התמודדות עם מתח וסבל - ד''ר דוד פלקוביץ - עם כתוביות בעברית HD

this topic is a topic that can go in different directions I'm going to take it in the direction though of talking about the lessons I learned about loss in the last 35 years or so of work in the field of trauma and loss my specialty in terms of my secular research area my clinical area has been working with populations that have experienced different kinds of chronic stress be it families of children with cancer be it in Sri Lanka after the tsunami or in Israel at the height of the most recent intifada or most intensively in New York in the years after the 911 attacks and what's interesting

is in my work with people who have gone through various kinds of intense suffering and loss I've learned from them they've taught me three or four core points that we could bring into our everyday life so many of the people in this audience have gone through your own loss your own tragedies your own chronic stress is it's almost impossible to live life without it it says at the beginning of one of the classic mooser works that the purpose of life is la mode benicio knows it's to be able to withstand living with the inevitable trials and tribulations of life I'm going to talk a little bit

about the collected wisdom that I learned from people who have taught me about the following areas i'm going to start by first talking about naming the monster the need to talk the question often comes are we better off not talking about certain things so you're better off putting things behind you is the better off to just sort of say okay I've experienced this tragedy if I have to move on to the next space of my life and I want to share with you first a Jewish thought and then some of my clinical experiences there's a brilliant Jewish thought in a very cryptic passage in the Torah

describing God's footstool and here's what it says it describes God's foot still who even knows what this means that whatever mystical levels and it says that it was kamasan live nice ass up here sapphire the footstool was sapphire and embedded in the sapphire was brick and I rabbis teach us the brick was a reminder of our suffering and slavery was a reminder of suffering whatever that means surabhi rook Amla buffets and pre Holocaust Europe says the following he asked an obvious question my in Yad she bowed la caja gula which means that is so strange she says why whatever the meaning is of

this brick in the Sapphire footstool is why the need to remember suffering after times are good Egypt was a long time ago we were freed a long time ago why the need for that and he answers in his typical brilliant psychological way with his insights it's that we always have to even when times are good in bed in our lives the lessons of the brick to live alongside the lessons of the light I get this question all the time family god forbid loses a child to some kind of illness and they subsequently have a number of other children they ask me should I tell my children now that they once had a

brother or sister why have them have that insecurity I've often worked with people who let's say have a child who had cancer at age two had active treatment for it has no memory for it whatsoever and added Shaw was totally healthy and they asked do I ever tell the child that one time he had cancer as she had cancer it's an incredibly valid question wherever I live of it says and what I want to argue is that what we're talking about this afternoon is actually a very important issue in life and that's that life has an ebb and flow we have good times and we have tough times that's the nature of

life but when the Sapphire and the light comes into our life we have to integrate into it the lessons of our past you have to let it Sean oh yeah it's true you once had a serious illness when they're old enough for it and it's a case-by-case situation to let them know k because this may have meaning in your life later on even though you don't remember it or you had a younger brother or sister or yes to remember I once had a brush with death and now thank God things are good but what did I learn from that because we very quickly go back into the new normal and may forget the lessons of the

past there's a magnificent statement that is brought down in the meddra sh2 hilum it's one of my favorites statements in the Hebrew language in terms of the wisdom of this point says that when we're looking on the tough times in our life we have to remember the following iluu nuh faulty low compte if I never fell down I never would have gotten up iluu yo shaft e by OSHA lohiya Arlie if I never sat in the darkness I wouldn't have experienced the light so it's the brick in our life the darkness in our life that often in for worm the light that often inform our sense of gratitude as we heard

last night in the presentation by the rebbetzin that's the key point I want to make here in terms of that first point now related to it is a little vignettes I have a colleague who I've been privileged to work with for a number of years who's considered one of the world's leading experts on post-traumatic stress disorder think he's been here in South Africa's been all over the world but he's boston-based he was at Harvard now Boston University of psychiatrists name is dr. Bessel vanderkolk we were once working on a paper together and he shows me an fMRI picture of the brain of one of his

patients when he was reliving the worst moment of his life this was the man who was caught in the stairwell of the World Trade Center on 911 and barely got away with his life horrifying experience life-threatening experience and he actually is part of trying to understand this person veteran trying to understand trauma better he had him in an fMRI take a picture of what does the brain look like when you're having a flashback to the worst moment of your life and he showed it to me and was amazing because you know what your brain looks like when you're having the worst moments of your life

