what cures, how to start the change (simple!)

Simon has returned after a three month absence and again provides a simple, powerful demonstration of 1) why psychotherapy, 2) the dangers of silence.  You may recall I wrote about him at some length here and here (also here).  He was gone in part because it was busy but mainly because he had retreated back into his preferred mode of resistance wherein he believes that he must hide all his flaws, however small, from everyone.  As we saw in my last discussion of him this habit comes from a time in his life when he really had to be Superboy in order to avoid the frightening, unpredictable, and very dangerous outbursts of his father.  As an adult, for example, Simon would sit in his cold house rather than turn up the heat or put on a sweater because in his mind – just outside of awareness, so he could not see how silly it was until he said it out loud – real men don’t get cold and are prepared because someday there may be no heat.

So Simon was absent from treatment for a few months.  During that time he resolved to cope on his own – steeling himself as he did against the cold in his apartment – despite ever increasing problems.  He was getting more and more anxious, had trouble sleeping or tolerating silence – he could not sleep unless he had music playing or called a rather long-suffering girlfriend who would chat with him until he drifted off; he was increasingly paranoid at work despite nothing being held in quite high esteem high esteem by his boss and colleagues, he was paranoia about his good friends, again completely unwarranted, and in general was – his words – a mess.  Despite all this, or in fact because of it, he avoided contacting me:  Whether with me, his close friends, his girlfriend, or himself, the last thing he wanted to do was acknowledge being in pain or feeling shaky.

It was only when he began experiencing full-blown panic on the subway that he called me.  By this time his anxieties were such that the symptoms sounded at times quite alarming.  He had moments of feeling a kind of claustrophobic rage towards his girlfriend, a feeling that her beautiful face was quite ugly, and he struggled at times with the feeling that he had no idea who he was and that his personality changed moment to moment (it doesn’t).

All of these symptoms were drastically reduced when he finally spoke to his girlfriend and his best friend about the problems he was having.  Suddenly, in his own words, he felt much calmer, “not so squirrel crazy, like that tightness in my heart and chest went away, grounded”.  This improvement would last an hour, perhaps half a day, but if Simon could continue in this changed way of interacting with others – and himself – he would find the gains gradually becoming more permanent.  His problems would not be gone, he would continue to be unreasonably insecure at work and with friends, prone to greater anxiety and even panic, but he would not feel so frighteningly “crazy”, and he would be much less debilitated by his anxieties.  And he would be calm enough to reap the more substantial benefits of psychotherapy, the reduction and maybe even elimination of these neurotic anxieties.

You may recall from previous entries about Simon that he has had this experience before of feeling markedly less crazy once he opened up.  Old habits, however, die hard.  As his anxiety returned, so did his clinging to old ways – at all costs show no weakness, be completely competent and independent or you’ll be killed.

This basic first step – saying it out loud, to yourself and to others – has a long history.  What is the first step in AA?  Admitting you have a problem.  How does every AA sharing start?  With a participant introducing him/herself as someone with a problem.  What is it that is always said about the person who “goes postal” by the people who knew him?  “He was very quiet, he never complained”.  (Of course I am simplifying things here to make a point.)

Artists and writers have persistently showed us the importance of this theme.  After a horrific rape of a mother and two small children in Pat Conroy’s “The Prince of Tides”, the mother frantically cleans up the house and disposes of the bodies so that when the impatient and at times physically abusive father returns home he need never know what happened.  Recalling this years later, the book’s narrator says “I think the silence was worse than the rapes”.  There is a reason that all the advertisements for the rock musical “Tommy” showed a brick wall with graffiti written on it saying “see me here me touch me feel me”.  There is a reason that Carl Rogers, a very influential psychoanalyst from the 1960s, said famously that what seems to him so central to how treatment works is “just being heard”.

But we resist this, often as strongly as Simon does.  You can see this in two relatively realistic movies about psychotherapy and its effect on families – “Ordinary People” and the more recent “Hope Springs”.  Here’s an exercise: keep count of how many lies you catch yourself telling, in word, action (even just body language), or by omission, in a week.

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