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The Quality of Mercy
All the passages below are taken from the book “Counting on Kindness: The Dilemmas of Dependency” by Wendy Lustbader. It was published in 1991.
Aristotle believed that the search for virtue is necessarily circular:
Not everyone can find the middle of a circle, but only a man who has the proper knowledge. Similarly, anyone can get angry— that is easy— or can give away money or spend it; but to do all this to the right person, to the right extent, at the right time, for the right reason, and in the right way is no longer something easy that anyone can do. It is for this reason that good conduct is rare, praiseworthy, and noble. 1
Helping “to the right extent, at the right time, for the right reason, and in the right way” has never been something easy. What is truly merciful changes from day to day, even from hour to hour. Often, we have to go to the extremes of doing too much or too little for someone before we can find the “right extent” of helping.
The word mercy has fallen out of common usage in our language. It derives from the Old French merci, which meant compassion and forbearance toward someone in one’s power. In Latin, merces signifies pay or reward, and the root merc refers to aspects of commerce. 2 The words merchant and mercenary at first seem antithetical to mercy, and one wonders at their common root. But when we have to give help or depend on others for help, we understand why the concept of exchange underlies both usages.
Mercy is based entirely on exchange. Giving help eventually embitters us, unless we are compensated at least by appreciation; accepting help degrades us, unless we are convinced that our helpers are getting something in return. As much as we might prefer to reject this stark accounting, we discover in living through situations of dependence that good will is not enough. This chapter probes the delicate balance at the heart of mercy, showing how reciprocation replenishes both the spirit of the helper and the person who is helped.
Those who depend on others for daily survival often feel their very existence is an imposition. Nancy Mairs, a forty-three-year-old writer with multiple sclerosis, describes “a relentless pressure to please— to prove myself worth the burdens I impose.” 3 Many ill people suppress complaints and avoid asserting themselves, believing that they owe every possible accommodation to those who help them survive. This sense of indebtedness is renewed day after day, with each cuff someone fastens for them and each errand run on their behalf.
I once counselled a man whose stroke had deprived him of the ability to speak and write. I found him immobilized at his kitchen table, barely responsive to my presence. I tried to ask him questions that could be answered with a shake of the head, but his wife kept interrupting. She said that he could not go off driving anymore by himself, because it was too dangerous. He could not walk over to the grocery store a few blocks away, because he was unable to ask for anything. She went on and on, and her husband stared straight ahead, his face completely frozen. Finally, I looked into his eyes. There was fire in them. I said, “You’re angry.” He nodded and started hitting the back pocket of his pants with his hand and pointing at his wife. He slapped harder and harder. I struggled to figure out what he was trying to say. Then I understood. “Your wallet. Where is your wallet?” I asked. He pointed more vigorously at his wife, “Oh,” she said, “I’m storing it in his desk. He doesn’t need it any more.”
After his wallet was returned, this man began to walk around his neighborhood and to smile triumphantly at his wife. Carrying written notes to the grocer, he started buying milk and bread at the local store. Gradually, he became less depressed and began working with the speech therapist on using other communication devices. Repossessing his wallet allowed this man to feel like himself again and to reach into the outside world, in spite of his speechlessness.
Taking care of a person does not have to entail having power over major aspects of his or her life, but frailty seems to invite invasion. The need to get things done is so pressing and time limitations are so severe that it soon becomes simpler to omit the person’s participation in small decisions and routines. Survival easily comes to seem more compelling than dignity. A sixty-two-year-old woman who was paralyzed on one side by a stroke told me about her feelings:
You can’t imagine how helpless I feel. Take my kitchen sink. A sink isn’t clean unless you scrub it first with cleanser and then disinfectant. At least that’s the way I’ve always done it. I can’t even reach my sink now. The chore worker swishes around some suds and says it’s done and I want to jump out of the wheelchair and do it myself. But I’m trapped in this chair, in this body, and I’m supposed to be glad that I have help. But I’m not glad. I’m furious.