Broca's area is shut down language centers of the brain are shut down you're literally rendered speechless I rabbis tell us that when Aaron heard that his two sons died suddenly the word used is by ye dome ah her own by ye dome is an interesting word it's a Hebrew word for silence but it's a different kind of silence the Barban l asks why doesn't it say by ish code are on the usual word for silence to check it be quiet ye dome and he answers because sheket is for when you know a response in your head but you choose not to share it the meme us as opposed to check it is where you literally or

rendered speechless that's what i was looking at when i looked at it the first words that i thought was this is Demi moats and then this is where it gets practical with dr van der kolk showed me over a period of subsequent months that as he gave this man words for his pain as he helped him name the monster as he lit up Broca's area the man got better the man integrated the lesson of the brick into the sapphire and he improved it's amazing I'm not saying it could happen right away for many of you may going through particularly devastating tragedies in your life it may take longer or maybe a

lifetime of struggling to have that integration but ultimately naming the monster in some way he doesn't have to be with words necessarily could be with meaning or whatever meaning you find I'm going to get to that in the next point I want to talk about but that is ultimately the answer just really briefly I wanted to tell you that there's a Jewish concept a rabbi Carla who was a well-known rabbi in Jerusalem in the early 1900's i work with his grandson yeshiva university in his haggadah he wrote in the early 1900's that slavery kind of slavery that we deal with on Passover takes away our

Khawaja deburr it takes away our power of speech slaves have no power of speech they aren't given the freedom in this space to name the monster and to talk about things he says when we celebrate the Seder on Seder night what's a cold maaga because that's our answer to suffering we sit around as our family we sit around together around the table and light up rochas areas the people light up the language centers he says magat which is what the Seder is about is our answer to having our freedom taken away from us all those years ago so that's part one part one is we have to integrate the tough

things that happen to us even in good times because there are tremendous lessons to learn from it and on top of that it's often helpful to figure out a way to approach it either with words or with other ways and that brings me to tip our two part two which is I think the most important point I want to share with you today is the variety of coping mechanisms that people have we all know the men and women for example often have different coping mechanisms about eighty percent of women when they go through a tough time they're often consoled by talking things out eighty percent of men aren't

necessarily going to be verbal about what happened they may prefer to go into the problem-solving mode so the very thing that helps women is often the very thing that makes men actually sick okay and the key is in any family there's often a variety of coping mechanism so I want to share with you a story and then make some recommendations it's a story that I learned a tremendous amount from I was invited to go to Israel at the height of the Second Intifada this is in 2002 I believe I was going there to do a lot of lecturing its various trauma therapists they knew much more about the topic than

I did but you can't think clearly for yourself even when you're an expert there's a brilliant saying in the Talmud ain't kovash matter as mommy basu room you can't free yourself from your own prison and these brilliant experts in trauma we're inviting me as an outsider to come to just hang out with them and talk and think things out because they needed somebody who was living in the relative safety of New York so one afternoon i was in the Jerusalem trauma center giving a talk to a group of 30 or 40 therapists and call comes in to the director of the clinic that there was just the bombing at

the hebrew university cafeteria the Frank Sinatra cafeteria there if I remember correctly nine people were killed and immediately we all know how tightly interconnected Israeli society is the phone starts ringing off the hook nine people that means who knows how many hundreds of connections and psychiatric emergencies they needed to be cared for right away and immediately all the therapists I was speaking to cleared out of the room of course and after everybody left dr. Braam gets the call from the director of a camp of summer camp in the middle of Israel and the word was the one of their

counselors one of their modhri coats had been killed in the bombing and dr. Braam comes at me he says look I'm at a therapist do you mind going there tell the kids that their beloved counselor was killed and spend the day with them the associate director of the center was still there and the two of us got in her car we go to the middle of the country we go into the camp fully expecting to be in charge we both done these kind of interventions many times before that's never easy but it's often helpful that doesn't happen in Israel no Israeli he's gonna certainly let an American tell them what

