Husband: self-regulate!

by Brian on January 21, 2019

in Cancer,Mindfulness

At Hadassah Hospital in Jerusalem

My long-suffering wife has earned that sobriquet. I was a kvetcher long before my cancer diagnosis, ruminating and over-sharing my concerns. 

But now after 30 years of marriage putting up with my vocalized emotional turmoil, exacerbated by a year with the greatest health challenge of my life, Jody’s had it with the suffering. 

No, we’re not splitting up or anything drastic. But I’ve been read the riot act: “You’ve got to self-regulate, husband.”

Jody’s change in attitude started around the time I went into remission last year. 

I was already worried that sharing my “good news” would lead to a flurry of “congratulations” and “way to go” messages that didn’t address the fact that I’m just in the first part of a long treatment protocol, that I’m far from being side effect free and, as someone with a chronic and incurable cancer, I didn’t deserve any accolades about “beating” the disease. 

What I didn’t realize is how the remission would also affect Jody.

“I’m ready for this cancer to be done,” Jody said one night as I was too fatigued from my most recent immunotherapy session to get up from the couch and walk the dog.

“Yeah, me too,” I replied. 

“Maybe you can, you know, complain a little less about it?” Jody said. “It’s like your fears about the future have created this constant background music. I’m not saying you have to hide where you’re at. I know you feel crappy some times. I just wonder if you could turn down the volume a bit?”

That’s where self-regulation comes in. 

Self-regulation is the ability to keep your emotions in check, explains psychotherapist Andrea Bell on the GoodTherapy website. Someone with strong self-regulation skills “can resist impulsive behaviors that might worsen their situation and they can cheer themselves up when they’re feeling down.”

Put another way, as Arlin Cunic writes on the website VeryWell, it’s about “thinking before acting.” Or in my case, considering whether I really need to express a particular gripe out loud or if I’d be better off keeping it to myself.

Words and phrases like “postpone,” “pace yourself” and “choose what to say” can help one cultivate a more self-regulatory approach to life.

Self-regulation sounds self-evident – of course this is how we should be in the world. But it’s not something we’re necessarily born with. We have to learn it. 

Usually that happens in childhood. Toddlers who throw tantrums eventually figure out how to tolerate uncomfortable feelings without flying into a rage. However, children who don’t feel safe and secure or who are unsure whether their needs will be met, may have trouble soothing themselves and self-regulating.

I don’t know if I fit into that category as a kid, but I retain a strong impulse to verbally vent as an adult. That’s the crux of the crisis with my wife. 

I brought up the topic with my therapist.

“Any feelings you’re having are OK,” she reassured me. “It all depends on what actions you take around those feelings. Can you find other people to talk to, not only Jody?”

“You mean, like … friends?” I said in return. “Yeah, I’ve tried that in the past. It didn’t work out so well.”

I remembered how, when I used to work in Tel Aviv, I had a boss who I didn’t get along with so well. He bullied me and I was miserable most of the 3 years I worked at the company. On the long commute home to Jerusalem each night, I would call a couple of confidants on my car’s speaker phone and proceed to growl for an hour. 

Eventually my friends got burned out, as Jody was now.

“It’s not black or white,” my therapist added. “You can still share your distress with Jody. Just not all day long. Maybe delay the desire to grumble in real time and limit it to an evening check-in. Or avoid being together in the same room when you’re in a particularly vulnerable and vocal state.”

Offloading some of my anxiety to friends who also care about me could help with the balance, she suggested.

“Can they be virtual friends? On Facebook?” I asked.

“Better to get together for coffee in person,” she said. 

Such an old school approach to relationships!

The truth is, friends havebeen calling me but I’ve mostly rebuffed them, not wanting to be a burden like I was with my Tel Aviv commute buddies. Instead, I turned Jody into my safe place.

“You’re like my personal human Evernote,” I once joked to Jody. As with my favorite note taking app, I reasoned that if Jody could hold my worries, then I could let go of them for a while myself. 

I love my wife dearly, of course, and the last thing I want to do is cause her pain. So I’ll give it a try. I’ll meet up with friends. I’ll try to keep the volume down. I’ll think before I act or speak. I’ll postpone and pace.

