Empowerment Therapy

INTRODUCTION

While it may appear that the major purpose of this book centers on disability issues, equally important are the humanly universal issues of loss. Because life for anyone is always a challenging process, a major challenge in successful living simply is the ability to deal with and, thus, accept losses. This acceptance of loss process can perhaps be summed up best as the ability to let go or to give up old ideas and behaviors in the pursuit of growth.

This book essentially has relevance for anyone who wishes to be more aware of and appreciative of the human drama containing sorrows linked to life's losses as well as its joys linked to life's benefits. While it may seem obvious that my studied group is one of physically challenged folks, it actually comprises a representative sample of all individuals who have experienced significant and, often, extremely traumatic losses. That is essentially why I have included the word "Other" in the subtitle of this book. The losses I refer to in this book are primarily physical losses. Often this includes diminished ability to function physically prior to the onset of the physically limiting condition. No matter how great or slight the loss, no matter the type of a loss, a loss is a loss is a loss.

Typically and traditionally, the very word loss conjures up negative associations of sadness and other painful feelings. Think about it. What happens to you when you hear the statement: The loss of his wife was a real turning point in his life? Try to determine if the feeling state (a term that simply means the way you feel) elicited from this statement is more similar to the feeling state elicited from either statement #1 or statement #2 that follow:

Statement #1: The loss of his wonderful wife was a real turning point in his life.

Statement #2: The loss of his dominating wife was a real turning point in his life.

My point is that unless the word loss is qualified by some adjective describing what is lost, the word automatically and typically stirs up feelings of sadness.

Consider these two statements. "The loss of his virginity occurred at the age of 15." or "The loss of her virginity occurred at the age of 15." Sexism aside, my guess is that the second statement in our male dominated culture strikes up automatic feelings of sadness or anger, while the first statement qualified by a two letter pronoun may stir up feelings of humor. Of course, some of the feeling state conjured up by the statement may very well have to do with the gender of the reader, but the major point is that different types of losses stirs up different feelings for different people. The value of the lossee (or loser?) plays a part in the emotional significance of concept of loss. To highlight this point, imagine if the girl losing her virginity is someone you do not know versus your own daughter or sister. So, as you can see, one of the rare times the word loss does not stir up negative feelings is when the word is used in connection with a group typically victimized by prejudice. Try to imagine a member of a White supremacy group getting all worked up over an African-American losing his wife. Pretty tough to do, isn't it? Notice what happens when you hear these two statements:

1. Bill Jones, a White supremacist skinhead, started to lose his civil rights when he was imprisoned for murder.
2. Bill Jones, an Afro-American, began to lose his civil rights around the time he moved into the affluent Hickory Hill section of the city.

The issue is admittedly a bit more complex here, but I think you get the point. We will be talking about automatic associations, or paired associations, in great detail in the chapters on Empowered Learning. But the million-dollar question is why does the word loss have to automatically arouse feelings of sadness and pain? Isn't it a universal part of everyone's life, such as the loss of childhood or the loss of adolescence?

This book is intended to expand consciousness about losses so we can take steps to expand our humanity. To appreciate the universality of losses, look around you. Think of any individual that you know or know of; a partner who has just lost his or her job due to mandatory retirement, a neighbor who has just lost his or her job due to a layoff, a relative who has lost a spouse because of divorce or an All American youth who was once followed intensively by the media for his or her outstanding athletic excellence but lost his time in the limelight by not making it to the pros. The experience of loss overlooks no one; rich or poor, famous or unknown, white- or black-skinned, yellow-skinned or brown-skinned, young or old and, most certainly, man or woman. Mohammed Ali, Christopher Reeves, Ronald Reagan, Paul McCartney, Priscilla Presley, Bill Clinton, Bill Bradley, your next-door neighbor, one of the earth's billions of people you will never know; all these people have at least one thing in common. They all have dealt with and will continue to deal with the human experience of loss. Some losses are regarded more compassionately and in a positive light, while others are not. OJ Simpson can perhaps be regarded as an example of the latter. As Bobby Dylan sang ". . . for those who are first will soon be last, for the times are a changin'."

