rumination

April 13, 2014

Getting Out of Your Head: Solving the Problem of Negative Self-Absorption

512px-Mirror-image

Sometimes it helps to realize that you are not the center of the whole world. Not so easy, is it?

In a moment I’ll suggest an exercise that may help, but first a few words on the problem of being too much “in your head.”

We know our own thoughts and feelings directly, from the inside out. With others, we understand them only from the outside, no matter how close we are to them or however much empathy we feel. We see what they look like, what they do and say, and how they describe themselves.

Too much absorption in our own thoughts about ourselves, however, can be a problem. It is easy to feel unique, not just in a way that feels good, like some strutting peacock or narcissistic overlord. We are not talking about self-love, but about something more like self-doubt or concern, and potentially anxiety or depression.

When our sense of uniqueness becomes attached to the idea that few others feel as bad as we do, life can be miserable. That includes the time you spend worrying about what others think of you, as well as all the moments preoccupied with distressing thoughts. An inner life that is spent targeted almost exclusively on one’s own problems can create a life-sucking whirlpool inside your head.

Regrettably, the more we think about our troubles, the worse we sometimes make them. Anxiety, worry, and self-doubt tend to feed on themselves. Downcast thoughts become automatic. Looking down piles up until those ruminations tower over us and block the bright side from our view. It can feel like living alone in a cave with only a hand-held torch providing any light.

Before you get too far down that looming road, here is an exercise that might help give you a little perspective and prevent you from falling into the cycle I’ve just described. Start by taking a walk, or ride a bus or a train.

What I’m suggesting is that you look at some of the cars on the streets and highways, parked or in motion. As you do, ask yourself a few questions.

Who might own that car? Might they own it outright or be paying for it on an installment plan? Might they have had financial problems, present or past?

What could go wrong with that car? What has already been broken and fixed? Don’t nearly all cars need maintenance, repair, and eventual replacement? Don’t cars sometimes get into accidents?

Remember that someone specific owns that car. Try to imagine the life of that person, both the good and the not so good. Might he be out of work? If not, what kind of job or jobs does he have? Is he happy with his boss and co-workers? What might his job be like, both the positive and the negative?

Who has ridden in the car with its owner? People he loved, friends, coworkers, dates, and so forth. Now imagine the range of possible relationships he has and those he has lost, from a very small number to a large one. Might he even be alone more than he wants? Might he desire more social contact, but be afraid of it? Think of the good times and the not so good times, the varieties of human social experiences.

Do you see anyone in a parked car who is reading a newspaper? Think of the news stories and problems involving other people who have nothing to do with you or with the reader. Don’t miss the reported awards and successes either, those that inspire you or fuel your ambition.

By now, I think you’ve got the idea. We endanger ourselves by too much inward focus. Most lives have much in common. The routine events tend not to be a big deal. The surprises, especially when they aren’t welcome, certainly can be a big deal; but, we aren’t as unique or special as we think most of the time. We don’t see more than a little of the lives around us, and people tend to put a good face on their public selves. Still, the laundry needs to be done, the heart will break occasionally, and we all laugh and suffer at one time or another, however much of the latter is hidden.

We live in a world that portrays itself unrealistically on TV and elsewhere. It is far too easy to believe that everyone else is having a better time and a better life — one that we’d grab if only it were offered. But scratch the surface and realize that few lead truly charmed lives, as the poem Richard Cory reminds us. For a wonderfully alive (but realistically) upbeat take on our shared human condition, also read Walt Whitman’s Crossing Brooklyn Ferry.

You probably have more in common with all those people who own all those cars than you might think. If you can take that knowledge and generate some activity that moves your mind away from your own troubles, there is no dishonor in doing so. Even reading out loud to yourself can be active enough to get you out of your head and into someone else’s: the writer’s head and his characters’ heads.

One thing to remember in particular: everything is temporary. All those cars you saw on the road won’t be there forever, nor will most problems feel as they might today. Get on with your life the best you can. That’s what the other drivers are trying to do. The more you try to do it, the less time there will be to think introspective thoughts that might not be helping you.

The roads lead in lots of directions. Explore them, especially those that might aim at something bigger than yourself — outside yourself.

You won’t always succeed. Nobody does. But be sure to keep driving, with your eyes on the road, looking inward only when necessary. The person who taught you how to drive must have told you to keep your eyes wide open and alert to what is happening on the highway. Good advice, too, for the highway of life.

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The top image is called Mirror Image and is the work of Amartya5, sourced from Wikimedia Commons.

March 4, 2010

The Upside of Depression and the Downside of Medication

http://upload.wikimedia.org/wikipedia/commons/thumb/d/dc/Depression.jpg/500px-Depression.jpg

Are there advantages to being depressed? Something good about something we think of as so bad? A recent New York Times Magazine article by Jonah Lehrer makes just that case: Depression’s Upside.

