MORTALITY AND MORALITY
Being mortal and being moral are wedded in our thinking and in our emotions. As numbered days grow fewer, one sorts out what is important from what is not. The legacy one will leave for the future is in the important category. Years of lived experience bring a perspective, and possibly greater objectivity about one’s place in the universe, one’s place in human history, and in the personal inner circle of loved ones. One word summed up for me where I stood in the world at age eighty. The word was “fortunate.” In my protected life through the twentieth and now the twenty-first century, I had indeed been able to do the things that were important to me. This despite many losses and many times when life presented problems that were more than I was equipped to handle with my limited knowledge and maturity. The poor judgement of youth, the many regrets, and yet, more chances, more learning, new perspectives, a clearer sense of direction; in the end, fortunate beyond measure.
What is important now is the younger generations. With them in mind, I bring up three large areas of concern for the twenty-first century, all well-known and observable in daily news reports.
First is the age-old “insoluble dilemma” of violence against one another. While the accelerated growth of knowledge in the last three centuries has brought us remarkable success in shaping the environment to meet human needs, in overcoming famine and disease, reducing child mortality, alleviating poverty, and extending the lifespan, it has not brought the level of wisdom and maturity we need to settle our tribal differences without violence. Spellman (2014) writes:
The very human ingenuity and technical prowess responsible for improving the quality of life over the past 100 years has also allowed us to kill one another more effectively, on a sweeping scale, and at greater distances. …Although an appalling constant in the human experience, organized warfare was not a major cause of death in terms of total population until the advent of mechanized combat in the mid-nineteenth century. (p. 154-5)
It should be noted that an increasingly high percentage of the casualties of war are the injuries and deaths of non-combatants, including, of course, children.
The second concern is social and economic inequality and its multiple effects. Statistics abound, underscored by popular uprisings in the United States and around the world, that distribution of resources has become increasingly unequal, the gulf between rich and poor wider. One way that this plays out on the ground in regard to health care is illustrated in the experience of Sunita Puri, a physician of palliative medicine in California. In an essay titled “Unequal Lives, Unequal Deaths,” Dr. Puri (2016) describes her work with families in the poorest neighborhoods of Los Angeles. “In these neighborhoods, people die an average of 10 years earlier than those who live less than ten miles away.” Her work includes explaining to overstressed caregivers the rules of what the health care system will pay for, and she wonders why our health care system will pay for last-ditch-effort interventions for a dying patient but not for one trained caregiver to help a family provide comfort at home. She offers this perspective:
Death may be humanity’s great equalizer, but the inequalities suffered in life—leading to a shorter life expectancy—become inequalities in the experience of dying as well.
(http://opinionator.blogs.nytimes.com/2016/01/20/dying-at-home-when-youre-poor/)
There is the obvious problem of doing too little for ill and dying patients, but there is also the danger of doing too much. With the great advances in the science of medicine, the art and practice of medicine has become divided into narrow specializations; focus goes to symptoms and failing organs; patients may be viewed more as candidates for interventions than as whole persons. Katy Butler cared for her parents at the end of their lives, and later wrote about the close up experience of medical decision-making from the perspective of the patient and the family. Following a stroke, her father’s life was extended with technology, resulting in prolonged suffering and a diminished life for him along with severe pressure on her mother to meet the demands of his care. Butler (2014) offer this seemingly radical proposal
I think the whole family should be regarded as the patient. …What have we accomplished if we’ve just shifted the illness from one member of a family to another? If you’re a doctor, I think you have to look at whether you’re adding suffering to the family as a whole when you extend the life of an individual. (p. 7)
Atul Gawande (2014) is one of many in the medical field who are looking closely at the intricate cost-benefit balances involved in decision-making at the end of life. He advocates for the new specializations of geriatrics and palliative medicine. He writes:
The battle of being mortal is the battle to maintain the integrity of one’s life—to avoid becoming so diminished or subjugated that who you are becomes disconnected from who you were or who you want to be. Sickness and old age make the struggle hard enough. The professionals and institutions we turn to should not make it worse. But we have at last entered an era in which an increasing number of them believe their job is not to confine people’s choices, in the name of safety, but to expand them, in the name of living a worthwhile life. (p. 141)
The third area of concern encompasses all of the issues that are now called “environmental.” E. O. Wilson (1998) wrote almost twenty years ago: “Humankind is like a household living giddily off vanishing capital.” (p. 286) He alerted us to the precarious position we are in, facing an environmental bottleneck or worse, in the twenty-first century.
