Guest Host: Susan Page

Today, seasonal affective disorder, also known as SAD, is a widely accepted mental condition. But when Dr. Norman Rosenthal first showed that dark winter months can cause depression — and that it could be treated with light — he was met with skepticism. It’s this kind of challenge Rosenthal addresses in his newest book, “The Gift of Adversity.” Part autobiography, Rosenthal describes his journey from growing up in apartheid South Africa to his breakthrough work in the U.S. at the National Institute of Mental Health. Along the way, he outlines setbacks in his own life and how we can benefit from inevitable hardship.

Guests

  • Dr. Norman Rosenthal author of "The Gift of Adversity: The Unexpected Benefits of Life's Difficulties, Setbacks, and Imperfections," and the first psychiatrist to describe and diagnose SAD, seasonal affective disorder.

Read An Excerpt

Excerpt from “The Gift of Adversity: The Unexpected Benefits of Life’s Difficulties, Setbacks, and Imperfections” by Norman E. Rosenthal. Copyright 2013 by Norman E. Rosenthal. Reprinted here by permission of Tarcher/Penguin. All rights reserved.

Transcript

  • 11:06:57

    MS. SUSAN PAGEThanks for joining us. I'm Susan Page of USA Today, sitting it for Diane Rehm. Diane is on vacation. When Dr. Norman Rosenthal moved from South Africa to New York City, he loved his new home, but there was one exception, the long, dark dreary winters. It became the basis for his groundbreaking research on what we now know as Seasonal Affective Disorder. In his new book, he uses stories from his own life to help others understand how we can cope and learn from hardship. Dr. Rosenthal joins me in the studio to talk about the book, "The Gift of Adversity." He is a professor of Psychiatry at Georgetown Medical School. Dr. Rosenthal, it's nice to have you here.

  • 11:07:36

    DR. NORMAN ROSENTHALGreat to be here.

  • 11:07:37

    PAGEWe invite our listeners to join our conversation later in this hour. You can call our toll free number, 1-800-433-8850. Send us an email at drshow@wamu.org or find us on Facebook or Twitter. Well, you know, I think that there's a practice of many psychiatrists to not reveal very much about themselves. You try to keep kind of blank slate in dealing with patients, and yet in this book, you reveal a lot about your own life, your own challenges.

  • 11:08:10

    ROSENTHALYou know, when I first learned to become a psychiatrist, it was the fashion to be a blank slate, but I did such a lousy job at it that I figured I might as well just be authentic from the word go because people would see through it anyway. And as I have written a number of different books for the general public, what I have found my readers want is just more and more stories about how have I dealt with things. So, really, this book is a response to popular demand.

  • 11:08:43

    PAGEThe subtitle of your book is "The Unexpected Benefits of Life's Difficulties, Setbacks, and Imperfections." You know, the fact is, none of us get through life without facing a certain amount of adversity.

  • 11:08:56

    ROSENTHALIndeed. You know, I don't recommend that we go out and look for it, necessarily, but we don't have to. It finds us. So the question really is, once it does, what are the best ways of dealing with adversity and what can we extract from it that's gonna be beneficial going forward?

  • 11:09:14

    PAGEAnd yet, despite all that, people often seem very fearful of adversity. They want to -- I think a lot of people pretend that they don't face adversity, that their marriage is perfect and their children are perfect. Why do we do that?

  • 11:09:31

    ROSENTHALYeah, I think you've hit the nail on the head. It's really happening at two levels. The one level is we're very scared of adversity and, of course, adversity can be terrible, but on the other level, we're scared of revealing adversity. We do have that feeling that we need to present a very perfect facade. I don't know whether it's more in this culture or anywhere else, but it's sort of typified by that form Christmas letter that you get where nobody ever has any problems.

  • 11:10:04

    ROSENTHALYou know, your son is at Harvard, your daughter is at Swarthmore, you've got a big estate with the Labradors having more room to run around in, and the reality may be very different, you know? Mom may be just out of rehab, Dad's business is on the skids, they're having a hard time covering the mortgage, but that's not what the form letter says. And what I'm really inviting people to do is to be a little more authentic, because I think that creates a common bond that is really more accurate and more human.

  • 11:10:33

    PAGEAnd what do you mean when you say "the gift of adversity?"

  • 11:10:37

    ROSENTHALWell, when adversity comes, the last word that comes to mind is gift, because it just looks like an unmitigated disaster. But, how many times have you heard a friend or somebody say, "you know, at the time, it seemed terrible, but in retrospect, it was for the best." Somebody gets a divorce. It's a disaster, but then they meet somebody who's much more suitable, and they realize that the previous partner hadn't been right, and this gets revealed through the adversity of the divorce, which is, of course, a very difficult thing for most people to go through.

