Wednesday, December 28, 2016

The Seven Basic Feelings   SAD

The seven basic feelings are;
Mad
Sad
Glad
Hurt
Afraid
Shame
Hope

Whenever I state these, people always ask me, well, what about love?  I answer that love is the core of everything.  It is called many things, but feeling connected to others and ourselves is our basic humanness.  The other seven are ancillary and help us negotiate the basic problems of love. 

Love is the most basic need of all.  To feel welcomed, valued, honored and accepted (to name a few) is what every one of us hopes to achieve.

Each feeling has its accompanying need and consequence if not met.

So I am going to take each feeling and expand on it a bit in hopes that people can begin to articulate what they are feeling a little better.  That helps a lot in relationships

It always amuses me that if you ask a an what he feels, he will tell you what he thinks and obversely, if you ask a woman what she thinks, she will likely tell you what she thinks.  The integrating of thinking and feelings creates the outcomes we all desire.  Putting who you are back on what you do.

The next feeling on the list is SAD.  Sad is also a very basic emotion, so basic that we have to stop little boys from crying as soon as possible, at least before they start kindergarten.   Girls get a pass for being “Tomboys” until about adolescence, then they have to become young ladies.   Hopefully that is changing for males.

There is so much to be said about grief that it is hard to know where to start, given that I have experienced grief as the great heal and simultaneously the most profound change agent available.  As the Bobby “Blue” Bland song goes, “You’ve Got to Hurt Before You Heal” because when humans lose something they value it changes us.

Grief requires comfort and expression.  If those two needs aren’t met people become cynical and, often, bitter.   This usually leads to distancing and further isolation.    If, on the other hand, they are met, healing, recovery and building a new life are possible, even likely.

Part of what makes grief so difficult and tricky is that it is easy to disconnect feelings from the cause.  Nothing turns hostile quicker than unexpressed grief.  Grief goes on longer then we expect or have the patience for because rebuilding after a major loss is slow, hard work.


I remember about five years after my daughters’ death I decided that that was enough grieving on my part, so I didn’t go to the cemetery or do any of my usual honoring of her life that year.  Imagine my surprise when I started hearing from my husband (not her father) “what is wrong with you, you are snappy and hostile in ways we Morrie & David, (my stepson) don’t deserve.  I was very surprised; I didn’t think anything was wrong.  In fact I was proud of myself for my decision.  It took a couple of days to realize that my decision to not honor her and myself was the “cause” of my hostility.    That disconnect happens so fast.  I have learned that I don’t have to do much anymore, just acknowledge the important anniversary dates, then I can move on.

Friday, December 16, 2016

The Seven Basic Feelings



The seven basic feelings are;
Mad
Sad
Glad
Hurt
Afraid
Shame
Hope

Whenever I state these, people always ask me, well, what about love?  I answer that love is the core of everything.  It is called many things, but feeling connected to others and ourselves is our most basic humanness.  The other seven are ancillary and help us negotiate the basic issues surrounding love.  

Love,feeling connected,  is the most basic need of all.  To feel welcomed, valued, honored and accepted (to name a few) is what every one of us hopes to achieve.

Each feeling has its accompanying need and consequence if not met.

So I am going to take each feeling and expand on it a bit in hopes that people can begin to articulate what they are feeling a little better.  That helps a lot in relationships

It always amuses me that if you ask a man what he feels, he will tell you what he thinks and obversely, if you ask a woman what she feels, she will likely tell you what she thinks.  The integrating of thinking and feelings creates the outcomes we all desire.  Putting who you are back on what you do. 

Starting with MAD; Mad needs a target, if that need is not met it becomes rage, passivity/hostility.  If it is met anger becomes assertiveness, and the ability to act on one’s own behalf.



