Anhedonia

In three weeks it will be the three year anniversary of Rubys death. 

I had planned to write an entry about Aniais Nin's expectation of writers to express things that non-writers cannot. She wrote about the duty of a writer to say the unsayable or the unsaid and I was initially hoping to expand on this idea with relation to my own experiences- navigating my way through a fortunately rare type of grief and hoping to express some of how I feel and think and what I have become. Then I realised I wouldn't be able to write about this hideous capability because I am struggling to keep upright and to keep moving forward. In fact I am struggling just to be normal these days. 

Then the final realisation revealed itself to me tonight- of course I can write about things other people don't know about including those struggles and the sheer psychic effort necessary to stay afloat. If I am struggling at the moment I should make an effort to communicate this struggle. 

I have finite cognitive capabilities. Maybe this is normal, maybe I am particularly witless or limited by poor genes or I ignored my fancy education due to bullying. Whatever the reason I am often torn by the dissonance of knowing that my intense curiosity is only matched by an awareness of the limits of my understanding. 

Recently I have been unable to enjoy anything. This lack of pleasure ("anhedonia" to psychiatrists) is primarily indicative of clinical depression but also, of course, grief. It isn't persistent or even consistent and it takes hold of me only at times I have to put particular work into maintaining an even keel when I have to labour towards normality. And, my god, the effort. At times like these it takes all my reasoning to appear acceptable to others around me who rely on me and look to me. I have to be conciously aware of each sentence I say, my body language, the nuances of my communication to my colleagues, my friends, my family, my patients.  I have to prioritise my energy focusing on my external life to the detriment of own joys and pleasures. There is nothing altruistic about this, I do not do this purposely for the good of others but it is simple self-preservation. As long as my shells' integrity is maintained the internal mess can reorganise, recover. 

Last weekend I received a book and a record I had waited weeks to arrive from USA. I also bought a fancy new digital SLR camera as I had been suspecting for a few years that my teenage passion for photography had been reignited. Claire and I were also looking at each other in a way we hadn't for a long time, as if we were young again, and my son Tom was regularly calling my name. All was well. I should have been comfortable, maybe content, maybe even happy at times. Instead my mood was flat and I found it a great effort to become interested in anything. Anhedonia. 

I am lucky in many ways, I know that I am. I do know this and regularly appreciate it. One of the many ways I am lucky is that I have an awareness that most shaded areas of my life will have light again. I know my shadows will lift and the breeze will blow away the clouds covering the sun. I will experience pleasure again. 

I will read my book, the one I waited weeks for. I will have hours and hours of pleasure listening to my greatly desired Count Basie record imported from USA under strong recommendation from Jazzy John, a friend who has forgotten more about jazz than I'll ever know. I will get pleasure concentrating on technical aspects of shutter speeds and lens apertures and ISO film sensitivity of my new camera and, of course, the almost spiritual bliss I get from photographic beauty. I will look at Claire again that way. And I will get get that innate paternal thrill from hearing my son say "daddy". 

So what do I do? As always with my grief I have to put the hours in. I have to navigate. So I work work work. I consider, I talk, I run, I look after myself. I put effort into enjoying my own company. I have a little bit of good gin, good coffee, good food. I prioritise strictly, I say no. I wait. I am formulaic when necessary, I improvise when necessary.

I remind myself that this is a natural long-term variation in my mood and that it will leave me soon. The occasional drudgery of simple existence can have a high psychic price of emotional exhaustion, relational distance and anhedonia. But it will pass. 

Inseparable love and grief

The unique and exquisite pain of grief for my daughter cannot be separated from the purity of my parental love for her. I think of Ruby and my body warms with the same deep satisfaction that a parent gets from feeding their offspring- a prehistoric, hard-wired, genetically embedded reminder of supporting the survival of my genes (after all, this is what Darwin really meant by "survival of the fittest"- survival of the fittest genes). I think of Ruby and I know the tightly coiled DNA double helix inside the nucleus of every cell in my body is unflinchingly and without fuss programmed to assist with performing the single most basic function any parents must do- to care for my children. 

There is no other reason, if there are any reasons, to exist. My heart, my soul, clarifies the bare facts- what else is life? What else am I for if not to protect my offspring? Why am I, if not for them? 

