dissociation

December 15, 2019

Hurdles to Healing: Dissociation, Self-Distraction, and Forgetting the Therapeutic Conversation

I noticed something surprising as a young clinical psychologist. A few of my patients forgot the most significant topics discussed in the previous visit. The client’s memory had been wiped clean as soon as he took a sidewalk step outside.

Let’s break the experience down. We are dealing with various methods of avoidance:

In behavioral avoidance, we stay away from or delay something. Not attending a party, not making a phone call, and side-stepping confrontation all fit the category.

Now think of the failure to recall segments of a penetrating conversation, a separate class of dodging. It is a kind of return to the state of ignorance we inhabited before the talk with the doctor, with an emphasis on the word ignore. This type of avoidance is a more internal, mental event.

Here are examples of the latter:

Dissociation:

One of the signs of dissociation is the fracturing of recollection. Parts of an individual’s lived-experience are compartmentalized, detached, put into a psychic safety deposit box. The mind drifts from ugliness, anxiety, or grief. In effect, the person walks for a while in daylight darkness. “Losing” the feelings and ideas raised in-session is an illustration of the phenomenon.

The occurrence doesn’t signify intention. The “disappearance” is automatic and unconscious: daydreaming, for example, to the point of losing awareness of time passing.

We all “space out” on occasion, but the recurrent loss of the therapeutic thread between sessions is noteworthy. A treatment obstacle exists.

Self-distraction:

Those who take on the unbuffered fury of every problematic life episode become like an unbending tree in a gale, lacking the flexibility to endure its impact. Self-distraction can be a way of moving aside from the indomitable force, at least for a while. Imagine it as akin to taking a breath, gaining strength, and coming back prepared to manage whatever taxes you.

Even so, because psychotherapy must unsettle the client’s internal climate enough to help him change, he mustn’t distract himself most of the time. If after-session contemplation of the therapeutic issues passes in a breeze of internet surfing, work, or socialization, so will the chance for progress.

However much these psychological defenses might be needed, they can also enact a cost. The fraction of the world we evade or forget leaves a smaller world for us to inhabit. Moreover, our acceptance of a miniaturized comfort zone implies a fear that we lack the abilities, resilience, and toughness to stand up to the larger cosmos.

The individual thus shrinks from all the glorious, dazzling, and frightening complexity of the real world. The universe of what is possible contracts: all the foods, adventures, types of people, behaviors, and opportunities for learning vanish. Existence is narrowed and diminished. Walls are built.

Here is an example. I treated many men who didn’t want annual physical examinations. They avoided physicians because they wished to block bad news (illness).

Quite a few of these men demonstrated bravery elsewhere in their lives. In this situation, nonetheless, they escaped reminders to lose weight, stop smoking, exercise, restrict their diet, and reduce drinking. They ignored troublesome coughs and chest pains. Any real malady was no less present, but the fantasy of make-believe health was maintained.

These people willed themselves “blind” rather than taking responsibility for their well-being.

Such individuals evaded conversations reminding them of their mortality and bodily vulnerability. By making a decision not to submit to medical evaluation, they reduced the freedom to know whether they were ill, defeat illness, and display courage in confronting the limitations and hardships connected with disease.

Excuses hid the truth of their existence, the truth of their avoidance of truth:

  • “I’m too busy to go to the doctor.”
  • “He’s just going to tell me X, and I already know it.”
  • “Doctors only want your money.”
  • “My insurance won’t cover the appointment.”
  • “Yeah, I’ll go, but not until next month.”

Whenever we duck taking responsibility for our welfare, we give up a portion of the capacity to shape the world to a different and more pleasing form. Whether alert to what we are doing or not, a choice occurs: to claim as our own the disturbing recognition of our inner and outer world or to bury it.

New knowledge, once aquired, always offers us a question: what are you going to do now and in the future in light of what you know?

As the existential philosopher, Jean-Paul Sartre wrote, “If you want x, you will have to (do) y.”