to do director of the camp immediately put me in a corner put my colleague in a corner and he got up and what he said next has really changed in many ways the way I view trauma and in subsequent research it's been proven to be a hundred percent true always listen to a smart Israeli here's what he said he tell the kids about the horrible tragedy he said I have five coping rooms one room you could go he tells these teenagers go into the room and write letters to the parents of your mad reef about what a wonderful woman she was another room is a music room go and express yourselves musically

they have musical instruments you can express yourselves that way another room was an art room express yourselves artistically another room was a prayer room and another room was the talking room and the kids were told they could go from room to room throughout the day but what was amazing to me is the kids divided themselves exactly equally between four of the five rooms none of them picked one of the rooms you want to guess what Truman was almost everybody says talking but it was actually the prayer room nobody picked prayer which is entitled another talk spirituality and adolescence just

an area that I've done I've been doing a lot of research in lately but that's another fascinating area but none of the kids shows the prayer room but a quarter of the kids spent the afternoon with us and we spoke for hours and hours about other losses they had and the writing kids wrote and the music is the music and the art kids that art what happened was the following week I go back to New York and I was very taken by this experience with the five coping rooms and I was giving a talk if I remember correctly was the the first anniversary of 911 as asked to give a talk in New York to a

community group and I told them the story of the five coping rooms because I thought it was a very important story and a woman comes over to me after the talk and she tells me the following unbelievable story she said that her father was a vision it's uhuh sidh who was in the concentration camps with elie wiesel she says it had been years probably about 60 years since her father had seen Elie Wiesel but Elie Wiesel had given Nobel laureate who writes about his in the concentration camps he was getting a lecture in Manhattan the week before I gave this talk and her father said I don't know if

professor Wiesel will remember me but just tell him my name maybe he'll remember me so she waits on line after the talk and she goes over to Elie Wiesel she says you know my father's name is such-and-such you may remember him he says that he shared a bunk with you in the concentration camp and immediately mr. Wiesel his eyes tear up and he says do I remember him he saved my life he never told you that anything I've accomplished is because of your father I'm here because of him and he says the following unbelievable story he said there was a day that was beyond endurance like all days are I

imagined in a concentration camp but it was really getting to them they were being frozen they were starved they were being tortured they'd already lost the immediate family members who could even imagine what that was like and a group of Russian prisoners of war got a hold of some rat poison and they decided that they're going to end their lives they wait on line each one patiently taking the dose of poison elie wiesel said you know I was a teenager what do I know I figured they're gonna kill me anyway and I figured I was gonna make that last day of my life and I go on line behind the

Russians all of us had every adolescent in that section of the camp went on line behind the Russians fully intending to end our lives that day everybody except your father the huset he said your father retained his faith even in that horrible place and he goes off to the side of the line and he breaks in to this ancient vision of sin egen this ancient Hasidic tomb for an imam in bamboo nosh lame of a vsi machine I believe with total faith in ultimate redemption professor ezel says the song broke our suicidal spell one by one we left the line one by one we surrounded your father and joins him

in singing Danny mom and none of us took our lives that day and I'm here because of your father go home and remind him of what he did for me that's the power of coping sometimes it's music sometimes it's writing sometimes it's talking sometimes it's taking it and instead of words it's doing facet acts of kindness for others and often it changes when we work with traumatized children based on what I learned in that we will actually show them an obsessing film clip and have them read how upset they are for about 10 minutes we then have a table filled with 13 different coping mechanisms perfumes

comic books for them to distract themselves we have aromatherapy and lotion therapies and you name it we have music on ipods and we have the kids go and they pick what works for them and over the course of time they develop their own toolbox of coping mechanisms this doesn't have to be extreme trauma could be the regular stress in your life what works for you what works for those who are close to you and don't get judgmental and think just because something works for you is going to work for your husband your son your daughter your father your mother your best friend doesn't work that way you

