Tuesday, June 30, 2009

Two Hope Lessons

Most of what I know about hope, I picked up from other people. In April 1997, I learned two lessons about hope. With my coursework behind me, I was wrapping up my last few months of clinical training at the Eisenhower VA Medical Center. The staff psychiatrist popped into my office. He had a case for the soon-to-be psychologist. Dr. McNutt (real name…couldn’t make that up) threw me several softballs during my time in the clinic. The case of Paul Carlson (pseudonym to protect client confidentiality) was not what I expected.

Paul was a full-bodied 63-year old veteran who had spent his life in the farm fields of Kansas. He was a pragmatist, from his work boots to his flattop to his no nonsense approach to life. In shock from a diagnosis of kidney failure he had only one fix – suicide. See, Paul had never heard of a farmer running a farm while on dialysis, so that treatment option did not make sense. Not getting treated would leave him too sick to work the fields. Get treatment, lose the farm. Don’t get treatment, lose the farm. Lose the farm, lose all sense of meaning. Paul wanted to avoid losing the farm, by any means necessary. That day, Paul and I completed Lesson #1: hope depends on the quality of our relationship with future.

Though few of my clinical techniques worked with Paul that first day, he did get to the point where he was no longer a danger to himself. With the help of his family and friends, we made sure that Paul had a safe home to return to and plenty of support.

The next day, he came back to the clinic and started Lesson #2 with a question, “What’s my story?” After fumbling a bit, I was able to grasp the full meaning of what he was asking. Paul wanted to know how talk about being ill, going to treatment, and getting better or getting worse. He hated the question, “How are you doing?” and wanted to have a go-to answer. We spent the next two hours talking about hope as an active process that requires constant attention. At the beginning of the next session, he told me, “I got it. ‘I am working on it’ When people ask me how I am doing, I tell them, ‘I am working on it.’” Lesson #2: hope is active and it fueled by the language we use.

Now, the two lessons Paul shared with me add to my book learning about people and hope.

Hope Lesson #1: We are the only creatures on the planet that truly think about the future. The quality of our relationship with the future determines our hopefulness. Future thinking at its best gives us high hope.

Hope Lesson #2: Human language makes hope infinite. Hope is brought alive by the stories we tell to ourselves and about ourselves. These stories live on, as does our hope.


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