{"id":52,"date":"2013-07-11T14:06:37","date_gmt":"2013-07-11T14:06:37","guid":{"rendered":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/?p=52"},"modified":"2013-07-11T14:06:37","modified_gmt":"2013-07-11T14:06:37","slug":"why-get-in-touch-4","status":"publish","type":"post","link":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/why-get-in-touch-4\/","title":{"rendered":"Why “get in touch” – 4"},"content":{"rendered":"

In my last entry, Why “get in touch” – 3,<\/a> I tried to explain in more concrete terms how one goes about psychotherapy, how one gets \u201cin touch\u201d, and what some of the common road blocks are to the process.\u00a0\u00a0 The day after I finished it, I had a session with a patient that illustrates some of the material beautifully.\u00a0 He gave me permission to share it here.\u00a0 (Names and details changed to protect confidentiality.)<\/p>\n

John (40 years old) came to treatment complaining of episodes of agitated depression during which he would feel suicidal, despairing, enraged; other times he reports anxiety symptoms (obsessing, chronic self-doubt and insecurity), or not feeling much of anything beyond a rather silly but intrusive preoccupation with dating women.\u00a0 Despite his considerable success in this area he is often preoccupied with feeling unattractive to the opposite sex and he seems to really believe that his occasionally failing to land a date is the source of his agony.<\/p>\n

Obviously such intense feelings and preoccupations are really about something else.\u00a0 John is not a man who struggles to find female companionship and even love \u2013 he\u2019s been married twice, both times choosing to end the relationships, and over the years has in fact experienced less rejection than most men.\u00a0 His claim, if true, that in his teens and early 20s he was less successful with women than some of his peers does not come close to accounting for such intense despair two decades later, especially after so much romantic success in the interim.<\/p>\n

So what is really hurting John?\u00a0 What is the true source of his distress?\u00a0 (He has no drug or alcohol abuse problems, and he is physically healthy.)<\/p>\n

In contrast with his intense overreactions to minor slights in the present \u2013 for example being rejected by a woman at a party to whom he acknowledges he was not even that attracted! \u2013 John recounts his childhood with a startling blandness.\u00a0 Today he told me of a recent conversation with his mother in which she told him a story from when he was 2 days old and brought home from the hospital.\u00a0 According to his mother, he was crying in his bed for an hour or more before his father would allow his mother to check on him.\u00a0 His mother reported that his father’s attitude was that life is hard and a child must learn to tolerate discomfort \u2013 something John recalls hearing from his father in later years as well, so he believes his mother\u2019s account.\u00a0 John remembers at about age 10 his father took him to a double feature of very intense horror movies; there were scenes shocking to adult audiences at the time (early 1980s, only a few years after we were all grossed out by \u201cAlien\u201d, long before we were used to such vivid gore as can now be seen regularly on television shows like \u201cHouse\u201d).\u00a0 Finally, John remembers his mother and paternal grandmother being very cowed by his father.\u00a0 He remembers \u2013 and his mother recently confirmed this to him \u2013 that neither woman would sing to the child unless John\u2019s father wasn\u2019t around because he would object so strenuously, demanding that \u201cno one will coddle my kid\u201d.<\/p>\n

You can probably begin to see the puzzle beginning to take shape here.\u00a0 John can\u2019t find any reaction in himself to these stories, either in the past when they happened or when he thinks about them now.\u00a0 Meanwhile, he overreacts so dramatically to what are by comparison very trivial blows to his ego in the present.\u00a0 Historians tell us that those who aren\u2019t aware of history are doomed to repeat it. \u00a0Same is true on the personal level:\u00a0 What we don\u2019t feel\/remember we\u2019re doomed to act out.<\/p>\n

As I describe in the main website<\/a> John is \u201clost\u201d in that he is unaware of what happens inside him and what happened to him; that is why he has symptoms.\u00a0 When he can remember his experiences, both from the far past and more recently, his symptoms diminish.\u00a0 This is what happens in any successful psychotherapy.\u00a0 Symptoms fade, functioning improves, happiness increases as a person remembers, gets \u201cin touch\u201d<\/p>\n

For example, a few months ago John came in during an episode of the agitation, despair, and suicidal thoughts he had described when we started.\u00a0 By the end of the session, we had identified \u2013 simply by going over the events of the previous few days \u2013 when the bad mood started and what the trigger was.\u00a0 As with Simon and Jim in the previous entry<\/a>, John\u2019s overactive mind interfered with him simply noticing what happens to him.\u00a0 But when he did see it, the result was unmistakable.<\/p>\n

By the end of the session he understood that being rejected by a woman at a party, combined with some other minor insults that day, sent him into his state of feeling like the most despicable creature on the planet, and made him furious that “everyone else gets to be happy”.\u00a0 Having articulated this, he could see how silly it was, he understood how it spiraled into the suicidal thinking that troubled him for the next few days, and \u2013 most importantly \u2013 he felt better.\u00a0 The improved mood sustained over the next weeks, and he was functioning somewhat better as well.<\/p>\n

