. Why is that?

Consider how emotions evolved. We share the amygdala and related emotion structures with other mammals. One of the reasons we bond better with dogs than with lizards is that mammals display emotional depth but reptiles don’t. Dogs can appear happy, downcast, hopeful, loving, and angry. Lizards can’t. As mammals became less lizard-like and more dog-like, something important was gained: feeling.

Emotions serve as a strong motivators for life-preserving action. Mammals respond to feelings as if they matter because, in fact, emotions weigh in on life or death decisions. A twinge of fear might warn of a lurking predator. A burst of lust might signal a chance to procreate. Craving might lead to a nutritious meal. Each of these cases makes a difference to survival, to reproduction, to life. Emotions are what motivate the vital choices that keep a species propagating through time. The animal that feels fear knows to hide, or flee, or fight. It does so with passion, driven by strong inner signals. In like fashion, an animal that feels love defends its young or its social group, and so preserves its progeny and kin.

In the wild, emotions drive behaviors that promote life: feeding, defense, reproduction. Feelings aren’t arbitrary preferences without import; they’re symbols of survival, death, and birth.

For humans, however, emotions no longer arise only in biologically meaningful situations. They pop up around concepts and beliefs. We can feel threatened by assaults on status, or hopes, or ideas. Think of wars fought over religion or ideology. Think of teenagers shooting neighbors who wear the ‘wrong’ colors. Think of children arguing over the TV remote.

We still have strong feelings, but they no longer relate to basic necessities of life like feeding, sex, and foiling predators. Instead, they’re attached to ideas, to abstract concepts that grow out of culture and history. But despite this disconnect, we respond as if our very lives are on the line. Why? Because that’s how it feels.

Every idea that we care about possesses taproots that draw sustenance from the emotional centers of the brain. If you mock my beliefs, I feel anger and want to attack. My fury would be appropriate if you threatened physical injury, but does it make sense if you just disagree with my ideas? Should verbal conflict escalate to rage? To violence? Probably not, but it often does.

Why? Because on an emotional level we are fighting for our lives. This is what our physiology remembers from the evolutionary past. Our emotion centers can’t distinguish between a fight over the only gazelle killed in a month on the savannah and an argument over which TV program to watch (the brain as a whole can, of course, but only if we exercise rational oversight sufficient to suppress emotional reactivity).

Nor do feelings readily distinguish between protecting a living, breathing parent versus defending a mythical concept of God, or a conviction that “God” is a dangerous delusion. I’ve lost both religious and atheist friends by challenging such beliefs.

We care about ideas more than we should because feelings evolved to aid decisions about life and death, not abstractions. This has implications on many levels; it explains a lot of political and social discord. But let’s keep it personal. Sometimes I feel badly about myself because I don’t measure up to society’s standards. To my amygdala, this doesn’t feel like mere failure to satisfy arbitrary criteria: it feels like I might be cast out of the tribe, an exile that would ensure death. No wonder I get upset!

Imagine what a relief it would be to separate the conceptual from the emotional. Imagine if I could recognize standards as contingent and historical rather than internalizing them as requirements for tribal support and survival. Imagine if my thoughts and feelings were less tightly linked.

What we know about neuroscience implies the possibility of disconnecting abstract ideas from strong feelings, because the two are generated by different brain regions that act at least somewhat independently. Interestingly, centuries before we knew anything useful about the brain, yogic and Buddhist philosophies were teaching that feelings and thoughts are separable. Working to recognize and increase the distance between emotion and cognition was one of the key steps toward achieving mature, enlightened peace of mind.

Am I reaching my full potential? Have I sufficient friends? Will I be isolated in twenty years? Does anyone think my blog worthwhile? With a bit of practice, I can ask these questions out of curiosity without surges of regret, insecurity, dread, or despair. The lexical and emotional gears don’t need to interlock, one driving the other as if my life depended on it.

Let’s close by remembering that sometimes ideas do matter. A belief that says unbelievers are dangerous can cause problems. But why? Because emotional turmoil might escalate and drive desperate, aggressive action aimed at defending the belief (as if it were life or limb). It’s hard to imagine fanatics attacking others if they didn’t feel strongly about their ideas. So the issue is partly with the logical content of thought, but it has more to do with emotional response to thought.

The prescription remains the same: separate ideas from feelings. If children were taught this skill, there would be fewer adults driven to insane acts by mere concepts.

Let me admit up front that I was tossing out an ill-formed opinion that stands contrary to truth. Jon Kabat-Zinn, the well-known advocate of mindfulness in clinical settings, hardly deserves scorn. Nor do Buddhist meditation teachers, many of whom have helped me advance on my path toward greater acceptance and less neurosis. I could chalk my comments up to a momentary breakdown of reason.

But after considering the matter for several days, I wonder if there isn’t some vein of truth hidden amidst the sediments of useless argument. If so, we can consider this essay a mining expedition, a search for the valid nugget of concern that motivated my remarks.

Since I kept labeling Western mindfulness derivative, it makes sense to start there. Meditation as taught in medical centers, as popularized by Kabat-Zinn, comes stripped of the Eastern metaphysical context from which it emerged long ago. Teachers emphasize technique and downplay interpretation. There is no discussion of the nature of reality. The origins of mind might be considered from a neuroscience perspective, but not from a mystical one. Students learn body scanning, mindful eating, walking meditation, and nonjudgmental awareness, but they are not encouraged to question modernity’s basic assumptions about the universe. Non-duality and cosmic consciousness are off the table.

