Depression, Anxiety, Grief, Marriage and Relationship Therapy
I became increasingly uncomfortable with the discussion, but have learned over the years to keep quiet in the face of the overwhelming and nearly universal belief that anxiety is a“BAD THING“. So, I waited until everyone got up to leave the table, leaned over to the young man, and said, “Have you thought about asking her WHY she is so anxious?” From the look on his face, I can only conclude that this was not something he had ever considered.
You may ask yourself how anyone in a helping profession can possibly be helpful if they don’t know what is at the root of their clients’ distress, but unfortunately this is all too common in the treatment of anxiety; perhaps it is because we are so afraid of our own that we want to erase it in others. However, in the field in which I am trained (Experiential or Emotion-Focused Therapy), we actually like anxiety–it means something is alive and trying to emerge into consciousness.
Because we don’t view anxiety as a disorder, but as the natural consequence of the suppression of feeling, the first thing we want to know is “what is going on in your life that is causing you distress?” We don’t want to change anything until we understand it better. Maybe you have good reason to feel anxious? Maybe there are things you need to look at and/or change? Maybe if you take care of the underlying cause of your unease, you won’t feel anxious anymore? If we charge in like avenging angels trying to erase your anxiety, we will probably make a bad situation worse. In the short-term, you may feel less anxious, but in the long-term, it will either come back to haunt you, or you will start to feel depressed.
Now, this is the point where things get a little technical, but if you bear with me, I promise it will be worth it. In Part One of this series, I talked about how one part of our consciousness is trying to emerge, while another part pushes it down, and that the tension between these two parts is what causes the sensation we identify as anxiety. But what am I really talking about when I say this? How can it be that our consciousness is split, and yet we are unaware of it?
Well, when you think about it, whenever we have an inner conflict about something, we are coming into contact with some version of a split in our consciousness. “Should I have that third piece of Chocolate Cheesecake?”, says one side, only to have the other side scold, “No! Think of your waist-line/blood-sugar/starving-children-in-China!”
This is perhaps the most common manifestation of a divide in our consciousness. If we are come from a Judeo-Christian background, we might characterize this as the conflict between the “devil” and our “conscience”. If we look at the world from a Freudian or psychodynamic perspective, we might call these two sides the “Id” and the “Super-ego”. Other schools of psychological thought call these the “Inner Child” and the “Inner Parent”, or the “Under-Dog” and the “Top-Dog”. Whatever we call it, we are all familiar with this inner dynamic as it plays out in our day-to-day lives.
If the subject under discussion is Chocolate Cheesecake, then we are probably quite aware of both sides of this inner argument, and we probably would be willing to admit our internal struggle to anyone who asked. But what would happen if we came from a society where Chocolate Cheesecake was considered so perverted, so dirty and disgusting that we are not even allowed to admit it exists, let alone discuss it in polite company?
In this imaginary society, even thinking about Cheesecake means there is something wrong with you. You have been taught since birth that only perverts and those who are mentally unbalanced desire cheesecake, so you would probably strongly resist admitting, even to yourself, that you have these longings. And let’s say, even further, that you cannot avoid thinking about cheesecake, because it is a natural, instinctual drive, so you have to eat at least some cheesecake some of the time in order to survive.
If you found yourself in such a position, you would be in deep trouble. And this is the dilemma faced by all of us when we are young and dependent on adults for our survival. One part of us has these normal, instinctual drives that are part of being human, but we are required, by parents and society, to deny that we have them because they are “dirty”, “disgusting”, “evil”, “sinful”, “wrong”, or “shameful”. Since we cannot get rid of these impulses, the only thing we can do is deny that we have them.
I once worked with a woman** who came to me because she was so anxious she could hardly leave her house. If she tried to ride the subway, she would have panic attacks because she feared “everyone was looking at her”. She would wear sunglasses and hats to “disguise” herself so she could walk on the street. Much of the time, she medicated herself with alcohol so she could function at all. Her boyfriend had threatened to break up with her because their life together was unmanageable.
As we worked together, I learned she had lost her mother when she was about five years old. Her family, perhaps because they were also devastated by their own grief, did not seem aware of how crippling the loss of a parent is to a small child. They pretty much left her to her own devices, not explaining what had happened, not encouraging her to talk about her feelings, not supporting or comforting her. In the days after her mother’s death, she was only aware of people “looking at her” with frowns on their faces. She remembered the funeral with particular agony, where everyone in the church seemed to be staring at her. Being so young, she did not know how to read the expressions on peoples faces, and as children will inevitably do, she thought she had done something shameful. And since her family did not want to talk about the death of her mother, she quickly learned this was a “forbidden” subject–again, something shameful, almost secret–something which must be suppressed and numbed out.
Of course, such a loss cannot be suppressed, and the body/mind will always seek a way to heal from trauma. So when the part of her psyche which retained the feelings of grief and shame tried to emerge, she would push them firmly down, only to have them resurface whenever she was reminded of the loss of her mother. By the time she came to see me, she was virtually paralyzed by this psychic deadlock, but the only clue that remained was the feeling that “people were staring at her”, and the panicky feeling that something terrible was going to happen.
This is an example of how normal, natural impulses (in this case, the normal grief of a child who has lost a parent) become suppressed and subverted into the sensation of anxiety. It is as if the unconscious mind sends up a flare to alert us to a part of ourselves that needs to be rescued. Had I focused solely on this young woman’s fear of riding the subway and tried to teach her various calming and soothing strategies, I might have succeeded in helping her negotiate the public transit system. But, in my experience, her anxiety would just crop up in some other context, because it had nothing to do with the subway, or leaving the house or even other people who might be staring at her, in her present-day life.
There are two morals to this story. The first is this: What helped this young woman was listening her story, validating her experience and allowing her to process the feelings which had been bottled up for decades. In this way she was able to heal the suffering, grief-stricken child that had remained alone, shamed and lost all those years. (Today, she is married to that boyfriend who was ready to leave her, and they have a child of their own. Ironically, considering how afraid she was of people staring at her, she found a job which requires extensive public speaking.)
The second moral of the story is about the importance of paying attention to the part of our psyche which is euphemistically called the “Inner Child”, the “Id”, the “Underdog” or, if you are religiously oriented, the “Devil”. For too long, this part of ourselves has been devalued, vilified and/or ignored.
In my next post, I will explore the origins of this much-maligned ego-state and discuss how we can learn to appreciate and even embrace our “Inner Cheesecake”–the parts of us we were forced to suppress and deny if we wanted to be loved and accepted by our families and society at large.
*These are terms which refer to specific techniques or protocols used, mostly in the realm of Cognitive Behavioural Therapy, to manage the symptoms of anxiety.
** It goes without saying, but I will say it anyway, that the names, genders, details and other identifying information have been changed to disguise the identity of the people in this story. In fact, sometimes the “client” in question might even be myself.