Monday, October 1, 2012

Learned helplessness.

"Old man look at my life,
I'm a lot like you were.
Old man look at my life,
I'm a lot like you were.

Old man look at my life,
Twenty four
And there's so much more
Live alone in a paradise
That makes me think of two.

Love lost, such a cost,
Give me things
That don't get lost.
Like a coin that won't get tossed
Rolling home to you."

~ from Neil Young's "Old Man"


The papers were sitting in a stack on the counter in front of me. Question after question asking all of these things that I wasn't sure applied to you.

"How long can you stand?"
"How much can you lift?"
"How many hours can you sit?"

I had no idea. I was just meeting you. Plus I had no idea what would make someone so young want disability. 

Disability? Dude.

"These are disability forms?" I went ahead and asked just in case you thought it was something different. "You know these are for disability, right?" 

"Yes, ma'am."  That answer was simple. But none of the rest of this was simple.

You had walked in. One foot in front of the other without even a trace of a limp. Your slender body appeared to be rather de-conditioned from lack of exercise but otherwise it seemed fairly healthy. The questions I'd asked you initially were answered logically and without any flight of ideas so it didn't seem like you had some disabling psychosis. And the truth is that you looked exactly like what you were--a twenty-something year-old dude seeking disability. 

I squinted at the sticker on your triage sheet to make sure I wasn't reading wrong. Yep. A date of birth from the 1980's. Yet the papers still sat there in three dimensions. For disability.

"Disability?" I cocked my head to the side and furrowed my brow. "Why are you seeking disability? I'm a bit confused, sir."

"I got medical issues that make it so I can't work." You said it matter-of-factly. Like it was what it was and like nothing about a man your age seeking for a doctor to deem him disabled was unusual.

Newsflash: It is.

"What kind of medical issues?"

"I have bleeding from my stomach. I had a bleeding ulcer. And I got some problems with my liver."

I leaned my chin into my palm and perched my elbow on the desk. I waited to see what you'd say next because that still didn't sound like the full story. You were going to have to give me more than that.

"They had me in the hospital for almost a week. I was vomiting up blood and by bowel movements was black like tar. They put a camera down my throat and said I had a ulcer and a flared up esophagus. I have to take medicine and everything."

"I see. When was all that, sir?"

"Like six months ago."

I nodded and looked into the computer a bit. Tempted to review your whole chart right then and there, I paused and decided to wait. You--the chart--were right in front of me. 


"Yes, ma'am?"  The way you said "Yes, ma'am" reminded me of the high school boys I see volunteering on the sidelines at Zachary's football games. Youthful, respectful, and Eddie Haskell-like. Way too young for a permanent disability request. 

"I'm a little confused about you wanting disability. You're not even thirty. And so far I'm not fully sure of why you got sick. Like. . . was there a reason why they told you this could have happened to you?"

That question wasn't fair. It was passive aggressive since I knew for sure that I could smell beer emanating from your breath and your skin. It wasn't even ten in the morning and there was no question about whether you'd had a drink very recently. 

Maybe that suggested some kind of disability after all. Even if the papers didn't ask about the kind I was thinking of.

"I mean. . . really, Miss Manning. . I don't know. I ain't working. Haven't been able to work too much either. Basically my life is just messed up."

"Messed up how?" 

That question made you drag in a big breath of air. Your face dove into your hands and then you sat up, still pressing your palms into your eyes. 

"Man. . .I don't know, Miss Manning. I just got . . . you know. . .mind problems and I got a generational curse on me. It's messed up."

"I got a generational curse on me."


You'd think that I would have thought you were crazy when you said that but I didn't. This made sense to me because I was familiar with that language and even that idea. A generational curse. See, I'd heard the Grady elders and church folk speak of this many times. Yes. . . . .those words that usually refer to strongholds of addiction or even the kinds of anger problems that get people locked up over and over again. Or they reference those long, long lineages of poverty and low-literacy and under-employment. The kinds of things that, without some kind of intervention, repeat themselves over and over again.


"Yes, ma'am." 

There it was again. That same "Yes, ma'am." Juvenile and full of deference. 

"What kind of work did you used to do?"

"Department of Transportation. But when you get DUIs on your record that's a wrap."

"Are you still drinking?"

"Not really."

"When did you last drink?"

You paused for a beat and then decided to answer. "Alcohol? Like a week ago. But I had a beer."

Beer is alcohol, I wanted to say. But this wasn't the time for that. 


"Yes, ma'am. But just one." 

Damn. The clock had just struck 9:21 and you'd already had a beer. This was serious. And honestly? You were disabled from whatever it was that made you crack open a beer while somebody else was pouring coffee.