These awarenesses and choices are disagreeable. Otherwise, everyone would make them with ease. They are thrust upon us by the condition of being human. If we keep recognition of our current and past evasions underground, we thereby enlarge the risk of unseen catastrophes, as we do if we walk across the street without looking both ways.

Then, with our eyes ignorant of danger, we are inclined to consider these calamities a matter of hard luck or destiny. External forces appear to have destroyed our dreams. We tell ourselves we couldn’t have changed the outcome.

Maybe, but maybe not.

No one escapes trouble, but some number of calamities are preventable given enough time to prepare. That is, if one chooses to see and accept the freedom to push the boundaries of our knowledge of our psychological world to something closer to full size.

Therapists are wise to take sensitive issues slowly, lest they overwhelm the client, and trigger the tendency to “put away” enlightenment (insight) revealed in the office. Even so, no healer believes he can instill fortitude in another person to face his dilemmas where sprouts of courage don’t exist to be nurtured.

If buds are present, however, the counselor becomes something like the gardener who tends to his plants. His job is to enrich the soil and shelter them from part of the wind and cold.

Then, in the best case, the developed vegetable life — now independent — uproots itself, discovers it has legs and walks into a fuller animal life on his own.

In the end, freedom — the path to growth — is not free.

Whatever our life is to be, whatever it was, whatever historical harm we suffered, the life now and ahead is ours.

We must forever choose to make it.

———

The first image is Papagenato, imported by Archive Team. Next comes Gaze -3, an oil painting by Rajeskharen Parameswaran. The bulldog is called Barlow in Hiding by Andrew Smith. Finally, a Hide Pose by Peter Trimming. All were sourced from Wikimedia Commons.

August 12, 2018

How Much Do You Think About Your Future?

“What dreams may come?” wondered Hamlet as he considered whether “to be, or not to be.” The potential of an afterlife of nightmares stopped him short of self-murder. For the rest of us, the time beyond today is either ignored, dreaded, colored in unending rainbows; or maybe even calmly planned.

Experience suggests that whatever comes will include both good and bad; and depend, in part, on how we approach it.

One’s individual weather forecast depends, to a degree, on his history and inborn, genetic disposition. Yes, there are born optimists or born pessimists. Guess who has more fun?

Cognitive behavior therapists help the latter group’s struggle with catastrophization. The counselor trains his patient to recognize the error within the terror of anticipated disaster when little realistic likelihood exists. The worst of life is best encountered in the moment. Don’t pour worry over yourself, like a sticky syrup mucking-up every day. “Borrowing trouble” comes at much expense, killing our ambitions before they begin.

When we do think past the horizon, some of us mistakenly focus on only half of what must be done to raise our prospects. It is not enough to quit an awful marriage or job, despite the immediate relief of departure. What comes after? Ask how you deposited yourself in a swamp? Envision a destination and a plan of attack. None of this is easy.

I know people who need a permanent set of attached binoculars to check out next steps. Some take bodily risks. Think prodigious drinking, eating, or drugging. Nor do I speak of the ones who simply deny their self-abuse. Too many possess the “talent” (or curse) of shutting off their brains when offered a drink or walking into a restaurant: an unconscious, dissociative process like a selective amnesia. A hour earlier they intended to pass by the cocktail or the quarter-pounder with cheese. Faced with the devilish dilemma, the brain takes a vacation — temporarily closes-off a sliver of awareness. One might think of it as the sky on a clear day, but for one cloudy portion.

The future is a trickster. His opening act makes us believe we own an unused bank vault full of years. For those who do survive, unlived time is most often neither so wonderful or terrible as we imagine. Humans hedonically adapt. After a period of euphoria we tend to move back to our “set point:” our usual level of emotional equanimity or distress. Time’s passage also elevates our spirits from the first awfulness of many seeming disasters. Review your history. You might find lots of misfortune from which you bounced back.

