About the Author
Shane J. Lopez, Ph.D., a Gallup Senior Scientist, is the world’s leading authority on the psychology of hope. He has published numerous professional books on what is right with people, including The Encyclopedia of Positive Psychology. He lives in Lawrence, Kansas, with his wife and son.
Excerpt. © Reprinted by permission. All rights reserved.
Making Hope Happen Chapter 1
What the Man with No Future Taught Me About Hope
IT WAS the fall of 1997 and I was starting my final year of clinical training at the Eisenhower VA Medical Center in Leavenworth, Kansas, trying to get good at using psychotherapy to treat depression in veterans of all ages. My primary rotation was in the Mental Health Clinic.
The clinic itself was cast in the image of its director, an old-school military psychiatrist named Dr. Theodore McNutt. McNutt’s white coat was a bit yellowed, but perfectly pressed with lots of starch, and he walked with a posture that suggested his clothes could crack at any moment. During my time in the clinic, Dr. McNutt had thrown me several softballs. Most of the veterans he had sent my way had needed little more than someone to talk to plus a few new techniques for managing sadness and stress. McNutt had a way of making me feel like a part of the treatment team without overwhelming me.
One morning, I heard McNutt’s black wingtips coming purposefully down the corridor. He walked right into my office, looking very serious and dispensing with his typical formalities, and sat in the chair reserved for patients.
“There’s a man in the lobby who just got some bad news. He needs someone to talk to.” So far, it was a typical McNutt referral—a guy needing some support and a little bit of cognitive therapy. “There’s more. He is acutely suicidal. He said he’ll shoot himself as soon as he gets home. I’d rather not hospitalize him. It’s just not a good option for this veteran. The inpatient psychiatric ward would scare the hell out of him—you know what inpatient is like—and probably make him more desperate. So he has to go home today, but he can’t be a threat to himself. I will go get him.”
Go get him? What? Now? Wait! Dr. McNutt had no time for questions and had already turned on his heels and was double-timing it to his office.
The vet who had just received the bad news was John, a full-bodied sixty-three-year-old veteran of the Korean War who had spent his life both before and after his years of military service in the cornfields of Kansas. Dr. McNutt escorted him and Paula, John’s wife, a short, sturdy woman with tired eyes, into my office. John sat silent and stared at the floor while the three of us quickly recapped the day’s events. Pragmatic from his silver flattop to his brown cowboy boots, John had never before seen a psychiatrist or a psychologist; he had never needed to.
But early that morning, John had come to the hospital complaining of fatigue and high blood pressure. He’d seen the physician, taken a bunch of tests, and then waited for the results, thinking he would just have to up his blood pressure medication. He merely wanted the new script and his discharge papers. He was ready to go back to work.
After reviewing John’s test results, however, the young VA doc had an unexpected diagnosis that he had to give John. He tried the “bad news, good news” approach: “John, the bad news is that your kidneys are failing. The good news is that you can live a relatively normal life with the help of dialysis.”
Paula said that John had handled this revelation well, initially—until the physician had described the treatment regimen. “The closest dialysis center is about an hour and a half away from you. You will need to go there three times a week. Plan on being there mid-morning. You can be done by lunch, and you’ll have the afternoon to rest.”
That’s when John started to lose it, Paula said. His first question was “Doc, how will I run my farm?” The doctor groped for an answer and came back with his own question: “Can someone else do it for you?”
To John, the diagnosis plus dialysis equaled a death sentence . . . for his farm. The internist made it clear that John could not run the farm while on dialysis, so that treatment option did not make sense. But not getting treated would also leave him too sick to work his fields.
So John was trapped:
Get kidney treatment, lose the farm.
Don’t get treatment, lose the farm.
John saw himself as a man with no future.
When John said the word suicide out loud, the internist sent him and Paula straight to the Mental Health Clinic. By the time they were shuttled over, John had mapped out a plan. He was going home to shoot himself. “I want to die. I will kill myself,” he said. And we all believed that he would.
A strong John Wayne type, he seemed like someone who would never give up. In fact, there was nothing in John’s past that suggested he would react this way. He was a survivor—he had already made it through a war, a big recession that hit his farm hard, and the summer floods of 1993, which turned his fields into a giant lake. For decades, nothing could knock this man down. But now, as he faced the idea of losing his beloved farm and the future he had worked for his entire life, John had given up on living.