Dealing with losses is dealing with life. Putting the inescapable, but supposedly tragic, human phenomena in its proper context of acceptable reality, successful living means successfully dealing with losses. Losses in living are just as significant an element of anyone's life as oxygen is. Alternatively and logically, unsuccessful living is the opposite; the inability to successfully deal with losses. Some losses happen to be premature, unpredictable and quite traumatic. Others are expected, even welcomed. But it is definitely agreed upon by psychologists, clinical social workers and, undoubtedly, any sagacious guru of a higher order that the successful challenging of one of life's losses, blessed or cursed, always brings on something newer and greater that strengthens rather than weakens.

Objective observation reveals that losses are crises which catalyze change, be it good or not so good. Such change features new ideas, new perceptions and new behaviors, all offering the possibility of greater enrichment mentally, physically and spiritually. It is how these losses are acted upon that determines whether the inescapable change will be good or not so good, or even good or bad. We have often heard these cryptic words of wisdom: When one door closes, another door opens. While these words are certainly true, their imperial tone tends to lead one to believe that a loss will always lead to something good. This assumption is definitely untrue. It is untrue simply because doors to goodness are side by side with doors to not-so-goodness. Furthermore, only one door opens automatically. The other has to be opened through deliberate application of will. When such a door is shut behind us, we need to go on to one of the new doors and painfully start the process of opening one of them. Many times, that not so good door is the old
door, or a new door that very much looks like the old door through a futile effort to repeat the same old door. Turning to the old door or the replicated one and futilely attempting to open either door can only lead to a vicious circle of frustration and debilitation. The old door will always be fortified with so many locks that even Houdini himself wouldn't be able to get in with three years to pick the locks. The attempt to repeat the old door on the other hand, runs the risk of creating an illusion that could baffle even Einstein. I believe these words of wisdom are far greater ones of truthful revelation: "When a door closes, go to the door of opportunity and open it."

For the most part, especially in the more technologically developed countries, we live in an achievement-oriented world, featuring giant, depersonalizing mega-corporations and other maze-laden bureaucratic organizations. Such structures contain mechanistic "yes-people," whom Erich Fromm identifies as folks with "marketing personalities."
As a consequence of this de-humanization, there tends to be, in my opinion, serious ethical deficiencies that are reflected in our legal, economic, health, governmental, educational and even family systems in the home. Opinionatedness aside, I believe the major characteristic of the ethical and spiritual breakdown that leads to physical and psychosocial neglect is the widespread over-emphasis and over-valuing of images and appearances rather than the cherishing of personal fulfillment and spiritual growth. I read that former Ambassador to England, Joseph Kennedy, once told his children that it doesn't matter what you are, what really matters is what people think you are. My fundamental-and perhaps oversimplified-view is that most common folks are not provided with sufficient lessons in the empowerment building that is necessary for developing the universal art of accepting losses.

Acquiring personal growth and satisfaction in our sacred lives is simply and essentially, once again, the ability to successfully resolve losses. The secret Key to Rebecca, however, which mystifies this inability, or dis-ability, to accept losses lies in the unavoidable reality that losses are painful. While dealing with losses brings on new exciting possibilities, it simultaneously and always leads to stressful feelings of vulnerability, humility and that dreadful sense of things being out of control. Out of control? Heaven forbid, that's a real no-no for the image of the successful, self-made individual who squanders his or her way to the top in the survival of the fittest race in the modern world.

I have practiced psychotherapy as a clinical social worker for the past twenty-five years. I am also a person who has experienced (notice that I didn't write suffer) what most people would describe as a dual loss of enormous proportions, the total loss of sight and hearing. Because of these facts of my life, I believe that I am in a uniquely
qualified position to write a book that provides at least one formula for an understanding of the grieving process in dealing with losses. More important to me, however, I also believe-in fact, I know-that I can write a book that offers enlightening action-oriented strategies that motivate one toward constructive physical, psychosocial and spiritual growth in the wake of loss.

