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Chapter Three

EXISTENTIAL CONCUSSIONS

SUFFERING IS A PART OF LIFE. WHETHER BROUGHT ON BY the “slings and arrows of outrageous fortune,” as William Shakespeare’s Hamlet ponders, by our own actions or those of others, or by unpredictable natural or man-made disasters, suffering happens.⁹ Humans are resilient and able to tolerate all sorts of suffering. And many do believe, along with Friedrich Nietzsche, that what doesn’t kill us only makes us stronger.

Many of the classics in Western literature are tales of meaningful suffering. We devour these stories because we love how people are able not only to make sense of their suffering but also transform it so that it serves a higher purpose. A perfect example is Sydney Carton in Charles Dickens’s classic, A Tale of Two Cities. Set in France at the time of the French Revolution, Sydney Carton is an unexceptional, possibly alcoholic, young attorney who lacks any confidence or purpose in his life. Carton does bear an uncanny resemblance to a French aristocrat, Charles Darnay, who has been sentenced to death at the guillotine. Carton loves Darnay’s wife, Lucie. Out of this love, Carton tricks Darnay and trades places with him so that he may be executed. It isn’t until he sacrifices himself for love that he finds meaning and peace. His last words are some of the most famous in English literature. He says, “It is a far, far better thing that I do, than I have ever done; it is a far, far better rest I go to than I have ever known.”¹⁰

As noble as it may be to make huge sacrifices for others or to dedicate one’s life to a higher calling or purpose, there are times when it is simply not possible. Life presents many instances when a person cannot make sense of her suffering. This is the kind of suffering Nietzsche identifies as intolerable and life destroying. In the throes of this sort of suffering, a person experiences an existential concussion.

A concussion is a brain injury that results from a blow to the head or violent shaking. The brain is either shaken or moves back and forth within the skull. A concussion alters the brain’s function for a period of time that is directly related to the severity of the concussion. By analogy, an existential concussion is caused by a sharp blow or a violent shaking of a person’s life conditions—such as a sudden death, traumatic injury, or end of a long-term relationship. An existential concussion is both a cause and a consequence of acute suffering that is characterized by a lack of meaning.

These concussions have degrees of severity and some combination of the following manifestations is common: compromised decision-making ability; significant impairment in perspective such that one is not able to inhabit alternate viewpoints; disorientation in the world such that one does not know who one is, where one belongs, or how one fits in the world; difficulty in transforming one’s suffering into something meaningful; despair that one has no freedoms and no possibilities; absence of meaning and value in one’s own life that expands to nihilism about there being any meaning and value in the world; and loss or destruction of the primary framework in which a person orients her life.

Existential concussions can occur in a variety of ways, but all of them involve a separation from the primary framework that has provided a person with adequate conditions for making sense of all her experiences, including suffering. Consider a person of faith who suffers a series of tragedies. She may wonder if she has done something to deserve this. She might also start to wonder about a God she’s always understood to be loving and kind allowing such suffering. Or, even more upsetting to her, she may wonder how God could inflict such suffering.

Her faith had been the axis around which her life revolved to explain both good fortune and loss. Having that axis tilt might cause a mild to moderate concussion. Having that axis ripped out suddenly would cause a severe existential concussion. Knock out the axis and everything it held in place will fall. When this occurs, the framework of her faith no longer provides viable conditions for making sense of what has happened. Nothing in her faith provides an explanation or amelioration, and so the sufferer may reject all or part of the framework. She may reject it in defiance with a mighty scream, or she may reject it with a quiet whimper. If enough time passes, the person who has lost her faith may become incomprehensible to herself and to those with whom she shared a faith. She is alienated from herself and others, which only exacerbates the effects of an existential concussion. This alienation may fuel behavior that becomes addictive.

Addictions are themselves causes and consequences of existential concussions. As an addiction progresses, a person often begins to trade away—even in small amounts—some of the commitments and principles that have been crucial to his sense of self. The addict may slowly start to do things he promised he would never do. He may start to lower his standards for his own “acceptable behavior.” Trade away too many of these commitments and a person may no longer recognize himself. He may look in the mirror and see a stranger. This disorientation may become full-blown alienation, which in turn may fuel addictive behaviors that further fuel alienation.

