I had two firsts this past election: For the first time ever, I voted a straight party vote, and for the first time ever, I voted by mail. Then, with the rest of the country, I waited with some anxiety in the uncertainty of the final result. Eventually, it became clear that we had a winner, and this brought for me a noticeable sense of relief. Nationwide there was both a massive outpouring of joy by more than half of the electorate, as well as an equivalent experience of disbelief and non-acceptance by the nearly other half.
I personally did not experience as much joy as many did, not that I wasn’t happy with the result. What was much more troubling for me was that nearly ½ of the country had voted for the other candidate. I had the thought that had the results been otherwise and had the other candidate won, it would have been the other ½ of the country would have been ecstatic. There are more than 70 million people in this country whose mindsets, and values, and perspectives I don’t understand. Should my response have been unmitigated joy? And even here in liberal Massachusetts where 2 in 3 of us voted for Biden, 1 in 3 voted for Trump.
Yes, for sure. I get it. For more than half of the electorate, this election was about finally paying attention to the many things that have been neglected for such a long time. However, maybe we needed the last four years. Would we have paid as much attention to the issues ailing our country had the situation not been what it was? Might another candidate in power not have led to the very polarization that we needed to bring critical matters to the front pages? Would the entrenched injustices simply have continued to go unaddressed?
I recently went to get a haircut from my favorite barber, a jovial young Italian addicted to coffee and cigarettes. He was uncharacteristically glum, and I asked him what was up. He said, “I voted for Trump!” I nearly jumped out of the chair, but he was holding a sharp pair of scissors. I decided to listen instead.
“You know, all you people in Lexington, you can all go to work by zoom when the governor shuts down the economy, but you know what? I need this job. I can’t cut hair by zoom! I have no money, I take pride in my work. Don’t you think I can take precautions and keep my barbershop safe? It’s in my financial interest to make sure that people in my shop don’t get sick. It’s not the government’s job. I voted for Trump. He said he wouldn’t get us into wars, he didn’t. He said he would lower taxes, he did. He said he would nominate conservative judges, he did. With Trump, I had money. I felt that I was in charge of my life. When COVID-19 hit, he wanted to keep things open, and now this fool, the governor wants to close everything down again. What am I going to do? Don’t I matter? All I see is Black Lives Matter signs everywhere? What about me?”
What about him? He was so upset. He felt so unheard. I grew up in apartheid South Africa, and there, our politicians taught us that Black Lives Didn’t Matter. White lives certainly mattered, but people of color were always second class. In our elections, you could choose between one conservative government or another. It seemed a dangerous path. Surely when the oppressed finally had a chance to vote and took power, they would exact an understandable vengeance on White South Africans?
And yet from the confines of the tiniest of prison cells, Nelson Mandela, who would later become the first democratically elected president of South Africa, vengeance was not what he sought. Rather, he wanted equality and reconciliation. Mandela had endured far, far worse oppression than my barber, and yet he lived by a value system that caused him not to suffer; he was the embodiment of compassion and dignity and in living this way, he did not hate, and by not living in hatred, did not suffer. How could this be? Surely, he had every reason to hate, seeing what had happened to him, to his murdered friends, and to his community. But he rose above it all, saying: “No one is born hating another person because of the color of his skin or his background or his religion…People must learn to hate, and if they can learn to hate, they can be taught to love…For love comes more naturally to the human heart than its opposite.”
I was coaching my patient the other day, a young person who was more upset than I had ever seen. “I just called my dad. I found out that a close relative just voted for Trump. I’ll never speak to that relative again. They are disgusting. Can you believe it? My relative voted for Trump!” And yet this was a child whose relative had bent over backwards to ensure that my patient felt loved and protected. A relative who had been there when no one else had visited them in the hospital. Someone who had driven them to therapy, when they needed a ride.
Mandela did not find his oppressors disgusting. His approach to leadership had three core principles: forgiveness, understanding, empathy. He forgave enemies who had perpetrated heinous crimes. He never hated his haters, nor did he attack his attackers. He saw promise in each person, and he was able to validate even his most seemingly evil of adversaries. He recognized that they were products of their circumstances and that because of this, they could only see the world the way they had been taught to see it. Had he retaliated in anger, this would have perpetuated a false narrative that we had been taught to believe about who he was. With deep compassion, he said: “The oppressor must be liberated just as surely as the oppressed.” For Mandela, leadership was not about closing his mind and narrowing his view but was instead about opening his heart to include the suffering of those who had been his captors and oppressors.
My parents had two very different perspectives on parenting. In my youth, my father believed that you pulled yourself up by your bootstraps, whereas my mother believed that people were doing the best they could, given their circumstances, and that it was more compassionate to help where you could. Both had a point, and although I mostly agreed with my mother, I learned from both. My mother was a devout Catholic who told me she was waiting for the Messiah to return. Her reason for treating everyone with deep compassion was that, as she said, “We do not know when the Messiah will come and so it could be anyone. I don’t want to take a chance and treat that person dismissively. Also, my day goes so much better when I act with love and kindness towards someone than when I judge or even hate them.”
With the experience of Mandela and my mother, when I discovered Dialectical Behavior Therapy, I found a natural psychotherapeutic home. DBT was different than any other therapy I had been exposed to. It had in its approach and at its core, an articulated list of assumptions about people, whether patient or therapist that resonated powerfully for me. Marsha Linehan, the developer of DBT, wrote the following:
We assume that patients, therapists, and all people, are doing the best they can.