Anger is a natural emotional response to disappointment.  When anger is shut down through intimidation or intellectual co-opting, the unnatural and abnormal response of passivity and/or hostility are created and reinforced

                                       When a discrepancy exists between
                                      Between what I have and what I wan

                                       I should experience and express anger
             
                                 Not expressing anger, leads to;                                                     
  

                  Withdrawal/Passivity .............  ....................................Blame/Hostility                                                                                               
(I don’t care “                                                                                                 “You people screwed
“It doesn’t matter”                                                                                                  me again”






If I can express anger, that leads to;

Assertiveness, which leads to
(the ability to act on one’s own behalf)

Access/Examine/Strategize/Plan, which leads to
(the practical expression of self worth)

Results
(the natural outcome of being able
to express your anger)



Tuesday, December 6, 2016

A Walk Alone

But grief is a walk alone
Others can be there, and listen.  But you will walk
alone down your own path. at your own pace. with
your sheared-off pain, your raw wounds, your
denial, anger, ane bitter loss.  You'll cone to your
own peace, hopefully ...but it will be on your own,
         in your own time

Cathy Lamb
Out of the Ashes

Sunday, November 20, 2016

The Two Levels of Human Life


I am always amazed when I witness a couple arguing the same issue they have been for all their married life.  How can this be, that two adults who raised kids together, ran households and businesses, etc. can’t come to a resolution about something as simple as “What’s for dinner?”   How can that get so gnarly so fast?

There are lots of reasons for that state of affairs, mostly it’s old stuff, but for this post I want to focus on one aspect.  It is usually the case that one partner is “rational” and measured “while the other is “emotional” and erratic.  We tend to chalk it up to the difference between the sexes.  It often looks that way.  I have come to believe that it is more about the differences in the levels of human interactions.

There are two levels in each of us; there is the thinking/doing side and the feeling/being side.  Each aspect plays an important role in the trinity of success, which is; a feeling processed through the intellect and then translated into behavior.   Unfortunately we have so emphasized the thinking/doing side that the feeling/being side has basically been consigned to the dustbin in most of our lives.

The thinking/doing side is about all the things we accomplish and get done.  The feeling/being side is about our hopes and dreams, our values, our feelings, our self-esteem, namely all those invisible, intangible, immeasurable parts that, in fact do measure our happiness and well-being. 

As we grow up, most of us got all our accolades and kudos from what we do, like grades, sports, and music or just for being “good”, while our internal lives are ignored or disregarded as a nuisance.  So by the time we are teenagers we have become human doings, as opposed to human beings. 

In the example above, the couple keeps trying to solve their feeling issues by thinking it through.  That often works for a little while, but soon enough, they will be right back to the ten-year-old arguments.  So it would be a good thing for them to begin “thinking” about their “being” parts.  Perhaps drag them out of the dustbin and feel what this is really about. 

This internal divide is a result of all the decisions we made growing up, to be safe from scolding and shame and discomfort.   It is a matter of discovering what those decisions were and making new ones from the adult that eases those old patterns. 


Thursday, November 3, 2016

Foundation


From birth to death any human is inundated with information, input, stimuli, internal goings on and all sorts of chaos.  For the infant and growing up child it is their job to sort all that out and make sense of the world.  As they grow things happen around them that force a conclusion about their world and a subsequent decision on how to handle that conclusion. 

Unfortunately all the decisions we made at three and seven and twelve and all the years in between are as operational today as they were the day they made them.  So we end up in the absurd position of having a three year old in charge of our lives, because we haven’t made any new or different decision, these decisions are very difficult to access for two reasons. 

First they were often made before we had much language or the ability to conceptualize, second they were survival tactics and strategies for us as children.  Literally our survival was at stake. The strategies and tactics defended a child so the overwhelming pain of their emotions wouldn’t kill them.  These decisions are actually implemented over time, through trial and error -what is less painful then that action-and what fits a particular child’s way of being in this world.

Let me give an example;  Let's say a three year old witnesses a parent hurting a sibling and in the indignation only a three year only can muster, intervenes in the abuse.  Assuming, that, of course, the parent will do what is right.  Instead the abuse gets turned on this child.  So what happens internally to this child the next day, and the next and the next?  And for years, watching the abuse go on.  If she intervenes she gets hurt, and if she doesn’t she has to endure a sibling getting hurt.  So how does the child learn to handle that impossible ethical dilemma?


This small example sets the stage for how to unravel our inexplicable responses/behaviors to certain events that puzzle us and we haven’t a clue how to undo.

Thursday, October 20, 2016

The Change Process



What is this mysterious change process I talk so much about?

As I work with people and they start making connections many clients say, “This is great, now what do I do to change it?”  The answer is always the same; small risks in the present.   We can’t change our pasts, but we can heal from them “ Like what?” they ask.  Anything that is big enough to make you nervous, but not so big as to be catastrophic if you fail. 
For EXAMPLE, Sometimes it is as simple as saying “No” to a request.  The key is how it feels.

