The Pleasure Paradox and the pursuit of happiness 192 Observational studies have shown that perhaps the most powerful way to achieve a lingering pleasure experience is to help someone. This is perhaps the most powerful form of having to work for it. I will never forget being taught this by, Joan, a client who was dying of metastatic melanoma. At only 35, with a husband and two very young children, hers was a particularly sad story. After some urging she agreed to make a video to her children for them to watch in future years if I agreed to guide her by asking her certain questions. As we worked our way through their childhoods we came to the point where she was giving advice to her daughter, who was only three when we made the recording, for her teenage years. I stopped the tape as she advised her daughter that there was always love that she could turn to if she was feeling rejected or alone. Confused I asked,‘ What do you mean there is always love to turn to? Isn’ t the problem that there maybe no one around to give her love at this time?’ Confronting death has a strange way of creating wisdom. In this case Joan was about to share something that she had found she could rely upon in her darkest moments – which were darker than most of us can imagine. Patiently, she explained to me how when she was down and feeling hopeless and helpless she could always participate in a loving interaction by giving love to another. She explained that there was always someone to love, to give to in some small way, whether they be friend, family or a stranger. There was always someone to give to if we looked long enough. Giving could be anything from a hug or an‘ I love you’ to doing something for them that they appreciate. She spoke about how this was a reliable way to make yourself feel better because it was totally under your control and did not rely on others to meet your needs. There is not such a big difference from being on the giving end of love to being on the receiving end. Either way you are part of a loving experience. It is one of the things that makes my work as a doctor so rewarding. I found the moment quite profound as I realized that there was no one more qualified to talk about grappling with emotional pain and the