People who are adept at self-regulating tend to “view challenges as opportunities,” writes Cuncic. They “are clear about their intentions, act in accordance with their values, put forth their best effort [and] keep going through difficult times.”

Those are all attributes worth aspiring to. Maybe getting cancer will be the trigger that helps my wife to no longer be so “long-suffering.” 

Perhaps the same will be true for me. 

Jody first read me the riot act at The Jerusalem Post.

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Correction: “Waiter, there’s a fly in my soup.” “Sshh, don’t say anything or everyone will want one!” That’s meant to be funny, of course, but my misrepresentation of Rabbi Aaron Leibowitz’s fly-in-the-soup story in “Judaism’s honesty problem” was serious business. As several readers have pointed out, a fly floating on the surface wouldn’t have made the soup treif once removed. In his talk, Leibowitz spoke of a fly lost in the pot. I apologize for the error.

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Judaism has a fundamental problem with honesty and it’s driving the Jewish world apart.

That was the take-away from a challenging talk by Rabbi Aaron Leibowitz, the conclusion of a six-part series on “Jewish Life, Halacha and our Changing Reality” held at the Pardes Institute of Jewish Studies in Jerusalem.

Leibowitz is an Orthodox activist and provocateur. He started the private kosher certification organization Hashgacha Pratit to break the Israeli rabbinate’s monopoly on kashrut in 2013 and is now heading up a new initiative called Chuppot that marries couples according to Jewish Law but outside the auspices of the rabbinate.

It’s not surprising, then, that to illustrate the extent of Judaism’s honesty obstacle, Leibowitz brought two examples from his own confrontations with Israel’s ultra-Orthodox-controlled rabbinic establishment.

Story #1: A restaurant under kosher supervision has a special soup on its menu. Just before the evening rush, a very large fly makes an ill-advised dive into the big soup pot in the kitchen, where it is incapacitated, sinking deep into the creamy broth.

Once he is made aware of his bug bogey, the restaurant owner faces a dilemma. If he throws the soup out, as it is may no longer kosher, he risks losing hundreds of shekels of business. Leibowitz explained. But if he serves the soup, he could be causing kosher patrons to unwittingly sin.

The restaurant has a kashrut supervisor, but he mainly stops by once a month to pick up his check, providing no real inspection or guidance. This situation annoys the owner who doesn’t understand why he has to pay so much for a service he isn’t really receiving.

The relationship became even more antagonistic in the previous few months when the supervisor demanded a pay hike without any corresponding increase in visits. Kashrut supervisors in Israel are paid directly by the restaurants, not the rabbinate, creating a clear conflict of interest.

The owner doesn’t have any incentive to reach out to his never-there inspector, and the supervisor doesn’t really want to know, as it would entail more work on his part or – heaven forbid – the restaurant might be shut down, jeopardizing his easy money job.

Story #2: When someone decides to get married in Israel, the rabbinate requires proof of his or her Jewishness. Conversion is sometimes required.

Leibowitz shared the saga of a bride who needed to convert but was assured by the rabbinate that, in her case, it was just a formality and she didn’t have to take the lengthy conversion course required of other brides and grooms.

The day of the wedding was fast approaching, but the rabbinate still hadn’t set a time for the bride to immerse in the mikveh. Finally, just two days before the chuppah, this final step in the conversion process was scheduled.

At the mikveh, one of the conversion rabbis asked the bride if she intends to keep all of Jewish Law. She answered truthfully: “no.”

The rabbi looked puzzled and asked again. “Will you keep the halacha?” The bride responded “no” a second time.

“Well, we cannot convert you until you take the full conversion course,” the rabbi told her. “You can apply again in a year.”

What did the rabbi want to hear? That, yes, the bride would keep all 613 commandments, even if she knew – and everyone else knew, too – that she wouldn’t.

“They wanted her to lie!” Leibowitz cried, pounding his fist on the lectern.

How did we get to a situation where dishonesty is baked into the relationship between “client” and “service provider?” Why don’t the bride and the restaurant owner have a rabbinic ally to whom they can turn to solve problems, rather than cover them up with a wink and a nod?