So long as we still possess it, the power to carry out simple intentions is one of the many unnoticed pleasures of life. When we lose it, we see what it means to do the most ordinary things our own way. This woman’s sink is only one of the areas in which she can no longer exert influence or get things done in accordance with her wishes. When others have to serve as our arms and hands, asking that a sink be cleaned exactly us we would have done it seems absurd. Anything but a “thank you” for the help seems ungrateful. Lest we be regarded as a burden, most of us rage inwardly about the complaints we are afraid to voice and the desires we dare not impose.
Some people make rebellious bids for control that they then keep secret from their helpers. One sixty-two-year-old woman recounted her acts of defiance to me, on the condition that I not repeat them to her daughter:
I had a fall down the basement steps, and so my daughter says she’ll throttle me if I ever go down there. She hired a woman to come in and do my wash once a week so I never have to go down there. But I do go down. My daughter doesn’t know it and I’m very careful, but once in a while I get the crazy urge to do whatever I want to do. It’s as simple as that. It’s my house, my basement, my washing machine, and my life. That’s the way I feel.
Submission does not come easily to people who have spent decades running their own lives. Going down those steps made this woman’s basement her own again, just as choosing to violate her daughter’s restriction made her life her own again. Seizing freedom can be as unreasonable as it is gratifying.
Those who have had their wings clipped by illness or old age often feel the need to do something “crazy” to remind themselves that they are still able to exert influence, if only over their own domain or their own body. This need conflicts with their feeling obliged to give full cooperation to their caregivers. When other means of repayment are lacking, compliance does become the only resource that can be exchanged for sustenance. James Dowd, a sociologist, affirms this:
[Power] is derived from imbalances in the social exchange…. The relative power of the aged vis-à-vis their social environment is gradually diminished until all that remains of their power resources is the humble capacity to comply…. [For instance,] the widowed woman living with her married children may be required to exchange compliance or approval for her room and board. 4
Those with personality styles that prevent their squelching themselves in this manner lack even the power of compliance. Instead, they turn their helplessness into its reverse, commanding their helpers to follow their exact specifications and blasting their helpers with anger when their directives are not heeded. Not surprisingly, such people are dreaded by hired workers and family helpers alike. Their company is shunned, except when the performance of duties necessitates interaction. They become more and more isolated emotionally as their sullen helpers get the work done but infuse little warmth into their labors.
For those receiving care but craving control, the “right” amount of self-assertion is always complicated. Personality and life history must be taken into consideration. For instance, if a wife is providing care to her ill husband, useful compromises in their marriage may have been disrupted by the illness. Years may have passed since they last negotiated their power balance or had to make adjustments for each other’s personality style.
A seventy-six-year-old man whose hand tremor interfered with his writing checks explained the process of disruption and renegotiation that took place in his fifty-five year marriage:
Watching my wife ruin the checkbook was driving me crazy. She would just dash off the bills, not bothering to mark down the dates, check numbers, who it was to, all that stuff. A couple of times she didn’t even mark down the amount. How the hell could I balance the checkbook without the amounts? It was making me sick. Finally, we made a deal— that I could stand over her head to make sure she did it right, so long as I stayed out of her hair in the kitchen. That was fair.
This man needed control over the household finances more than he needed a say in meal preparation. His wife needed at least one arena in which she was not subject to her husband’s meticulous instruction and criticism. Their trade was based on recognition of what was most important to each, not merely on pragmatic considerations. In situations of dependence, it is easy to get lost in the pressures of the practical and to put aside preferences that are not strictly “necessary.”
Every detail of checkbooks and kitchens cannot be negotiated, and not all preferences can be respected. The trick for caregivers and dependent people is to find small but specific concessions to each other’s preferences that yield large satisfactions. There is no formula for this process beyond the most basic concept of exchange, such as “You do this for me and I’ll do that for you.” Such exchanges tend to multiply feelings of efficacy, even as they divide actual opportunities for wielding power.
