The Anatomy of Happiness

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Text originally published in 1961 under the same title.

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Although in most cases we have retained the Author’s original spelling and grammar to authentically reproduce the work of the Author and the original intent of such material, some additional notes and clarifications have been added for the modern reader’s benefit.

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THE ANATOMY OF HAPPINESS

BY

MARTIN GUMPERT, M.D.

TABLE OF CONTENTS

Contents

TABLE OF CONTENTS 3

DEDICATION 4

INTRODUCTION — Happiness—A State of Mind and Body 5

I. PROFILE OF UNHAPPINESS 12

Trapped 12

Ugly 15

Secretive 18

Stingy 21

Bored 22

Timid 23

Aggressive 26

Suffering 28

Snobbish 31

Worried about Money 32

Misplaced 35

II. PATHOLOGY OF UNHAPPINESS 42

Obesity 42

Underweight 46

Insomnia 47

Headache 50

Heart and Blood Pressure 53

Constipation 59

Peptic Ulcer 62

Gall Bladder 64

Diabetes 64

Gout 66

Allergy 67

Arthritis 71

III. THE STATIONS OF LIFE 76

Childhood 76

Adolescence 82

Maturity 86

Change of Life 92

Old Age 97

IV. TOOLS OF HAPPINESS 104

The Power of Hope 104

The Reality of Miracles 104

The Power of Repetition 105

The Banishment of Fear 106

The Power of Love 107

The Balance of Loss and Gain 108

The Goal of Health 108

V. THE LANDSCAPE OF HAPPINESS 111

Pseudo Happiness 112

The Climate of Happiness 115

March 14, 1950 116

Where Are People Happy? 121

Fort Wayne, Indiana 126

Home 132

Clothes 136

Food 137

Health 140

Relaxation and Recreation 143

VI. RELIGION 148

Faith and Happiness 148

POSTSCRIPT 153

Happiness vs. Anxiety 153

Glossary 156

REQUEST FROM THE PUBLISHER 160

DEDICATION

TO MARIA LEIPER

Happiness and unhappiness are not like snow or wind, they can be ruled and recognized according to the law of nature: unhappiness is ignorance, and happiness is knowledge.—Paracelsus

INTRODUCTION — Happiness—A State of Mind and Body

Physicians are in a peculiar position in this world. Their dealings are with patients—not people. To be a patient is not to be a normal human being, but an appendage to an ailment. The doctor does not see a man who comes to discuss his gall bladder or the dysfunction of his thyroid gland; he sees an individual who begins by saying, I am no longer myself, or I can’t go on living this way, or I am desperately unhappy. To seek a physician’s help is, in our present system of medicine, something like a declaration of bankruptcy. It is confession of an awareness of disorder affecting the normal cycle of existence—a disorder which does not respond to self-help.

The doctor starts to work. And with the help of his knowledge of physical changes, of the nature of disease, of the evaluation of the body as a working unit, he tries to diagnose his case and to develop a plan for treatment. But he would be incompetent if he did not attempt to explore the function of his client as a human being. He must know about his work, his interests, his family, his financial position, his conflicts. He must relate his objective medical findings to the specific wants and needs of this unique person. His advice will be of profound importance to the patient’s fate; indeed, it is often a matter of life or death which has to be decided. Such responsibility and power are hard to carry. One can be an excellent ophthalmologist or surgeon and still be unable to comprehend the drama of life. The technical operations of medical practice require skill and experience which often can be found only in the specialized expert. But the real physician stands behind the specialist and coordinates and directs his work. He is the patient’s trustee.

A brain surgeon does not need to identify himself with the victim of a brain tumor. The physician who advises the victim, on the other hand, must always identify himself with his patient. This intimate process of identification is the essence of the practice of medicine. The physician has to ask himself again and again: what would you do if you were in his skin? This amalgamation of doctor and patient (to the best of the doctor’s ability) is the only way in which a physician can keep his conscience clear or accept the responsibility of deciding and acting for his patient And such a concept of medicine leads far beyond X rays and test tubes, into every possible sphere of life. It also demands the most sympathetic insight into, and understanding of, human situations.