Jon Kabat-Zinn, Larry Berkelhammer, and others who have introduced the power of mindfulness to the suffering would never have succeeded had they insisted on philosophical stances contrary to what moderns consider realism. Medical institutions are both cautious and conventional. Even devoid of metaphysics, mindfulness faced resistance at first.

Meanwhile, teachers at Buddhist centers have long brought contemporary values and outlooks to task. They point out the destructive power of greed and selfish competition. They emphasize the delusions that underlie unhealthy behavior. If the situation demands it, they don’t shrink from questioning cherished Western notions.

So I have to ask myself, what makes me resist acquiescence to the status quo? What important ingredient is missing from mindfulness training?

Mindful meditation remains powerful as a stand-alone technique. And the Buddha himself cautioned against obsessing about unanswerable metaphysical questions; he advised us to focus on healing our tormented minds. So if isolated mindfulness instruction is deficient in some way, the flaw is far from fatal.

Still, some nugget of valid concern drove me to criticize this demonstrably useful training.

Twenty-five years ago I began my spiritual quest after Alcoholics Anonymous challenged me to believe in a “higher power.” Since I’d been raised as an atheist, this seemed like an impossible demand. But I valued my sobriety and felt it important to seek something like God.

Visitors to this site have read some of the results. During my search for a higher power, I’ve experienced profound religious visions and felt “something like God” burn its presence into my consciousness. I’ve entered deep meditative states and seen cosmic unity as not only true but obvious, brimming with love and rightness. My entire worldview has been transformed. I can’t say anything too specific about reality’s underpinnings, but my heart is flooded with affection whenever I contemplate this fertile world. I don’t believe in a God separate from creation, but I wonder if the Cosmos itself isn’t something like the great deity religions speak of: timeless, creative, powerful, and embracing.

I imagine that anyone reading the previous paragraph can see how it goes beyond everyday mindfulness. To be precise, it opens to the Sacred. Numinosity, I now understand, is what’s missing from clinical mindfulness training. Sadly, because of prejudice against mysticism, Buddhist Vipassana meditation centers emphasize it less than they might. There is reverence, yes, but not much awe.

I would argue that one big problem in the modern world is exactly our refusal to feel dumbstruck by Creation. We believe that because we can explain its mechanistic details, we have bridled Nature. This leaves us feeling powerful, but alone. Deluded into thinking we can control chaotic and complex forces, we destroy the very world that nurtures us.

Religions, for all their faults, encourage us to crumble to our knees before powers too vast and mysterious to be comprehended. This is the essential ingredient that contemporary mindfulness instruction lacks. Even some “spiritual” teachings, like those in many urban Buddhist centers, constrain their demands in deference to a widely accepted but devotionally bereft worldview.

Materialist atheism is no more provable than traditional deism. And ultimate truth likely lies somewhere in between. I am by no means advocating belief in improbable doctrine or literal interpretation of primitive myths. But let’s also be realistic in our valuation of human reason, which easily dissects processes but cannot nail down absolute reality. The appropriate stance is therefore humility, not certainty. Humanity would do well to nourish feelings of awe in place of arrogance.

Meditative techniques were developed in India, millennia ago, in order to guide seekers to union with the great mystery, with Brahmin, or God (take your pick of terminology). Nowadays intellectuals dismiss most theologies, and Buddhism moved away from asking about ultimate reality in order to confront the more immediate problem of day-to-day insanity. But the human spirit seems driven to worship something, and there is great danger if it chooses to worship itself rather than the inscrutable forces that created it.

While evolving as hunter-gatherers, humans recognized their smallness relative to the biosphere and their intimate dependence upon Nature. This would have felt frightening, but also embracing. Our society now acts as if it stands separate from global ecology. The traditional Gods of civilization appear inorganic and detached. Scientific materialism appeals to the intellect but not the heart. The human psyche feels ever more disconnected and bored in this stark conceptual landscape.

Because conventional mindfulness training fails to encourage bowing before ineffable forces, it is not the most effective cure for feelings of isolation and alienation. Admittedly, in its full expression mindfulness triggers the non-dual state, which opens one’s eyes to the lack of distinction between the witness and the Witnessed. But resonant awareness comes late in the game, and not everyone experiences it. Mindfulness is a derived technique of great value, but recovering the abandoned Sacred is at least as vital to a healthy future.

With everything said above, my conclusion still must be that I was wrong to criticize mindfulness. It is an invaluable tool that has brought relief to many suffering souls, including mine.

Still, no single tonic is capable of healing all disease. The human collective needs mindfulness, but it also needs devotion to something greater than itself.

So I’ve been thinking about this ever since. Consider the classic story of the boss yelling at the manager, the manager punishing a worker, the worker going home and insulting his wife, the wife scolding the child, and the child kicking the cat. The angst that drove the boss to act out gets propagated and ends up hurting the hapless family pet.

We see variations on this all the time. In every stock market crash negativity spreads so rapidly that securities can lose half their value in a day. Terrorist attacks are intended to inject paranoia and despair into a population, and they often succeed. Arguably, the massive US debt that now weighs down our economy resulted from the (second) Iraq war, which never could have been launched save for 9/11. Psychic toxins spread swiftly and do great harm.

I’m reminded of Richard Dawkin’s concept of a meme: “an idea, behavior or style that spreads from person to person within a culture.” In his 1976 book, The Selfish Gene, Dawkins used the example of religion, which transmits highly specific ideas about God and morality. He proposed that as they are passed from person to person, concepts replicate with occasional modification; over time the most ‘successful’ (i.e., most adopted) memes come to dominate group thought.