And assimilated into this learnt benevolence like foundational rock strata of alternating textures is my grief. Sometimes it is sharp and piercing like a glass shard, sometimes it grinds like a huge boulder slowly rolling over wet cement, sometimes it dully thuds like a vertical rock slab falling over onto mud. My grief is always there stratified with the sheer joy of remembrance. 

I can't recall any memory of Ruby without knowing she isn't there and I can't look into my grief without recalling memories of her. 

I will always carry her life in me. I will always be cut through by her death. I will always have her voice in my ears. I will always have her absence. Always I will know her hair against my cheek. Always I will know I won't feel her hair on my cheek. 

Always there will be abstract reminders- the scuff on a strangers' shoe, the curve of a colleagues' shoulder, the "daddy" shouted outside my office window, my sons' laugh-  that will never ever go away. I will always have to have awareness of my loss but also awareness that I once knew Ruby. 

Fleetingly, for only eleven beautiful and joyous years I was the luckiest father in the world- I was allowed the privilege of being Ruby' dad. I wasn't just allowed to know her-  a prize to be celebrated for life- I was actually related to her. This is a triumph over any loss. 

You don't know what wars are going on down there

I need to be constantly aware of my prejudices. Many years ago I used to look at strangers and make ill-informed decisions about their lives and their character and about how I should react to them. I guessed that they might be ignorant of the deeper explanations in life, that they did not consider what I thought were "important things", that they lived an easy and blissful life probably free from serious stress. 

In the last twenty years working in mental health and nursing I have had this ridiculous idea destroyed about the ease of others' existence. I can make absolutely no accurate judgement about anyone's experiences and character from how they look and how they hold themselves. 

I once met a man who was lined up with eighteen of his relatives and were sprayed with machine-gun fire until all of them were presumed dead. He was the only survivor and lost his father, two brothers and uncles and cousins. I once met a man who was forced to watch his parents being killed with machetes. They were then cooked and he was forced, along with his younger sister, to eat them. I once met a brother and sister who, as teenagers, were gathered in a room with more than thirty family members. Half the room were chosen at random and taken outside to die. The remaining half including the two I met were then forced, on pain of torture, to shoot and kill their relatives outside. 

I have met countless people- just normal humans like you and I- who have been dragged into extraordinary situations experiencing immense loss, forced complicity in trauma, psychic pain and monstrous degradation.

A commonality to almost all my patients is their, and immodestly therefore my, natural humanity. Most people are forthright, stand straight, are receptive and warm, have a flexibility in their potential for growth, have compassion and empathy. I believe these are universal human traits that can not be broken by any oppressive force, that we are hard-wired to make loving connections with others. There are many things I have learnt from those I have met and I aim to present myself with the integrity and grace that many of them naturally express. It is a goal I doubt I will ever fully achieve but I commit to the endeavour because many of my patients are role-models.

I once read a story about the relationship between Ludwig Wittgenstein (a philosopher who lost three of his brothers to suicide) and his sister Hermine. Hermine asked him why he was often so sombre and uncommunicative. He replied that she reminded him of someone looking through a closed window at a man walking down the street bent over and seemingly frail. She doesn't realise the man is struggling to stay upright against a strong wind threatening to whisk his feet from under him. 

Have compassion for everyone you meet, even if they don't want it. What seems conceit, bad manners, or cynicism is always a sign of things no ears have heard, no eyes have seen. 

You do not know what wars are going on down there where the spirit meets the bone.

Miller Williams, poet

Easy Light Smooth Fast

Easy, light, smooth, fast. Easy light smooth. Easy and light. 

It was probably inevitable that I would start running barefoot one day. I have jogged long comfortable runs recently whilst chanting "easy and light, easy and light" to myself, focusing hard on the correct foot strike and body posture. I think it is working, I think the barefoot style suits me. 

The secret Santa gifting at work last Xmas meant that I ended up with one of the best presents I'd ever received- the book "Born to Run", a brilliant history of long-distance runners, the Tarahumara indigenous tribe in Mexico, and an introduction to barefoot running. I have read further evidence about this naturalistic running style and feel that modern running shoes with their hugely padded heels and high drop (the vertical distance between the toes and heel) encourage the unhealthy habit of heavy heel-striking (instead of the forefoot striking the ground first) and forcing disabling amounts of energy through the joints. A barefoot running style encourages fore- or mid-foot striking, small steps instead of large strides, a straight but relaxed back and a sensation of falling forward from the feet up (after all, running is simply controlled falling). And a persistent focus on easy, light, smooth, fast. 

