Useless, yet full of urgency and importance

A friend shared this REALLY good post. It’s a must-read for anyone working in the helping professions.

I’ve written before about the importance of guarding against stealing pleasure through vicarious nonconformity and transgression. I’ve always struggled with conceptualizing and articulating this clearly, but Joe Wright, MD very clearly captures a very important dynamic for anyone working in addiction.

He describes an experience with helpers when he and his (now) wife were displaced by a fire in their apartment building.

A small group of Red Cross volunteers were going through some kind of disaster response inventory, and making us register for something before they would do something else for us. So, not knowing what we were going to do next, we registered, only to find that the something else they would do was in fact, nothing else. Probably they were perfectly nice, but our reaction was eventually: these people are useless. And yet they seemed full of a sense of the urgency and importance of their mission.

Of course, my wife, now a medical school professor somewhere respectable, doing respectable things, would surely never have said, with a bleak and definitive dismissal: “Those people get off on this.”

So it must’ve been me who said that.

Any experienced and self-aware helper will have observed this in themselves and others–deriving meaning, importance, and nobility from the suffering others, whether we’re actually useful or not. (Helpers who deny ever having done this are the helpers I trust least.)

His description of it as an emotional experience (whereas I emphasized identity) captures something very important that I failed to articulate. Parts of his description made me think of this as a helper version of emotional self-injury.

Anyway, we’ve seen it in our colleagues, and recoiled from it whenever we started to see it in ourselves: going towards grief and pain for the wave of emotion it brings the observer. Medical ghouls looking for suffering, for the realness, for the intensity, for the drug of other people’s unsolvable pain. After standing there getting nothing useful from Red Cross volunteers who seemed to be inspired by their own feelings of sympathy for our pain, I think both of us have ever since looked at certain kinds of “medical humanism” with a deep suspicion. Because being there for people’s pain can stand right on the line of being either the noblest part of humans as social animals, or—

—it’s such a thin line—

just low-down vampire hunger.

Feeding off the intensity of other people’s circumstances is a way to substitute other people’s strong emotions, or the emotions they inspire, for our own emotional state. It allows clinicians to have strong feelings without having to feel our own experience, without having to delve into the complexities of our own circumstances and histories. We can feel a version of the pain itself, without the bitter notes like shame or guilt that accompany our own personal pain. Other people’s pain is simpler than our own. Shoot it into your veins: here comes the rush of realness, without having to feel your own real.

Of course, another trap we’ve all seen is those who become calloused and unaffected by the pain and suffering encounter in this work. He discusses his own approach that he describes as the “rule of tears” where he is emotionally connected and avoids playing the role of an emotional vampire.

His discussion of navigating this path reminds of several of my favorite notions about effective helpers, Ernie Kurtz’s “kinship of common suffering“, Marty Mann’s emphasis on love as an essential element effective treatment relationships, Bill White on “fellow travelers“, and Greg Boyle on kinship and awe.

Go visit the post and take the time to read the whole thing.