have to accept it tell you a story okay I know this gets a little heavy but somewhat lighter story I think I said this to a group of therapists earlier this week last week on Friday I was at a retreat for families of children with cancer it was the first one this organization had my lifeline had everybody was very nervous about whether it would work and I getting up to start the program and to break open what the program was about which was talking about everybody having in common is seriously ill child and I standing at a lectern like this and I'm about to start the talks was just about 20

years ago and before I could open my mouth a couple comes marching down the center of aisle and the man starts screaming at me I didn't even open my mouth he says you had my body here my mind's gonna be a million miles away i'm not going to listen to a word you have to say and he rushes back to his seat so i running after him i say help me understand what just happened you know I I didn't say anything he said look he says my son was diagnosed with leukemia um about a year ago he said I'm a physician he's a physician he said I spent last year doing what comes most naturally to me I went and I

found the best possible treatments for my son I traveled around the world to see for this kind of leukemia what's the best treatment he says now we finally have a weekend that is for me a week and I've been looking forward to for a long time it's in a beautiful resort hotel there are counselors for all my children their doctors for my six son I could finally relax and my wife is making me go listen to you and she's in the side whispering to me make him stay make him stay so I tell them look I say go to go to your room it's fine and he runs away I never saw anybody get away so fast for me okay

he runs away I don't see him the rest of the weekend his wife sits in the last row last seat for the whole weekend shooting murderous glances of rage at me okay not a pleasant experience otherwise the weekend went fine six years later there's a Friday night program that is for families of children at risk and it's Friday night and I was asked to give one of the talks on Friday nights and again I'm getting up behind the lectern and the same couple comes marching down the center aisle he sees I have post-traumatic stress disorder to this I'm like ducking behind the lectern and he says so

worried I have good news for you he says my son who was sick is cancer-free the doctors say they think it's secure I have to bring him in for a checkup once a year but he's fine said but my older daughter who was always fine realized it's her turn now it's safe so she started to become a real behavior problem so we decided to come to this weekend retreat he said it's gonna be very different than last time because he said the strangest thing happened over the last six years based on that weekend six years ago my wife realized I need to go into my cave I need to do my problem solving thing and

she accepted that and I realized she loves this shrinky stuff she loves talking about things she was talking about emotions and I respected that he said the strangest thing happened as I accepted her coping stones she accepted mine we met halfway and he sat in the front seat for all the lectures given that weekend people change but the key is to deal with alternative coping styles from a position of strength next point the next point has to do we the power of connection the power of connection you know here's one of my favorite studies they take people and they put them at the bottom of the

hill say thank you as an individual they put you on the bottom of a mountain and they say estimate the steepness of this mountain study shows the following if you're alone you see the hill is very steep if you have somebody at your side the hill looks less steep the closer you are to the person at your side the less steep the hill looks and less tired you get walking up the hill that's a metaphor for the power of connection reflected in this room and reflected in general in terms of dealing with the stresses in life study came out last couple of years from the field of positive psychology and

it was an interesting thing they found if you had one question to ask somebody going through a tough time that would predict their resilience the best just one question you want to know what that question is do you have one person in your life who you could wake up at three o'clock in the morning if you were really troubled about something if the answer is yes you're it predicts resilience when I first read that study I did something terrible to my poor wife three o'clock that morning I wake her up and I say Loni Loni get up get up she says what does everything okay I said well is it okay if

I talk to you about something and she says yeah sure I said fine go to sleep ok so it's so like I needed to know so um if we're blessed with that it's wonderful and if we're not that's fine that's fine the question is is there a way to recruit if not that one person is there a way somehow to figure out is there some way to foster that sense of connection in in in some in some way okay and it doesn't only have to come in form of a three o'clock in the morning partner okay final point is cognitive so so far I didn't talk really about how the way we think about loss can really make a difference

the Baal Shem Tov would say but Malcolm Chamakh Shaftoe shall Adams shamoon emsa huish the place where a person's thoughts are that's where the real essence of the person is want to share with you a couple of thoughts about it but I'm going to keep it keep it short there's a beautiful thought I heard from rabbi howre in Baltimore at a talk that he gave to one of these retreat weekends to a group of parents whose kids were going through a tough time what was amazing about this I never heard of a talk that more powerfully helped people out and it was with only one switch of words it's amazing

