I only got around to checking out the Randy Pausch talk yesterday. I'm in
agreement with some - not all! - of what Mike Palij wrote, but I first want
to deal with one side-issue he brings up:

> Perhaps I am looking at this situation the wrong way but 
> given Pausch's death as well as the recent deaths of such 
> celebrities as Tony Snow and Tim Russert, men who have 
> might be described as being positive/optimistic in outlook, 
> high in self-efficacy, having a "fighting spirit" and other 
> "good" psychological characteristics, all these things going 
> for them and yet they have died at such early ages.

I don't discern any implications along these lines in the more appreciative
responses to Rausch's talk, so I think this is a separate issue.
(Nevertheless an important one - a friend of mine whose reading *has* led
her to think in this way experienced excruciating feelings of guilt when
her husband died of cancer in his 40s a few years ago because she believed
that her previous pressure on him to "communicate" his feelings against his
strong temperamental reluctance to do so was a factor in his developing the
disease.)

Back to Pausch's talk. One's reaction depends so much on one's own
personality/temperament/personal experience that there is (of course) no
right/wrong or morally/emotionally better way of responding to it.
Personally I incline more to Chris's view, partly as a reaction to the
unremittingly upbeat sentiments - his parents, his family, his teachers,
his work colleagues, his students, his work, all were wonderful. (And I'm
afraid the teddy-bear interlude didn't do anything for me - maybe because I
don't recall having one. :-) As Chris says, no one would want to detract
for one moment from an appreciation of Pausch's courage and the inspiration
he has given others, but we can only try to be honest in describing our
responses. (And I think Chris deserves some credit for doing so on such an
emotive topic after the several strongly appreciative postings.)

For those like Joan and Louis who argue for attitudes/practices that
enhance one's capacity to deal with life's problems and tribulations, I'm
in full agreement. But, like Chris, I would want to add some caveats. As
personal experience counts so much here, I must add that, though I suspect
I have never been as low as Dick Cavett, I do know what he means when he
says that in the depths of depression accomplishing the most mundane task
is a day's work. (And this state can last for many months on end, sometimes
years.) I can recall a time when I genuinely believed that walking all day,
for day after day, week after week, while practising mindfulness, focusing
on one's breathing, and so on, *must* eventually reap some reward, some
lifting of the depression/anxiety. Alas not, and in the worst states only
the dreaded (!) drugs eventually produced results. That doesn't mean I
think self-help, from developing positive attitudes to
relaxation/meditation techniques, and so on, are not important - on the
contrary, I think these are all ways of helping to maintain a
mentally/emotionally healthy state, or dealing with down periods, but I
fear that some of those self-help books out there that sell in their
millions are liable to produce self-reproach in those for whom it just
doesn't help when they most need it, as the authors all too often make it
seem (if only by implication) that if the techniques are not effective it's
your own damn fault.

So if there's any moral here, I'd say we must recognise that there are no
"answers" that apply to each and all of us, and keep in mind that (believe
it or not) people are born with different temperaments:
J. Kagan, *Galen's Prophecy: Temperament in Human Nature*, Basic Books,
1994.

A rather different public talk: TV Playwright Dennis Potter gave a
televised interview a few days before his death, occasionally stopping to
sip morphine from a cup. Brief extracts: 
http://www.guardian.co.uk/news/video/2007/sep/11/dennis.potter

Edited interview:
http://www.guardian.co.uk/theguardian/2007/sep/12/greatinterviews
: 
And a very different response to a death sentence:
http://tinyurl.com/6xpevu

All courageous in their own way.

Allen Esterson
Former lecturer, Science Department
Southwark College, London
http://www.esterson.org

-------------------------------------------------------------------- 
[tips] Pausch and Cavett
Christopher D. Green
Sat, 26 Jul 2008 08:46:05 -0700
I must admit that this outpouring of praise for Randy Pausch -- from a 
bunch or professional psychologists, no less -- has me a little baffled. 
Don't get me wrong. Pausch seemed like an energetic, optimistic guy who 
would be fun to be around, and his death as so young an age is a 
tragedy. But his view of human behavior was, well, naive at best.

If you really think that the world of behavior is so simple that it can 
be reduced to Tiggers and Eeyores, and, what is more, that we all have 
the power to simply choose which kind of person we'd like to be, then I 
suggest you read the column that Dick Cavett wrote on depression in the 
New York Times a few weeks ago: 
http://cavett.blogs.nytimes.com/2008/06/27/smiling-through/

It strikes me as being much more sensible and realistic, even if it 
isn't quite as "uplifting."

Chris
--------------------------------------------------
Re: [tips] Pausch and Cavett
Joan Warmbold
Sat, 26 Jul 2008 13:51:42 -0700
I also enjoyed Cavett's poignant, frank and insightful column about
depression.  However, the work by cognitive-behavioral psychologists
combined with Seligman's work on the science of happiness strongly support
that we can make the conscious choice to focus on the positive, to
emphasize and effectively use our strengths, as well as learn to 
establishing our priorities and use our time for effectively.  To me, in
Randy's "Last Lecture," he provided a sterling cognitive-behavioral model
of a person who had the attitude and behaviors that enabled him to live a
wonderfully satisfying and productive life.  In so doing, I personally am
far less likely to take the downside to my situations.  I mean, I just
have to view segments of his lectures and/or his book, and I'm back up and
running.