I am not only writing about losses experienced by 48 million disabled Americans. I am also writing about disadvantaged groups such as minorities, victims of sexual and physical abuse, veterans of wars and other catastrophic events, displaced housewives and other female groups, single parents and countless others from the inexhaustible categories of misfortunate population groups that are targeted either for true compassion or true prejudice. It is likely that the total number of people comprising these unfortunate demographic categories exceeds three times the entire American population. If this is true, we can see that losses are the central issue of anyone's life,
since all it means to be a member of a disadvantaged group is to experience the loss of what we perceive could have been if our lives comprised a non-disadvantaged group. After all, which member of the homosapiens really lives in a so-called "non-disadvantaged" group? Even fantasizing that such a non-disadvantaged group does exist; consider the leftovers living in these "normal" groups. Which considering "normal" losses of the chronological process of passing from one developmental stage to another, the number of American people, let's use the word this time, "suffering" from losses would be, according to my spread sheet, a vast negative number of nearly infinitesimal proportions. This would be the sad case because now everyone is fitting into at least two categories of loss; one being the "normal" category of loss, while being in at least one disadvantaged group. No matter how one looks at it, there's no getting around the fact of losses.

Thus, this is a book virtually and exclusively about losses, about changing and, ultimately, about growing. This is, therefore, a book about the universal human experience of loss that applies to all members of the human race. I believe that the basic root of the problems that confront us all on this planet lies in the majority of people's inability to become personally empowered on a genuine level. The equivalent of personal empowerment is the acquiring of a greater sense of control and peace in one's life, through changing in a growth direction in the accepting and successful challenge of losses. That is my formula for empowerment.

The majority of people, including those in positions of leadership in business and government, believe that peaceful living results from controlling circumstances, ideas, activities in the outer world and, eventually, other people themselves. The reason for this need for control in the outer world is that far too many need to subjugate other in order to feel validated and worthy themselves. Shifting from an external locus of control, relating to the outside world, to a more peaceful internal locus of control, is in itself a major transition. An internal locus of control could be defined as the practice of depending on ourselves to make us feel good about ourselves. A major transition is a major loss, thus, the successful shifting from the insecure outer orientation to the more secure inner orientation is, in itself, a major loss. This is a major and dramatic, often traumatic, shift which, for some people, occurs in a developmental life stage (such as mid-life crisis that is so often referred to), while for others it occurs catastrophically, due to some uncontrollable, catastrophic change (such as confinement to a concentration camp).
Over and over again as a practicing psychotherapist, I have established that my main job is helping clients let go of the urge to try to control things that are not possible to control in the outer world. Similarly, I endeavor to assist clients in releasing the urge to control turmoil in their inner physical worlds. Such turmoil often involves coping with physical loss and/or the aging process, which many of we baby boomers will be welcoming this decade! Whether or not this futile struggle relates to the outer or inner physical world, it all still boils down to a futile attempt to control the cosmic world of inner experience.

The brave new way of the Twenty-First Century in facing these necessary and growth enhancing challenges means to encourage people from all walks of life to focus time and energy on true power, a sense of potency and aliveness by developing competencies and interests within their range of control. These competencies and, hopefully, interests, include:
1. The way they perceive themselves;
2. Making greater efforts to communicate better and be more loving with their fellow man;
3. Working harder on personal goals and;
4. Perhaps most important, accepting responsibilities for their lives.

The implication of all of this is that losses, whether "normal" or traumatic, does not automatically convert to growth, but often converts to regression and self-neglect (including mental illness). The difference between the former and the latter is the experience of our free will, our awareness and consciousness to seize these times of inevitable
losses as possibilities and opportunities for growth. We must use our awareness and our will to turn away from the door that has locked forever behind us, and turn towards the new door of opportunity to open it, how ever vulnerable and frightened as we may feel. In this book, I offer you the opportunity to see that even in the extreme circumstances, taking the choice of opening the door to opportunity instead of opening the illusionary door of replication is still very possible. The choice always exists retreating into social isolation and self-neglect, or battling it out against the odds to find different and new ways to get one's fundamental human needs met.