The first feeling is some kind of implosion (hurt), which is the opposite of explosion. That means you come down very hard on yourself, beating yourself up for being stupid or something.  Many of my clients are very good at that.  I bet you are too.  I have been.

The second is a very strong sense that something is wrong, or that you have done something wrong (guilt).  When I’m in this stage I keep looking at my appointment book because the sense is so strong, like I’ve missed an important appointment.  Just, something is wrong.

The third feeling is a very strong sense of impending doom;(fear) you just know something awful is about to happen.  This is the hardest one to manage because it is full of fear.  I remember being relieved when something went wrong, just to feel relief from that terror.

What these feelings are related to is the expectation of consequences.  If you could put a child’s words to a narrative it would be along the lines of, “Oops. Uhoh, and now I’m really gonna get it.” As an adult the expected consequences don’t happen anymore, then the feelings will gradually dissipate, but not before those three feelings of hurt, guilt and fear are felt through.

It really was that serious for you as a youngster, which brings me to why that is true.  Why do some things we try to change come with ease and others are so difficult.  Like the same battles we have had for ten years with our spouse, or how difficult it is to kick any addiction.  The sticking points are about decisions we made as young children to survive in the family we were born into.

Stay tuned for the next post about how those old decisions continue to rule our lives


Friday, October 7, 2016

A Safe Place To Grieve

Why has a safe place to grieve has become my mission over time?  In retrospect, looking back over the last 35+ years since my daughter’s death, I have been asked and wondered myself, what made healing possible?  How have I been able to live a rich, satisfying life in the face of such wrenching pain and loss?   In the late ‘70s and forward, there wasn’t much available for any kind of grief, especially in small towns.  

The messages and pressure to “get over it”, “time to move on”, “you’re a downer to be around”, was intense and pervasive.  All the messages about, “she’s in a better place, or your lucky to have other children, while well intended were most unhelpful.  The truth is that for the first year at least, nothing helped.  The pain was so intense, all consuming and inescapable that there simply was little relief.  Except the grieving, if I were able to ride the waves of grief, there was temporary relief until the next wave. 

Every bereaved person has to find their own path and does that in their own way and their own time.  There have been many people, books, music and support that made life possible for me but as a bereaved parent and therapist what has been consistent over time as a client and practitioner is the ability and availability of a place to keen and wail.  Most of us have to do that in the night or when no one else is around.  This leaves out the factor of comfort.

Grief is brutal and life changing.  The chasm between the safe place and grief seems to be unbreachable.  I think that that gulf is because of the secrecy surrounding grief, all the injunctions to Man-up, suck it up or a thousand other dismissals and discounts of the seriousness of catastrophic loss.  But the real reason is that if we allow people to have their grief it forces us to change with them, or lose the relationship.  This is a painful choice that is hard to understand.  I heard many remarks along the way that I was not the same as I used to be, or I’m not as nice.  I think that is true because I no longer have any patience for all the PC attitudes and certainly not for BS.


What do I mean by a safe place to grieve?   Basically a room or space that is set aside for the specific purpose of allowing people to do the keening and wailing that is ultimately so healing.  If ou know of such a place, please share so we can all benefit.


Thanks

Tuesday, September 27, 2016

On The Other Side Of Grief (Stage 6)

Stage 6

            The final stage is called "In Memoriam."  This stage is not mentioned much in the literature but seems to belong because so much has been created out of significant losses. It is the need to do something creative, useful, and meaningful - to create some personal meaning out of an event that seems meaningless and often absurd.  There are many examples of this, such things as foundations, support groups, books, etc.  This kind of writing is mine.

Some final notes:  Grief cannot be denied; only delayed.  When people try to deny and suppress it grief shows up in physical symptoms, due to the stress of so much control.  The physical symptoms most closely related to grief are any number of chronic upper respiratory illnesses.  The hard part is that these are also very real diseases.  It is more an association then a one to one cause/effect.  But over the years I have noticed that people who have experienced loss, and not grieved, tend to catch cold more often and their colds last longer.    

