Sitting With Uncertainty In A Culture of Knowing

The quest for certainty blocks the search for meaning. Uncertainty is the very condition to impel man to unfold his powers. – Erich Fromm

As a child, to escape a world that could be both chaotic and occasionally cruel, I would hide in my room, reach into my stack of books and fall into fairy tales, reading the same stories over and over again.  Yet no matter how beloved the story, nor how many times I had read it before, after the tension of the plot reached its peak, I would invariably skip to the end.

I needed reassurance that Hansel and Gretel would indeed survive the witch, that Jack would continue to slay the Giant, Sleeping Beauty would once again wake up and all Goblins, Trolls and Evil Doers would always meet their just deserts.

I needed confirmation, not so much of the permanence of the happy ending, but of some kind of resolution.

Only then could I go back and tolerate the middle ground… the gray area…. “the not knowing.”  That unique space where the trouble has already occurred but the way out still isn’t clear.

I found it deeply unsettling to sit with my heroes in what seemed to me our most frightening and least attractive state of being:  uncertainty.

And I still do.

And apparently I am not alone.

Whether related to a trauma, or loss, a life event – or simply transitioning from one phase of life to another – more and more people are talking about being in this place of “uncertainty”… of not knowing.  They speak of their anger, their impatience – and really their discomfort and shame – at finding themselves in a place of seeming inaction.

We know the facts of our story:  “This” (whatever “this” is) has happened.  And since we know the facts of our story – this thing that has happened – we want to take steps to move beyond it, to fix it, to solve it.  We feel we should “know what to do”.  We should have a plan.  We should be on the move.  Something has shifted, or changed, and in our “fix it and move on” society, we rush to fill the void – to sweep out uncertainty.

“A call to action” has become a cultural mantra and we equate it with strength of character… and success… and power… and perseverance.

But action for actions sake, action without consideration, is not truly powerful, it is simply reactive.  It is artifice and it can be self-sabotaging.

We have become a culture that is increasingly uncomfortable with complex, difficult emotions.  While we are all sophisticated enough to name them… “I’m confused”, “I’m depressed”, “I’m anxious”, “I’m sad.” – we have become less sophisticated about understanding those emotions… we have become less willing to be intimate with them – and we have become less able to appreciate the opportunity for true change that lies in sitting with discomfort.  Which means of course that we are more likely to repeat the actions that got us here to begin with, rushing to the next hookup, the next relationship, the next job, the next friend, the next pharmaceutical, the next emotion, the next “answer” – but never finding the resolution we so desperately want.

We have lost our appreciation for the process of journey.
We have lost our appreciation for the process of ripening.

We have lost our appreciation for the tension that exists between what came before and what comes next… a tension that will ultimately give birth to the meaningful forward direction we crave.

Our ancient myths are filled with examples of the hero’s journey being tied to the period before emergence…. a period of watchful waiting… a period of stillness, pregnant with possibility… a period of gathering, defined by every moment that came before it, joining in the now, inevitably unfolding into the future.

Examples are endless recently with clients and friends who have come to me struggling with uncertainty.

A man whose wife passed away suddenly and tragically two years ago feels a failure because he tried so hard to “get over it” but can’t.  From my perspective as a clinician, he was not suffering from a diagnosable depressive disorder, yet a few months after the death, his friends began pressuring him to get medication, to help him “move on,” to date, to be more positive, less of a drag.  “Fake it ‘til you make it.”

A 13 year-old boy I met recently had been placed in foster care off and on beginning at the age of 8.  Since that time he has been diagnosed with Depression, Bipolar II, OCD and now ADD, the prescriptions changing with each new diagnosis.  When I asked him how he felt about all these labels he said “I think I was just sad that I had to leave my Mom.”

This boy was grieving.  As he should have been.  It wasn’t the boy who was struggling with uncertainty, it was all the adults in his life who recognized the sad and angry emotions but could not tolerate them. The impulse may be noble – move people out of pain – but the actions are questionable.

“Oh good – he’s on Zoloft.  We can check him off the list.”

What he needed, what the widower needed, what we all need, is someone to sit with us in our uncertainty… in our anxiety… in our absolutely appropriate “not knowing” before committing to action.

But in our collective discomfort, in our familial discomfort, in our personal discomfort with grief, with anger, with unattractive emotions… in our rush to “get over it” – we medicate and move on.

So today when I think for myself, or hear from someone else, “I don’t know what to do…  and I’m scared, or frustrated or angry”, the first thing I say is – “Congratulations.”  Congratulations, and don’t be afraid to stay there for a minute, or an hour, or a day, or many days.  Not in complacency… let us be clear about that… not as a victim… but as a scholar, as a friend to yourself.  Stay there confident in the fact that by bearing witness to your uncertainty, by embracing this middle space, you will find a way out of it.  You will eventually take meaningful action.

Our fear of course is that stillness leads to paralysis.  That we will become narcissistic and self-indulgent… that we will become whiners or losers. And we believe that action, any action, is better than uncertainty.

But nature shows a different destiny.  We are born to self-actualize biologically and psychologically.  Movement is our birthright and our DNA.

