We Are What We Do

Editor’s Note:  Dr. Livingston was born in Memphis, Tennessee and raised in upstate New York. He attended the U.S. Military Academy and upon graduation as an infantry officr and trained as a parachutist and an Army Ranger. He served for two years in the 82nd Airborne Division before atending medical school at Johns Hopkins from which he graduated in 1967. He interned at Walter Reed General Hospital before volunteering for Vietnam where he served as the Regimental Surgeon for the 11th Armored Cavalry Regiment. He was awarded the Bronze Star for valor. While in Vietnam he registered a public protest against the war and subsequently left the army.

He trained in adult and child psychiatry at Johns Hopkins. He is a parent twice bereaved and his first book, Only Spring, described the death from leukemia of his six year old son. He is the author of the recent bestseller, Too Soon Old, Too Late Smart, which is now in its sixth printing. He has been published in a variety of magazines and newspapers including The Readers Digest, the San Francisco Examiner, the Washington Post and the Baltimore Sun. He is the father of four grown children andlives with his wife Claire in Columbia, MD where he continues to practice psychiatry.
People often come to me asking for medication. They are tired of their sad mood, fatigue, and loss of interest in things that previously gave them pleasure. They are having trouble sleeping or they sleep all the time; their appetites are absent or excessive. They are irritable and their memories are shot. Often they wish they were dead. They have trouble remembering what it is to be happy.

I listen to their stories. Each one is, of course, different, but there are certain recurrent themes: Others in their families have lived similarly discouraged lives. The relationships in which they now find themselves are either full of conflict or “low temperature,” with little passion or intimacy. Their days are routine: unsatisfying jobs, few friends, lots of boredom. They feel cut off from the pleasures enjoyed by others.

Here is what I tell them: The good news is that we have effective treatments for the symptoms of depression; the bad news is that medication will not make you happy. Happiness is not simply the absence of despair. It is an affirmative state in which our lives have both meaning and pleasure.

So medication alone is seldom enough. People also need to look at the way they are living with an eye to change. We are always talking about what we want, what we intend. These are dreams and wishes and are of little value in changing our mood. We are not what we think, or what we say, or how we feel. We are what we do. Conversely, in judging other people we need to pay attention not to what they promise but to how they behave. This simple rule could prevent much of the pain and misunderstanding that infect human relationships. “When all is said and done, more is said than done.” We are drowning in words, many of which turn out to be lies we tell ourselves or others. How many times do we have to feel betrayed and surprised at the disconnect between people’s words and their actions before we learn to pay more attention to the latter than the former? Most of the heartbreak that life contains is a result of ignoring the reality that past behavior is the most reliable predictor of future behavior.

Woody Allen famously said that “Eighty percent of life is showing up.” We demonstrate courage in the numberless small ways in which we meet our obligations or reach out to try new things that might improve our lives. Many of us are afraid of risk and prefer the bland, the predictable, and the repetitive. This explains the overwhelming the overwhelming sense of boredom that is a defining characteristic of our age. The frantic attempts to overcome this ennui take the form of a thirst for entertainment and stimulation that is, in the end, devoid of meaning. It is the answer to the question “Why?” that weighs most heavily upon us. Why are we here? Why do we choose the lives we do? Why bother? The despairing answer is contained in a popular bumper sticker: “Whatever.”

In general we get, not what we deserve, but what we expect. Ask a successful hitter in baseball about what he thinks will happen when he steps to the plate and you will hear something like, “I’m taking that thing downtown!” If you point out that the best hitters in the game make an out two of three times they bat, any good player will say, “Yeah, but this is my time.”

The three components of happiness are something to do, someone to love, and something to look forward to. Think about it. If we have useful work, sustaining relationships, and the promise of pleasure, it is hard to be unhappy. I use the term “work” to encompass any activity, paid or unpaid, that gives us a feeling of personal significance. If we have a compelling avocation that lends to meaning in our lives, that is our work. It is a tribute to the diversity of life that people can find pleasure and meaning in pursing mediocrity on the golf course or at the bridge table. Think about the traffic problems if we all liked the same thing.

Much is made of the presumed difficulty in defining “love.” Because the basis for the feeling itself is mysterious (Why do I love this person and not someone else?), it is assumed that words cannot encompass what it means to love another. How about this definition? We love someone when the importance of his or her needs and desires rises to the level of our own. In the best of cases, of course, our concern for the welfare of another exceeds, or becomes indistinguishable from, what we want for ourselves. An operational question I use to help people determine if they really love someone is, “Would you take a bullet for this person?” This may seem an extreme standard, since few of us are required to confront such a sacrifice and none of us can say with certainty what we would do if our desire for self- preservation collided with our love for another. But just imagining the situation can clarify the nature of our attachments.

The number of people we would consider sacrificing ourselves to save is very limited: our children, certainly; our spouse or other “loved one,” maybe. But if we cannot contemplate this gift, how can we pretend that we love them? More commonly, feelings of love or the lack of it are noticeable in all the mundane ways we show that someone matters to us, especially in the amount and quality of the time we are willing to give them.

The point is that love is demonstrated behaviorally. Once again we define who we are and who and what we care about, not by what we promise, but by what we do. I constantly redirect people’s attention to this. We are a verbal species, much given to the use of words to explain – and deceive. The worst deceptions, of course, are those we practice on ourselves. What we choose to believe is closely related to deeply felt needs—for example, the dream we all carry around inside of us of perfect love, unqualified acceptance of the sort available only from the good mother. This desire makes us vulnerable to the worst forms of self-deception and disillusionment, an indulgence of the hope that we have at last found the person who will endlessly love us exactly as we are.

When, therefore, someone purports to do so and says the words we so long to hear, it is not surprising that we might choose to ignore incongruent behaviors. When I hear someone say, “He does inconsiderate things, but I know he loves me,” I usually ask if it is possible to intentionally hurt someone we love. Would we do such a thing to ourselves? Can we love the truck that runs us over?

The other thing that true love requires of us is the courage to become totally vulnerable to another. The risks are obvious. Who has not had their heart lacerated by a mistake in judging the person to whom we gave this trust? Such wounds are the basis for much of the cynicism about love that pervades our relationships and produces the competitive games that frustrate our efforts to have faith in each other.

Other people alternate between the extremes of loneliness and self-deception. Somewhere in the middle lies our best chance for happiness. Finally, we are entitled to receive only that which we are prepared to give. This is why there is truth to the adage that we all get the marriage partners we deserve, and why most of our dissatisfactions with others reflect limitations in ourselves.