  • 11:11:11

    PAGEYou also find this instinct, and I think this is pretty distinctly American, although maybe that's just my limited perspective, of taking a terribly adverse event and trying to make it into something positive or meaningful. I think of people who've undergone disasters or their children are facing illness and they've turned around and really tried to foster research into a disease or limit drunk driving or these various causes that people turn to in the face of some terribly adverse development.

  • 11:11:43

    ROSENTHALI think that it's very strongly present in the American consciousness, and I'm actually very much in favor of that. In fact, you know, we've heard a lot about post traumatic stress, but there's also this concept called post traumatic growth that comes out of a new positive psychology that is there to say let's understand the joyful and good aspects of human behavior. So post traumatic growth, I think, is going to be, "a growth area for us."

  • 11:12:12

    PAGESo what do -- if our listeners are facing situations of adversity, how do they make it not post traumatic stress, but post traumatic growth? What are the attitudes or the practices that can help people take advantage of adversity?

  • 11:12:27

    ROSENTHALThe first step is really to accept that the adversity has happened. If you suffer a loss -- Joan Didion, in her very poignant "Year of Magical Thinking," talks about after the death of her husband, looking at his shoes and thinking she can't get rid of them in case maybe he should come back and need them again. That's part of the kind of denial that a lot of us engage in, in order to try and ward off the painful feelings of adversity. We have to somehow come to terms that it really has happened. Then, we have to analyze the situation, every adversity is different, and respond accordingly.

  • 11:13:10

    ROSENTHALAnd there are definitely things you can do, things that you can do to stabilize your psychology and your physiology and we can go into more detail about that. Tell a story, create a narrative out of what's happened. That's a very wonderful way to organize the different confusing aspects of an adverse situation. So I go through a series of things that people can do to emerge the better on the other end.

  • 11:13:34

    PAGETalk more about telling a story, because we all know -- we've been in situations where a family member has had a trauma and they want to tell you that story over and over again. Why?

  • 11:13:46

    ROSENTHALIt's fascinating. I remember one story I mention in the book is when I was in Johannesburg, I was parked in a car with a girlfriend and we were attacked by thugs. And I was stabbed nearly to death and survived, and I found this compulsion to tell everybody the story. In fact, I was kind of embarrassed, you know? Why do you have to yak and yak and yak and yak? And then I went and read the literature, and it's actually part of coming to terms with trauma.

  • 11:14:18

    ROSENTHALYou know, the ancient mariner who's standing outside, stopping one in three wedding guests to tell them his tale of woe, how he shot the albatross. Well, you know, Coleridge was onto something with that. We have this compulsion, and I think it's a way of processing. But the key to telling a story in a way that's going to work for you, is not to tell it exactly the same way every time.

  • 11:14:43

    ROSENTHALEach time you tell it, see different things, find different angles, because that means you're processing it in new ways continually.

  • 11:14:50

    PAGEIt can demand some patience from those to whom you are telling the story.

  • 11:14:56

    ROSENTHALWell, you better tell it well. That way they won't get so bored so quickly.

  • 11:15:00

    PAGEYou were the first to diagnose Seasonal Affective Disorder. First of all, tell us -- often called SAD. What is it?

  • 11:15:11

    ROSENTHALYou know, it's this rather common condition that afflicts us when the days get short and dark. Can even happen at other times of year if there's a spell of cloudy weather, but mostly, it's going to start soon for us here in the north. And we will have a hard time waking up in the morning. We'll slow down, eat more sweets and starches, gain a little weight, not be as effective, as productive, as creative, as efficient and then it goes all the way down from there, if you've got it in a bad degree. And then, spring comes and it gets better. And it hadn't been recognized until my colleagues and I described it in the early '80s, but now it turns out to be very common and very treatable.

  • 11:15:53

    PAGEAnd how did it effect you?

  • 11:15:56

    ROSENTHALWell, I was doing my residency in New York City, and I remember that first day after the daylight savings time change, coming out and that cold wind blowing off the Hudson, and the dark, and I actually was almost afraid. You know, what's this? The world is suddenly dark and cold and blowy. And what I realized was that I hadn't -- I'd taken on too much in the summer. I wasn't able to keep up with it all. And my wife had it to a more extreme degree than I did, and year after year, we had it.

  • 11:16:33

    ROSENTHALThen I came to the NIMH and all the pieces began to fall together. We met somebody who had it much worse than I had, an engineer who, in fact, began to think that light might have something to do with it, and one thing led to another, and we developed light as a treatment for the condition.

