Anna: First, I have a question from myself – when we (“Semper Anticus”) reached out to you with an offer to participate in this “AMA”, you said that you “would be happy to get involved in this venture”. This raises the question – are you a venturer and do you often participate in things for which you cannot foresee the result right away?
Dr. Miksons: Honestly – no. I have started to do it a lot more recently, a part of the reason for this is my psychotherapist’s education in residency and psychotherapy as such, to which I have both gone and still am going to.
Looking back at my life, I have missed out on quite many opportunities just because I didn’t dare to take them. Back in the day, I didn’t go on ERASMUS, or on some other shorter or longer exchange program – at that time I was thinking “Why should I go?”, “What for?”, which was the rationalization for why I didn’t. Now, looking back – at one point, I was just scared – what’s going to happen, this feels uncomfortable. Here everything is well known, everything is pleasant, safe, I’m in my comfort zone – why change anything? In recent years, I’ve been more active in getting out of my comfort zone. That means, for example, taking part in a project, even if it occasionally seems that I cannot be sure whether something will come of it or trying to create a lecture on a subject that I don’t immediately know what to say about, but I can get a little deeper into it and try to touch issues that no one really talks about. About parent-children relationships, about all kinds of conflicts between the parents themselves, about child behaviour. It’s more of a purely academic, clinical challenge for me – to try and see if I succeed before fear takes over and discourages me from doing something.
Anna:Now we will continue with questions directly from our readers. The first of them is: “Were you not afraid to choose psychotherapy, taking into account such prejudices as – you’ll analyze your own life too much, it will be difficult to build and maintain relationships and that work will get in the way of personal happiness?”
Dr. Miksons: When I was making the decision – definitely not. When I applied for residency, if I’m honest with myself, I didn’t know where I was going. I knew I was interested in psychotherapy as such, from what I knew about it. I was also interested in psychosomatics, but I would say that back then, the information about it was not as extensive as it is today. For example, interest groups and clinical events that we have developed make psychosomatics much more known, wider and more visible. That’s why I understand the reader who has this concern about how is it going to go there. When I started residency, yes, I went through it all at once, the process, my therapy, my education, and I started thinking – does this not interfere with my life? How will I be able to communicate with people, meet my friends, or establish relationships at all, because I already know so much? In the first years you try to change people, you give advice to all of them, you want to save your friends and your family – like the savior of the world, like Mother Teresa. Later, there are many things you notice, but you realize that you don’t have to do or say anything. It’s their choice, it’s their life, it’s not yours, you’re not on a therapy visit, they haven’t come to counseling, they haven’t asked for your help. If someone asks me something, then my answer is rather limited at that moment. But psychotherapy certainly makes life more colorful and expands your horizons. There are also times when it makes life harder, such as the times when you go to counseling and go deeper into yourself, you no longer split things – you no longer see only black and white, you see everything in shades of gray (not in the sense that everything is gloomy), you can see things from different points of view. The reality of life is that it’s not all black and white – that’s the hardest part. It is more interesting to make various decisions because you simply see the playground on a wider scale. You don’t see one narrow part as the only choice, you see four, five, ten choices now. If anyone is worried about how that would be, I would just encourage you to try.
Anna: “Does a cat know which side of the street he is walking on?”
Dr. Miksons: I don’t have the slightest clue. I know for sure that he knows he’s going somewhere, but as far as I know from research, an opinion stands that animals aren’t conscious of the concepts of “I” and “myself”, or that they exist. Is that true or not – hard to say, because the cat can’t tell us anything. In the same way we have assumed for a long time from specific examples that an infant also does not know who he is. I have done an experiment myself with the son of my acquaintances who was about a year and two or three months old at the time. He knew the people around him so well that, when asked “where is Arthur”, “where is John” – he pointed exactly at them. But, for example, his name is Peter and if you asked: “where is Peter”, he did not point at himself, did not understand, he did not have the concept of “I am here” and from that we concluded: “he still does not have a concept of “I” “.
The same will happen if you take a small child up to 2 years old to the mirror – he does not understand. Only with time he understands – “that’s me, I exist”. We can also try drawing parallels here – at which point the concept of “I” is formed; considering that the animal does not recognize itself in the mirror (according to the behavior we can observe), just like the child, we can say in response to this question – maybe he doesn’t know, but maybe he only wants to make us think that he doesn’t know, but in fact he already knows everything. Maybe the cats are planning to take over the world? Who knows.
