The Intimacy of Personal Space

I always had my own room as a kid. I was pretty lucky in that way that I didn’t have to share it with a sibling as some people did. It was really nice to have a place in my house that I could really call my own and that I had a lot of control over. The rest of the house was definitely my family’s house and the spaces were shared with other people and others dictated the rules surrounding it but in my room I was in charge. Well, as long as I kept it clean enough that my parents didn’t have to step in that is.

As I grew up, this space became an extension of my own identity. I organized it the way I wanted, I decorated it with pictures and posters and my favorite things.  It was a place where I could retreat if I wanted to be alone, a place I could go with friends where we wouldn’t be interrupted. I place that I could share with whomever I wanted and keep away from those I didn’t.

This pattern continued, as I got older and moved out of my parents home. Now the house was an apartment and was shared with roommates and friends instead of family but my room was still my own. I could decorate it as I liked without having to negotiate with others and people only came in if I wanted them to. It was still my place, where I could be me and no one could tell me different. Continue reading

Depression: Inward Anger?

Emotions show

Image via Wikipedia

Emotions are a subject of considerable importance in most therapy settings.  It’s pretty hard to do any kind of useful therapy without bringing emotions into the picture in some way.  Traditionally, this equates to the old standby that therapy is just talking about your feelings.  Although this is partly true, it would be a great falsehood to claim that this is all that therapy is or can be.

Regardless, in my opinion, the core of all dysfunction stems from some kind of emotional ‘disturbance.’  This could take many forms, form as serious as a past traumatic event to the way that emotions were handled in the family you grew up in (arguably the only variable in life over which you truly have no choice).  For example, if you grew up in an environment in which emotions were regularly hidden or suppressed, you might be unlikely to be comfortable expressing outward emotions like anger or frustration most of the time.  Inward emotions, like sadness, might be more comfortable for you because they naturally lead to behaviours such as isolation and withdrawal from situations that may be overly stimulating.

In any emotion-focused therapy, one of the main goals can be to explore how problems manifest emotionally on different levels of awareness.  A lot of people are just not that familiar with their own emotions.  I have some theories on why that might be (like most things related to mental health, we’re not doing a very good job educating our children on emotions – despite the fact that they’ve been proven to be the same all over the world), but I’ll save that for another article.  Often times people will come to therapy with a problem, say depression, that seemingly comes out of nowhere, but often has to do with another emotion they’re uncomfortable with, for example anger.  Sometimes exploring how emotions are processed leads to insight about how the problem developed and how to move towards health.

Let’s consider the example of Rachel, a pretend case loosely based on an amalgamation of former clients.

Rachel grew up with a mother who worked at a demanding job, was often stressed out and irritable around the kids, and frequently had angry outbursts.  Rachel’s dad played the role of the even-keeled peacekeeper whenever a family conflict arose, and was pretty good at this seeing as Rachel can’t remember her dad ever really getting outwardly emotional.  Rachel quickly learned to navigate her interactions with her mom by taking after her dad and keeping as many of her emotions as she could on the inside.  It didn’t take her long to figure out that getting angry with her mom only made things worse for her, as mom would only get more upset in return.  Furthermore, she began to associate outward anger with her mom, and vowed (consciously or not) that she would not end up this way when she grew up.

Now in her twenties, Rachel (who no longer lives with her parents) starts to feel depressed.  This starts to affect her grades at school and her relationships with friends and roommates.  It’s not long before she’s dropped her classes, and as her depression gets steadily worse, she’s soon spending most days unable to even get out of bed.

This is the point that Rachel seeks therapy, something she has never done before.  Her therapist soon notices that although Rachel describes terrible symptoms of depression, hopelessness, and despair, she often smiles and speaks with a bubbly voice.  The only evidence of her ordeal is an occasional bout of stifled tears.  Through talking with her therapist, she begins to explore how she experiences emotions, and states that she is often “the conflict mediator” or peacekeeper in her relations with others.  Even in her darkest hour, she nobly (or perhaps stubbornly) attempts to downplay the magnitude of her depression.  She’s so used to being “the helper,” that being in a position of needing help is completely foreign to her.

Eventually, her therapist makes the comment that given some of what Rachel has experienced, it would make good sense for her to feel angry.  This comes as somewhat of an epiphany to Rachel, who had never thought of it that way.  With the help of therapy she was able to see how she actually was really angry.  The rub is that she didn’t have any way to express that anger healthily, and so it festered and grew inside until it became unable to be ignored.  But still, Rachel’s discomfort with the emotion of anger was too deep-rooted for her to notice what was going on.  Something had to give, though.  If Rachel wasn’t going to let herself experience anger, that anger was going to get out in a different way.  So, instead of going outward, it was turned inward, which appeared outwardly as sadness, an emotion that Rachel was much more comfortable with because she could hide it.

After realizing this, Rachel began to work on better differentiating her emotional states and working on ways to healthily express her anger.  It wasn’t long before the worst of her depression lifted.