  • 11:16:48

    PAGENIMH, The National Institute of Mental Health, where you work. Now, initially, this was considered kind of a radical idea. You encountered a lot of skepticism.

  • 11:16:58

    ROSENTHALYes. I was definitely regarded as being on the lunatic fringe, and maybe I still am, but not for this particular reason. And colleagues, at meetings, would say, "come, let's go stand under the light. I'm already feeling depressed." But, you know, those that came to scoff remain to pray. Not everybody. We still have the skeptics out there and I decided long ago that I was not going to try and dissuade the last skeptic, because some people have a vested interest in holding onto a skeptical position and they should be permitted their privilege.

  • 11:17:33

    PAGEAnd this skepticism, and even ridicule, that you encountered with this diagnosis, this discovery, is that part of the gift of adversity? How did you make it a gift?

  • 11:17:44

    ROSENTHALIt was. You know, the first gift was actually the pain and suffering of the dark, because that led me to describe the syndrome. The second gift was actually -- I talk about an early gift of a school teacher who misspells the word ruler, and I couldn't believe it. A school teacher misspelling a simple word? Impossible. And my parents laughed. And when they continued to laugh, I realized they were not laughing at her. They were laughing at me for my naivete, and that really opened a window to me that anybody could be wrong about anything. And so I lost my sort of adulation for authority and I began to have great fun questioning authority wherever I could.

  • 11:18:34

    PAGEDr. Norman Rosenthal. His new book is called, "The Gift of Adversity." We're going to take a short break. When we come back, we'll go to the phones. Our phone lines are open. You can call us toll free 1-800-433-8850, or send us an email. drshow@wamu.org. Stay with us.

  • 11:20:02

    PAGEWelcome back. I'm Susan Page of USA Today sitting in for Diane Rehm. We're talking with Dr. Norman Rosenthal about his new book. It's called "The Gift of Adversity." He is a clinical professor of psychiatry at Georgetown Medical School. Now you know one of the most familiar adverse situations a lot of Americans have faced in the last few years during the great recession was a loss of a job. Hard to -- very few things can be as crushing to somebody as losing their job. Now despite your professional success, you did have the research group you led at the National Institute of Mental health dismantle. It was a shock, right?

  • 11:20:43

    ROSENTHALWell, yes. It was actually in retrospect very, very interesting. At the time I was not quite as dispassionate about it. And -- but managements changed and they deemed that our work that had previously been very highly regarded was good for the chopping block. And I included this particularly because I think so many people are laid off their work or discontinued, retrenched, whatever euphemism you want to use. And I think oftentimes it's simply because maybe they can be replaced with cheaper people or money can be saved. Maybe -- it's almost always purely for the organization's sake.

  • 11:21:30

    ROSENTHALBut the organization can't come in and say, listen we just don't want you anymore. We want all the positions you occupy we want to go give them to somebody else because there would be all kinds of legal repercussions, Especially if you've got that dreadful nuisance called tenure. Nasty institution that prevents administrative from doing the things they want to do, which is to promote their own careers.

  • 11:21:57

    ROSENTHALSo in any event they can't come in and say, you know, we don't like you anymore. We want to get rid of you. Goodbye. Give up your tenure and go. So instead they assemble a group of scientists who they brief to say, you know, we want you to deliver a bad scientific review. And it's well known, you know. It's like one of those kind of open secrets. Want to give you a bad review and then somebody gets a bad review and then they come and they -- they know they can't just kick you out because you've got tenure but they find something that resembles a broom closet and they say, this is your new office.

  • 11:22:36

    ROSENTHALAnd by the way, your secretary is going to be permanently moved somewhere else and so on and so forth. And you know, if you've got any self respect at all, you get the message and you move along. And that's basically what happened to me. And then of course one of my friends who was an administrator said, well you know, your boss is going to go next because they take away his people and then he can't be productive. And then the next time he comes for review they say, oh you haven't been productive, so they take him away too. And that happened and our group got dismantled.

  • 11:23:10

    ROSENTHALBut as I say in the book, it had benefits for me because it was time for me to be exploring new things. So that's when I wrote some new books. I started my own clinical trials organization. I studied things like transcendental meditation for depression and post traumatic stress disorder. I studied Botox for depression. I did the kind of wild and whacky things that I have always loved to do, and I wrote books. And so, you know, the gift of that adversity was that, you know, I just found a new path for myself and it was a very enjoyable one. And I'm continuing to enjoy it even to the present day.

