Our current mental health culture is a skewed too far to the side of the medical model. Meaning, it reduces mental health to science alone (i.e. we have a brain but no mind or heart). Mental health is more the just the sum of its parts. Helping people get better requires science, yes, absolutely. Evidenced based research and neuroscience greatly informs any clinician who takes their job seriously. That said, helping people get better also requires art. Being with people in a way that feels healing, that feels human and not just like the zeros and ones of care requires an art form of “being with”. Psychoanalysis and psychotherapy holds the dialectic between science and art form more than any other theory I know. Today probably the most common way of doing supportive psychotherapy is through utilizing attachment theory. Many who do this do not readily recognize or identify with being psychoanalytic but guess what? Attachment theory came from a psychoanalyst (John Bowlby was a card carrying member of the London Psychoanalytic Society to the day he died)! In psychotherapy there is a balance; science informs the frame within which we work but the humanities (art, music, film, comedy, poetry, dance, theology, philosophy, drama, rhetoric, etc.) inform us about what it means to be human and how to be human with others.
Affect or self regulation is a slow thing to master and requires committed and relentlessly understanding relationships (like a psychotherapeutic relationship) because we will never unconsciously trust ourselves to another without that and therefore won't move from self protection to relational protection (the thing we need to gain self regulating capacity). We need relationships that understand the health inside our problematic behaviors and respond to that over the problematic behavior chiefly. We need less focus on behaving right and more on what behavior means.
Compensatory actions (like anger, shutting down, feeling numb, addictions, anxiety, etc.) often are the last thing to go because the "self" needs to grow enough to be ready to replace the compensatory thing. We need to keep compensations in place until we have the replacement ready.
Evan was a hard worker. Ever since he was young Evan never settled for less than excellence in whatever he did. When he did not feel he could be excellent in something he would often lose interest in it or disengage. This strategy for life served Evan very well in many respects. After all, people respond well in our society to excellence. However, Evan's emotional state was a fragile one. He was terrified of feeling he was underperforming but also simultaneously over burdened. He struggled to allow himself to relax. In fact it seemed the only way he could feel good was by achieving something or doing something or by totally numbing out (an act that left his wife and friends feeling ignored).
This is a process I've developed based on Ekman's and other's research on emotions. Taming triggers begins with reflecting on triggered moments.
Step One: What triggered you?
It's important to reflect on the particular moment of flipping your lid and losing control. What pushed you over the edge? Was it a look, a tone, a movement, a phrase, something physical like getting pushed or touched. Or was it an environment, a situation that you didn't expect.
Continuing the series about Paul Ekman's book, "Emotions Revealed" this post will highlight his research conclusions of the nine ways emotions get turned on in a human. Ekman points out that most of the time we can't control or predict becoming emotional but that one of these nine are most likely to leave us feeling regret.
Often a couple will come in and talk about a fight they're having. The problem usually is, they are talking about the issue but they're also not talking about the issue. Our fights, I mean our repetitive deeply felt fights, are about more than what's one the surface (unloading the dishwasher, helping with the kids, making plans, cleaning the house, sex, in-laws, etc.). The surface issues are really houses for the core issues. They do matter, otherwise you wouldn't be triggered by them, however just talking about the surface issues will never solve the problem.
All of these styles are not good or bad, they are amoral and simply the ways that our young minds devised was the best way to get our needs met in our initial environments. Problem is, these schemas (attachment theory calls them, Inner Working Models), become outdated as we grow up and encounter new environments but because we operate out of them unconsciously we continue to react to our world as if it was the same as the one we grew up in (an act that tends to turn our current environments into our initial ones).
Trauma is a word that probably gets thrown around too much. When that happens words often lose their accuracy and impact. So what is trauma and what does it have to do with repetitive relational struggles?
Psychotherapy (a word which means “healing of the soul”) and psychoanalysis (a word which means “an examining of the soul”) are methods of talk therapy designed to help people identify feelings and thoughts and needs that they have hidden from themselves explicitly (often during session people remark that they now have words for what they have known only by feeling or gut). This is helpful because it allows people more freedom of choice in life. They are less prone to repeating patterns of relating that keep them feeling stuck, dissatisfied, depressed, anxious, etc.