Grief comes in waves that are relatively short in duration, and very intense.  This intense expression of deep feelings leaves one feeling dazed and stunned - briefly - then there is some relief, until the next wave.  Between the waves, life goes on as usual.  Eventually the waves of grief get further apart, less intense and less devastating - like a receding tide.  Grief and guilt go hand-in-hand. Guilt is woven throughout the process.  It is so profoundly a part of our humanness and is the result of being imperfect and often impotent.  As we face our limitations, the guilt gradually disappears.  There is so much in life that we have no control over and no say about.  We are stuck with what life deals us.  Our freedom is in how we choose to deal with that hand.

            Given all the possibilities of how the process can go awry, most people somehow manage to get through and recover.  Usually with grace and dignity.  It is a continual tribute to the human spirit, and I am always impressed.




Arleah K. Shechtman

Monday, September 26, 2016

On The Other Side Of Grief (Stage 5)





            The next stage is acceptance.  This is like a sunrise.  The grieving person begins to get on with life.  Energy and interests, pleasure and joy gradually return.  If the grief work has been done for the bereaved person and the helper, there is a new sense of strength and purpose, and the relationship is deeper and wider than before.   Both feel OK about the relationship and so are able to connect in new, nourishing, and more productive ways.  Both the bereaved person and the friend have to make a myriad of choices to achieve a stage of acceptance.  One of the hard lessons learned throughout the healing is that adults often have to learn how to pick the choice that sucks the least.

Saturday, September 24, 2016

On The Other Side Of Grief (Stage 4)

     The next stage is depression.  This is usually the longest, lasting up to a year or longer in duration.  This is often a very private time - the mourner is deeply internalized.  It looks like withdrawal- and it is.  This is where the major work is done.  Sadness, remorse, guilt, weeping, sighing and a lower level of activity characterize this time.  Life feels bleak, futile and sometimes meaningless.  Most people continue to work and do things as usual, but it is like going through the motions.  That is because most of the energy is being used to recover, much like recovering from major surgery.  There is not much lightness or joy during this time.  Depending on the nature and degree of the loss, this is an existential crisis, an identity crisis; one’s entire life view is being redone.  For example, in dealing with my own bereavement - the death of my 15-year-old daughter - the belief that I could protect my children was shattered.  I realized about eight months after her death that this loss was no guarantee or insurance that I would not lose again.  I realized that I had no exemptions from life, no special privileges.  And perhaps the hardest:  No restitution.  No one would or could make up or replace what I had lost.  I was faced with terrible fear and the choice of whether I wanted to risk loving again.  All those thoughts, feelings and decisions occurred during my very long depression.

            This is an equally difficult time for those around the grieving person.  Grief goes on longer than anyone wants it to, or thinks it should.  Everyone gets sick of it, including the bereft person - and still it goes on.  Hang in, is the message here.  It will end, time does heal.  As helpers, once again we feel our own helplessness and impotence and we want to withdraw.  That is a normal and natural response and to be trusted.  Some distance is necessary at this point because so much of the work is private and internal.  Just sitting together, walking, or a brief handclasp is the most required and the most effective way through this time.
 
            This is the rebuilding time after a shattering experience and all the little bits and pieces that take so long to accept need to be put back together, often in a different configuration.  Once again this is the continued evolution of a new history together.

     The last phase a person can be stuck in (chronic grief)  is depression.  This is really hard to call because depression is also the longest part of recovery.  We often get weary of the length of depression.  So much happens during this time; the most significant choice being made is whether or not to pick up and go on with life.  A person stuck in depression uses the loss as the reason to stay in place.  The loss is used as a sort of brake and break from moving too fast.  Sometimes the person just stops and never seems to get moving again.

            I will never forget how a friend of mine helped me move on.  About two years after my daughter's death, he commented that I used her death like a black ace, to hide behind.  I, of course, was very hurt and indignant at first, but as time passed I realized he was right.  Again, it was thre the kindest.  I am glad he and others cared enough for me to want me back.

            This is also another example of the new person and new relationship emerging from the old.  Because people pursued me, and because I chose to live, I have been able to recover.  My goal has become to turn around and give back to others who have just begun their journey.

            Being stuck in depression is probably related to an early loss of self.  More than any other stage, this may require some additional professional help.  It is broader and more pervasive than most other feelings and harder to define and get to the root.  It is amazing to me how many people sense that they are stuck and simply need support to follow through.  Perhaps some reassurance that they are not bad or crazy - just stuck for the moment.