  • 11:23:52

    PAGELet's invite some of our listeners to join this conversation. We'll go first to Morgan who's calling us from San Antonio, Texas. Hi, Morgan.

  • 11:24:00

    MORGANHi. Thanks for taking my call. I just wanted to specifically talk about how our schools have gotten away from a sense of competition or a sense of earning anything. Our kids are always winners. They always do a good job and there's no -- we're not teaching them how to overcome adversity because we've taken it out of their lives. And I think that that specifically needs to be talked about, how they have to fail to learn how to grow. And I think we've lost that.

  • 11:24:30

    PAGEMorgan just an interesting point. And I wonder, Dr. Rosenthal, if you think it's a problem that, you know, how many times have we had our kids on teams where everybody gets a participation award and you don't report the score with some kids on games because you don't want one team to feel like they've lost. Is that a good approach, do you think, or do you have problems with it?

  • 11:24:52

    ROSENTHALNo. I think Morgan is right on point. I have problems with this approach because I think it deviates from reality. Everybody knows who played well and who played badly. And the best players should get the gold one and the second best should get the silver and the third best should get the bronze and everybody else should be thanked very much for being good sports. And that's reality. That's what happens at the Olympics and that's what happens in life.

  • 11:25:17

    ROSENTHALNow we American are not competing on the world stage. In math, in science, in all kinds of things I think we really need -- and yet more than -- you know, most people think that they're more intelligent than average and most think people because we've been given this sort of boost of self esteem because the old idea was that we didn't have good self esteem, so we all had to be told how wonderful we were. And they didn't have this, like, woebegone, you know, the children are about average.

  • 11:25:46

    ROSENTHALAnd I think Morgan is quite right. I think people should really -- I mean, you know, the person who doesn't get a prize is still a good human being and still has lots of wonderful qualities, or may or may not. But I think people should face reality. And competition is part of that reality.

  • 11:26:05

    PAGELet's go to Louisville and talk to Heidi. Hi, Heidi.

  • 11:26:10

    HEIDIHi. I am a licensed clinical social worker in a community mental health agency. And work with individuals who have anywhere from major depressant disorder to, you know, severe and persistent mental illness. and upon intake we do sort of a psycho social assessment. And then if appropriate we refer to our psychiatrist who may or may not prescribe psychiatric medications.

  • 11:26:43

    HEIDIAnd my question is, I'm a little on the fringe as well. I use -- suggest things like relaxation response, deep breathing, meditation. But I struggle with making sure that these type treatments are paid for by the insurance agencies. So my question is, when I -- you know, if I were to utilize the light therapy, do you recommend using that in addition to psychiatric medication?

  • 11:27:21

    ROSENTHALWell, I think you -- you're touching upon a lot of important points. I think I should just say that there are certain things that are called standards of care . And if somebody has a major mental illness, there are standards of care that need to be implemented. And I think we need to be very careful before going and using alternative or complimentary things in lieu of those things. I'm not hearing you saying that at all. I just want to say that for the audience's benefit.

  • 11:27:50

    ROSENTHALI think that a lot of these alternative and complimentary things are wonderful and can be helpful. I think getting them reimbursed is a problem. Now light therapy can be reimbursed to some degree. And in another book of mine, "Winter Blue," I've got a letter that can be used for insurance companies. And then I've got a second letter for when the insurance company turns the first letter down. But I think we've been partially successful but not nearly enough.

  • 11:28:22

    ROSENTHALAnother thing that should be reimbursed is meditation. And now, for example, the American Heart Association is endorsing transcendental meditation for lowering blood pressure. That's the level of the data on that particular point, but I think only some companies reimburse. So I think companies are very slow to embrace these complimentary things, even in situations where it would be in their interest because it would lower health costs.

  • 11:28:52

    PAGEHeidi, thanks so much for your call and thanks for your work as a social worker. You know, in your book, Dr. Rosenthal, you write about considering unconventional therapies like transcendental meditation. How did you discover TM?

  • 11:29:06

    ROSENTHALWell, firstly I didn't discover it. It was a 3,000-year-old Vedic practice brought to the West in the late '50s by Maharishi Mahesh Yogi. And, you know, many centers are all around. But, you know, I did discover it in the sense that one discovers a restaurant. You should see this restaurant that I just discovered. So it's been around for ages but I just discovered it. So, you know, in that sense I found how powerful it was.

  • 11:29:40

    ROSENTHALA patient urged me to get my training refreshed and I did. I learned it as a medical student in South Africa. But once I started doing it regularly, I found it had a lot of potent effects. And I started recommending it to some patients and others. And, in fact, I've written in the last three, four years three books and revised a fourth, all since starting meditation. I had like a nine-year hiatus before doing that.