Perhaps the phenomena I’m discussing here could be referred to as affemes, or ‘affective memes.’ The propagated tendencies aren’t ideas that can be modified over time (like memes). Instead, we see transmission of mood or emotional tone. And affemes aren’t replicated mental constructs like memes, because all that’s diffusing is strong feeling, not a specific idea. Thus, a raging parent will affect the child, but the child may become fearful rather than rageful.

An affeme doesn’t have to be negative. Kindness spreads too. And again, it doesn’t replicate in the strict sense of the word. If one child offers another a chance to play kickball during recess, the included youngster will be more inclined to share cookies at lunchtime. What’s transmitted is the uplifting emotion, not the specific act.

Perhaps we can distinguish a total of just two affeme types: negative and positive, or malignant and beneficial. We could call these malaffemes and benaffemes, respectively. Nearly every time we interact with another person, we unconsciously broadcast affemes of one sort or another. The task for anyone devoted to personal and world peace, then, would be to build immunity against malaffemes while learning to generate and appreciate benaffemes.

OK. I’ll admit introducing all this terminology probably just clouds the issue. Sayings like, “don’t fight fire with fire” and “turn the other cheek” have long guided the wise to resist absorbing negativity from others. There is nothing new here.

Still, I like viewing the widespread social toxicity we experience today as a contagion. That way I am able to see those who offend me as ill and suffering rather than mean and subhuman. If I feel a negative affeme penetrating, I can quickly recognize the incipient infection and mount my mental immune system. On several occasions I’ve found this strategy effective.

When we don’t resist malaffemes, they spread until we encounter irritable, hostile people at every turn. Not only do others become more unpleasant as the negativity diffuses through the population; we are also more likely to view them that way. On the other hand, if we resist the contagion and broadcast counterbalancing benaffemes, we generate kindness in the world and are more inclined to see small instances of it.

Personally, I don’t buy into the Judeo-Christian belief (or meme) that Good and Evil exist as personified forces battling for human souls. But there is a sense in which negativity and positivity are locked in an ongoing struggle for ascendance. If we can see how moods spread through populations, and how we internalize both the pain and happiness of others, we can begin to make choices about which influences to absorb and encourage, and which to reject. The world might become a bit friendlier as a result.

At the same time, it’s important to keep in mind that both so-called positive and negative emotions can be constructive or destructive. Depending on the context, a painful emotional state may actually be a benaffeme. During a recent weekend workshop devoted to grieving, we all expressed a lot of painful feelings, but these were in the service of healing. For that reason, I would consider the emoting beneficial, despite the pain felt by participants. If someone had laughed out loud while another was sobbing about loss, the lightening of tension might have felt positive to the person laughing, but it would have hurt the person grieving. Thus, I’d have considered the laughter a malaffeme.

The central issue is constructive (healing) versus destructive (harming) behavior. Anger could be a benaffeme if employed to stop child abuse. One needs to look at the big picture; the perpetrator might feel humiliated but the youngster would be saved, which certainly outweighs the objections of the former. (And eventually even the abuser might feel grateful, if prevented from harming an innocent.)

We can all watch the affemes we project as well the ones we internalize. What we send out into society should be chosen with care: most often we do well to act kindly, but sometimes forceful words are needed. Wise behavior and strong immunity serve both collective and personal wellbeing.

But even stasis leaves an imprint, so we need to be sure of ourselves before rejecting society and its activities. We cannot avoid marking the world; our freedom lies in selecting how. We are destined to work and to love, but our decisions direct our efforts and affection. Some strive toward selfish ends and love narrowly. Others behave generously and adore the entire biosphere.

All of which raises another question: How do we optimize our choices?

According to Acceptance and Commitment Therapy (ACT) , which I discussed in the post before last, a value is an aspect of life we want to nurture. Examples include: family, friendship, work, spirituality, aesthetics, and play. Note the generality of these categories, and the diversity of manifestation. Family might mean tending children, parents, or pets. Work might be pursued by performing surgery or serving soup at a shelter. Spirituality could suggest Roman Catholic mass or contemplation under a tree.

A value is the direction, while a goal is a destination. As an analogy, I might choose to head west from my home next to San Francisco Bay. Perhaps I’d drive an hour to reach the Pacific Ocean. Or I could sail a boat to Hawaii. Or maybe I’d fly to Tokyo. “Going West” could be achieved in any number of ways.

It is possible to pursue values ineffectively. One doesn’t make westward progress by driving from here to Mexico. While many of us want to help those in trouble, we sometimes end up doing harm rather than good. Mindfully listening to someone in pain offers support and compassion. But advice, while usually well-intentioned, is often poorly received.

We can always progress toward our values, no matter our limitations. To head west, all I need to do is walk a little westward. One can be an affectionate spouse (value) with a simple smile (goal).

Note that a value is never exhausted. I could travel west forever, round and round the globe. Supporting our friends (a value) is not something we finish, the way we might complete an errand for someone ill (a goal). There is always more work to be done and fun to be had. Of course, at some point we run out of energy and time. We die. So pursuit of values ends, but not in the sense of polishing off a task.

Nor is our quest toward value about leaving a permanent mark; all our works eventually will be forgotten. We build meaning into our lives for its own sake.