I also offer the crucial aspect of growing through losses, the crucial role of positive support systems. Support systems are simply people helping others to get through their losses. In essence, I would like this book to be a sort
of support system to those who are struggling with their own unique losses or sets of losses. The capacity to cope with losses and to move on with a life that is enriched with new ideas and possibilities, not only depends on the type and severity of the loss itself, but also perhaps even more importantly, on the quality of support systems surrounding the
individual at the anticipation and/or the actual wake of the loss. Support systems are essentially survival systems, whether they be friends, family or co-workers, or even professional counselors. The level of maturity at the time of the loss is significant as well. One can easily imagine, for example, when one reflects on a fifteen-year-old youth with insufficient adult maturation, who has been told of the death of his parents in a tragic accident. In a case such as this, one can easily estimate the pricelessness of a healthy support system.

Because of the complexities and multiple possibilities of the following three variables: the loss itself, the maturity level, and support systems, no single loss experience is ever the same. Moreover, each is highly individualized. Hence, there is no such thing as a typical loss, a typical divorce, a typical disability, or a typical death. For every person alive, the experience of loss is a totally unique experience regardless of how the loss is classified. Thus, this book is an effort to create new associations with respect to the necessary pain of living. It is only through loss, or what many refer to as crisis, that we must discard our old thought patterns, belief systems and behaviors in order to survive physically and psychologically from the loss.

While the issue of loss is as universal as the Milky Way, I do not want to overlook the unique role it plays in the lives of billions of physically and chronically ill on the planet Earth. Earlier in this Introduction, I referred to the automatic negative connotation of loss is applied to certain population categories that are the ungrateful recipients of stereotypes and prejudicial attitudes. These attitudes exist whether acted out in condescending compassion or in outright contempt. It is my strong belief that not only is this the case for disabled and chronically ill folks, but it is magnified a hundred-fold. This is essentially why the largest minority has earned the unenviable reputation of being the last minority.

What complicates the loss issue for many, many disabled people is that the issue is attempted to be fixed by people who see themselves as being fortunate enough to be categorized outside of the disability label, the so-called able-bodied. This problem of titanic proportions, targeted for solutions by people not directly affected by the problem, accounts, for example, for why the problem of physical loss is viewed only as a physical problem. Far greater progress would be made if everyone, disabled and non-disabled, viewed the problem as a physical and a psychosocial problem.

The Rehabilitation Act of 1973, for instance, authorizes the Federal government to provide funding to states for vocational rehabilitation services for disabled Americans so that these folks can get jobs that are compatible to the conditions of their disability. Despite billions of dollars paid out, the program has essentially failed. It's possible that the program is improving, but has a long, long way to go. I was asked directly by a University of Utah professor in the rehabilitation educational program at the doctoral level at a Washington, DC conference, in front of twenty other
doctoral level professors, why I thought the Federal Vocational Rehabilitation program was, to use his words, "failing." I knew instantly what he was referring to. Despite looser and far too flexible the criteria standards of successful rehab, the ratio of people who have been "successfully" rehabbed to the number of initial applicants is somewhere in the ballpark of one or two out of ten. Without missing a beat, I responded to the Utah professor that the evidence is clear. That to me, reason for the failure (or what the non-disabled bureaucrats see as "growing success") is pretty simple. There has been way too much neglect of the emotional impact of the physical disabled, or those with chronic illness. One professor from Boston University said coolly that I was fifteen years ahead of the time. That was ten years ago. I'd better roll up my sleeves.

There's a cluster of reasons for this, of course. Looking at it from a "supply and demand" marketing perspective. The mental health profession has long been disinterested in the mental health needs of the disabled. Why? I think the biggest reason is their own fear of people with disabilities. Focus on disability could arouse long dormant feelings of their own mortality and limits. They will, perhaps smugly, report that there isn't enough business with these poor folks to warrant the investment. In fact, one student of mine reported that her clinical supervisor warned her against working with "those people," since, as she reported, "it's far too depressing working with those people." Despite the fact that many administrators will cite concrete barriers to quality counseling services, including inadequate funding, inaccessible architecture, lack of disability-appropriate transportation and the like, I believe, (in fact would be willing to bet all the money I make from this book) that the real reasons are attitudes.