It stems from economics, Leibowitz explained. The rabbinate has, for most of its existence, had no competition. And when clients can’t take their business elsewhere, there’s no impetus to improve.

Leibowitz is passionate about breaking what he described as a government-sponsored religious services monopoly. He did it first with Hashgacha Pratit, which created the first real alternative for standalone kashrut certification.

The program, which started with just a couple of restaurants in Jerusalem, was so successful that it was taken over earlier this year by the Orthodox but liberal Tzohar organization, which now supervises 110 restaurants, pubs, hotels and catering businesses and, significantly, flips the business model so that it’s Tzohar, not the restaurants, paying for supervision.

Leibowitz’s newest initiative, Chuppot, is technically illegal: a law passed in 2013 imposes potential jail time on both the couple and the officiating rabbi if a marriage ceremony is conducted outside of the rabbinate – although Leibowitz says the law’s language is so vague, he’s doubtful it could ever be enforced.

In the meantime, Chuppot, which is headed by Rabbi Chuck Davidson, has already conducted 89 weddings since it was established in July 2018, and is on track, Leibowitz said, to perform 200 ceremonies in its first year.

Since the rabbinate lost their monopoly on kashrut and with the pressure Chuppot is putting on them with weddings, “they’ve become 100 times more user-friendly to the public,” Leibowitz said.

Will that mean fewer tearful brides driven to despair two days before their weddings? No more flies surreptitiously skimming our kosher soups?

“I think we’re going to win,” Leibowitz said at the conclusion of his talk.

In the competitive marketplace of ideas, creating a climate for honesty to flourish really is the best policy.

I first wrote about Rabbi Aaron Leibowitz’s rabble rousing at The Jerusalem Post.

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Defining Courage

by Brian on December 24, 2018

in A Parent in Israel,Cancer,Science

The Merriam-Webster dictionary describes courage as “the ability to do something that frightens one.” I’d give it a slightly different definition.

Courage for me, as I’ve discovered over the past year coping with chronic cancer, is not about choosing to jump out of an airplane or bungie jump off a bridge near Katmandu. Rather, it’s doing something you really don’t want to do but know you have to.

It was courage I needed when my next immunotherapy appointment came close.

I finished four months of chemotherapy for my follicular lymphoma earlier this year and am officially in remission. Now I need to go in every other month for an IV of biologic “maintenance” treatment to keep the cancer at bay for as long as possible. I’m supposed to do this for two years. It’s not as bad as chemo, but it still comes with side effects.

As the day approached, I became acutely aware of my resistance to going back under the needle. Part of that was just not wanting to feel uncomfortable – not so much the hospital visit but the fatigue and aches and pains that come after. Part was that each trip to the hematology daycare ward reminds me that I have a chronic, incurable cancer that will be with me for the rest of my life.

But there’s also a lingering uncertainty about whether maintenance treatment is worth it.

According to Dr. John Leonard, a lymphoma specialist at Weill Cornell Medicine in New York, only 16 out of 100 patients will see an improvement in PFS (that’s “progression free survival,” the number of years before the disease returns) as a result of the kind of maintenance immunotherapy I’m supposed to be getting.

“Moreover, it makes no difference in overall survival,” Leonard adds. He advises most of his patients these days to skip maintenance and simply “re-treat” when necessary – even if that’s sooner than it might have been if you’re in the lucky 16 percent group.

Dr. Jonathan Friedberg, chief of hematology-oncology at the University of Rochester Medical Center in Rochester, New York, puts it more plainly. “Maintenance therapy is probably over-treatment.”

I asked my own doctor at Hadassah in Jerusalem. She admitted that “we really don’t know what maintenance therapy does or how,” but she still recommended it. “Sixteen percent is not insignificant.”

As my appointment became imminent, I tried to think of other examples of courage that fit my definition, to see whether any of those might provide clarity for the decision in front of me.

The first thing that came to mind was perhaps the complete opposite of healing: war. No sane person ever wants to go to war, but sometimes you have to do it for the health and survival of your nation.

Divorce also is a form of courage. Resistance to this kind of major life change can be overwhelming, but if you’re in the wrong relationship, you know deep down that sometimes the only way to get healthy again is to get out.