Look at the big picture: the sun will expand as it burns up its fuel. Eventually, “the Earth will plunge into the core of the red giant sun and be vaporized.” Science fiction notwithstanding, there is little chance that humanity will escape physically to other planets, except perhaps as well-shielded, frozen embryos. All the glorious work of civilization will be lost, at least in material terms.

To the cynical, this might seem futile, or even absurd. Why strive, day after day, if all comes to naught? It sounds like Sisyphus, ever pushing his boulder uphill only to watch it roll down again. But isn’t this the nature of life? Each spring new flowers bloom that are destined to wither and die. The promise of every birth ends in death sooner or later. The cycle of fertilization, germination, maturation, and deterioration never ceases. All that activity generates the lush, fecund beauty of our world.

Albert Camus concludes his classic, The Myth of Sisyphus, with these words: “One must imagine Sisyphus happy.” His meaning is more bereft of optimism than mine (he is arguing for absurdity, which precludes hope), but the reasoning is similar: fulfillment demands we move something, despite inevitable collapse and decay.

Maybe our endeavors will be preserved as cosmic memory, embedded in a quantal microstructure (or the Mind of God, depending on your preferred terminology). But we don’t need to believe this to continue our lives. We romance, raise children, build bridges, and play music because Life asks this of us.

A necessary event in the Universe’s formation was what’s called symmetry breaking. I have only a vague notion of what that means, but it shows that we live in a fundamentally fractured world. The brokenness breeds vitality. We pick up the pieces not because there’s hope of repair, but because we love them.

Work in support of values is an exercise in fertility, not futility. It’s not endless toil; it’s eternal dance.

So how does one reconcile this with the dissatisfaction inherent in worldly pursuits? Here again, we distinguish between values and goals. We can pursue values without concern for recognition, accumulation, satiation, affection, or excitement. They fulfill because they are worthy in themselves, not because of their fruits. Goals, on the other hand, are ‘stickier.’ They can be judged as successes or failures. We tend to get attached to their outcome. They draw us into the cycle of stimulation, disenchantment, and suffering.

In a broken world, we value healing despite our inevitable defeat by death. We further the value of health without chasing the goal of immortality. Such is the paradox of wise living.

I knew mine was not a healthy attitude and harbored no doubt that my personality was flawed. But I could not fix the problem.

Although I don’t call myself a Buddhist, there is little doubt that the Buddha saw our human situation clearly. One of his “Four Noble Truths” states that life is inherently unsatisfying. This comforts me, because it situates the root problem in the world rather than my character.

Not that I don’t need to change, but the issue isn’t one of learning to feel fulfilled in the common sense of the word. Adjusting my personality won’t alter the fact that life disappoints.

According to Buddhist nosology, afflictions of the human spirit derive from three delusions about reality. We habitually seek permanence, satisfaction, and individuality, but impermanence is the rule, dissatisfaction is unavoidable, and individuality is an illusion.

A recent series of posts on my primary site, WillSpirit.com, attempted to tackle the last of these three, which I believe to be the most challenging. Today’s essay deals mainly with the second and a little with the first, both of which are easier to accept.

The word dukkha is a Buddhist term (from the Pali language) that historically was translated as ‘suffering,’ but nowadays gets rendered as ‘unsatisfactoriness.’ Etymologically, the word refers to a cart’s axle that fails to fit the wheel properly. It implies a rough, unreliable, unstable quality to human life.

One doesn’t need to ponder dukkha deeply to see the truth of it. Every once in a while life manages to feel fully satisfactory, like after a delicious meal with friends or a sweet session of lovemaking. But satiation never lasts. All-too-soon the mind starts to want more. The well-fed dinner guest thinks of seducing the woman next to him; the lover catching her breath begins to feel hungry.

Every staple of human life disappoints, sooner or later. Hollywood and Madison Avenue have reinforced already strong cravings for status, possessions, sex, love, and novelty. But none of these pays off in the way we expect.

Status-seeking excites the young person building a career. But by midlife most of us recognize that the ladder of success is infinitely tall. We might make our peace with the fact that no matter what we achieve there will be others who look greater, but we only delude ourselves if we think our accomplishments truly individual, exceptional, or of lasting significance.

Perhaps I say this out of frustration; after all, my own career tanked early. But I spent many years working with world-renowned physicians while training at a major medical center, and none seemed truly content with his or her success. Even if their egos had inflated to global proportions, they seldom appeared free of petty concerns about how they were perceived and treated by others.

The market economy is a testament to the endless greed that afflicts the human spirit. It exalts the notion that possessing more will bring peace of mind. But no matter how wealthy people become, they always seem to want more, at least until they mature to the point where they understand that material gain never leads to heartfelt satisfaction.

Sex hardly needs to be written about with regard to its failure to fulfill. It offers moments of intense pleasure, and it can provide endless (if stormy) adventure when pursued as a chief end in life. But it never leads to a place of ease. One can find momentary bliss, but not lasting satisfaction, in sexual exploit. The point of the reproductive drive, after all, is to create babies, not contentment. In that context the sex act may provide a sense of purpose and meaning over the course of gestation, child-rearing, and so on. But for all its deification in the media, sexual activity alone is a weak substitute for happiness.