In my clinical practice, I have found that most family members giving care to an ill relative refuse even to mention the word “power,” as if power and affection cannot coexist. When their disempowered relative becomes depressed, they mistake this despondency for an accusation that they are not doing a good job. Hoping for appreciation, they instead get quietly hostile acquiescence. Once families acknowledge the presence and importance of power in situations of dependency, they tend to have little difficulty taking stock of its distribution and beginning to remedy imbalances on either side. The next section explores what happens when caregivers give up too much power by sacrificing their needs and suppressing their complaints.
THE PREVENTION OF RESENTMENT
Resentment is a reliable gauge of when helpers are doing more than they should. The problem with heeding this gauge is that there are ongoing pressures to deny its validity. Dedicated helpers insist that they are doing “fine.” At all costs, they want to avoid evoking the ill person’s fear of abandonment and to keep from revealing that the care has become burdensome. They conceal their feelings and strive to maintain a contented exterior. Eventually, their pretense isolates them from the ill person, and any previous intimacy becomes veiled by this effort to hide the truth.
Warning others against such pretending, an adult daughter wrote an article called “The Sandwich Generation.” She felt herself sandwiched between her husband, her children, her job, and her mother’s need for frequent contact with her. Each time she visited her mother, she feigned an attitude of successful coping, while inside she felt tense and overwhelmed. Finally, she came to a crucial realization: “I began to see how my mother’s illness had become a wall between us.” She went on:
The next time we were together I held her hands very tight in mine, as if to pass my strength to her, and told her that I couldn’t bear the distance between us. If the time that remained to us was to have any meaning at all, I said, we would have to speak of our feelings…. And so we began to talk. We agreed on a schedule of visits and phone calls that made my life less chaotic and gave me more time and energy for my own family. But more important, as we began to speak honestly the wall between us started to break down. “I feel guilty because I’m taking you away from your children,” she confessed. And I told her, “I wish I could care for you better,” admitting how hard it was for me to be mother to my mother. 5
Unacknowledged weariness puts a barrier between ill people and those who assist them. But feelings leak through in subtle ways. A strained voice or tension in the grip of a hand are difficult to conceal. Ill people who fear becoming a burden stay alert for just such nuances. This woman’s mother felt guilty all along because she had been aware of her daughter’s stress and dividedness. For both mother and daughter, admitting the truth was not nearly so agonizing as avoiding it had been.
Ill people often grapple with painful ambivalence about continuing to accept help that they know is burdening members of their family. At the same time that they wish to release their loved ones, they want to cling to the comfort they provide. One seventy-five-year-old woman told me how she lay awake at night for months, ruminating over whether to free her son from his imprisoning helpfulness:
My son says he likes fixing me dinner every night, but he looks so tense when he’s here. He comes over right from work, and his wife holds dinner at their house until he gets home. He smiles, makes chitchat, but I know he’s racing against time. Sometimes he looks like he’s going to explode, his face is so tight, but he keeps on smiling. I wish he could just say it’s too much for him. I’d be disappointed, don’t get me wrong, but TV dinners wouldn’t kill me.
This woman saw that beneath his cheerful demeanor her son was suffering, but she did not initiate his release from the obligation. She was afraid, not of TV dinners but of the loneliness that would await her on a nightly basis if she spoke up and urged him to visit her only on weekends. The worst consequence of her silence was the gap it left between them. He could no longer speak with her beyond the level of “chitchat” because she herself had become the unmentionable problem in his life. Ironically, her loneliness would perhaps have lessened if she had exchanged frequent contact with him on weekdays for more relaxed contact on weekends.
Here again is the notion of exchange: trading frequency for quality, guilty silence for relieving honesty. Dependent people and their helpers can release each other from guilt, but gestures must be mutual if they are to be effective. I met one daughter who had instinctively begun a series of positive exchanges with her ill mother, thus discovering the quality of mercy on her own:
My mother was on oxygen and bedbound. Taking care of her twenty-four hours a day was wiping me out. I kept waiting on her hand and foot, getting her whatever she wanted whenever she wanted it. One day I heard her calling me from upstairs and I actually hated her voice. I went cold all over. Then I knew it was time to stop this perfect daughter stuff. Who wants to be hated? I wasn’t doing her any favors. So I started spending a few hours a day outside in my garden, just leaving her a pitcher of water beside her bed. She had to wait to go to the bathroom sometimes, but so what. It was worth it to her. I started liking her again, doing sweet things for her. She looked so much happier when I stopped being so perfect. I wish I had realized sooner that this was more important.