The pact between doctor and patient is quite different from the pact of the spiritual adviser with a member of his flock or of the teacher with his student. They are bound by moral or educational premises and aims. The physician deals with nothing but the naked patient, he does not want to influence his moral principles nor form his mind, he wants to restore his order, to repair or to improve his functions. From there on the patient has to decide for himself. If the physician succeeds in such a task, he will have contributed to the patient’s happiness. Indeed, the crucial test for any kind of medical treatment is whether the patient has become a happier human being at the end of the treatment.

Most of the many books which have recently been published about emotional conflicts are written by psychiatrists. I have nothing against psychiatrists, but their thinking is more or less oriented by mental pathology, not by the physiological vacillations as they affect the emotions as a whole, and still less by the extra-mental disturbances of the organism. Their language is strangely uncolloquial, especially when they are addicted to the dogma of some particular school or theory: a secret dialect, which shows a tendency to explain everything, even what cannot be explained, within our present limitations of knowledge.

Though I am thoroughly familiar with this clinical terminology, I have tried not to use it in this book. I have tried to describe in everyday language the patterns of happiness—and of unhappiness—as they appear in actual daily experience in every physician’s life, indeed in the life of everybody who has an eye or an ear for the adventures of the human heart. This is, therefore, not a systematic and exhaustive investigation of happiness. It is not a scientific research project. This book is rather a diary about happiness, a chronicle of thoughts and impressions which have arisen from daily contact with unhappy people over many years. It is, finally, a report on the author’s own struggle with a profound human problem that concerns his own fate no less than that of all his readers. There may be much that is controversial in what he has to say. However, he hopes to contribute to a worthwhile end: to revive the word happiness—which is today to most of us an empty word—to make it something with flesh and blood and meaning, something which can be had or missed, but which is as real as our body and its adventures on earth.

Happiness is a state of mind which is caused by the release of tension. Unhappiness is caused by the inadequate release of tension. This is the most simple and most comprehensive definition I can think of. It puts the age-old problem of human happiness into biological terms. There, I believe, it belongs. Happiness and unhappiness are, in my opinion, biological phenomena; their aberrations and disturbances must be understood and treated by the physician. Tension and the release of tension are fundamental physical states which appear in the inorganic and in the organic world, which affect all processes of nature, which determine life everywhere, the life of cells, of organs, of organisms, of groups, of societies.

Realization of the release or the absence of tension requires the knowledge or the experience of tension. A happy human being is one who can release a maximum of tension with a minimum of conflict and effort and who does not suffer, either mentally or physically, under the continuous burden of tension and its release, which is the most vital quality of the rhythm of life.

A life without suffering would be in reality a static and life-less condition which none of us would want to endure while living—although all of us look forward to enjoying it once we are dead. But life, today probably more than ever, has a tendency to produce a surplus of suffering and, so it seems to many of us, the power of releasing suffering is being increasingly curtailed, our rhythm of disbalance and balance is deeply disturbed, more of us are more and more unhappy and less and less happy.

A happy person must be at peace with himself and with his environment; he must also have the ability to face, to over-come, and, if necessary, to fight whatever disturbs his peace. He must be able to use wisely his own physical and emotional reserves and to get along as far as possible without the help of illusions or of artificial or charitable help. Only the happy few seem to achieve this.

The trouble with happiness is that it can be bought, or at least borrowed, at a price which often seems rather cheap if compared with the effort of creating happiness by one’s own force and will. We can get drunk and be happy, buy a car and be happy, go to a baseball game, to a psychiatrist, to church, and we may succeed in releasing tension, at least temporarily, by such methods. However, unhappiness returns too soon, too oppressively; relaxation and tension take on the character of an addiction which is fostered by anxiety. The free and independent play of mind and body is deranged. We are unhappy. We are sick.