Truth is, we are poor affective forecasters — weak at predicting the emotional residue of our adventures. Psychologists Daniel Gilbert and Tim Wilson tells us this leads to “miswanting.” We guess we will like some choices more than we do when they happen, in addition to “mispredicting” how long strong feelings will last afterward.

You think a $10,000 raise offers sustained joy? Most likely not for long. Simply put, after a year or two, most of us feel about the same as we did before the wonderful or terrible thing happened.

If you dislike the fallible weatherman, examine your prognostic success. In 10-years-time you could be surprised by how much you change and how those alterations complicate your ability to make predictions about what you will enjoy:

While I’m giving crystal ball warnings, beware of “bucket lists.” Other than people like my old buddy Ron Ableman, I knew many who kicked the bucket before they reached the list inside. Another group believed their long-awaited trip to Paris, for example, would have held more enchantment in the springtime of their life.

If you peg your well-being to winning an Olympic gold metal or some similar recognition, reconsider. Someone will win the distinction, but far more won’t. The impossible dream is the graveyard of life satisfaction. Instead, enjoy the process and more probable rewards along the way. A spot on the highest podium while your national anthem plays then will be the cherry on top.

The difficulty of depending on tomorrow for all your pleasure is well-described by Dan Greenburg and Marcia Jacobs. Their funny and all-too-true book is called How to Make Yourself Miserable.

The authors believe we manage the dreariness of our regular duties by looking toward to THE WEEKEND.

Unfortunately …

By Saturday morning you may be vaguely aware that Friday night wasn’t as great as you hoped it would be, but you don’t have much time to think about it because … you are still looking forward to the climax of THE WEEKEND — Saturday night. By Sunday afternoon, however, it is all over. Hope is dead. There is nothing further for you to look forward to, except the gloomy prospect of Monday morning and another whole week of drudgery at a job or school you detest. The weekend — like your life — can at last be viewed in its correct perspective: one colossal letdown, one gigantic anticlimax. On Sunday afternoon you are free to ponder all the great times you felt sure lay ahead, but never quite materialized.

We do need to suppose something better is in the offing — somewhere, somehow — and energize the resolve to get there. All those who trod a long educational road toward a career valued the lofty goal. The fathers of our antique religions realized the worth of a heavenly reward — a world without gravity — for the grave circumstances we ofttimes endure on earth. But, as Greenburg and Jacobs recognized, laughing at ourselves helps too, and sooner.

Just as a predictable joke is never funny, the most remarkable opportunities and joys take you by surprise.

In my own temporary stay on the planet, for example, I never contemplated that I might become a consultant to more than one major sports team. The unsought path just revealed itself.

Sure, I passed through down times and understand more will come, but I find little profit in attempting to improve the distance-vision of the nearsighted man I am. Indeed, if I live long enough, I’ll hesitate before buying unripe bananas. Most senior citizens are wise not to take a mental leap forward. They do well to make every day count.

Nothing is static. Expect sunny days and stormy weather and many partly cloudy skies. The ability to adjust to conditions is a skill necessary for you and me, both.

The largest portion of our contentment comes not beyond our noses, but by grabbing the beauty near at hand.

Of course, I have a surgically reconstructed left knee, so she may elude me.

—–

More on affective forecasting.

The first image, What Lies Ahead, was sourced from Eurotimes.org. The art work that follows is The Future of Statues, by Rene Magritte. It was sourced from Wikiart.org.

 

 

April 29, 2018

Escaping from Ourselves: Music, Crowds, and Other Ways Out

April 21 was Record Store Day, an international event celebrating the hunt for tunes you can hold in your hands. By coincidence, this classical music lover found himself listening to a rock concert at a stop where I hoped to shop, not bop. I’d never attended anything similar, but learned something you won’t in a Mozart-friendly venue: the pain people suffer to escape themselves. Or simply to have a good time.

Only a matter of feet from the amplified band, everyone was moving to the music, ear drums be damned by snares and cymbals. What was punishing to me in sheer volume got other people out of themselves. Big music doing a big job. The point was not to use thought, but to submit to the mood-altering bombardment and escape reasoned analysis and reflection.