Anna: Next question is “A questionfrom a 5th year medical student – How do you match theory that you have been studying so hard all these years with the practice while keeping your sanity?”
Dr. Miksons: The question is what do they mean by “keeping your sanity”. But I can try to somehow rephrase the question: “How do you not get confused with all that information?” The theory that we must learn really is a huge amount of information. The hardest part to not get confused is to try not to put all the theory to use at once. The most important thing for a physician at the beginning is to establish a relationship with the patient. If you establish a relationship, diagnostics and treatment will work much better. If you don’t establish a relationship, then the process will be hard to advance. You might have the best knowledge, you might be a theoretician with the highest grades… But it doesn’t matter when you must start talking to the patient. If you need to do very little talking or none at all in your field, say, if you’re a pathologist or a radiologist, maybe it doesn’t matter that much. Theoretical knowledge is very good. What should always be kept in mind though is that theory and practice tend to be very different. There is some definite and specific way of acting according to theory, but life is not theory, it has many variables. Therefore, you must be prepared for stress, anxiety, possibly failure and disappointment that the theory does not correspond with practice. It will happen very often. There are these great moments when everything will coincide and come together, but it will be quite common when it doesn’t. And so, we gain experience and learn.
Anna
Dr. Miksons: The question is: “What is bad news?” I talk to my colleagues about it sometimes. Is it an unexpected situation, is it a foreseeable situation, or do you feel – that’s bad news. Bad news for you may seem like some complication you have to tell the patient about, which has not happened yet. If we assume the bad news is a diagnosis, for example, there is
Let’s talk about something a little lighter… Diabetes! Or appendicitis! Also, an unpleasant message and the next sentence is important: “We will do everything” or “I will do my best to help”. If it is a case of death, there is no difference: “I am very sorry, your relative is dead, unfortunately, we can no longer do anything about that… But we can help you”. Whether it is some emotional support or the involvement of a psychologist / psychotherapist / psychiatrist – in such cases, we can give support to help them with something.
Anna:What do you think – are young residents afraid to report those diagnoses because they don’t know how they themselves will behave in that situation?
Dr. Miksons: Of course, because when you start to say something, your voice might tremble, or a tear might roll down your face, or you might suddenly become angry, you might experience shortness of breath…
Anna: This question is often asked because people don’t know how to structure this information, there are no guidelines on how to create a sentence so that your voice does not tremble…
Dr. Miksons: Why couldn’t your voice tremble? If you’ve lost a patient for the first time in your life… It’s awful. It is understandable that you are shy about it, that you feel uncomfortable and very sad about what has happened. Us, doctors, we too are only human, and we have feelings. No matter how much we try to escape from it and sometimes deny it.
Anna: “What came first – the chicken or the egg?”
Dr. Miksons: I don’t know (laughs). My answer – really, I don’t know. But my follow-up would be… how would we feel if we found out the answer? There is something magical in that people want [to answer] questions that don’t have answers and they’re looking for them. It is our progress towards development. It’s really interesting to me what would change in society if we learned the answer. I suspect that nothing would change. It’s just the same as the many questions that we have that have long been answered, such as the question about vaccination. It has long been proven what vaccination does and what it is. There will still be someone who will say, “No, it’s a conspiracy!”
So, I want to know why it is interesting for people to find an answer to this question. What does it mean to them? We can assume that this question is more like a metaphor, but everyone puts something of their own in it. My own unanswered question, if we talk about the human psyche is nature vs. nurture. How much is really encoded in a human from generation to generation, on a neuronal level, which we cannot yet prove? And how much are they a blank page – whatever will be written on it during their life, is going to stick? That is, in my opinion, just like the chicken or the egg question. These are similar issues. But hey – let’s wait and see (laughs)!
Anna: “How to cope with depression, which is a common trend among medical professionals?”