  • 11:30:08

    ROSENTHALSo I credit meditation with helping all sorts of adversities. In the book I talk about some really awful adversities that people were helped out of through meditation. And then there's more subtle adversity like a writers' block.

  • 11:30:22

    PAGENow not everyone knows what transcendental meditation is. Tell us just briefly how it works.

  • 11:30:27

    ROSENTHALIndeed. It's one of several different kinds of meditations but this one uses a word sound or mantra that people are taught how to think and repeat inwardly as they think it. And you sit comfortably in a chair for 20 minutes twice a day, close your eyes, think your mantra as you've been instructed. And what happens is that people pass into a sort of state of mind that's very pleasant. You're alert but you're tranquil at the same time and not necessarily thinking of anything in particular. And that is the state called transcendence that gives it its name. So that's the whole mark of the transcendental meditation approach.

  • 11:31:09

    PAGEAnd you found it helpful for several groups, including veterans who were having trouble with post traumatic stress disorder.

  • 11:31:17

    ROSENTHALYes. There's now quite a number of studies. There was a controlled study on Vietnam veterans. We did a pilot study on Afghan and Iraqi veterans. There are studies ongoing, large controlled studies. There's also studies of refugees in Africa. And all these people seem to benefit from settling down the sympathetic nervous system, the fight and flight response that propagates the hyper vigilance, the startle response, the flashbacks that are whole marks of PTSD.

  • 11:31:50

    PAGEAnd also people with bipolar disorder have found it helpful.

  • 11:31:54

    ROSENTHALYes, to some degree. It's not as clear cut but the person who really put me onto it is a man with bipolar disorder who said -- he said, you know, your drugs are helping me but this is making me really happy. And you should try it too.

  • 11:32:10

    PAGEDo you think there's a reluctance to accept that something as simple as transcendental meditation can work as well as taking a pill?

  • 11:32:21

    ROSENTHALI think so because we are, I would say, educated -- I could say indoctrinated -- but we're educated to think of popping pills. It's, you know, part of our culture. Take two aspirins and call me in the morning, you know. It's not meditate and call me in the morning.

  • 11:32:41

    PAGEI'm Susan Page and you're listening to "The Diane Rehm Show." We're going back to the phones, 1-800-433-8850. Let's go to Katy. She's calling us from Tallahassee. Hi, Katy.

  • 11:32:52

    KATYGood morning. Thank you for taking my call. And thank you, Dr. Rosenthal, for the work that you've done. I'm from New York and from the time I was a child I would get this sense of melancholy as fall rolled around, a sense of emptiness and loss. And I always thought it was because summer was over and I was going back to school. But then as I moved south to Florida I realized that it was the light, that I could not, you know, adjust to the changes in the fall. And then this study came out on seasonal effects of disorders so I am happy to know that that is what has caused it.

  • 11:33:39

    KATYAnd conversely in the sunshine I have so much energy. I'm very energetic and I just think it's great to know that there's a reason for both the depression when the light is changing and also the energy when the light is high.

  • 11:34:01

    PAGEKaty, thanks so much for your call.

  • 11:34:04

    ROSENTHALYes, thank you, Katy. It is nice to have a name to something you've known has existed all along. It's also nice to have treatments that you can use in case you haven't moved far south enough. So thank you.

  • 11:34:17

    PAGELet's go to Michelle. She's calling us from Cleveland, Ohio. Michelle, thanks for holding on.

  • 11:34:23

    MICHELLEHI. Great show today. I just would like to know the doctor's thoughts on the role of social media in terms of embracing adversity with people constantly feeling the need to talk about themselves, talk about what's going on in life through Facebook, Twitter and all those sorts of avenues. How can people feel comfortable embracing adversity, or do you feel people embrace it even less now because of all these outlets that are so focused on who we are and what we're doing?

  • 11:34:56

    ROSENTHALWell, you know, social media is such a mixed bag. For example, two chapters in my book "The Gift of Adversity" come directly from social media from my reconnecting through Facebook with childhood and school friends of mine. The one concerns a pedophile teacher who was posted on Facebook by a colleague that led me to write a whole chapter on the long arm of sexual abuse, how it reached out over 50 years and still affected the people who responded to this post.

  • 11:35:28

    ROSENTHALThe other one was a girl who had been in my class whose mother had survived death in the death camps of the Holocaust three successive times and now lives as a 90-year-old woman in good health in Australia. So these were two wonderful stories I would never have been able to get, as well as other people's childhood memories of my home, the way my father would organize cricket matches in the backyard. Wonderful things. So I need to really say it has it's terrific aspects to it.