When the full story was told in my office, Dr. McNutt said, “John, you are going home tonight. Shane here will see that you are safe.” McNutt patted me on the back extra hard and walked out of the room.
Fortunately, after a few hours, a few of my clinical techniques did work enough to stabilize John on that first day, and he got to the point where he was no longer a danger to himself. Though still entertaining suicidal thoughts, he shook hands with me on a deal that he would not act on those thoughts. We made sure that he had a safe home to return to and plenty of support once he got there. With the help of his family and friends, recruited by Paula with just a few phone calls, all of his guns were removed from their home. Paula, an amazingly strong woman, took responsibility for seeing that John made it through the night.
But after they left, I was confronted by my own sense of helplessness. None of my training had prepared me for this situation. How could I help a person who was so utterly hopeless? In a just a few hours’ time, the strongest of men—a battle-hardened Marine—had simply given up on the future and on his life. Could something that broken be fixed?
I had no answers. Once home, I grabbed a beer and then started trying to think of a plan. After an hour or two, I reached for another beer and a book, The Psychology of Hope, written by one of my graduate school professors, Rick Snyder. Rick talked about hope as a life-sustaining force that is rooted in our relationship with the future. He wrote, “Just as our ancestors did, today we think about getting from where we are now, let’s call it Point A, to where we want to be, say Point B.”
John had lost his way, his Point B. He needed new strategies for getting to his old goals, or he needed a new Point B.
The next day, John returned to the clinic with less intense suicidal thoughts and with a question: “So, Doc, what’s my story?” After fumbling a bit, I realized what he was asking. John needed a way to explain his illness to the “boys at the coffee shop” (his fellow farmers), to his family, and, most of all, to himself. He wanted to know how to talk about being sick, going to treatment, and getting better or getting worse. He was looking for a quick, go-to response to the simple question that now seemed difficult to answer: “How are you doing?”
We spent the next two hours talking about his future. Somehow, I had to convince John that hope had helped him through hard times in the past and hope is what would help him deal with his diagnosis and treatment. All of John’s thoughts about the future focused on his farm. All of his goals were wrapped up in his land. He was clear about what the farm meant to him: “Everything.” He had leveraged his whole life to keep it going. Like many farmers, he owed hundreds of thousands of dollars on farm machinery. Over the previous year, the stress had gotten the better of him, and he believed that he had to work harder than ever, every day, or he would lose the equipment, the land, the house, all of it. His eighty-hour workweeks, though doable for most of his life, had worn him out.
I asked John about people who could help him out of a jam. Paula was doing everything she could, as were his friends, local farmers who were, as John described, “up to their ears with their own corn crops.” Then he admitted that he had one more possibility. “Well,” he said hesitantly, “there is my son, Carl.” It was clearly difficult for John to discuss his relationship with Carl, which was strained. Two decades before, father and son had worked side by side, planning the farm’s future. But they had stopped speaking. John couldn’t remember why, but he did not see that changing, even though his life plan had always been to pass down the family farm to Carl.
That night, John went home, again under Paula’s supervision. He was no longer suicidal, but he still had no Point B, no story about his future.
The following day, at the beginning of our next session, John announced, “I got it, Doc. ‘I am working on it.’ How about that? When people ask me how I’m doing, I tell them, ‘I am working on it.’ ” For John, those words would help him save face in front of his friends. For me, they meant that John once again saw himself as an active participant in his own life.
“John, what’s the next big job on the farm?” I asked.
“Gotta get the corn in.”
Timing is everything when harvesting corn. After fifty years in the fields, John knew exactly what to do to get a good yield, weather permitting. The harvest typically involved two weeks of eighteen-hour days. But as he talked, I realized John still did not have a clear understanding of his kidney failure and his need for dialysis. The clincher came when he told me, “If I get the corn in, and the price is right, then I can take some time off for that kidney treatment.”