Encouraging as such a change is, it is only temporary.\u00a0 Although a bit more resilient each time we can have such a session, John remains susceptible to intense despair and will continue to be so until he makes a similar connection to the more distant and powerful causes of his bad feelings \u2013 the stories he has begun to tell me about his childhood, stories in which profound despair are an understandable reaction, stories in which anyone would respond with such agony.<\/p>\n

And here is where the blocks to remembering feelings\/experiences \u2013 to getting \u201cin touch\u201d \u2013 appear.\u00a0 After John told me about hearing of his third day of life I asked him for his reaction to the story.\u00a0 I asked whether any feelings or thoughts came to mind either as he heard it or in recounting to me.\u00a0 His answer was “no, because many people have bad childhoods; some must be worse than mine\u2026\u201d.\u00a0 As with Simon and Jim in the previous entry<\/a>, John is not open to his own reactions in part because he has decided in advance what those reactions should be.<\/p>\n

His answer is a classic case of “rationalization”.\u00a0 It is important to understand that rationalization feels to the rationalizer like productive thought.\u00a0 That is, you think you’re doing the work of psychotherapy but in fact you are doing the opposite.\u00a0 You are using what feels like thinking to actively avoid noticing or feeling anything that\u2019s going on inside you or even between you and other people.\u00a0 We can see how this process continued with John as our dialogue proceeded.<\/p>\n

In response to his generalization about other people’s childhoods, I asked if he would say to a friend who told him she had cancer and was feeling frightened and despairing that \u201cother people have cancer and worse, so why are you so upset\u201d.\u00a0 He answered “of course not”, then smiled and acknowledged that he was using that same preposterous rationale to deny any reaction to the stories he was telling me about his own life.<\/p>\n

But this motivation to avoid getting “in touch” \u2013 that is, to resist<\/a> \u2013 is powerful.\u00a0 So John’s next words were “but of course this story is probably not relevant to the treatment”.\u00a0 Again, he tried to skitter off the topic.\u00a0 You may notice that this is exactly what Jessica<\/a> did (her story starts a few paragraphs into the posting).\u00a0 John tried to slither out of the discussion despite being well aware:\u00a0 1) he can’t possibly know what is or is not important to the treatment any more than a medical patient may know why a history of neck injury might be relevant to pain or tingling in the hands; that\u2019s what he\u2019s hired me to know; 2) it\u2019s pretty far-fetched to imagine that such striking information about how he was raised father would be irrelevant to helping him understand intense bad feelings in the present that have no apparent source in anything happening in the present.<\/p>\n

John\u2019s next words begin to answer the question of why<\/span> we tend to be so avoidant of getting in touch.\u00a0 He asked me how to go about noticing his reaction to things like his mother\u2019s stories about his childhood or his own memories of those years.\u00a0 I said think of going to a movie like \u201cJaws\u201d, years ago when we saw those things for the first time on huge movie screens and were not yet used to such realistic gore and suspense.\u00a0 If you sit back from the experience, analyzing the film technique, you might learn something but you won\u2019t feel that thrilling fear such a movie evokes.\u00a0 By contrast \u2013 and he remembers doing this \u2013 when you simply buy the popcorn, sit down eagerly, and open up to whatever comes at you, it\u2019s scary!\u00a0 He suddenly said \u201cI don\u2019t want to be scared.\u00a0 I see that now.\u00a0 I feel a lot of fear and never want to feel it.\u201d<\/p>\n

This is why we avoid getting in touch, avoid the memories and feelings that cure us:\u00a0 Because it\u2019s scary and because it hurts. \u00a0Take a look back at Fred’s story<\/a> in this previous entry (scroll down the entry to find the paragraph about Fred). \u00a0His is a very painful experience to recall, full of deep humiliation, fear, helplessness.\u00a0 Who wants to remember that?<\/p>\n

John\u2019s statement also shows how<\/span> such avoiding makes us \u201clost\u201d.\u00a0 His habit of rationalizing away from any awareness of what his memories feel like leaves him out of touch with what happens to him day by day.\u00a0 Thus, he\u2019s surprised<\/span> to realize that even today \u201cI feel a lot of fear\u201d.<\/p>\n

This is more common than you might think. Lots of people walk around unaware of what they\u2019re feeling although everyone around can see it.\u00a0 The most obvious example of this is the teenager \u2013 usually a male \u2013 who insists \u201cI ain\u2019t scared!\u201d\u00a0 The louder they say it, the more fear we can see.\u00a0 But if the shouter shouts it loudly and persistently enough, even he starts believing the denial.\u00a0 And years later, like Simon<\/a> and John, like Ron<\/a> and “Bully”<\/a>, he\u2019s unaware of what goes on inside him but he\u2019s subject to bewildering bouts of despair, preoccupied with something that he\u2019s entirely competent in, and hampered by panic and anxiety symptoms.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

In my last entry, Why “get in touch” – 3, I tried to explain in more concrete terms how one goes about psychotherapy, how one gets \u201cin touch\u201d, and what some of the common road blocks are to the process.\u00a0\u00a0 … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts\/52"}],"collection":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/comments?post=52"}],"version-history":[{"count":3,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts\/52\/revisions"}],"predecessor-version":[{"id":55,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts\/52\/revisions\/55"}],"wp:attachment":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/media?parent=52"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/categories?post=52"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/tags?post=52"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}