what parsing out language could do to people's perception of things and it's going to seem you're gonna almost be disappointed when I tell you what it is but it's an amazingly powerful way of thinking about our tough times in life I've used it and I find it very helpful he told the parents the following image he says I want you to put yourself to the day of a que desee it's luck it's one of the course stories in our national history and we know that something very famous and well-known preordained at the beginning of time at the dawn of time happened that day that in place of Isaac being

sacrifice there was an aisle Aram sort of walking around innocently that day this Ram we're told was created at the dawn of time and it gets stuck in the thicket so that Abraham is able to take it ace of his son whatever that story means it's a profoundly interesting story and biblical example to look at in a lot of ways but here's what rabbi howre said he said there are two ways of looking at that Ram one is you could look at the ram as being stuck right it's not true in life sometimes we just feel stuck we feel like a log on the river floating at the mercy of the currents okay he says

here's another way that we could think of that ram or that ram if we could get into its head could think of itself you change the word from stuck two positions think about it that's the key you could either see yourself as stuck or is positioned if you're positioned and you see that as your destiny especially for things you have no control over it's a game changer rabbi soloveitchik at why you among others would talk about in Jewish thought ye'd versus go roll which is basically in life you could either see the tough times in life as go roles chance this is the bad luck of life and I'm a

passive agent helpless in the face of the stresses or you could see it as yield this is my destiny and I'm going to grow from this destiny and he loo your shop t bioshock la jolla or leave i didn't sit in darkness I never would have appreciated light so that is the cognitive approach in terms of how we view the tough times that happen to us I'm not saying that you have to accept things I'm saying it's something a little bit different you view it as an agent of change you approach it as the Talmud tells us as a myriad of our of something bad happens to you frustration famas so if you do an

eternal self examination and try to find meaning out of it because all the research shows when we find meaning out of what's happening to us in the tough times in our life it's a game changer when you go from passive to active it's a game changer there there are dozens and dozens of studies that show that and before i go to my final final part here i just want to share with you the following the following thoughts from greg mathis Joe Solomon and I shared a panel in Brooklyn the day after 911 and he said the following thoughts to people many of whom were in the thick of things that that

horrible Tuesday 10 years ago he said you know he said it says in the Torah that when Jews are in trouble were compared to an eagle kanesh aryahi no I'll go solo of your faith we're compared to an eagle hovering over her young he says why of all the animals in the animal kingdom why an eagle he says because you know why since because an eagle unlike any other animal other animals of let's say a baby bird is that or is in danger the mother swoops down saves the baby and the baby's in a passive position the eagle because she flies higher than any other living thing she hovers around the nest

and the baby eagle has to hop on her back taking an active role in its salvation and that's why the Torah tells us we have to be that way connectshare yahi know we have to be that leap that that like that Eagle going from passive to active from viewing it as go roll to yield changing it from stuck to positioned and I think I'll end instead of with this story I have so many things I could say about this but I'll end with a parable famous parable that is set over by the dubna mogget and it's again about the tough time in our lives and had a view it and going back to what I started with in terms

of the sapphire and the brick and the integration of the good and the bad through the market has the following story story about a king that has a jewel in the middle of his crown that's the biggest diamond in the world massive diamond bigger than the hope diamonds and the king is an insecure King he gets in ordine and a man of feelings of power from having the biggest and the best in the land one morning he wakes up first thing he does it goes to his nightstand wants to put the crown on and he's totally spooked cuz there's a flaw down the center of the diamond not a good omen he thinks what

does this mean for his future he's panicked and he puts out a call to the kingdom that anybody who can fix this flaw he will make wealthier beyond his wildest dreams jewelers come from all over the world to take a crack at the Kings diamond but you can't you can't fix the flaw in a diamond a flaunted diamond is a flaw in a diamond sect one little old Jew you have to have a little old Jew as a hero of this story right from the guvnah Magan little old Jew comes into the palace he takes the diamonds and he engraves magnificent leaves around the flaw that now become the trunk of the tree that's