The essence of the argument is that some episodes of depression allow for and encourage a kind of analytic rumination that is productive. Put another way, the tendency in depression to focus on a problem, mulling it over to the exclusion of other thoughts, permits the sad person to find a solution to his difficulty and change his life in a positive way.

The counter-argument, however, is that the ruminative process is both painful and unproductive — that it often creates a kind of self-flagellating preoccupation with one’s trouble rather than a process that leads to something good; that unhappiness and focusing on pain and its concomitants simply feed on themselves to no helpful end.

In my clinical experience, therapy with people who are depressed over loss or injury often breaks down into two phases. The first of these is a grieving process, where the person expresses and processes (or sometimes purges) the feelings of anger, sadness, emptiness, desolation, and hopelessness that come with the loss of something of value — a love, a job, high social status, a capability, a fortune, etc.

The second phase involves learning from one’s painful experience about how to live differently, make different decisions, associate with different people, become more assertive, overcome fear; value things differently in life such as money, material things, status, accomplishment, friendship, and love.

Naturally, neither of these two phases is absolutely discrete — they blend into each other and overlap each other. As a practical example, someone who has had a series of bad relationships will typically need to grieve the unhappy end of the most recent one and, in the process, learn how he happened to choose a person or persons who made him so miserable; then changing whatever needs to be changed internally and externally so that different and more satisfying choices occur in the future.

People who are like the hypothetical individual just cited usually come into therapy in emotional pain and seek relief of that pain as promptly as possible. This desire is entirely reasonable — who wouldn’t want this? Some of them request medication, which is often the fastest way to “feel better.”

But many are leery of psychotropic drugs and see them as artificial, hoping that therapy will produce a more lasting fix without dependency upon a foreign substance. Indeed, while a good therapist will strongly encourage the use of medication for someone who is seriously depressed, i.e. suicidal, unable to work, sleeping away the day away (or almost unable to sleep); that same therapist will also know that medication sometimes serves to “de-motivate” the patient, giving him or her a relatively quick solution that allows that person to tolerate an intolerable situation. In the New York Times Magazine article mentioned above, Dr. Andy Thomson describes this problem eloquently:

I remember one patient who came in and said she needed to reduce her dosage. I asked her if the antidepressants were working, and she said something I’ll never forget. ‘Yes, they’re working great. I feel so much better. But I’m still married to the same alcoholic son of a bitch. It’s just now he’s tolerable.’

Clearly, this woman was aware that she needed to be in some amount of discomfort in her relationship with her husband in order to be motivated to get out of it. The drug made her feel better, but, it also reduced her incentive to change herself and her life. It was, in effect, a kind of band-aid, rather than a real cure. It anesthetized her and, in so doing, robbed her of something that was essential for new learning and behavior change to occur.

Unfortunately, most people who come to therapy are neither as courageous or insightful as the woman just described. Once they feel significantly better, whether due to therapy or medication, it is common for them to be less interested in continuing treatment. They have recovered from the event that precipitated their entry into therapy, but they might not yet have learned enough to avoid making the same mistakes that contributed to the problem in the first place.

Such a person can reason that the cost of therapy (both financially and in terms of time, effort, and the difficulty that comes with changing one self) is now greater than emotional pain from which they might still be suffering. Put another way, at this point, doing therapy “causes” more difficulty and pain than not doing therapy, just the reverse of what seemed true when they started the treatment process.

At this stage, those who continue in therapy have something that an old mentor of mine, Truman Esau, used to call “therapeutic integrity.” What he saw in some of his patients was an almost heroic desire to make themselves better regardless of how much the actual process of doing so was difficult, uncomfortable, or painful.

These patients didn’t shy away from problematic truths about themselves or others. They worked hard to stretch and challenge themselves, knowing that it was crucial to improve. They didn’t simply want a quick fix. Like the woman in Dr. Thomson’s example, they recognized that some pain was essential to being motivated. They knew that there was no such thing as “a free lunch,” and were willing to do whatever it took to repair and better their lives.

If you are in therapy now, it will be important for you to be sensitive to this shift from the often intense distress that brought you into therapy, to the point when the therapy itself might seem distressful. This can mean that the therapist is not skillful or that he is pushing you too much, but it just might also signal that some of the most difficult life changes you need to make are still ahead of you, even if the cost of making those changes seems greater than when you started treatment.

If you leave therapy because it is hard and unpleasant work, the problems you have won’t care. They will simply continue to reside in you, work on you, and trip you up. It is not enough to get over your last disappointment or unhappiness, but to change yourself enough to avoid future problems.

Few things that are worthwhile come to us for free.

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The above image titled Depression is the work of Hendrike, sourced from Wikimedia Commons.