The reward for recognizing resentment as a limit is enjoying the ill person’s company again. To feel that one can give pleasure and to receive small acts of sweetness is a fair exchange for a few hours’ wait. A spiral of good feeling was set in motion between this mother and daughter, replacing the negative spiral that had been evolving between them as the daughter was becoming more and more weary of the care. If given the choice, few people would choose being waited on over being enjoyed.
Unfortunately, instigating enjoyment is often difficult when life has become constricted by illness, bereavement, or the sheer tedium of subsistence. Within this limited range, aging parents and adult children are often reduced to holding onto opposite ends of an obligation. They come to feel that little binds them together except abject duty. One daughter came to me because she was unable to get resentment out of her voice when her father made his nightly calls to her. In the four years since her mother’s death, her adoring relationship with her father had turned sour. He was almost continually despondent, and she had grown impatient trying to cheer or comfort him. She expressed her dilemma clearly:
I hear my father’s voice on the phone and my heart sinks. It’s awful to feel this way, but I know he’s going to tell me how lonely he is and how much he misses Mom. I’m sick of hearing about it. I’ve heard it so many times already and there’s nothing I can do about it. The worst part of it is he always calls just as my husband and I are lying down in bed together. This is the time of night when he misses Mom the most, but it’s also our time, our time to be together, and I resent my father terribly then.
Saying these forbidden words, that she was “sick” of her father’s loneliness, made her cry. Underneath this exasperation was her sadness that night after night of phone calls had made little impact on her father’s sorrow. The crux of this session came when she suddenly saw that no amount of conversation was going to diminish her father’s yearning for her mother’s company, especially at that time of the night. She also realized that preserving the sanctity of her bedtimes with her husband celebrated what she had learned from her parents about making a marriage work. She made up her mind to tell him the truth.
A few weeks later, she announced that her father had reacted “wonderfully” to her honesty. Caught up in his sorrow, he had not noticed the poor timing of his calls, and he thanked her for stopping his intrusions into such a precious part of her day. Together they devised other ways he could cope with his worst moments, such as listening to a tape she made for him of childhood memories. This gave him both the sound of a familiar voice and a distraction back to happier times. She began to call him earlier in the evening, when it was most convenient for her. Almost immediately, she found that her resentment receded: “He’s my father again, not just a weight on my back.”
With frankness, ill people and those who assist them can begin to surmount the impasse created by unacknowledged power and unspoken resentment. Honesty also sets the stage for further, equally crucial corrections in the balance of the relationship.
TO BE OF USE
In a passage about his volunteer work as a visitor to homebound elderly, a seventy-seven-year-old man describes what happens each time he fails to find something that his clients can give him in return:
The old person being visited knows that he is simply being visited. He knows that he is in receipt of a charitable act and that there is no true relationship. He knows that you and he have nothing in the world in common except old age. The old person knows that all too well, ah, too well. 6
He goes on to tell the story of discovering a common passion for genealogy with one of his clients: “So we welcomed each other’s craziness and became real friends at once.” Suddenly the homebound man was not receiving charity but rather was participating in a pleasure. He was not “simply being visited,” but rather was granting his visitor a chance to indulge and amplify his own interests.
The Roman historian Tacitus warned against generosity that cannot be returned. He stated that “services are welcome as long as it seems possible to repay them, but when they greatly exceed that point they produce not gratitude but hatred.” 7 Frail people are generally denied chances to give something back to their helpers or to their communities. Their offers are refused with statements like, “You don’t have to do that. We’ll take care of everything.” Helpers mean well, without realizing how urgently people in their care crave a tangible counterbalance to their dependency.