I also recommend to my students the book by Richard Carlson, "You Can Be
Happy No Matter What," as well as Burns book, "Feeling Good Handbook," and
Seligman's book, "Authentic Happiness."  I truly feel if we would start
working with children on how to learn to focus on the positive and on
one's strengths, many would have far more productive and happier lives. 
We develop patterns early and some learn to feel sad and have a low
self-esteem.  Randy freely admitted in his lecture that he had 'the luck
of the draw' with the wonderful parents and family life he experienced. 
We all can't have such ideal childhoods but we all CAN learn how to become
more productive, optimistic and content.  I think why Randy touched so
many of us was that he could maintain such an upbeat and
productive/pragmatic attitude and lifestyle while knowing he was dying and
leaving behind a wonderful family.  He served as an inspiration to us all
that apparently could even touch the hearts and minds of professional
psychologists.

Joan
-------------------------------------------------------
RE: [tips] Pausch and Cavett
Louis Schmier
Sun, 27 Jul 2008 11:21:25 -0700

Well, I haven't been "in trouble" on this list for a while.  So, here goes.
 Chris, I agree that human beings and that which afflicts them, is
extraordinarily complex.  I agree that we must be careful not to think that
the likes of Pausch are a panacea, although his rapid rise to renown
reflects a wide-spread need among so many people.  Yet, as the like of Dick
Cavett and Mike Wallace testify in interviews and on help ads, we do have
the power to choose to fix "busted brains" in the attempt not to be
"drowned," as Cavett phrased it, by their affliction and to become at peace
with themselves and that which is around them.  However, not all mental and
emotional issues, for want of a better term, are physiological; not all can
be managed or "cured" with a pill.  We can't accuse Pausch and those who
cheer him as simplistic and offer an alternative simplistic reality.  I
would argue that there is a place for the Pausches of this world, for
medication and meditation, for drug-therapy and psycho-therapy.  From my
various personal observations and experiences, as well as my wife's
personal and professional experiences, too much of psychiatry and
psychology seems to have gone from one extreme to another.  Contrary to the
impact of any extreme, we shouldn't drown out human nuance. Make it a good
day.

Louis

---------------------------------------------------------------------------
re: [tips] Pausch and Cavett
Mike Palij
Sun, 27 Jul 2008 19:18:03 -0700
Perhaps I am looking at this situation the wrong way but given
Pausch's death as well as the recent deaths of such celebrities as
Tony Snow and Tim Russert, men who have might be described
as being positive/optimistic in outlook, high in self-efficacy, having
a "fighting spirit" and other "good" psychological characteristics,
all these things going for them and yet they have died at such
early ages.

Perhaps being positive/optimistic etc. does not extend one's life.
Maybe it may make one's quality of life better before the end
but in Pausch's case, given the severe pain caused by pancreatic
cancer, I have the feeling that such an attitude would have been
overshadowed by the desire to keep the level of pain medication
at an appropriate level up until the point that it was still effective.
One can always choose how to exit, which may suggest a viewing
of the movie "The Shootist" which was John Wayne's last movie.

Perhaps I am asking what is the lesson to be drawn from Pausch's
life beyond a lecture he once gave.  Maybe only the standard 
lessons apply (i.e., choose your parents carefully, choose your
genetic endowment carefully, choose your childhood environment
carefully, etc.).

As for the view of life provided by Dick Cavett, I have mixed 
feelings about this as well.  I think that it is a good thing for people
with depression or other significant conditions to get help because
sometimes that might help.  But sometimes it doesn't.  There are
people with depression who don't respond to standard pharmacoptherapy 
or psychotherapy, a condition known as treatment "refractory"
depression (for a brief review based on presentations made at
the "other" APA see the following entry on Medscape.com [you
might be asked to register to access the info]:
http://www.medscape.com/viewarticle/576515
>From the  opening paragraphs:

|Selection from: APA 2008: Depression
|Treatment-Refractory Depression  CME/CE
|Jerrold F. Rosenbaum, MD   Jennifer M. Covino, MPA 
|
|Treatment-refractory depression (TRD) and its associated 
|distress and disabilities continue to challenge caregivers. 
|Innovations in therapeutics that address residual symptoms, 
|and improve rates of remission and quality of life are essential. 
|Obstacles to such innovations include a lack of understanding 
|of the pathophysiology of the illness, and an array of confounding 
|factors, including social and environmental stressors.
|
|For years, the mainstay of treatment for severe depression 
|has been pharmacologic interventions and electroconvulsive therapy 
|(ECT). Yet for many individuals these essential treatments fail 
|to alleviate the suffering associated with this debilitating condition. 
|Data from the World Health Organization ranked unipolar major 
|depression fourth among all medical conditions in disability-adjusted 
|life years (DALYs) with a projected increase to second by the year 
|2020.[1] It is therefore essential that researchers develop novel 
|treatment strategies as we expand our understanding of biological 
|and genetic mechanisms of depression. Research presented at the 
|161st Annual Meeting of the American Psychiatric Association on 
|May 3-8, 2008 in Washington, DC, included further advances in 
|research and treatment of TRD.

Perhaps it is good thing to give people hope.  But maybe it's not
such a good thing when the only thing one can give is hope (or,
in its extreme form "irrational exuberance").  

Perhaps we should just look on the bright side of life.  See:
http://www.thebards.net/music/lyrics/Always_Look_Bright_Side_Life.shtml

| (You know, you come from nothing - you're going back to nothing.
|What have you lost? Nothing!)

-Mike Palij
New York University

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