Human communication is fragile. Interruptions in human dialogue can range all the way from very brief absences from loved ones to the permanent loss of dialogue through death. By monitoring the occurrence of disease and even the occurrence of death, these investigators have been able to weigh numerically the effects of death of a spouse, separation, divorce, death of a close family member, children leaving the house, and death of a close friend. All of these disruptions were followed by a significant increase in disease and death. These statistical relationships between human loss, disease, and death suggest that those who experience interruptions and disruptions in the dialogue of life require help and support. While it is true that only individuals can love and participate in dialogue, such interactions, like chemical reactions, require the proper social milieu in order to flourish. Thus, an individual’s grief, insecure ego, inability to love, shattered dialogue, or entanglement in loneliness traps is also a collective problem for society. If children lose their parents or are abused, neglected, or abandoned by their parents, it seems obvious that someone else must help them. It is generally recognized that children require love, and if they do not receive it from their biological parents, society has an obligation to help them. The debate here centers on how such love can be effectively provided. Similarly, when adults suffer from interruptions in the dialogue of life—when they are bereaved, experiencing divorce or separation, living alone or lonely—they too require help, and it is in society’s collective interest to provide it. The problem, then, is how? I once knew this guy who really looked up to his father, but after spending a year getting to know him, he started to strongly dislike his father to the point he wanted to forget he ever existed. He looked at his dad as being a desperate coward, who has no control over his life, would do anything for a dollar, and someone who was not really a man. 

Psychiatrists, psychologists, social workers, and other health professionals do know a great deal about bereavement and loss, and they are on the whole quite cognizant of the physical and emotional impact of disruptions in dialogue. An entire new discipline called crisis intervention has developed within the past few decades specifically designed to begin immediately helping those experiencing interruptions in dialogue. These professional groups are performing a vital, and in many cases, absolutely essential, service. What is at issue here is the usefulness of an exclusively objective approach to assisting people in trouble. Ironically, the most problematic aspect of these professional efforts is that they now seem to be so necessary. They seem to be filling a void that is constantly growing. One is left to conclude that perhaps individuals, who suffered interruptions of dialogue a few decades ago were not cared for properly, or that the sources of support that once existed have now been eroded and are no longer viewed by society as particularly helpful. There is a new diagnosis of Developmental Trauma Disorder: Children who develop in the context of ongoing danger, maltreatment and disrupted caregiving systems are being ill served by the current diagnostic systems that lead to an emphasis on behavioral control with no recognition of interpersonal trauma. Studies on the sequel of childhood trauma in the context of caregiver abuse or neglect consistently demonstrate chronic and severe problems with emotion regulation, impulse control, attention and cognition, dissociation, interpersonal relationships, and self and relational schemas. In absence of a sensitive trauma-specific diagnosis, such children are currently diagnosed with an average of 3-8 co-morbid disorders. The continued practice of applying multiple distinct co-morbid diagnoses to traumatized children has grave consequences: it defies parsimony, obscures etiological clarity, and runs the danger of relegating treatment and intervention to a small aspect of the child’s psychopathology rather than promoting a comprehensive treatment approach. 

It is my opinion that in much the same way that medicine slowly abandoned its appreciation for the healing role of bedside manner, society has abandoned its appreciation for the healing capacity of human contact. Emotional support that once came from families, neighbors, friends, ministers, rabbis, and priests is now purchased from psychiatrists, psychologist, and various social service agencies. While delivering needed support to people, these professional helping groups have also tended to usurp our functions and relieve us of our sense of personal responsibility. Understanding the nature of human dialogue and the degree to which an individual’s very existence is sustained by other human beings helps us explain why the loss of a loved one or the lack of love can be so devastating. It also suggests why those who are suffering interruptions in the dialogue are often avoided. To engage a bereaved person in dialogue means sharing his or her pain. What emerges from the eyes of a bereaved individual is grief, what emerges from the eyes of those who live alone is loneliness; what emerges from the eyes of the unloved adolescent is frightened anger. These people all need to share these painful aspects of the lives through dialogue. The dialogue of pain, anxiety, anger, and loneliness is also part of life, but it is a dialogue that can be both frightening and painful. How convenient to label these as scientific-medical problems and therefore have others look into their eyes. And remember, if you have spent a year abusing and depending on your son, I am sure you noticed he is starting to like you less and less and no longer sees you as a man, but a punk. You may want to do something kind before his heart hardens towards you and he grows to hate you.