            In many instances, professional counseling is the only help available.  This is due to not having families and communities easily available anymore.  It is also due to the strange lack of permission in our culture to grieve.  The further away from the event, the less it is OK to still feel sad or be mourning.  After 3-6 months the person is expected to be back to normal, and after the first year fewer and fewer people even remember the loss.  It takes a good three years to feel good after moving geographically from one home to another, let alone a death, divorce or a major illness.  The less tangible and concrete the issue, the more pressure to forget it, or the implication that it is only in our head, but not real pain


Counseling offers an understanding ear, supportive assurance, cognitive understanding, and simply a safe place to continue the process.  For a person to admit they need help, and then to actually go for help, takes enormous courage and strength - because the message is that we should be tough, handle our own problems, and after all, this is "only feelings.”

Friday, September 23, 2016

On The Other Side Of Grief (Stage 3)

Stage 3

            The next stage to be discussed is bargaining, which is a deep regression to an earlier, much younger state. We often see strange rituals, enshrinement or deification that seem puzzling or obscure.  This is primitive, magical thinking and also the attempt to regain some sense of control or "normalcy."  There is the need to feel safe, and there is no safety.  The work during this phase is to realize that nothing will bring back life as you have known it, no matter how many things are enshrined.  This is a very important time and is part of the redoing of the upset sense of reality.  It is an - "if this, then that" attitude.  For example, in bereavement we sometimes see a room or object enshrined; the thrust being, if I keep everything exactly as it was, then the person will not be so gone.

     In this stage the grieving person’s response is to bargain for impact.  To try and do something safe and familiar.  The most common form this takes is for us to join in the rituals.  It is such a relief to feel useful and see the grieving person interacting once more.  It seems like the person is finally getting on with life, and they are.  This joining together continues to strengthen the relationship and is part of our new history together.

     A person stuck (chronic grief) in bargaining continues with the rituals or enshrinement or deification in order to avoid further hurt.  I have known parents that haven’t touched anything in the child’s room since the death, as though that child would return and continue like always.  Others I have worked with simply won’t talk about the child, as though they never existed. These people also do not bother those around them.  It is as though everything were OK once again.  The problem is that further growth and intimacy is not possible in all other areas of life.  This is a very tricky type of stuckness  because it is usually not visible to others.  The person may appear to be peaceful - the key is the lack of growth because all energy is being used to stay in place.  Sometimes there are clues in unreal conversations about the loss.  This phase is probably related to significant earlier loss that is also unresolved and the person is simply overwhelmed.  As a youngster this person was probably required to be stoic or a good soldier.  The bargain is usually not spoken, but goes something like - "If I do not change anything, it will not be so true."  The way to help a person stuck in bargaining is a gentle, but firm confrontation that life must go on. This type of message may need to be expressed several times.  Otherwise the mourner may sink deeper into isolation and magical thinking.

Thursday, September 22, 2016

On The Other Side Of Grief (Stage 2)


      The second stage of grief is anger, which is related most closely to feelings of helplessness, and is the attempt to regain some sense of control.  Anger is often disguised or misplaced.  Often emerging in this stage is an upset sense of reality, characterized by obsessive reviewing.  The obsessive review is woven throughout recovery and is like talking the loss and the event, literally, to death.  The person may insist on talking about old times a thousand times and have little tolerance for other's problems and no interest in other's lives.  There is frequently a verbalized statement that "no one has suffered as much as me."

     This phase is also characterized by the need to place blame.  A great deal of time and energy is invested in trying to figure out why this loss happened and what or who “caused” it.  This is another attempt to reduce the pain.  It is also another way of trying to hold on to life, as they knew it. The time and energy is a distraction from reality for a little while.
    
It is so difficult to be angry directly - especially at the dead person.  It is hard to be angry with someone you cared for, who didn’t decide to die.  It is so difficult because anger exposes our needs and our fear of weakness with it. This makes us feel terribly vulnerable and exposed
 
            Our response is often feeling angry, fed up and even disgusted.  We feel angry at the person's passivity, inappropriateness, or self-absorption.  We are sick of hearing about it.  We feel angry that nothing we do seems to help, and we just want them to get on with life.  This is an important turning point in the process, and the most important thing we can do is to say exactly what we feel.  This truly helps the person move into the next stage and keeps the connection of the relationship alive and growing.  If we turn away because we do not want to add to the burden or upset them more, we begin to create distance.  The grieving person is then even more isolated and alone.