So far (four runs) it has worked. They have been easy and comfortable and I have felt less joint soreness and have recovery quicker. Instead of taking two days to recover from my last 20km run (half marathon) I was refreshed after a few hours. I ran home from work this week (13km) and felt as if I could have turned around and run straight back. 

My long run (20 km) last weekend took me on a new route along the sea front and toward Belfast docks. I ran and I thought and I felt relaxed and free. I noticed things around me without the usual distraction of impending exhaustion- the huge, shiny seahorse sculpture welcoming travellers in towards the docks and the safety of land, the perfectly efficient ergonomics of road networks designed with international lorry transit in mind, the knowing smiles from other members of the running clique. 

It was the perfect (for running) weather combination of bright sun and slight chill which keeps me cool as I run and also takes all the moisture out the air providing a quality of light unparalleled on a summers day. The tide was high, almost to the edge of the path, the sea was green and barely rippled. It reminded me of medieval glass. The sea made no noise, there was no wind, I didn't even hear one dog bark. Easy and light, easy and light.

I ran past long-distance runners and we exchanged full smiles, a cheery hello and a raised wave. I identified them by their clothing which was chosen to keep them warm instead of cooling them down, neck warmers, cosy hats, sensible leggings. I ran past two young women who ran long strides and kicked their legs up behind them. Their style was springy, pushy, competitive. Their ponytails swished back and forth and their clothes were expensive and immaculate. As with all runners I pass I nodded and waved but they were too busy chatting to notice me. I passed a regular jogger I often see. I imagine she and I appear similar to most people who don't run- we look a long way off from the lithe, sinewy athletes one might normally expect to run a long way- but we have passed each other before at points which, as only local runners know, can only be reached by running over 10 miles in one go. I nod and wave but her thoughts appeared too focused to look my way. I pass a friend of a friend who, like me, is the wrong side of 40, tall with a big paunch and a lolloping, inelegant running style. He always has a pained expression on his face as if he has been forced at gunpoint to run for his life. He breaks into a rare smile and waves enthusiastically as we pass and I give him the thumbs up and shout "all right mate". I know it is only when he runs that he is sociable because he is so painfully shy he would walk straight past me on the street if we were strolling. I also know he can run a marathon in his sleep, runs over 100 miles a week and regularly completes "ultras" of 50 and 100 mile distances but to look at him you might think he couldn't run the length of himself. 

Often, when grieving, I have had to let go- some things are simply not worth the effort. I have also had to hold on tight to some other things as if my life depended on it. It has been easy distinguishing between these two, the hard work has been comprehending the depth of their significance and putting in the work. And when I do, life can be good again. 

A quiet three weeks

After a wait of nearly three years we received the draft report from the education authority of their investigation into Rubys death at that outdoor activity centre hundreds of miles from home two years and nine months ago.

Their results forced us to relive an experience that I have found the most unpleasant of all the unpleasant experiences I have survived and the only one I force myself not to consider whenever it begins to enter my thoughts- the last 6 hours of Rubys life. 

I have been forced to contemplate the worst day of my life which includes reflecting on the actions of people around my dying daughter. 

So in the last three weeks I have found myself reading obsessively about new topics of interest, getting drunk with work colleagues for the first time ever, totally redesigning my running technique which will take months to develop, teaching myself all about 1950s Jazz from America's west coast and being side-tracked and over-involved in all manner of distractions. 

I have not had the motivation to write a word nor to do many other things. So I didn't. But I hope this will soon change. 

Improvisation

In the sleeve notes to Miles Davis' 1959 magnum opus "Kind of Blue" Bill Evans, the pianist on the recording, explains the essence and beauty of improvisation- an artist is forced to be spontaneous. Their naturalism empowers an idea to be expressed openly and with immense honesty. Their talent and their limbs allow a communication of beauty "in such a direct way that deliberation cannot interfere" resulting in music without the complex depth of Mahler or Bach but with a truthfulness in which "those that see well find something captured that escapes explanation". 
Evans likens it to a Japenese painting technique, haiga, the most important aspect being the spontaneity of the artist and the felt, unplanned flow of the brush over the thinly stretched delicate paper surface. Any readjustments or nostalgia is irrelevant and simply couldn't work because a second stroke of the brush would rip the canvas and destroy the painting. 