"What kind of beer do you drink?" I braced myself for the answer. 

"Icehouse. Or Colt 45." 

Malt liquor. Dang. 

"Do you consider. . . I mean. . .how do you feel about your drinking? Like. . .is it something you consider a problem?" 

You leaned forward with elbows onto knees and turned your face toward me. Next your mouth fell open and your eyelids lowered which was the silent movie equivalent of saying "duh." 

"You said it was a. . .  generational curse?"  

One corner of your mouth turned up when I said that. I thought it was ironic that you'd smile about something that I personally considered very sobering. Strongholds--especially generational ones--aren't anything to smile about. I called you on it. "I'm sorry. Did I say something that sounded kind of funny?"

"Naw, not really," you replied with a chuckle. "Just the way you asking me these questions seem like you don't know this kinda thing up close and personal. Like you .  . . .from somewhere else."

Somewhere else? Damn.

"Like 'somewhere else' meaning not Atlanta?"

"Naw. Somewhere else like not the kind of family where most black folks come from. You know. . .like a family with no alcoholics or drug addicts in it. And, real talk, I don't know nobody like that."

I froze on those words. I immediately felt like surveying everyone nearby in our demographic to see if this was a valid statement. Instead, all I could go by was the "n = 1" sitting in front of you. 

Did I have any people in my family of upbringing who struggled with alcohol dependence and drug abuse? Yep. What about the family I married into? Yep. 

"No. I'm from the same place. I can't say every black person fits that description, but you're right--I do. I have family members with drug and alcohol problems." 

You smirked again. I knitted my brow in response so you clarified.

"Must not have been your mama or your daddy, though. I can tell from looking at you and listening to you."

That punched me in my chest. You were right again. It wasn't my mother or my father. It was someone who didn't live in my house at all. The relatives whose necks I hugged on holidays and who laughed louder than all the others at the grown up table. 

"What about you?" I quietly asked. 

Your back was hunched over in a 'c' and your forearms were still pressing into your thighs like a high school sixth man waiting for a coach to let him in. With a shake of your head you answered. "Both. Mama and Daddy. But what's going on with me came from my daddy. That's about all I got from that dude." 

"Is he alive?"

"Yeah, but he all messed up from his liver. Stomach be all big like a pregnant lady 'cause he got cirrhosis and all that. And he always was a mean drunk. Be hitting people and fighting and shit." You let out a gentle laugh. "And me, I got me a parole officer that I get to talk all about that to." 


"What about your mother?"

"My mom? Yeah. She got mixed up on crack so I grew up with her but, you know, she one of them every day crack smokers. The ones that ain't shaking on the corner like Pookie but still do it enough to eff they whole family up." Again the sideways smile.

"The ones that ain't shaking on the corner like Pookie 
but still do it enough to eff they whole family up." 

Now that was some real talk. The image of Chris Rock as "Pookie" in the nineties cult classic "New Jack City" flashed inside of my head. Then I tried to see your mother, talking loud and dancing like a teenager on your front porch when you wished she wouldn't. I pictured electricity turned off, belongings stacked up on curbs from evictions and report cards that you signed yourself. All signs of "just enough to eff the whole family up."

"Have you ever looked into getting some help? Like rehab or something?"

You shrugged. "They make you go to stuff when you get a DUI. I been to AA before, too."

"Have you ever seen anyone in mental health?"

"Naaah. This shit is in my blood. Can't no counselor or psychiatrist fight demons that run in your family." 

"You know? I think this is what they do better than anyone else. Plus they can probably help you to do it better than what you've been doing up until now." 

This time you just looked at me and didn't say anything else. Your eyes were warm and hoped mine were, too. 

We talked some more about your family and your father and how you grew up. We talked about how much you really drink and where you live and how getting some help might really change your life. You told me that your mind is strong but that since all you know is a life with people drinking and ruining everything that you couldn't see past all that. Also you said you have a little daughter but you don't see her none because you hit her mama in the face once and her mama's mama won't let her mother have nothing to do with you. But that you're glad because you don't want to mess her life up, too.

"That's all a part of the generational curse," you kept saying. And every time you did, you said it like it was so final and non-negotiable and with no antidote that anybody could gain access to.

Not me, not you, not AA, and not mental health. Not anybody. 

All I had was the time remaining in your visit. And I wasn't even the main one seeing you; I had just come in to talk to you behind a resident doctor. I knew I couldn't get all this stuff back into Pandora's box and I felt kind of bad that I'd even started pulling out the contents. Kind of like when neighborhood kids come over for play dates, pull all the stuff out of every single crevice in your yard and then just leave all the stuff in the driveway for somebody to run over with their car.

