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A few months before my memoir Pathological comes out, my father calls mid-morning on Sunday. I answer and ask how he is.
“Well, not very good.” His voice has the strain of someone who’s more confused than in acute pain. He tells me that he hurt his back. He fell but doesn’t remember falling. All he knows is that he fell and hit his head because there’s a wound on his forehead.
My father doesn’t have pain—or doesn’t talk about it; he complains only of arthritis in his hands. Even then, he minimizes it, saying it’s not that bad.
“I’m not going to be able to meet for lunch.”
His voice is so apologetic it makes me tear up. Then a pit forms in my stomach, the guilt for the way I treated him during the twenty-five years I struggled with serious mental illness. We were often estranged, sometimes for long periods. Now that I’ve recovered, I look back on a lot of my life with regret, the feeling that I lost a quarter of it to psychiatry’s myths that the media and so many clinicians perpetuate (psychiatric conditions are biological, caused by a “chemical imbalance,” and lifelong). If only I’d known that none of these is true, I might have gotten well sooner. I might not have pushed my father away. I might not have become so hopeless I couldn’t live independently and was suicidal. That Sunday, I haven’t worked through the regret and grief that makes mental health recovery so hard.
I ask if he needs anything and I’ll miss seeing him. My stepmother is with him, so I don’t worry too much about him going through this alone. I tell him I love him.
“I love you too, hon.”
My chest surges with love, and the pit of regret hardens.
*
Hours later, he texts me. He’s in the ER. Immediate Care sent him there because his condition warranted more serious treatment. They’re going to keep him overnight for observation.
My sister calls. He actually fell yesterday. He’d been in the basement. Suddenly, he woke to find himself on the stairs, having fainted on his way back upstairs. He didn’t notice the gash on his forehead until a woman at the desk of his health club told him he was bleeding. Then, that Sunday morning, his back started to hurt.
The doctors diagnose him with bradycardia. His heart beats too slowly. A slow heart rate is typically a sign of good health. It’s the goal of exercise, meditation, and good sleep hygiene. But bradycardia is life-threatening. Not enough oxygen-rich blood pumps through the body. Undiagnosed, it can lead to cardiac arrest and death.
My father will have surgery the following day. The pacemaker will send electrical signals to his heart to make it beat faster. It’s a routine procedure. Minimal risks include infection, blood clots, and maybe a collapsed lung, but there are always risks.
That night, he texts. He says he doesn’t like being in the hospital. The next line practically breaks me: It’s lonely. I call and tell him I love him. He says he loves me too, his voice brittle and weak.
*
That night I start a gratitude practice, something I’ve never been drawn to. Gratitude can have a punitive ring to it: You better be grateful. But it will end up being pivotal to my recovery and continued mental health.
Although some authors claim that the research on gratitude points to its positive effects, the science of gratitude is still a nascent field. Even the University of California Berkeley’s Greater Good Science Center, the country’s gratitude hub, readily admits that gratitude studies haven’t, for the most part, been replicable, meaning they’re more theory than proof.
Part of the problem is that researchers can’t agree on what gratitude is. Robert Emmons, professor of psychology at the University of California Davis and reigning authority on gratitude, wrote, “Gratitude has been conceptualized as an emotion, a virtue, a moral sentiment, a motive, a coping response, a skill, and an attitude. It is all of these and more.” Gratitude depends on the person experiencing it and the context, but Emmons and his colleague Michael McCullough define it as “recognizing that one has obtained a positive outcome” and “recognizing that there is an external source for this positive outcome.” The source is often thought of as a benefactor, but it doesn’t have to be a person; often, it’s God, the universe, fate, etc.
Checklists and scales try to measure gratitude. UC-Berkley’s Greater Good Science Center’s Gratitude Adjective Checklist asks people to gauge how much they’ve felt the emotion of gratitude on a scale of one to five. The Transpersonal Gratitude Scale measures the more ethereal aspects of gratitude, like being grateful just for being alive. There are others, but the most telling is the Gratitude Questionnaire-6:
Write a number beside each statement to indicate how much you agree with it.