Dr. Miksons: First off – what is depression? Same goes for anxiety. I don’t like the way these two words are used. They have their place and time. Depression is a specific syndrome, a compound of specific symptoms. I’m wondering what is at the bottom of depression, because one depression can vary drastically from another. For instance, I could say that one person has depression because he thinks something’s wrong with him. He’s on his own, with no friends, people reject him, he feels lonely, he doesn’t know how to make friends, how to gain this validation and plummets deeper into depression. That’s one example. Another person looks just as depressed but it’s possible that he is depressed because he’s not on top of something. The former will have more depressive personality traits while the latter – more narcissistic. In this scenario, his problem will be “What’s the point of living if I’m not № 1?” And that is completely different from the former case. There’s no be-all end-all solution to these problems. You can’t just tell them to get out more. The second guy gets out a lot as is, he has friends around him but he’s lacking some sort of achievement, or goals. Someone else, on the contrary, might have it the other way around – they might be trying to distance themselves but fail. And family, friends or relatives keep them so close all the time that he can’t break out of it. They have a depression because they can’t say “no”. They sink deeper in depression because they are being repressed from all sides. And if you do try to tell them to get out more, they’ll come back with “Don’t you understand, I don’t need those people!” And then, what to do with all of that?
Anna: But if we talked about depression among medical professionals, what do you think would be prevalent?
Dr. Miksons: One thing that’s for certain is that we deal with human suffering on a daily basis, and it’s pretty clear that we too are affected by these sufferings on a biological level. You can go on about how thick-skinned you are, how you don’t react but biologically you are affected. That would be just like someone coming to yell at you every day. Sure, after a year or so you’ll get used to it, but it doesn’t change the fact that your brain is half-exploding. Or if someone jabs you in the arm all the time. Then what? That spot will either go numb or you’ll grow a thicker skin there. You won’t feel the pressure anymore and there will be a defense reaction, but that doesn’t change the fact that some changes have taken place. Therefore, it’s important for us to find ways to recover. There’s a certain point in our careers when we want to help people too much, and we end up working overtime and eventually burn ourselves out. And when that happens, we’re not able to help patients as well as we did before and begin to slip into depression. A patient comes to us desperate, depressed and in pain, but at that point we have begun to become just like them. If we can’t find ways to rejuvenate ourselves, then our job is going to get even more difficult. I’ve experienced it first-hand. If for a certain period of time I take too many patients and students, interviews and what not, I realize that eventually I will need to rest. I can work for certain periods of time, certain months like that, but there will come a point when I’ll need to take a breather. If you don’t feel when you need to take a pause you’ll inevitably begin to slip into depression. In the best case scenario, you’ll just burn out emotionally but in the worst case you’ll begin to suffer physically, too – you’ll get high blood pressure, headaches, stomach problems, trouble sleeping and so on.
Anna: And everyone has their own way of recovering.
Dr. Miksons: Yes, exactly.
Anna: And what’s your way?
Dr. Miksons: Hmm… what’s my way? Personal therapy, my colleagues’ support, my family. I also like to have a good meal (laughs). Definitely. If, say, I go travelling somewhere, or even if I don’t, I just like to go to a new cafe or a restaurant to just enjoy the food and the music, to have a good chat with someone. Sometimes I like being alone with my thoughts, and, of course, do some sports. That I sometimes neglect (laughs). But it’s important to stay active.
Anna: Don’t we all… (laughs) Next question will be like straight out of a counseling session. “Why do I get offended and hurt very easily by someone and how can I prevent it?”
Dr. Miksons: The question is what exactly offends you? There’s this new “you said something to me and it offends me” fad going on. The first point is if you take what someone has said personally. Maybe that wasn’t even directed at you. Maybe the other person is having a bad day and he or she decided to lash out at you. In a way it’s your own choice to get offended and not the other person’s fault. You can draw a line and say that you don’t like it.
The second point is, if it is directed at you, then maybe what the other person says is the truth. It’s actually pretty common. It might not be presented correctly or be a bit rude, I agree. But the real question is, why are you offended by what’s been said? Let’s say, if someone told me “Artūrs, you work too much” and I replied with “Ahhh…how dare you say that?!” and got offended by it. But that’s just it! What they said corresponds with the truth. If we discuss this question from the point of view of counseling – you did not get offended by that person. What does it even have to do with them? The truth is, a long time ago, you got offended, humiliated or bullied and most likely you still haven’t managed to get over it. Mom, dad, brother, sister, grandmother, grandfather. The question is – who? You’ve been carrying that load on your shoulders for years. And that one thing which that person said, that which offended you, basically worked like an allergen. For curiosity’s sake, are people who get offended easily really offended by everything? If they are, then… hmm…(chuckles), quite an interesting theory. But if you get offended by one particular subject matter (usually people get offended by, say, money, sexuality, work, career, child raising, or anything) then the question is – why don’t you get offended by other topics? Is it not interesting that you get offended by this one subject matter? Apparently, this subject triggers a certain spectrum of emotions in you that you really don’t want to deal with or don’t want to touch upon. It would be productive to think what exactly offends you? Why does it offend you? Maybe you’re not really offended? Maybe it’s just awkward at this moment? Maybe I’m just angry at this moment because I don’t like your opinion, because you don’t agree with me. Now, that’s no longer being offended. That’s anger, dishonesty, envy and jealousy which belong to a completely different spectrum of emotions.