Like that.

You didn't mind when I said that disability didn't seem like the best thing for you. You listened carefully and you were cooperative through the SBIRT referral (screening, brief intervention, referral to treatment.) And eventually I just had to let you go. 

That was several weeks ago. Maybe even some months now. But I haven't stopped thinking of you. Thinking of your despair and your learned helplessness. Feeling this pang in the part of my stomach that is connected to my soul because I knew that you presenting a stack of disability papers was nothing more than a manifestation of that same learned helplessness. Like those lab animals described in those classic psychological studies. . . . shocked and harnessed or thrown into vats of water while scientists took notes as they scrambled and scrambled until eventually they realized the there was no way out. The ones who over time when tossed back into the same situations by those same scientists would just lie there because they knew that there was just no use. None at all.

And this is the theory of learned helplessness. 

When I think of you I worry that, if I'm not careful,  I could succumb to the same as your doctor. Listening to your truths and your reality, but somehow desensitized to it all. Fearful that it will all end up floating in a giant tank full to the brim with unfixable generational curses and social catastrophes. With me just lying there flaccid, immune to the shocks and not making a splash.


"Lullabies, look in your eyes
Run around the same old town
Doesn't mean that much to me
to mean that much to you

I've been first and last
Look at how the time goes past
But I'm all alone at last
Rolling home to you

Old man take a look at my life
I'm a lot like you
I need someone to love me
The whole day through
Ah, one look in my eyes
And you can tell that's true

Old man look at my life,
I'm a lot like you were.
Old man look at my life,
I'm a lot like you were. . ." 

Welcome to October.

Now playing on my mental iPod. . . this song punches me in my chest.

I love this soulful remake by N'Dea Davenport (formerly of The Brand New Heavies). The way she chants "daddy" in it is haunting. This version speaks to my soul -- and makes me wish I could play electric guitar. It also makes me wonder what she was feeling inside when she recorded it. (SO annoyed that I lost my original CD of this version because it's not on iTunes for some reason! BOOO!)


  1. You know, the fact that you're an amazing doctor is one thing, but there's also the fact that you're an amazing writer, and this post is amazing. I want to share it with everyone I know because it captures, perfectly, all the tragedy in the world and all that's good, too.

    Those of the us in the other disability world know all to well the theory of "learned helplessness" --it's something that I wonder about regarding my daughter Sophie and her dysfunctional brain -- the way she's learned things and the way she hasn't. I have never thought of it in any other way than what I imagine it was coined for, but this post suggests otherwise. I'm not sure if there's a way to unlearn helplessness, if the neurons have fired, misfired and re-fired, permanently. I am ever hopeful, though, and hope that this young man had at least one neuron fired up by you that might "kindle" and spread.

    1. Wow. I love this piece and the raw emotion in it.

      Elizabeth, your comments stopped me in my tracks. I think you're right. As someone who's been thrown into the other disabled world, I've been instructed to learn how to reach out for help and not try to do everything myself. And, it makes sense, right? If it takes all the energy I have in a day to take out the trash, my friend should just take it out since it takes .1% of her energy.

      But is it conditioned helplessness? I find myself wondering if my worldview needs to change. It's not so much about a hierarchy of tasks but the specialization of them. I'm an excellent planner while my coworker is a great public speaker. So I plan the work parties, and he gives the introductions. It's a win-win. I'm not less of an employee because I don't like speaking in front of a crowd.

      It's true that I have to work harder than most people to accomplish certain goals. But I'm learning that it's worth it because I have something to offer people around me, something that comes naturally to me that the world needs. I'm stepping away from the attitude of "I'm not good enough" to one of "I have some to give and something to take."


    2. So much food for thought. The theory of learned helplessness has always fascinated me because it's so true in so many different ways. You have both given me different ways to think of it, too.

  2. This is a sock to the gut, this post. Because whoa- whole generations of people who will probably never find the one tiny step to start to overcome the generational curses laid down upon them with fists and with observation and words and every breath drawn since birth and yeah, before that too, most likely.

    I'm going to be thinking about this for awhile.

    It sort of boils back down to that thing we've talked about before- how do you pull yourself up by the bootstraps if you don't have any bootstraps? Can't even imagine having any?

    1. I know, right. It's really deep. I wish there were clear answers.

  3. Dr. Kim, this post really spoke to me, and it's so strange that you bracketed it with that song I just wrote about because it made me cry. N'Dea's version is new to me and an instant favorite. And coincidentally, her last name is an old family name of ours.