So what of love? Long term relationships stabilize and comfort us on life’s journey. Family can bring joy. Can’t we look to love for true satisfaction? We could, if people didn’t get sick, or die, or lose affection for one another, or disappoint, or act out. We could, in other words, if people were not human. While love is vital to a meaningful life, it fails to give us lasting satisfaction because it remains tainted with loss. During a lecture about bereavement, I once heard a psychiatrist say, “grief is the price we pay for love.” Sooner or later all relationships end, and this means that although they matter a great deal to us, they fail to deliver enduring contentment. We gather our rosebuds only while we may.

Finally, there is novelty. These days most young people with sufficient means spend long periods abroad. One of the advantages of modern life is the ease with which we can travel to distant lands. Or even if we don’t physically transport ourselves, through reading and study we can investigate the world of knowledge. We can learn about distant galaxies, subatomic particles, evolution, art history, ancient cultures, or anything else we wish to explore.

I’ve done a lot more intellectual investigating than world traveling, but both activities can be exciting. Yet do they truly satisfy? I can’t go into a library without feeling a bit discouraged by the number of books on the shelves and my inability to read more than a minuscule fraction. The hunger for knowledge is wonderful in many ways, but it cannot be permanently satisfied.

Similarly, I suspect that sooner or later most globe-trotters detect some monotony in continual travel. Not that it isn’t enjoyable, but the pleasure must begin to feel a bit repetitive and forced. Or if the desire for adventure remains strong, it likely forestalls and alternates with feelings of boredom.

Name any pursuit that promises satisfaction, and you will be able to find ways in which it ultimately lets us down. As I’ll try to cover in a future post, the answer lies in not pursuing. But for today, I want to shine a spotlight how ordinary activities never to lead to unshakable contentment.

Granted, one can make peace with all of the facts I outlined above. But making deals with the devil is different from defeating him. The engines of craving can be slowed to an idle, but they can never be fully shut down via a strategy of pouring ever more fuel into the tank.

Life provides moments of satisfaction, but we inevitably oscillate between pleasure and distress. The wobbly axle forces us to endure a bumpy ride, wherein high moments are overtaken by low, and vice versa. We cannot quell this agitation of body and mind through pursuit of worldly goals. No measure of success, material accumulation, sexual gratification, loving relationships, or worldly exploration can permanently satisfy the human appetite for comfort. This is the truth of dukkha.

We can begin to decrease dukkha only after we recognize the futility of escaping it through pursuit of desires. Once we understand this fixed law of human nature, we can seek peace in the world through channels other than achieving, accumulating, indulging, clinging, or escaping.

It seems like a worthy topic for that reason, but I should emphasize that my perspective is that of an informed layperson, not a psychotherapist. Consider this a disclaimer: these blog posts cannot be used as guides to adopting ACT behavioral techniques. My goal is merely to advertise the power of the therapy. Interested readers should consult authoritative books and professionals.

With that out of the way, I’d like to return to my last post, which attempted to illustrate some ACT concepts through the vehicle of my own hangups following my mother’s death.

As I look back at that essay, I see it covers a lot of ground. Single sentences gloss over topics that take up entire chapters in ACT texts. For the sake of clarity, it’s worth dissecting the key points a bit further.

The last post starts by pointing out how ACT emphasizes the interaction between thoughts, feelings, and behavior. Of course, all psychotherapies do this to some extent. Psychodynamic approaches aim to reduce undesired feelings and behaviors by illuminating the connection between childhood experiences and adult neuroses (i.e., by increasing thoughtful insight).

Cognitive Behavioral Therapy (CBT) redirects negative thinking and ineffective actions through empirical testing; unpleasant feelings are expected to abate with accurate thoughts and behavioral activation. Because ACT is still a form of “talk therapy,” it isn’t using a radically new approach, but its theoretical underpinnings are distinct from those of traditional methods.

According to ACT and the theory behind it (technically called Relational Frame Theory, or RFT), verbal thought must be engaged in therapy, but it is actually a root problem in human dysphoria. Although I just read a book about RFT, it remains a bit baffling to me. So I won’t attempt to explain it in detail. Briefly, however, the idea is that we construct verbal rules and follow them habitually despite the fact that they limit our lives.

One common rule many of us obey is this: if something makes me uncomfortable, I should avoid it. This doctrine promises to relieve discomfort by taking us away from its source. To the uninitiated, it sounds quite reasonable, which is why it’s so widely adopted. In the natural world, animals survive by staying away (for instance) from foods that make them sick and places frequented by predators.

But what if getting close to other people makes you feel nervous and insecure? The rule says: stay away from relationships. Unfortunately, if followed consistently, this practice fosters fearfulness and isolation; it leads to a limited and lonely life. The rule fails to deliver on its promise of lessened discomfort. In fact, living disconnected from others will likely increase feelings of insecurity, so a policy of avoiding social situations results in the opposite of its intended effect.

Yet, it isn’t entirely without benefits. In the short run those convinced of this rule might derive brief relief by sidestepping contact with people. This immediate reduction in anxiety reinforces the behavior pattern, despite the longterm accumulation of highly negative consequences. The early payoff obscures the late cost.So the rule dominates behavior even as life become increasingly constricted. (Note that in some cases the very act of avoidance increases anxiety, but that doesn’t spur any change in behavior. Longstanding rules can be believed with such conviction that we continue to follow them even when they worsen unpleasant feelings—though they may seem familiar or provide other ‘rewards’ that support the pattern.)

As I pointed out in the last entry, the circumstances of my mother’s death back when I was six left me highly fearful of abandonment and very sensitive in relationships. It seemed like the safest tactic was to evade new connections and terminate friendships quickly at the first hint of criticism or rejection. By following the rule of avoiding what made me anxious, by age forty I had very few friends. I enjoyed a reasonably harmonious marriage but few other social contacts. I felt safe in my home but overly dependent on my wife; I remained chronically lonely and insecure.