  • 11:36:04

    ROSENTHALBut I was just reflecting the other day more at this point was on cell phones. You know, we now are never alone. We're always connected. And I think we've lost that capacity to be on our own and to think of it as okay. You know, we're picking up our cell phones, we're constantly connecting. And I think we're losing that capacity to sit with our own thoughts and take in our own selves to the extent that we were once able to do.

  • 11:36:35

    PAGEThere's also that Christmas card phenomenon when you post on Twitter or on Facebook because people sometimes post about shortcomings or setbacks. But often it's about something great they've done or something wonderful they've written.

  • 11:36:50

    ROSENTHALYes, I Think so. But I think -- I don't expect people to post bad news. And I don't recommend that they should. But it is nice actually. I enjoy seeing various things. And some people put a poem up or a quote or a picture. So I'm a bit of a fan myself of the social media, but I also see that it has a problematic side to it.

  • 11:37:16

    PAGEWe're talking with Dr. Norman Rosenthal about his new book "The Gift of Adversity." We're going to take a short break. When we come back we'll talk about his growing up in South Africa and some of the lessons he learned from that. We'll take your calls, 1-800-433-8850. We'll read your email drshow@wamu.org. Stay with us.

  • 11:40:03

    PAGEWelcome back. I'm Susan Page of USA Today sitting in for Diane Rehm. We're talking with Norman Rosenthal about his new book "The Gift of Adversity: The Unexpected Benefits of Life's Difficulties, Setbacks and Imperfections." Now, you grew up in South Africa during the era of Apartheid. How aware were you as a child of the inequity, the injustices there?

  • 11:40:28

    ROSENTHALIt was apparent every day because behind the main house were the servants' quarters. And the servants there would be in a typical house maybe three. Servants would have small rooms with beds high off the ground and tiny windows. And it would be across the courtyard and there would be laundry hanging from wash lines that would give an additional buffer between the main house and the servants' quarters. And they would eat different food. And everything would be different. They would not be able to live with their families. It was terrible. It was absolutely terrible.

  • 11:41:11

    ROSENTHALAnd we had a sense all the time that this was very wrong and very unfair. At the same time we were aware we were living in a fascist state and that if you dared to challenge the system, you could land up in terrible trouble. I've got a chapter on a cousin of mine who just infringed to some extent some of these Apartheid rules and was thrown into jail and tortured in solitary confinement and just brutally treated. They would leave -- they would torture them and they would leave razor blades out for him to commit suicide with, which he fortunately didn't do.

  • 11:41:52

    PAGEHe fled to Israel, established a charity for victims of torture.

  • 11:41:56

    ROSENTHALYes, he actually went to London. His name is John Schlapobersky. He went to London and founded a psychotherapy organization to deal with victims of torture there.

  • 11:42:10

    PAGEDo you -- I don't know how to ask this exactly, but do you feel any guilt that your family didn't do more to try to combat Apartheid?

  • 11:42:23

    ROSENTHALYou know, yes and no. I had a wonderful experience many years later. When I was in Austria, I met the great Victor Frankel. He had been a holocaust survivor who had come out of the holocaust with a brilliant philosophy that even in the worst of circumstances, you can see the world in a way that makes a difference. So he really went on to write his masterpiece "Man's Search for Meaning." And I asked him what he thought of ordinary Germans during the Nazi era and shouldn't they have done more. And he said, you know, it was a very dangerous time. If you stepped out of line, you could easily be killed. And he said, you know, you can't ask other people to be heroes. If you want to be a hero, fine, but don't ask it of other people.

  • 11:43:18

    ROSENTHALAnd something seemed to fall into place when he said that, because I thought, you know, I was not a hero. That was not what I was doing there. I was just an ordinary person trying wherever I could to be, you know, good to people, but at the same time part of a very unjust system and basically supporting the system with tax money and various things. So I would say there was a kind of chronic low-grade guilt associated with it that was a big relief when I was no longer part of that system.

  • 11:43:53

    PAGEYou write about Frankel and his insights, one of which is when you're in a situation which you have no control over terrible things that are happening around you, the one thing you can control is how you choose to view the circumstances. What does that mean?

  • 11:44:12

    ROSENTHALIt means that controlling your own mind is the final human liberty that it's hard for anybody to take away from you. Even in terrible circumstances you can choose. So in his wonderful book, for example, he talks about how he tried to teach a humorless colleague how to tell a joke or laugh at a joke. He was trying to teach somebody what is a sense of humor and how can it make a situation better. And somebody else would carve a chess set and play a game of chess. So there are certain things that you can hold onto that are part of your humanity even in places that are really awful.