“The first philosophical position in DBT is that all people are, at any given point in time, doing the best they can. In my experience, borderline patients are usually working desperately hard at changing themselves. Often, however, there is little visible success, nor are the patients’ efforts at behavioral control particularly obvious much of the time. Because their behavior is frequently exasperating, inexplicable, and unmanageable, it is tempting to decide that the patients are not trying. At times, when asked about problematic behavior, the patients themselves will respond that they just weren’t trying. Such patients have learned the social explanation for their behavioral failures. The tendency of many therapists to tell these patients to try harder or imply that they indeed are not trying hard enough can be one of the patient’s most invalidating experiences in psychotherapy.”
The second DBT principle that resonated was Linehan’s seemingly simple observation that we should see people through a non-judgmental stance and recognize that everything is caused. Wasn’t this what Mandela and my mother had been talking about? Yes, bad things happen. But things don’t “just happen”. Everything is caused. Many times, we are asked: “What is the root cause of my, or my loved one’s problems?” DBT is different from other therapies in that we don’t spend too much time looking for so-called “root causes”. If I accept that reality is as it is, and I accept that everything has a cause, I then see that it makes perfect sense that things turned out the way they did. I also see that my liking or not liking an outcome is not relevant to the fact of the outcome. If you like it, it is as it is, and if you don’t like it, it still is as it is. Also, have you ever considered that we typically only ask ourselves, “Why did this happen?” when things don’t turn out the way we wanted, but we almost never ask the question when things do turn out the way we wanted them to turn out. Fairness is almost always a point of view.
And yet even if you get to the cause, those causes had causes. The reason patients, politicians, the country, and we ourselves are how we are, is that we are all caused and shaped: by our genes, our experiences, the information we get from the news channels we watch, and the morals we learn in our spiritual communities. Knowing this deeply is key to arriving at what we need to do in order to create enduring change.
My mother, Mandela, and Marsha saw the best in people, even those who were the most difficult to deal with, whether patient, politician or anyone else. They recognized that our private expression and experience of anger and hatred doesn’t always impact the other person, but instead often keeps us stuck in a cycle of our own anger and hatred. Mandela, politically, and Marsha, clinically, saw that the open expression of hostility, would only lead to further hostility and move us further away from a goal of political harmony or clinical equanimity. And so, because everyone is caused by their own particular circumstances, it makes sense that not everyone sees things the same way. The child who learns to hate, grows up hating; the child who is invalidated, self-invalidates. It all makes sense, whether we like it or not.
We bring our own nature shaped by our own experiences, genes, and learning history to how we see others. We may think that we are not judgmental, but is this accurate? Do we judge a difficult patient on the unit or a politician of the opposing party pontificating on TV? Can we see them as caused by their circumstances, and that given who they are and what they have experienced, it makes sense that they would behave in the way that they do? Are they not, like we ourselves, shaped by the forces that got each of us here?
Now here is where we delve into a beautiful paradox. On the one hand, we have the option to continue to hate and fight and to judge, but if that is our response, the status quo endures. On the other hand, we can choose to change the causes that reliably predict and lead to alienation. For instance, if we have previously shunned our politically opposite neighbor, we can agree to meet with, and then listen with open curiosity to their perspective. Or as therapists, can we commit to notice and change any judgmental attitude we have towards patients whose behavior we find annoying, confusing, or oppositional. Then, if I recognize that something I do causes alienation, I can commit to change that cause and try a new approach. Changing habitual behavior is the element that will generate a different outcome. I don’t pretend to know what the outcome will be, but if I am dissatisfied with the present state of political affairs or clinical outcomes, doing something different is key.
What if we could hold in mind the understanding that all people are a product of their circumstances and are doing the best they can? What if we could sit with them and listen to their legitimate fears? Are 70+ million people in this country evil? Do they not aspire like all of us for a better life for themselves, their children, and their communities? Is the difficult patient not someone who deserves your compassion, rather than someone to be judged and labeled? Do you speak of patients whose behaviors are off-putting and complicated as “that borderline” or use even more colorful language for the politician you dislike?
On a personal level, I struggle with understanding politicians. I don’t always get their motivations and choices, and yet the decisions they make can impact so much of our lives. On the other hand, I also realize that as a White male, it probably does not matter too much to me personally who is in power. I likely won’t be impacted that much. Because of this, in my position of relative privilege, it is important to me that I commit to fight for the rights of people whose voices seem to matter less than mine, while at the same time listening openly to those with whom I disagree politically. But what is even more important than this, is that this fight not be an endeavor to undertake only every four years when the rhetoric is at its most deafening and the plight of the disaffected most jarring. It is something I need to do every single day.
And then at work, can I be open to seeing the ways in which I have more in common than not with the patients who confuse and challenge me the most? Am I open to listening to their fears and concerns, recognizing that the struggles that brought them into therapy are a manifestation of their biology and their circumstances, rather than of some choice to make life difficult for me? In seeing them in this way, and engaging with them with a less judgmental and more compassionate attitude, perhaps they, in turn, will see that I am not the enemy or some dispassionate caregiver.
By practicing living this way, committing anew to seeing the most dissimilar among us with compassion and open curiosity, then tomorrow, and the day after, and the day after that, the other too can begin to believe in the possibility of a shared and healing humanity.