We were not born to stagnate – we were born to unfold.  We were born designed for forward momentum.  It is only when we careen from circumstance to circumstance that we stay in chaos.  Before rushing into the next relationship, the next job, the next drink, the next antidepressant or antianxiety medication… before we rush into what we think is “the solution”… before we rush into the knowing… sit, for a while, in the space of uncertainty.  Sit in the space of “I don’t know.”

Our discomfort is less likely to stand if we attend to it.

Our discomfort is less likely to stand if we acknowledge it.

Our discomfort is less likely to stand if we embrace it.

In a world of quick answers “uncertainty” is a space of gathering forces… it is a space of action potential. It is every moment and every interaction that led you to where you are.  It is the here and now.  It is the gloaming… it is the twilight … it is you – becoming.

Honor it.


The days go by, and I, like you, struggle to make meaning out of literal madness.

Every day, with every funeral, these children call out to be remembered. I think now of the empty spaces in the homes of their families and friends, where the innocent best of our humanity played and planned and imagined and loved – and were loved and treasured in return.

And I do what so many of you are doing – asking myself what I can do to help, how I can fill that empty space, asking what comfort I might provide, for myself I suppose as much anyone else.

For the moment, I have no other choice but to sit with my sorrow and embrace not knowing, not understanding. I have to sit for the moment in discomfort, waiting for the veil to lift and the mind-numbing reality to set in.

This terrible thing has indeed happened.

These people, these children, were slaughtered and we are left now with an obligation to help those left behind.

While I am personally paralyzed with a grief that cannot yet find words, as a mental health professional I do have a perspective that you might find compelling. Many of you by now may have read ‘I Am Adam Lanza’s Mother’: A Mom’s Perspective On The Mental Illness Conversation In America, by Liza Long. It is a personal account of a mother living with her son’s frightening mental illness. While there may be controversy surrounding whether or not she should have written it, and what her motives may have been, the piece brings into sharp focus our collective inability to deal with mental illness in general, and potentially violent mental illness in particular (whether that violence is directed at one’s self or others).

I know this woman’s story. And you should too. It is a world all too familiar to those of us in the profession.

I sit in rooms with adults who are either suffering from varying degrees of mental illness themselves, or coping with children who are struggling with it. A vast majority of those seeking help are not a danger to themselves, or to anyone else. They come for help with depression, or anxiety or grief. They come in order to make sense of their lives, or to feel more connected to people or to free themselves from the shackles of a difficult past.

We also meet people who are struggling with much more challenging mental illnesses, with symptoms that make it difficult to maintain relationships or jobs, or to establish the many micro-connections the rest of us make every day and take for granted. These are people wrestling with something they cannot understand – terrifying and confusing, a darkness resulting in fear and rage – the exhibition of which often surprises and frightens them as much as the people it becomes directed against.

They know they need help. And too often they can’t get it as readily as they should. And I can’t give it to the extent I would like.

When mental illness takes a dangerous turn, psychiatric care with medication (however imperfect it may be), is the first line of defense. And yet, for those most in need, getting those services requires an emotional skill set they do not have due to the very nature of their disease.

In South Florida, where I currently practice, without fail, each time I have called a private psychiatrist to make a referral on a client’s behalf, I am given wait-list dates and an insistence on cash payments for the first visit. And while our community does what it can to support reduced fee clinics, they are completely overwhelmed with staff limitations and budget cuts.

Picture yourself being told that your only option to get the help you need is to first navigate a bleak phone system underworld where your call is passed from one voice mail to another. When you finally get the addresses of potential service providers, you wander from clinic to clinic, filling out forms and sit in waiting rooms with no guarantee of being seen that day. For anyone, the task is herculean, frightening and overwhelming.

Now picture someone already struggling with a mental illness doing it.

And then having to do it again, and then again, on a regular basis.

Many collapse under the weight of fear and frustration and simply do not go, or go once and do not follow up. They hunker down, staying at home, trying to quiet the voices and stifle the rage. They wait. The shame and anger building. We wait – until they become violent enough to themselves or someone else so that we can have them committed to a hospital. Once there, the meter begins to run and those without health insurance play beat-the-clock with providers to get enough meds and cursory psychiatric care to get released. The hospital staff, overwhelmed and under-funded, can only triage and move on.

By this point, social relationships are usually deeply damaged – the very nature of severe mental illness results in dangerous isolation. Even families attempting to help loved ones often find themselves left to their own devices, cut off from a world that would rather not see them.

Because mental illness is unattractive.
Because mental illness is unpredictable.
Because mental illness is everything we fear.

We need a system of care that educates the public about mental illness, its signs and symptoms so we can engage it full on.

We need to rethink limitations on which health care providers can be authorized to write the necessary prescriptions. At this point, most states limit this to psychiatrists and medical doctors (even PhD Psychologists are prohibited from prescribing). Yet the first person most likely to have ongoing contact with someone struggling with a debilitating mental illness is someone like me – a Master’s level mental health professional, usually with sliding fee scales, the majority of whom also do pro bono work or show up on insurance provider panels. We are trained in establishing a deep level of communication, and in interpreting nuanced behaviors that medical doctors and psychiatrists (for the most part) are not. We meet with our clients and ascertain their current levels of connection, of anger, of paranoia. Yet when those levels begin to become alarming, and medication or hospitalization need to be considered, our only option is to put our patients into a system that, unless they are already high functioning with good health insurance, is very difficult to navigate and nearly impossible to sustain.