This is just one example of how emotions can get in our way when we don’t know our way around them well enough.  Doesn’t have to be sadness and anger, although some have theorized that depression can be thought of as a kind of inward anger, as described above.  We all have emotions we’re more comfortable with than others, and we’re the only ones that experience our own emotions, so it can be hard to know when they’re getting us into trouble.

In general, emotions do us a lot more good than harm.  I guess the bottom line in this article is that knowing our emotional selves better can be a great way to capitalize on the good and minimize the harm.

Addict for a Day: Inside AA

One of the final classes of my degree – the long, painful, exceedingly expensive (okay, also purposeful and rewarding) last 2 years of my life – is an introductory course on addictive disorders, their treatment, and the pharmacology of substance use.  While dark, disturbing, and downright depressing, the subject matter is also curiously intriguing and interesting.  Anyone who’s watched an episode of Intervention knows what I’m talking about.

There’s something about addiction that just tears people right apart, along with their career, family, and hope for a future.  Yet, we’re drawn to this suffering, moths to the flame.  Perhaps we wonder on some level how far we ourselves would have to go, how bad things would have to get, before crossing our own line.  Isn’t it our way – as people and as society – to try to get as close as we can to self-destruction without actually doing it?

So, the class is a mixed bag.

One assignment sent me to an alcoholics anonymous meeting.  I had never been to one before.  Plus, I never agreed with their philosophy of recovery, being the stubborn atheist/humanist I am.  I guess the whole concept of surrendering control of yourself to a higher power never sat well with me.  Nonetheless, I looked forward to going and seeing what it was all about.  The assignment was simple enough: attend a meeting, write about it and whether or not you think the program is effective.

Sure.

It was about 2 in the afternoon.  I don’t know why, but I was feeling nervous as I walked up to the building.  Maybe it was fear that I would be “found out.”  That somehow the fact that I didn’t have a problem with alcohol at all would be written all over my face and I would be some kind of outsider.  Maybe it was that I just had no idea what was going to happen in the meeting.  I mean, everyone sees them portrayed on TV or in movies… people sitting in a circle of chairs, taking turns talking about their daily struggles with sobriety, maybe praying, that kind of thing.  But I wasn’t taking anything for granted.  I knew how inaccurately therapy is portrayed in the media, so I was ready to be surprised.

It wasn’t until later that I realized why I was feeling nervous.  It was fear of being judged.  Did other people know what went on in there?  What if they did, and saw me walking in, and thought – god forbid – that I was an alcoholic?

With a sinking feeling, I thought, ‘wow…  what must it be like for someone with a real problem?’

Inside there was nothing to write home about.  A bunch of chairs set up in rows, a podium and mic at the front, flanked by windows covered by large posters emblazoned with the 12 steps and the 12 traditions of AA.  There was a coffee bar.  $1.50 to indulge in an addiction that I actually did have.  I was happy to have something to do as I took a seat in the back row, directly facing the podium.  Sip, sip… don’t mind me…

There were a few people already there, some at tables behind me, some on couches lining the perimeter of the room, a couple seated in the rows of chairs in front of me.  A man was at the podium now, he read some rules and something called a ‘daily reflection,’ not, of course, without introducing himself under his breath with the perfunctory “I’m an alcoholic” statement.  At least the movies got that part right.  There was a murmured greeting from the crowd.  He went on about something to do with honesty and admitting powerlessness, periodically scanning the crowd, who now numbered maybe a couple dozen.

One by one, he called people to the podium.  There was a couple – American – who had just got off a cruise ship that didn’t have any meetings on board.  “Real glad to be at a meeting now,” he said.  About a year sober, trapped on a cruise ship for 2 weeks with no way of avoiding booze.  I believed him.  An older woman was next.  Then a ‘newcomer’ who was clearly in a rough spot in his life.  He talked about treatment centres, relapses, boredom, mental agony trying to decide whether or not to drink on any particular day.  Another guy said that he used to go to a bar, order a beer, and stare at it for half an hour trying to decide whether to take that first sip.  Sounded like torture to me.

Everyone spoke eloquently.  Some very convincingly.  I got the sense these were experienced people.  And then, the inevitable moment came.  Podium guy looked for someone to come up to speak, and sure enough, gestured to me.  Of course, I had thought of what I might do if this situation arose.  Sure, I could pass – not speak, stay in the silent comfort of my seat – but then, this was an educational opportunity.  ‘I’m here, aren’t I?  Might as well get as much of an experience as I can while I’m pretending to be an addict.’

My introvert alarms were sounding as I stepped up to the mic.  ‘I told you not to do it!’

Sshh.

“My name’s David,” I said, without the ‘I’m an alcoholic’ part – I couldn’t make those words come out, like they were cursed or something, or would sound too forced, or any of a million other lame excuses.  I didn’t want to lie to these people, who had shared such painful stories that were, in all seriousness, pretty courageous and inspiring.

