Lost. 

Wounds I accumulated over years, starting back in childhood and continuing well into adulthood, have left me sick. Often, I’ve felt there is no hope of healing. After all, I’ve been in therapy for close to 15 of the past 20 years, usually taking some combination of anti-depressants and anti-anxiety medications. And I haven’t improved very much. I mean, I’ve left a bad marriage and raised my children and had a fair amount of professional success and remarried a man who is nothing but loving and kind. But I haven’t been able to shake the depression. I’ve come to believe that it’s just a chronic illness, and it’s not my job to recover but rather to manage my condition. That’s what I believed, until very recently.

The Path.

I finally started to put the pieces together, pieces I learned from E., from reading and from other bloggers. In very brief form, healing mean recognizing the different “parts” of myself, the parts that experienced some sort of trauma and building a kind of relationship with those parts. Previously, something might trigger remote, maybe not even fully conscious memories, of being molested at a particular age and I would spin off into panic or collapsing into a listless puddle of self-loathing. Instead, in therapy we pull those memories up and talk about them in a safe, non-judgmental setting, all along also learning self-soothing strategies. In my role as my most functional self (sometimes I call her the wise woman), I talk about the girl experiencing whatever she did at that age, as if she were someone else. This helps awaken more sympathy and tenderness toward her than I can generally rouse for myself. I allow her to have the feelings she didn’t feel safe to experience at the time. I tell her I’ll protect her and she’s safe now. We talk in therapy about the beliefs she may have taken from those experience and suggest alternatives if those beliefs no longer serve her.

In this process, my most functional self becomes a better manager of the “system”: better able to recognize triggers and their impact on the parts, increasingly competent with distress tolerance strategies, gentler and less judgmental of the past. The parts feel safer and are less likely to panic or to need to self-harm to alleviate distress.

The route is not necessarily a straightforward one, but that’s the map I’m supposed to be following, with E. as my guide and at key points, my companion.

Why It’s Hard To Stay On The Path. 

Ah, there are so many sharp rocks and deep pits and terrifying monsters and wild delusions that hurt or frighten me off off the path at different times. A list of just a few of them might look like this:

Not believing what happened. Because my memories of some events are foggy, I was convinced I had made them up. And making them up must mean that I was a very bad, very sick person. Who would think such a thing about their own father? I was stuck on this for literally years, until I agreed to just go ahead and believe the girl for a month. That was a big turning point for me. Now I do believe it, most of the time. Sometimes when I’m very triggered, I go back to not believing for a while. Usually, though, I agree with E’s assessment: whether or not the story is 100 percent empirically accurate, something was wrong, and you deserve to heal.

Not understanding how I could have parts. I spent months getting confused over this, even when I was trying to be an accommodating client and follow directions. I’d ask E., well if I am talking to the eight- or nine-year old about her experience, but that was my experience, and I am feeling the fear and disgust, who is the I that is talking to her? Is there no I? Do I even have a core self? Is that why I feel so empty sometimes? Does everyone lack a core self, or is that just a way that I’m messed up? This was a completely aggravating tangent because it led to intellectual and philosophical conversations that I am not particularly interested in and which didn’t make me feel any better. I have finally just accepted parts as sort-of-true in a metaphorical way.

Finding unpleasant surprises along the way. I start off thinking it’s about healing childhood wounds. Then as the work progresses, I skim through old journals looking for a date, and find something I’d forgotten: a guy who was engaged to my friend, who used to come over to my apartment and pressure me for sex. I’d give in sometimes, and other times I would curl up in a ball and dissociate, and he’d recognize what was happening and push me for details. I guess it was titillating for him while it was humiliating, no, worse, it was soul-crushing for me. That’s when I realized that I was over 30 years old and had zero control over my body and my sexuality, which led to another round of self-loathing.

The girl doesn’t want me to talk to her. This isn’t the case with the little girl parts. They are fairly open and want love and comfort and safety. But the teen has an edge to her. She is distrustful and suspicious. She is angry. She hates herself and sometimes everyone else, too. It’s hard to talk with her. Sometimes she’ll let me for a little while, and then she locks the door and rages for a while. She can’t tolerate pressure and often wants to hurt herself. She is impatient with soothing and thinks it’s a way of getting her to shut up. I haven’t found a way past this one yet, and it’s occupying a lot of my time right now.

Unfamiliarity with feelings. I’m very familiar with numb. We have been close for a long time. But other feelings, I don’t know them very well. I push them away. I have excellent self-control and use it to ignore them or run them down. If necessary, I burn them away. They tolerate this treatment for a while and then band together and rise up in an explosion that knocks me over and sends me to bed for the weekend. (Of course, it’s always the negative feelings that do that. I have yet to experience an overwhelming explosion of joy.) Intellectually, I understand that I have to let myself feel the feelings. It’s hard though, when I’m not used to it and half the time I’m not even sure I recognize what the feeling is. “What are you feeling?” E. asks me. “Uh, bad?” One thing that helps me a bit with this is a long list of feeling words that E. has put together. Sometimes we go down the list and find something that seems to fit.