This morning I was extremely sad. I was truly clinically depressed and although I was up early with Tom this Sunday morning, making breakfast and playing games together, I spent much of it in quiet tears. There was no reactive reasoning to how I felt, it is simply what mental health professional call a diurnal variation in my mood- the natural daily ups and downs of depression, grief or even in the mind that is well and functioning at full capacity. My mood continued to vary throughout the day, an ebb and flow that culminated eventually to what maybe feels like joy, sitting in a very comfy armchair in my front room opposite a woman I love and who I know loves me, drinking good wine and listening to jazz on vinyl, my favourite of all musical experiences. It is not the height of human achievement, I'll admit, but it is a zenith of my choice. It is the cream in my coffee, the sunny break in the clouds, the fresh wedge of lime in my gin. 

Sometimes I can gain a little control over the variations in my mood, sometimes I can't- I talk, I cry, I consider and weigh up, I focus on the minuscule or immense, I find discourse or harmony, I write, discover and read. The narrative arc of my story of grief is influenced by the sheer quantity of psychic effort I have to input to remain in charge. Mostly I am in charge. Mostly. 

But sometimes it is necessary to let go too. Sometimes, too rarely, I afford myself the luxury of mindlessness. I run to let my mind run for the sheer liberation of it. I drift, without fuss, into aloneness for the sheer emancipation of it. Sometimes the detention of grief is a shackle in need of reparation. Sometimes I need to be inconsiderate and, instead, to propitiate aloofness. 

Sometimes feeling is everything. Sometimes it is perfect to flow without conscious thought, unemcumbered by the weight of expectation or acceptable premise, to improvise. 

Solitude

These days I am more alone. This is true in the sense that I am around fewer people. In another sense I have been forced to learn that for me to put the hours in to learn to live again after monumental psychological shifts due to my grief, I internalised many of my thoughts and used very personal methods to address them- I have read and continue to read about psychological models of grief counselling, the philosophical and humanist address of grief, ethics and "how to live" and I follow blogs and books about others' coping mechanisms after experiencing similar loss. Through grief my skills of reflection and introspection have sharpened and, with it, an increased comfort with aloneness. In addition I have learnt consideration. Consideration of others, of self, of my environment. 

The greater attention I now direct towards the small and subtle provides stimulus that can fill my mind as if I can now peer down a microscope at a world previously beyond my scope, a world that perversely has grown and grown even though I am focusing on finer and finer detail. Learning how to cope with my grief has taught me the importance of looking, really looking, at things previously dismissed as unimportant and inconsequential. My world now demands this of me. 

To be lonely is to feel isolated and alienated. To be lonely is to feel disconnected and separate from myself and my surroundings. But I cannot be lonely when I relate to others, to ideas, to living and non-living things. I am defended from loneliness by the trees on my walks, the sea less than a mile from my door, the chilled air I gasp on a run, the bread I bake, my cats and beautiful, ugly and interesting things. My loneliness is kept jailed by the hills I can see from my home, my patients at work, good tools in the kitchen, the shed and online, a real paper book, electricity, education and a huge array of other micro saviours. 

When I am solitary I move at my own pace. It is my own pace that provides the deepest state of comfort to me and, as a relaxed and autonomous agent I am free to imagine and explore as freely as possible. It is only when I am solitary that my heart rate, my circadian rhythm and my brain are at their most natural state. Behind solitary allows me the safety to lose myself. 

Being alone is a fact. Being lonely or enjoying solitude are emotions. This is key- appreciating the control I can have over my feelings about being solitary. If I am alone with my thoughts I need to exercise enough discipline to be an autonomous agent. It follows, for me, that to appreciate self-determination I need an uncluttered, introspective and, most importantly, solitary examination.

I know I am very lucky in many ways. One of those ways is that, on the whole, I like myself. I am unsure how common or rare this may be and although I am acutely aware as to how arrogant I may sound I try to avoid grandiosity and unrealistic expectations of myself- I hope to be as honest as possible. 

Only when I am solitary, either alone or in company, can a type of individualism emerge in that I can experience a strong sense of self. Being solitary encourages a reinforcement of foundations and a sharpening of borders. In turn this promotes a type of liberty, a freedom from destructive influences. 

Anyone that survives the death of their child and has the courage to keep on moving has earned the right to self-respect. It is extremely tough to be comfortably alone unless you like the person you are alone with and so I allow myself this fragile authenticity. 

"And those who were seen dancing were thought to be insane by those who could not hear the music"