A prescription for happiness is easily formulated though difficult to fulfill:

1. Prevent physical suffering.

2. Prevent guilt.

3. Do not accept illusions.

4. Accept the reality of death.

5. Do what you like to do.

6. Keep learning.

7. Accept your limitations.

8. Be willing to pay for everything you get.

9. Be willing and able to love.

10. Avoid secrets.

There is not one of these laws which we do not violate many times during our life span, willingly or innocently. However, these infringements will always result in our experiencing unhappiness which could have been avoided if we had known better. The entirely unhappy individual is a sick person, haunted by anxiety and guilt, clinging to illusions, afraid or negligent of death, working without enjoyment, ignorant or lazy, unaware of his reserves and limitations, stingy and unwilling to offer and to give, burdened with suspicions and secrets.

A physician has to deal most of the time with the unhappy. There is not an itch or an ulcer or a heart condition or a headache which does not lead directly into the jungle of human suffering, confusion, tension, imminent catastrophe. Each patient who sits down beside us and talks frankly reveals a complex of disturbances which makes the artificial separation between mind and body seem ridiculous and which cannot be unraveled by some pills. Like the teeth of a vicious gear, defect fits into injury and injury into defect To the doctor’s despair he can usually do but little to stop this clock of unhappiness from running because too much damage has already been done, too little willingness or energy for repair is evident This person seems trapped; time is running away on its one-way street. The existence of a man is a historical process, an accumulation of the past and of the foreseeable future which can only be corrected in details and with great effort and patience.

Never are we alone with our lives. We are enmeshed in families, in groups, in ancestries, in obligations and affections, in hates and longings, in fears and hopes. Much is done by a statement of facts and, indeed, the physician is in a good position when this is expected of him. He can act as a technical expert who is asked definite questions about the function of this or that part. But very few patients want facts; most of them want relief from fear, want reassurance, consolation, removal of discomfort, want more and better illusions.

I have long ceased to play this game. It is a frustrating job to reconstruct a sinner who does not want to repent—a matter for prayer or charitable care, not for scientific advice.

It has long been customary to think of the period of childhood as a happy one. Today we know how wrong this assumption is. It is true that the responsibilities imposed on a child weigh relatively more lightly than the responsibilities carried by an adult. But, still, they can be a terrible burden. To keep clean, to eat, to obey rules without the assistance of knowledge, experience, and habit is a gigantic strain made bearable only by the child’s greater vigor and health, by his lesser amount of dark memories, by his greater innocence. We know, moreover, how many of us have to carry the burden of first unhappiness throughout our lives and how deeply and almost ineradicably first injuries are seeded and grow into the roots of lifelong sickness. Most children seem happy because few children are physically impaired and the immense energies which are incorporated in a growing, young organism are yet unspent. But the awareness of happiness, which unfortunately so often becomes conscious only after a period of happiness has ended, conscious happiness, can only be accomplished when a human being has advanced to some state of maturity or still further to a state of wisdom. There appears to be a greater number of happy old people than of happy young people. This statement is not at all surprising. Happiness must be reached, it is a goal, a most difficult task, and whether we have had a happy or an unhappy life can often be decided only at the end of it, when a just balance of our deeds and failures can be drawn.

There is no doubt that one can learn how to be happy—no doubt that man must learn how to be happy at a time when unhappiness is the most widespread chronic ailment on earth. The phenomenon of happiness is never a static one. Its sources, its contents, its colors are steadily changing in accordance with the changing character of tensions, the changing character of human history. The disturbances of happiness in this time of crisis and conflict have the character of disease, they can be diagnosed like disease, and they can be treated like disease.

An editor of a most successful periodical which devotes it-self to spreading the gospel of confidence and success told me recently, Anybody who is happy today ought to have his head examined. What is the world coining to if a man who represents the professional voice of confident living has lost his faith in the reality of happiness? There are—perhaps—some remote areas left where people still are happy, the few forgotten happy in the midst of a general contemporary atmosphere of utter unhappiness. But what we are looking for and hoping for is the eventual creation of mature men and women who can escape the confusion and anxiety of shock and change and find for themselves a newer and better and happier form of existence in which they can be at home, no longer strangers—as most of us now are—in their own changing world.