Anna: So, what would you recommend to this person?
Dr. Miksons: Firstly, are you able to openly say what you don’t like? Or do you wait until the other person finds out about it and stops upsetting you? If it’s the latter, then unfortunately it’s only a matter of time before your common misunderstanding only grows in magnitude. That’s why if you don’t want others to upset or offend you, you need to say it, you need to show it, you need to physically or verbally express it. At first, of course, verbally. If it’s not respected, then physically at one point. Secondly, what other feelings you experience besides feeling offended? Do you feel happy, joyful, sad, shameful, scared, angry, envious? What other feelings are you having? If you only feel offended, then I have to say – I’m sorry that you’ve suffered at a certain point and haven’t gotten over it yet, and it has nothing to do with society. But it’s difficult to recognize.
Anna: The next question is “What to do if I can’t withstand the slightest criticism?”
Dr. Miksons: How do you feel when someone criticizes you? What do you mean by “can’t withstand?” When you “can’t withstand” do you tell someone not to criticize you, leave, try to do everything perfectly just to avoid criticism or do you stop doing anything altogether in order to avoid criticism? What are your coping mechanisms at that moment? Maybe the criticism is constructive and you don’t like the fact that someone who criticises you is right and you’re not? We can modulate all sorts of scenarios, but the point is – what feelings does criticism trigger in you? There’s shame when you are criticised, there’s anger “why do you bug me, I know everything myself”, or maybe you feel guilty, afraid of being fined or fired – it can be pretty complex. The question is, what’s hiding beneath it? For the most part, there’s some sort of shame hiding beneath the criticism, the kind which you don’t want to deal with, which means avoiding situations where such criticism might be possible.
Anna: Why is it shame that’s most often hiding under criticism?
Dr. Miksons: Because during childhood parents would always criticise us to a certain extent. Usually I bring up a silly example of boys being taught not to cry, and girls being told that “little girls don’t get angry”. “Little girls behave properly” – and that’s just shaming. “Look at how you behave in the store!” – that’s shaming, too. Afterwards you learn that certain behaviours, feelings, actions, relationships are wrong and you should be ashamed of them. Because someone will walk up shaking their finger at you. You are 25-30 year old, you’re an adult now, why should you care what others will say? But inside your brain cares. It can’t tell the difference between now and then. At that moment it thinks that the big mommy or daddy will come shaking their fingers. As a result, when you think that you’re going to get criticised and it’s bad, you have created a kind of a criticizing character in your head. Those who have a strong fear of criticism have this inner criticiser. He could be real, quite often a person is 30 or maybe 23 or 22 years old and still getting criticized by parents, although he is already an adult. Or maybe this criticiser no longer exists. They doesn’t exist now but the experience has stuck in your head as normal so much that everywhere you go now everyone will criticize you.
Anna: Right, next question… hmm… (Anna smiles, Dr. Miksons laughs – “Smile says it all!”)– “If John is green and Zane is yellow but Carlos is red, can I be blue?”
Dr. Miksons: Yes. (pause, Veronika – “That’s it!” , everyone laughs) Why not?… How do you feel being blue?
Anna: “I have nightmares (or very vivid dreams) almost every night. Sometimes they are linked to everyday events. As a result, upon waking up I experience a feeling of unreality. It is hard to remember which events are real and which are dreamed. How to get rid of dreaming?”