  • 11:44:56

    PAGELet's go back to the phones. We'll talk first to Brian. He's calling us from Leesburg, Va. Good morning, Brian.

  • 11:45:03

    BRIANHi, good morning. Thank you again, Dr. Rosenthal, for taking my call and hearing this. I was recently convicted of a serious felony, and I've been having an extremely time dealing with the consequences it's had on my life and on the life of others. And I'd just like get your thoughts on how to deal with adversity that is of one's own causing. Thank you.

  • 11:45:27

    PAGEAll right. Thanks so much, Brian.

  • 11:45:29

    ROSENTHALWell, you know, obviously, Brian, so much depends upon all the details involved, which I'm not going to ask you about, but I would say that there's a lot of hope in the fact that you are here acknowledging that you were convicted of a felony and taking responsibility and saying, I did that and I've caused other people trouble, because that is part of accepting the reality of your circumstances. You know, people who have actually done bad things and say, well, it wasn't really my fault and I didn't really do it and somebody else did it and they made me do it, that's not taking responsibility.

  • 11:46:10

    ROSENTHALI think an important element is to analyze your situation and to see what is it that is going to make you more of a whole person. Now, presumably you're out of jail or out of prison or wherever, but what's going to help you? I learned a lot. In my last book "Transcendence" I wrote about really somebody who was a multiply convicted felon named Pat Corum in the California penitentiary system, convicted of murder on multiple occasion. And it turned out that he had no control over his temper. If you looked at him the wrong way, he'd stick a shiv between your ribs.

  • 11:46:54

    ROSENTHALAnd he learned in the prison, in the California prison, he learned to do transcendental meditation from a teacher there and slowly was able to put those few seconds between the insult and the reaction. And he was able to get himself out of prison, become a paralegal, helping people, helping lawyers deal with criminal prisoners and was able to -- he said, I can't believe it. I've got a middle class existence. I've got a wife. I've got a four-bedroom house. I was actually able to attend a relative's funeral. All the normal things that we take for granted. Take a look at that. I think it might be very interesting to you. It's written in my last book "Transcendence."

  • 11:47:48

    ROSENTHALBut in this book "The Gift of Adversity," there is a chapter called "The Gift of Meditation," which deals with people who had been imprisoned, homeless and drug addicted who were helped in multiple ways. You might find that useful. And best of luck to you.

  • 11:48:04

    PAGEBrian, thanks so much for your call. Here's an email from Max. He writes, "My question concerns larger strategies to address trauma and adversity on a national scale. For example, South Africa after Apartheid or 9/11 in the United States, are there effective tools to treat trauma such as truth and reconciliation commissions that work on mass?"

  • 11:48:27

    ROSENTHALWell, I think the truth and reconciliation type approach has been used when there's been a whole regime as in Latin America who's been guilty of all kinds of horrors, and then the regime turns around and you have to encounter your former torturer in the marketplace. And what do you do? So I think that there are mass things at that level. As a whole, I think these mass programs oftentimes are very expensive, they're effectiveness is dubious.

  • 11:49:00

    ROSENTHALBut I think that -- I'm hoping my book will be part of a mass program of people talking about adversity. What's wrong here? How can we fix it? How can we get some benefit from it? I think just being honest about it, sharing about it promotes a kind of openness and collective problem solving. Maybe we shouldn't look to government to solve all these problems.

  • 11:49:25

    PAGEThe South African experience was shaped in large part by the leadership of Nelson Mandela, now in his final days. Do you have thoughts on Nelson Mandela as he approaches the end of his life from, of course, your native country?

  • 11:49:41

    ROSENTHALI really do because the peacefulness with which the country transitioned from Apartheid to the modern South Africa, the development of a constitution that is very highly sophisticated and used world scholars. Remember, Mandela was trained as a lawyer. These would never have been conceivable in my adulthood before I left. It was a miracle. It was remarkable. And I think rarely do we see one man having had such an enormous influence. He is really a hero of mine on a level of someone like Winston Churchill and world figures like that. I think his contribution really cannot be underestimated.

  • 11:50:38

    PAGELet's go to Searcy, Ark. and talk to Barbie. Hi, Barbie.

  • 11:50:42

    BARBIEHi. I've really enjoyed this subject this morning, adversity. I'm in a 12-step program for alcohol addiction for many years. And one of the hardest things is trying to manage my emotions, also adult children of an alcoholic parent. And, you know, I've just been trying this meditation. And I noticed for myself and others in the meetings one of the hardest things to do is trying to quiet our minds for meditation.