Joining the voices of the scientists, now comes the voice of Pope Francis. He, of course, comes from the transcendental tradition, but has proven himself a keen student of the empirical research on our relationship to the planet. He begins the encyclical letter Laudato Si’ (2015) recalling the devotion of Saint Francis of Assisi to “our Sister, Mother Earth.” (p. 7) Under the heading, “The Human Roots of the Ecological Crisis,” the Pope names the developments that have brought us to this point. They include: the creation of immense technological power and economic resources without sufficient wisdom and responsibility to control them or use them wisely; interventions in nature that lack the ancient attunement and respect for nature; the illusion of unlimited growth based on an infinite quantity of resources which can be renewed quickly; lifestyles conditioned by dependence on technology; wasteful consumerism that stands in unacceptable contrast with dehumanizing deprivation; the overwhelming of the real economy by finance and the profit motive; fragmentation of knowledge and loss of appreciation for the whole and for the relationship between things.
As I read the encyclical, the words “down to earth” come to mind. The Pope has shown himself to be refreshingly down to earth in his personal style; hierarchy seems less important to him than connecting with people. In Laudato Si’, Frances is calling us down to earth, as in these passages:
Nobody is suggesting a return to the Stone Age, but we do need to slow down and look at reality in a different way, to appropriate the positive and sustainable progress which has been made, but also to recover the values and the great goals swept away by our unrestrained delusions of grandeur. …our “dominion” over the universe should be understood more properly in the sense of responsible stewardship. (pp. 78-79)
If the present ecological crisis is one small sign of the ethical, cultural and spiritual crisis of modernity, we cannot presume to heal our relationship with nature and the environment without healing all fundamental human relationships. (p. 80)
Murray Bowen introduced a new way of understanding how we have arrived at the levels of violence, inequality, and environmental degradation that concern us today. In Bowen’s natural systems theory, these extremes are seen as part of a broad continuum of human behavior that goes from calm, thoughtful, responsible functioning at one end to anxiety-driven, reactive, out-of-control functioning at the other.
Bowen believed that humans had the faculties in our brains that could, along with disciplined effort, permit us to think scientifically and objectively about ourselves. Not everyone thought this was possible. He organized and led an empirical study of the human family, arguably nature’s most complex system. The result was the concept of the family as an emotional system in which individual development is profoundly shaped by the system as a whole.
Over the years of research and development of family systems theory, Bowen kept notes on indicators of emotional process in the larger society. In 1972, in response to an invitation from the new Environmental Protection Agency to write a paper on man’s reaction to crisis, he began to organize this data into a conceptual framework, and later added the concept, emotional process in society, to the theory. Seeing the same emotional process in society as in the family, he identified the common elements: chronic anxiety, the balance between thinking and emotion, and the balance between the pressure for togetherness and the force individual autonomy.
In the family and in the society, an anxiety-driven process leads to emotional and social regression:
When a family is subjected to chronic, sustained anxiety, the family begins to lose contact with its intellectually determined principles, to resort more and more to emotionally determined decisions to allay the anxiety of the moment. …The societal concept postulates that the same process is evolving in society. (1978, p. 386)
Regression deepens as togetherness pressures intensity and individuality is reciprocally constrained. The endpoint is reached “when viable members desert the group and there is overwhelming reactivity, violence and chaos.” (278)
Bowen saw the same human phenomena that environmental leaders and the Pope see: the pressure of exponential population growth and unsustainable lifestyles on the earth’s resources, the resort to short-term solutions that exacerbate problems, the difficulty of getting cooperation between societies. He believed that the origins of the anxiety that drives regression were in the disharmony between man and nature more than the disharmony between man and his fellow man.
Bowen did more than name and describe the end results of family and societal regressions; he developed an original body of knowledge to explain the natural, instinctually driven, human emotional systems that lead to these results. He identified the relationship patterns that operate automatically, out-of-awareness, when fear and contagious anxiety are on the rise. Distancing, conflict, dominant-adaptive reciprocal functioning, triangling, the projection process, and emotional cut-off work in combination to produce insider-outsider polarities and the host of “isms” that divide us and fuel chronic anxiety. The phenomenon of the emotional shock wave that Bowen observed in families may also be part of the emotional process in societies. It is not hard to see how the massive losses suffered in human conflicts could propel further conflict and loss.
Bowen saw a pathway out of regression that operates in both families and societies. That pathway is known as differentiation of self. Those individuals who are able to observe systemic regression, recognize and change their own participation in it, and find more responsible avenues for action, become the leaders who gradually move the larger system to a new norm of higher functioning. Bowen (1978) described this remarkable process:
A shift toward individuality on a family level can be illustrated by a single, responsible family member who proceeds on an individually determined course. …Increasing individuation is slow and difficult and it takes place only with a disciplined decision to stay on a principled course in spite of the urge to return to the togetherness. …When one family member successfully makes such an individuality move, then another, and another will do the same. In a small or large social system, the move toward individuality is initiated by a single, strong leader with the courage of his conviction who can assemble a team, and who has clearly defined principles on which he can base his decisions when the emotional opposition becomes intense. (pp. 278-9)
Increasing regression means increasing pressure to think and act with the group, more difficulty developing an independent view, more risks and costs in expressing or taking action on a different view. At the extreme, it becomes life-threatening to challenge the status quo. Nevertheless, there have always been people who recognized regression and had the motivation and courage to speak and act for more responsible courses of action.