Dr Judith Guedalia

By Dr. Judith Guedalia and Chaim K. © 2008

We have many needs.  Sitting with Chaim K. as an annoying fly buzzes around, a need that is not on Maslow's iconic pyramid comes to mind.  The specific need to which I am referring is the need to be able to brush a fly off your face or just scratch something that itches. 

As the world suffers the effects of what looks like an economic "tsunami," a new look at Maslow - and maybe through the eyes of someone seemingly as "limited" in his choices as Chaim K. - may be in order.

That said, one caveat of Maslow's hierarchy needs to be explained.  The first lower level is being associated with Physiological needs, while the top levels are termed growth needs associated with psychological needs. The higher needs come into focus when the lower needs in the pyramid are met; Once an individual has moved upwards to the next level, needs in the lower level will no longer be prioritized. If a lower set of needs is no longer being met, the individual will temporarily re-prioritize those needs by focusing attention on the unfulfilled needs but s/he will not permanently regress to the lower level (Wikipedia).

I asked Chaim K.- an eight-year veteran of a catastrophic vehicular injury that left him quadriplegic and on a respirator - what levels would be represented on his "pyramid;" "What is your triangle of importance?"

"What is important is the dynamics.  It is the same for me as for an Indian in deep darkest Amazon.  It is important to me as my clothes, I need to be dressed."

"And you always dress well," I add.

He smiles bashfully and goes on: "The Amazon can live like in Gan Eden; he doesn't feel uncomfortable as he is.  But put him on Yaffo Street - if he can cross it without getting killed because of the construction of the 'light tram-rail,' he will be very out of place and uncomfortable.

"That's the reason the triangle cannot be a fixed concept; rather it is dynamic and influenced by our environment."

But what is your triangle?

"Schopenhauer" - Chaim says, as I look at this "highbrow" with renewed respect - "has something to say about this."

"Schopenhauer?" I squeak in question, Chaim smiles, he has just watched the movie: "When Nietzsche Wept" which is a film released in 2007 starring Armand Assante, Ben Cross and Katheryn Winnick. The movie is based on a book of the same name by Dr. Irvin D. Yalom and was directed by Pinchas Perry and it is about a fictional relationship between Freud and Neitzsche.

Back to Schopenhauer - Born 1788 - Died 1860 - who was also a "character" mentioned in the movie.  Chaim has Googled the characters since he saw the film and this conversation is a result of his "erudition" on the subject.

The World as Will and Representation emphasized the role of man's basic motivation, which he called "will."  Schopenhauer's analysis of "will" led him to the conclusion that emotional, physical, and intimate desires can never be fulfilled.  Consequently, Schopenhauer favored a lifestyle of negating human desires.   Chaim K. continues: "There are three things that a person doesn't feel that are missing until they are taken from him: 1-Freedom; 2-Youth; 3-Health.

"I feel that all three have been taken from me.  I always say that I am a prisoner in my body.  No freedom to do what I want or anything.  Also, youth has been taken from me. I am 22 years old and have osteoporosis and my health is taken from me."

"So what do you have and what didn't he say?" 

Chaim goes on: "Nietzsche (Friedrich Wilhelm Nietzsche Born 1844 - Died 1900) says: 'The weak person is in charge'. Ha Halash Cholesh." 

Nietzsche's style (see Wikipedia) and radical questioning of the value and objectivity of truth raise considerable problems of interpretation, generating an extensive secondary literature in both continental and analytic philosophy. Nevertheless, some of his key ideas include interpreting tragedy as an affirmation of life an eternal recurrence.

In that vein, Chaim goes on: "If I say, 'bring me a drink,' they have to bring me something to drink; Like a 'damsel-in-distress.'  I take advantage of my position.  In the theatre I use it, I always get in and a good seat too! Whenever I can, I do."

"You paid for it," I murmur. 

"Yes, I paid a heavy price for it.  I would give anything to be OK and work at minimum wage for 20 hours a day.  This is not my choice.  All the Docs can explain what happened to me and how; but no one can explain why it happened to me. This is what is so frustrating.

"Belief-in-understanding, is an important step in my hierarchy - we think we can understand the world until something as big as health is taken away from us.

"It is a paradox.  If we had answers to everything our lives would be bland. Just as it was in Gan Eden." he says with a wink.

"I'm proud of myself that I can control my need to hide within myself.  I could have checked out of speaking, or being with others Motzei Shabbat but I didn't." 

Achieving the goals one set, and being proud of one's achievements are higher forms of the Maslow's Self Actualization.

People need to feel a sense of belonging, respect and acceptance, whether it comes from a large social group, such as clubs, office culture, religious groups, professional organizations, sports teams, etc.  They need to love and be loved (intimately and non-intimately) by others. In the absence of these elements, many people become susceptible to loneliness, social anxiety, and clinical depression. This need for belonging can often overcome the physiological and security needs, depending on the strength of the peer pressure; an anorexic, to use an over-simplification, may ignore the need to eat and the security of health possibly in a misguided search for a feeling of control and belonging.

I see many children who are in trouble in the education system or at home, frequently their stories reflect young people who don't receive the respect of others, their teachers being on the top of this house of cards.  From this teetering edifice they see their parents' respect for them failing, not to speak of the respect of their peers.   These self-same teachers then write in referral notes that the child lacks self-esteem, self-respect, and respect for others. From which "bank" is s/he supposed to withdraw this emotional currency?

Now more than ever, as the youngest and oldest in the workforce are being let go,  financial houses are failing, the community on the whole needs to redefine what is considered valuable and worthy of our respect.  The signs of the past are going to need a new overhaul, as in all probability a 21st Century WPA - Works Progress Administration (renamed in 1939 the Work Projects Administration; WPA which was the largest New Deal agency) will take form.

 I am not judging, and I use money and enjoy its comfort as do the rest of us, but the definition of "Learning-in-Israel" for five years or so, for many Al Chesbon HaBaron as we say here, or on benevolence of a benefactor - may require nipping and tucking i.e. change drastically in the near future. 

Internationally many people have lost and will lose their jobs and financial security; therein a real and present danger exists for their respective "Triangles."  In Staten Island, N.Y. on January 4 and 5, Nefesh International (the Networking Organization for Orthodox Mental Health Professionals) is holding its Annual Conference. 

Our communities around the world need to be made aware and avail themselves of the wonderful work of Nefesh International and its National (Nefesh Baltimore and Nefesh Chicago) and International satellites (Nefesh England, Nefesh Brazil and Nefesh Israel) see www.nefesh.org for a schedule of events.

Change is not a "six-letter word." Our preparation for change and ability to move up the pyramid is only limited by our ability to be flexible and redefine ourselves as needed so as to learn how to live within compromise of our basic needs.  This I have learned from Chaim K.

Originally published in the Jewish Press on December 31, 2008.

Tags: Chaim K. | Change | Hierarchy Of Needs | Jewish Press