Making aliyah takes courage, as well. My wife, Jody, and I planned our immigration to Israel for seven years. Making a life in the Holy Land was part of the shared values we brought to our marriage.

But when the time finally came to move, I kept delaying. My career was in full swing: I had a great job at a software company, I was teaching at San Francisco State University, I’d just finished a term as president of an international professional association. We had friends, community, two cars and savings.

I knew that aliyah would be the healthy thing for our relationship, for our children, for the Jewish people.

“Making these kinds of monumental decisions takes a special kind of faith,” a friend once told me.

“Faith is not something I’m big on,” I joked in return.

“Then call it a ‘leap of faith’ – making an important choice with imperfect information. Gather data then reevaluate. If it doesn’t work out, you can always go back.”

Melanie Greenberg writes in Psychology Today about six kinds of courage: feeling fear yet choosing to act, following your heart, persevering in the face of adversity, standing up for what is right, letting go of the familiar, and facing suffering with dignity or faith.

At least four of those six are part of my personal definition of courage. (You guess which four.)

In the end, though, it was not my cognitive deliberations, an appeal to faith or a pithy article in a pop psychology journal that shone a light on how I should decide.

It was an episode of the TV show “This is Us.”

One of the main plot points of the popular NBC series is that the father of the family dies when his kids are teenagers. The harrowing experience of losing their father at such a young age impacts much of how they live as adults.

My own kids are all in their 20s but that’s still young enough that I wouldn’t want to bequeath to them any avoidable trauma.

Sixteen percent may not sound like a lot statistically, but I owe it to my family to do whatever I can to stick around as long as possible.

I might feel like crap, temporarily at least, but I know, too, that my long-term health and the health of everyone around me depends on me mustering up that courage – however I define it.

I first defined courage at The Jerusalem Post.

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My problem with Maoz Tzur

by Brian on December 9, 2018

in Jewish Holidays and Culture

I have a problem with Maoz Tzur, the song that’s traditionally sung at Hanukah time after lighting the hanukkiah. One of the poem’s uncomfortable recurring themes is vengeance.

In the opening stanza, we pray to God to “prepare a slaughter of the ‘barking foe.’” It gets even more extreme by the song’s closing verses: “Wreak vengeance upon the wicked nation … thrust the enemy into the shadows of death.”

I get why the author of this poem was pissed. A lot of bad things have happened to the Jewish people and they keep happening, even today. So, the thinking must have gone, the only way to stop more pogroms, expulsions, desecrations or modern missile attacks is to utterly annihilate our enemies.

That’s certainly a message that resonates in the Bible.

In Deuteronomy, you can read the following: “But you shall utterly destroy them, the Hittite and the Amorite, the Canaanite and the Perizzite, the Hivite and the Jebusite.”

During the war against the Midianites, after the Israelites kill every male among their adversaries, Moses ups the ante and demands the Israelites eliminate all male children and any women who are not virgins.

Can we dismiss these commands as simply reflecting the way things were back then? Or are these sacred rules of conduct that are supposed to endure forever?

A few weeks ago, my daughter and son-in-law were, for the second time this year, forced to flee their home in Sderot in order to get out of range from the rocket barrage coming from Gaza.

When a ceasefire was eventually negotiated, many residents of the communities bordering the Gaza Strip were livid. The IDF must go into Gaza and wipe out Hamas entirely, they rallied. What if innocent people are killed? “We’ve got to teach them a lesson” was one of the most striking lines I heard.

Really? Pull out the ruler and slap their hands indiscriminately, because that’s the only way kids learn? It sounds so childish.

Now, I’m not someone who opposes war at all costs and would rather retire the army, open any borders and hope for the best.

Rather, it’s the language of vengeance that arises in times of crisis that troubles me. Is this something that we carry from Jewish tradition? Do those who live their lives according to a strict reading of the biblical narrative have a greater propensity to seek revenge? Or do our sacred texts simply echo human nature, much as Shakespeare wrote in The Merchant of Venice, “if you wrong us, shall we not revenge?”

Colgate College Prof. Kevin Carlsmith created a group investment game. Participants were to put a dollar into a group pot and the researchers would add a 40 percent bonus. The pot would be distributed equally.