John thought of kidney failure as a virus that could be knocked out by a course of antibiotics rather than a chronic ailment that required a lifetime of care. Nevertheless, after John and I consulted with his physicians, we all agreed that John could postpone dialysis until after he got the corn in. With the support of his docs and some cooperation from the weather, John started his one-man harvest. During that time, he occasionally visited with me in person or over the phone during his lunch breaks. And four weeks after threatening to shoot himself, John finished his harvest and sold his corn at a good price.
True to his word, John scheduled an appointment with his primary physician to begin preparing for treatment. He took a new battery of tests, and the results surprised us all. His GFR (glomerular filtration rate) was slightly improved; even though he hadn’t undergone any treatment at all, his kidneys were somehow functioning better than they had a month before.
Feeling feisty, John tried to strike a new deal with his doctor: “How about you give me two more weeks, so that I can do some custom baling?” John was excited about his new Point B. If he could finish the hay-baling jobs around the county, he could save some money for the long winter.
Meanwhile, Paula had identified a Point B of her own—she would reconnect her husband and son. Her plan was simple. John would go out early in the morning, as always, to start baling a large field. But once he got started, he would look across the field to see another baler coming toward him from the opposite side. Although John didn’t know it was going to happen, Carl showed up to do what his mother asked—to take the first step—and the two men met in the middle, in more ways than one. A father and a son reconciled, and both the family farm and the family itself were much more stable after that day.
Those sessions with John were the highlight of my training. He would breeze into the clinic, wave hello to Dr. McNutt, sit down in my office, start eating his sandwich, and tell me all the things he had done around the farm. His eyes would sparkle as he envisioned the next big thing he wanted to accomplish before he went on dialysis. Winter passed, and so did the spring. Together, father and son knocked down one big goal after another. And, somehow, contrary to all reasonable medical expectations, every month, even without treatment, John’s kidney functioning either stayed the same or improved.
By the time my rotation ended, John and Carl had a long list of goals to tackle together. And John had made peace with a future that included kidney treatment (which he finally understood to be a lifetime course). He conceded, “Carl will run our farm while I get treatment.” A few months later, before I left the VA at the end of my internship, I pulled up John’s records one last time. The most recent note read, “Dialysis postponed again due to improved kidney functioning.”
I am not telling John’s story to claim that hope can cure chronic disease—although in this case his health improved along with his hope. His story challenged a tale I had been telling myself—the one about what helps people have a good life. Until then, I thought you could smart your way into a good life and out of a bad one. Turns out, smart is not enough. I was just another academic putting too much stock in passive analytical intelligence—book smarts—and too little in what makes us believe that the future will be better than the present and that we can make that future our own.
Through my work with John, I realized that how we think about the future—how we hope—determines how well we live our lives. John’s transformations, from thriving to suffering and back to thriving, were simple and compelling. When he had clear hopes for the future, his life was good. When John had a sudden break with his future, he felt his life was not worth living. As John reconnected to a meaningful future, his life became good again, and he was excited by it. And his health mysteriously stabilized.
Since the day I met John, I have studied hope, both in my clinical work and in my research. Every client that followed John benefited from what he taught me—that our relationship with the future determines how well we live today. I asked my clients new and different questions, starting with “How hopeful are you about your future?” I changed the way I opened my first session with them. “How can I help you today?” became “If therapy is successful now, what will your life look like in five years?” I didn’t see clients as broken in the way I once had; I wasn’t trying to fix them anymore. I was doing everything I could to help them be better students, partners, or patients so that they could realize bigger goals in their lives.
The very week I met John, I stopped doing research on human intelligence. For a few years, I had been cranking out papers that demonstrated that IQ could be reliably measured and that it mattered and affected, somewhat, how well we did in school and at work. Until John came around, I had never really questioned the value of that research. Journal editors liked it. Other researchers cited it. It would get me tenure at a good university. So why stop? Well, John’s IQ didn’t—and couldn’t—help him bounce back. For all his intelligence, he didn’t have a clue about how to cope with the threat of losing life’s meaning—his reason to get up every morning. And nothing I’d learned from my research on intelligence could actually help John—or my other clients or anyone else I knew—when he needed help the most. So I decided that intelligence is overrated. It is much discussed and celebrated, and it is somewhat important at school and in the workplace, but a high IQ is not essential to a good li...
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