“Hi, David!” came the group’s reply.  I couldn’t help smiling.  I felt accepted.  The nervousness started to evaporate.

“I’ll make this quick,” I said instead.  “This is actually my first ever meeting,” I blurted, to cheers from the crowd.  I went on to say that I wasn’t sure where I was in the grand scheme of things, and that I wanted to see what these meetings were all about, which were both technically true.  When I was finished, there was more applause, and several encouraging handshakes on my way back to my chair.  I felt welcomed, but still pretty awkward as I listened to the next few speakers mention what it was like for them when they first started coming to meetings.  Speakers consistently made direct eye contact with me when talking about how important it is to keep coming to meetings.  That nice feeling of being welcomed started to turn into a sense that I was being gently pushed.  A vivacious, attractive younger woman was last to speak.  She was a great speaker, very charismatic, very personable.  She made a convincing case for following all the steps and reading all the AA literature.  I wondered if she was routinely asked to speak at the end the meetings with young newcomers.  Or maybe just at the end of meetings to provide those in attendance some motivation to return.

Finally, everyone formed into a circle, holding hands, and a prayer was spoken (the “serenity prayer“):

God grant us the serenity to accept the things we cannot change,
courage to change the things we can,
and wisdom to know the difference.

It was pretty awkward to be the only one that didn’t know the words.  The meeting ended and I think I was the first person out of the building, as if I had a limited time before my ‘clever guise’ wore off.  I didn’t get out without a short conversation with the young woman who spoke last, she gave me a booklet with meeting times and locations for the whole month.

I did feel like a weight was lifted off my shoulders as I walked away.  I think it was the whole pretending thing, and the mindset that I seemingly adopted to go with that ‘addict’ role.  That feeling that I was being judged by ‘normal’ people.  It was all very automatic, which is kind of frightening.  We do this to people, society.  Great job.

So, is the whole thing effective? From what I saw, it was keeping some people sober.  Maybe their addiction just switched to having to go to meetings, but there’s surely a lot worse out there.  I can tell you that I felt welcomed, supported.  That if I really needed it, these people would help me.  I don’t think that means that it’s going to work for everyone, nor should it.  I still don’t believe in the same things they believe, and I don’t think I ever will.  I think that the power to change, for better and for worse, is fundamentally within one’s control, not outside it.  I believe in responsibility, on a personal and a social level.

One Word

She glanced up momentarily as her hands relentlessly picked away at a tissue in her lap, eyes moist and reddened, yet unable to mask an inner resolve as hard as steel.  The counsellor across from her shifted in his chair, and casually folded one leg over the other.  When he spoke, it was with a quiet hope that his voice would not waver.

“There’s one last thing I’d like for us to do.  It’s a visualization, of sorts.  Just a way  for you to have something to take away that will help remind you of the work we’ve done here.”

As he spoke, her awareness drifted back to her fingers as they tore nervously at the tissue.  Knowing that it was all coming to an end, she eventually looked back up at him and nodded, a mix of apprehension and curiosity washing over her.  He took a breath and nodded as well.  Her fingers went still.

“I’d like you to reach into this bag and choose one of the small rocks inside.  It’s going to be your rock, so take a moment and pay attention to how you are making your choice,” he said as he passed her a small ziploc bag full of small, smooth stones.  A look of interest flashed across her face and she began to carefully feel several rocks before selecting two, feeling each in the palm of her hand.  After a moment of thoughful examination, she made her choice.  A roundish one, uniform gray in colour.

“Great.  I’d like you just to hold on to that rock in your hand for a minute.  Now, I’d like you just to take a deep breath and make yourself as comfortable as possible in your chair.  Plant your feet firmly on the ground, and close your eyes, if you’re comfortable.  We’re just going to take a few moments to reflect on what coming here has been like…”

As he spoke, calmly and evenly, thoughts and images of the last several months began to race into her mind.  She saw herself in the waiting room, fidgeting nervously and keenly aware of others’ sideways glances.  The long walk down that hallway to his office, trying to make idle conversation.  The familiar, crippling fear she felt when she first decided to come for help that had never completely gone.  The pain, the panic, the frustration.

“…now, as you’re recalling all of these memories and sitting in that experience, just try to let a word come to mind that seems to fit for you.  Just one word, one that wants to come on its own.  Don’t look too hard.”

Several moments passed as the air in the room thickened.  He watched the thoughtful expression on her face twist up for a moment, then suddenly, a single tear shot down her cheek.  She opened her eyes, and let him know that she had found her word.

“Here is a marker.  Now, if you’d like, you can write your word on the rock, and it will be my gift to you.”

She didn’t hesitate as she reached for the pen and carefully drew onto her rock the word that had so clearly come to mind as she remembered the fear, the anxiety, and the many, many tears.  She turned the rock over to show him what she had wrote, and in clear, purposeful lettering, one word was scrawled:

“Strength.”