The only way out of this trap was to break my rule of avoiding others. But until I was referred to an ACT therapist, every counselor reinforced my belief that anxiety was bad and should be reduced at all cost. For example, I’d left a valued job after a psychiatrist proclaimed it too destabilizing to my moods. Given such strong encouragement to limit agitation (often diagnosed as hypomania), I monitored my discomfort closely and allowed it to steer my actions.

While treated under the CBT model, I was encouraged to engage others socially and test my fears, but my underlying assumption that anxiety must be eliminated was never addressed. Although I practiced the CBT empirical method, I usually found socialization so aversive that I ended up reverting to my lifelong rule of avoiding interpersonal contact.

Psychodynamic insights helped me understand why I ended up so fearful, and CBT taught me to challenge unhealthy thinking and build positive activities into my routine. However, only ACT encouraged me to pursue what I want in life even while experiencing uncomfortable thoughts, memories, feelings, and bodily sensations.

ACT taught me that many of my rules, and especially the one about spurning relationships, worked against my values. I want friendships and my policy of avoidance was preventing them. So I began to reach out to others despite the self-doubt, fears, and bodily agitation that often resulted. I developed new behavior patterns that weren’t rigidly controlled by a rule that promised safety but delivered isolation. This led to anxiety in the short run but confidence and community over the longer term.

My new approach didn’t come easily. In fact, despite years of working to apply new behaviors, I often find engaging others distressing. But it’s getting easier. Best of all, I have many more friends than ever before.

Of course, there are many other rules that malfunction in similar ways. Some people find standing up for their rights so frightening they habitually remain passive. Others believe they should strike the first blow at the first sign of conflict. Some seek continual social stimulation to avoid the discomfort of being alone. In each case the rule promises relief but instead fosters rigid and limiting behavior.

Rules can also be beneficial, of course. Look both ways before crossing the street is an example of a wise strategy. When in doubt, do the kinder thing is another rule that usually (but perhaps not always) pays off. Rules are unavoidable side-effects of language, according to RFT. The healthy response is to choose rules mindfully and follow them flexibly. Problems arise when rigid habits dominate and restrict behavior and so undermine pursuit of values.

Note that everyone could benefit from challenging his or her inflexible strategies. One of the things I like best about ACT is its insistence that therapist and client confront the same human dilemma and work their way through it together. This is the opposite of the psychiatric model, where the mentally ill patient turns his or her life over to the all-knowing doctor.

I had planned to use this post to unspool the many concepts that were rolled into the last one. But it turns out that just covering the problems with rule-based behavior took up an entire (long) entry. I’ll try to cover more ground in future writings, but perhaps readers would be best advised to seek out books on the subject. T

wo good starting points are: Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy by Steven Hayes (2005), and Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated from Anxiety by Kelly Wilson and Troy DuFrene (2010).

Acceptance and Commitment Therapy has been very helpful to me in grieving important losses, including those that still haunt me from childhood. In this context, ACT’s working hypothesis is that the questions and recriminations with which we torment ourselves after the death of a loved one are products of language and can be addressed by adjusting our relationship with verbal thought.

ACT emphasizes how thinking can interact with feelings to obstruct our pursuit of values. Let’s take my mother’s death as an example and see how this works.

As mentioned last time, my mother died in a psychiatric hospital after battling depression for years. That much is factual. But my mind has never been satisfied with the documented information.

A big question for me has always been: Did she commit suicide? Factually, I cannot know for sure. She died several days after admission to the hospital. I’ve long suspected she overdosed on her many medications, and tricyclic antidepressant toxicity can sometimes cause death after a long delay. So it is possible that she took too many pills and died of the effects. On the other hand, no family members who were adults at the time have ever concluded my mother took her own life.

Even if my mother died of natural causes, she wanted her life to end. At home, she prayed out loud in petition for death. She spent her time alone in a darkened bedroom, displaying little interest in her children. So regardless of the facts, her death felt like a suicide to me.

And I was left without a mother whether or not she deliberately ended her life. In a very real sense, the ‘truth’ doesn’t matter.

Even so, the truth or falsity of suicide has obsessed me for most of my life. An answer would have made no difference in any material aspect of my life. It wouldn’t have changed how my stepmother mistreated me. It wouldn’t have made my father into a better parent. It wouldn’t have prevented my sister’s death from alcoholism. Only in my mind could the answer have exerted any influence.

And that’s exactly the point. The idea that my mother killed herself altered my world view and worked against my happiness. The (unproven) belief that my mother committed suicide fueled deep-seated fears that she didn’t value me as a son. I felt unlovable, which drove me to sabotage friendships and spurn viable romances. A toxic belief augmented by distressing emotions led to avoidant behaviors that limited me for decades.

This would be one interpretation under ACT; other psychological models might view the situation differently. But without doubt, thinking that my mother’s death proved me unworthy undermined my behavior in relationships.

Although it’s useful to inspect and challenge my beliefs, what’s needed even more is practice in relating effectively with others.

Admitting that my mother might have died of natural causes won’t suddenly make me feel worthy. My mom’s actions toward the end of her life transmitted the message that I had become unimportant. The implications became deeply ingrained. My obsession with knowing “the truth” has perhaps been a quest for validation of the insecurity bequeathed by the waning interest in motherhood that preceded her death. (Note how thoughts and feelings are in constant interplay; it isn’t simply a case of one leading to the other.)