    I listened to Neil sing that song as I was crossing the actual and symbolic divide between me and my childhood family. The generational curse is strong in our blood too, but like you, my parents were strong, or lucky. Each had one sibling, a sister, who's lives were marred by alcohol and drug abuse. It colored our lives. Of my siblings, I am the least caught in the trap, but I feel the pull, I barely escaped with my life as a young, foolish child trying to catch and keep a buzz, as any altered reality seemed preferable to me than my own.

    I feel that man's struggle, I feel your compassion and wisdom too. But I want to shake that young man, and so many of my long gone relatives, and my young self and say snap out of this, be strong, get help, see your life through open eyes, hope for luck. I got lucky, so lucky. A good man saved me, the child of an alcoholic who didn't fall prey to the curse, and I hung on tight to him, I married him and so far, our kids are curse free too. But we are vigilant, and hopeful.

    I wonder so much about the differences between the lucky and the cursed, and I keep coming back to love. It's so much easier to break free when somebody has your heart and your back. Maybe it's in the Scot-Irish-English genes too, maybe it's too complicated an equation to proof, but I marvel daily at the life I left behind, the mess I should have been, and wonder so much about my family and why addiction haunts so many of us.

    I wonder too, if someone, anyone, like you had paid attention, asked the questions you asked, if I might have been spared that crazy decade. Of course, I realize that any deviation from the path I've taken would have cost me the chance meeting with my husband, so I guess it was meant to be.

    Your greatest gift, I think, is that spidey sense that makes you slow down and look real close, peel back the layers and get to the truth. You are amazing.


    1. Mel, that patient was insightful and smart. HIs own self reflection and ability to describe it all was amazing and some part of me wishes someone had just been chucking his chin and telling him so as a child. You're right. It comes down to love. Love and having someone preserve your innocence for as long as they possibly can. So much of this comes from innocence lost too soon and ignorance held onto for too long.

    2. It goes to show, like the previous post, how much of a person's life depends on community: both the community he was raised in but also the people around him now. The mercy and the care in this one encounter no doubt meant so much to this young man. Even if you can't change his past or make the impact on his present that you wish you could, I know that his life would be different without you. And sometimes, that's all you're called to do.

      I know that people have changed my life through the tiniest encounter. My favorite memory is of a pharmacist who took the extra ten seconds to smile at me when he handed me antidepressants during a particularly dark period of my life. He'll never know how big a difference that made for me.


  4. Ah, Kimberly, this post hit me where I live. My cousin is an addict and I think we have all, in the family, become fatalistic about her chances for ever overcoming her addiction. Neither her mother nor her father were addicts, but she was epileptic and put on pheno barb from a young age, and when they took her off it in her teens she veered straight into drug abuse, the world was just too much with her, and she also never learned to love herself, her beautiful dark skin and tightly kinked hair that never grew like her mother's mixed heritage hair grew, she couldn't see her own beauty and somehow she decided early on that she was not worthy of better, or that she didnt know HOW to find her way to better, and now it is self-fulfilling and it breaks my heart. A couple years ago she agreed to enter rehab, but she needs inpatient rehab. Someone with her history will never stick to outpatient rehab, but that is all her insurance would cover and so she was back on the streets, with that man who means her no good, and it seems as if the rest of us have become immune to the shocks, as you say, with our own brand of learned helplessness. I wish I knew how to help her, how to help that young man that sat before you, i wish we knew what to do and had the resources to do what's necessary, too.

    Thank you for this brilliantly written post. Most of all thank you for you searing compassion. For refusing to lie inert and desensitized, for thinking about that young man all these months later, and for praying for him, because I know you do.

    So much love.

    1. Wow. Just. . .yeah. Wow. Thanks, and I appreciate you.

  5. This touched me deeply. I seem to have escaped the generational curses and by luck, found a wonderful man. But I see it in so many around me, especially in my cousin. He's spiraling into the same end that my older cousin did; death. How do you disembed habits, traits, feelings...that are ingrained into your DNA?

    Thank you for this. You changed that man's life even if he doesn't know it yet.

  6. I'm very familiar with "generational curses". I'm very dismayed by how people cling to them while dismissing the other side...the generational "cure", if you will...the opportunity for curses to be broken. Generational curses, though universally applicable, have a Biblical context, certainly where I'm from. The curse causeless does not come, but further reading of my Bible tells me that "all things are possible with God". I wish my community would embrace the other side of the coin. Yes, curses exist, but they *can* be broken by various means. Learned hopelessness plays right into learned helplessness.



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