Can We Help Cease Suffering?

“What does it mean to be a human being? What is life all about? Why are we here? Why are we supposed to be here anyway? How did we get here? And did we have to come here to live a life that is often so unpleasant, such a struggle, and so challenging? 

Is this what life all about? Is life supposed to be that hard?

What’s the difference between me and these other folks who are making it? Those rich people, with a lot of money, born with a silver spoon in their mouth, why them, and why not me? 

What did I do to be born into this family? What sins did I commit to be here, born to an addict mother, adopted by a mother, who’s just lovely when she’s fine, yet just the opposite when she becomes manic?

Why was I born mixed? Why was I not just either all white, or all black? Now, where do I belong? No one thinks I belong to their group, except when I am smoking and using with them, and now that I am sober, which group do I belong to? Who am I? What am I? Why am even alive?

I can see why so many people kill themselves. I used to think it was stupid, but when you really think about it, when you become realistic, you realize that they are right in “just ending it.”

This is an extract of one of Mardoche’s patients, who was being seen for combined psychotherapy and medication management. Let us call him Mike. He had graduated from a specialized high school (for gifted and talented students) and received scholarships from three different Ivy League colleges. Mike had started college but had to take time off for reasons related to substance use disorder and mental health conditions. But he is now sober, in recovery, back to complete college, working, and attending his mental health services on a regular basis. 

Almost 1 million people die by suicide each year. That’s more than one person every 40 seconds, and for each person who dies, 20 persons attempted to die, which means 1 person attempts to die by suicide every two seconds. Now, when accounting for confounding factors, the most common reason behind all forms of suicide, either attempted or completed, is “depressed mood.” Of course, “depressed mood,” does not mean Major Depressive Disorder,  though it may be part of it. “Depressed mood,” can be part of or due to a variety of factors, one of which being related to where Mike was at that point in his life. 

As a forensic psychiatrist, Mardoche has participated in what is called a, “Psychological autopsy,” a fancy word for a post hoc psychiatric and psychological assessment on the manner of death. “Did Mr. Jones die by suicide, homicide, or from any other causes, like an accidental drug overdose?” Or to be more exact, “Was this a suicide attempt or not?” A forensic autopsy is not easy to carry out if it is to be complete and compressive, which is essential if it is to reach the accuracy threshold. In the process, one gains a thorough retrospective investigation of the intention of the deceased. And one of the methodologies used is a thorough review of the decedent’s writings, in forms of social media, e-mails, journals, diaries, and other types of correspondences. Structured interviews with as many people as possible who knew the deceased to then learn about him or her as much as possible, is a minimum requirement.

When people died by suicide, several of the above questions posed by Mike have been found to be their questions as well. Just like Mike, those who do not die by suicide do also ask these questions. They have attempted to find the answers to these questions in ways different from suicide, but in ways that at times are rather detrimental to them, to their loved ones, and to society at large. At times, substance use ensues, at other times, symptom formation in forms of depression, anxiety, or OCD becomes apparent, while at other times, episodes of mania or psychosis occur. Many patients and clients come to us for answers to these questions. At times they explicitly pose them, other times, they are implicit, while at other times, they hardly know these are the types of questions they are asking. They know, deep inside, something is missing, something is not making sense, something is not clicking. They know deep inside, their self-concept is shaky, their sense of identity is confusing, and their sense of purpose is rather nonexistent.

As clinicians, how do we best help these patients and clients? Do these patients and clients belong to the minority of patients or are they part of the human race, asking the same questions, with answers that further confuse us more than bring us clarity?

Five major thought systems have been trying to make sense of the world, of our human race, and of our existence. Philosophy, Religion, and Science started, while Spirituality and Metaphysics continued. Who’s right? Who has the Truth? What’s a better thought system? What is not? While these may be common questions to ask, they may be less helpful than they may seem. Instead of asking who has the Truth, it is more helpful to ask what the Truth is. And believe it or not, the Truth is at the intersection of all our five major thought systems. In other words, the Truth is not in Religion, not in Spirituality, not in Metaphysics, and not in Philosophy. No, the Truth is not in Science, either, and as mentioned in our past article, entitled, The 3 Fundamentals Behind Our Biology and Psychology, the great truths of Today (in Science) are expected to be the great lies of tomorrow. Does that mean everything in Science works that way? The answer is no, and not any less than how things work in Philosophy, in Metaphysics, in Spiritualty, and in Religion. Each and every one of these major five thought systems have something in common among them, and that commonality is the Truth.

This Truth that is common to all our major thought systems is contained in the psychotherapeutic model found in The Course, and SWEET is making it available to all clinicians through our one-year psychotherapy course. Now, the question is why is this important? To which we answer in the form of the following five questions:

1. Do we want to help our patients and clients cease their suffering?
2. Do we want our patients and clients to learn a new way to navigate the world
3. Do we want our patients and clients to know aliveness, peace, freedom, authentic happiness, and authentic success?
4. Do we want to help our patients and clients to use fully their talents, skills, passion, and strength?
5. Do we want to grow, ourselves, as clinicians, and elevate ourselves to a new way of being in the world, making bigger differences in the lives of our loved ones, in the lives of our patients and clients, in the field, and in the world?

If you say yes to at least one of the above five questions, then you belong to this course, and we look forward to welcoming you back to Week 2, or to welcoming you for the first time.

Let us elevate ourselves a new world of providing care, and let us elevate the world, with us, in the process.

With Love,

Karen and Mardoche

Karen Dubin-McKnight, PhD, LCSW, is a Columbia-trained Social Worker with wide clinical, teaching, and supervision experience. She also has a background in management, mentorship, and leadership that spans almost 20 years. Her added passion is in advocacy, coaching, public relations, and mediation. Her goal is to ensure that social workers and women feel empowered and have a voice “at the table.” She has previously held Executive level positions, and two other directorships in different organizations. She is currently Adjunct Faculty at Columbia University School of Social Work and Adelphi University School of Social Work. She also maintains a private practice, working with individuals who have experienced loss and trauma, and also provides clinical and management supervision.

Mardoche Sidor, MD is a quadruple board-certified psychiatrist, with board certifications in Psychiatry and Neurology (General Adult Psychiatry), Child and Adolescent, Addiction, and Forensic, Psychiatry. He has training in public and community psychiatry, and advanced training in psychopharmacology, Cognitive Behavioral Therapy, Family Therapy, Motivational Interviewing, and Strategic Intervention. He also has additional training in Dialectical Behavioral Therapy, Psychodynamic psychotherapy, Play therapy, and Couples therapy. He has clinical, teaching, and supervision, experience; he has mentorship, coaching, and management, skills and experience; and he has experience as a primary care physician, in public speaking and writing. His overall purpose is to help heal the world, through an increase in awareness, a shift in belief systems, and an education that empowers. He speaks and writes fluently in four (4) languages—French, English, Spanish, and Creole, with intermediate proficiency in Portuguese and Italian. Dr. Sidor is the author of 3 books and is currently working on several others.