at the center of the diamond that makes the diamond even more beautiful than it was before can't get rid of the flaw bad stuff happens bad stuff happens and we we feel the pain and we struggle with the meaning of it and we try to find the new normal and we try to regain our footing and we try to support each other but ultimately what I find over and over and over again is that even though you can't get rid of the flaw you could change the floor into a magnificent tree that makes the meaning and depth of our I even more meaningful and more beautiful and let me take time for questions we have

we have either questions so we have quite quite either questions or more stories whatever you're in the mood for let's have a vote it's okay okay it's just a little concern you want me finish in in about 10 minutes fine okay I'm gonna what I want to just share with you a story about this theme in terms of reordered priorities because it's something if I have to think about one thing I learned most from the various people I worked with who have gone through tough times it's this sense of reordered priorities and the growth that comes in some ways and again nobody would want it nobody would ask

for it but let me share with you something I learned from a study I did a number of years ago I had a grant together with some colleagues to look at the impact of having a child with the serious chronic illness was a multinational grant and I designed the whole packet of psychological measures and we had research assistants fan across the United States to give these measures mostly the mothers of children with life-threatening illness I was pretty proud of myself it was pretty early in my career and almost immediately I start getting angry phone calls from all the research assistants yelling

at me saying David we can't go on with this study people are furious at us so I said why they said because everybody's saying the same thing you didn't ask a single question about what positive came from the experience I said well how could I do that seemed so arrogant they said look we're just the messenger you figure out what to do so I added questions about that of course it became the most valuable part of the study and here's what one of the women wrote in response to that question she said her son was diagnosed with the form of cancer she said before the diagnosis the most important

thing in her life was to perfect her tennis swing and when her son was on active treatment there was a stormy night and her husband was spending the night in the hospital with her son it was about seven o'clock in the morning she was about to go to the hospital to spell her husband and spend the day with her son and her doorbell rings mr. next door neighbor there was a storm the night before as I said and a tree in between their two houses fell on her car and totally destroyed her car her neighbors car neighbors inconsolable she comes into this woman's kitchen she's crying hysterically and

this mother helps her out she calls the insurance agent she gives her a lift to work and as this woman who lost her car's going into her office this woman says I started to laugh to myself because I thought to myself I would have had the same reaction a year ago but what of the wind was blowing in the other direction and the tree fell on my car instead you know what I would have done I would have said oh I guess I better call taxi I guess I better get a lift to work and I would've go on to work because I know what's important in life I would have gone to the hospital to spell my husband's

support to my life is to give my husband a break it's to spend the day with my son who cares about things she says that's how my life's changed and I'll end with a somewhat more positive light note and with this I'm truly gonna end I'm within my time I think it should be just about right I shared this story earlier this week with some therapists and even though it's a baseball story I South Africa nice tits a little bit to explain a little bit about the basics of baseball there's a baseball field in boston new york i heard this story from a trauma expert in boston because a baseball field

very famous it's called fenway park it's where the Boston Red Sox play it's a legendary feel they usually lose and there's um an off day at the park and the groundskeeper takes his little ten-year-old son with him to work and his son is on the field playing you know pitching the ball to himself so right in baseball we got three strikes you're out but he was self pitching you know and the only other person in the park is an 80 year old man high up in the bleachers in the stands chewing on his cigar and the boy is at the field enjoying being in this famous place and enjoying being at work with

his father and he calls out to the empty field I'm the greatest baseball player who ever lived picks the ball up swings and misses strike one it's not daunted picks the ball up again says I'm the greatest baseball player ever lived picks the ball up swings and misses strike two he does it 20 times in a row he only got three strikes 20 times in a row totally not being phased by the fact that he just missed the ball 20 times in a row in the old man can't take it anymore he takes the cigar out of his mouth he says sunny stop it I have to talk to you and he makes his way down the stands and he

says to the boy look I admired your confidence but let's face it you have to be realistic in life you're saying you're the baddest best baseball player who ever lived and you just missed the ball 20 times in a row and the boy looked at him proudly and he says yes sir he says but have you ever seen such incredible pitching that's that's often the challenge often the challenge in terms of coping with stress and loss so you have to figure out the way to focus on the pitching has forgot a to focus on the tree around the floor and to transform the lessons of the brick into the light thank you all English lectures are available online at either group com you