1 = strongly disagree
2 = disagree
3 = slightly disagree
4 = neutral
5 = slightly agree
6 = agree
7 = strongly agree
I have so much in life to be thankful for.
If I had to list everything that I felt grateful for, it would be a very long list.
When I look at the world, I don’t see much to be grateful for.
I am grateful to a wide variety of people.
As I get older I find myself more able to appreciate the people, events, and situations that have been part of my life history.
Long amounts of time can go by before I feel grateful to something or someone.
Does anyone really get a perfect score? Are they grateful in all the right ways and never disgruntled? It’s not that the statements determining positive levels of gratitude require Mother-Terasa level thankfulness. But there’s something inhuman about someone who’s 100 percent grateful.
Gratitude emerges in different ways. You can have a grateful disposition, which means your baseline is one of gratitude. You can be in a grateful mood, which is more transient. Experiencing the emotion of gratitude is typically short-lived and in response to an event.
Most researchers agree that gratitude is an essential part of being human—though not in the way you might think. Evolutionarily speaking, gratitude is a mercenary act, something we and animals do to get something. A parrot gives one of his seeds to his brother parrot, so his brother will do the same later. If you send that thank-you note, your aunt will send money on your next birthday too.
We can’t know for certain, but that may not be the case anymore. Researchers who study the differences between obligation and gratitude have found that gratitude diminishes if you know the gift-giver is expecting a show of thanks. We’re more grateful when we know there’s no ulterior motive behind a good deed, and our gratitude decreases if we know someone wants something in return.
*
A gratitude journal seems like the place to start. I’d forced and faked gratitude before—on Thanksgiving, in yoga classes, upon receiving gifts—but it felt disingenuous, even a little deceitful. Maybe writing it will help.
I lie in bed, put my pen to the page, and wait for gratitude to come. Images of gratitude websites and pithy social media posts flash through my mind. But that’s it.
All I have to do is write three things I’m grateful for. What’s wrong with me? Why can’t I just simmer with thanks? I let my mind wander for some time. My eyelids start to droop and I fall in and out of sleep. Lamely, I scribble, walking, fresh air, Dad and turn out the light.
*
My father’s surgery goes well. He says he feels fine, except he’s hungry from not having eaten all day. I google visiting hours, which are almost over, and ask if he wants me to bring him a sandwich. He says the nurses are going to bring him something. He’ll be discharged by this evening.
The next day, I visit him and my stepmother. He answers the door. His cheeks are sunken, his skin wan. He looks very, very tired. As we walk inside, he’s unsteady on his feet. When we sit, he has to ease himself onto the chair.
He points to the part of his back that’s most painful and tells me that the doctors don’t know what he did to injure it. The cut on his forehead is already starting to scab. He shows me the scrape on his elbow. He’s never looked so fragile.
Something rises up in me, a pleasant vibration in my chest. Gratitude. I’m sure of it. I’m grateful he’s okay, so I can have more time with him.
Eventually, I start listening to a gratitude meditation on my walk each morning that asks me to think of three moments from my past that maybe I wasn’t grateful for then but could be now. Moments, not things. Scenes. Experiences. It takes a while—a year or so—but the regret I feel for the years I spent living with mental illness starts to fade.
A few months later, after my book has come out, my father leaves a message while I’m teaching a class on Zoom. I listen to the message after we finish.
He says he’s reading my book. “I love you,” he says. “I just want you to know I’m here.”
That same pleasant vibration fills my chest. It fills me to the point that my eyes brim with tears. Gratitude. It’s too late to call, but I text how much I love him and how grateful I am that he’s my father.
» Continue to Chapter 31.
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I have a simple little gratitude game that I play w/ both kids & my adult clients. It’s interesting how most will struggle w/ finding things to be grateful for at first. By the end of the game it’s as easy as ABC.
The whole book is rivetting and addictive.