      Someone that is stuck (chronic grief) in anger is very easy to spot.  They are often bitter, blaming and sometimes cynical. A person stuck in the anger phase of grief is difficult to be around.  Though they often do not ask for much emotionally, they may be overly demanding in other ways.  The purpose, or attempt here is to feel safe and back in control.  The tasks for this phase is to break free of the attachments that no longer exist so healing can occur. Once again, chronicity creates distance.  Anger of this nature is probably related to early betrayal of the child.  As a youngster this person was most likely required to protect others from their own needs/pain.  So grief elicits enormous guilt and shame at one's impotence.  Helplessness is very hard to deal with, particularly for men.  A lifetime of being in charge and knowing how to "fix" life can be profoundly compromised when faced with loss.  This is very frightening and may cause internal panic, in the form of rage.  Few men have the understanding or emotional skills to deal with intense loss.  The way to help someone stuck in anger is to help articulate the bind they are in and how unfair it all is, that they have to change or retreat.  Otherwise the person is profoundly alone and isolated and believes they are different or strange.

Wednesday, September 21, 2016

On The Other Side Of Grief (continued 3)

            However, given all that, there are some behaviors that suggest when a person is in chronic grief.  Let me step back and say that what makes grief so mysterious and hard is that it cuts right through all the defenses and touches our core.  In cutting through it touches all other grief and unresolved issues and brings them to the surface with the current grief.  That is a lot of the sense of being out of control and feeling crazy.  If there are significant unresolved issues, the defensive system will go into overdrive and the result is that a person gets stuck.  Much like a record, just going round and round in the same phase.  This is also true for those around the grieving person.  If we have unresolved issues, we will have a difficult time being around any grief.  It is difficult to discern the difference, because "stuckness" is simply an extension of normal, acute grief.  The key is that it "feels off" to people around them.


Stage 1

The first stage of grief is shock and denial.  This stage is characterized by feeling and acting chaotic. Often a person will say that they feel crazy or disorganized.  Often it will be difficult for the person to concentrate and stay focused.  This is usually exacerbated by cultural norms that require life to go on and for the person to be "tough."  The internal experience just does not fit, so the person feels guilty or ashamed that they do not have better control.  No words can capture the full depth and intensity of grief, so the person has a great deal of trouble defending themselves from these messages.

            The people around often have similar reactions, wanting to minimize and make things OK.  There is often a sense of great helplessness.  This is often captured in the phrase - "I don't know what to say."  This is shock and denial on our part.  The mind freezes and we draw a blank.  It is the "Oh no, this can't be true."  And (in a secret place) “I don't want to deal with this.”  Denial is important and necessary in the beginning.  Often we know the truth before we totally accept it.   Shock and denial protects us from being totally overwhelmed, and then the dealing with it comes in small manageable pieces.  This is why it takes so long.
 
            It is difficult to give a time frame for stages, since each person is different and the shift from one stage to another is usually gradual, seldom sequential and not ever neat and tidy.  Often a person will experience all the stages in a whirl from time to time, but each stage has a specific set of tasks that has to do with healing and restructuring and a characteristic mood or "sense of."

            The shock and denial phase of the non-mourner is much shorter and usually passes quickly, and we do think of something comforting to do or say.

      A person who is stuck (chronic grief) in shock and denial is amazing to be around.  They seem strong and in control.  We seem to admire them and wish we were that tough.  Do not believe it.  This type of behavior is necessary and appropriate to get through the first few days or weeks after a loss, to simply accomplish all the practical tasks required.  But if there is no reaction, it is a danger sign.  This stuckness is characterized by lack of, or inappropriate, affect or feeling.  There is a strange incongruence in affect and behavior that does not fit the circumstances.  I have come to call this "chirpy."

            Chirpiness is probably the result of a lifetime of "being there" for everyone else and feeling too terrified of the vulnerability of "breaking down" and needing to ask for something from others.  Someone stuck in this phase is certainly no trouble to be around.  They do not bother anyone with their problems.  They are also impossible to get any closer to.  A safe distance from others is the rule here, so as not to risk grieving.  This is most likely related to early abandonment issues and as a youngster this person was required to perform far beyond their developmental abilities.  The way to help someone in this terrible dilemma is to gently insist on closeness.  In short, to offer the help this person is so terrified of asking for.