Americans tend to ignore the weight of shame and indebtedness that is carried long after someone receives assistance. Conversely, in Japanese culture owing gratitude to a benefactor is acknowledged as a hardship. The anthropologist Ruth Benedict notes that Japanese people “do not like to shoulder casually the debt of gratitude” and that this reluctance is reflected in the words they use to express indebtedness. She writes:
The Japanese have many ways of saying “Thank you”…. The least ambivalent, the phrase that has been adopted in modern city department stores, means “Oh, this difficult thing” (arigato). The Japanese usually say that this “difficult thing” is the great and rare benefit the customer is bestowing on the store in buying…. Other just as common words for “thank you” refer like kino doku to the difficulty of receiving. Shopkeepers who run their own shops most commonly say literally: “Oh, this doesn’t end,” (sumimasen), i.e., “I have received (an obligation) from you and under modern economic arrangements I can never repay you; I am sorry to be placed in such a position”…. Another word for thank-you, katajikenai, which is written with the character “insult,” “loss of face” … means both “I am insulted” and “I am grateful.” 8
When culture and language fail to acknowledge the difficulty of receiving, the dependent person is left doubly burdened, in disliking the help that cannot be repaid and in feeling guilty about the dislike. A forty-eight-year-old man with metastatic cancer explained what it is like to receive too much mercy:
Ever since I got sick, everyone’s been bringing me things— new blankets, special treats, even a new couch. I’m grateful for all this, but it gets to me. I mean, when Christmas came I got more fruit and candy than I could possibly eat. I went door-to-door here in my building and left little packages outside everybody’s door. Now, that felt good. I was on the giving end for a change. That’s what’s missing in my life. I wish I had more I could give to people. Saying “thank you” all the time makes you feel bad.
Being of use makes being in need easier. This man “felt good” delivering his packages, imagining all the while the delighted surprise on his neighbors’ faces when they opened their doors. As the French philosopher Montaigne wrote, “There is a sort of gratification in doing good which makes us rejoice in ourselves … and this natural rejoicing is a great boon to us, and the only payment that never fails us.” 9
As soon as opportunities to be useful become scarce, such as during times of illness, we appreciate the full meaning of Montaigne’s remark. We wake up to the stark fact that no one expects our presence and no one needs our efforts. Lacking external obligations, we discover that we have to summon all of our resolve just to take care of bodily concerns. I have often heard people in these circumstances say, “Look at my life— all I do is eat and sleep. What kind of life is this?” They equate their lack of productive activity with worthlessness. One gerontologist writes, “With older people there often comes a point of having few responsibilities for others. At the same time a good and proper caring for self may lose importance.” 10
Mere existence does not imbue us with the will to thrive. An eighty-two-year-old woman once let me know her secret for enduring the pain of a degenerative spinal disease:
I have a neighbor who can’t see to take her pills. It’s hard for me to get down the hall to her apartment, but she has to have the help. I wake up and I know I have to get down there, no matter what. My back hurts, but I have two good eyes. Thinking how she can’t see takes my mind off my aching back. What would she do without me?
This woman does not have to rely upon her own fickle willpower each morning, but rather the necessity of meeting her neighbor’s need for help. Every day she swings her legs over the side of her bed and gets dressed, in spite of the aching. She works hard to maintain her ability to walk that crucial distance down the hall. Three times a day, her neighbor’s need ensures that she keeps her legs strong and her spirit supple. Obligations curtail our freedom to waste ourselves.
James Wallace, a philosopher of ethics, points out that people who are kind, generous, and compassionate give others “a striking affirmation of the intrinsic worth and importance of individual human beings.” 11 But their good deeds and thoughts confirm the value of their lives for themselves as well. This insight was given ample demonstration by Barbara Myerhoff, an anthropologist, in her study of Jewish older people in an urban ghetto. She was struck by the vibrance of many of the women she interviewed, attributing their animation to their engagement in networks of giving and receiving help:
The old women I have described communicated a quiet conviction and satisfaction with themselves… in domestic religion, in caring for others, in serious, dedicated friendships, in constructing individual careers made of personally discovered projects, in arranging lives of self-care and attentiveness to others who are needy…. 12
In spite of their own bereavements and infirmities, these women sought out the opportunity to perform acts of service. These commitments gave them reasons to transcend their own problems. Looking back on her research, Myerhoff comments, “Theirs is not a world in which something is given for nothing. Everything is built around exchange. There are no beggars, no charity, only webs of donors.” 13 Through these “webs,” dignity is passed around from one person to another and no one is left without the pride of being a donor.