One tenet of learning theory is that we build on what came before; we never truly forget anything that carries psychological weight. The feelings of unworthiness stirred by my mother’s death will always remain a (hopefully diminishing) part of me, even as I gain a mature understanding of my importance to others. And yes, that sense of consequence can be fostered, but only if I take the necessary risks and create friendships.

The critical question becomes: How do I act in the face of negative expectations and painful feelings? Can I still reach out to others even if my love was insufficient to sustain my mother’s life? Can I take the risk of rejection despite how much it hurt to lose my mom? Can I remain in friendships even if they sometimes dredge up feelings of abandonment? Can I resist the urge to flee when the awful fear of loss arises?

Only by reaching out despite my dread of rejection will I reclaim my worthiness and begin to feel better around others. Only by taking chances will I find community. Only by sticking with relationships even when they hurt will I discover love. Only by acting effectively despite my obstructing thoughts and challenging feelings will I build a meaningful life.

How we perceive a situation, and how we feel about it, aren’t as vital as how we act. We can move toward what we value no matter how bleak our thoughts or how painful our emotions. This is the message of ACT that has so decisively improved my life.

To be alive is to be vulnerable, but to be human is to be sensitive in ways undreamt of by other creatures. All life forms are prey to death, loss, illness, and injury. But people also fear disappointment, ill-repute, and injustice. As was touched on last time, our values make us susceptible to considerable pain.

The most obvious and universal value is love, and it inevitably brings grief. No one we love will be with us forever, and except for those rare cases of simultaneous death, one lover always passes from this life before the other. The result is grief. No one who lives beyond youth escapes it, and many children suffer it too.

When I was five years old my grandfather died, and a beloved dog was stolen, never to return. I learned two flavors of bereavement that year. In the first case, I felt remorse. My father’s father seemed to me a frightening and humorless man. He often yelled at me and my cousin and never played with us. We made fun of him behind his back.

When he died after a bad car crash, I couldn’t forgive myself for my disrespect. If only I could have gone back and behaved better, learned to love him more and tried to understand him.

The loss of the dog was tragedy tainted with guilt. My mother had received threatening notes about our pet, saying we would lose Inky if he continued barking and escaping into the neighborhood. After he disappeared, I never saw him again despite multiple trips to the police station and dog pound. I felt miserable, inconsolable. I also felt at fault; I might have forgotten to latch the gate. I should have been more careful.

These early losses were preludes to the major bereavement the following year. My mother had been suffering with severe depression after a painful divorce, cycling in and out of psychiatric hospitals, and openly wishing for death. Then one day she failed to return from her confinement for shock treatments. Her parents told everyone she died of natural causes, but suicide seemed a more likely cause of death given her oft-stated desire to die and her otherwise good health at age thirty-seven. It seemed obvious that she had taken her own life, a fact I understood even at age six.

That grief was unspeakable, shameful and untouchable. I felt crushed and utterly without hope. When our family moved to another town, I pretended my stepmother was my real mother until the woman’s cruelty toward me in front of my friends forced me to admit my mom had died. But even then I never named a cause of death. It was an awful, lonely secret. And as I hid the facts, it seemed as if I were betraying the only person who ever truly loved me.

There’ve been many losses since, of course. Three more grandparents (two of whom were almost like parents to me), a father, a beloved uncle, a remarkable cousin, a stepmother (whom I both loved and hated), two of my best friends (one to suicide), a number of other relatives, and then (just last year) my sister and only sibling. Each time there has been pain, regret, guilt, questioning, lost dreams, and hopelessness in varying combinations.

Grief is universal, as is the fallout from it.

Each loss feels different. If it comes with advance warning the death seems easier to bear than if sudden. If the person led a joyous life one feels less regret than if they were unhappy. If the relationship was harmonious there is less guilt than if otherwise. If nothing could have saved the loved one, there are fewer questions than if things could have gone better. If the person died elderly and frail, near the end of life with little opportunity for joyful experience, there is less sense of tragedy. And if the person was someone we spoke with rarely, someone with whom we only occasionally shared hopes and dreams, there is less sense loneliness and isolation.

Each grief is different because each relationship is unique, with its own special meanings. To lose a mother to suicide at age six is different from losing a sister to alcoholism at age fifty-three. Both losses are painful, but they are not the same. Death baffles a young child, and to be motherless is to be cut adrift in an unfriendly world. But one feels torment watching a loved one choose to continue a deadly habit despite constant warnings from her own body and protestations of love from those nearby.

To lose a child, they say, is the worst bereavement of all. Myriad hopes and dreams get crushed. The wish that one could have protected the son or daughter must forever haunt. I don’t know the experience of losing offspring, but just watching my pomeranian get killed by a large dog on the beach gave me a taste for how wrenching it can be to see a being you’ve nurtured from birth die while you are powerless to protect. I can’t imagine the far greater pain of losing a human child.

My father died suddenly, robbing me of the chance to offer the many apologies and praises he was owed. I would have loved to forgive him, too. So much regret. Hardly a day goes by that I don’t wish he were here for one last conversation. How many of us share such remorse?

And on and on.

My aunt lost her husband of six decades about two years ago. Talk about an unspeakable loss. I’ve been with my wife but twenty years and already feel so bonded that life without her is inconceivable. To overcome such a separation must be one of the greatest challenges of human existence.