The addiction/existential concussion of one person may also contribute to the existential concussion of others. Many existential concussions involve what psychologist Pauline Boss calls “ambiguous loss.”¹¹ Boss offers two categories of ambiguous loss. The first is when a person is physically absent but psychologically present, such as a soldier missing in action and presumed dead or a child who has been kidnapped. An active addict who abandons his family may also fall into this category. He’s both there and not there, which affects the family dynamic in uncountable ways. Hoping and wishing for someone’s return or remaining furious about someone’s abandonment may become an axis around which other concerns of the family revolve.

The second type of ambiguous loss is when a person is physically present but psychologically absent, such as a person with dementia or someone suffering from significant mental illness. An active addict parent who attends primarily to his use may fall into this category. He’s both there and not there. His presence and his moods define the dynamics of his family. Everyone in the family may try to act in ways that do not draw his attention or upset him in any way. Walking on eggshells becomes the family pattern.

Ambiguous losses do not fit easily into our patterns of grief and loss. A person is either present or absent, alive or dead. One is either single, married/partnered, divorced, or widowed. Dichotomous categories are always the most rigid. Each time a person hits the rigid limits of these categories or careens back and forth between them, she may become a little more disoriented and full of more despair. Disorientation and despair cause more careening and a vicious cycle begins.

Consider the varying ways that different illnesses and the suffering of individuals and their families are regarded. In a poignant article, “Food Comfort,” Larry M. Lake describes a “tsunami of food offerings [as] an edible symbol of our community’s abundant generosity,” when his wife is diagnosed with breast cancer.¹² The outpouring of concern took many forms—rides to appointments, notes and cards, and telephone calls. As crass as it sounds, his wife had the “right” sort of illness, one that people acknowledge. The family’s suffering was recognized and shared, which contributes to it being meaningful.

There is no such acknowledgment ten years later when Lake’s daughter is admitted to a psychiatric hospital with bipolar disorder following years of alcohol and drug abuse. Clearly his daughter is ill, but it isn’t the sort of illness that elicits a community’s acknowledgment. No one brings you dinner when your daughter is an addict.

A person can also experience ambiguous loss of her own person. This can be one of the most profound forms of alienation. Consider the ways that a person often recognizes—even at the same time as she denies—how she is losing parts of herself to her addiction. Commitments, values, activities, and dreams that once made her feel alive, valuable, connected, and like she was contributing to the world, start to fall by the wayside. She is still physically present, but pieces of her are now missing.

When she is no longer capable of caring for her person or has no interest in doing so, she is psychologically absent in significant ways. Addiction causes a person to lose parts of herself when she loses important relationships that have become fundamentally fused into her identity and her self-understanding. She may no longer be someone’s partner. She is no longer the best friend. She is no longer the parent who is actively engaged in her child’s life. Without these relationships that have been so life affirming, she is not able to care for her person. This is ambiguous loss.

The ambiguous loss of a person to herself does not fit neatly into our more usual and recognized categories of loss. People whose experiences of loss fall into the cracks and fissures of frameworks keep hitting jagged edges. No wonder they are concussed and find themselves on a precipice.

Are there ways to prevent existential concussions? Not even the best-padded helmet is sufficient to prevent all concussions. But we can effect changes in the conditions that contribute to existential concussions and make them less likely and less severe. One way to do this is to continue to expand our understanding and acknowledgment of types of suffering, especially those that relate to ambiguous loss. We can also work against the stigmatization of groups of people, which has happened with many types of addiction.

Recovery from addiction involves making or finding meaning that begins to orient a person in her life and the broader world. Some people will do well in a program that provides an easily recognizable framework, such as a twelve-step fellowship. Some desire different frameworks that make no reference to powerlessness or a higher power; they may incline to something more secular. Yet others will want a more explicitly faith-based model or a more therapeutic model. Some will eschew ready-made frameworks in favor of ones that are more of their own construction.

Regardless of the particular framework, people begin to orient their actions and their lives around recovery. Recovery becomes an axis around which life can turn. Recovery is a passionate commitment to living a life of self-care, self-examination, and respectful connection to others.