  • 11:51:11

    BARBIEBut my question is, how would you deal with a sibling who won't take ownership for anything and it's spilling over to her adult children now? And she needs professional help. I've been researching it myself. And she has this borderline personality, I believe, which is very hard to diagnose. And my question is, what kind of help can I give her myself without actually giving her advice? And how can you find a good psychotherapist or...

  • 11:51:47

    ROSENTHALWell, I think if I may -- if I may chip in, that the biggest question is whether she has any interest in your advice whatsoever, whether she will listen to you, whether anything you say or do will register on her. So I think since you are a 12-stepper, you know that every meeting ends with a serenity prayer, that you need to distinguish what you can change and what you cannot change. So I think you need to look carefully and look at her and say, what is there that I can do anything about?

  • 11:52:21

    ROSENTHALMaybe if I just give her a brochure of a local resource, maybe if I give her an email. Maybe there's something I can do. Dialectic behavior therapy is the new main tool for borderline personality. Maybe if I let her know that, oh, up the road there's a practitioner who does this. I hear she's great. Maybe you want to go. Here's her name and telephone number. Maybe that's all you can do. Or actually maybe she doesn't really want to hear from you. So you need to make that judgment and then decide what can you control, what can you not control and have the wisdom to know the difference.

  • 11:52:57

    PAGEBarbie, thanks for your call and our best wishes to your sister. I'm Susan Page and you're listening to "The Diane Rehm Show." Let's go to Pam. She's calling us from Pittsburgh, Pa. Hi, Pam.

  • 11:53:09

    PAMHi, thank you for taking my call and giving me the opportunity to talk with Dr. Rosenthal. I want to express my absolutely undying gratitude to him and his staff. I was part of the clinical trials at the NIMH in the late '80s and early '90s. I managed very well afterwards in D.C. with the use of light therapy. And upon my retirement in 2009 I moved to Pittsburgh, which has become both the home of my heart and the trial of my life, in that it challenges Seattle for cloudiness in the wintertime. I recently reread Dr. Rosenthal's book "Winter Blues" and have taken on the task of working with a lovely mental health clinic in Wexford to try to start a support group for folks who deal with seasonality. And I just am very, very grateful.

  • 11:54:14

    PAGEPam, thanks so much for your call.

  • 11:54:16

    ROSENTHALThank you. You may want to -- I don't know if you've got the fourth edition, which is the latest edition, which includes the use of meditation to de-stress people during the winter. Some of my folks have found that a nice addition to the light therapy and other things that exist in the earlier editions.

  • 11:54:34

    PAMYes, I'm very impressed and I was just drawing an interesting analogy between your talking about taking responsibility for our actions and how well you present in the latest edition, which I have, of how much we can do to improve our own state of mind. I'm a reflexologist and a holistic health worker, so I also do use drugs to deal with my seasonality, but I'm in the midst of a very enthusiastic exercise program, diet adjustments and find that when I take responsibility for myself, things are amazing.

  • 11:55:16

    PAGEPam, thank you so much for your call. You know, Dr. Rosenthal, in this book you close with a discussion of mortality, I guess, the final episode of adversity we all face in our lives. Why did you choose to close the book with that?

  • 11:55:30

    ROSENTHALIt's a really good question because one of my dear friends said, oh, what a downer to end the book on, but really that is the final set of adversities. I wanted to say goodbye to the people that you met during the book. I wanted to share with you what it was like saying goodbye to my father who died suddenly, to my mother who slipped away slowly. I think that's so much part of our experience as adults saying goodbye to our parents who pass on in different ways. And how even as they're dying, we can give them enormous gifts and they give us enormous gifts. I wanted to share that with the reader.

  • 11:56:10

    PAGEHere's an email we got from Karen writing us from St. Louis. She writes, "The hardest thing I've ever done and may ever do was to move in with and care for my aging parents, both of whom were suffering from various levels of dementia. The experience was the most exhausting, frustrating and often heartbreaking experience I've ever had, but I do not regret doing it for one minute. Not only because I knew it was the right thing to do, but because the very experience made me feel stronger as a person, and coming out the other side of a difficult task made the things that used to seem difficult seem like a breeze."

  • 11:56:42

    PAGEThank you, Karen, for sharing your own gift of adversity. And, Dr. Rosenthal, thank you so much for being with us this hour on "The Diane Rehm Show."

  • 11:56:50

    ROSENTHALIt's been my pleasure. Thank you.

  • 11:56:52

    PAGEI'm Susan Page of USA Today sitting in for Diane Rehm. Thanks for listening.

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