Such integration of individual well-being into social, human well-being, a state of health in the widest, most constructive sense, is what we are striving for. As health is a matter of sufficient reserves in case of shock, of hidden health, rather than of absence of obvious disease, so is happiness more than just the absence of unhappiness: it is a positive immunity and resistance against the invasion of misery. Happiness is, therefore, not a limited psychotherapeutic problem, not simply a matter of spiritual fortification: it is a way of adequate, awake, and well-adapted living in all directions open to human beings.

What little we can do to change the fate of mankind we can do only by changing ourselves, by better fulfilling our desires and hopes, by covering our deficiencies, by protecting ourselves and others from injury, by strengthening the enjoyment and the dignity of living.

We shall, therefore, try to give an analysis of the cause and cure of unhappiness and of the techniques for securing and preserving and restoring happiness to the contemporary patient. Only if we find out what has become of happiness in our time of mass discontent can we expect to find out what finally may become of us. The editor was right: we ought to have our heads examined since some of us still—in spite of all—are happy. And all of us wish to be happy. Let us then examine our heads.

In writing this book I shall not take on the air of an expert who has solved all his problems and knows all the answers. Indeed, the author’s only justification for writing this book seems to lie in the fact that he has had an ample share of unhappiness but has, thus far, survived with only a number of scars and injuries.

A friend of mine once fell under the spell of a little book which tried to give to its readers the unfailing prescription for winning at roulette in Monte Carlo. He was in desperate need of funds, studied through many nights the rather intricate sys-tem, and finally went to Monte Carlo, where—after some initial success which deepened his faith in the book—he ended up by losing his last cent. In his despair he remembered that the author of his gambler’s guide resided in Monte Carlo. He decided to ask his advice: he must have misunderstood some of his rules. After a long search he found the old man living in pitiful circumstances and unspeakable poverty. That was the end of my friend’s career as a gambler.

The reader of a how to book has the right to ask questions about the person who pretends to know so much more about his problem than he himself does.

Hardly had I started this book when I was gripped by an acute and rather severe attack of unhappiness. I am a physician, past fifty, was born in Berlin, and have lived in this country since 1936. My father was a doctor. I grew up in the peace and security of a civilized and benevolent home. I went through a great deal of trouble during adolescence because I was badly understood by stupid and authoritarian teachers. At the age of eighteen I entered the German Army and spent the last years of World War I as a soldier in Turkey. My father died a week before the outbreak of the revolution in 1918. I studied medicine in Heidelberg and Berlin and married a co-student at the end of my studies. My mother died. My child was born. I practiced successfully as a dermatologist and became the head of a city clinic. Hitler appeared on Germany’s scene. My wife died in 1933. In 1936 I emigrated to the United States, learning English, passing through the formalities, opening a practice in New York. Almost four years ago, I suffered a heart attack from which I made a good recovery. My daughter married last year. Last summer for the first time in thirteen years I returned to Europe. Attracted and repelled by this dying continent to which my fate is so deeply attached, I plunged into a whole chain of emotional adventures which deeply disturbed the peaceful routine of my everyday life. These emotional adventures may be classified as symptoms of what is today usually called male climacteric. This critical period now seems to be over. I had my apartment freshly painted a few weeks ago, I threw away tons of paper and hundreds of letters, polished my brass, dusted my books, and started a new phase of life—not much different from what it was before: practicing medicine, doing some research in the hospital, writing books and articles—relieved, however, from an oppressive burden of outer and inner confusion. This is the typical life story of an average citizen of this century repeating itself with minor modifications all over our earth in many countries. It seems that the more violent incidents in my life—warfare, loss of money and property, military service, flight from my country to escape oppression or death, reassembling of a broken existence—have always worked as vigorous stimulants for increased effort, have increased my maturity, knowledge, and tolerance, have added humility to an overfed opinion of myself, and have prevented premature aging. Without them and with the inheritance of social and economic security, still more of intellectual security, I would have ceased long ago to be alive in more than a physical sense. I would have ceased to accept and to look forward to unexpected changes and to preserve the profound curiosity which seems to be an accurate measure of the vitality of a human being.