But people move on after even the most painful losses. How do we overcome grief? By filling in some of the holes in our lives and making peace with those that remain. By forgiving ourselves and others. By recognizing the universality of suffering and bereavement. By finding faith in something greater than daily life with its bills, chores, and frustrations. By learning who we are without the beloved by our side.

I can offer very little here. Through the losses I’ve endured I’ve learned only one certain thing: grief lessens with time. It never ceases, but its horrible early sting dulls a bit, and one is left with a gnawing ache rather than a gaping wound. People regularly go forward after even terrible bereavement. What choice do we have?

Values bring vulnerability, and love brings the greatest vulnerability of all. Animals have been known to grieve; elephants in particular are recognized for behavior that looks like mourning. But it is unlikely that elephants imagine what life might have been like had the beloved survived. I doubt they feel regret for past acts or wish they had acted more protectively. I doubt they wonder if life is worth pursuing anymore.

All the questions and recriminations with which we torment ourselves after the death of a loved one are products of language. They are human constructs without counterpart in nature. Perhaps we would be happier if we experienced life and death like the animals who, while capable of genuine love, live mostly in the moment without vivid and unstoppable imagination of past, future, and better outcomes.

We all hope to pursue certain directions in life. We may not always admit how much our values affect us, but they greatly influence our thoughts, emotions, and actions.

The person who makes a mistake and loses a cherished job feels shame. The mental obsessions that surround the shame may center on what went wrong, on the boss who couldn’t tolerate errors, or on the spouse who will be disappointed. Despite these different thoughts, the shamed response is driven by the conviction that doing a good job is important.

Mistakes matter because the work matters (consider a surgeon who made a dreadful error—he or she is concerned about the patient’s outcome, not just personal consequences). Performance matters because work well done brings social approval, which is painfully lost when the boss fires a failing worker. Employment matters because material support keeps family fed, clothed, and sheltered. But most of all, work matters because it is a central value in the lives of most people.

If the job is lost because of addiction, then the addict feels shame about his or her dependence on substance use. But the shame remains driven by the underlying value: useful work.

If the job is lost because of agoraphobia, the anxious person feels shame about the emotional vulnerability that makes leaving home difficult. But again, the shame is driven by the value.

This description is an oversimplification. Making mistakes, suffering addiction, and feeling controlled by fears lead to many negative self-appraisals, some of which seem independent of external consequences. The self-criticism may echo punishments from childhood or internalized societal judgments. But the primary reason we feel badly about such problems is that they undermine what we consider meaningful and valuable.

Our values make us vulnerable. If a certain valued domain has not been pursued effectively, we may resist even acknowledging its importance. For instance, after my surgical career collapsed due to neck problems, it wasn’t long before even thinking about my old work felt terribly painful. Accusations arose whenever I considered what had been lost: Why didn’t I wait longer before quitting? Could I have found ways to deal with the pain and keep operating? Why did I choose a surgical specialty in the first place, when my neck was hurting already?

Although motivated by regret, these thoughts steered me away from looking squarely at how much I’d lost. Rationalization served the same end: “There were many things I didn’t like about that job;” “I didn’t have a surgical temperament;” “I should never have chosen to train in that field.”

This inner dialogue, with its accusations and justifications, kept me from simply experiencing a terrible loss. It kept me from feeling grief. My frantic mental striving to avoid the sorrow shows how much the career truly meant to me.

If feeling useful in an occupation hadn’t been so important to me, early retirement would not have stimulated such distress. If it hadn’t been for the value, there’d have been no vulnerability.

When life serves up too many setbacks, cynicism becomes a tempting response. It certainly protects us from facing our values and feeling the pain they cause. If I give up on ever succeeding at anything ever again, I don’t have to fight the fears, uncertainty, and inertia that stand in the way of my trying. If I say work no longer matters to me, I don’t have to feel badly about not working? Isn’t that right?

No, in fact such cynicism just substitutes unconvincing rationalizations and anxious avoidance for the more empowering choice of looking squarely at a value and figuring out how to pursuit it under current circumstances. Maybe I can’t work as a surgeon anymore, but I can blog. Does a blogger enjoy the same status, money, and accomplishment as an oculoplastic surgeon? Not even close. To compare the two activities on any of those dimensions would be laughable. But does blogging help me feel like I’m making a contribution? Yes. And so it furthers my value of working to help others. Taking small steps in a valued direction is better than taking no steps at all.

Blogging has helped me feel effective again. As a result, I was able to try my hand at acupuncture. Writing a book begins to seem plausible. If I had chosen cynicism and stasis, my ‘work is important’ value would have languished and I’d have made little forward progress.

While writing about the Acceptance and Commitment Therapy (ACT) stance on values in the last post, I imagined the discussion might distress some readers. One person might see himself mirrored by my example of staying in bed rather than socializing. Another might feel anguish about the way her workaholism degrades relationships. Others would recognize destructive consequences of addictions. And in looking at the effects of problematic behaviors, they would feel pain.

This pain is exactly what we feel when we value a life dimension highly, but our behaviors sidetrack us from its pursuit. It is the vulnerability that comes with caring. Just as they say, “grief is the price of love,” vulnerability is the price of every value.

The natural response can be to turn away and not look at how we’ve abandoned some of our values. But there is more vitality in sitting with the pain of our choices and acknowledging that regret highlights our priorities. We can then start working toward valued directions in whatever small ways we can.

Engagement, not avoidance, is the answer.