Dr. Miksons: It’s not possible to get rid of dreaming. Dreaming at night only indicates that there is something happening during daytime that you can’t deal with. So, the brain tries to process the information at night. In this case, it would be worthwhile to consider if what happens during the day and what you dream about all the time is not some kind of a circle that you walk around. The same problem that you avoid and leave unsolved, sit in it and let it upset you. You are stressed, you can’t cope with it, you are angry, you feel somehow helpless in this moment, so the dream is about the same thing. It would be useful to understand that the dream is about feelings and thoughts. Or perhaps the overlap between dreams and reality is something very unpleasant. Let’s say all day you are constantly stressed out about the health of a family member – mom, dad, brother, sister, whoever… when they have an illness, addiction, failures? Clearly, in the dream you will see how you suddenly save them, they die, they disappear, and then you wake up and it’s like – “What if they have disappeared?” So, the feeling is still alive – the worry, the fear that something is going to happen. The question is – why is it so pronounced? Is the chance that the person is going to, for example, die, become sick or divorce realistic? Or is it just a fantasy in your head that is rooted in previous experiences? Someone went somewhere, something happened, something disappeared and for that reason it flares up now even more, like an allergen that you can’t get rid of. It’s important to understand what is what, what is it that you dream about and what feeling lies beneath it.
Anna: Next question “What is a person’s expiration date?”
Dr. Miksons: … Expiration date… (at this point Dr. Miksons thinks for a long time with a hand pressed to his forehead)Well, that’s a challenge! (laughs)… hmm… expiration date… Well, of course, the association here is with food… potato, banana, condensed milk, meat, cabbage, anything else – all completely different products and each has a different expiration date.
Anna: And regarding a person, on what does it depend?
Dr. Miksons: With regard to a person, we determine our own expiration – how we use our time. Unfortunately, the date we don’t decide, even though sometimes we can considerably accelerate it.
Anna: In this situation, what would an “expiration date” be?
Dr. Miksons: Death.
Anna: This questions I think is very classic: “How do you know that “crazy” (diagnosed with mental disorder) people aren’t normal? Maybe we, the so called “normal” are the crazy ones?”
Dr. Miksons: Let’s say, here we can ask the question – what is normal and what is not. I try to follow purely the biological principle about who adapts and who doesn’t. If we consider adapting to life’s crisis, then inevitably a person with a mental disorder won’t adapt as well. Regardless of whether they have a psychosis or a depression, at one point they will break down. Whether they have a mild or a severe disorder they will reach their limits. Every one of us has these limits but for people with mental disorders it’s much more narrow. Much more. Therefore, it is hard to say if they are normal or not but clearly they will find it a lot more difficult to cope with situations in life. They will more often be destructive towards themselves and others, and will certainly just have a much harder life. We see them through our “healthy”, “normal” mind. What is it like to be a schizophrenic who constantly thinks that someone is chasing them? I don’t think it’s pleasant.
Anna: “Is it true that we all have mental disorders? In what situations can it be helpful?”
Dr. Miksons: If the question is about mental disorders then everyone doesn’t have them but we certainly all have emotional difficulties. Disorders show when, in the case of emotional difficulties, the adaptive mechanisms that we have developed or that we have accepted as ours either don’t work or become too destructive. For instance, a mechanism could be when you act out and get into a fight with someone, get drunk, distance yourself from everything, isolate yourself or just on the contrary – get busy, don’t sleep and so on. If we talk about classic depressions, manias – these are disorders but if we talk about personality structures, such as, when you are narcissistic, depressed, obsessive-compulsive, hysteric – it’s nothing overly serious. These are emotional patterns, how you react to something. However, if you start constantly reacting in the same way, for example, believing that no one in the world is equal to you – that’s a disorder, in this case, narcissistic. Depressed – when you believe that you’re at the bottom, that you don’t deserve anyone, that you are nothing even though you have good skills and so on. The question is when you have emotional difficulties do you deal with it or do you use it as an excuse to get out of something. This is called a secondary morbid gain. Do you say that you have this anxiety and that you don’t do and don’t want to do anything about it or do you instead say “I won’t do it because I have anxiety”? That is a gain. Or, “I won’t see my friends because I am depressed.”
Anna: These are the kind of gains with a message “I won’t do it because I’m allowed not to”. However, are there peculiarities in emotional perception that can be beneficial in some situations? For example, I imagine a person with obsessive disorder finds it easier to do a scrupulous work. Or is it just that all disorders make people’s lives harder?