We do need to get away from reality. Intensity of sound was the key. The straight-jacket of our brain gets loosened and our suffering is covered-over, swamped by an aural tsunami.

Music isn’t the only way. Take the extremity of self-mutilation: cutting your body, as some do, not for decoration, but replacement of emotional pain by the application of physical pain; like a new coat of paint.

Sports venues also use loudness to launch escape from self. Conversation is difficult. Even attention to the game on the field. “Play ball?” You’ll see it, but won’t hear the infield chatter or bat striking ball. No foreground of sound and background of silence, like visual art, but all foreground all the time.

Beyond a flight from acute emotional distress, why might we want to depart reality? Life can be rather too much, don’t you think? The vocational rat race, mortality, and inevitable comparisons and competitions come to mind. No wonder we drink, smoke funny cigarettes, and overeat.

The human being is a clever creature, tricking himself to fly without even knowing what he is doing or why.

Those who dissociate in the midst of a traumatic event describe their transformation as a “going away:” separating a part of themselves from the portion encountering the unsparing awfulness. By breaking into segments, another facet of the personality experiences the grotesquery in a muted fashion or not at all.

Nearly everyone sometimes compartmentalizes his experience. We take in what distress can be managed and screen out the rest, without the extreme loss of awareness in dissociation. “I’ll think about this later,” so we tell ourselves, and a door in the brain closes.

Crowds can help you get out of yourself. Not just at concerts, but political rallies. Size matters. We give up thinking for nonbeing, joining, submerging. At the crowd’s worst, rules disappear, exchanged for bad faith. Humanity and civilization are discarded. We return to more primal roots. The unity of the group is all. You are not solo, not separate, but swept into in a mob of homogeneous excitation. No wonder the mass goes crazy and the individuals lose themselves, surrendering their agency to the power of the collective.

Talented populist orators evoke a frenzy, a single-mindedness they manipulate with our complicity. Why? Because we desire this loss of responsibility and control; the mental weight of making a decision. Once unburdened, anything is possible with someone else’s permission and direction. Think Lord of the Flies and what happens to Piggy.

Sensation of a transcendent kind is found in sex. Sexual contact allows us to escape of our bodies in the body of another. We are swept away in the stretching, sweating, touching, playing, craving, and holding. Our surrender to flooding hormones and synchronous beating hearts yields ecstasy: escape velocity that returns us to our unthinking creatureliness, our animality.

But there is more. When wills and wants and sensibilities align we exchange essences. After, we take some portion of the other’s otherness with us. Each party is completed. We are less ourselves and alone. In the consummation we escape our own boundaries.

Dancing and religious rites can create self-abandonment. Some worshipful gatherings sanctify and applaud those who “speak in tongues.” They become unmoored, taken over by a language that is not a language.

Quieter ways to lose yourself exist, but they lack the drama and require concentration; say, on a book you are reading or by the discipline of a hard-won meditation practice. We can depart our self in a state of “flow” at work, too. But, if you want to leave your consciousness behind without industrious effort, these will not do.

Standard variety vacations suffice, especially if they take you to a place of anonymity, a strange culture, away from work and obligation: in the most positive sense, out of your mind. The tendrils of thought pulling you back to homely discontent are cut.

No judgement here. Relief is necessary. Distraction and diversion take many forms. We don’t always choose our evasive poisons or medicines wisely, but one cannot make the best of reality without the occasional departure from the realm of the hard and real. Passing time without flights of fancy would be too grim.

Here’s to the high flyers, the ones climbing toward the clouds in search of cloudiness. It is true, the upper reaches are opaque, but where is it written we must always be clear-eyed?

Smile, laugh, and make love. Or, as the old verse tells us, “Eat, drink, and be merry, for tomorrow you will die.”

So says the Bible!

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The first image is Tape Floor by Jim Lambie. The second is Fenix by Josignacio. Finally, Dancers by Degas. All are sourced from Wikiart.org/