I have been fortunate, so far, to escape acts of violence, injustice, or torture which might well have been beyond my power of endurance. I believe, however, that the very fact of being a physician endows a person with an unusual means of protection against the many pitfalls of existence. It is actually one purpose of this book to communicate to the layman some of the experiences and insights which are basic to the medical profession and which are so essential to the successful fight against the hazards of living.

A wise physician cannot be afraid of death and disease; these are of necessity his intimate enemies and companions. He knows enough about the biological facts to escape irresponsible ignorance and to be aware of his limitations of knowledge. He knows how to help and he knows when his help will be in vain. The result is a mixture of alert skepticism and unfailing enthusiasm which is a good approach not only to medical problems but to life in all its varieties. A doctor knows life without any masks of manners and pretense. A doctor knows life in all its fear and pain and misery, and he knows the incredible strength and power of recuperation of a human heart. Dignity, realism, and compassion, a safe instinct for diagnosis, and foresight are the main instruments of his profession. No wonder that he should be well-equipped for tackling his own ailments. Indeed, I am often bewildered by the way in which people dare to lead nations and make history without learning even the simplest facts about the human body and its reactions under rest and stress, about the human body’s needs and urges and compulsions, about the state of well-being which creates happiness and has been the age-old goal of human individuals and human societies.

My life has not been easier than most of the lives which I have had the opportunity to observe. My character, my health, my emotional make-up, my gifts or deficiencies are not different from those of other normal human beings. It is surprising how similar, in spite of nature’s immense varieties, the basic adventures and drives and mishaps and hopes of people are. Incredible things, good and bad, have happened to me and to you. I have behaved well on some occasions and I have been ashamed of myself on many occasions. One can learn how to take all this without confusion or panic. One can learn how to be prepared for conflict and how to recognize and to enjoy happiness when it comes.

Fear of death and of suffering and illusions about the situation of life in which each of us is inextricably caught—these are the two main sources of our unhappiness. To understand what ails us is often—if not the cure—the first condition for cure. No doctor can help a patient who refuses treatment. To be my own doctor and my own patient has been my great advantage. A doctor who has not suffered sickness himself is apt to fail in treating it in others.

It has been stated that about two-thirds of the patients who come to a doctor’s office are not organically sick. That means no specific changes or destruction can be found in their organism. They complain about nervousness, fatigue, insomnia, constipation, headaches, lack of energy. Some years ago these complaints were classified as functional and were not taken very seriously. The viewpoint of modern medicine is different. The concept of psychosomatic medicine has been developed and it has been found how surprisingly many organic diseases start as functional ailments and how intricate is the interplay between emotional disturbance and physical disease.

But one might well be dissatisfied with the concept of psychosomatic disease. The separation of mind and body has confused medicine for many centuries. It is the result of mistaken philosophical speculation. There is but one human individual, but one body, and what happens in my brain affects my toe and my skin and my heart. There is no physical disturbance which does not change my mood or my soul and vice versa. We can study specific physical changes and their course, localize them, and give them a name. A bone that is broken heals according to regular rules or a germ which has invaded our body can be identified and then destroyed by specific drugs or actions. But even such accidents as are imposed by a hostile environment take their course according to our general resistance, our ability to fight, our general attitude toward life and disease. They depend to a great degree on our state of mind, which in turn depends on our state of physical health. We don’t talk about body and digestion or body and metabolism. We would advance much further in the understanding of our organism if we would forget about the artificial separation of mind and body and consider mind and emotions as partial functions, like the functions of our