To be of help to others is one of the highest honors in Jewish tradition, but the recipient of a mitzvah, a good deed, must not be shamed. In his portrait of Judaism’s tenets, the philosopher Leon Roth explains, “The Rabbis of the Talmud held that to help one’s fellow man is the best of all deeds but to bring shame on him is one of the worst: a man should be (like Job) ‘eyes to the blind’ without being himself seen.” 14 In retirement homes and other communal settings, shame is a recurring obstacle to the formation of helping networks. What people encounter is a virtual conspiracy of independence.
The unwritten code in most of these settings is that residents are supposed to fend for themselves. The able-bodied shun those who appear to be frail, and frail people try to conceal their needs as much as they can. Writing about life in a retirement home, an eighty-five-year-old woman depicts her experience with this code in the cafeteria:
Sometime, somewhere, the idea developed that one must neither give nor receive help in carrying the cafeteria trays. Occasionally, if someone has had an eye or a hand operation, the custom is varied for a short time, but soon those people are struggling with their trays again. 15
Dreading pity more than hunger, many omit items from their trays in order to carry them without assistance. The resident quoted above continues: “We keep up with one another on the way to the elevator and in the hall… but we never visit inside our apartments.” 16 Inside their residences are their badges of vulnerability: crumbs that cannot be vacuumed from the floor and unmade beds that fumbling hands can no longer correct. To visit each others’ apartments would expose their frailties. Instead, they live in private cells, concealing the evidence of their incapacities and averting their eyes from each others’ problems.
As a social worker, I have been admitted to many such apartments over the years. Usually, my presence was accepted only because a sudden illness had necessitated my help. In one such instance, I found that my client had been sitting in the dark for weeks. The light bulbs had burned out in her ceiling fixtures, and she had no floor or table lamps. Rather than ask one of her neighbors to help, she had been reading by daylight and going to bed when it became too dark to see. She explained:
What can I do for my neighbors? Nothing. Look at my hands. They’re useless from this arthritis. I can’t keep asking for favors, day in and day out. They’ll get sick of me. Pretty soon they’ll see me coming and they’ll duck into their apartments. No, I’d rather do for myself or just do without.
This woman saw herself as a black hole of needs that other people should avoid, since she had “nothing” to give in return. At first, she flatly refused to let me stand on a stool and replace her bulbs. I insisted that it would make me happy to do this for her, and that I would take away with me the image of her reading again through the long winter night. She studied my face as I told her how I hated the idea of her tossing fitfully in bed, unable to sleep and unable to read. Finally, her pride relented and she led me to her supply of light bulbs. As I left, I thanked her for giving me the honor of helping her. She understood what I meant, for it was she who was carrying the burden of uselessness and I who was being granted satisfaction.
The one who gives help is more powerful than the one who receives it. The sheer acknowledgement of this inequality is a relief to those who have to occupy the inferior position. They no longer have to pretend that they are pleased, and they can insist upon forms of repayment other than compliance. Those who provide mercy can then accept consideration for their own needs without feeling guilty, and helping arrangements can be structured toward the aim of achieving a balanced exchange.
The highest qualities of mercy may not be fully achievable, but such efforts at least minimize degradation and relieve resentment. In his Essays in Pragmatism, William James affirms the complexity of striving for ethical ideals within the murky conditions of actual life:
The actually possible in this world is vastly narrower than all that is demanded; and there is always a pinch between the ideal and the actual which can only be got through by leaving part of the ideal behind…. Some part of the ideal must be butchered. 17
Knowing what to do for an ill person and what to cease doing begins with understanding what life is like from that person’s perspective. Without this comprehension, there is a tendency to worry about the wrong things and to give assistance in the wrong ways. Learning all that we can about being dependent allows us to fall short of the ideal to the right extent. [17-36]
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