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Note: this one is written dedicated to “R” who comes in once a season for a ‘med check’ and to tell me how awful is life. Not just hers, but all life. A Dementor could do no better to bring me down. This essay is what I want to tell her, if she was open to hearing it. Spo

I have a handful of patients who play a sort of game called the ‘What’s the point?’ game. The goal is to defeat me in my meager means to help them. They list their woes and circumstances, and it’s my role in the game to try to come up with why their convictions are not so. Mind! This is not the hopelessness commonly seen in clinical depression. This is something else. There is almost a defiance to it, a ‘just try me” emotion, done with a slight smirk when I don’t ‘win’. My attempts to get them to see things differently or to persevere/something will work out, are deflected faster than bullets off of bracelets in ‘yes, but’ replies or other rationales. This is often the result of anger, turned-in: they feel much pain and they want me to experience their rage and helplessness – not assuage it.* “Yes,” they want me to admit in a defeat, “You’re right. It’s all pointless. Let’s give up”.

Many times in my life my mind has played “What’s the point?” with myself, so I recognize the game when it happens.

Once brains start playing the game, they often can’t find a way to stop. Everything hurts. The present has no value and the future has no point. Both my mind and patients distill all endeavors down to the universe not caring if we are here or not. They hold onto nihilism and think me stupid for thinking otherwise.What kind of idiot looks at the state of mankind and responds with anything other than despair?

Despair (I tell my patient and myself) is a certainty and I haven’t met a certainty that isn’t so. To look at it otherwise, one doesn’t pretend meaningless isn’t there, nor does one go the opposite direction that is all there is. We are wrong about meaningless when we wear it like a helmet against life.

“Meaning” I tell them “is what you do next”. ‘What’s the point?”: The answer is what we do in response to this emotional question.

I was recently reminded the word ‘believe’ stems from a Germanic-like word for ‘to care’ . I choose to care, to do something/anything that may nurture love and good work. I choose not to play this game. I choose to believe and persevere towards answering the question. The answer may not be at the destination but along the way when we were least expecting to encounter it.

*This is one definition ‘projective identification”. The therapist feels the emotions of the patient as if they threw a beachball and you caught it. One is on guard to see these coming and not catch or hold onto them.

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