The best thing for the group would be for everyone to cooperate. But a player could also refuse, in which case he or she would keep the dollar and get a share of the pot – a better deal for the individual.

Carlsmith secretly inserted a “free rider” into each group who convinced the others to invest equally, but then chose not to play along. The rest of the group was understandably annoyed.

When Carlsmith then presented a way for group members to take revenge, everyone took up the offer. More than that, they predicted that they would feel better after they got their revenge.

Dan Ariely has uncovered a biological basis. The best-selling author and professor of behavioral economics scanned participants in a PET CT machine and found that just the thought of revenge stimulates the reward center of the brain to give us pleasure.

Vengeance goes hand-in-hand with a desire to make yourself look good at the expense of your opponent. That too has found its way into Jewish tradition.

Our morning prayers beseech men to thank God for not making them a woman.

The Aleinu prayer states that non-Jews “bow to nothingness and vanity and pray to a God that does not save.”

Hebrew Union College Professor Rabbi Dalia Marx is overseeing a revision to the Israeli Reform prayer book. She and her team have decided to replace that line in Aleinu. “We don’t feel that we need to bring down others in order to cite our uniqueness,” Marx explains.

Similarly, the popular A Night to Remember Haggadah suggests that instead of (or in addition to) the furious “pour out your wrath” closing to the Passover Seder, we proclaim “pour out your love on the nations who have known you.”

Vengeance and belittling may have their roots in biology, but avengers rarely receive the pleasure they’re expecting. In Carlsmith’s experiment, he asked students to report how they felt after getting their revenge. The results showed that, despite their predictions, they actually felt worse compared to others who weren’t given the same opportunity.

Our avenging brains evolved over millions of years, making it tough – but not impossible – to affect a change. Perhaps the best place to start is with language.

So, with Hanukah here, I’m going to take a tiny step in excising vengeance from our vocabulary. Dalia Marx suggests replacing two words in the first stanza of Maoz Tzur.

Instead of “l’et tachin matbe’ach” – when you prepare a slaughter – let’s sing “l’et tashbit matbe’ach” – “when you put an end to slaughter.” And instead of “mitzar ha’menabe’ach” – for the ‘barking foe’ – we’ll say “u’mitzar terave’ach” – “and spare us from the foe.”

Give it a try as you light the sixth candle tonight. Happy Hanukah!

I first shared my frustration with Maoz Tzur in The Jerusalem Post.

Aharon Varady, who runs the Open Siddur Project, points out that former British Chief Rabbi Dr. Joseph Hertz first proposed swapping “tachin” for “tashbit.” 

Picture from Eva Rinaldi [CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0)]

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Surprise me, Moshe Lion

by Brian on November 26, 2018

in Politics

I love voting. Even if the candidates I support tend to be underdogs who wind up in the opposition, I’m positively giddy walking into my local balloting station, placing the colored slip into the voting envelope and dropping it in the flimsy cardboard box (that hopefully will be replaced someday by iPads and the cloud).

The flip side of my plebiscital joy is the depression that descends when my guy or gal inevitably loses. That’s how I woke up last Wednesday morning to the news that Moshe Lion had beaten Ofer Berkovitch in Jerusalem’s runoff race for mayor.

The stakes were high: Lion was portrayed across my social media echo chamber as the devil incarnate (an ironic appellation, given that’s what Lion backer MK Arye Deri name-called his opponent). When it was clear Lion would become mayor, my online friends were despondent.

All the pluralistic gains of the Barkat years will be lost, they wailed. The First Station will be shut down on Shabbat. The Pride Parade, too. Lion will only work for the thin majority that voted for him. Some even wondered if it was finally time to consider moving to Tel Aviv.

Some in the Berkovitch camp chastised the non-ultra-Orthodox public for its apparent apathy. That’s not what I saw in my admittedly small familial sample – everyone in the Blum household voted, including our soldier son who spends his days in Tel Aviv and our daughter and son-in-law who dodged missiles to drive home from Hamas-targeted Sderot in time to cast their ballots. But the 31 percent citywide turn-out was certainly not as high as it could have been.