It goes the other way around as well. Many disabled people don't want to see a shrink. They're already dealing with one stigma, never mind being crazy as well. Too bad these people don't understand that it's even crazier not to be at least a little crazy after something as devastating as losing your sight, for instance. There are also many overprotective parents who are all too eager to fix up their children's problems resulting from the loss. If these parents, who are likely emotionally tortured themselves, suggest a head-bender, heaven forbid, that will only be a true blue sign of their own failure.

But the real culprit is what I like to call (to sound a little fancy in the hope that some people will listen to me, especially since I don't wear MD after my name) social co-dependency. This simply refers to the encouragement by the majority of society to be unproductive and idle; it's OK to sit at home and do nothing. I mean, for crying out loud, the guy is blind, what do you expect? Then if the blind guy does anything even remotely described as something regular, you get one of those "isn't that amazing" lines where you're supposed to get goose bumps all over
your body right down to the pinkie toenail. Despite these good intentions, I usually react to one of those by suppressing a slight urge to throw up.

Yet, despite my personal letters and visits to US Senators in Washington, as well as other influential legislative leaders, little attention has been heeded to my facts of rehabilitative life. Yes, despite meetings with influential US Senators including Senators Pell, Chafee, Kennedy, Weiker and Harkin, as well as a visit with the US Senate Committee on Handicaps administrator, Len Silverstein, not much happened despite enthusiastic replies. I also testified before the National Institute on Disability Rehabilitation and Research on November 27, 1990. Not much happened there, either. I am not sure what I even expected, but what was especially disturbing was my inability to get a constituency for these obvious needs. I did get a lot of rhetoric that undoubtedly would have impressed Billy Graham.

Again, too many of the disabled are defensive, and too many of the "others" are disinterested. Too bad. The taxpayers are just dumping billions down the drain of uselessness. This inexcusable and sad fact of waste is comparable, for example, to the Department of Defense's spending billions on a nuclear submarine that they know is totally obsolete, but do it anyway to appease the voting constituency, and in turn, to keep their own jobs. I repeat, the simple reason for the failure is that there has been severely insufficient attention to the psychological and social needs of the disabled. For the most part, only the physical needs of the physically disabled or chronically ill is paid attention to.

What makes this lack of judgment really interesting is that the "bible" of diagnosis for emotional disorders, The Diagnostic and Statistical Manual, states a loss of physical functioning as an example of an extreme psychosocial stressor. What does it feel like to lose your sight? Or your ability to see? Or hear? Can a person not having experienced a loss of this type and magnitude really know what it is like to cope? I doubt it, otherwise, there would be far more attentiveness by the 'compassionate' one-uppers, the able-bodied, to these issues in rehabilitation programs and services. This attentiveness to the wrong thing by the wrong "able-bodied" people accounts for the largely ineffective rehabilitation system rooted in the cold, scientific medical model, in both North America and abroad. The
assumption remains that the restorative psychological needs of the psychologically disabled is to be addressed, while the physical needs of the physically disabled are the predominant, if not exclusive, issues addressed in current systems of global rehabilitation.

In Rhode Island, this is still the case, despite the fact that a survey revealed that lack of self-confidence was the greatest barrier to independent living. The only reason the question was on the survey to begin with was my successful fight for that question at the eleventh hour. This accounts for the sad and surprising fact that it wasn't until the incredibly recent year 1990 that a person, I, developed the nation's first program to provide professional psychosocial counseling to disabled people on a community-based level. Just as incredibly, it explains, for the most part, why my former consultant, in a literary marketing review, discovered that few, if any, books on the subject I am about to present to you have ever been done. In her search, she couldn't find one book on the subject at the local Waldenbooks, one of the world's largest retail distributors of books in print.

In my case, as much as I loathe my inability to see and, for the most part, hear, I welcome the strengths and resources I have acquired because of these limitations. I am quite certain that these strengths would not have developed without these limits. This is not to romanticize my physical disabilities but to express a simple statement of reality, in which growth is a series of losses which, when confronted truthfully and courageously, will create new possibilities and dimensions in living. That is what I wish to do with this book; to help you as a reader develop newer and broader dimensions in living by becoming more truthful and courageous in challenging your own personal losses.