I graduated from NYU, one of the best universities in the country. Surely standards could be put in place that would train those of us in the field to become certified in psychopharmacology, which could augment the benefits of the psychotherapeutic relationship for more severe mental illness. I am not an advocate for medicating without reason. But medication should be considered as one of a constellation of services for those clients who are spiraling out of control.

We need humane institutions to care for those who have been diagnosed with mental disorders and exhibit behaviors that make them likely to harm themselves or others – before they inflict that harm. Not as punitive outposts for our discarded ill, but compassionate, secure spaces where treatment can be implemented and progress and state-of-mind monitored.

And we certainly need more mental health care professionals in our schools to identify at-risk youth and get them services before they become risky adults. We know what the signs are. And once we know what the signs are, and we identify at risk youth, we should work with parents, the school system, and medical professionals to track their progress and insure that they do not simply fall off the radar screen – becoming damaged ghosts skittering around the edges of our communities but never part of them.

Never truly seen, never truly heard.

Until their screams become Columbine, or Virginia Tech or Aurora or Tucson or Newtown.

Or your town.

Let’s make mental health services – education, screening, prevention and treatment – a major health priority.

Authenticity In 2013

When Michelangelo was asked how he was able to create such transcendent sculpture out of what are essentially lifeless slabs of stone, he is said to have replied, “The living art already exists inside the stone. My job, as I see it, is simply to remove the excess marble.”

There have been various interpretations and incarnations of this quote throughout the centuries. It has become one of my favorites. I use it in my life, and in my psychotherapy practice, because it speaks to my hopeful belief that at the core of our humanity lays our inherent individual potential. This potential, and the striving for it, are our birthright. You can see it in infants and children. They are built to maximize their individual gifts.

And then life happens.

And we react to it.

We react to being hurt, to being judged, to being rejected, to being afraid. We react to broken families, to toxic relationships, to the feeling that perhaps we are not quite good enough.

Our reactions take the form of defenses, of emotional armor, of masks. We do it, in the moment, for self-preservation – or so we think.

But over time, all of these layers, all of this excess, begin to obscure the truth about that essential you. The very things that you put in place as protection become the roadblocks to the happiness and fulfillment you say you want.

For me, in my long and continuing quest for personal authenticity, the excess marble was shame regarding my sexuality. My excess marble was mistrust and fear of others (well earned I might add, but destructive nonetheless). It was fear of failure, and ironically, fear of not living up to my potential. It was holding onto anger, at myself, and others. It was a refusal to forgive.

Through my own work with a wonderful therapist, I began the frightening but humanizing work of examining my “emotional wardrobe” – all the things I put on in order to survive, or thought I did. I began to ask myself, which pieces were serving me in being the person I said I wanted to be – and having the life I said I deserved – and which things did not. And once I had that information, what was I willing to remove?

As we move into a New Year, I ask myself the same questions.

And I ask them of you.

What is your mask? What is your “excess marble”? What layers obscure the truth about you? What armor have you acquired over the years that could be reconsidered? Which pieces still serve you – and which pieces are you willing to remove?

Fritz Perls, founder of Gestalt Therapy, said, “every living thing has only one inborn goal – to actualize itself as is.”

As you reflect on 2012 and move into 2013, I hope that you hold on to the image of your pure potential. Remember that the essential you is not the mistakes you made. You are not the armor, nor the excess marble. You remain what you have always been – but sometimes forget.

As we approach a new year, I take comfort in knowing that, every day, I can lift the veil. I can remember who I am and what I want. I can acknowledge the barriers to my happiness and, should I decide, I can choose to do it differently.

I wish you a joyous year ahead and look forward to sharing more on these pages.

Let It Go…

What would it be like, just for today, to let it go…

What would it be like to let go of your anger at – whatever it is… the situation, the job, the friend, the enemy, your parents, your children, your ex, your boyfriend, your girlfriend, your spouse.

Just for today, what would it be like to let go of your anger at yourself.

Just for today, what if you let go of what they did, or should have done and didn’t – or what you did, or should have done and didn’t?

How would it feel, right now, to just let go of the story?

No matter how right you are.
No matter how wrong they are.
No matter how justified you might be.

How would it feel, just for today, to take a vacation from it. Not for them, but for yourself.

Today, you don’t hate – whoever.

Today, you don’t hate yourself.

Today, you are not broken.

You are not a mess.

Today, you are not the fat person, or the weak person or the unwanted.

You are not the loser. You are not the victim.

Today, you are not inherently flawed, or incapable of love, or unlovable.

And neither are they.

What if, just for today, you let go of the shame?

What would that look like for you?

And then – tomorrow – you can have it all back again.

If you want it.

As always, I thank you for spending time with me on this site. Feel free to write if you are so inclined. I appreciate your comments.