Even before the votes were tallied, I was not entirely comfortable with all the alarmism. Will it really be so awful with Lion? I found myself asking anyone who would listen. Was it possible that the doomsayers were mostly playing politics, emphasizing the worst to bring out the vote?

I desperately want to see the good in Jerusalem’s new mayor. I want to believe that he will deliver on his campaign slogan of being a mayor for all the city’s residents. That his years of managerial experience in both the private and public sectors will allow him to effectively head Israel’s largest city with its NIS 9 billion annual budget. That he will know how to work with the national government to avoid the kind of financial showdowns that have plagued Jerusalem in the past.

Most of all, I want to believe that, just because Lion has the backing of some of the more crooked politicians in the Knesset, it doesn’t mean he will obey their every word once he’s installed as mayor; that he can still be an independent thinker with the best interests of the city’s citizens at heart. I want to give him the benefit of the doubt.

That won’t be so simple.

Our brains are wired for suspicion. Psychologists have a name for it: the “negativity bias.”The part of our brain that governs this negativity, the amygdala, “uses about two-thirds of its neurons to look for bad news,” explains Rick Hanson, founder of the Wellspring Institute for Neuroscience and Contemplative Wisdom.

We were built this way over millions of years of evolution.

“Our ancestors had to make a critical decision many times a day: approach a reward or avoid a hazard,” Hanson says. Or in more colorful language: “Pursue a carrot or duck a stick.

If you miss out on a carrot today, Hanson continues, “you’ll have a chance at more carrots tomorrow. But if you fail to avoid a stick today – WHAP! – no more carrots forever.”

That’s why animals in the wild interpret any rustle in the woods as a potential predator. Failure to take into account the worst case scenario too often results in a tiger’s tasty lunch – at your expense.

Trying to see the best in someone, especially someone in public office, takes work. We have to fight our natural negative inclinations. The current legislative climate – both in Israel and the U.S. – where politicians have enthusiastically been confirming many of our greatest fears, doesn’t make that any easier.

Yet, I feel cautiously optimistic about Lion. Have I somehow magically transcended humanity’s default negativity bias?

Hardly.

But wallowing apoplectic isn’t good for anyone. That’s a lesson I’ve internalized over this past year as I’ve had to cope with chronic cancer; a teachable moment that originated far from politics. (I only wish I didn’t have to get sick to learn it.)

There’s another reason to remain positive. Democracy in Israel still works. Yes, there were alleged improprieties in the months leading up to election day, far too many “fake news” texts and the awkward bedfellows that always accompany politicians (especially those who win). But no one “stole” the election. To the best of our knowledge, Russians didn’t hack the Jerusalem mayor’s race.

Ofer Berkovitch ran a strong campaign that was well-executed and generally clean. That led to his Hitorerut party winning an unprecedented seven seats – the largest on the new city council.

Moreover, Berkovitch isn’t going anywhere. He’ll get another shot at the top slot and, if Lion does take the city to a dark place, that will provide all the more impetus to vote the incumbent out of office in 2023.

But I hope that’s not the case. I’m actually rooting for Lion to be the “mayor of everyone.” So surprise me – surprise us all – Moshe Lion and upend the human propensity for negativity.

We’ll talk again in five years.

I first wrote about the 2018 Jerusalem elections in The Jerusalem Post.

Photo credit: קובי קנטור [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]

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The best-laid plans

November 11, 2018

“Let’s plan a party,” she said. “I’m not out of the woods just yet,” I replied. But my forest is looking healthy overall – even if some of the trees need extra care.

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“You look good”

October 28, 2018

What do you do when the way you look on the outside doesn’t match how you feel on the inside? It comes up all the time with chronic cancer.

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Religion as complementary medicine

October 15, 2018

I’ve been looking at religion all wrong. Does religion need to make sense rationally? Or is it more like complementary medicine – a cultural placebo?

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Rules for rumination

September 30, 2018

Finally some good news: my cancer is in remission. But the treatment is just beginning. Did I do the right thing? How to stop ruminating.

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Turning empty hotel rooms into “healing holidays”

September 17, 2018

“You look like you need a l’chaim,” the yeshiva bocher said to me, extending a plastic cup. “I can’t,” I responded. “But it’s Shabbos!”

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