Dr. Miksons: If a person has a mental disorder, it definitely makes life harder. I can agree that perhaps in some specific field it can be helpful. For example, a person with schizophrenia has such specific changes in the brain structures that they can probably create artwork like nothing we could ever imagine. Thereby, their disorder “helps” to create art. The example with obsessive-compulsive traits – yes, perhaps in a workplace where it’s necessary to structure many things or monitor a large amount of data at the same time a person with obsessive-compulsive disorder will function great. But the moment they have to talk to colleagues, go home to wife and kids, or husband and kids, or meet a relative they can’t function at all. At this point we say that these are disorders,when there is only a narrow niche where you function really well. But it can be the other way around as well – when you function equally well in most aspects of life but have a problem with one particular sphere. Then we talk about a person with emotional difficulties – on larger scale, everything is stable but in one field things aren’t going well. If we walk this path then, yes, to answer the question: can a disorder be beneficial in one particular field? Yes. But in all the other spheres it will cause hardships.
Anna: In this respect, could everyone benefit from psychotherapy? Could we say that everyone should go talk to someone? Not that they should but…
Dr. Miksons: I think here you differentiated well yourself. Should they? I’d say no. Would it be beneficial? Then, yes. It’s very important to differentiate whether it’s obligatory to go now. Perhaps, no. Perhaps you are currently emotionally healthy enough. Would you benefit from it? Yes. I usually compare psychotherapy with doing sports. If you are active, you go to gym, you run, you ride a bike, then you are physically in a good shape. Would you reach better results with a personal trainer? Absolutely. Work with physiotherapist, dietician – even better, but you are already in a good shape. If you want to do even better – okay. But do you need to add a physiotherapist? No, you don’t. Would you benefit from it? Of course, logically. So, consider what you need in life at the given moment.
Anna: Next question – “Is it okay to feel anxious or depressed sometimes?”
Dr. Miksons: Of course. You have to feel anxious. When you feel anxious everywhere all the time (here you need to start thinking about the feelings that stop you from fully enjoying life and achieving something in life) then it’s not okay. If you feel nervous every now and then, it’s normal. Here I usually draw parallels with going on a first date – you have to be nervous! If you go on a first date and don’t feel nervous, that’s not normal (laughs)! You go to see a girl or a boy that you really like, your heart is in your mouth – that’s anxiety that has to be there. But it’s more an excitement – how is it going to be, how will things go down ? It’s normal! Anxiety as such is experienced when something unexpected, unforeseen happens. Therefore, everyone wants to avoid anxious, sad, depressive moments in life, everyone tries to maintain control just to avoid feeling. The problem is that we want two things at the same time – to feel nothing and to be very emotional. (laughs)
Veronika: But what about depression? Is it okay to feel depressed?
Dr. Miksons: Here, it depends on the kind of lexicon we use. Does instead of “depressed” the person means to say “sad”, “lonely”, “abandoned”, “left”, “rejected”? What resides under the word “depressed”? Sometimes I am depressed but I know that at times those are reactions to patients or certain moments in life but it doesn’t mean that it’s a clinical depression. It’s just an emotional state for a brief period of time – an hour, a day. You feel it and then it passes. If you have it for a longer period of time, then you have to find the reason instead of just saying, “oh, my brain is damaged, I have a depression.”
Anna: The word “depressed” is also a fashionable word that everyone uses without defining what exactly is wrong.
Dr. Miksons: We have to look closer. And if it’s hard to define, then it hasn’t been taught – feelings haven’t been talked about in the family.
Anna: “Does everyone deserve to be happy?”
Dr. Miksons: Yes. Definitely.
Anna: And the last question “Is a person a person without a person?”
Dr. Miksons: If I understand the question correctly, we are talking about relationships. And certainly there are people who due to their individual, genetic, biological characteristics can get by without the other person. Those are specific disorders why they don’t need this other person. The other, healthy individuals, I’d say – no. The question is whether there has been a close emotional connection in the family while growing up. It has a great impact on our ability to adapt to the environment. It’s been proven on rat pups. The rat pups that have received attention, care, support from their mother (the factor was being close and getting licked by the mother rat if I’m not mistaken) cope with stressful situations a lot better. If they are placed in a maze, they get out much faster than those that were neglected and left without a mother. In life, emotional connection is always necessary even if it’s been lacking or not enough at some point in life.
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