Distress tolerance skills are pretty weak. This one is hard. I have a limited range of strategies here. I can write in my journal, okay. Though I do have probably hundreds of pages of journals that say something to the effect of “I’m nothing, I’m terrible, I’m not worthy of anything better.” I have the blog, almost a year now, and that is actually a good strategy. Yoga is good but depressive apathy can make it hard to go. A lot of the recommended physical pleasures designed to bring me to the present moment aren’t that enticing. I’m just not a person for long, relaxing soaks in the bathtub (besides, a confession: I don’t really scrub the bathtub often enough to want to bathe in it). Work is good. Working too much is a good distraction. But I’m not sure that distraction is the same as self-soothing.

An inability to find empathy. It’s one thing to have empathy for a child who is sexually abused. Anyone can see it’s wrong and not her fault. But what about older parts that do risky, stupid, or even hurtful things? It’s not so easy to feel a kindness toward them. In fact, even trying to find empathy can feel like making excuses for terrible behavior, which is a terrible cop-out. Another place I haven’t found my way out of.

Resentment that I have to do this myself. Why wasn’t I parented properly the first time around? Why did multiple irresponsible, self-centered men think I was there for their sexual entertainment? And now I have to clean up the mess myself. They moved on, and I have to fix everything. I’m tired. I’m the sick one, for god’s sake. I want a pity party; I don’t want to be the wise woman. I don’t want to have to comfort myself all the time. It’s lonely.

Projection of all the bad shit onto the therapist, making myself uncertain about what has been a long-term solid relationship with her. I feel disgusted with myself–therefore my therapist must think I’m disgusting. No one paid any attention to what was happening to me as a teen–therefore E. can’t really be interested, not when it takes this long. There were limits on the degree to which the little one’s needs were met with warmth–therefore E. must have limits, and I’m very afraid I”m going to hit them soon, and that will be very painful, so I might as well start pulling away from her now. In fact, it’s going to destroy me when she pulls away. What a mean thing that is. I hate her. I should quit therapy. Of course at the next session, she’s very supportive, and I love her again. But that’s scary, because she might not always be there. I might hit her limits soon… repeat, ad nauseum. The “funny” thing is that I never realized until recently that I even had abandonment issues. Ha ha, you can hear how I’m laughing about that realization.

Impatience with the process. It takes a long time. The mistakes and tangents take up a lot of time. It gets expensive. I’ll make progress, and then fall down again. Inevitably, I’ll ask myself, “Why am I doing this? Maybe I’d feel better if I just lived my current life and let the dark stuff lie there in the dark.” I’ll think of abandoning the path entirely.

But ultimately I do think that if there’s any chance of not spending the rest of my life depressed, it’s by sticking with the path, with all its dangers.

“Not out, but through.” C.G. Jung (see my prior posts) recounts one of his patient’s dreams in which he played a central part: There was a very dangerous-looking circle of lions. In the middle there was a pit that was filled with something hot. She knew that she had to go down into the pit and dive into it. So she went in and was somehow burned in the fire. Just one shoulder of her jutted out. I pressed her down and said: “Not out, but through it!” When patients come for therapy, what they typically want is for the doctor to extricate them from some problematic situation, symptom or state of mind. To alleviate their suffering as quickly as possible. To swiftly solve their problem. That is understandable. And this is exactly what contemporary treatment approaches like psychopharmacology, CBT and even DBT (see my prior post) attempt to provide. Symptomatic relief. But these are all forms of what I would call “suppressive therapy.” The truth is that, psychologically speaking, suppressing symptoms without addressing the underlying problem is only a temporary fix. Eventually, they return with a vengeance. Or else require stronger and stronger suppression over time. More medication. More treatment. The secret, as Jung (and, unconsciously, his patient) understood, is not to suppress or escape the problem, but being willing to go through it. Not around it. Not over or under it. But right through it. What would that look like? This theme comes up quite often in treatment, especially when patients are feeling resistant to confronting their deepest fears, agonies or concerns. To facing the unconscious. They instinctively want out. Out of the fire or proverbial “frying pan.” Or the “hot seat” of psychotherapy. But it is the therapist’s job, like Jung in his patient’s dream (and in reality), or like Virgil in Dante, to carefully and compassionately guide and facilitate the patient’s full immersion into the flames. Down into their personal inferno. Gradually. In measured, titrated doses. And, finally, through it. Then, and only then, suppression will no longer be necessary. As the ancient alchemists suggested: “Into the destructive element immerse yourself.” Only then can you be creatively transformed.

An excerpt from Essential Secrets of Psychotherapy: The Healing Power of Clinical Wisdom

So I stay on the path, hoping it will take me through.